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[The neurovascular island pedicle: basic considerations and its application in the face (author's transl)].

The island pedicle flap has in comparison with other skin flaps a number of important advantages which include elasticity, minimal shrinkage, absence of dog ears, success in irradiated areas and innecessity of a second stage procedure. On the head the most common donor areas for an island flap are postauricular, nasolabial, submental, and less cosmetically satisfying frontal and temporal regions. For large reconstrictions, however, only those pedicles which contain a branch of the superficial temporal or frontal arteries suffice. The major indications for an island pedicle flap include defects of the auricle, stenosis of the external auditory canal, through and through defects of the nose and paranasal region, in combination with other methods of skin grafting, and soft tissue loss and ectropion of the lower lid.

Cleft Palate↗

[Selected reconstructive technics in the surgery of cancers of the face].

The technique of facial reconstruction used by the plastic team at the Cancer Center of the University of Brussels are presented. Free grafts are seldom performed because they often lead to disfigurement. An appropriate evaluation of the margins of resection is obtained during the operation by multiple frozen sections, and reconstruction is achieved by local flaps when possible. It is considered that a normal appearance is of extreme importance for old patients suffering from facial cancer, and that the aim of surgery is not only complete eradication of the lesion but also careful reconstruction of the removed structures by simple and safe procedures. The selected techniques are presented for each region of the face.

Aged↗

Benign dermal eccrine cylindroma. A pitfall in the cytologic diagnosis of adenoid cystic carcinoma.

Aspiration cytology from four benign dermal eccrine cylindromas and five adenoid cystic carcinomas were compared. These two lesions were found to have so much in common morphologically that they may be indistinguishable on a purely cytologic basis. Accordingly, we recommend a restricted excision to obtain a histopathologic diagnosis before more extensive surgery is performed whenever a lesion is cytologically consistent with adenoid cystic carcinoma but clinically shows a picture that does not exclude dermal eccrine cylindroma.

Biopsy, Needle↗

Temporal bone cancer.

Temporal bone cancer, a relatively rare disease, often presents in a subtle manner, which may delay diagnosis. It should be suspected in any case of persistent otitis media or otitis externa that fails to improve with adequate treatment. This article discusses physical and diagnostic imaging indications and epidemiology and histologic distribution of these tumors. Staging systems, patient selection criteria are presented as well as operative techniques and follow-up treatment. Despite advances in operative technique and postoperative care, long-term survival remains poor.

Age Factors↗