Use of Ultra-high-frequency Ultrasound for Aplasia Cutis Congenita of the Scalp

Summary:. Aplasia Cutis Congenita (ACC) in the scalp is a rare congenital malformation. The treatment for ACC with large defects involving the scalp, bone, and the dura is challenging. Local debridement of necrotic tissue is important to prevent lethal complications such as infection and meningitis....

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Autores principales:	Ryo Karakawa, MD, Tomoyuki Yano, MD, PhD, Hidehiko Yoshimatsu, MD, Mayu Koto, MD, Atsushi Nakao, MD, Shunsuke Ichi, MD
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Surgery RD1-811
Acceso en línea:	https://doaj.org/article/d4c9bf2fb00a49c89e2ce4f7ddfcc7af
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spelling	oai:doaj.org-article:d4c9bf2fb00a49c89e2ce4f7ddfcc7af2021-11-25T07:57:34ZUse of Ultra-high-frequency Ultrasound for Aplasia Cutis Congenita of the Scalp2169-757410.1097/GOX.0000000000003876https://doaj.org/article/d4c9bf2fb00a49c89e2ce4f7ddfcc7af2021-10-01T00:00:00Zhttp://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003876https://doaj.org/toc/2169-7574Summary:. Aplasia Cutis Congenita (ACC) in the scalp is a rare congenital malformation. The treatment for ACC with large defects involving the scalp, bone, and the dura is challenging. Local debridement of necrotic tissue is important to prevent lethal complications such as infection and meningitis. However, debridement has the risk of damaging the sagittal sinus or the dura. Recent developments in ultra-high-frequency ultrasound(US) systems provide frequencies of 70 MHz and capability resolution as fine as 30 μm, which could allow precise imaging of small and thin anatomical structures. The study aimed to describe the methods of precise evaluation of the defect in the scalp and safe debridement using ultra-high-frequency US. This is the first report on direct observation of a newborn’s brain using ultra-high-frequency US. The boy was delivered spontaneously with a large defect of the scalp and bone. After 14 days, due to signs of infection, local debridement was performed carefully under ultra-high-frequency US-based evaluation. The dura, the sagittal sinus, and the small anatomical structures such as arachnoid granulations could be observed. Because the brain herniation gradually aggravated, dural reconstruction using fascia lata and scalp reconstruction using transposition flap was performed. Finally, good skin coverage over the defects was obtained. This method minimizes the risk of damaging the sagittal sinus and the brain parenchyma, which may cause fatal complications. Although further clinical investigations will be required to confirm its efficacy, ultra-high-frequency US has the potential to be a useful device for ACC treatment.Ryo Karakawa, MDTomoyuki Yano, MD, PhDHidehiko Yoshimatsu, MDMayu Koto, MDAtsushi Nakao, MDShunsuke Ichi, MDWolters KluwerarticleSurgeryRD1-811ENPlastic and Reconstructive Surgery, Global Open, Vol 9, Iss 10, p e3876 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Surgery RD1-811
spellingShingle	Surgery RD1-811 Ryo Karakawa, MD Tomoyuki Yano, MD, PhD Hidehiko Yoshimatsu, MD Mayu Koto, MD Atsushi Nakao, MD Shunsuke Ichi, MD Use of Ultra-high-frequency Ultrasound for Aplasia Cutis Congenita of the Scalp
description	Summary:. Aplasia Cutis Congenita (ACC) in the scalp is a rare congenital malformation. The treatment for ACC with large defects involving the scalp, bone, and the dura is challenging. Local debridement of necrotic tissue is important to prevent lethal complications such as infection and meningitis. However, debridement has the risk of damaging the sagittal sinus or the dura. Recent developments in ultra-high-frequency ultrasound(US) systems provide frequencies of 70 MHz and capability resolution as fine as 30 μm, which could allow precise imaging of small and thin anatomical structures. The study aimed to describe the methods of precise evaluation of the defect in the scalp and safe debridement using ultra-high-frequency US. This is the first report on direct observation of a newborn’s brain using ultra-high-frequency US. The boy was delivered spontaneously with a large defect of the scalp and bone. After 14 days, due to signs of infection, local debridement was performed carefully under ultra-high-frequency US-based evaluation. The dura, the sagittal sinus, and the small anatomical structures such as arachnoid granulations could be observed. Because the brain herniation gradually aggravated, dural reconstruction using fascia lata and scalp reconstruction using transposition flap was performed. Finally, good skin coverage over the defects was obtained. This method minimizes the risk of damaging the sagittal sinus and the brain parenchyma, which may cause fatal complications. Although further clinical investigations will be required to confirm its efficacy, ultra-high-frequency US has the potential to be a useful device for ACC treatment.
format	article
author	Ryo Karakawa, MD Tomoyuki Yano, MD, PhD Hidehiko Yoshimatsu, MD Mayu Koto, MD Atsushi Nakao, MD Shunsuke Ichi, MD
author_facet	Ryo Karakawa, MD Tomoyuki Yano, MD, PhD Hidehiko Yoshimatsu, MD Mayu Koto, MD Atsushi Nakao, MD Shunsuke Ichi, MD
author_sort	Ryo Karakawa, MD
title	Use of Ultra-high-frequency Ultrasound for Aplasia Cutis Congenita of the Scalp
title_short	Use of Ultra-high-frequency Ultrasound for Aplasia Cutis Congenita of the Scalp
title_full	Use of Ultra-high-frequency Ultrasound for Aplasia Cutis Congenita of the Scalp
title_fullStr	Use of Ultra-high-frequency Ultrasound for Aplasia Cutis Congenita of the Scalp
title_full_unstemmed	Use of Ultra-high-frequency Ultrasound for Aplasia Cutis Congenita of the Scalp
title_sort	use of ultra-high-frequency ultrasound for aplasia cutis congenita of the scalp
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/d4c9bf2fb00a49c89e2ce4f7ddfcc7af
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Use of Ultra-high-frequency Ultrasound for Aplasia Cutis Congenita of the Scalp

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