Augmentation mentoplasty is an increasingly common surgical procedure that reshapes the contour of the mental area. Presently, there is a paucity of information comparing the efficacy and potential complications of the various techniques and implant materials now utilized in correcting chin deficiencies. A survey was thus devised and sent to Fellows of the American Academy of Facial Plastic and Reconstructive Surgery. Ninety-two surgeons responded describing their results on 11,095 mentoplasty procedures. The overall complication rate was 7.6% with both intraoral and extraoral approaches having similar morbidity. Silicone prostheses had the lowest complication rate, while a higher incidence was associated with acrylic and Proplast® products. The ideal implant has yet to be found and the search should continue for more suitable materials.
These complication rates compare favorably with reported rates of larger studies over the past 30 years. These data support the conclusion that rhytidectomy can be performed safely by otolaryngology residents with little morbidity and good patient satisfaction.
Objective/Hypothesis: To test the hypotheses that 1) magnetic resonance imaging (MRI)-guided biopsy and aspiration with an open 0.2-T system (Magnetom Open, Siemens, Erlangen, Germany) in the head and neck is feasible and successful and 2) procedure times can be sufficiently short to be well tolerated by the patient. Methods: Sixty-one MRI-guided procedures were performed in 47 patients (ages, 6 mo-88 y) in the head and neck, including the mucosal sites and masticator and parapharyngeal spaces (n ؍ 23), parotid space (n ؍ 6), submandibular space (n ؍ 2), cervical vertebral column/paraspinal tissues (n ؍ 8), skull base (n ؍ 3), larynx or hypopharynx (n ؍ 3), and infrahyoid nodal chains and surrounding tissues (n ؍ 16). A clinical C-arm imaging system was used, supplemented by an in-room radiofrequency-shielded liquid crystal monitor, rapid gradient echo sequences for needle guidance, and MRI-compatible anesthesia, monitoring, and surgical lighting equipment. Tissue sampling included fine-needle aspiration (n ؍ 58) and cutting-needle core biopsy (n ؍ 27), with 24 patients undergoing both procedures. Procedures were evaluated for success of needle placement, procedure time, and complications. Results: Successful needle placement was accomplished in all cases without complication, with tissue sufficient for pathological diagnosis obtained for all but five patients with an average of 2.1 passes per patient. For fine-needle aspiration, average instrument time was 7.8 minutes per pass, and average cutting-needle core biopsy time was 9.2 minutes. Conclusions: Interactive MRI guidance for needle biopsy and aspiration of deep head and neck lesions is feasible, successful, and safe. Procedure times are sufficiently short to be well tolerated by the patient.
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