We recommend the use of ultra-thin porous polyethylene implants in the reconstruction of the orbital floor defects in facial trauma patients. The implants are durable in the long-term and mimic the anatomy of the thin orbital floor and avoid the morbidity of autogenous bone grafts.
Background:Although various techniques have been described for correction of crooked and saddle nose deformities, these problems are challenging with high recurrence and revision rates. Conventional septal surgery may not be adequate for nose reconstruction in crooked and saddle nose deformities.Materials and Methods:Between December 2005 and October 2009, six patients with crooked nose and five patients with saddle nose deformities underwent corrective surgery in our clinic. All patients were male, and the mean age was 21 years (range, 19-23 years). We used rigid radial bone graft to prevent redeviation and recurrence following corrective nasal septal surgery.Results:The mean follow-up period was 28 months, ranging from 18 to 46 months. Mean operation time was 4 hours (3-4.5). All patients healed uneventfully. None of the patients required secondary surgery.Conclusions:We believe that radial bone grafts offer a long lasting support in treatment of challenging cases with crooked and saddle nose deformities.
The actual pathology of the Nicolau syndrome (NS) is still unknown. It is thought to involve direct vascular damage and vasospasm. Many NS cases were reported in the literature but a treatment protocol is still not established. However, after demarcation of the necrotic tissue, surgical intervention is mandatory. Five NS cases with extensive tissue necrosis on the upper lateral gluteal region were analyzed retrospectively. Operative technique was described in details for freestyle perforator-based fasciocutaneous flaps from the gluteal region to reconstruct defects of NS-related tissue necrosis. Freestyle perforator-based fasciocutaneous flaps were used for defect closure in all patients. All flaps survived totally. No complications occurred during the follow-up period. Although rare, NS is a serious complication of inadvertent intramuscular injections. Prevention is the best treatment. However, in case of large-tissue necrosis, freestyle perforator-based fasciocutaneous flaps harvested from the gluteal region is a satisfactory option for reconstruction.
Intraosseous cavernous hemangioma is an uncommon benign vascular tumor. A 21-year-old man presented with a small painless swelling of the left foot's long toe. X-ray examination showed an outgrowing bony lesion that has cortical continuity in the tip of the long toe's distal phalanx lateral aspect. Preoperative examination yielded no final diagnosis. En bloc resection was performed. The histological diagnosis was intraosseous cavernous hemangioma. To the best of our knowledge, this case is a first report of primary intraosseous cavernous hemangioma of the toe.
Parosteal lipoma of the head and neck is very rare, and there is no reported case of parosteal lipoma in the frontal region. We present the case of frontal parosteal lipoma in a 20-year-old man who was referred for a forehead mass causing a cosmetic problem. Computed tomography revealed an osseous projection with cortical irregularity and soft tissue enlargement. Excision of the lesion revealed a 7 x 4.5-cm lobulated, encapsulated, yellow tan mass. Histopathologic examination revealed mature adipose tissue, and pathologic diagnosis of lipoma was made. Here, we present the first case of parosteal lipoma in the frontal region.
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