From Stoke Mandeville Hospital, Aylesbury, Bucks.

Size: px
Start display at page:

Download "From Stoke Mandeville Hospital, Aylesbury, Bucks."

Transcription

1 STENOSIS OF THE NOSTRILS: A REPORT OF THREE CASES By P. S. BAjAJ, M.S., F.R.C.S.(Ed.), F.R.C.S. and B. N. BAILEY, F.R.C.S. From Stoke Mandeville Hospital, Aylesbury, Bucks. ACQUIRED stenosis of the anterior nares is caused by loss of the vestibular lining which may result from infection or trauma. Syphilis, tuberculosis or smallpox may involve the nasal mucosa, while the trauma may be that of burns, lacerations or surgical misadventure. O'Connor in 1937 described in detail the pathogenesis and treatment of this condition. Since then only three cases have been reported in the English literature: one by Shaw (1967) from India and two by Soni (1961) from Burma. It is interesting to note that all three cases developed stenosis of the nostrils following smallpox, which is reported to lead to this condition only occasionally (Barsky et al., 1964). We wish to report three cases seen at Stoke MandeviUe Hospital in a period of less than one year, each resulting from a different cause. Case I.--N.B., aged 5 years, was admitted in November 1967 with stenosis of both nostrils. Chemical cauterisation with trichloracetic acid had been performed in a casualty department to stop epistaxis three months prior to admission. The right nostril was completely blocked and the left one was about one-fourth of its normal size (Fig. I). Scar tissue was excised by inserting the point of a number xi B.P. scalpel and coring out the aperture. The raw surfaces were covered by a split skin graft on a stent mould, and maximum over-correction was attempted. Later the child was fitted with a Perspex prosthesis to maintain the nostrils in their over-corrected position and the mother advised of its constant use. The prosthesis consisted of two linked nostril plugs with holes drilled in them to allow nasal breathing. Unfortunately, the prosthesis was not regularly used after the child was discharged from hospital and when he was seen six weeks post-operatively the right nostril had contracted again to a pinhole. We hoped that the left airway might still be salvaged by regular use of the prosthesis, but when the child came back for review after three months, the prosthesis had been lost. Both the nostrils had contracted down to their pre-operative size. A repeat operative correction has been carried out and this time a prosthesis attached to an upper dental cap splint is being used (Figs. 2 and 3). Case 2.--K.B., aged I I years, an old case of cleft lip and palate, was admitted in October 1967 with a pinhole left nostril (Fig. 4). His cleft lip and anterior palate had been repaired at 2 months and the palate at the age of one year. The left airway was partly obstructed by a fold of mucosa along its lateral wall. A Z-plasty of that fold carried out at the age of 4 years and repeated at 9 years failed to achieve a satisfactory result. Thinning of the lateral wall of the left nostril carried out a year later was not any more successful. The final stenosis was due in part to the natural flattening of the cleft nostril but mainly to repeated surgical interventions. Excision of all the scar tissue and split skin grafting of the raw surface on the inside of the nostril using a stent mould was carried out as in the first case. The nostril was maintained in its dilated position by a prosthesis (worn continuously except for normal cleaning) for six months. Nine months post-operatively the nostril aperture is still well maintained (Fig-. 5)- Case 3.--R.M., aged 15 years, was admitted in February I968 with stenosis of both nostrils following smallpox at the age of 6 while he was in West Pakistan. The left nostril was completely blocked and the right one stenosed to less than half its size (Fig. 6). A similar procedure to the first case was carried out and the patient fitted with a prosthesis. Both nostrils remain satisfactorily dilated six months after the operation and use of the prosthesis has now ceased (Figs. 7 and 8). 269

2 270 BRITISH JOURNAL OF PLASTIC SURGERY FIG. I Pre-operative photograph of Case r. Note complete occlusion of right nostril and stenosis of left nostril. FIGS. 2land 3 Same case three months after the second operative correction.

3 STENOSIS OF THE NOSTRILS 27I DISCUSSION Stenosis occurs in the outer and upper part of the nasal vestibule. This is because the septal cartilage and medial crus of the ala are rigid and provide support while the flaccid alar wing gradually contracts with the formation of scar tissue, obliterating the upper lateral portions of the vestibule. The nasal skin is pulled over the free border of the ala with a rolling effect causing an apparent thickening in that area. Since stenosis is brought about by loss of vestibular lining, the only way to restore the normal aperture is to replace it. We have provided lining by split skin grafts after all the scar tissue has been excised and the opening restored to its original shape. To FrG. 4 FIo. 5 Pre-operative photograph of Case 2. Note pinhole left nostril. Same case nine months after the operation. compensate for the tendency of graft to contract, the nasal openings must be overcorrected and maintained in that position by a prosthesis for six months. O'Connor (r937) described a technique in which a pocket lined by a skin graft is made outside the scarred nostril before it is excised in a serrated manner to avoid ring contracture. Use of a small flap along the medial part of the floor of the nostril has been advocated to keep the graft from being completely annular (Barsky et al, I964). This flap is fashioned from the obstructive curtain of the nostril. In a severe case of stenosis several factors militate against flap manipulations. I. If the obstructing web is due to a genuine excess of tissue, Z-plasty may effect a cure, but when the constriction is due to shortage of tissue, Z-plasty can never increase the amount of lining. 2. Placing of sutures to obtain perfect inlaying of flaps is almost impossible in these small nostrils unless their alar bases and columeua are separated from the face, and this procedure may make matters worse. 3. The tiny stiff flaps which must be transposed through 9 0 to break the" constricting ring" may or may not survive, much less sit comfortably. If they do not heal by

4 272 BRITISH JOURNAL OF PLASTIC SURGERY FIG. 6 Pre-operative photograph of Case 3Note complete occlusion of left nostril and stenosis of right one. Fins. 7 and 8 Same case six months after the operation.

5 STENOSIS OF THE NOSTRILS 273 first intention, the raw area cicatrises and a vicious circle of (edema, fibrosis and scar contraction starts. 4- Tissue shortage must be treated by tissue replacement, and since a complete flap to line the vestibule tends to occlude its own orifice a graft must be used. 5- Split skin is the ideal resurfacing medium in a potentially infected cavity. Close contact and avoidance of ha:matoma formation will ensure IOO per cent. take. The natural tendency of grafts to contract is reduced at the end of six months but probably does not disappear completely for years. Over-correction should be maintained continuously for six months with the prosthesis removed only for the few seconds necessary to wash the nostril and the prosthesis. After six months night use only is suggested. As long as the prosthesis slips in easily it can be kept in reserve, but if there is any sign of difficulty its continuous use should be re-instituted. Over-correction is desirable in a child for there is little chance that even the softest and non-contracted graft will keep pace with surrounding development while it lines a concave surface. Full thickness skin has been used to cover the raw area in stenosis following excessive removal of the vestibular lining (Converse, 1964). This is supported by a small acrylic shell-like prosthesis worn inside the vestibule for long periods and even permanently. The Wolfe graft is less reliable than the Thiersch graft in obtaining IOO per cent. take, and both require prostheses. Whatever technique is used the crux of the problem is the use of a prosthesis. In the first case the child's parents did not realise the importance of constant use of the prosthesis, and rapid return of the stenosis occurred despite early correction. Cases 2 and 3 were co-operative and show excellent results. SUMMARY Three cases of stenosis of nostrils are reported. One of them was due to cicatrisation following chemical burns, the second one resulted from fibrosis following repeated surgical procedures on his left nostril, and the third was a sequel of smallpox. Treatment by excision of scar tissue and Thiersch grafting is described. The importance of the use of prosthesis to maintain the nostrils in an over-corrected position in the post-operative period is stressed. REFERENCES BARSKY, A. J., KAHN, S. and BERNARD, E. W. (1964). "Principles and Practice of Plastic Surgery". New York: Mccaraw-Hill. CONVERSE, J. M. (1967). "Reconstructive Plastic Surgery," Vol. II. Philadelphia: Saunders. O'CONNOR, B. Ca. (1947). Archs Otolar. 25, 208. SHAW, J. S. (1967). Plastic reconstr. Surg. 39, 57. SONI, R. L. (I961). Burma Ivied. J. 9, 179.

Plastic Surgeon, Middlesbrough General Hospital, Stockton Children's Hospital, Newcastle Regional Hospital Board

Plastic Surgeon, Middlesbrough General Hospital, Stockton Children's Hospital, Newcastle Regional Hospital Board THE NASAL TIP IN BILATERAL HARE LIP By J. POTTER, F.R.C.S.Ed. Plastic Surgeon, Middlesbrough General Hospital, Stockton Children's Hospital, Newcastle Regional Hospital Board IN the problem of the bilateral

More information

Vancouver, B.C., Canada

Vancouver, B.C., Canada THE "ALAR SHIFT" REVISITED By THEODORE F. WILKIE, B.A., M.D., F.R.C.S.(C), F.A.C.S. Vancouver, B.C., Canada IN the hands of many plastic surgeons certain procedures have an evanescent history. Usually

More information

RECONSTRUCTION OF SUBTOTAL DEFECTS OF THE NOSE BY ABDOMINAL TUBE FLAP. By MICHAL KRAUSS. Plastic Surgery Hospital, Polanica-Zdroj, Poland

RECONSTRUCTION OF SUBTOTAL DEFECTS OF THE NOSE BY ABDOMINAL TUBE FLAP. By MICHAL KRAUSS. Plastic Surgery Hospital, Polanica-Zdroj, Poland RECONSTRUCTION OF SUBTOTAL DEFECTS OF THE NOSE BY ABDOMINAL TUBE FLAP By MICHAL KRAUSS Plastic Surgery Hospital, Polanica-Zdroj, Poland RECONSTRUCTION of the nose is one of the composite procedures in

More information

Scientific Forum. Nostrilplasty: Raising, Lowering, Widening, and Symmetry Correction of the Alar Rim

Scientific Forum. Nostrilplasty: Raising, Lowering, Widening, and Symmetry Correction of the Alar Rim Nostrilplasty: Raising, Lowering, Widening, and Symmetry Correction of the lar Rim Richard Ellenbogen, MD; and Greg azell, MD ackground: lthough the alar rim has frequently been neglected in correction

More information

Proboscis lateralis: report of two cases

Proboscis lateralis: report of two cases The British Association of Plastic Surgeons (2003) 56, 704 708 CASE REPORT Proboscis lateralis: report of two cases Lütfi Eroğlu a, *, Osman Ata Uysal b a Faculty of Medicine, Department of Plastic and

More information

BONE GRAFTING IN TREATMENT OF CLEFT LIP AND PALATE 337

BONE GRAFTING IN TREATMENT OF CLEFT LIP AND PALATE 337 PRIMARY BONE GRAFTING IN THE TREATMENT OF CLEFT LIP AND PALATE WITH SPECIAL REFERENCE TO ALVEOLAR COLLAPSE By FRANK ROBINSON, F.R.C.S., and BARRIE WOOD, L.D.S. Burns and Plastic Surgery Unit, Booth Hall

More information

ORIGINAL ARTICLE. patients with impaired nasalbreathingandaestheticdiscomfortduetostenosisofthenasalvestibule.

ORIGINAL ARTICLE. patients with impaired nasalbreathingandaestheticdiscomfortduetostenosisofthenasalvestibule. ORIGINAL ARTICLE Postoperative Management of Nasal Vestibular Stenosis The Custom-made Vestibular Device Dirk-Jan Menger, MD; Peter J. F. M. Lohuis, MD, PhD; Steven Kerssemakers, MD; Gilbert J. Nolst Trenité,

More information

All surgery carries some uncertainty and risk

All surgery carries some uncertainty and risk Dr Mi chel s on@mi chel s onmd. com All surgery carries some uncertainty and risk While scar revision is normally safe, there is always the possibility of complications. These may include infection, bleeding,

More information

UCL Repair: Emphasis on Muscle Dissection and Reconstruction

UCL Repair: Emphasis on Muscle Dissection and Reconstruction UCL Repair: Emphasis on Muscle Dissection and Reconstruction Unilateral cleft lip repair is performed using rotation-advancement technique. Markings are made on columella base, redlines, Cupid s bow on

More information

From the Orthopaedic Department, St. George's Hospital Medical School, London S.W.I.

From the Orthopaedic Department, St. George's Hospital Medical School, London S.W.I. TRANSPLANTATION OF THE NAIL: A CASE REPORT By NICHOLAS P. PAPAVASSlI.IOU, M.D. 1 From the Orthopaedic Department, St. George's Hospital Medical School, London S.W.I. THE loss of a finger nail may be of

More information

CARCINOMA IN A RECONSTRUCTED (ESOPHAGUS. By PERCY H. JAYES, M.B., F.R.C.S. From The Queen Victoria Hospital, East Grinstead

CARCINOMA IN A RECONSTRUCTED (ESOPHAGUS. By PERCY H. JAYES, M.B., F.R.C.S. From The Queen Victoria Hospital, East Grinstead CARCINOMA IN A RECONSTRUCTED (ESOPHAGUS By PERCY H. JAYES, M.B., F.R.C.S. From The Queen Victoria Hospital, East Grinstead THE purpose of this short paper is twofold: first, to report a condition which

More information

Rotation-Advancement Principle. in Cleft Lip Closure. D. RALPH MILLARD, JR., M.D., F.A.C.S. Miami, Florida

Rotation-Advancement Principle. in Cleft Lip Closure. D. RALPH MILLARD, JR., M.D., F.A.C.S. Miami, Florida Rotation-Advancement Principle in Cleft Lip Closure D. RALPH MILLARD, JR., M.D., F.A.C.S. Miami, Florida Correction of prealveolar, alveolar, and postalveolar clefts poses a fivefold project: natural appearance,

More information

THE pedicled flap, commonly used by the plastic surgeon in the reconstruction

THE pedicled flap, commonly used by the plastic surgeon in the reconstruction THE PEDICLE!) SKIN FLAP ROBIN ANDERSON, M.D. Department of Plastic Surgery THE pedicled flap, commonly used by the plastic surgeon in the reconstruction of skin and soft tissue defects, differs from the

More information

International Journal of Medical Science and Education

International Journal of Medical Science and Education International Journal of Medical Science and Education www.ijmse.com Original Research Article pissn- 2348 4438 eissn-2349-3208 A PROSPECTIVE STUDY OF POST BURN CONTRACTURE: INCIDENCE, PREDISPOSING FACTORS,

More information

Institute of Reconstructive Surgery, Sofia, Bulgaria

Institute of Reconstructive Surgery, Sofia, Bulgaria TRANSPOSITION OF THE LATERAL SLIPS OF THE APONEUROSIS IN TREATMENT OF LONG-STANDING " BOUTONNIERE DEFORMITY " OF THE FINGERS By IVAN MATEV Institute of Reconstructive Surgery, Sofia, Bulgaria RUPTURE of

More information

TREATMENT OF CLEFT PALATE ASSOCIATED WITH MICROGNATHIA. By RANDELL CHAMPION, F.R.C.S.(Ed.) From the Duchess of York Hospital for Babies, Manchester

TREATMENT OF CLEFT PALATE ASSOCIATED WITH MICROGNATHIA. By RANDELL CHAMPION, F.R.C.S.(Ed.) From the Duchess of York Hospital for Babies, Manchester TREATMENT OF CLEFT PALATE ASSOCIATED WITH MICROGNATHIA By RANDELL CHAMPION, F.R.C.S.(Ed.) From the Duchess of York Hospital for Babies, Manchester IN spite of the present-day technique and medical research

More information

Nose Reshaping (Rhinoplasty)

Nose Reshaping (Rhinoplasty) Nose Reshaping (Rhinoplasty) Are you interested in improving the appearance of your nose? If so, you re not alone. Nose reshaping, or rhinoplasty, is one of the most common plastic surgery procedures performed

More information

Surgical Treatment of Short Nose

Surgical Treatment of Short Nose Surgical Treatment of Short Nose Dr. Otto YT Au MD (JEFFERSON, USA) 1957, MCPS (MANITOBA) 1963, FHKAM (SURGERY) 1995 Diplomate American Board Plastic Surgery Plastic Surgery Specialist Dr.OttoYTAu A nice

More information

RHINOPLASTY (NOSE RE-SHAPING)

RHINOPLASTY (NOSE RE-SHAPING) PROCEDURE FACT SHEET PLASTIC SURGERY RHINOPLASTY (NOSE RE-SHAPING) This is a guide for people who are considering having a nose re-shaping (Rhinoplasty) operation. We advise that you talk to a plastic

More information

MOHS MICROGRAPHIC SURGERY: AN OVERVIEW

MOHS MICROGRAPHIC SURGERY: AN OVERVIEW MOHS MICROGRAPHIC SURGERY: AN OVERVIEW SKIN CANCER: Skin cancer is far and away the most common malignant tumor found in humans. The most frequent types of skin cancer are basal cell carcinoma, squamous

More information

King's College Hospital Dental School, London, S.E. 5.

King's College Hospital Dental School, London, S.E. 5. OSTECTOMY AT THE MANDIBULAR SYMPHYSIS J. H. SOWRAY, B.D.S., F.D.S.R.C.S. (Eng.), L.R.C.P., M.R.C.S. and R. HASKELL, M.B., B.S., F.D.S.R.C.S. (Eng.). King's College Hospital Dental School, London, S.E.

More information

Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear

Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear The British Association of Plastic Surgeons (2004) 57, 238 244 Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear Yong Oock Kim*, Beyoung Yun Park, Won Jae Lee Institute

More information

Specially Processed Heterogenous Bone and Cartilage Transplants in Nasal Surgery

Specially Processed Heterogenous Bone and Cartilage Transplants in Nasal Surgery Specially Processed Heterogenous Bone and Cartilage Transplants in Nasal Surgery By GRAEME M. CLARK (Melbourne) IN nasal surgery, cartilage or bone transplants are required for support or correction of

More information

Columella Lengthening with a Full-Thickness Skin Graft for Secondary Bilateral Cleft Lip and Nose Repair

Columella Lengthening with a Full-Thickness Skin Graft for Secondary Bilateral Cleft Lip and Nose Repair Original Article Columella Lengthening with a Full-Thickness Skin Graft for Secondary Bilateral Cleft Lip and Nose Repair Yoon Seok Lee 1, Dong Hyeok Shin 1, Hyun Gon Choi 1, Jee Nam Kim 1, Myung Chul

More information

8 External Ear Canal Surgery

8 External Ear Canal Surgery 30 Chapter 8 8 External Ear Canal Surgery Henning Hildmann, Holger Sudhoff Surgery in the external auditory canal without surgery in the middle ear may be necessary: 1. After surgery 2. After trauma 3.

More information

Principles of flap reconstruction in ORL-HN defects. O.M. Oluwatosin Department of Surgery

Principles of flap reconstruction in ORL-HN defects. O.M. Oluwatosin Department of Surgery Principles of flap reconstruction in ORL-HN defects O.M. Oluwatosin Department of Surgery Nasal defects and deformities Cleft palate and Velopharyngeal incompetence Pharyngeal and oesophageal defects Pinnal

More information

Core Curriculum Syllabus Emergencies in Otolaryngology-Head and Neck Surgery FACIAL FRACTURES

Core Curriculum Syllabus Emergencies in Otolaryngology-Head and Neck Surgery FACIAL FRACTURES Core Curriculum Syllabus Emergencies in Otolaryngology-Head and Neck Surgery A. General Considerations FACIAL FRACTURES Look for other fractures like skull and/or cervical spine fractures Test function

More information

Dr. N. Retnakumari. MDS, M.Phil, Dr. Manuja Vargheese, Dr. Madhu.S, Dr. Divya. S

Dr. N. Retnakumari. MDS, M.Phil, Dr. Manuja Vargheese, Dr. Madhu.S, Dr. Divya. S IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861. Volume 12, Issue 5 (Nov.- Dec. 2013), PP 11-15 A new approach in Presurgical Infant Orthopedics using an Active

More information

MedStar Health considers Septoplasty-Rhinoplasty medically necessary for the following indications:

MedStar Health considers Septoplasty-Rhinoplasty medically necessary for the following indications: MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.038.MH Septoplasty-Rhinoplasty This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP CSNP MedStar CareFirst

More information

THE OPEN PALM TECHNIQUE IN DUPUYTREN'S CONTRACTURE. By CHARLES R. MCCASH, Ch.M., F.R.C.S.E. Roehampton Plastic Surgery Centre, London

THE OPEN PALM TECHNIQUE IN DUPUYTREN'S CONTRACTURE. By CHARLES R. MCCASH, Ch.M., F.R.C.S.E. Roehampton Plastic Surgery Centre, London THE OPEN PALM TECHNIQUE IN DUPUYTREN'S CONTRACTURE By CHARLES R. MCCASH, Ch.M., F.R.C.S.E. Roehampton Plastic Surgery Centre, London IN 1833 Baron Dupuytren laid down the essential principles in the operative

More information

RICHARD J. SORBERA, D.D.S. SHIBLY D. MALOUF, D.D.S., INC. DIPLOMATES AMERICAN BOARD OF ORAL AND MAXILLOFACIAL SURGERY

RICHARD J. SORBERA, D.D.S. SHIBLY D. MALOUF, D.D.S., INC. DIPLOMATES AMERICAN BOARD OF ORAL AND MAXILLOFACIAL SURGERY RICHARD J. SORBERA, D.D.S. SHIBLY D. MALOUF, D.D.S., INC. DIPLOMATES AMERICAN BOARD OF ORAL AND MAXILLOFACIAL SURGERY INFORMATION AND CONSENT FOR IMPLANT SURGERY PURPOSE OF THIS FORM: State law requires

More information

INTRODUCTION. Typical secondary bilateral cleft lip nasal deformities present a short columella, a laterally-spreading dome of the alar cartilages

INTRODUCTION. Typical secondary bilateral cleft lip nasal deformities present a short columella, a laterally-spreading dome of the alar cartilages The Correction of a Secondary ilateral Cleft Lip Nasal Deformity Using Refined Open Rhinoplasty with Reverse-U Incision, V-Y Plasty, and Selective Combination with Composite Grafting: Long-term Results

More information

A Clinical Study on the Gingival Regeneration with Reference to the Curative Process. Masao K US UNOKI * and Noriko F UJISAKI *

A Clinical Study on the Gingival Regeneration with Reference to the Curative Process. Masao K US UNOKI * and Noriko F UJISAKI * A Clinical Study on the Gingival Regeneration with Reference to the Curative Process by Masao K US UNOKI * and Noriko F UJISAKI * In 1962 the authors published their study as " 303 Clinical Cases of the

More information

11/13/2017. Complications of Flexor Tendon Repair. Brandon E. Earp, M.D. How do we best get there?

11/13/2017. Complications of Flexor Tendon Repair. Brandon E. Earp, M.D. How do we best get there? Complications of Flexor Tendon Repair Brandon E. Earp, M.D. Chief of Orthopaedic Surgery Brigham and Women s Faulkner Hospital Vice-Chair of Clinical Operations Brigham and Women s Hospital Frontiers in

More information

Role of free tissue transfer in management of chronic venous ulcer

Role of free tissue transfer in management of chronic venous ulcer Original Article Role of free tissue transfer in management of chronic venous ulcer K. Murali Mohan Reddy, D. Mukunda Reddy Department of Plastic Surgery, Nizams Institute of Medical Sciences, India. Address

More information

INFORMATION REGARDING YOUR NASAL SURGERY

INFORMATION REGARDING YOUR NASAL SURGERY INFORMATION REGARDING YOUR NASAL SURGERY This document contains information about the following aspects of nasal surgery: Pre-op information: How to prepare for surgery. Procedure: Wat is done during surgery.

More information

Surgical treatment for Dupuytren s disease

Surgical treatment for Dupuytren s disease Surgical treatment for Dupuytren s disease Hand Surgery Patient Information Leaflet Introduction This leaflet is for people who have been diagnosed with Dupuytren s disease and who are considering surgical

More information

By SIDNEY KAHN, M.D., and JOSEPH WINSTEN, M.D. From the Plastic Surgical Service of Dr Arthur 3?. Barsky, Mount Sinai Hospital, New York City

By SIDNEY KAHN, M.D., and JOSEPH WINSTEN, M.D. From the Plastic Surgical Service of Dr Arthur 3?. Barsky, Mount Sinai Hospital, New York City SURGICAL APPROACHES TO THE BILATERAL CLEFT LIP PROBLEM By SIDNEY KAHN, M.D., and JOSEPH WINSTEN, M.D. From the Plastic Surgical Service of Dr Arthur 3?. Barsky, Mount Sinai Hospital, New York City INTRODUCTION

More information

Dr Doron Sher MB.BS. MBiomedE, FRACS(Orth)

Dr Doron Sher MB.BS. MBiomedE, FRACS(Orth) Dr Doron Sher MB.BS. MBiomedE, FRACS(Orth) Knee, Shoulder, Elbow Surgery PATIENT NOTES ROTATOR CUFF REPAIR You have elected to undergo an operation to repair the Rotator Cuff of your shoulder because it

More information

Stanford University School of Medicine, Department of Surgery, Stanford, California

Stanford University School of Medicine, Department of Surgery, Stanford, California THE RESTRICTIVE PHARYNGEAL FLAP By JAROY WEBER, Jr., M.D., ROBERT A. CHASE, M.D. and RICHARD P. JOBE, M.D. Stanford University School of Medicine, Department of Surgery, Stanford, California THE historical

More information

Complete denture copy technique A practical application

Complete denture copy technique A practical application Singapore Dental Journal 35 (2014) 65 70 Available online at www.sciencedirect.com journal homepage: www.elsevier.com/locate/sdj Case report Complete denture copy technique A practical application Steven

More information

Correction of the Retracted Alar Base

Correction of the Retracted Alar Base 218 William D. Losquadro, M.D. 1 Anthony Bared, M.D. 2 Dean M. Toriumi, M.D. 2 1 Mount Kisco Medical Group, Katonah, New York 2 Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology

More information

The Hospital for Sick Children, Great Ormond Street, London

The Hospital for Sick Children, Great Ormond Street, London EARLY AND LATE BONE GRAFTING IN CASES OF CLEFT LIP AND PALATE By D^vm NIATTHEWS, O.B.E., M.Chir., F.R.C.S., IVOR BROOMHEAD, M.Chir., F.R.C.S., WILLIAM GROSSMANN, M.D., D.Orth. R.C.S. and HENRY GOLDIN,

More information

What is an otoplasty?

What is an otoplasty? What is an otoplasty? Otoplasty in an operation performed to reduce one or both prominent ears. Children with prominent ears have excess cartilage in the bowl or concha that protruded the ear out away

More information

By FENTON BRAITHWAITE~ O.B.E.~ F.R.C.S., M.Sc., and J. WATSON, F.R.C.S.E. From the Queen Victoria Hospital, East Grinstead

By FENTON BRAITHWAITE~ O.B.E.~ F.R.C.S., M.Sc., and J. WATSON, F.R.C.S.E. From the Queen Victoria Hospital, East Grinstead SOME OBSERVATIONS ON THE TREATMENT OF THE DORSAL BURN OF THE HAND By FENTON BRAITHWAITE~ O.B.E.~ F.R.C.S., M.Sc., and J. WATSON, F.R.C.S.E. From the Queen Victoria Hospital, East Grinstead INTRODUCTION

More information

ORIGINAL ARTICLE. Reconstruction of the Nasal Columella. David A. Sherris, MD; Jon Fuerstenberg, MD; Daniel Danahey, MD, PhD; Peter A.

ORIGINAL ARTICLE. Reconstruction of the Nasal Columella. David A. Sherris, MD; Jon Fuerstenberg, MD; Daniel Danahey, MD, PhD; Peter A. ORIGINAL ARTICLE Reconstruction of the Nasal Columella David A. Sherris, MD; Jon Fuerstenberg, MD; Daniel Danahey, MD, PhD; Peter A. Hilger, MD Objective: To report techniques successful for nasal columella

More information

76 Inventors: late Stella YErin, 5,479,944 1/1996 Petruson /858

76 Inventors: late Stella YErin, 5,479,944 1/1996 Petruson /858 USOO593.1799A United States Patent (19) 11 Patent Number: 5,931,799 Guastella et al. (45) Date of Patent: Aug. 3, 1999 54 PARASEPTAL SPLINT FOR USE IN 4,340,040 7/1982 Straith... 606/204.45 SURGICAL NASAL

More information

Fibular Bone Graft for Nasal Septal Reconstruction: A Case Report

Fibular Bone Graft for Nasal Septal Reconstruction: A Case Report 220 Nasal septal reconstruction Case Report Fibular Bone Graft for Nasal Septal Reconstruction: A Case Report Yakup Cil1* Diyarbakır Military Hospital, Department of Plastic Surgery 21000 Diyarbakır, Turkey

More information

Department of Plastic Surgery. Forehead Flap Reconstruction

Department of Plastic Surgery. Forehead Flap Reconstruction Department of Plastic Surgery This leaflet explains more about a forehead flap reconstruction procedure and what to expect. We may use this type of flap following skin surgery to your nose, to repair the

More information

SEMI- ANNUAL FELLOWSHIP REPORT June 2015 to December 2015

SEMI- ANNUAL FELLOWSHIP REPORT June 2015 to December 2015 SEMI- ANNUAL FELLOWSHIP REPORT June 2015 to December 2015 Submitted by, Dr.Arun Ramaiah., Resident fellow, St.Thomas Cleft and Craniofacial centre. Letter to CCI To start with I would like to thank Cleft

More information

Mr Glenn Watson M.B., B.S., B.Sc. (Hons), F.R.A.C.S. Ear, Nose and Throat Head and Neck Surgeon

Mr Glenn Watson M.B., B.S., B.Sc. (Hons), F.R.A.C.S. Ear, Nose and Throat Head and Neck Surgeon Mr Glenn Watson M.B., B.S., B.Sc. (Hons), F.R.A.C.S. Ear, Nose and Throat Head and Neck Surgeon FUNCTIONAL RHINOPLASTY SURGERY A guide for Mr Watson s patients During your consultation with Mr Watson,

More information

Primary Repair of Unilateral Cleft Lip Nasal Deformity

Primary Repair of Unilateral Cleft Lip Nasal Deformity CLEFT THE IRAQI LIP POSTGRADUATE NASAL DEFORMITY MEDICAL JOURNAL VOL.8, NO.3, 2009 Primary Repair of Unilateral Cleft Lip Nasal Deformity Zakaria Y.Arajy*, Ahmed A.M.Nawres** ABSTRACT: BACKGROUND: There

More information

Thomas T. Jeneby, M.D Wurzbach Suite 801 San Antonio, TX /

Thomas T. Jeneby, M.D Wurzbach Suite 801 San Antonio, TX / Nose reshaping, or rhinoplasty, is one of the most common plastic surgery procedures performed today. Often, the structure or size of the nose is not proportionate with the other features on the face.

More information

Associate Professor of Plastic Surgery, Karol. Institute; Plastic Department, Serafimerlasarettet, Stockholm, Sweden

Associate Professor of Plastic Surgery, Karol. Institute; Plastic Department, Serafimerlasarettet, Stockholm, Sweden A NEW METHOD OF SHAPING DEFORMED EARS By A. RAGNELL, M.D. Associate Professor of Plastic Surgery, Karol. Institute; Plastic Department, Serafimerlasarettet, Stockholm, Sweden NUMEROUS methods of shaping

More information

Dupuytren s contracture

Dupuytren s contracture Patient information Dupuytren s contracture i Important information for all patients. Golden Jubilee National Hospital Agamemnon Street Clydebank, G81 4DY (: 0141 951 5000 www.nhsgoldenjubilee.co.uk Last

More information

Surgical Therapy. Tuesday, April 2, 13. Alessan"o Geminiani, DDS, MS

Surgical Therapy. Tuesday, April 2, 13. Alessano Geminiani, DDS, MS Surgical Therapy Alessan"o Geminiani, DDS, MS Periodontal Flap: a surgical procedure in which incisions are made in the gingiva or mucosa to allow for separation of the epithelium and connective tissues

More information

Treatment Considerations in Management of Soft Tissues Injuries A Case Report. Key Words: Facial Injuries, Delayed Treatment, Antibiotics, Scar, etc.

Treatment Considerations in Management of Soft Tissues Injuries A Case Report. Key Words: Facial Injuries, Delayed Treatment, Antibiotics, Scar, etc. ISSN-0975-8437 INTERNATIONAL JOURNAL OF DENTAL CLINICS: 2 (1):22-27 CASE REPORT Treatment Considerations in Management of Soft Tissues Injuries A Case Report Siddqua Aaisha MDS 1 and Thakur Nitin MDS 2

More information

19 THE ORIGINAL ADVANCEMENT

19 THE ORIGINAL ADVANCEMENT 19 THE ORIGINAL ADVANCEMENT GRADUALLY CHANGES NV TWOTHIRDS OF THE LIP INCLUDING TWOTHIRDS OF THE CUPIDS BOWONE PHILTRUM COLUMN AND THE DIMPLE ROTATED DOWN INTO NORMAL POSITION THE REMAINING ONETHIRD OF

More information

Trigeminal Trophic Syndrome: Report of 2 Cases

Trigeminal Trophic Syndrome: Report of 2 Cases Trigeminal Trophic Syndrome: Report of 2 Cases Yoko Osaki, MD, Tateki Kubo, MD, PhD, Kyosuke Minami, MD, and Daisuke Maeda, MD Department of Plastic Surgery, Osaka Rosai Hospital, Sakai, Japan Correspondence:

More information

Principles of Facial Reconstruction After Mohs Surgery

Principles of Facial Reconstruction After Mohs Surgery Objectives Principles of Facial Reconstruction After Mohs Surgery Identify important functional anatomy and aesthetic units of the face. Describe techniques used in facial reconstruction. Discuss postoperative

More information

ABDOMINOPLASTY TUMMY TUCK

ABDOMINOPLASTY TUMMY TUCK ABDOMINOPLASTY TUMMY TUCK Modified Brazilian Technique... 1-20 Hernia Repair - Modified Brazilian Tummy Tuck... 21-23 Fleur de Lys... 24-25 Apronectomy... 26 Mini Tummy Tuck... 27 This is a procedure which

More information

SURGICAL TREATMENT OF SEVENTH NERVE PARALYSIS. By B. GRUNDT, M.D. Oslo, Norway

SURGICAL TREATMENT OF SEVENTH NERVE PARALYSIS. By B. GRUNDT, M.D. Oslo, Norway SURGICAL TREATMENT OF SEVENTH NERVE PARALYSIS By B. GRUNDT, M.D. Oslo, Norway WE are all familiar with the patient who has paralysis of the facial nerve. The oblique mouth and the corresponding oblique

More information

Retinal Tear and Detachment

Retinal Tear and Detachment Retinal Tear and Detachment Introduction The retina is the layer of tissue in the back of the eye that is responsible for vision. It is attached to the choroid tissue, which supplies the retina with blood.

More information

Combined tongue flap and V Y advancement flap for lower lip defects

Combined tongue flap and V Y advancement flap for lower lip defects British Journal of Plastic Surgery (2005) 58, 258 262 CASE REPORTS Combined tongue flap and V Y advancement flap for lower lip defects Kenji Yano*, Ko Hosokawa, Tateki Kubo Department of Plastic and Reconstructive

More information

Nasal Soft-Tissue Triangle Deformities

Nasal Soft-Tissue Triangle Deformities 339 Hossam M.T. Foda, MD 1 1 Division of Facial Plastic Surgery, Otolaryngology Department, Alexandria Medical School, Alexandria, Egypt Facial Plast Surg 2016;32:339 344. Address for correspondence Hossam

More information

CHILDREN S SERVICES. Patient information Leaflet BRONCHIOLITIS

CHILDREN S SERVICES. Patient information Leaflet BRONCHIOLITIS CHILDREN S SERVICES Patient information Leaflet BRONCHIOLITIS Sept 2014 INTRODUCTION This leaflet aims to help you understand bronchiolitis, how to make your child comfortable and when to contact for emergency

More information

The Advantages of Two Stages in Repair. of Bilateral Cleft Lip. VICTOR SPINA, M.D. Sado Paulo, Brazil

The Advantages of Two Stages in Repair. of Bilateral Cleft Lip. VICTOR SPINA, M.D. Sado Paulo, Brazil The Advantages of Two Stages in Repair of Bilateral Cleft Lip VICTOR SPINA, M.D. Sado Paulo, Brazil The suggestion of using two stages for the surgical correction of complete bilateral clefts of the lip

More information

Intrinsic muscles palsies of the hand Management of Thumb Opposition with BURKHALTER s Procedure

Intrinsic muscles palsies of the hand Management of Thumb Opposition with BURKHALTER s Procedure Intrinsic muscles palsies of the hand Management of Thumb Opposition with BURKHALTER s Procedure TRUONG LE DAO, MD, IFAAD 1 Burkhalter W.E, Cristhensen R.C, Brown P.W, Extensor Indicis Proprius opponensplasty

More information

Circumferential skin defect - Ilizarov technique in plastic surgery

Circumferential skin defect - Ilizarov technique in plastic surgery Brief Communication Circumferential skin defect - Ilizarov technique in plastic surgery Vrisha Madhuri, Shankar R. Kurpad, Manasseh Nithyananth, Thilak S Jepegnanam, V. T. K. Titus, Prema Dhanraj Department

More information

Anatomy of. External NOSE. By Dr Farooq Aman Ullah Khan PMC

Anatomy of. External NOSE. By Dr Farooq Aman Ullah Khan PMC Anatomy of External NOSE By Dr Farooq Aman Ullah Khan PMC 24 th Nov. 2017 The External Nose Descriptions of the nose always begin with that part of it which is covered by the skin, i.e., the EXPOSED PART

More information

TOTAL HIP ARTHROPLASTY (Total Hip Replacement)

TOTAL HIP ARTHROPLASTY (Total Hip Replacement) (Total Hip Replacement) The Hip Joint The hip is a ball and socket joint. The joint is formed by the head of the femur (thighbone) and the acetabulum (pelvis). The bones are coated in cartilage, which

More information

OF CONCHA-HELIX DEFECTS. BY JAMES K. MASSON, M.D. Mayo Clinic and Mayo Foundation, Rochester, Minnesota

OF CONCHA-HELIX DEFECTS. BY JAMES K. MASSON, M.D. Mayo Clinic and Mayo Foundation, Rochester, Minnesota British Journal qf Plastic Surgery (x97z), 7,5, 399-403 A SIMPLE ISLAND FLAP FOR RECONSTRUCTION OF CONCHA-HELIX DEFECTS BY JAMES K. MASSON, M.D. Mayo Clinic and Mayo Foundation, Rochester, Minnesota AFTER

More information

Heart Valve Replacement

Heart Valve Replacement Heart Valve Replacement Introduction Sometimes people have serious problems with the valves in their hearts. A heart valve repair or replacement surgery restores or replaces a defective heart valve. If

More information

Meniscus Problems - Torn Meniscus Repair

Meniscus Problems - Torn Meniscus Repair Meniscus Problems - Torn Meniscus Repair The two crescent-shaped menisci in each knee absorb shock, disperse weight, and reduce friction when the knee moves. Activities such as walking or jumping transfer

More information

There are numerous suture techniques described for nasal. Septocolumellar Suture in Closed Rhinoplasty ORIGINAL ARTICLE

There are numerous suture techniques described for nasal. Septocolumellar Suture in Closed Rhinoplasty ORIGINAL ARTICLE ORIGINAL ARTICLE Erdem Tezel, MD, and Ayhan Numanoğlu, MD Abstract: Several surgeons advise a variety of tip sutures and describe their own techniques in open approach. Septocolumellar suture is one of

More information

TRAUMA TO THE FACE AND MOUTH

TRAUMA TO THE FACE AND MOUTH Dr.Yahya A. Ali 3/10/2012 F.I.C.M.S TRAUMA TO THE FACE AND MOUTH Bailey & Love s 25 th edition Injuries to the orofacial region are common, but the majority are relatively minor in nature. A few are major

More information

Treatment of Snoring. Useful Telephone Numbers. Information for Patients on. North Hampshire ENT Partnership Hampshire Clinic

Treatment of Snoring. Useful Telephone Numbers. Information for Patients on. North Hampshire ENT Partnership Hampshire Clinic Useful Telephone Numbers North Hampshire ENT Partnership Hampshire Clinic - 01256 377733 The Hampshire Clinic Switchboard - 01256 357111 Lyde Ward - 01256 377773 Enbourne Ward - 01256 377772 Frimley Park

More information

INFORMED CONSENT-RHINOPLASTY SURGERY

INFORMED CONSENT-RHINOPLASTY SURGERY INFORMED CONSENT-RHINOPLASTY SURGERY 2000 American Society of Plastic Surgeons. Purchasers of the Patient Consultation Resource Book are given a limited license to modify documents contained herein and

More information

The earlobe occupies a unique position among facial

The earlobe occupies a unique position among facial Rev Bras Otorrinolaringol 2006;72(4):447-51. ORIGINAL ARTICLE Earlobe cleft reconstructive surgery Lucas Gomes Patrocínio 1, Rodrigo Márcio Morais 2, José Edmundo Pereira 3, José Antônio Patrocínio 4 Keywords:

More information

PATIENT GUIDE TO CARTILAGE INJURIES

PATIENT GUIDE TO CARTILAGE INJURIES Lucas Wymore, MD Sports Medicine 23000 Moakley Street Suite 102 Leonardtown MD 20650 Office Phone: 301-475-5555 Office Fax: 301-475- 5914 Email: lwymore@somdortho.com PATIENT GUIDE TO CARTILAGE INJURIES

More information

KNEE ARTHROSCOPY. How the Normal Knee Works

KNEE ARTHROSCOPY. How the Normal Knee Works KNEE ARTHROSCOPY If you have persistent pain, catching, or swelling in your knee, a procedure known as arthroscopy may help relieve these problems. Arthroscopy allows the diagnoses and treatment of knee

More information

Hospital das Clinicas, Brazil

Hospital das Clinicas, Brazil THE IMPORTANCE OF THE CARTILAGINOUS FRAMEWORK IN PLASTIC SURGERY OF THE NOSE By ROBERTO FARINA, M.D., OSVALDO DE CASTRO, and RICARDO BAROUDI, M.D. Hospital das Clinicas, Brazil As far as plastic surgery

More information

Department of Surgery, Medical College, Nagpur, India

Department of Surgery, Medical College, Nagpur, India SCROTAL AVULSION : A NEW TECHNIQUE OF RECONSTRUCTION BY SPLIT-SKIN GRAFT By C. BALAKRISHNAN, F.R.C.S. Department of Surgery, Medical College, Nagpur, India ACCIDENTAL avulsion of scrotal skin presents

More information

AN EXPERIMENTAL TUBE PEDICLE LINED WITH SMALL BOWEL. By J. H. GOLDIN, F.R.C.S.(Edin.) Plastic Surgery Unit, St Thomas' Hospital, London

AN EXPERIMENTAL TUBE PEDICLE LINED WITH SMALL BOWEL. By J. H. GOLDIN, F.R.C.S.(Edin.) Plastic Surgery Unit, St Thomas' Hospital, London British Journal of Plastic Surgery (I972), 25, 388-39z AN EXPERIMENTAL TUBE PEDICLE LINED WITH SMALL BOWEL By J. H. GOLDIN, F.R.C.S.(Edin.) Plastic Surgery Unit, St Thomas' Hospital, London ONE of the

More information

ADHESIVE CAPSULITIS (FROZEN SHOULDER)

ADHESIVE CAPSULITIS (FROZEN SHOULDER) ADHESIVE CAPSULITIS (FROZEN SHOULDER) Frozen shoulder, or adhesive capsulitis is a condition that generally begins with the gradual onset of pain followed by a limitation of shoulder motion. The discomfort

More information

Implant Placement in Maxillary Anterior Region Along with Soft and Hard Tissue Grafting- A Case Report.

Implant Placement in Maxillary Anterior Region Along with Soft and Hard Tissue Grafting- A Case Report. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 10 Ver. XII (October. 2016), PP 68-73 www.iosrjournals.org Implant Placement in Maxillary Anterior

More information

Advances of Plastic & Reconstructive Surgery

Advances of Plastic & Reconstructive Surgery Chapter 1 Advances of Plastic & Reconstructive Surgery Cleft lip nasal deformity: Analysis and treatment Martínez-Capoccioni Gabriel*; Martín-Martín Carlos Servizo Galego de Saúde, Service of ENT Head

More information

52 COMBINED NASAL AND LABIAL

52 COMBINED NASAL AND LABIAL 52 COMBINED NASAL AND LABIAL UNILATERAL CLEFT CORRECTIONS SIMULTANEOUS CORRECTION OF SECONDARY LABIAL AND NASAL DEFORMITIES HAD BEEN DONE BY SURGEONS FOR MANY YEARS GILLIES AND BARRON TAUGHT ME THIS COMBINED

More information

Honorary Assistant Plastic Surgeon, Royal Melbourne Hospital; Honorary Research Fellow, Department of Surgery, University of Melbourne

Honorary Assistant Plastic Surgeon, Royal Melbourne Hospital; Honorary Research Fellow, Department of Surgery, University of Melbourne THE PTHOLOGY ND TRETMENT OF H~MTOM OF THE NSL SEPTUM By HUNTER J. H. FRY, M.S., F.R.C.S., F.R..C.S. Honorary ssistant Plastic Surgeon, Royal Melbourne Hospital; Honorary Research Fellow, Department of

More information

Management of Commonly Encountered Secondary Cleft Deformities of Face-A Case Series

Management of Commonly Encountered Secondary Cleft Deformities of Face-A Case Series DOI: 10.7860/IJARS/2017/28759:2331 Surgery Section Case Series Management of Commonly Encountered Secondary Cleft Deformities of Face-A Case Series JACOB JOHN, ARJUN MADHU USHA, MUBARAK AZIZ, VINIT RENKAN

More information

Nasotracheal Intubation for Head and Neck Surgery

Nasotracheal Intubation for Head and Neck Surgery Nasotracheal Intubation for Head and Neck Surgery Dr A J Cartwright Introduction History Anatomy Indications for Technique of Complications Contraindications Conclusions History First described in 1902

More information

THE MANAGEMENT OF THE SWOLLEN ARM IN CARCINOMA OF THE BREAST

THE MANAGEMENT OF THE SWOLLEN ARM IN CARCINOMA OF THE BREAST THE MANAGEMENT OF THE SWOLLEN ARM IN CARCINOMA OF THE BREAST NORMAN TREVES, M.D. The terms "brawny arm" and "lymphedema" have been given to the swollen arm which may complicate the inoperable, recurrent,

More information

The CMC approved a motion to accept all editorial action requests that remain on the consent calendar 21 Yea / 0 Nay / 0 Abstain

The CMC approved a motion to accept all editorial action requests that remain on the consent calendar 21 Yea / 0 Nay / 0 Abstain PAGE 1 OF 14 Editorial Actions One or more member organizations requested that the following editorial action submissions be removed from the consent calendar and addressed individually: #s 4, 7, 8, 9,

More information

AP2 Lab 3 Coronary Vessels, Valves, Sounds, and Dissection

AP2 Lab 3 Coronary Vessels, Valves, Sounds, and Dissection AP2 Lab 3 Coronary Vessels, Valves, Sounds, and Dissection Project 1 - BLOOD Supply to the Myocardium (Figs. 18.5 &18.10) The myocardium is not nourished by the blood while it is being pumped through the

More information

CAREFULLY READ ALL INSTRUCTIONS PRIOR TO USE

CAREFULLY READ ALL INSTRUCTIONS PRIOR TO USE CAREFULLY READ ALL INSTRUCTIONS PRIOR TO USE INDICATIONS FOR USE The LATERA Absorbable Nasal Implant is indicated for supporting upper and lower lateral nasal cartilage. CAUTION: Federal law restricts

More information

Naso-Orbital Complex Reconstruction with Titanium Mesh and Canthopexy

Naso-Orbital Complex Reconstruction with Titanium Mesh and Canthopexy Case Report imedpub Journals http://www.imedpub.com DOI: 10.4172/2472-1905.100011 Naso-Orbital Complex Reconstruction with Titanium Mesh and Canthopexy Abstract Context: We are introducing the reconstruction

More information