Results of a surgeon-directed quality improvement project on breast cancer surgery outcomes in South-Central Ontario.

Background: Gaps in breast cancer (BC) surgical care have been identified. We have completed a surgeon-directed, iterative project to improve the quality of BC surgery in South-Central Ontario.

Methods: Surgeons performing BC surgery in a single Ontario health region were invited to participate.

The implementation of a surgeon-directed quality improvement strategy in breast cancer surgery.

Background: The investigators designed a sustained, surgeon-directed, iterative project to improve the quality of breast cancer surgery in south central Ontario.

Methods: The strategy included audit and feedback of surgeon-selected quality indicators, workshops, and tailoring interviews. Workshops were held to discuss quality improvement strategies, select quality indicators, review audited results, and select interventions for subsequent implementation.

Topical mitomycin C in the prevention of keloid scar recurrence.

Objective: To assess the ability of mitomycin C to prevent the recurrence of surgically excised keloid scars. Mitomycin C has been successfully used to prevent scar tissue formation at the site of subglottic stenosis in the field of pediatric otolaryngology. It appears that mitomycin C interferes with the ability of fibroblasts to produce a scar without causing changes in epithelialization.

African American rhinoplasty.

This article describes the topographic and surgical anatomy of the African American nose and the surgical techniques used in the authors' practice.

Accuracy of ultrasound in localization of breast boost field.

Background And Purpose: To prospectively compare diagnostic ultrasound to the 'gold standard' of surgical clips for localization of the lumpectomy site for electron boost irradiation.

Patients And Methods: Consecutive breast cancer patients referred following lumpectomy underwent diagnostic ultrasound in radiation treatment position 21-100 days post-surgery. All patients had 3-6 surgical clips defining the excision cavity.

Aggressive fibromatosis of the parapharyngeal space: two cases and treatment recommendations.

Aggressive fibromatosis is an uncommon tumor that is locally aggressive but not malignant. Therefore, its classification falls between the benign and malignant neoplasms of soft-tissue origin. In the past, these lesions were misdiagnosed as low-grade fibrosarcomas.

The AbCs of rhinophyma management.

Background: Rhzinophyma is a benign inflammatory growth of the nose. It usually involves the caudal one-third of the nose in men. It not only affects the patient's appearance, but also can have profound functional implications.

Management of severe bilateral nasal wall collapse.

Objective: The aim of this study was to examine and analyze the pathology contributing to severe bilateral nasal wall collapse seen in certain revision rhinoplasty patients and identify those surgical maneuvers in the previous nasal surgery, which may have contributed to this complication; suggest alternatives or modifying steps in nasal surgery to prevent lateral wall collapse; analyze consecutive revision rhinoplasties and identify those patients who have complete bilateral nasal collapse at the internal nasal valve; and analyze the results achieved after surgical reconstruction of complete bilateral nasal collapse.

Patients: We identified 49 patients, who presented from 1990 to 2000 for revision surgery, who had bilateral collapse of the upper lateral cartilage. All patients had at least one previous rhinoplasty and all but 14 patients had undergone two or more procedures.

A method to repair auricular defects after perichondrial cutaneous grafting.

Objective: To describe and illustrate the technique for closing the auricular bowl defect after perichondrial cutaneous grafting. The postauricular flip-flop flap is used for this purpose.

Study Design: A retrospective clinical study of 354 patients using the perichondrial cutaneous graft for various reconstructions of the face and then performing the postauricular flip-flop flap procedure.