The Pillars Concept: An Approach for Managing Hypertrophic Concha in Otoplasty.

Prominent ear deformities often result from a combination of hypertrophic conchal cartilage and an underdeveloped antihelical fold. Traditional otoplasty techniques, such as antihelical folding sutures and conchal setback maneuvers, may introduce tension and risk of relapse, leading to suboptimal aesthetic outcomes. The PILLARS CONCEPT: represents an alternative surgical approach specifically designed to address hypertrophic concha, ensuring stable and natural results.

Precision Rhinoplasty Cylindric Burrs-Sidewall Aesthetics.

The development of power instruments has led to great advances in rhinoplasty. It has helped to reduce operating time, minimize damage to the surrounding soft tissues, and allow precision bony modification compared with the use of manual rasps. Burrs help ensure precise results by (i) creating a smooth transition between the lateral nasal sidewall and the face, (ii) treating bony asymmetries, and (iii) producing homogeneous upper and middle thirds that softy translate into the upper lateral cartilages.

Precision Segmental Preservation Rhinoplasty: Avoiding Widening, Defining New Dorsal Esthetic Lines in Dorsal Preservation Rhinoplasty.

Experiencing great worldwide scientific excitement, the number of nose preservation surgeries has increased rapidly, promoting a considerable percentage of drawbacks and complications, causing many surgeons to recoil and return to classic resective techniques. In this study, we develop concepts that allow us to operate noses with preservation rhinoplasty that were previously considered to be among the absolute contraindications. Redefining new dorsal aesthetic lines, controlling the nasal lateral wall and the naso-facial groove surfaces, avoiding mid-vault widening and being precise in the design of bony and cartilaginous nasal profile, avoiding any type of irregularity, are strategies that will be presented.

Avoiding Aesthetic Drawbacks and Stigmata in Dorsal Line Preservation Rhinoplasty.

For over a century, discussion on the management of nasal dorsum has been a struggle between the techniques of resection and preservation. This is because, each technique has its advantages and disadvantages, with the Joseph technique dominating over the past 30 years despite its surgical stigmas. The dorsum preservation techniques offers a good option for the treatment of nasal hump but like resective techniques it has its drawbacks.

Rhinoplasty Dissection Planes (Subcutaneous, Sub-SMAS, Supra-perichondral, and Sub-perichondral) and Soft Tissues Management.

Rhinoplasty as an operation is akin to a game of chess, where every maneuver will influence the eventual outcome. Undoubtedly, more than one approach to the nasal soft tissues envelop can produce beautiful and safe results as will be described in the paper namely, the subcutaneous, sub-superficial musculoaponeurotic system, supra- and sub-perichondral planes. For different justifiable reasons surgeons have their preferences, regarding dissection planes on the tip, middle and upper thirds, and regarding the manipulation of the soft tissue layers and nasal ligaments.

History of Dorsum Conservative Techniques in Rhinoplasty: The Evolution of a Revived Technique.

The correction and management of the nasal hump has been a classic problem in rhinoplasty since the beginning of the aesthetic purpose of this surgery. For many years, the resective technique described by Joseph has been the battle horse to solve this problem but it has several drawbacks if not done properly. In the late 19th and early 20th centuries, a new dorsal conservative technique was born and for several years was an alternative option to treat the same problem without damaging the keystone area while preserving the dorsal connection between the upper lateral cartilage and the septum.

Middle turbinate mucosal flap: Low-morbidity option in the management of skull base defects.

Background: To describe the low morbidity of middle turbinate mucosal flap (MTMF) to repair anterior skull base defects.

Methods: Skull base endonasal endoscopic surgeries performed at a tertiary hospital between 2015 and 2018 were analyzed. Patients were divided into two groups according the existence or not of a significant intraoperative cerebrospinal fluid (CSF) leak.

A Segmental Approach in Dorsal Preservation Rhinoplasty: The Tetris Concept.

Rhinoplasty has become a detail-dependent surgery. With precise techniques better results have been achieved. We are continually searching for the ideal technique to offer predictable, accurate, and desired long-term results.

The Segmental Preservation Rhinoplasty: The Split Tetris Concept.

Dorsal preservation rhinoplasty has seen considerable advances in the recent years as many doctors have improved and developed new ideas on the subject. In the era of minimal trauma surgery, it is important to achieve a beautiful nasal aesthetic result with minimum injury to the nose. Preserving the main structures of the nasal pyramid has been pursued for more than a century, and some different approaches have been described and developed since then.

Periorbital Surgical Anatomy.

This article discusses the periocular anatomy region thoroughly because its knowledge in detail is of paramount importance for any surgeon dedicated to periocular surgery or any practitioner who dedicate their practice to aesthetic medicine. Mastering the anatomical details permits obtaining consistently good results with the minimal amount of complications possible.

Does pediatric septoplasty compromise midfacial growth? A systematic review.

Objective: Septal deviation is an important cause of impaired nasal breathing among pediatric patients. A widespread solution to septal deviation is septoplasty. However, there are certain controversies surrounding the effect of this technique on pediatric patients and its influence on the growth centers of the nose.

Sensitization profile in patients with respiratory allergic diseases: differences between conventional and molecular diagnosis (a cross-sectional study).

Background: Component-resolved diagnosis (CRD) allows to identify single molecular allergen components, and constitutes a routine practice in many allergy units. However, skin prick test (SPT) remains the technique of choice in many otorhinolaryngology departments, thus increasing the risk of using inadequate immunotherapies in patients with respiratory allergies. This study aimed to compare sensitization profiles determined by SPT and CRD in patients with respiratory allergy, and to explore the relationship between sensitization and type and severity of the respiratory disease.

Identification of Factors Related to Cases of Benign Paroxysmal Positional Vertigo Refractory to Canalicular Repositioning Maneuvers and Evaluation of the Need for Magnetic Resonance Imaging in their Management: Retrospective Analysis of a Series of 176 Cases.

 Benign paroxysmal positional vertigo (BPPV) is the most common form of peripheral vertigo, and, in most cases, it presents a favorable prognosis. The treatment is based on a series of specific canalicular repositioning maneuvers that offer an efficacy close to 100%. Despite this, there are cases that are refractory to treatment, with the persistence of the vertigo symptoms.

Head and Neck Manifestations of Granulomatosis with Polyangiitis: A Retrospective analysis of 19 Patients and Review of the Literature.

Granulomatosis with Polyangiitis (GPA) is a small vessel vasculitis characterized by a necrositing granulomatous inflammation of the upper and lower respiratory tracts and focal/proliferative glomerulonephritis. In more than 70% of the cases, the presenting symptoms are head and neck manifestations that are often misdiagnosed as infectious or allergic in etiology.  The present study provides an analysis of head and neck manifestations in a series of patients diagnosed with GPA.

Postoperative Care of the Facial Plastic Surgery Patient-Forehead and Blepharoplasty.

In any kind of surgery, postoperative care is essential for a good result, but especially when the matter at stake is facial plastic surgery. Despite having performed a perfect surgery, with the least amount of damage to the soft tissues and osteocartilaginous structures, minimal bleeding, and in terms of the surgical time, without adequate postoperative care our results can be affected considerably in the short and long run. Therefore, we must have very clear guidelines regarding postoperative care and the duties of our patients, which should be emphasized during the informed consent of the intervention.

Safe use of systemic bevacizumab for respiratory recurrent papillomatosis in two children.

Recurrent respiratory papillomatosis can be a devastating condition for a child, with severe consequences. Currently, there is no proven successful medical treatment. We describe the use of systemic bevacizumab to treat two children affected by aggressive recurrent respiratory papillomatosis.

Hearing outcomes of the active bone conduction system Bonebridge in conductive or mixed hearing loss.

Objective: The active transcutaneous bone conduction implant Bonebridge, is indicated for patients affected by bilateral conductive/mixed hearing loss or unilateral sensorineural hearing loss, showing hearing outcomes similar to other percutaneous bone conduction implants, but with a lower rate of complications. The aim of this study was to analyze the hearing outcomes in a series of 26 patients affected by conductive or mixed hearing loss and treated with Bonebridge.

Methods: 26 of 30 patients implanted with Bonebridge between October 2012 and May 2017, were included in the study.

Efficacy of particle repositioning manoeuvres in benign positional paroxysmal vertigo: A revision of 176 cases treated in a tertiary care centre.

Introduction And Objectives: Benign paroxysmal positional vertigo is the most common peripheral vertigo disease. The aim of this paper is to review the results obtained with the different specific particle repositioning manoeuvres, evaluating the possible risk factors linked to a poorer prognosis.

Methods: One hundred and seventy-six patients with a diagnosis of benign paroxysmal positional vertigo were reviewed retrospectively, of whom 150 had vertigo of the posterior canal, 20 had vertigo of the horizontal canal, 3 had vertigo of the superior canal, and 3 had a double vertigo.

Development and evaluation of an audiology app for iPhone/iPad mobile devices.

Conclusion: The application described in this study appears to be accurate and valid, thus allowing calculation of a hearing handicap and assessment of the pure-tone air conduction threshold with iPhone/iPad devices.

Objective: To develop and evaluate a newly developed professional, computer-based hearing handicap calculator and a manual hearing sensitivity assessment test for the iPhone and iPad (AudCal).

Methods: Multi-center prospective non-randomized validation study.