“
“We report a case of an 18-year-old female who was referred to our

institution after incurring a permanent quadriplegia resulting from spinal cord infarction following cricotracheal resection Methods were case report and review of the literature. A tracheal stenosis had resulted from long-term intubation after premature birth, followed by tracheotomy after 1 year, surgical revision Go 6983 at 4 years of age and a spontaneous closure at the age of 6 after decannulation. At the age of 18, a cricotracheal resection was performed at another institution At the termination of the procedure, a chin-to-chest suture was placed to prevent unintentional hyperextension of the neck She was extubated on the third postoperative day, however, serious dyspnea required repeated re-Intubation for 2 days thereafter She developed paraplegia on the sixth postoperative day, prompting an MRI to be performed,

which identified spinal cord edema Intravenous administration of Elafibranor ic50 steroids in high doses was ineffective and unfortunately the patient has remained severely impaired since then. Permanent quadriplegia is a complication of cricotracheal resection with chin-to-chest sutures and should be included in the informed consent process. Therefore, a daily postoperative neurological examination should be performed in these patients Immediate MRI should be performed if any abnormal findings are seen to verify the diagnosis. Quadriplegia in this setting likely resulted from compromised blood supply with concomitant edema, however, the exact cause of injury remains unclear: despite having chin-to-chest sutures, R788 concentration the patient’s head remained in neutral position and was not in hyperflexion. Such an injury is likely more susceptible to steroid

therapy if diagnosed as early as possible. (C) 2010 Elsevier Ireland Ltd. All rights reserved.”
“Severity of the Harlequin deformity seen in unicoronal synostosis may be augmented when frontoparietal suture synostosis has an associated fusion of the frontosphenoidal suture or in cases of isolated frontosphenoidal synostosis. The purpose of the current study is to characterize various suture fusion patterns along the coronal ring using a modified orbital index (MOI), orbital angle (OA), and endocranial base (EB) angle.

This study is a retrospective single institution cohort study. Charts were reviewed over the past 12 years; patients with isolated UCS were included. MOI, OA, and EB were used to identify 3 groups of UCS patients.

Twenty-one patients were identified for inclusion in skeletal dysmorphology analysis using MOI, OA, and EB measures. Frontoparietal synostosis patients were diagnosed at significantly younger ages than frontoparietal + frontosphenoidal patients (P = 0.0001). Ipsilateral MOI measures were more severe for frontoparietal patients compared with frontoparietal + frontosphenoidal patients (P = 0.0239).