Background
Hump recurrence is one of the commonly encountered problems following dorsal preservation rhinoplasty (DP) during the learning period.
Objective
The aim of this paper is to discuss different methods for the prevention and treatment of dorsal problems following dorsal preservation surgery.
Methods
One hundred fifty primary rhinoplasty patients were included in our study. The noses were classified as to both hump shape (V- or S-shaped) and height. All patients had a dorsal preservation rhinoplasty with either a push-down (PD) or a let-down (LD) technique. The PD method was used for humps <4 mm and the LD for humps >4mm. Follow up evaluations were made with physical examination and photographs at 1 week, 3 months, and 12 months.
Results
Mean follow-up was 12.68 ± 1.78 months. 78 humps were V-shaped and 72 were S-shaped. PD was used for 77 cases, LD for 83 cases. 8 patients (5.3%, 8/150) had a visible dorsal hump problem after DP surgery. Based on their preoperative hump shape, 3 cases were V-shaped and 5 were S-shaped. All recurrent cases had a preoperative hump deformity greater than 4 mm. The revision procedures were as follows: 4 patients had PD procedure, 3 had a LD procedure, and one patient was treated by classic open resection rhinoplasty.
Conclusion
We can say that there is a relatively correlation between preoperative hump height and eventual hump recurrence. The complication rate can be decreased with additional technical maneuvers and proper patient selection.
Cheek defects are common facial defects, especially after tumor ablation. Although primary repair yields the best aesthetic outcome, wide defects require flap resurfacing. Among the flap techniques, the cervicofacial rotation/advancement flap is one of the most common. In cases with eyelid involvement, it is very unlikely that a local flap would single-handedly resurface the defect and additional flaps must be used.This article presents our clinical experience with 14 patients with cheek defects for whom cervicofacial rotation/advancement flaps were used. In 3 of the 14 patients, local flaps that include the laterally based Tripier flap, the Fricke flap, the nasojugal flap, and the median forehead flap were combined with the cervicofacial flap to reconstruct the lower eyelid defects in accordance with the principle of individually reconstructing different anatomic subunits. All infraorbital defects were resurfaced with residual cheek and cervical skin with a good color and texture match. In patients whose eyelids were intact, no malposition was observed.Posteriorly based cervicofacial rotation/advancement flaps offer a very reliable and convenient method for resurfacing infraorbital and medial cheek defects. When a lower eyelid defect is also present, its individual reconstruction as a separate facial subunit needs to be considered using a combination of smaller local flaps.
Avulsion of the globe is a rare condition that can occur with severe maxillofacial trauma. A few bilateral cases have been reported. The objective of this study was to present a case of this challenging condition in a 15-year-old male patient who was admitted to the emergency service after a motor vehicle accident.
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