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uptake levels as a marker of epileptic regions), and recording of brain signals using EEG. These tests form a patient-specific database, which allows to identify the anatomical location of the epileptic focus and thus reduce the invasiveness of the required treatment. Conc l us i ons and D i scuss i on : The preoperative integrative model, performed by amultidisciplinary team, is essential for making an accurate diagnosis and deciding on themost appropriate treatment for drug-resistant epilepsy. The model is also important because it allows preserving vital functions while minimizing neurological, cognitive and emotional damage. Keywords: drug-resistant epilepsy, integrative model, minimally invasive treatment

treatment, a dedicatedmultidisciplinary team must comprehensively assess the patient to identify a possible epileptic focus. Objectives: To present an integrative model for detecting and treating the epilepticnetwork using aminimally invasive approach, basedon preoperative functional assessment in three main stages: (a) Non-invasive diagnosis that includes video electroencephalogram (VEEG), signal processing and advanced imaging methods alongside diagnosis by a multi professional team; (b) Minimally-invasive diagnosis using stereo EEG (SEEG); and (c) SEEG-guided radio frequency therapy. Procedure: Preoperativeassessmentat theCenter for Functional Neurosurgery includes several exams performed in a unique integrativemodel. The process starts with a diagnosis of seizure

type and epileptic syndrome based on reports by the patient and other witnesses, alongside a neuropsychological assessment of cognitive and emotional functions (attention, memory, perception, language and executive functions). Then, ictal and inter-ictal periodsare identifiedby VEEG. During the inter-ictal periods, an innovative and unique exam is performed, which combines several information sources that are recorded synchronously and closely to the emergence of brain activity suspected as an epileptic source. These sources provide anatomic information (using magnetic resonance imaging, MRI), functional information (using functional MRI, fMRI, which examines motor areas, language, vision, etc.),metabolism(usingpositronemission tomography [PET] withafluorodioxyglucose [FDG] radioactive marker indicating different glucose

Inferior turbinate reconstruction using an innovative implant for the treatment of empty nose syndrome Roee Landsberg, MD, Shay Schneider, MD A.R.M , Center of Otolaryngology, Head and Neck Surgery, Assuta Medical Centers, Tel Aviv, Israel

Empty nose syndrome (ENS) is a paradoxical feeling of nasal obstruction despite an objective presence of clear nasal passages, that sometimes develops due to over resectionof the turbinatesduring conchotomy. Individuals who have ENS may also feel suffocation, dryness, painandexperience scab accumulation. In addition, the syndromemay cause mental and behavioral symptoms such asdifficulty concentrating, fatigue, frustration, irritability, anger, anxiety and depression.

Inferior turbinate reconstruction surgery is an effective treatment for ENS performed in only a few centers around theworld. A unique implant, made of porous linear-high-density polyethylene, wasdesignedby theauthors. The tiny pores in the implant enable blood vessels to grow into them, thus enabling integration of the implant material into the tissue. The implant was designed such that its structure is flexible without compromising its shape. In 2020we performed the first inferior turbinate

reconstruction surgerieswith the new implant after conservativemoisturizationandhydration treatments failed. Surgery is performed under general anesthesiausingendoscopicguidance. The implant is inserted into a pocket located between the nasalmucosa and the lateral wall of thenose. Thenasalmucosaheals completely about three weeks after surgery . Keywords: empty nose syndrome, inferior turbinate, conchotomy, inferior turbinate reconstruction, nasal obstruction

Nipple Reconstruction using a novel permanent solid silicone and nitinol implant: A case report Michael Scheflan, MD Rotem Katzenellenbogen Scheflan Plastic Surgery, 10 Habarzel Street, Tel Aviv 69710 , Israel

Nipple-areolar complex (NAC) reconstruction is the final stage of breast reconstruction. Most NAC reconstruction techniques do not achieve satisfactory results; themost common problems of NAC reconstruction include decrease innippleprojection, nippleflattening

and poor cosmetic outcome. This case report describesanovel siliconandnitinol implantable device, FixNip NRI, used for reconstructing the NAC structure and projecting the nipple in a female patient with a history of multiple surgical procedures in the treated breast and

previous failedattempt to reconstruct thenipple with a triple-opposing-flap. Keywords: implant, nipple-areolar complex reconstruction, breast reconstruction

57 AMR ASSUTAMEDICAL REPORT VOL 8 ISSUE 1