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Objectives: A surgical technique for a double medial and lateral overlay autologous fascia graft myringoplasty is described in this paper along with its indications and results., Material and Method: The presurgical and one year post surgery characteristics are analyzed for 100 cases with the double medial and lateral overlay autologous fascia graft technique. The anatomical and functional results are analyzed., Results: The results are analyzed one year post surgery. The probabilities of obtaining a graft take using this methodology are 95%. The incidence of persistence of the perforations is 12.5% in children under 10 and 2.5% in children over ten years of age and adults. The complications are 4% of epithelial pearls with blunting of the neo-tympanum, 1% of retractions and 3% of epithelitis which is resolved with a topical medical treatment. The average residual air/bone gap is less than 20dB in 85% of the cases. Less than 10dB in 38%, and between 10 and 20dB in 47%. The causes for incomplete closure of the gap are analyzed; possibly related to fibrosis and sclerosis of the tympanic remnants and/or the ossicular chain., Conclusions: It is concluded that this methodology provides the best results in comparison with other methods we have used and have set aside for very specific situations related to the size and location of the perforation., (Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.)

Abdominal wall transplantation has been consolidated as an alternative to primary abdominal wall closure in intestinal and multiple organ transplant recipients. Given that it is feasible to obtain the visceral graft and the abdominal wall graft from the same donor, abdominal wall transplantation could offer satisfactory outcomes and be easily coordinated. Non-vascularized fascia is one of the alternatives for abdominal wall closure in transplantation. We report two cases of non-vascularized fascia transplantation in intestinal and multivisceral transplants, respectively. Both donors were young (23 and 18 years old). Both recipients had endured multiple previous surgeries, and no surgical alternatives for primary wall repair could be offered. In both cases, a complete abdominal wall flap was retrieved from the donor, however, due to the characteristics of the recipient's abdominal wall defect, only non-vascularized fascia was used after removing skin and subcutaneous cellular tissue from the graft. Abdominal wall transplantation is an option to consider for abdominal wall closure in patients with multiple previous surgeries and no alternatives for primary wall repair., (Copyright © 2019 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: The tympanoplasty for high-risk tympanic membrane perforation is a challenge. It is necessary to compare the most useful and feasible surgical technics in our environment for these patients. The objective was to compare the cartilage island tympanoplasty for the treatment of high-risk tympanic membrane perforations versus the use of temporalis fascia., Methods: Randomized controlled clinical trial in 69 patients of ten years or older, diagnosed with high-risk tympanic membrane perforation in a third level hospital. The MERI index was determined and an initial audiometry was obtained. 7, 30 and 60 days after the tympanoplasty the tympanic graft integrity was evaluated. The audiometry was only repeated at 60 days., Results: 69 patients were included, 33 received cartilage island (group 1) and 36 temporalis fascia (group 2). 93.9% was the success rate for group 1 at 30 and 60 days and 83.3% for group 2 (p = 0.17). Hearing improvement was neither different between groups (33.1 vs. 33.6 dB; p = 0.88), for group 1 and 2, respectively., Conclusion: No difference in morphological and audiological outcomes using cartilage island tympanoplasty or temporalis fascia for the treatment of high-risk tympanic membrane perforation was found.

This paper describes a series of cases with severe hand injury that required antebrachial flaps as part of treatment, and their functional results. The clinical records of patients with a diagnosis of traumatic hand injury and major skin cover losses, reconstructed with a reverse-flow forearm flap, were reviewed. The following variables were studied: type of flap, sex, age, mechanism of injury, receiver site, size, adjacent injuries and their treatment, vascular integrity test prior to flap placement, operative time, follow-up and complications. A total of 25 patients were included, with 25 reverse-flow fasciocutaneous forearm flaps; in 15 of them the blood supply was based on the radial artery and in 10 in the posterior interosseous artery. The Allen test was used in 13 cases of radial flaps (RF) to check the integrity of the superficial palmar arch; Doppler ultrasound was used in the remaining two cases. Sixteen cases (64%) underwent bone and tendon reconstruction, four cases (16%) isolated tenorrhaphy of one or several tendons, two cases (8%) isolated osteosynthesis, one case due to electrical burn underwent Littler opponensplasty with a radial flap in the anterior aspect of the wrist (4%), and in two cases (8%) an isolated flap was used. In one 67 year-old patient (4%) there was congestion and total loss of the posterior interosseous flap. The recommended indications for this type of flap are: coverage of the distal forearm, hand dorsum and fingers, first interdigital space, palmar region of the wrist and hand. Only two cases required coverage of the palmar region of the wrist and hand, and they were both treated with radial flaps, probably for reasons of anatomical convenience.

Introduction: Surgical treatment of intraoral and maxillary sinus carcinomas requires a reconstructution of the defect. It is better to do it in one time in order to decrease the morbidity for the patient and the sanitary cost. The temporalis myofascial flap is used for reconstruction of oral cavity, skull base, periorbital region and maxilla because of its feasibility., Material and Methods: We describe the surgical technique and present our results of the reconstructions after total or partial maxillectomy using the temporalis muscle flap in 22 patients., Results: No total necrosis of the flap was seen in any case, a partial necrosis was seen in four cases., Conclusion: The temporalis myofascial flap is an excellent choice for oral and maxillary reconstruction.

Epidermoid carcinoma of jugal mucosa is an aggressive tumor. Its treatment is based on broad excision and reconstruction in order to avoid fibrosis and restriction of mouth opening. Neck dissection and radiotherapy are indicated in selected cases. We display our experience with microvascularized flaps with the aim of preventing the flaws. We reconsider 8 patients (representing 10 flaps) handle in our Department. Besides we discuss other therapeutic alternatives after the growth's removal. The conclusion reached is that the mucovascularized forearm flaps give a great quantity of thin tissue and therefore so results to be the best option for the reconstruction of the jugal mucosa.

Clinical applications of the musculoskeletal system tissue bank are currently enlarging in areas such as tumour surgery, spine surgery and arthrodesis, reconstructive procedures of the hip joint and ligament repair. We report our experience about the use of more than 1,000 grafts utilize from 1987 to 1992. We concluded that a bone bank or a musculoskeletal system tissue bank has a great usefulness in different reconstructive surgery technics and arthrodesis. They are used more frequently in orthopaedic and traumatology surgery improving the development of this surgery.

Herein we explain the experiences we have had, in the ORL department of the HCU of Valencia, al along a period of seven years, by using the formaldehyde formed fascia graft, exposing the anatomical and functional results obtained after a minimum pursuit of five years on a sequence of 188 myringoplasties. With such method we got to close the tympanic membrane, and that they remain entire after five years, on the 72.87% of the cases, getting improvement of audition determined by a reduction of the air-bone gap greater than 15 dB, in the 62.77% of the cases. Such results are obtained with a very slight number of complications. This all makes us to consider this technique as the proper one in cases where perforation is greater than 50% of tympanic membrane.

From June 1987 to June 1990, the musculoskeletal system tissues bank of the Orthopaedics and Traumatology Department of the University Clinic of Navarra has used 310 allografts. Of this, 219 has been used in our Department, 142 of cancellous bone and 42 of cortical bone. 24 of patellar tendon and 11 of fascia lata. The other 91 grafts have been sent to other hospitals in the country. In the present work we make a retrospective study that included the patients who were operate with allograft. We observe the differences between several types of allografts comparing them with conventional surgery technics. Within the complications we distinguished a 10.52% of infection in cortical bone allografts used in patients with neoplastic treatment. In the other type of allograft we didn't present this complication. We concluded that a bone bank or a musculoskeletal system tissues bank has a great usefulness in different reconstructive surgery technics and arthrodesis. They are used more frequent in orthopaedics and traumatology surgery improving the development of this surgery.

In the paper the AA. introduce their experience and the results obtained with the use of an homograft (a cast of fascia treated with formaldehyde) in order to repair tympanic membrane perforations. They discuss the anatomical and functional results.