Nasal reconstruction with a forehead flap in children younger than 10 years of age

Nasal reconstruction has been analyzed extensively in adults but not in children. The purpose of this article is to review the authors' experience with the forehead flap for nasal reconstruction in 10 children under the age of 10 during a 10-year period. Outcomes were assessed by an objective grading system for cosmetic surgical results. Subjective criteria were also applied by an assistant surgeon and by the patients' relatives. Appropriate results were obtained by the following principles: (1) A modified approach that considers three subunits consisting of the dorsum, tip, and ala was used; (2) a forehead flap is the best option for an entire subunit or a full-thickness defect repair; (3) the forehead flap design should be paramedian, oblique, and opposite to the major defect to avoid the hairline and allow better caudal advancement; (4) ear or costal cartilages are good options for structural support (the septum is a nasal growth center that should not be touched); (5) infundibula

A clinical retrospective study comparing two short-scar face lifts: Minimal access cranial suspension versus lateral SMASectomy

BACKGROUND: The purpose of this study was to retrospectively compare the short- and long-term cosmetic outcomes of two minimal incision rhytidectomies and analyze their advantages and disadvantages. METHODS: The results of minimal access cranial suspension face lift versus minimal incision rhytidectomy with lateral SMASectomy were evaluated after 1 and 24 months. Statistical analysis considered surgeon/patient satisfaction, time used in the procedures, pain, and learning curves. Photographs were sent to the patients and two plastic surgeons, unfamiliar with the cases, for evaluation of results that were assessed by an objective grading system described by Strasser. RESULTS: Eighty-two patients completed 1 and 24 months' follow-up. Complications were two hematomas, two retroauricular-lobule dog-ears, and one hypertrophic preauricular scar. Surgical time was longer for the SMASectomy. Postoperative pain was worse for minimal access cranial suspension face lift. There were no difference

A new approach to nasoseptal fractures: Submucosal endoscopically assisted septoplasty and closed nasal reduction

Background: Nasal bone fracture is the most common among facial bone fractures. The prevalence of concomitant septal and nasal bone fractures fluctuates between 34% and 96.2%. An adequate management of such fractures is essential to prevent complications such as post-traumatic nasal obstruction and nasoseptal deformities. The purpose of the present study is to introduce the submucosal endoscopically assisted septoplasty (SEAS) as an alternative approach for acute septal lesions and to report our experience and outcomes. Methods: Retrospective review including patients with nasal fracture in association with septal fracture (nasoseptal fractures) who underwent to submucosal endoscopically assisted septoplasty and closed nasal reduction. The surgical technique is described and a video is presented. Results: Ninety patients were included; 23% were female and 77% were male, with a mean age of 40 years. All the cases were workplace accidents or commuting accidents. The mean time elapsed between the accident and surgery was 15 days. There were no technique-related intraoperative complications. Three (3.3%) patients suffered a subsequent nasal obstruction and/or deviation of the nasal axis, requiring subsequent secondary open rhinoseptoplasty. Conclusions: Submucosal endoscopically assisted septoplasty and closed nasal reduction for the treatment of nasoseptal fractures is a novel approach that reduces the rate of secondary rhinoseptoplasty as compared to other authors' reports. The technique described is reproducible, cost-effective and has very encouraging outcome

Characterization of the orbital volume in normal population

Introduction: The aim of the study was to describe the normal orbital volume and its most important relationships with other clinical variables. Methods: We designed a correlation study and consecutive normal CTs scans were included. Orbital volume and facial anthropometrics were measured and correlated between them. Two independent and blind observers made all the measurements. Uni and multivariate statistical analysis were performed in order to create a predicting model for orbital volume. Results: A total of 199 consecutive patients were included in the study (398 orbits). The mean Orbital Volume (OV) was 24.5 ± 3.08 cc. Adequate intra and interobserver reliability was observed. There were no differences between the right and left orbit (p¼0.73). The male average OV was 24.9 ± 3.03 cc, the female OV was 23.9 ± 3.08 cc. Age group analysis demonstrated a slow increase in OV beyond thirty years, but these differences were not significant (p¼0.98). Only the age, total facial height, facial width and the interorbital distance were significant and were included in the predictive model of OV. Conclusion: We have characterized the normal orbital volume,variations and associations. In order to further advance in the understanding of the clinical implications the abnormal orbital volume must be fully studied.AO foundatio