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https://www.readbyqxmd.com/read/28079699/a-new-technique-for-total-reconstruction-of-the-lower-lid
#1
Mehmet Mutaf, Metin Temel
BACKGROUND: Although several methods have been described for total lower eyelid reconstruction, it remains as a major challenge in reconstructive surgery. Here, we present a new technique, the Mutaf unequal Z-plasty procedure for reconstruction of defects of the lower eyelid. METHODS: In this technique, 2 skin flaps designed in an unequal Z-plasty manner are used to provide skin coverage. Except for 2 patients whose additional upper eyelid defects were closed with Fricke flap, all patients were reconstructed with Mutaf unequal Z-plasty procedure...
February 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28079655/microarchitecture-of-schlemm-canal-before-and-after-selective-laser-trabeculoplasty-in-enhanced-depth-imaging-optical-coherence-tomography
#2
Alon Skaat, Michael S Rosman, Jason L Chien, Mark P Ghassibi, Jeffrey M Liebmann, Robert Ritch, Sung Chul Park
PURPOSE: To characterize the in vivo effect of selective laser trabeculoplasty (SLT) on the Schlemm canal (SC) in eyes with primary open-angle glaucoma (POAG). MATERIALS AND METHODS: Eighty-one serial horizontal enhanced depth imaging optical coherence tomograph B-scans (interval between B-scans, ∼35 μm) of the nasal corneoscleral limbus were obtained before and 4 weeks after SLT. Fifty B-scans in the overlapping regions before and after SLT were selected for analysis based on the structures of aqueous and blood vessels as landmarks...
January 10, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/28072550/rotational-advancement-in-cleft-nose-rhinoplasty-buccal-mucosal-grafts-serve-as-a-powerful-tool
#3
Andreas Kehrer, Tim H J Nijhuis, Pál Pesthy, Sten Willemsen, René Poublon, Jacques J J N M van der Meulen
OBJECTIVE:   Our aim was to analyze our technique of a modified rotational advancement in conjunction with buccal mucosal grafts (BMGs) in a subgroup of severe cleft cases. DESIGN:   A retrospective clinical and photographic evaluation was conducted. Columella angle (CA) and tip projection (TPR) served as instruments in a photometric analysis. SETTING:   Academic university hospital and specialized craniofacial cleft center. PATIENTS:   At the time of the secondary rhinoplasty, 61 cleft patients were included, all 17 years or older...
January 10, 2017: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/28045816/risk-factors-predicting-nasoseptal-flap-failure-in-the-endoscopic-endonasal-transsphenoidal-approach
#4
Boo-Young Kim, Ji Hyeon Shin, Sung Won Kim, Yong Kil Hong, Sin-Soo Jeun, Soo Whan Kim, Jin Hee Cho, Yong Jin Park
OBJECTIVE: Reconstruction of the skull base using a pedicled nasoseptal flap (NSF) seems to be advantageous after the endoscopic endonasal transsphenoidal approach (EETSA). A few reports have evaluated the cause of flap failure in EETSA using NSFs. The aim of this study was to evaluate the perioperative risk factors for NSF failure. STUDY DESIGN: Patient series. SETTING: Retrospective review of medical records at a tertiary referral center...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28039007/pedicle-orientation-in-free-flap-microvascular-maxillofacial-reconstruction
#5
Daniel M Cummins, Beomjune Kim, Arshad Kaleem, Waleed Zaid
Oncologic and traumatic defects of the maxilla can pose a challenge to patients, reconstructive surgeons, and maxillofacial prosthodontists in an attempt to provide satisfactory treatment. Oral-nasal and oral-antral fistulas are frequently treated with soft tissue flaps, osteocutaneous flaps, or a maxillofacial obturator. Often, surgical reconstruction is preferred for patient quality of life and definitive restoration. Surgical reconstruction also avoids the difficulties encountered with fabricating an obturator in an irradiated field with the often-resultant microstomia...
December 10, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28038480/intracranial-ameloblastoma-arising-from-the-maxilla-an-interdisciplinary-surgical-approach
#6
Johanna Quick-Weller, Felix Koch, Nazife Dinc, Stephanie Lescher, Peter Baumgarten, Patrick Harter, Friedrich Scheerer, Robert Sader, Volker Seifert, Gerhard Marquardt, Thomas Freiman
Background Ameloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only a few cases are known to grow aggressively and to invade the orbit, nasal cavity, or even the brain. Patient and Methods/Case Report We present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the left maxilla, and the anterior fossa. Histologic diagnosis was made by biopsy. A combined two-stage neurosurgical maxillofacial approach was planned...
December 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28033636/treatment-strategy-for-revision-rhinoplasty-in-asians
#7
Yong Ju Jang, Do-Youn Kim
Revision rhinoplasty in Asian patients is associated with problems related to the use of grafts or implant materials. Moreover, the septal cartilage of Asian individuals is generally weak and small, which makes it particularly vulnerable to injury or secondary deformity during primary surgery. Hence, there is an increased demand for major reconstruction of the septal cartilage framework during revision surgery in Asian patients. In revision rhinoplasty of the nose in Asian patients, appropriate management of the graft or implant is vital...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28033632/aesthetic-rhinoplasty-as-a-surface-contour-operation-from-analysis-to-surgery-personal-concepts
#8
Palma Pietro, Khodaei Iman, Vasilenko Irina
Numerous beautiful rhinoplasty results have been created by closed rhinoplasty techniques over the past 100 years. This operation was mainly a "reduction" surgery. Overaggressive reduction rhinoplasty is not a hallmark of the closed approach per se, but represents the result of inappropriate aesthetic appraisal, inadequate technical execution, or lack of sound anatomical understanding. Clearly, an operation based primarily on reduction intrinsically exposes the surgeon to the possibility of excessive diminution of support structures and consequently undesirable side effects...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28012842/reconstruction-of-the-isolated-columellar-defect-a-novel-2-stage-technique-and-review-of-the-literature
#9
Brian S Pan, Anthony T Vu, Scott J Rapp, Nick J Saenger
The importance of the nasal complex cannot be overstated from a functional, social, and psychological perspective. The goal of reconstruction is to restore the trilaminar composition of the nose. This is accomplished by recreating the nasal lining and providing a cartilaginous framework to simultaneously support a patent airway and project the defining features to the overlying soft tissue. The columella is one of the smallest subunits of the nose, but the loss of this structure has important esthetic and structural implications...
December 10, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28005824/anthropometrically-based-surgical-technique-for-tessier-3-cleft-reconstruction
#10
Aaron L Morgan, Roger Cason, Christian A El Amm
Craniofacial clefts are rare entities, with an incidence reported as 1.43 to 4.85 per 100,000 births. The Tessier number 3 cleft, the most medial of the oblique clefts, can manifest as clefting of the lip between the canine and lateral incisors, colobomas of the nasal ala and lower eyelid, and inferior displacement of the medial canthus-frequently disrupting the lacrimal system with extreme variability in expressivity (Eppley).Literature on cleft lip repair is extensive and has evolved to incorporate anthropometric techniques, based on identifiable landmarks and anthropometric measurements that are compared with contralateral unaffected anatomy or population means and tracked over time to assess impact on growth...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005812/microcystic-adnexal-carcinoma-of-the-nasal-tip-treated-with-surgical-excision-and-rotational-forehead-skin-flap
#11
Min Seok Kang, Eun Jung Lee, Ji Seop Kim, In Sik Yun, Hyung Kwon Byeon
Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous adenocarcinoma that typically occurs in the head and neck, particularly at the central face. There are only slightly more than 300 patients reported worldwide, and most patients occur in Caucasians. A 72-year-old man was referred to our hospital for definitive treatment of known MAC from previous biopsy. Wide excision of nasal tip and reconstruction of nasal defect with paramedian forehead flap and nasolabial flap transposition were performed rather than conventional Mohs surgery, due to grossly evident disease...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005655/columellar-reconstruction-after-nasal-continuous-positive-airway-pressure-associated-necrosis
#12
Jerry W Chao, Janani A Raveendran, Tina M Sauerhammer, Gary F Rogers, Albert K Oh, Michael Boyajian
Though a life-saving modality in neonatal intensive care units, nasal continuous positive airway pressure (nCPAP) carries a small risk of irreversible ischemia and necrosis of the columella due to the configuration of the pressure delivery system. Iatrogenic injuries to the columella after nCPAP use result in a spectrum of disfigurement and functional airway obstruction. The authors performed a retrospective review of patients evaluated for nCPAP-related columellar deformities by the Division of Plastic and Reconstructive Surgery at the authors' institution over a 10-year period to assess reconstructive outcomes...
December 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005651/columellar-reconstruction-a-new-technique-for-median-cleft-lip-repair
#13
Murat Livaoğlu, Yasemin Imamoğlu
Median cleft lip (MCL), failure of the fusion of the medial nasal prominences in the midline resulting in vertical cleft through the center of the upper lip, can be repaired by various columellar reconstruction approaches depending on the nature of patient. The main drawback of these surgical techniques is the use of healthy neighboring structures that may compromise the process. In this report, the authors present a new approach for repairing MCL which involves simultaneous columellar reconstruction without damaging any nasal units...
December 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27998737/anatomical-study-and-clinical-application-of-facial-artery-perforator-flaps-in-intraoral-reconstruction-focusing-on-venous-system
#14
Wei-Na Zhou, Lin-Zhong Wan, Ping Zhang, Hua Yuan, Hong-Bing Jiang, Yi-Fei Du
PURPOSE: Facial artery perforator flaps (FAPFs) are preferred for the repair of intraoral and peri-nasal defects because it is a convenient procedure with minimal donor-site morbidity. The purpose of this study was to investigate the anatomic features of FAPFs and present their clinical application in intraoral reconstruction. MATERIALS AND METHODS: Five cadaver specimens (10 sides) of the head and neck region and 90 clinical cases (90 sides) of neck dissection were analyzed to explore the facial venous drainage system of FAPFs...
November 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27994432/presurgical-nasoalveolar-molding-a-boon-to-facilitate-the-surgical-repair-in-infants-with-cleft-lip-and-palate
#15
Prabhakar Ramasetty Attiguppe, Y M Karuna, Chandrashekar Yavagal, Saraswathi V Naik, B M Deepak, Rekhamani Maganti, Chaithanya G Krishna
Cleft lip and palate (CLP) is the most common congenital craniofacial anomaly. Rehabilitation of CLP generally requires a team approach. Alveolar and nasal reconstruction for these patients is a challenge for the reconstructive surgeon. Various procedures have been attempted to reduce the cleft gap, so as to obtain esthetic results postsurgically. The presurgical nasoalveolar molding (PNAM) technique, developed by Grayson, is a new approach to presurgical infant orthopedics. PNAM reduces the severity of the initial cleft alveolar and nasal deformity...
October 2016: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/27978574/nasal-reconstruction-in-the-vasculopathic-patient-saddle-up
#16
Taha Z Shipchandler, Cyrus C Rabbani, Dominic Vernon
No abstract text is available yet for this article.
December 15, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27978568/reconstructive-techniques-for-the-saddle-nose-deformity-in-granulomatosis-with-polyangiitis-a-systematic-review
#17
Waleed H Ezzat, Rebecca A Compton, Krystyne C Basa, Jessica Levi
Importance: Repairing the saddle nose deformity in the setting of granulomatosis with polyangiitis disease is a rare but challenging situation for any surgeon. Given that the available data in the literature is based on case reports and small case series, there is little evidence available to help delineate which reconstructive techniques are optimal. Objective: To examine which techniques were most successful in reconstructive rhinoplasty for a saddle nose deformity secondary to granulomatosis with polyangiitis...
December 15, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27978554/technical-and-clinical-considerations-for-facial-feminization-surgery-with-rhinoplasty-and-related-procedures
#18
Raúl J Bellinga, Luis Capitán, Daniel Simon, Thiago Tenório
Importance: Together with the forehead reconstruction, feminization of the nose is one of the most common procedures in facial feminization surgery. Rhinoplasty surgical techniques, which provide correct support and stability in the midterm to long term, are essential for obtaining a predictable result. Objective: To report on the technical and clinical considerations of rhinoplasty and related procedures to feminize the nose, harmonize the nose in relation to the other modified structures (mainly the forehead and maxillomandibular complex), and achieve an aesthetic result beyond gender differences...
December 15, 2016: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/27977482/a-modified-approach-to-extensive-oromandibular-reconstruction-using-free-fibula-flaps
#19
Casian Monaco, John T Stranix, Z-Hye Lee, David Hirsch, Jamie P Levine, Pierre B Saadeh
In select patients with advanced disease resulting in large composite tissue defects, consideration is often given to multiple flap reconstruction. The authors propose an alternative option. Using virtual surgical planning the authors demonstrate how modest sacrifice in projection translates into a substantial decrease in the volume and surface area of soft tissue needed, in turn maximizing soft tissue coverage with a single fibula free flap. The authors used 3-dimensional virtual surgery to simulate angle-to-angle reconstructions using free fibula flaps...
December 12, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27942370/surgical-pearl-on-reconstructing-surgical-defects-of-the-nasal-tip
#20
Artur César, Ana Barros, Paulo Santos, Filomena Azevedo
Repairing surgical defects of the nasal tip is challenging, mainly because of the lack of freely mobile skin available peripherally. The Peng flap is a one-stage cutaneous flap that circumvents this difficulty by recruiting skin from the nasal dorsum and sidewall regions. The design produces a tridimensional shape perfectly adapted to the configuration of the nasal tip and allows for an inconspicuous closure of the defect. We present three examples of full-thickness skin defects involving the nasal tip, reconstructed using a modified version of the Peng flap, and present the experience at our department with this surgical technique...
June 15, 2016: Dermatology Reports
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