Postauricular fascia in augmentation rhinoplasty.

Ten rhinoplasty operations performed using postauricular fascia for the purpose of augmenting the radix and dorsum of the nose were analyzed retrospectively. All the operations were performed over a 1-year period, between 2005 and 2006. The fascia of the postauricular area has been used as a source of pliable soft-tissue grafts in primary and revision rhinoplasty.

Comparison of tensile strength of resorbable plating systems used in monocortical mandible angle osteotomy repair.

Objective: To determine the usefulness of resorbable plating systems in load-bearing applications of the mandible and the location of critical failure.

Methods: An osteotomy was created in 24 fresh cadaveric mandibles at the angle and fixated by the Champy technique with similar resorbable craniofacial plating systems from 4 manufacturers. Each mandible was held rigid as a material test system applied a downward force anteriorly.

Advantages of perforator flaps in reconstruction of complex defects of the head and neck.

Microsurgical transfer of vascularized tissue during the past three decades has allowed highly complicated postoncologic defects in the head and neck region to be reconstructed. Recently, perforator flaps have been used to reduce postoperative pain, shorten hospital stay, and lessen donor-site complications. These flaps are offsprings of previously known musculocutaneous and fasciocutaneous flaps and are harvested with preservation of the underlying muscular and fascial structures.

Frontal sinus fractures: management guidelines.

Management of frontal sinus fractures (FSF) has been the subject of great debate for more than six decades. Multiple treatment options and algorithms have been proposed by multiple specialties throughout the years; however, the optimal method of frontal sinus repair has yet to be elucidated. Because of the location of the frontal sinus and its proximity to numerous intracranial structures, inadequate treatment may lead to life-threatening intracranial infectious complications.

A comparison of resistance to fracture among four commercially available forms of hydroxyapatite cement.

Hydroxyapatite cement is a relatively new biomaterial that has found widespread use in craniomaxillofacial surgery. Despite its common usage, complication rates as high as 32% have been reported. When failed implants are removed, implant fracture has been cited as a potential cause of failure.

Soft-tissue reconstruction after meningococcal septicemia using a posterior tibial artery perforator flap in a 6-year-old boy.

Fulminant meningococcemia can have life-threatening as well as limb-threatening complications. However, unlike other types of peripheral gangrene, areas of necrosis do not follow known anatomic vascular patterns. Instead, irregular and patchy areas of necrosis are found to exist adjacent to viable tissues.

A comparison of combinations of titanium and resorbable plating systems for repair of isolated zygomatic fractures in the adult: a quantitative biomechanical study.

Multiple studies have sought to determine the postreduction stability of internal fixation in zygomaticomaxillary complex (ZMC) fractures. Three-point fixation with titanium miniplates is increasingly recommended to repair these injuries. Use of bioresorbable plates has been suggested to eliminate potential postoperative hardware complications.

Comparison of bacterial inoculation and transcutaneous oxygen tension in the rabbit S1 perforator and latissimus dorsi musculocutaneous flaps.

Muscle and musculocutaneous flaps have been used reliably in reconstruction of soft-tissue defects for many years. Previous experimental studies have shown musculocutaneous flaps to be superior to the random pattern and fasciocutaneous flaps in the management of infected wounds. Over the past decade, perforator flaps have gained acceptance as alternative methods of reconstruction in the clinical setting that can decrease donor-site morbidity and hospital stay, and increase patient satisfaction.

The thoracodorsal artery perforator-scapular osteocutaneous (TDAP-SOC) flap for reconstruction of palatal and maxillary defects.

Despite technical advances over the past 3 decades, subtotal, total, and extended total maxillectomy defects remain challenging reconstructive problems. In particular, postoncologic resection of the maxilla results in complex 3-dimensional defects of the midface, which cause severe functional and esthetic deformities. Such defects generally require composite tissue flaps for reconstruction.

Simultaneous bilateral breast reconstruction with superior gluteal artery perforator (SGAP) flaps.

The superior gluteal artery perforator (SGAP) flap is a useful technique for restoration of the breast after mastectomy. If appropriately planned, the soft-tissue envelope supplied by the superior gluteal artery perforator vessels can be harvested with minimal donor site morbidity and often results in a highly esthetic restoration of the breasts. Dissection of the flap is performed with complete preservation of gluteus maximus muscle function.

Variability of the postauricular muscle complex: analysis of 40 hemicadaver dissections.

Background: The postauricular area is often explored by reconstructive and otologic surgeons. We previously reported on the use of postauricular tissues as a graft for wrapping hydroxyapatite implants in orbital reconstruction. This procedure reduced the incidence of implant exposure, while achieving acceptable cosmetic results.

Use of the deep inferior epigastric perforator flap in a 15-month-old boy after resection of lymphatic malformation.

Lymphatic malformations are benign tumors that arise from congenital defects of the lymphatic system. Despite the fact that all lymphatic malformations develop embryologically, their presence may not be detected until the tumor enlarges from hemorrhage or infection. Typical of these tumors is a slow-growing, asymptomatic phase with the potential for rapid and massive expansion and a tendency to infiltrate into surrounding tissues.

The thoracodorsal artery perforator flap: clinical experience and anatomic study with emphasis on harvest techniques.

The thoracodorsal artery perforator flap is a relatively new flap that has yet to find its niche in reconstructive surgery. At the authors' institution it has been used for limb salvage, head and neck reconstruction, and trunk reconstruction in cases related to trauma, burns, and malignancy. The authors have found the flap to be advantageous for cranial base reconstruction and for resurfacing the face and oral cavity.

Bilateral breast reconstruction with the deep inferior epigastric perforator (DIEP) flap: an experience with 280 flaps.

Bilateral prophylactic mastectomy can reduce the incidence of breast cancer by 87 to 93% in high-risk individuals and is an appealing option for many patients if reconstruction can be provided with acceptable morbidity and outstanding esthetic results. Autogenous breast reconstruction techniques have evolved over the last 20 years to meet this goal. Familiarity with the deep inferior epigastric perforator (DIEP) flap led us to carry out simultaneous bilateral breast reconstruction with acceptable morbidity and superior esthetic outcome in 3 patient groups: (1) after bilateral prophylactic mastectomy, (2) after therapeutic and contralateral prophylactic mastectomy, and (3) after explantation of bilateral implant failures.

The role of topically administered FK506 (tacrolimus) at the time of facial nerve repair using entubulation neurorrhaphy in a rabbit model.

Peripheral facial nerve palsy is a common sequela of traumatic craniofacial injury, often resulting in dramatic and sometimes permanent functional deficits. Exogenous agents and methods of repair that accelerate axonal regeneration would be of great benefit to the multitude of patients with facial nerve injuries. The objective of this study was to evaluate the effect of FK506 at the time of facial nerve repair using entubulation neurorrhaphy, and to compare entubulation neurorrhaphy versus interposition autograft in critical facial nerve gap defects.

A 10-year retrospective review of 758 DIEP flaps for breast reconstruction.

This study examined 758 deep inferior epigastric perforator flaps for breast reconstruction, with respect to risk factors and associated complications. Risk factors that demonstrated significant association with any breast or abdominal complication included smoking (p = 0.0000), postreconstruction radiotherapy (p = 0.

Breast reconstruction with gluteal artery perforator (GAP) flaps: a critical analysis of 142 cases.

Fujino was the first to introduce gluteal tissue as a free flap for breast reconstruction. The use of the musculocutaneous flap from the buttock in breast reconstruction has been championed by Shaw. Despite the initial enthusiasm for this area as a donor site, few other large series exist on the subject.

The thoracodorsal artery perforator flap: anatomic basis and clinical application.

Based on the dissection of 20 fresh cadavers, the authors have detailed further the vascular anatomy of the thoracodorsal artery and its cutaneous perforator vessels. The thoracodorsal artery showed a constant bifurcation into a horizontal branch and a lateral branch, located on the deep surface of the latissimus dorsi muscle 4 cm (range, 3-6 cm) distal to the inferior scapular border and 2.5 cm (range, 1-4 cm) medial to the lateral free margin of the muscle.

The bare area of the upper conjunctiva: a closer look at the anatomy of transconjunctival upper blepharoplasty.

Transconjunctival upper blepharoplasty is a novel technique for which the overall experience has been limited. The authors have used this technique in 42 patients for eyelid rejuvenation, with predictable results and low morbidity. The authors previously described the "bare" area in the medial upper conjunctiva, which was initially noted during their clinical series.

Anterolateral thigh flap for breast reconstruction: review of the literature and case reports.

More women than ever before are undergoing mastectomies secondary to increased awareness and screening. This has also caused a corresponding increase in the number of breast reconstructions requested each year. The demand for improved results has fueled recent advances in new techniques.

New technique for nipple areola reconstruction: arrow flap and rib cartilage graft for long-lasting nipple projection.

The nipple-areola complex is an integral part of breast reconstruction. It serves as an important landmark for the new breast and many techniques have been described for its reconstruction. Historically, nipple projection has been most difficult to achieve and maintain.

Transconjunctival upper blepharoplasty: a safe and effective addition to facial rejuvenation techniques.

Transconjunctival techniques for eyelid rejuvenation are now well accepted in the lower eyelid. Transconjunctival upper blepharoplasty is a relatively new technique for which overall experience has been limited. Since October 1998, the authors performed 42 bilateral transconjunctival upper blepharoplasties on patients undergoing facial and eyelid rejuvenation.