The impact of fibrin glue on helical composite graft take and outcome after reconstruction of the soft triangle of the nose was demonstrated. A superior helical ear composite graft was harvested for the reconstruction of the soft triangle of the left nostril. Fibrin glue is used frequently with split-thickness skin grafts but not with composite grafts before. It was used intraoperatively as a sealant, haemostatic and fixating agent, promote wound healing and prevent skin graft contracture. The complete composite graft-take occurred along with good aesthetic outcome and integration. The symmetry of both nostrils was restored. No graft shrinkage or contracture was observed for more than 10 months follow up. In this case, fibrin glue helped the composite graft complete take and integration with the restored good aesthetic appearance and minimal graft contraction. The level of evidence was-Therapeutic, V.
Purpose: Estimate the effect of combination of different otoplasty techniques and its effects of patients' psychological condition. Methods: From January 2015 to July 2019, otoplasty for 30 patients complaining of bilateral prominent ears were done. Suture techniques were combined with scoring with no cartilage excision have been used to ensure symmetrical and adequate repair with no relapse from the surgery. Results: 30 patients were operated. 28 patients were satisfied. 2 early complications occurred in the form of hematoma, which were evacuated and treated conservatively. Also, 2 late hypertrophic scaring of the post auricular sulci were treated with silicone gel and intra lesional injection of corticosteroids. Patient satisfaction was the utmost, with great impact on psychological status and lifestyle changes. Conclusion: Combination of suture techniques and cartilage scoring with no cartilage excision in surgical management of protruding ears has a great role in restoring normal and symmetrical shape and greatly prevents relapse of the condition. Minimal of no complications could be guaranteed if combination is adequate. Postoperative psychological improvement and change in life style is well established.
Background: Coverage of post-traumatic or post-oncosurgical nasal defects is a very challenging procedure. Small nasal defects may be covered by skin grafts or small local flaps while larger nasal defects require more complex flap coverage techniques as using tissue expanders, prefabricated flaps or free flaps. The forehead flap has been used for centuries and remains a workhorse flap for reconstruction of large and complex nasal defects. Aim: evaluate the feasibility and versatility of forehead flap for resurfacing nasal defects. Materials and Methods: 12 patients underwent coverage of nasal defects after trauma or tumor excision using forehead flaps. All flaps needed a second stage for flap separation 3 weeks after the time of operation. The size of the harvested flap, the harvesting time, results of transferred flaps, patient satisfaction and flap-related complications were analyzed. Results: 12 patients (10 males and 2 females) underwent reconstruction of different nasal defects using 12 forehead flaps. The overall complications occurred in 2 patients. The remaining 10 patients showed no complications and passed an uneventful follow-up period. 7 Patients were very satisfied, 4 were satisfied and only one patient was not satisfied as she was 23 years old young female and was subjected to human bite. Follow-up periods ranged from 6 to 12 months. Conclusion: Nasal defects can successfully be managed with the forehead flap. Probably, the flap provides the best result due to the good matching of the skin in terms of color, texture, and thickness. Also, despite the increasing use of free flaps, the forehead flap is still a valid and safe option for nasal defects coverage that allows good aesthetics and functional outcomes.
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