Daily Cosmetic Research Analysis

Gingival pigmentation is a common cosmetic concern that can negatively impact a patient's smile aesthetics. Laser-assisted depigmentation has emerged as a reliable and effective treatment modality. The study aimed to compare the efficacy, comfortability of the patient, and the post-operative outcomes among patients who underwent either an ablative or a non-ablative diode 450 nm laser for gingival depigmentation. A split-mouth, single-blind, randomized controlled trial was conducted on 20 subjects exhibiting physiological pigmentation scores of 2 or more, as assessed by the Dummett index. A diode laser emitting 450 nm wavelength was employed. One side of each subject's mouth was randomly assigned to receive ablative laser treatment, while the contralateral side received non-ablative treatment. Primary outcome measures included changes in Oral Pigmentation Index and Melanin Pigmentation Index scores at baseline and at 1, 6, and 12 months' post-treatment. Patient perception of pain and discomfort was assessed using a modified McGill Pain Questionnaire. Both ablative and non-ablative techniques demonstrated significant reductions in OPI and MPI scores at all follow-up time points. Immediate and total depigmentation was achieved using ablative techniques, which showed fewer rates of re-pigmentation but higher intraoperative discomfort. In contrast, non-ablative techniques result in less pain but required more sessions to obtain optimal results. The choice of technique should be individualized based on patient preferences and clinician expertise. Non-ablative treatment may be preferred for patients seeking minimal discomfort and rapid healing, while ablative treatment may be suitable for patients who prioritize complete pigment removal in one session.

INTRODUCTION: This study aims to present our experience with totally transaxillary endoscopic surgical release (TTESR) for the treatment of patients diagnosed with congenital muscular torticollis (CMT), as well as to compare the efficacy of this minimally invasive approach with that of conventional open surgical release (OSR). MATERIALS AND METHODS: A retrospective analysis was conducted on patients diagnosed with CMT who underwent either TTESR or OSR between January 2014 and December 2020. Herein, we provide a detailed description of the TTESR procedure. A total of 24 children were enrolled, with 6 patients undergoing TTESR and the remaining 18 undergoing OSR. The latter group was matched based on age and lesion location. Clinical data, including length of hospital stay, operative duration, intraoperative blood loss, and range of cervical rotation, were meticulously recorded. Comparative analysis was performed between the TTESR and OSR groups. RESULTS: In our series, all 24 patients exhibited a marked improvement in cervical range of motion. No statistically significant differences were observed between the TTESR and OSR groups with respect to gender distribution, length of hospital stay, operative duration, or intraoperative blood loss. However, a significant difference was noted in the combined scores of scar evaluation and subjective assessments. No severe postoperative complications were reported. Additionally, with the accumulation of surgical experience, the average operative time for TTESR decreased to 40-50 min. CONCLUSION: This study demonstrates that TTESR serves an effective alternative to conventional OSR for correcting CMT, with the additional advantage of eliminating the aesthetically undesirable neck scar.

BACKGROUND: Postoperative hypoparathyroidism is the most common complication of total thyroidectomy, often resulting from injury or devascularization of the parathyroid glands. OBJECTIVE: Indocyanine green fluorescence (ICG) technique has been applied in the last 10 years in different kinds of surgery including colorectal, oncological lymph node and endocrine surgery. Minimally invasive thyroidectomy, introduced more than 25 years ago, is a valid surgical option for selected benign and malignant thyroid disease with advantages in terms of cosmetic results and postoperative pain. Aim of this study is to evaluate the feasibility and safety of ICG during minimally invasive thyroidectomy to assess and predict parathyroid gland perfusion and guide preservation. METHODS: We report the initial experience in our center of ICG during minimally invasive video-assisted total thyroidectomy in a case series of 9 patients, using the Striker System® to assess parathyroid perfusion and guide preservation. Demographic and surgical data were registered with special attention to hypoparathyroidism. RESULTS: All patients underwent standard minimally invasive video-assisted total thyroidectomy; a standardized dose of ICG was administered intravenously. Real-time near-infrared imaging allowed for clear visualization of parathyroid vascularization, enabling the preservation of well-perfused glands and the auto transplantation of those removed into the sternothyroid muscle. Postoperative assessments, including serial measurements of serum calcium and parathyroid hormone levels, revealed a transient drop in two patients with overall correspondence to indocyanine green evaluation. CONCLUSION: These findings suggest that ICG angiographic imaging is a valuable adjunct in thyroid surgery, potentially reducing the risk of hypocalcemia by optimizing parathyroid preservation. Further studies are needed to standardize the technique and the evaluation score to confirm preliminary results on definitive hypoparathyroidism.