Results: Results: 117 patients were studied, aged 12-89 years (mean 48), 70 women and 47 men. Thirty-nine patients (33.3%) were affected by inflammatory diseases (28 patients with lithiasis), 70 had benign tumors, and malignant tumors, eight. Regarding FNA, the sensitivity and specificity were 85.7% and 100%, respectively. Nine patients (7.7%) had temporary paralysis of the marginal mandibular nerve and one had permanent paralysis. Conclusion:Conclusion: Conclusion: Conclusion: Conclusion: resection of the submandibular gland is a safe procedure, with low complication rates. . The most found benign tumor is the pleomorphic adenoma. Total resection of the affected gland is the standard treatment proposed for all tumors.The surgical transcervical lateral access is considered standard for approach the submandibular gland 4 . Although other open and endoscopic approaches have been proposed 5 , the lateral transcervical remains the only one used in our Department.The report of operative complications in the submandibular gland excision for benign lesions ranges from 0 to 14% for hematoma and infection. However, the need of reoperation is rarely reported 3,6,7 . Subjective complaints are also reported by some patients. Permanent damage to the marginal mandibular branch of the facial nerve accounts for 0 to 8%, the lingual nerve, 0 to 12%, and the hypoglossal, 0 to 1.4% 1,[6][7][8] . The objective of this study is to analyze the value of fine needle aspiration and the rates of postoperative complications in patients undergoing resection of the submandibular gland. METHODS METHODS METHODS METHODS METHODSWe reviewed the records of unselected cases of patients treated with resection of the submandibular gland in the Head and Neck Surgery Service at the Hospital Ana Costa and at the Irmandade da Santa Casa da Misericór-dia de Santos, São Paulo -SP, Brazil, from January 1995 to December 2008. The data analyzed were age, gender, findings on clinical history, results of FNA, indication for surgery, surgical procedure, histological diagnosis and complications. Clinical examination was performed with bimanual palpation to differentiate between glandular tissue and lymph node.The evaluated postoperative complications were hematoma, wound infection, salivary fistula and paralysis of the hypoglossal, marginal mandibular and lingual nerves. The physiological function of each involved nerve was clinically assessed before and after surgery by observing the movements of the facial muscles and the appearance, movement and tactile sensation of the tongue. We performed the postoperative evaluation at the time of skin suture removal, and if there were nerve changes, we carried out periodic reviews until complete resolution of paresthesia.Ultrasonography was performed routinely as a complementary imaging study to clinical findings. The fine needle aspiration with frozen specimen was performed in patients with nodular disease of the submandibular gland to clarify the benign or malignant nature of the lesion, not being indicated for patients...

Azevedo DM et al. Lower lip reconstruction using the Karapandzic technique Reconstrução do lábio inferior pela técnica de Karapandzic

Complications after breast implant use in Poland's syndrome: a case report Complications after breast implant use in Poland's syndrome: a case report Complicação pós-implante mamário na síndrome de Poland ABSTRACT Poland's syndrome is described as the absence of the pectoralis major muscle associated with deformities of the hands such as variable syndactylia, absence of the middle phalanx, fusion of the carpal bones, or shortening of the forearm. There may be variations in the extent of the thoracic impairment from the absence of anterior portions of ribs or costal cartilages to "sunken chest," which is generally used to describe thoracic depressions associated with skeletal dysplasia. In general, the areolar-papillary complex is in an upper region in men, and women have hypoplastic breasts. A 32-year-old female patient with Poland's syndrome sought our outpatient service wishing to improve the appearance of her thorax and breasts. She had undergone surgical intervention 7 years earlier with implantation of a silicone breast prosthesis, aiming to minimize the characteristic thoracic deformity. After an assessment, we opted to replace the prosthesis. During the intraoperative period, an area of osteocartilaginous resorption about 4 cm in diameter was observed in a region of costochondral articulation. After the surgery, the patient progressed as expected. Extensive research was carried out on the deformity found, and the patient was referred to a thoracic surgeon. Anterior regional bone resorption in the left hemithorax can be an important surgical finding. It can also represent a decrease in cardiac protection, necessitating greater care in cases of breast prosthesis replacement and the requirement of specific imaging examinations such as CT scans in order to minimize surgical risks.

637Rinoplastia endonasal: um estudo do grau de satisfação dos pacientes em cinco anos Rinoplastia endonasal: um estudo do grau de satisfação dos pacientes em cinco anos Endonasal rhinoplasty: a study of patient satisfaction in five years RESUMO Introdução: Muito tem sido discutido a respeito das várias técnicas e vias de acesso em rinoplastia. Todas as técnicas buscam um resultado previsível e reprodutível, associado à melhora estética e funcional do nariz. Nesse trabalho, foi avaliado o nível de satisfação dos pacientes submetidos à rinoplastia nos últimos cinco anos: rinoplastia reducional por via endonasal associada ou não a rinodinâmica. Método: Por meio de um estudo retrospectivo foram identificados 201 pacientes submetidos à rinoplastia endonasal entre 2005 e 2010. Todos os procedimentos foram realizados com a mesma rotina cirúrgica, conforme indicação. Os pacientes foram avaliados de maneira objetiva quanto à cirurgia realizada e, de maneira subjetiva, a respeito de sua função respiratória anterior e posterior à intervenção cirúrgica e o grau de satisfação quanto à estética nasal por meio de um questionário. Resultados: A idade dos pacientes variou de 14 a 68 anos; com predominância da raça branca (96,75%). Referiram melhora no padrão respiratório após a cirurgia, 83,87% dos pacientes estudados. Em relação à estética nasal, 30 (32,26%) pacientes tiveram suas expectativas superadas, 42 (45,16%) consideraram muito boa, 18 (19,36%), como boa e três (3,22%), como abaixo do esperado. Conclusão: O procedimento resultou em melhora da função respiratória em quase 90% dos pacientes, além disso, o alto grau de satisfação com a estética exposto pelos pacientes permite concluir que rinoplastia endonasal tem apresentado ótimos resultados até o momento.Descritores: Rinoplastia/métodos. Satisfação do paciente. Respiração. Estética. ABSTRACT Background:Much has been discussed about the various techniques and access routes in rhinoplasty. All seek a predictable and reproducible associated with improved aesthetic and functional nose. This study evaluated the level of satisfaction of patients undergoing rhinoplasty in the past five years: by endonasal reductional rhinoplasty associated or not to rhino dynamic. Methods: Through a retrospective study identified 201 patients who underwent endonasal rhinoplasty the period between 2005 and 2010. All procedures were performed with the same routine as surgical indication. Were evaluated in an objective manner about the surgery and subjectively about their lung function before and after surgery and the degree of satisfaction with the nasal aesthetics through a questionnaire. Results: The age ranged between 14 and 68 years of age; predominant among Caucasians (96.75%). 83.87% of the patients changed their minds after surgery, indicating improvement in breathing pattern. Regarding the nasal aesthetic, 30 (32.26%) patients had exceeded their expectations, 42 (45.16%) felt very good, 18 (19.36%) looked as good and three (3.22%) evaluated with lower than expected. Conclusion: The high d...