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At least 271 records · Page 15Linked to original sources
PubMed2005

The surgical correction of protuberant ears.

While prominent ears are considered a sign of good fortune in the Far East, Western society looks upon prominent ears in a far less positive manner. Children with prominent ears are often the subjects of verbal and at times physical abuse by their peers, resulting in adverse psychological effects. Advances in otoplasty have made it possible not only to pin back the ears, but also to reshape them, reduce their size, or make them more symmetrical. For a dermatologic surgeon, an otoplasty may be an unfamiliar surgical procedure, however, the surgery itself does not significantly differ from ear wedges or cartilage removal procedures for skin cancer, procedures with which the dermatologic surgeon is quite familiar.

Ear, External↗
PubMed2005

Anesthesia for office-based oculoplastic surgery.

BACKGROUND: Many common oculoplastic surgical procedures can be performed in an office-based setting. OBJECTIVE: To describe a system of local anesthetic use that provides superb anesthesia administered in a nearly painless manner. METHODS: Combined conjunctival, topical, and injected local anesthesia is used in outpatient oculoplastic surgical procedures. The use of optional adjuvant oral sedation can decrease pain and anxiety in selected patients. RESULTS: We have successfully employed our described system of local anesthesia for office-based oculoplastic surgery. CONCLUSION: In suitable patients, the shifting of operative location from the hospital or ambulatory surgery center to the office provides many benefits to both the patient and the surgeon.

Ambulatory Surgical Procedures↗
PubMed2005

An integrated environment for plastic surgery support: building virtual patients, simulating interventions, and supporting intraoperative decisions.

In the last decade a number of environments for Computer Supported Plastic Surgery have been presented. Nevertheless, an overall approach for training and intraoperative support is still missing or has not been widely exploited yet. We developed a fully integrated system which allows surgical simulation, planning, and support for computer-guided plastic surgery procedures starting from image acquisition to final intraoperative assistance. The system also provides the user with a radiological workstation able to analyse patient medical images and case studies, with advanced bidimensional and three dimensional image processing functionalities. We intend to demonstrate that such a platform can be built at an affordable cost. The radiological workstation is capable of supporting radiologists and surgeons in real patient case studies and the simulation workstation may be adopted by plastic surgeons in teaching and training of complex surgical planning. Moreover, results of simulation can be used in the operating room with a relatively high benefit in terms of improved accuracy, reduction of surgical risks, and decrease in training costs.

Decision Support Techniques↗
PubMedDate not supplied

Graft fixation in cruciate ligament reconstruction.

Cruciate ligament reconstruction has progressed dramatically in the last 20 years. Anatomic placement of ligament substitutes has fostered rehabilitation efforts that stress immediate and full range of motion, immediate weightbearing, neuromuscular strength and coordination, and early return to athletic competition (3 months). This has placed extreme importance on secure graft fixation at the time of ligament reconstruction. Current ligament substitutes require a bony or soft tissue component to be fixed within a bone tunnel or on the periosteum at a distance from the normal ligament attachment site. Fixation devices have progressed from metal to biodegradable and from far to near-normal native ligament attachment sites. Ideally, the biomechanical properties of the entire graft construct would approach those of the native ligament and facilitate biologic incorporation of the graft. Fixation should be done at the normal anatomic attachment site of the native ligament (aperture fixation) and, over time, allow the biologic return of the histologic transition zone from ligament to fibrocartilage, to calcified fibrocartilage, to bone. The purpose of this article is to review current fixation devices and techniques in cruciate ligament surgery.

Anterior Cruciate Ligament↗
PubMed2000

[Progressive hemifacial atrophy in the young patient: surgical problems in children].

Parry-Romberg syndrome is characterized by a limited progressive hemifacial atrophy. For young patients, the surgeon has to deal with two tendencies: the patient's growth and the course of the syndrome. When managing such an unpredictable disease, the surgeon has to make a guess about the future course of the structural movements. We reviewed our experience and analyzed the different surgical possibilities for reconstructive surgery for Parry-Romberg syndrome.

Adipocytes↗
PubMed1997

[Video matching as intraoperative navigation aid in operations to improve the facial profile].

Planning and simulation of individual interventions are not yet the common standard treatment in general surgery. Improvements in planning and simulation of individual orthognatic and craniofacial interventions have led to the need to transfer the results of preoperative planning to the location. Videomatching offers a new approach to the surgeon so that simulation output can be used in a highly intuitive way. Congruent video superimposition of the real site and a view of the simulation give the surgeon a unified view of both domains. Visual merging is immediately accepted by the surgeon who prefers the intuitive, non-tactile nature of this highly informative navigational aid. Application and positioning of anatomical markers and time-consuming calibration procedures can be reduced to a minimum. Alternative plans can be discussed among several surgeons preoperatively, and different therapeutic concepts solidified in various simulation models can be selected intraoperatively. We concentrate on the application of this new method in craniomaxillofacial surgery, but it is applicable in other disciplines as well.

Calibration↗
PubMed2001

Reconstruction of intraoral defects after cancer surgery using cervical pedicle flaps.

PURPOSE: This article reports the results of using cervical myocutaneous flaps for reconstruction of small- and medium-sized oral defects. PATIENTS AND METHODS: One hundred thirty-one cervical pedicle flaps were used for reconstruction of the defects after resection of oral cancer. Primary sites of the lesions were the tongue, buccal mucosa, floor of the mouth, and lower gingiva. RESULTS: Infrahyoid myocutaneous flaps were used in 53 cases, sternocleidomastoid flaps in 47 cases, and platysma flaps in 31 cases. Among the 131 patients, there was complete necrosis of the skin paddle in 5 cases and partial necrosis in 7 cases. The success rate was 92.5%, 89.4%, and 90.3%, respectively for the 3 types of flaps. CONCLUSIONS: It was concluded that cervical pedicle flaps have clinical value in selected patients needing reconstruction of small- and medium-sized defects after intraoral cancer surgery.

Adult↗
PubMed2001

[Evaluation of canal wall down tympanoplasty with canal reconstruction for draining ear with middle ear cholesteatoma].

OBJECTIVES: We studied the postoperative stability of canal wall down tympanoplasty with canal reconstruction for middle ear cholesteatoma with preoperative otorrhea. SUBJECTS AND METHODS: 155 ears with middle ear cholesteatoma treated with canal wall down tympanoplasty with canal reconstruction were evaluated retrospectively. A comparison was made between the group of 80 ears which showed otorrhea, preoperatively, and the group of 75 without preoperative otorrhea. Problems observed in the tympanic membrane or reconstructed external auditory canal were evaluated both at the postoperative initial stage and more than 1 year after surgery. Postoperative hearing prognosis was also studied. RESULTS: 1) In the postoperative initial stage, local infection and necrosis of materials for canal reconstruction were significantly more likely to be observed in ears with preoperative otorrhea. 2) In ears with postoperative local infection, necrosis of materials for canal reconstruction occurred more frequently, and the period until drying of the reconstructed external auditory canal was significantly extended. 3) No significant difference was seen in postoperative status of the tympanic membrane and reconstructed ear canal at least 1 year after surgery. 4) The presence of preoperative otorrhea had no influence on hearing prognosis. CONCLUSIONS: When canal wall down tympanoplasty with canal reconstruction is used for ears with preoperative otorrhea, careful attention should be paid to local treatment at the postoperative initial stage. However, no significant problem occurred in the outcome of preoperative ear draining at least 1 year after surgery.

Adolescent↗
PubMed2000

[Reconstruction for posterior wall of external meatus and sound transmission apparatus after radical mastoidectomy].

OBJECTIVE: To reconstruct middle ear structure for open mastoid antrum with external auditory canal after radical mastoidectomy in one-stage. METHOD: 71 ears of post-mastoidectomy (discharging 53 ears and dried up 18 ears) were undergone with reconstruction of middle ear. The posterior wall of external auditory canal, mastoid cavity and chain of ossicles were reconstructed with homologous costal cartilage. RESULT: 69 ears of 71 cases were near normal structure followed up 6 months to 5 years after operations. The result showed hearing improvement over 15 dB were 55 ears (77.5%) and under 15 dB were 11 cases (15.5%). Five cases (7.0%) were failed. CONCLUSION: Reconstruction of middle ear with homologous costal cartilage is a ideal surgery to reconstruct hearing structure and avoid infection of middle cavity after radical mastoidectomy.

Adult↗
PubMed2000

Cosmetic oral and maxillofacial surgery options.

BACKGROUND: Dentistry and its related specialties have made exponential increases in the functional and cosmetic treatment of the maxillofacial region. Oral and maxillofacial surgeons historically have been involved in functional and cosmetic rejuvenation of the face, and newer technologies have enhanced the ability to make patients look and feel better. METHODS: Cosmetic oral and maxillofacial surgery is being taught in residency programs, is included in the oral and maxillofacial surgery board examinations and represents a part of contemporary oral and maxillofacial surgery. The author discusses common facial rejuvenation procedures with an emphasis on newer treatment technologies. RESULTS: Many oral and maxillofacial surgeons have the ability to improve the esthetics of the maxillofacial area and related structures. The large number of aging baby boomers and technological advances in cosmetic facial surgery have made these procedures easier to perform and more popular than ever. CONCLUSION: A global diagnosis and treatment plan to include facial esthetics can enhance cosmetic dentistry and serve to frame the work of the restorative dentist. The oral and maxillofacial surgeon can help the dentist and patient pursue both functional and cosmetic improvement with safe and effective procedures. CLINICAL IMPORTANCE: All dentists should be aware and abreast of advances in all areas of dentistry and have a basic understanding of available procedures that can benefit their patients. Cosmetic oral and maxillofacial surgery can enhance the work of the restorative dentist and improve facial esthetics, as well as enhance the well-being of the patient.

Esthetics, Dental↗
PubMed2005

Otoplasty: a review of the surgical techniques.

Otoplasty surgery carries a high satisfaction rate for participants (96%). Surgeons are more critical of the results of otoplasty than the participants or parents (92% satisfied). There is no statistical difference in qualitative results with different surgical techniques when comparing the published data. Data on otoplasty surgery is numerous, but quantitative assessment of surgical outcome is rare. The authors propose the measurement of cephaloauricular distance to allow comparison between studies.

Ear↗
PubMed2006

Giant cerebral aneurysms: endovascular challenges.

OBJECTIVE: Giant (>or=25 mm in diameter) cerebral aneurysms have a poor natural history, with high risks of subarachnoid hemorrhage or progressive disability or death caused by mass effect or stroke. Surgical treatment may be effective but carries a high burden of morbidity and mortality. Thus, attempts at endovascular solutions to these complex lesions have been developed to offer therapy at reduced risk. METHODS: The authors reviewed their clinical experience and the current body of literature concerning giant cerebral aneurysms and present their perspective on the current state of the art in endovascular therapy for these aneurysms. A variety of techniques are described that can be used in an attempt to provide a solution to the wide variety of clinical dilemmas associated with the management of these difficult lesions. Preprocedural planning and periprocedural considerations are discussed briefly. The use of intracranial balloons and stents are described in conjunction with the use of detachable platinum coils. The developing concept of using stents alone to treat aneurysms is discussed. Alternative methods of treating giant aneurysms are discussed. RESULTS: Current endovascular approaches, when properly selected and applied, can provide lower-risk therapies than conventional microsurgical approaches for patients harboring giant cerebral aneurysms. However, endovascular approaches do not, at present, provide results that are as durable as current surgical techniques for giant cerebral aneurysms. CONCLUSION: Treatment of giant cerebral aneurysms via endovascular therapeutics requires the interventionist to possess an extensive armamentarium. Meticulous preprocedure evaluation, patient selection, and execution of the treatment plan enable safe and effective management. Current therapies do not provide an ideal solution for every patient, so one must consider creative and evolving solutions to these difficult clinical challenges. The procedural morbidity of open surgery versus the decreased durability of current endovascular techniques must be assessed carefully.

Blood Vessel Prosthesis↗
PubMed2003

Versatility of temporalis myofascial flap in maxillofacial reconstruction--analysis of 30 cases.

Temporalis myofascial flap holds great promise for the reconstruction of various defects of the maxillofacial region-either congenital or surgical. The dependable blood supply through the middle and deep temporal arteries, proximity to the maxillofacial region, possibility to mobilize it to the oral cavity through the under surface of zygomatic arch and its fanned out nature permits the surgeon to use this flap for the reconstruction of various maxillofacial defects and even as an interposing tissue. In this series of 30 cases, we have used the temporalis myofascial flap for the reconstruction of different types of maxillofacial defects and as an interposing material in TMJ surgeries. We found that this flap is very valuable in maxillofacial reconstruction.

Ankylosis↗
PubMed2000

Reconstruction following radical maxillectomy with flaps supplied by the subscapular artery.

The authors present their experience of 27 cases with repairs of defects following radical maxillectomies with free flaps. A total of 28 flaps were used (five latissimus dorsi, six scapula, 16 combination flaps of scapula and latissimus dorsi and one combination of scapula, latissimus dorsi and serratus anterior flap). Only one scapula flap was completely lost and in three cases where a combination of scapula and latissimus dorsi flap was used, partial necrosis of one component occurred. The authors first choice for reconstruction is a scapula bone flap raised on the angular artery combined with the latissimus dorsi flap. The combination of flaps with a long pedicle and of the bony and muscular components provides the surgeon with the option of customizing the flap to meet individual patient needs. For intraoral closure the authors prefer the latissimus dorsi muscle which rarely requires secondary procedures for prosthesis placement following epithelialization and atrophy. The main disadvantage of the flap is the difficulty of two teams working simultaneously, thus increasing the average operating time. All postoperative corrections and prosthetic rehabilitation should be postponed for at least 2 months following surgery because of postoperative swelling.

Adolescent↗