1/5. External rhinoplasty approach for repair of posttraumatic nasal deformity.Up to 50% of patients who have suffered a nasal fracture may seek reconstructive surgery because they are dissatisfied with their appearance and/or ability to breathe. Distortion of native anatomy and dissection planes increases with severity of the injury. The external rhinoplasty approach is a biologically sound technique that offers several advantages over endonasal access for the repair of complex nasal deformities. In 30 consecutive posttraumatic rhinoplasty cases over a 2-year period, 27 (90%) patients underwent correction of their deformities via the external rhinoplasty approach. No technique-specific sequelae were encountered, and all patients were satisfied with their respective result and the healing of the transcolumellar incision. This article reviews the advantages, disadvantages, and contraindications of the external rhinoplasty approach in the posttraumatic patient.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/5. Nasal cocaine abuse and centrofacial destructive process: report of three cases including treatment.We report 3 new cases of a centrofacial destructive process associated with chronic nasal abuse of cocaine. This complex first described in 1988 is a rare entity involving sinonasal tract necrosis after cocaine abuse. Of special interest in this report is a male patient with columella and lip involvement instead of the more usual rhinopalatal destruction. This cocaine abuse complex should be included in the differential diagnosis of centrofacial midline destructive processes in young patients as the first diagnostic possibility. We suggest a management strategy for these patients.- - - - - - - - - - ranking = 2keywords = complex (Clic here for more details about this article) |
3/5. A new cocaine abuse complex. Involvement of nose, septum, palate, and pharynx.A new complex of findings caused by cocaine abuse is presented. The complex consists of nasal collapse, septal perforation, palatal retraction, and pharyngeal wall ulceration. The findings and their causes are described. Pathologic evaluation to ensure that a concomitant disease, such as Wegener's granuloma, malignant reticulosis, autoimmune lesion, or various other destructive diseases, was not present was performed on only one patient. Although three patients presented with the findings caused by cocaine abuse, only one patient consented to the biopsy examinations. This case is presented in detail.- - - - - - - - - - ranking = 6keywords = complex (Clic here for more details about this article) |
4/5. The effects of nasomaxillary injury on future facial growth.The appearance of results of injury to the columella, the nasal septum, and the nasal bones, in particular, has been well described. Anomalies of the maxilla and global facial balance secondary to nasomaxillary injury are less well known. Three cases involving children, aged 11, 14, and 17 years, who had suffered nasomaxillary injury at least 8 years earlier as a result of physical beating, were studied with the use of photographs and architectural craniofacial lateral cephalometric radiographic analysis. The architectural craniofacial analysis of Delaire produced a graphic representation of the resultant maxillofacial deformities rather than a description of the deformities in terms of deviation from a statistical mean. Traumatic injury to the nasomaxillary complex provides an experimental model that implicates the role of the cartilaginous nasal septum and local functional conditions in the growth of the nasomaxillary complex. The importance of the functional premaxillary skeletal unit in balanced facial growth allows better understanding of the pathophysiology of malformation of this region.- - - - - - - - - - ranking = 2keywords = complex (Clic here for more details about this article) |
5/5. Limits for the use of forehead flaps for small and extensive midface reconstructions including septum/columella reconstructions.I describe six selected cases of challenging reconstructions in the midface including a small deepithelialised and tunnelled flap for volume-replacement and conjunctiva-reconstruction in the orbit and a case of septum/columella reconstruction with a tunnelled paramedian forehead flap. Big flaps for extensive complex reconstructions in the midface (cheek, lip, and nose) emphasis the efficiency of the flaps. In extensive reconstructions the paramedian forehead might primarily be used for lining. Indian forehead flaps should be dissected to the base in the upper eyelid to increase their strength and for greater versatility. The base can be de-epithelialised without threatening its viability. This procedure allows the flap to be tunnelled and increases the mobility of the flap. Long flaps can even be folded without delay.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |