concluSIon: Excellent cosmetic results can be obtained in breast reconstruction with or without ADM as Figure 2 demonstrates. The algorithm demonstrates the specific situations when the uses of ADM are beneficial. This algorithm can contain costs when anatomy following mastectomy is favorable and ADM is not necessary. Figure 2. Two stage right breast reconstruction without use of ADM. reFerenceS: 1. Namnoum JD. Expander/Implant Reconstruction with Alloderm: Recent Experience Plast Reconstr Surg.
Primary closure of donor site when performing ALT free flap gets increasingly difficult as the ratio of deep tissue including muscle in the thighs increased. Such information prior to the procedure will be helpful in determining flap design and finalizing the operation plan.
Operative techniques in performing cleft palate repair have gradually evolved to achieve better speech ability with its main focus on palatal lengthening and accurate approximation of the velar musculature. The authors doubted whether the extent of palatal lengthening would be directly proportional to the speech outcome. Patients with incomplete cleft palates who went into surgery before 18 months of age were intended for this study. Cases with associated syndromes, mental retardation, hearing loss, or presence of postoperative complications were excluded from the analysis. Palatal length was measured by the authors' devised method before and immediately after the cleft palate repair. Postoperative speech outcome was evaluated around 4 years by a definite pronunciation scoring system. Statistical analysis was carried out between the extent of palatal lengthening and the postoperative pronunciation score by Spearman correlation coefficient method. However, the authors could not find any significant correlation. Although the need for additional research on other variables affecting speech outcome is unequivocal, we carefully conclude that other intraoperative constituents such as accurate reapproximation of the velar musculature should be emphasized more in cleft palate repair rather than palatal lengthening itself.
Many methods of surgical repair of pure medial orbital fractures have been reported. In this study, we discuss the outcome from the surgical corrections of hydroxyapatite (Biocoral) or porous polyethylene (Medpor) through subciliary approach, and the transnasal endoscopic corrections. Between March 1993 and July 2003, 63 patients were treated with porous polyethylene and 48 patients were treated with hydroxyapatite. Between August 2003 and December 2005, 50 patients were treated with transnasal endoscopic approach. Patients had at least 6 months' follow-up, and the records for diplopia, enophthalmos, and other postoperative complications were reviewed retrospectively. As a result, 1 patient from the group using porous polyethylene, 2 patients from the group using hydroxyapatite, and 1 patient from the endoscopic correction group had enophthalmos. Besides enophthalmos, no other complications were observed. There was no significant statistical correlation among 3 groups. In conclusion, a transnasal endoscopic correction may be considered a useful method for surgical repair of pure medial orbital fractures, with no external facial scar and excellent visualization and accuracy comparable to that of the subciliary approach.
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