PubMed · 10949607
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I S Jones, W C Cooper. 1973. Lateral canthal reconstruction.. https://pubmed.ncbi.nlm.nih.gov/10949607/
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BACKGROUND/PURPOSE: The aim of this study was to determine the normal position of the umbilicus and hence improve the cosmetic result of exomphalos major repair. METHODS: The position of the umbilicus was determined in 50 neonates with respect to the xiphisternum and pubis. RESULTS: The normal umbilical position is 60% of the way from the inferior border of the xiphisternum to the superior border of the pubis in the midline. CONCLUSION: In the repair of exomphalos major, the most aesthetically pleasing result is obtained if the umbilicus is placed 60% of the way from the xiphisternum to the pubis.
Different methods have been used in our department for nipple-areola reconstruction. This study was undertaken in order to find out which method of reconstruction shows optimal long-term results. Between 1983 and 1999, breast reconstruction was performed in 204 patients and different methods were used for nipple-areola reconstruction. 91 patients could be examined. For areola reconstruction full-thickness skin grafts from the groin were used as well as skin grafts from the contralateral areola, vaginal mucosal grafts, and tattoos. For nipple reconstruction we used nipple sharing, labium grafts, local flaps, and a tattoo. Areola reconstruction with full-thickness skin grafts from the groin was performed in 45 patients, in 16 patients a graft from the contralateral areola was used and in 19 patients the technique of intradermal tattoo was applied. One patient had a vaginal mucosal graft, in another patient the nipple areola complex was transplanted to the groin after mastectomy for later reconstruction. Nipple projection was measured and the colour of the reconstructed areola was compared to the other side. Concerning the match of colour, best results were achieved with grafting from the contralateral areola, followed by areola tattoo and skin grafts from the groin. The vaginal mucosal graft was too dark. The transplanted original nipple-areola complex maintained its colour. Nipple projection between 3 and 4 mm was achieved by nipple sharing and local flaps. With grafts from the labium, a projection from 1 to 2 mm was achieved. Thus, best results were achieved by nipple sharing, local flaps for nipple reconstruction and areola skin grafts from the contralateral side. Vaginal mucosal grafts and grafts from the labium are not recommended.
OBJECTIVE: The transorbital keyhole approach to anterior communicating artery aneurysms was developed as a minimally invasive method for safe control of the anterior communicating artery complex. This approach does not necessitate resection of the gyrus rectus. METHODS: The technique is described in detail. The transorbital keyhole approach provides more ventral access than the supraorbital approaches, and the anterior communicating artery complex can be controlled by splitting the basal aspect of the interhemispheric fissure. RESULTS: Since late 1998, the authors have used the transorbital keyhole approach routinely. During the initial experience with 33 patients, the only observed complication specific to this approach was transient diplopia in one patient. At follow-up examinations 2 to 15 months after surgery, the cosmetic results were favorable as compared with those of standard pterional craniotomy. CONCLUSION: We have designed a small, custom-tailored approach to the anterior communicating artery complex for routine use. The small orbitocranial approach is a step toward the ideal of purely extra-axial safe control of anterior communicating artery aneurysms. The orbitocranial keyhole approach seems to be substantially better than the craniotomy, although it requires additional effort and time.