Publications by authors named "Vuyk H"

Importance: This study clarifies the pedicle geometry and vascular supply of a midline forehead flap for nasal reconstruction. It reports on the vascular reliability of this flap and its ability to reduce hair transposition to the nose, a major complicating factor of previous forehead flap designs.

Objective: To compare the vascular reliability of 3 different pedicle designs of the forehead flap in nasal reconstruction (classic paramedian, glabellar paramedian, and central artery flap design) and evaluate hair transposition rates and aesthetic results.

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Objectives/hypothesis: To assess the survival of full-thickness skin grafts and perichondrial cutaneous grafts when placed on subcutaneous soft tissue flaps used in nasal reconstruction.

Study Design: Retrospective case series from a secondary-care cutaneous cancer practice.

Methods: Twenty-eight patients with nasal defects secondary to basal cell carcinoma excision were included.

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Objective: Although protruding ears are one of the most frequently occurring congenital deformities in the craniofacial area, there is no clear consensus in literature as to the definition. Our aim was to provide a clear delineation for the definition of prominent ears, deduced from the anthropometry of normal (nonprotruding) ears.

Methods: We performed a prospective cohort study to assess the anatomy of the normal auricle in children using computer-assisted anthropometry in photographs of 102 children aged 5 to 18 years.

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Background: In facial and reconstructive surgery objective assessment of anatomy is crucial to evaluate surgical results. Photographic computer-assisted anthropometry substitutes clinical measurements. The constancy of the horizontal iris diameter (IDh) allows iris dependent calibration of photographs, replacing the need for a scale.

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Reconstruction of nasal tip and columella.

Facial Plast Surg Clin North Am

February 2011

Reconstruction of nasal tip and columella defects is demanding area with a range of reconstructive options, varying in complexity depending on requirements from simple skin grafting to multiple stage reconstruction with regional flaps. A framework is suggested to aid the reader in choice of reconstruction by classifying the defect based on size and the requirements of one to three layer (full thickness) reconstruction.

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Objectives/hypothesis: To determine and compare the efficacy of Mohs micrographic surgery (MMS)- and conventional excision (CE)-confirmed resection of nonmelanoma skin cancers (NMSCs).

Study Design: Retrospective cohort study.

Methods: A retrospective cohort study of NMSCs treated in a tertiary referral center by a single facial plastic surgeon and a group of five histopathologists over an 18-year period.

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The objective of the study is to determine efficacy in terms of survival rate and cosmesis of "normal" full-thickness skin grafts (FTSGs) as compared to perichondrial cutaneous grafts (PCCGs) in facial reconstruction. A chart review of all facial reconstructions using FTSGs and PCCGs between 1995 and 2005 was undertaken. All patients were treated by the same surgeon.

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Background: There is no consensus about the value of objective measurements of nasal patency.

Objective: To assess the correlation between the subjective sense of nasal patency and the outcomes found with rhinomanometry and acoustic rhinometry.

Type Of Review: Structured literature search.

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Objective: To assess the feasibility and outcome of free cartilage grafts left to heal by secondary intention in the reconstruction of nasal alar skin defects.

Design: We describe the retrospective analysis of 13 patients who were treated in a single department with the use of free cartilage grafts in combination with secondary intention healing for reconstruction of the alar subunit and lateral nasal wall defects after Mohs surgery for cutaneous cancer. Outcome measures included patient and surgeon satisfaction, alar retraction, cartilage extrusion, nasal valve collapse, revision rate, and time to healing.

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Background: Most data on secondary intention healing of skin cancer defects in the head and neck are empirical and descriptive. This study statistically evaluates the prognostic value of several wound characteristics and location on the final cosmetic result of skin defects left to heal by secondary intention after tumor removal.

Methods: A chart review of all facial reconstructions using secondary intention healing performed in one center between 1992 and 2001 was undertaken.

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Objective: To describe and evaluate our experience with the surgical technique of nasal valve suspension for treating nasal valve insufficiency.

Methods: Twenty patients with nasal valve insufficiency underwent nasal valve suspension (a total of 33 sides). The patients were prospectively studied and their nasal patency was rated per side pre- and postoperatively, by subjective self-evaluation on a scale from 1 to 10.

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Objective: To describe the experience of a single department using uncovered subcutaneous hinge flaps to repair the nasal portion and adjacent facial subunits of defects after skin tumor excision.

Design: Case series of 16 patients needing reconstruction for lesions of the alar subunit with 1 or more adjacent facial subunits after Mohs surgery for cutaneous malignant neoplasms.

Results: All flaps healed well by secondary intention, and the results were gauged at least satisfactory by the patients and surgeons.

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Objectives: The objectives of this study were to describe and compare two techniques used to correct nasal septum deviations located in the dorsal and/or caudal septum.

Study Design: The authors conducted a retrospective clinical chart review.

Methods: The authors conducted a comparison of functional and technical results between surgery in the L-strut of the septum in 114 patients with septal battens or by septal replacement by subjective self-evaluation and by examination of the position of the septum during follow up.

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In this article, we briefly review the aetiology and symptoms of nasal septal perforations, and focus on a surgical reconstruction technique of which the results were retrospectively studied. The technique described, involves the interposition of a connective tissue graft between differently designed local mucoperichondrial and/or mucoperiosteal flaps on each side of the perforation, thereby preventing opposing suture lines. On one side a rotation/advancement flap is derived from the septum, the nasal floor and lateral nasal wall while in the opposite nasal passage, bipedicled flaps from the septum and nasal floor and/or from the superior septum and under-surface of the upper lateral cartilage are created.

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Objective: To describe and evaluate the functional results of a surgical technique for treating nasal valve incompetence, in which a cartilage graft called a sub-alar batten graft is placed along the undersurface of the lateral crus of the lower lateral cartilage.

Methods: The functional outcomes of 27 patients who had sub-alar batten grafts placed on 39 sides were evaluated by means of clinical examination and subjective self-assessment.

Results: Of a total of 39 sides operated upon, 10 (26%) were rated as optimal, 15 (39%) as improved, 13 (33%) as equal and 1 (2%) as worse.

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The razor-blade shave technique uses a slightly-curved classic razor blade to shave and remove the exophytic part of a skin lesion and part of the intradermal structure down to the stratum papillare. It can then be sent for pathology investigations. This treatment is curative for many benign skin conditions.

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Objective: To describe and evaluate results of a surgical procedure to treat internal nasal valve insufficiency with the use of spreader grafts placed via an endonasal approach without division of the upper lateral cartilages from the nasal septum.

Design: Eighty-nine patients with complaints of nasal obstruction, at least partially due to internal nasal valve insufficiency, underwent this operation on 120 sides in a private practice setting. Only autologous material was used, and 3 different techniques for fixating the grafts were evaluated.

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Most otolaryngologists treat patients with chondrodermatitis nodularis (CDN) by wedge excision. Although the results of this technique are generally good, it can leave the patient with an asymmetric, deformed ear. In the dermatological literature, a relatively straightforward technique has been described for the treatment of CDN by smoothing only the underlying cartilage.

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Augmentation mentoplasty is a commonly performed operation especially in conjunction with rhinoplasty. While various materials have previously been used for this procedure, silastic has been the implant of choice for the last three decades. Concerns have been raised due to the occurrence of bone resorption beneath these implants.

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Although it is well established that conventional treatment modalities generally result in high cure rates for non-melanoma skin cancer, it has been demonstrated over recent decades that the highest overall cure rates are achieved using Mohs micrographic surgery. The key to Mohs surgery is the excision and control of complete peripheral and deep resection margins in one plane, allowing orientation, mapping and re-excision of microscopic tumour extension. These extensions can be followed without sacrificing inappropriate amounts of normal tissue, yielding high cure rates and maximum preservation of tissue.

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Out of the numerous implant materials that have been used for augmentation of the nasal dorsum, autogenous cartilage is considered to be the optimal grafting material due to its versatility and long-term survival. However, in the case of extensive augmentation often an alternative grafting material is needed. Homologous cartilage seems an attractive option, but is not commonly used because of the fear of disease transmission, the long-term unpredictability and the possibility of warping.

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