Disasters and Impacts in Appalachian Kentucky: A Behavioral Health Analysis.

Introduction: Major disasters continue to occur in Appalachian Kentucky with devastating consequences. A major disaster, defined by the Federal Emergency Management Agency (FEMA) as an event too large for a community to manage without outside help, involves emergency responders from the local, state, and federal disaster agencies, plus national volunteers.

Purpose: This paper reports on recent disasters in eight southeast Kentucky counties, the changing nature of these disasters, and the behavioral health impact on the people affected.

Total Nasal Reconstruction: Advances in Free Tissue Transfer for Internal Lining and Structural Support.

Total nasal reconstruction is a complex challenge due to the need to establish new internal lining, internal structural support, and external skin covering that is both functional and esthetic. The medial femoral condyle corticoperiosteal free flap represents an innovative option for restoration internal structure and internal nasal lining. When used in conjunction with a paramedian forehead flap, acceptable results in both function and esthetics can be achieved.

Updates in Butterfly Graft Technique.

Nasal obstruction is a significant challenge greatly affecting individual quality of life. It is one of the most common presentations in the otolaryngology clinic, often persisting despite medical and, at times, surgical intervention. The butterfly graft has proven to be a veritable option addressing nasal valve collapse.

Casual Observers' Perception on the Aesthetics of the Butterfly Graft.

Objective: The butterfly graft is an effective technique for improving the internal nasal valve, however, there is hesitancy among surgeons due to possible aesthetic changes. This study aims to determine if average observers rated the post-operative appearance of the butterfly graft negatively.

Methods: An online survey was distributed by social media to non-medical observers in which they rated either the pre-operative or post-operative appearance of 22 patients' noses (11 butterfly graft, 11 spreader graft).

Body Dysmorphic Disorder in Adult Patients With an Orofacial Cleft: An Unseen Psychological Burden.

Objectives: Facial dysmorphic disorder (FDD), a variant of body dysmorphic disorder, occurs when individuals are preoccupied with perceived defects in their facial appearance. Cleft lip and/or palate (CL/P) requires many clinical interventions and has significant psychological impacts on a patient's perception of appearance. This study identified psychological burdens related to living as an adult with CL/P and characterizes the degree of FDD symptoms in an adult craniofacial population.

Anatomic Optical Coherence Tomography (aOCT) for Evaluation of the Internal Nasal Valve.

Objectives/hypothesis: To establish the utility of anatomic optical coherence tomography (aOCT) in evaluating internal nasal valve (INV).

Study Design: Anatomic specimen imaging study.

Methods: Fresh-harvested human specimen heads were evaluated using both computed tomography (CT) imaging as well as using aOCT.

Intraparotid Superficial Temporal Artery Arteriovenous Malformation Causing Persistent Pulsatile Tinnitus.

Objectives: This article discusses the diagnosis, imaging workup, and management of a rare cause of pulsatile tinnitus: intraparotid arteriovenous malformation.

Patient: A single patient with a superficial temporal arteriovenous malformation diagnosed by carotid duplex causing pulsatile tinnitus that failed initial surgical management. Repeat imaging failed to identify a cause for the persistent tinnitus.

Auricular avulsion injuries and reattachment techniques: A systematic review.

Objectives: Multiple surgical techniques exist in the acute management of auricular avulsion injuries, including reattachment of the tissue as a composite graft, reconstruction using local skin flaps, the pocket principle, the Baudet method, and microvascular repair. This review aimed to compare the success rates of reattachment methods in auricular avulsion injuries.

Methods: A PubMed search systematically identified cases in which (a) an auricular avulsion injury occurred and (b) reattachment was attempted.

Intraorbital Dermoid Cyst With Zygomaticofrontal Suture Erosion in an Adult.

Background: Dermoid cysts are squamous epithelium-lined sacs that result from abnormal migration of ectodermal cells. They are typically superficial and present in children. This study reviews a rare patient with a congenital dermoid cyst occurring as a superolateral intraorbital and extraconal mas.

Reconstruction of Defects Involving the Lip and Chin.

Successful perioral reconstruction is the result of consideration of both functional and esthetic goals. The lips are complex esthetic units with multiple tissue layers and distinct anatomic landmarks. Reconstruction can be difficult due to variables affecting the defect, such as size, depth, location, and involvement of adjacent subunits.