Background:Sternal cleft is a rare anomaly with a reported incidence of 1:100,000 cases per live births. Surgical intervention represents a crucial factor altering the overall patient prognosis, since they are at high risk of impaired oxygenation, as well as multiple chest infections. Herein, we are reporting our experience of surgical management of such rare cases, alerting plastic surgeons to their possibly crucial role in the reconstructive team.Methods:A retrospective chart review of 2 cases presenting with chest wall defects. All perioperative data were collected and presented.Results:Two patients with sternal clefts of variable degrees were managed. The first was an 18-month-old boy with partial inferior sternal cleft, who was otherwise asymptomatic. The patient underwent reconstruction at the same age using autologous rib graft and pectoralis major flaps due to ectopia cordis that was putting the patient at higher risk for cardiac trauma. The second patient was a 3-month-old girl having a V-shaped partial superior cleft with lung herniation. Surgical reconstruction was applied due to difficulty in weaning the patient off of ventilator support. Initially, reconstruction was applied with SurgiMend dermal matrix, but this was complicated by chest retraction and high oxygen requirement. Definitive reconstruction was later applied with allogeneic bone graft and pectoralis major flaps.Conclusions:Meticulous patient assessment and screening for associated anomalies are crucial. Surgical intervention is warranted at an early age. The use of acellular dermal matrix products in the reconstruction is of interest, but should be approached with caution.

IntroductionPatients with carpal tunnel syndrome have a high prevalence of hypothyroidism, therefore, it is recommended to assess thyroid function routinely in patients with carpal tunnel syndrome. This study aims to determine the prevalence of hypothyroidism among carpal tunnel patients and to relate carpal tunnel in hypothyroidism to other socio-demographic factors. MethodsThis was a retrospective study carried out in King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia. A total of 422 samples were collected conveniently from the files of patients who underwent carpal tunnel release surgery. The Statistical Package for the Social Sciences (SPSS) version 23 was used for data processing. The chi-square test was used to test the association between the categorical variables. A p-value of less than .05 was considered to be significant. ResultsMost of the respondents were females and most of them within the age group of 46 to 60 years. Thirteen point eight percent (13.8%) of the respondents are suffering from hypothyroidism and 5% from the subclinical form of the disease. More than two-thirds of those with hypothyroidism were asymptomatic. The duration of the disease was one to five years, and bilateral nerve concerns were mostly present in patients with carpal tunnel syndrome. The presence of thyroid abnormality doesn't affect the duration of carpal tunnel syndrome but body mass index (BMI) is significantly associated with hypothyroidism (p-value = .001). ConclusionClinical symptoms of hypothyroidism are mostly absent in patients with carpal tunnel syndrome. Most patients with carpal tunnel syndrome have the disease for one to five years and this is not significantly associated with abnormal thyroid. Most patients have bilateral wrist involvement with no apparent symptoms and signs.

BACKGROUND AND OBJECTIVESHump reduction in the presence of short nasal bones can result in significant esthetic and/or functional problems in patients seeking rhinoplasty in the Middle East. The aims of this study were to determine the mean length of nasal bones, amount of nasal dorsum it forms in relation to the whole nose, and incidence of short nasal bones in the Middle Eastern population.DESIGN AND SETTINGSA prospective study that has been carried out in a tertiary care hospital.PATIENTS AND METHODSA total of 154 patients (80 females and 74 males) who were scheduled for computed tomography scan for the paranasal sinuses were included in the study. The inclusion criteria were adults with no history of facial/nasal trauma, sinus space occupying lesions, or surgery.RESULTSIn males, the mean clinical nasal bone length was 19.59 mm and the mean radiological nasal bone length was 24.96 mm. In females, the mean clinical nasal bone length was 18.17 mm and the mean radiological bone length was 22.82 mm.CONCLUSIONThe bony vault represents 44.2% of the female nose and 44.3% of the male nose. In the present study, no patients displayed a short nasal bone that was less than one-third of the whole nasal length.

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