BACKGROUND: Our purpose was to determine and compare the external rotation moment arm (ERMA) of the latissimus dorsi (LD), teres major (TM), and lower trapezius (LT) when transferred to selected locations on the proximal humerus. We hypothesize that the LT transfer has a higher ERMA compared with LD or TM. ...

Pedicle damage is a rare complication of latissimus dorsi (LD) flap breast reconstruction. We report a case of accidental avulsion of the vascular pedicle of a totally autologous (extended) LD flap during immediate breast reconstruction in a patient who had previously undergone contralateral breast reconstruction with a pedicled TRAM flap ...

Background: Free tissue transfer with lower abdominal flaps for autologous breast reconstruction is not suitable for all patients. The latissimus dorsi (LD) musculocutaneous flap is an alternative, effective method for both immediate and delayed breast reconstruction. Objectives: The authors assess their experience with LD flaps for breast reconstruction, including indications ...

PURPOSE: The purpose of this study was to consider the indications and evaluate the clinical advantages and disadvantages including, results and complications, of immediate reconstruction using a latissimus dorsi (LD) free flap and reconstruction plate (R-plate) in advanced oro-mandibular tumour resection. METHODS AND MATERIALS: Our cohort included 116 patients who ...

The bipolar hip prostheses after some time functions as a unipolar device. There is a need to change the design of bipolar hip prostheses to make it function as a bipolar device over a prolonged period of time. A bicentric bipolar hip prosthesis was used as an implant for various ...

A soft tissue defect requiring flap cover which is longer than that provided by the conventional "long" free flaps like latissimus dorsi (LD) and anterolateral thigh (ALT) flap is a challenging problem. Often, in such a situation, a combination of flaps is required. Over the last 3 years, we have ...

BACKGROUND: Hip replacement using a hemiarthroplasty (HA) is a common surgical procedure in elderly patients with fractures of the femoral neck. Data from the Swedish Hip Arthroplasty Register suggest that there is a higher risk for revision surgery with the bipolar HA compared with the unipolar HA. PURPOSE: In this ...

Bipolar clavicular dislocation rarely occurs. Although referred to by several different names (panclavicular dislocation, bifocal clavicle dislocation, traumatic floating clavicle, and periarticular clavicle dislocation), knowledge regarding appropriate treatment of this condition is limited. Conservative therapy remains the gold standard in asymptomatic individuals. In younger individuals with higher functional demands, or ...

Bipolar hemiarthroplasty remains a treatment option for displaced femoral neck fractures in elderly patients without pre-existing hip disease. Implant-related complications associated with this procedure include acetabular erosion, dislocation, disassembly of the modular components, polyethylene debris-induced osteolysis, metallosis from outer cup impingement, and femoral component loosening. This article presents a case ...

The nose is the most prominent of all facial structures and is susceptible to many types of trauma. All soft tissue injuries of the nose have the potential to distort its appearance and adversely affect the patient's self-image and self-esteem. Once life-threatening injuries are stabilized, a careful history and physical ...

BACKGROUND: Adjacent defects are commonly encountered during Mohs micrographic surgery for nasal skin cancers and often present a formidable reconstructive challenge. OBJECTIVE: This article will describe similar modifications of both the bilobed and nasolabial transposition flaps' Burow's triangles that allow for the repair of two adjacent defects of the distal ...

Nasal septal deformity is a central feature of the crooked nose, contributing to functional and aesthetic problems. Straightening of the septum often requires resection, scoring, or incision of the septum--maneuvers that inevitably weaken the cartilaginous dorsal and caudal L-shaped struts, which together are known as the L-strut. Compromise of this ...

Herein, I describe lateral crural setback with cephalic turn-in flap as a new technique for management of the drooping nose. I report a technique for reinforcement of the alar cartilage after partial removal of its caudal portion used in 23 patients during open rhinoplasty. An objective assessment, which included measurement ...

The purpose of this study was to evaluate a new sonographic technique for identifying the nasal bones using the retronasal triangle view, ie, the coronal plane at which the palate and frontal processes of the maxilla are simultaneously visualized. Three-dimensional (3D) volumes were acquired from women undergoing first-trimester sonographic screening ...

In this study, a modified surgical method was carried out to repair large nasal septal perforations with a galeal pericranial flap using endoscopic technique. Six adult human cadavers were dissected by applying the classic open rhinoplasty technique. Large perforations were created in the septal cartilages. To repair the perforations, we ...

We describe an alternative method of manipulating fractured nasal bones using a surgical mallet and a champagne cork. This method enables accurate fracture reduction with minimal skin trauma, by affording the surgeon a high level of control. This method may be applied successfully to late-presenting fractures.

Skin cancers of the nasal tip present a challenge for the dermatologic surgeon. The bilobed flap has been widely used as the "workhorse" flap for such defects but requires meticulous design and may be complicated by a tendency toward pin-cushioning. To describe the use of the nasal sidewall rotation (NSR) ...

Background:The use of interosseous wire to fix bone grafts is well known. Herein, we describe a technique for fixation of an iliac crest bone graft for nasal augmentation, using a stainless steel wire.Method:A hole in the cancellous part of the graft guides the wire exactly into a groove in the ...

For the internal lateral nasal osteotomy, a 4-mm double-guarded straight osteotome that separates the external periost and mucoperiosteum while the osteotomy is progressing is presented. Before the osteotomy, the external periost and the internal mucoperiosteum are infiltrated with local anesthesia and elevated by tunneling with an elevator. As the sharp ...

The bilobed flap is reliable for reconstruction of Mohs defects on the lower third of the nose. It uses skin from the proximal nose to reconstruct defects of the nasal tip and ala. The goal is to avoid alar rim displacement and asymmetry. The trilobed flap's design and execution leverage ...

Osteogenesis imperfecta (OI) is a rare hereditary disorder of collagen synthesis that results in weak bones that are easily fractured resulting in deformities. Osteogenesis imperfecta refers to a wide array of genetic disorders with variable phenotypic presentation. In general, type I is the mildest form of disease; types IV, III, ...

To establish a normal range of nasal-bone length at 16-24 weeks' gestation by the use of three-dimensional (3D) ultrasound and to investigate the effect of deviations from the exact mid-sagittal plane on the measurement of nasal-bone length. We acquired 3D volumes of the fetal profile from 135 normal fetuses at ...

Nasal fractures are commonly treated by primary closed reduction. However, studies suggest this produces unacceptable functional and aesthetic results. Many patients require revision surgery. We aimed to assess patient satisfaction following closed reduction of nasal fractures. Retrospective chart review of patients with nasal fractures treated by closed reduction at the ...

An idea to fix broken nose pads of spectacles has been suggested.

Premaxillary augmentation is a widely adopted procedure used as an independent facial contouring operation or as an adjunct to rhinoplasty. Insufficient projection of the praemaxilla is a relatively common deformity, especially in the Asian population. We performed two cases of premaxillary augmentation using autologous costal cartilage as an adjunct to ...

Reconstruction of near-total and total nasal defects is technically challenging, particularly in patients with an extensive smoking history. One of the keys to a successful esthetic and functional reconstruction is the use of intranasal lining that is reliable and not susceptible to necrosis. Unlike mucosal flaps and skin turn-in flaps ...

Rhinoplasty often requires precise, graded bone removal without damage to surrounding nasal soft tissue and mucosa. Unfortunately, current techniques are associated with decreased visualization, heat generation, mechanical chatter, and lack of surgical precision with resultant soft tissue injury. We introduce a novel technique to sculpt the nasal dorsum in a ...

Corrective rhinoplasty for functional and aesthetic recovery relies much on the use of grafts. This may be effectively accomplished with alloplastic materials; however, certain circumstances mandate the use of autologous grafts. Septal and auricular cartilages are inadequate for dorsal augmentation of the Asian nose. Here, we present our experiences with ...

Seventy-five percent of nonmelanoma skin cancers are located in the head and neck area, of which 30 percent occur on the nose (225,000 new cases per year). The aim of this study was to develop a nasal reconstruction algorithm for nasal defects, based on experience with 788 consecutive nasal reconstructions ...

A 57-year-old Filipino woman had paraffin materials placed in her nose, chin, and cheeks approximately 15 years prior to consultation. Progressive enlargement of the chin had occurred, simulating a witch's chin deformity, with a lesser degree of the distal nose and columellar area. Restoration of a relatively normal chin contour ...

Nasal fractures are the most common facial fractures and displaced fractures may cause considerable cosmetic concern. Traditionally, displaced nasal fractures have been manipulated under general anaesthesia (GA) performed within 2 weeks of the injury. Despite evidence for the benefit of local anaesthesia (LA), nasal fractures are still most commonly reduced ...

BACKGROUND: Nasal fractures are the commonest facial fracture. They can cause morbidity in terms of nasal obstruction and cosmesis. They can be treated by simple external digital manipulation, provided they are seen and assessed in a timely fashion. This manipulation is commonly done under general anaesthetic (GA), which utilises precious ...

The term "bulbous nose" is used to describe a large or boxy nasal tip. Typically, correction of the bulbous tip has been achieved through a variety of cartilage-modifying maneuvers based on incision or excision of the lower lateral cartilage. Horizontal reduction with a cephalic hinged flap of the lateral crura ...

OBJECTIVE: To investigate the performance of nuchal fold thickness, nasal bone hypoplasia, reversed flow in the ductus venosus and tricuspid valve regurgitation in the prediction of fetal aneuploidies in the early second trimester. METHODS: This was a prospective study of 870 fetuses at 14 + 0 to 17 + 6 ...

The paramedian forehead flap has become the standard of care for major nasal reconstruction. The classic procedure involves a second-stage operation to divide and inset the external pedicle. We present our experience in a clinical series using single-stage forehead flap reconstruction. Our indications include elderly patients, pediatric patients treated during ...

Temporoparietal fascial grafts have been used for both nasal and facial contouring, for vascularized tissue coverage, and to augment the nose and lip. The temporoparietal fascial graft provides thin, broad, pliable, easily neovascularized, adequate coverage, contour, and bulk on the cartilage dorsum of the nose, as well as an inconspicuous ...

Over the last 2 decades, many of the difficulties in shaping primary tips and rebuilding destroyed secondary tips have been solved through the use of tip sutures and grafts. Dorsal grafts, which are a highly visible determinant of the nasal profile and contour, have become the greatest challenge in rhinoplasty ...

Forehead skin is often insufficient to use for nasal reconstruction because of a low hairline. In addition, skin graft used to repair donor-site defects results in obvious mismatched patches, whereas healing by secondary intention of donor-site defects causes conspicuous scars. To make up for the shortage of forehead skin used ...

The face tells the world who we are and materially influences what we can become. The nose is a primary feature. Thin, supple cover and lining are shaped by a middle layer of bone and cartilage support to create its characteristic skin quality, border outline, and three-dimensional contour. The delicacy ...

The aim of this study was to analyze the cases that were reexplored shortly after closed reduction of the nasal bone fracture. From 1996 to 2009, 955 patients (757 males and 198 females) were operated on for the nasal bone fractures. The nasal splints were applied and removed 1 week ...

BACKGROUND: Nasal bone fracture is a common injury, but its repair can be unexpectedly difficult. To date, intranasal gauze packing has been used to support the nasal bone in position and to maintain contact between the mucosa of the septum and the cartilage. This gauze packing, however, has a tendency ...

Objective: To evaluate nasal morphology, symmetry, and nostril shape in patients with unilateral cleft lip and palate following mixed-dentition alveolar bone grafting. Design: Prospective stereophotogrammetric study. Setting: Hospital-based. Patients: Thirty-nine patients with a history of repaired unilateral cleft lip and palate who received an iliac crest alveolar bone graft were ...

The forehead flap is one of the oldest reconstructive techniques and is still regarded the standard procedure for large nasal defects. Controversy exists regarding reconstructions in infants, but only very few long-term results of this technique in infants have been documented. We report on a 4-month-old girl requiring subtotal nose ...

The absence of sphenoidal sinuses (SS) in an adult is an extremely rare condition. We investigated in agenesis of the sphenoid, maxillary, ethmoid, and frontal sinuses in 20 male adult cadavers. In a 50-year-old man, bilateral absence of the SS was observed. On the macroscopic examination, opening of the SS ...

The nasal bone is among the most frequently broken facial bone due to all types of trauma and is the most frequently fractured facial bone due to motor vehicle collisions. This study reports the results of anterior-posterior impacts performed on male cadavers using a free-falling impactor with a flat impacting ...

INTRODUCTION: Reconstruction of nose defects after tumor resection, trauma or infection disease is imperative for full patient rehabilitation. For satisfying esthetic and functional results achievement, it is necessary to use surrounding skin with similar semblance, which precisely restores and imitates missing part with its outlines. MATERIAL AND METHODS: This paper ...

Nasal tip and septal perforations may lead to significant upper airway problems as well as disturbing esthetic changes in the external contour of the nose. Nasal defects impede normal social contact and create great self-identity problems for the patients. We report the case of a 37-year-old woman, taking drugs for ...

Nasal bone fractures are the most common type of facial fracture. Closed reduction has been used as the standard treatment modality for nasal fractures for many years. In cases of nasal fracture with lacerations at the fracture sites, bioabsorbable/metallic plate or interfragment wire fixation can be used with accurate alignment ...

A 10-year-old, neutered, male Domestic Shorthair cat was presented to the teaching hospital for labored breathing, anorexia, and weight loss of several months duration. External examination revealed distortion of the bridge of the nose and pink fleshy polyps protruding from each nostril. The cat was euthanized and submitted for postmortem ...

OBJECTIVE: To provide a new approach for the treatment of tumor in Meckel's cave, by dissecting adjacent structures of the nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel's cave approach. METHODS: Fifteen adult cadaver heads (30 sides) were dissected and the correlated anatomic landmarks were observed, measured and analyzed in an operative route. RESULTS: ...