Complications of frontal defects

A case where the severe course of an orbital phlegmon led to a functionally and cosmetically poor condition is presented. Thirty-five years later, it was possible to achieve a satisfactory result through several operations performed with interdisciplinary cooperation. The orbit and forehead were reconstructed with porous polyethylene, thus ensuring a cosmetically good result. In two operations, the left eye was freed from its upward fixation through cicatrectomy and mobilization of the mucles, so that the eyes were straight again in the primary position. There is a limited binocular visual field. Binocular vision could be restored again after an interruption of 35 years

Surgical concepts for reconstruction of the auricle

We compiled and evaluated the world literature on auricular reconstruction, for a total of over 400 publications, more than 200 authors, and over 3,300 reported cases. We found that partial reconstructions were already performed as early as 600 BC; total reconstructions were still considered impracticable in 1830. But since 1891, more than 40 different cartilaginous, osseous, and alloplastic frame materials have been described. Only eight of these were still being applied in the last decade, with autogenous costal cartilage and silicone as the leading substances. Results of the operation can be improved by special surgical manipulations, eg, the "fan-flap" technique. Taking into consideration the complication rate, the number of individual interventions, and the stability of the results, we devised a special point system that makes possible a limited assessment of the different surgical techniques

Implants for reconstructive surgery of the nose and ears

Implants shorten reconstruction, reduce trauma for the patients, are, in principle, of unlimited availability and can be given definable qualities that outnumber those of biological transplants. Lots of sometimes exotic materials have already been suggested for facial surgery and most of them have turned out to be unsuitable in the short or long term, because they did not satisfactorily fulfil the requirements of a “perfect implant”. However, transplants obviously cannot be regarded as ideal either because they often involve the necessity of a second intervention for removal, they are only available to a limited extent and some are at risk of postoperative deflection, shrinkage and absorption