Biomedical subjects

Afshin Parhiscar

Publications and source records attributed to Afshin Parhiscar.

3 recordsLinked to original sources

PubMed2003

Nasal dorsal augmentation with silicone implants.

Silicone rubber has been used safely and effectively for facial augmentation for nearly 5 decades in eastern Asia. We have used silicone rubber nasal implants in primary ethnic rhinoplasty and have found consistent and long-lasting results with low complication rates. Silicone dorsal nasal augmentation in primary rhinoplasty avoids donor site morbidity and implant resorption as seen with autogenous implants. Silicone nasal implants have a low extrusion and infection rate. In the appropriate patient with proper placement, silicone nasal implant is nearly the ideal implant material.

Biocompatible Materials↗

PubMed2002

Temporoparietal osteofascial flap for head and neck reconstruction.

PURPOSE: This article describes the use of the temporoparietal osteofascial flap (TOF) for reconstruction of bony defects in the midface and mandible. PATIENTS AND METHODS: We reviewed the demographics, etiology, indications, surgical technique, radiographic evaluation, and final outcome of 11 patients with upper or lower jaw defects who underwent reconstruction using the TOF between 1994 and 1999. RESULTS: The TOF was used to reconstruct a defect of the mandible in 7 patients, the hard palate in 2 patients, the maxilla in 1 patient, and the zygoma in 1 patient. The defect was a result of tumor resection in 9 patients and of trauma in 2 patients. The defect size ranged from 3 to 6 cm. Ten flaps (91%) were successful and 1 flap failed. There was 1 donor site complication (small dural tear) that was repaired immediately without sequelae. One patient had osseointegrated dental implants placed in the bone with good results. Exploration of the construction area was performed in 1 patient 13 months after surgery because of recurrent tumor. It showed a fully integrated bone flap. CONCLUSION: This vascularized calvarial bone flap can be used for the reconstruction of small to medium-sized defects of the maxilla and lateral mandible with good functional and cosmetic results. It can be performed without special microvascular expertise and with minimal donor site morbidity. A full-thickness bone flap can support osseointegrated dental implants.

Adult↗

PubMed2002

Can patient satisfaction with decisions predict compliance with surgery?

BACKGROUND: Patient satisfaction with treatment decisions is a discrete and measurable component of the satisfaction paradigm, distinct from satisfaction with health care services. OBJECTIVE: The study goal was to determine if the Satisfaction With Decision (SWD) scale, a valid and reliable 6-item survey, can predict patient compliance with surgery proposed by their otolaryngologist. DESIGN: Prospective study using the SWD scale plus measures of office visit satisfaction, provider satisfaction, and disease-specific quality of life. SETTING: Metropolitan, private nonprofit hospital. PATIENTS: The study population consisted of 151 patients scheduled for surgery, with a median age of 5.8 years and an age range of 0.6 to 65.3 years. INTERVENTIONS: At the time surgery was scheduled, the decision-maker completed a 12-item questionnaire about satisfaction and quality of life that included the SWD scale. Noncompliant patients were contacted, and the specific reason for cancellation was ascertained. RESULTS: The strongest predictor of surgical cancellation was the SWD survey score, with a median value of 4.8 for patients completing surgery compared with 3.8 for those who cancelled (P < 0.001). Patients with scores <4.0 had a 57% cancellation rate, whereas those with scores > or =4.0 had a 98% completion rate. Patients were also more likely to cancel if it was their first visit with the surgeon (P = 0.004) or if they were responsible for their own decisions (P = 0.007). Cancellations were not associated with office visit satisfaction, patient quality of life, or demographic characteristics of the decision-maker. CONCLUSIONS: Patients who are satisfied with their initial decision to undergo surgery are most likely to comply with planned therapy. Conversely, patients who score <4.0 on the SWD scale may benefit from additional preoperative counseling to increase the likelihood of compliance.

Adult↗