NEW THREE-FLAP SCALP RECONSTRUCTION TECHNIQUE

Size: px
Start display at page:

Download "NEW THREE-FLAP SCALP RECONSTRUCTION TECHNIQUE"

Transcription

1 NEW THREE-FLAP SCALP RECONSTRUCTION TECHNIQUE By MIGUEL ORTICOCHEA, M.D. Professor of Plastic Surgery, Medical School, Javeriana University, Bogotd, Colombia Former Student, Pasteur Hospital, Montevideo, Uruguay Head, Plastic Surgery Division at the National Cancer Institute, BogoM, Colombia IN cases of not very large scalp loss in the frontal and occipital regions, we have reconstructed the defect by mobilising three large flaps that contain the whole remaining scalp. The technique of using only three large flaps instead of the original four-flap technique (Orticochea, 1967, 1969) has two advantages : the reconstruction becomes FIG. I Patient with benign tumour including the right superior eyelid, base of nose, two-thirds of the forehead and a portion of the temporal and parietal regions. The tumour covers the right eye. easier and the blood supply of the flaps is better since their pedicles are wider. technique is suitable for defects of the size shown in Figures 2 and" 6. This Technlque.--Two flaps (1 and 2 in Figure 3) are outlined along the superior border of the raw area. Their ends are cut at an angle and their width is equal to half that of the raw area, so that when mobilised and juxtaposed, they will automatically cover the raw surface. But when the width of the raw surface is larger than 12 cm., the width of the flaps should not exceed 6 cm. Each of these flaps should have its own vascular pedicle. When reconstructing scalp and forehead, the superficial temporal artery and vein are in the pedicle. When the reconstruction is carried out on the occipital region, their pedicles will carry the occipital and posterior auricular vessels of the external carotid. Behind flaps I and 2, a very large flap (3) is outlined which includes nearly the whole remaining scalp. The pedicle on the temporal region contains the posterior auricular and occipital vessels if the region to be reconstructed is located on the forehead I84

2 NEW THREE-FLAP SCALP RECONSTRUCTION TECHNIOUE I85 FIG. 2 Following excision, the raw surface is on the right side of the midline. Fit. 3 Development of the surgical technique. It is preferable to cut flaps I and 2 at an angle as shown. The secondary defe~r (C) that appears after juxtaposing flaps I and 2 is smaller than the primary one.

3 I86 B R I T I S H J O U R N A L OF P L A S T I C S U R G E R Y - ~. = ~. o ~.~ ~ ~ c~.~,~ ~

4 NEW THREE-FLAP SCALP RECONSTRUCTION TECHNIQUE 18 7 (Fig. 4). When the occipital region is to be reconstructed, the pedicle includes the superficial temporal vessels (Fig. 7). If the scalp defect, either on the forehead or the occipital region, is symmetrically situated around the midline, the pedicle of the large flap may be placed on either side If the area of reconstruction is lateral to the midline (Figs. i, 2, 4), it is preferable to place the pedicle on the opposite side. The vertex of the flap extends to the opposite temporal region. The three flaps are elevated by dissection in the loose areolar tissue lying between the pericranium and the galea aponeurotica. Great care has to be observed when approaching the base of the flaps to avoid injury to the vessels passing from the superficial FIG. 6 Squamous cell cancer, radiated and relapsed, located in the occipital region. There is an alopecic area following radiotherapy. The tumour has been resected and a portion of the occipital bone excised. The specimen, when retracted, measured 14 cm. long by 6 cm. wide. The surgical area to be reconstructed measured 16 cm. long by 8 cm. wide. and external plane of the aponeurosis to a deeper plane in the paro~id regions in the case of the superficial temporal vessels, and the mastoid and occipital regions in the case of the posterior auricular and occipital vessels. Here the separation of the flaps has to be performed by blunt dissection. The aponeurosis is divided with incisions transverse to the longitudinal axis of the skull. Many parallel incisions are made x cm. apart. Great care is taken not to cut or injure veins and arteries. Uncomplicated post-operative healing depends principally on a good blood supply to the flaps. When the flaps are raised, numbers I and z are juxtaposed covering the primary raw surface (Figs. 3, c and 4, B). These two flaps are subjected to a homogeneous and balanced traction. Now, when the primary raw surface is almost completely covered, a smaller secondary defect is created which will be covered by the large flap (Fig. 3, c). Because of its size and large pedicle, this flap can be subjected to a greater degree of traction than flaps I and 2. This is the advantage of the new technique over that of the original four flaps.. By including half of the scalp in one giant flap, a better circulation is obtained.

5 188 BRITISH JOURNAL OF PLASTIC SURGERY FIG. 7 Final result eight days after operation. It was not necessary to use a free skin graft. The forehead has been stretched and mobilised and looks larger. CONCLUSIONS With this technique the whole scalp can be stretched to cover raw surfaces located at the frontal and occipital regions. The scalp is subjected to a distribution of regular pressures throughout its full extent and in all directions. REFERENCES ORTICOCHEA, M. (1967). Four flap scalp reconstruction technique. British Journal of Plastic Surgery, 2o, ORTICOCHEA, M. (1969). Application de la technique des quatre lambeaux dans la reconstruction du front et des regions pari6tales. AnnalesdeGhirurgiePlastique, I4, i53-i58.

A NEW METHOD FOR TOTAL RECONSTRUCTION OF THE NOSE : THE EARS AS DONOR AREAS

A NEW METHOD FOR TOTAL RECONSTRUCTION OF THE NOSE : THE EARS AS DONOR AREAS A NEW METHOD FOR TOTAL RECONSTRUCTION OF THE NOSE : THE EARS AS DONOR AREAS By MIGUEL ORTICOCHEA, M.D. 1 Professor of Plastic Surgery, Medical School, Javeriana University, Bogotd, Colombia THE early history

More information

THIEME. Scalp and Superficial Temporal Region

THIEME. Scalp and Superficial Temporal Region CHAPTER 2 Scalp and Superficial Temporal Region Scalp Learning Objectives At the end of the dissection of the scalp, you should be able to identify, understand and correlate the clinical aspects: Layers

More information

The SCALP. Prof. Dr. Muhammad Imran Qureshi

The SCALP. Prof. Dr. Muhammad Imran Qureshi The SCALP By Prof. Dr. Muhammad Imran Qureshi The SCALP includes FIVE layers external to the Calvaria. These are: S: Skin & Superficial Fascia C: Connective Tissue A: Aponeurosis (Epicranial) L: Loose

More information

Tikrit University College of Dentistry Dr.Ban I.S. head & neck anatomy 2 nd y.

Tikrit University College of Dentistry Dr.Ban I.S. head & neck anatomy 2 nd y. Lec [3]/The scalp The scalp extends from the supraorbital margins anteriorly to the nuchal lines at the back of the skull and down to the temporal lines at the sides. The forehead, from eyebrows to hairline,

More information

RECONSTRUCTION OF SCALP DEFECTS: AN INSTITUTIONAL EXPERIENCE Sathyanarayana B. C 1, Somashekar Srinivas 2

RECONSTRUCTION OF SCALP DEFECTS: AN INSTITUTIONAL EXPERIENCE Sathyanarayana B. C 1, Somashekar Srinivas 2 RECONSTRUCTION OF SCALP DEFECTS: AN INSTITUTIONAL EXPERIENCE Sathyanarayana B. C 1, Somashekar Srinivas 2 HOW TO CITE THIS ARTICLE: Sathyanarayana B. C, Somashekar Srinivas. Reconstruction of Scalp Defects:

More information

be very thin and variable. Facial nerve branches that exit the parotid gland are deep to the SMAS.

be very thin and variable. Facial nerve branches that exit the parotid gland are deep to the SMAS. The Superficial musculoaponeurotic system (SMAS) fascia is a fanlike fascia that envelops the face and provides a suspensory sheet which distributes forces of facial expression.. The SMAS is continuous

More information

Neurosurgical Techniques

Neurosurgical Techniques Neurosurgical Techniques EBEN ALEXANDER, JR., M.D., EDITOR Supratentorial Skull Flaps GuY L. ODOM, M.D., AND BARNES WOODHALL,!V[.D. Department of Surgery, Division of Neurosurgery, Duke University Medical

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

Head and Face Anatomy

Head and Face Anatomy Head and Face Anatomy Epicranial region The Scalp The soft tissue that covers the vault of skull. Extends from supraorbital margin to superior nuchal line. Layers of the scalp S C A L P = skin = connective

More information

Dr.Ban I.S. head & neck anatomy 2 nd y. جامعة تكريت كلية طب االسنان مادة التشريح املرحلة الثانية أ.م.د. بان امساعيل صديق 6102/6102

Dr.Ban I.S. head & neck anatomy 2 nd y. جامعة تكريت كلية طب االسنان مادة التشريح املرحلة الثانية أ.م.د. بان امساعيل صديق 6102/6102 جامعة تكريت كلية طب االسنان مادة التشريح املرحلة الثانية أ.م.د. بان امساعيل صديق 6102/6102 The scalp The scalp extends from the supraorbital margins anteriorly to the nuchal lines at the back of the skull

More information

Alexander C Vlantis. Selective Neck Dissection 33

Alexander C Vlantis. Selective Neck Dissection 33 05 Modified Radical Neck Dissection Type II Alexander C Vlantis Selective Neck Dissection 33 Modified Radical Neck Dissection Type II INCISION Various incisions can be used for a neck dissection. The incision

More information

Superior View of the Skull (Norma Verticalis) Anteriorly the frontal bone articulates with the two parietal bones AT THE CORONAL SUTURE

Superior View of the Skull (Norma Verticalis) Anteriorly the frontal bone articulates with the two parietal bones AT THE CORONAL SUTURE Superior View of the Skull (Norma Verticalis) Anteriorly the frontal bone articulates with the two parietal bones AT THE CORONAL SUTURE 1 The two parietal bones articulate in the midline AT THE SAGITTAL

More information

Reconstruction of Scalp Defects: An Algorithmic Approach Author: DR.M.Sundararaj, M.ch, Corresponding Author: DR.A.KavithaPriya, M.

Reconstruction of Scalp Defects: An Algorithmic Approach Author: DR.M.Sundararaj, M.ch, Corresponding Author: DR.A.KavithaPriya, M. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 8 Ver. IX (Aug. 2017), PP 40-44 www.iosrjournals.org Reconstruction of Scalp Defects: An Algorithmic

More information

Kevin T. Kavanagh, MD

Kevin T. Kavanagh, MD Kevin T. Kavanagh, MD Axial Based upon a named artery. Survival length depends upon the artery not the width of the flap. Random Has random unnamed vessels supplying it. Survival length is directly proportional

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

Stracture The scalp consists of five layers,the 1st three of which are intimately bound together and move as a unit.to assist one in memorizing the

Stracture The scalp consists of five layers,the 1st three of which are intimately bound together and move as a unit.to assist one in memorizing the Anatomy of Scalp Stracture The scalp consists of five layers,the 1st three of which are intimately bound together and move as a unit.to assist one in memorizing the names of the five layers of the scalp,use

More information

Face. Definition: The area between the two ears and from the chin to the eye brows. The muscles of the face

Face. Definition: The area between the two ears and from the chin to the eye brows. The muscles of the face Face Definition: The area between the two ears and from the chin to the eye brows. The muscles of the face The muscle of facial expression (include the muscle of the face and the scalp). All are derived

More information

Repair of scalp defect using a superficial temporal fascia pedicle VY advancement scalp flap *

Repair of scalp defect using a superficial temporal fascia pedicle VY advancement scalp flap * British Journal of Plastic Surgery (2005) 58, 676 680 Repair of scalp defect using a superficial temporal fascia pedicle VY advancement scalp flap * Kiyoshi Onishi a, *, Yu Maruyama b, Akiteru Hayashi

More information

Interesting Case Series. Scalp Reconstruction With Free Latissimus Dorsi Muscle

Interesting Case Series. Scalp Reconstruction With Free Latissimus Dorsi Muscle Interesting Case Series Scalp Reconstruction With Free Latissimus Dorsi Muscle Danielle H. Rochlin, BA, Justin M. Broyles, MD, and Justin M. Sacks, MD Department of Plastic and Reconstructive Surgery,

More information

The Queen Victoria Hospital, East Grinstead

The Queen Victoria Hospital, East Grinstead IRRADIATION INJURIES OF THE PERINEUM By R. L. B. BEARE, F.R.C.S. The Queen Victoria Hospital, East Grinstead MISGUIDED radiotherapy has in the past caused much misery, and continues to do so, although

More information

The Language of Anatomy. (Anatomical Terminology)

The Language of Anatomy. (Anatomical Terminology) The Language of Anatomy (Anatomical Terminology) Terms of Position The anatomical position is a fixed position of the body (cadaver) taken as if the body is standing (erect) looking forward with the upper

More information

Tikrit University collage of dentistry Dr.Ban I.S. head & neck anatomy 2 nd y. Lec [5] / Temporal fossa :

Tikrit University collage of dentistry Dr.Ban I.S. head & neck anatomy 2 nd y. Lec [5] / Temporal fossa : Lec [5] / Temporal fossa : Borders of the Temporal Fossa: Superior: Superior temporal line. Inferior: gap between zygomatic arch and infratemporal crest of sphenoid bone. Anterior: Frontal process of the

More information

3-Deep fascia: is absent (except over the parotid gland & buccopharngeal fascia covering the buccinator muscle)

3-Deep fascia: is absent (except over the parotid gland & buccopharngeal fascia covering the buccinator muscle) The Face 1-Skin of the Face The skin of the face is: Elastic Vascular (bleed profusely however heal rapidly) Rich in sweat and sebaceous glands (can cause acne in adults) It is connected to the underlying

More information

Cardiovascular system:

Cardiovascular system: Cardiovascular system: Mediastinum: The mediastinum: lies between the right and left pleura and lungs. It extends from the sternum in front to the vertebral column behind, and from the root of the neck

More information

Veins of the Face and the Neck

Veins of the Face and the Neck Veins of the Face and the Neck Facial Vein The facial vein is formed at the medial angle of the eye by the union of the supraorbital and supratrochlear veins. connected through the ophthalmic veins with

More information

Scapular & Parascapular flap FLAP TERRITORY ANATOMY. is normally accompanied by two venae comitantes.

Scapular & Parascapular flap FLAP TERRITORY ANATOMY. is normally accompanied by two venae comitantes. Scapular & Parascapular flap FLAP TERRITORY This is a composite flap that is situated over the scapula with various incisional arrangements. It can be harvested as a skin and subcutaneous tissue flap,

More information

STEP 1 INCISION AND ELEVATION OF SKIN FLAP STEP 3 SEPARATE PAROTID GLAND FROM SCM STEP 2 IDENTIFICATON OF GREAT AURICULAR NERVE

STEP 1 INCISION AND ELEVATION OF SKIN FLAP STEP 3 SEPARATE PAROTID GLAND FROM SCM STEP 2 IDENTIFICATON OF GREAT AURICULAR NERVE STEP 1 INCISION AND ELEVATION OF SKIN FLAP Create a modified Blair Figure 1 or facelift incision. Figure 2 Raise a superficial cervico-fascial flap between the Superficial Musculo Aponeurotic System (SMAS)

More information

Breast conservation surgery and sentinal node biopsy: Dr R Botha Moderator: Dr E Osman

Breast conservation surgery and sentinal node biopsy: Dr R Botha Moderator: Dr E Osman Breast conservation surgery and sentinal node biopsy: Dr R Botha Moderator: Dr E Osman Breast anatomy: Breast conserving surgery: The aim of wide local excision is to remove all invasive and in situ

More information

OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY

OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY PARAMEDIAN FOREHEAD FLAP NASAL RECONSTRUCTION SURGICAL TECHNIQUE Brian Cervenka, Travis Tollefson, Patrik Pipkorn The paramedian forehead

More information

RECONSTRUCTION OF MICROtia

RECONSTRUCTION OF MICROtia ORIGINAL ARTICLE A 2-Stage Ear Reconstruction for Microtia Haiyue Jiang, MD; Bo Pan, MD; Yanyong Zhao, MD; Lin Lin, MD; Lei Liu, MD; Hongxing Zhuang, MD Objective: To introduce our 2-stage reconstruction

More information

Learning Outcomes. The Carotid 20/02/2013. Scalp, Face, Parotid. Layers of the Scalp. The Parotid Gland. The Scalp. The Carotid The Facial Artery

Learning Outcomes. The Carotid 20/02/2013. Scalp, Face, Parotid. Layers of the Scalp. The Parotid Gland. The Scalp. The Carotid The Facial Artery Learning Outcomes The Scalp Layers of the Scalp Bleeding from the Scalp The Carotid The Facial Artery Major Muscles of the Face and Jaw(s) Muscles of Mastication Muscles of Facial Expression The Parotid

More information

The bi-pedicle post-auricular tube flap for reconstruction of partial ear defects

The bi-pedicle post-auricular tube flap for reconstruction of partial ear defects The British Association of Plastic Surgeons (2003) 56, 593 598 The bi-pedicle post-auricular tube flap for reconstruction of partial ear defects Mohammed G. Ellabban*, Maamoun I. Maamoun, Moustafa Elsharkawi

More information

3. The Jaw and Related Structures

3. The Jaw and Related Structures Overview and objectives of this dissection 3. The Jaw and Related Structures The goal of this dissection is to observe the muscles of jaw raising. You will also have the opportunity to observe several

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

POSTERIOR 1. situated behind: situated at or toward the hind part of the body :

POSTERIOR 1. situated behind: situated at or toward the hind part of the body : ANATOMICAL LOCATION Anatomy is a difficult subject with a large component of memorization. There is just no way around that, but we have made every effort to make this course diverse and fun. The first

More information

The Neck the lower margin of the mandible above the suprasternal notch and the upper border of the clavicle

The Neck the lower margin of the mandible above the suprasternal notch and the upper border of the clavicle The Neck is the region of the body that lies between the lower margin of the mandible above and the suprasternal notch and the upper border of the clavicle below Nerves of the neck Cervical Plexus Is formed

More information

cally, a distinct superior crease of the forehead marks this spot. The hairline and

cally, a distinct superior crease of the forehead marks this spot. The hairline and 4 Forehead The anatomical boundaries of the forehead unit are the natural hairline (in patients without alopecia), the zygomatic arch, the lower border of the eyebrows, and the nasal root (Fig. 4.1). The

More information

1. EPINEPHRINE 2. PREDNISONE 3. BENADRYL 4. HYALURONIDASE 5. BABY ASPIRIN 6. NITROPASTE 7. VIAGRA 8. CANNULAS. Must Haves for Injection Safety

1. EPINEPHRINE 2. PREDNISONE 3. BENADRYL 4. HYALURONIDASE 5. BABY ASPIRIN 6. NITROPASTE 7. VIAGRA 8. CANNULAS. Must Haves for Injection Safety 1. EPINEPHRINE 2. PREDNISONE 3. BENADRYL 4. HYALURONIDASE 5. BABY ASPIRIN 6. NITROPASTE 7. VIAGRA 8. CANNULAS Must Haves for Injection Safety Facial artery: This artery stems from the external carotid

More information

Posterior Triangle of the Neck By Prof. Dr. Muhammad Imran Qureshi

Posterior Triangle of the Neck By Prof. Dr. Muhammad Imran Qureshi Posterior Triangle of the Neck By Prof. Dr. Muhammad Imran Qureshi For the purpose of anatomical description the neck is sub divided into two major triangles, the Anterior and the Posterior by muscle bellies

More information

An island flap based on the anterior branch of the superficial temporal artery for perioral defects

An island flap based on the anterior branch of the superficial temporal artery for perioral defects Free full text on www.ijps.org Original Article An island flap based on the anterior branch of the superficial temporal artery for perioral defects V. Bhattacharya, Ganji Raveendra Reddy, Sheikh Adil Bashir,

More information

Anatomy and Physiology. Bones, Sutures, Teeth, Processes and Foramina of the Human Skull

Anatomy and Physiology. Bones, Sutures, Teeth, Processes and Foramina of the Human Skull Anatomy and Physiology Chapter 6 DRO Bones, Sutures, Teeth, Processes and Foramina of the Human Skull Name: Period: Bones of the Human Skull Bones of the Cranium: Frontal bone: forms the forehead and the

More information

Head and neck cancer - patient information guide

Head and neck cancer - patient information guide Head and neck cancer - patient information guide The development of reconstructive surgical techniques in the last 20 years has led to major advances in the treatment of patients with head and neck cancer.

More information

The Reverse Galeal Hinge Flap: Another Valuable Technique in the Repair of Scalp

The Reverse Galeal Hinge Flap: Another Valuable Technique in the Repair of Scalp TITLE PAGE TITLE: The Reverse Galeal Hinge Flap: Another Valuable Technique in the Repair of Scalp Defects Extending to the Calvarium AUTHORS: Lam, Thomas, BA; Indiana University School of Medicine Miletta,

More information

Tumours of the Scalp: A Review of Ten Cases

Tumours of the Scalp: A Review of Ten Cases Feb. 2013, Volume 10, No. 1 2 (Serial No. 90), pp. 57 62 Journal of US-China Medical Science, ISSN 1548-6648, USA D DAVID PUBLISHING Emmanuel J. K. Adu Department of Surgery, School of Medical Sciences,

More information

ANATOMY & PHYSIOLOGY I Laboratory Version B Name Section. REVIEW SHEET Exercise 10 Axial Skeleton

ANATOMY & PHYSIOLOGY I Laboratory Version B Name Section. REVIEW SHEET Exercise 10 Axial Skeleton ANATOMY & PHYSIOLOGY I Laboratory Version B Name Section REVIEW SHEET Exercise 10 Axial Skeleton 1 POINT EACH. THE SKULL MULTIPLE CHOICE 1. The major components of the axial skeleton include the 7. The

More information

Neck-2. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology

Neck-2. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Neck-2 ` Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Triangles of the neck Side of the neck Midline Lower border of mandible Line between angle of mandible and mastoid Superior nuchal

More information

Case Report Reconstruction of Total Lower Eyelid Defects with the Temporoparietal Fascial Flap

Case Report Reconstruction of Total Lower Eyelid Defects with the Temporoparietal Fascial Flap Volume 2012, Article ID 927260, 4 pages doi:10.1155/2012/927260 Case Report Reconstruction of Total Lower Eyelid Defects with the Temporoparietal Fascial Flap Simon R. Bababeygy, 1 Anne R. Kao, 1 Niels

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

OBJECTIVES. At the end of the lecture, students should be able to: List the cerebral arteries.

OBJECTIVES. At the end of the lecture, students should be able to: List the cerebral arteries. DR JAMILA EL MEDANY OBJECTIVES At the end of the lecture, students should be able to: List the cerebral arteries. Describe the cerebral arterial supply regarding the origin, distribution and branches.

More information

Anatomical study. Clinical study. R. Ogawa, H. Hyakusoku, M. Murakami, R. Aoki, K. Tanuma* and D. G. Pennington?

Anatomical study. Clinical study. R. Ogawa, H. Hyakusoku, M. Murakami, R. Aoki, K. Tanuma* and D. G. Pennington? British Journal of Plastic Surgery (2002) 55, 396-40 I 9 2002 The British Association of Plastic Surgeons doi: 10.1054/bjps.2002.3877 PLASTIC SURGERY An anatomical and clinical study of the dorsal intercostal

More information

Medical Terminology. Anatomical Position, Directional Terms and Movements

Medical Terminology. Anatomical Position, Directional Terms and Movements Medical Terminology Anatomical Position, Directional Terms and Movements What we will cover... Content Objectives Students will be able to gain a better understanding and application of medical terminology

More information

Coding For Craniosynostosis. Peggy Feeley RHIA, CCS, CCS-P, COC AHIMA Approved ICD-10-CM/PCS Trainer

Coding For Craniosynostosis. Peggy Feeley RHIA, CCS, CCS-P, COC AHIMA Approved ICD-10-CM/PCS Trainer Coding For Craniosynostosis Peggy Feeley RHIA, CCS, CCS-P, COC AHIMA Approved ICD-10-CM/PCS Trainer Cranial sagittal Synostosis Cranium job is to protect the brain The top portion of the skull, which protects

More information

THE SURGICAL TREATMENT OF POST-RADIATION RECURRENT BASAL-CELL CARCINOMA OF THE FACE AND SCALP

THE SURGICAL TREATMENT OF POST-RADIATION RECURRENT BASAL-CELL CARCINOMA OF THE FACE AND SCALP THE SURGICAL TREATMENT OF POST-RADIATION RECURRENT BASAL-CELL CARCINOMA OF THE FACE AND SCALP By RANDELL CHAMPION, M.B.E., F.R.C.S.Ed., and ROBERT GIBB, M.B., Ch.B., D.M.R.T.(Eng.) From Christie Hospital

More information

Skull-2. Norma Basalis Interna. Dr. Heba Kalbouneh Assistant Professor of Anatomy and Histology

Skull-2. Norma Basalis Interna. Dr. Heba Kalbouneh Assistant Professor of Anatomy and Histology Skull-2 Norma Basalis Interna Dr. Heba Kalbouneh Assistant Professor of Anatomy and Histology Norma basalis interna Base of the skull- superior view The interior of the base of the skull is divided into

More information

The Role of Muscles in Movement

The Role of Muscles in Movement The Role of Muscles in Movement Muscles can t push, they can only pull as they contract, so most often body movements are the result of the activity of pairs or teams of muscles acting together or against

More information

Other ways to use tissue expanded flaps

Other ways to use tissue expanded flaps The British Association of Plastic Surgeons (2004) 57, 336 341 CASE REPORTS Other ways to use tissue expanded flaps Donald A. Hudson* Department of Plastic and Reconstructive Surgery, University of Cape

More information

Definition of Anatomy. Anatomy is the science of the structure of the body and the relation of its parts.

Definition of Anatomy. Anatomy is the science of the structure of the body and the relation of its parts. Definition of Anatomy Anatomy is the science of the structure of the body and the relation of its parts. Basic Anatomical Terms Anatomical terms for describing positions: Anatomical position: Supine position:

More information

A Frame of Reference for Anatomical Study. Anatomy and Physiology Mr. Knowles Chapter 1 Liberty Senior High School

A Frame of Reference for Anatomical Study. Anatomy and Physiology Mr. Knowles Chapter 1 Liberty Senior High School A Frame of Reference for Anatomical Study Anatomy and Physiology Mr. Knowles Chapter 1 Liberty Senior High School Anatomical Terms of Direction and Position Created for communicating the direction and

More information

THE THORACIC WALL. Boundaries Posteriorly by the thoracic part of the vertebral column. Anteriorly by the sternum and costal cartilages

THE THORACIC WALL. Boundaries Posteriorly by the thoracic part of the vertebral column. Anteriorly by the sternum and costal cartilages THE THORACIC WALL Boundaries Posteriorly by the thoracic part of the vertebral column Anteriorly by the sternum and costal cartilages Laterally by the ribs and intercostal spaces Superiorly by the suprapleural

More information

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution

More information

ANTERIOR CERVICAL TRIANGLE (Fig. 2.1 )

ANTERIOR CERVICAL TRIANGLE (Fig. 2.1 ) 2 Neck Anatomy ANTERIOR CERVICAL TRIANGLE (Fig. 2.1 ) The boundaries are: Lateral: sternocleidomastoid muscle Superior: inferior border of the mandible Medial: anterior midline of the neck This large triangle

More information

The Human Body: An Orientation

The Human Body: An Orientation The Human Body: An Orientation Body standing upright Anatomical Position feet slightly apart palms facing forward thumbs point away from body Directional Terms Superior and inferior toward and away from

More information

Face and Scalp 解剖學科鄭授德

Face and Scalp 解剖學科鄭授德 Face and Scalp 解剖學科鄭授德 本教材之圖片取自於 1 Gray s Anatomy for Students, 3rd ed, 2015, by Drake, Vogl, and Mitchell 2 Clinically Oriented Anatomy, 7th ed, 2014, by Moore, Dalley, and Agur 3 Clinically Oriented

More information

OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY

OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY BUCCINATOR MYOMUCOSAL FLAP The Buccinator Myomucosal Flap is an axial flap, based on the facial and/or buccal arteries. It is a flexible

More information

Breast Reconstruction Options

Breast Reconstruction Options Breast Reconstruction Options Natural reconstruction using your ABDOMINAL tissue: TRAM Flap (Transverse Rectus Abdominis Myocutaneous) There are various forms of TRAM flap reconstruction that are commonly

More information

Learning Objectives (1&2)

Learning Objectives (1&2) Learning Objectives (1&2) By the end of the session, students should be able to: 1) Identify anatomical position seated, standing, prone, supine. 2) Pronounce, define and be able to use directional and

More information

Anatomy & Physiology Autopsy of a Banana Planes / Anatomical Directions

Anatomy & Physiology Autopsy of a Banana Planes / Anatomical Directions Anatomy & Physiology Autopsy of a Banana Planes / Anatomical Directions Purpose: During this lab you will demonstrate your knowledge of directional terms by performing an autopsy on a banana. It is important

More information

Tor Chiu. Deep Inferior Epigastric Artery Perforator Flap 161

Tor Chiu. Deep Inferior Epigastric Artery Perforator Flap 161 18 Deep Inferior Epigastric Artery Perforator Flap Tor Chiu Deep Inferior Epigastric Artery Perforator Flap 161 Deep Inferior Epigastric Artery Perforator Flap FLAP TERRITORY The deep inferior epigastric

More information

Introduction to The Human Body

Introduction to The Human Body 1 Introduction to The Human Body FOCUS: The human organism is often examined at seven structural levels: chemical, organelle, cell, tissue, organ, organ system, and the organism. Anatomy examines the structure

More information

Scalp and Forehead Reconstruction

Scalp and Forehead Reconstruction 90 Mofiyinfolu Sokoya, MD 1 Jared Inman, MD, FACS 2 Yadranko Ducic, MD 3 1 Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado 2 Department of Otolaryngology Head

More information

Structure Location Function

Structure Location Function Frontal Bone Cranium forms the forehead and roof of the orbits Occipital Bone Cranium forms posterior and inferior portions of the cranium Temporal Bone Cranium inferior to the parietal bone forms the

More information

TRANSVERSE SECTION PLANE Scalp 2. Cranium. 13. Superior sagittal sinus

TRANSVERSE SECTION PLANE Scalp 2. Cranium. 13. Superior sagittal sinus TRANSVERSE SECTION PLANE 1 1. Scalp 2. Cranium 3. Superior sagittal sinus 4. Dura mater 5. Falx cerebri 6. Frontal lobes of the cerebrum 7. Middle meningeal artery 8. Cortex, grey matter 9. Cerebral vessels

More information

STERNUM. Lies in the midline of the anterior chest wall It is a flat bone Divides into three parts:

STERNUM. Lies in the midline of the anterior chest wall It is a flat bone Divides into three parts: STERNUM Lies in the midline of the anterior chest wall It is a flat bone Divides into three parts: 1-Manubrium sterni 2-Body of the sternum 3- Xiphoid process The body of the sternum articulates above

More information

Endoscopic assisted harvest of the pedicled pectoralis major muscle flap

Endoscopic assisted harvest of the pedicled pectoralis major muscle flap British Journal of Plastic Surgery (2005) 58, 170 174 Endoscopic assisted harvest of the pedicled pectoralis major muscle flap Arif Turkmen*, A. Graeme B. Perks Plastic Surgery Department, Nottingham City

More information

Fascial Turn-Down Flap Repair of Chronic Achilles Tendon Rupture

Fascial Turn-Down Flap Repair of Chronic Achilles Tendon Rupture 19 Fascial Turn-Down Flap Repair of Chronic Achilles Tendon Rupture S. Ghosh, P. Laing, and Nicola Maffulli Introduction Fascial turn-down flaps can be used for an anatomic repair of chronic Achilles tendon

More information

Skull-2. Norma Basalis Interna Norma Basalis Externa. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology

Skull-2. Norma Basalis Interna Norma Basalis Externa. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Skull-2 Norma Basalis Interna Norma Basalis Externa Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Norma basalis interna Base of the skull- superior view The interior of the base of the

More information

Bones of the Skull Lateral View

Bones of the Skull Lateral View Bones of the Skull Lateral View Frontal Bone Parietal Bone Occipital Bone Temporal Bone Sphenoid Bone Pterion Sutures of the Skull Lateral View Coronal Suture Lambdoid Suture Squamous Suture Sutures of

More information

AXIAL SKELETON SKULL

AXIAL SKELETON SKULL AXIAL SKELETON SKULL CRANIAL BONES (8 total flat bones w/ 2 paired) 1. Frontal forms forehead & upper portion of eyesocket (orbital) 2. Parietal paired bones; form superior & lateral walls of cranium 3.

More information

PCM1 Physical Exam Skills Session: Head and Neck FACILITATOR & STUDENT COPY

PCM1 Physical Exam Skills Session: Head and Neck FACILITATOR & STUDENT COPY PATIENT CENTERED MEDICINE - 1 GOALS & OUTCOMES: PCM1 Physical Exam Skills Session: Head and Neck FACILITATOR & STUDENT COPY 1. To introduce the applied anatomy relevant for the examination of the head

More information

Medical Terminology. Unit 2

Medical Terminology. Unit 2 Medical Terminology Unit 2 Students will apply medical terminology. Objective 1: Identify and utilize anatomical positions, planes, and directional terms. Demonstrate what anatomical position is and how

More information

The lumbar artery perforator based island flap: anatomical study and case reports

The lumbar artery perforator based island flap: anatomical study and case reports British Journal of Plastic Surgery (1999), 52, 541 546 1999 The British Association of Plastic Surgeons The lumbar artery perforator based island flap: anatomical study and case reports H. Kato*, M. Hasegawa,

More information

JPRAS Open 3 (2015) 1e5. Contents lists available at ScienceDirect. JPRAS Open. journal homepage:

JPRAS Open 3 (2015) 1e5. Contents lists available at ScienceDirect. JPRAS Open. journal homepage: JPRAS Open 3 (2015) 1e5 Contents lists available at ScienceDirect JPRAS Open journal homepage: http://www.journals.elsevier.com/ jpras-open Case report The pedicled transverse partial latissimus dorsi

More information

Radiological Anatomy of Thorax. Dr. Jamila Elmedany & Prof. Saeed Abuel Makarem

Radiological Anatomy of Thorax. Dr. Jamila Elmedany & Prof. Saeed Abuel Makarem Radiological Anatomy of Thorax Dr. Jamila Elmedany & Prof. Saeed Abuel Makarem Indications for Chest x - A chest x-ray may be used to diagnose and plan treatment for various conditions, including: Diseases/Fractures

More information

Sequellae of Chemical Burn.. Scar management in burn patient

Sequellae of Chemical Burn.. Scar management in burn patient Sequellae of Chemical Burn.. Scar management in burn patient ก ก ก ก ก ก ก ก ก ก ก ก ก ก ก กก ก ก ก ก ก (hypertrophic scar) ก ก ก ก ก ก ก ก ก immature 12 18 ก ก กก ก ก ก ก ก ก ก ก ก ก ก immature (2-9 )

More information

Lecture 07. Lymphatic's of Head & Neck. By: Dr Farooq Amanullah Khan PMC

Lecture 07. Lymphatic's of Head & Neck. By: Dr Farooq Amanullah Khan PMC Lecture 07 Lymphatic's of Head & Neck By: Dr Farooq Amanullah Khan PMC Dated: 28.11.2017 Lymphatic Vessels Of the 800 lymph nodes in the human body, 300 are in the Head & neck region. The lymphatic vessels

More information

OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY

OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY NASOLABIAL FLAP FOR ORAL CAVITY RECONSTRUCTION Harry Wright, Scott Stephan, James Netterville Designed as a true myocutaneous flap pedicled

More information

Thyroidectomy. Siu Kwan Ng. Modified Radical Neck Dissection Type II 47

Thyroidectomy. Siu Kwan Ng. Modified Radical Neck Dissection Type II 47 06 Thyroidectomy Siu Kwan Ng Modified Radical Neck Dissection Type II 47 Thyroidectomy STEP 1. EXPOSING THE THYROID GLAND The collar incision Figure 1 (curvilinear skin crease incision) is made at 1.5-2

More information

CASE REPORT An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty

CASE REPORT An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty CASE REPORT An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty Augustine Reid Wilson, MS, Justin Daggett, MD, Michael Harrington, MD, MPH, and Deniz

More information

Department of Cognitive Science UCSD

Department of Cognitive Science UCSD Department of Cognitive Science UCSD Verse 1: Neocortex, frontal lobe, Brain stem, brain stem, Hippocampus, neural node, Right hemisphere, Pons and cortex visual, Brain stem, brain stem, Sylvian fissure,

More information

DISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV

DISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV DISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV NEOPLASMS A) Epithelial I. Benign Pleomorphic adenoma( Mixed tumour) Adenolymphoma (Warthin s tumour) Oxyphil adenoma (Oncocytoma)

More information

Lab no 1 Structural organization of the human body

Lab no 1 Structural organization of the human body Physiology Lab Manual Page 1 of 6 Lab no 1 Structural organization of the human body Physiology is the science which deals with functions of the body parts, and how they work. Since function cannot be

More information

MICRINS. For more information see your ERIEM representative or call

MICRINS. For more information see your ERIEM representative or call Endoscopic Plastic Surger urgery Instr nstrumentation For more information see your ERIEM representative or call 800.833.3380 ERIEM ERIEM Surgical, Inc. 28438 Ballard Drive, Lake Forest, IL 60045 Phone

More information

Chapter 7. Skeletal System

Chapter 7. Skeletal System Chapter 7 Skeletal System 1 Skull A. The skull is made up of 22 bones: 8 cranial bones, 13 facial bones, and the mandible. B. The Cranium encloses and protects the brain, provides attachments for muscles,

More information

Surgery in Head and neck cancers.principles. Dr Diptendra K Sarkar MS,DNB,FRCS Consultant surgeon,ipgmer

Surgery in Head and neck cancers.principles. Dr Diptendra K Sarkar MS,DNB,FRCS Consultant surgeon,ipgmer Surgery in Head and neck cancers.principles Dr Diptendra K Sarkar MS,DNB,FRCS Consultant surgeon,ipgmer Email:diptendrasarkar@yahoo.co.in HNC : common inclusives Challenges Anatomical preservation R0 Surgical

More information

Anatomy & Physiology. An Introduction

Anatomy & Physiology. An Introduction Anatomy & Physiology An Introduction An Overview of Anatomy Anatomy - The study of the structure of the human body Physiology - The study of body function Branches of Anatomy Surface anatomy Gross anatomy

More information

fmri (functional MRI)

fmri (functional MRI) Lesion fmri (functional MRI) Electroencephalogram (EEG) Brainstem CT (computed tomography) Scan Medulla PET (positron emission tomography) Scan Reticular Formation MRI (magnetic resonance imaging) Thalamus

More information

Pterygium Excision and Conjunctival-Limbal Autograft Transplantation: A Simplified Technique

Pterygium Excision and Conjunctival-Limbal Autograft Transplantation: A Simplified Technique Pterygium Excision and Conjunctival-Limbal Autograft Transplantation: A Simplified Technique Kirti Nath Jha Professor of Ophthalmology Mahatma Gandhi Medical College & Research Institute,Pondy-Cuddalore

More information