Laser epiglottopexy for laryngomalacia: 10 years' experience in the west of Scotland.

Objectives: To determine the results of laser epiglottopexy and to compare them with other surgical techniques for severe laryngomalacia.

Design: A retrospective 10-year case note review of laser epiglottopexy for severe laryngomalacia.

Setting: Royal Hospital for Sick Children, Glasgow, Scotland.

Optimal parameters for marking upper blepharoplasty incisions: a 10-year experience.

Although a variety of techniques for upper blepharoplasty have been described, few studies illustrate and clinically evaluate a system for marking incisions. Presented is a 10-year experience using a specific method for marking upper blepharoplasty incisions that consistently yielded excellent esthetic results. All upper blepharoplasties performed by the senior author between April, 1994 and April, 2004 were reviewed.

Effect of adhesion on the acoustic functioning of partial ossicular replacement prostheses in the cadaveric human ear.

Background: Adhesion formation following ossiculoplasty surgery has been implicated as a cause of the progressive deterioration of an initially good postoperative hearing result. Scar tissue between the partial ossicular reconstruction prosthesis (PORP) and adjacent middle ear structures is a common finding at revision surgery.

Objectives: This study aims to investigate the effects of simulated scarring on the microacoustic transmission characteristics of a PORP in the fresh cadaveric human temporal bone.

Outcome of antenatally diagnosed sacrococcygeal teratomas: single-center experience (1993-2004).

Aims: Sacrococcygeal teratomas (SCTs) are the commonest neonatal tumors with an incidence of approximately 1:30,000. There are few large single-center series and even fewer describing both their antenatal and postnatal course. We report the outcome of all fetuses investigated at a tertiary fetal medicine center with this diagnosis.

Scar management: prevention and treatment strategies.

Purpose Of Review: Aberrant wound healing results in unsightly scar, hypertrophic scar, and keloid formation, causing functional and cosmetic deformities, discomfort, psychological stress, and patient dissatisfaction. Scar prevention and management, both surgical and nonsurgical, continue to be important issues for the otolaryngologist.

Recent Findings: Both animal and human models continue to point to the integral role of transforming growth factor-beta in aberrant healing.

Surgical techniques for scar revision.

Patients frequently seek cosmetic improvement for existing scars. While no scar can be completely erased, dermatologic surgeons can employ a variety of approaches to achieve more esthetically pleasing scars. Classification of a scar abnormality guides the choice of treatment technique.

Binocular fixation topography in patients with diabetic macular oedema: possible implications for photocoagulation therapy (3rd revision).

Background: During retinal photocoagulation for diabetic maculopathy, there is a potential risk of foveal burns, and laser scars may later enlarge to be sight-threatening when involving retinal areas previously used during fixation. Since the retinal area used during binocular steady fixation has been found to vary considerably in the normal test person and central fixation may be even further compromised in patients with diabetic maculopathy, the sight-threatening side effects could possibly be reduced by taking into account the fixation area individually. However, no study has described and quantified the retinal area of fixation binocularly in patients with clinically significant macular oedema (CSME).

Scar revision.

Classic techniques of scar revision in general are ablative and remain the gold standard, although newer nonablative laser therapies, such as the frequency-doubled neodymium:yttrium-aluminum-garnet laser, can help. Ablative therapies and techniques are examined.

Resolution of retracted scar after 585-nm pulse dye laser surgery.

Background: Laser scar revision has been an effective method for improving several aspects of scarring through ablative and non-ablative sources. The 585-nm pulsed dye laser (PDL) is an important non-ablative instrument for reducing scar bulk and symptoms.

Objective: To describe the use of a 585-nm PDL for the treatment of a retracted and atrophic facial scar.

Successful treatment of a chronic atrophic dog-bite scar with the 1450-nm diode laser.

Background: Atrophic scars can be revised with surgical methods and more recently with newer ablative and nonablative laser techniques. Nonablative laser technology offers the advantage of improving the appearance of atrophic scars without the risks associated with traditional surgery or ablative lasers.

Methods: A case of a large linear atrophic dog-bite scar on the chin of greater than 2-year duration treated for three sessions at 4- to 6-week intervals with the 1450-nm diode laser is presented.

A preliminary study of utilization of the 1320-nm Nd:YAG laser for the treatment of acne scarring.

Background: Multiple treatment modalities have been used for the revision of acne scarring with varying degrees of success. Nonablative laser resurfacing has recently been shown to improve the appearance of atrophic acne scars.

Objective: The objective was to determine the efficacy of a 1320-nm Nd:YAG laser for the treatment of acne scars.

Update in scar revision.

Scar revision is indicated in certain situations for cosmetic and functional reasons. Improvement is not feasible with all scars; expectations must be tempered and realistic goals set. There is no generic approach to timing or technique in scar revision.

Comparison of a 1450-nm diode laser and a 1320-nm Nd:YAG laser in the treatment of atrophic facial scars: a prospective clinical and histologic study.

Background: Atrophic scar revision techniques, although numerous, have been hampered by inadequate clinical responses and prolonged postoperative recovery periods. Nonablative laser treatment has been shown to effect significant dermal collagen remodeling with minimal posttreatment sequelae. Although many studies have been published regarding the effectiveness of these nonablative lasers on rhytides, there are limited data demonstrating their specific effects on atrophic scars.

Non-ablative scar revision using a long pulsed frequency doubled Nd:YAG laser.

Objective: Unsightly scars often are the only reminder of a previous surgical or traumatic wound. Surgical or ablative scar revision is sought by patients, sometimes unnecessarily. When the aesthetic drawback is mainly a result of hypervascularity or hyperpigmentation, these problems can be specifically targeted with a wavelength that is well absorbed by the two above mentioned chromophores.

Laser treatment of scars.

Over the past decade, refinements in laser technology as well as advances in laser techniques have enabled dermatologic surgeons to define the most appropriate lasers to use for different scar types without the adverse sequelae and recurrence rates noted with older surgical revision techniques and continuous wave laser systems.

Pulsed-dye laser treatment for inflammatory acne vulgaris: randomised controlled trial.

Background: Low-fluence (low irradiation energy density) pulsed-dye lasers (PDLs) have been used for atrophic acne scarring, and anecdotal experience suggests that long-term improvements in inflammatory acne can be seen after one PDL treatment. Our aim was to compare the efficacy and tolerability of such PDL treatment with sham treatment in patients with facial inflammatory acne in a double-blind, randomised controlled trial.

Methods: We recruited 41 adults with mild-to-moderate facial inflammatory acne.

Simultaneous reconstruction of the secondary bilateral cleft lip and nasal deformity: Abbé flap revisited.

The purpose of this retrospective study was to review the method of using the Abbé flap for correction of secondary bilateral cleft lip deformity in selected patients with tight upper lip, short prolabium, lack of acceptable philtral column and Cupid's bow definition, central vermilion deficiency, irregular lip scars, and associated nasal deformity. A total of 39 patients with the bilateral cleft lip nasal deformity received Abbé flap and simultaneous nasal reconstruction during a period of 6 years. Mean patient age at the time of the operation was 19.

Dermabrasion in dermatology.

Dermabrasion has been used for a number of years to treat a variety of dermatologic conditions, including facial skin resurfacing and scar revision. The popularity of this procedure has diminished with the advent of newer procedures including chemical exfoliation, laser resurfacing, non-ablative laser resurfacing, and microdermabrasion. Dermabrasion found its niche in treating acne and traumatic facial scars, and in cosmetic facial resurfacing.

Lasers for facial rejuvenation: a review.

Background: Different types of laser are used for resurfacing and collagen remodeling in cutaneous laser surgery.

Methods: A systematic review was performed of the different types of laser currently employed for skin rejuvenation. These systems are either ablative [high-energy pulsed or scanned carbon dioxide (CO2) laser emitting at a wavelength of 10,600 nm, single- or variable-pulse or dual ablative/coagulative mode erbium:yttrium aluminum garnet (Er:YAG) laser emitting at a wavelength of 2940 nm, or systems combining both 10,600 nm and 2940 nm wavelengths] or nonablative [Q-switched neodymium:yttrium aluminum garnet (Nd:YAG) laser emitting at a wavelength of 1064 nm, Nd:YAG laser emitting at a wavelength of 1320 nm, or diode laser emitting at a wavelength of 1450 nm].

Management of adult facial vascular anomalies.

Vascular anomalies are best classified by biologic behavior-active hemangiomas, and inactive vascular malformations. Hemangioma growth is restricted to infancy, but residual deformity may persist to adult life in the form of redundant skin, bulky fibrofatty tissue, and ectatic cutaneous vessels. Treatment largely consists of scar revision and laser photocoagulation of residual vascular pigmentation.

Laser scar revision: comparison study of 585-nm pulsed dye laser with and without intralesional corticosteroids.

Background: Hypertrophic scars affect 1.5% to 4.5% of the general population and remain notoriously difficult to eradicate because of the high recurrence rates and the incidence of side effects associated with treatment.

Can thermal lasers promote skin wound healing?

Lasers are now widely used for treating numerous cutaneous lesions, for scar revision (hypertrophic and keloid scars), for tissue welding, and for skin resurfacing and remodeling (wrinkle removal). In these procedures lasers are used to generate heat. The modulation of the effect (volatilization, coagulation, hyperthermia) of the laser is obtained by using different wavelengths and laser parameters.

Treatment of atrophic facial acne scars with a dual-mode Er:YAG laser.

Background: Scar revision with CO2 and Er:YAG lasers has become popular in recent years. Reports on the newest (modulated, dual-mode) Er:YAG systems have been limited mostly to the treatment of photodamaged skin and rhytides.

Objective: To prospectively evaluate the efficacy and safety of a dual-mode 2940 nm Er:YAG laser for atrophic scar revision.

Dacryocystorhinostomy. Diagnosis and treatment of nasolacrimal canal obstructions.

Since Toti's original description of the dacryocystorhinostomy (CDR) in 1904, most surgery for relief of lacrimal obstruction has been performed through an external incision. Although the endonasal approach was for the first time introduced by Caldwell in 1893, its use stayed limited due to difficulties in visualizing the endonasal structures during the operation. The advance of the operating microscope and later a rigid endoscope into the surgery awakened interest for the endonasal approach.

Surgical voice rehabilitation after laser surgery for glottic carcinoma.

Transoral laser surgery today is the mainstay of treatment for T1 and T2 glottic carcinoma. The vocal ability remains sufficient in the majority of patients. However, in some cases, a significant glottic gap may persist, leading to poor voice quality.