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Highlights of Archives of Facial Plastic Surgery
Arch Facial Plast Surg. 2002;4:72.
The Quantification of Surgical Changes in Nasal Tip Support
Mark M. Beaty, MD, Wallace K. Dyer, MD, and Matthew
W. Shawl, MD, (SEE ARTICLE) study nasal tip support in surgical
patients and cadavers using a custom-built tension meter. The authors were
able to quantitate the decrease in tip support when ligamentous attachments
to the lateral crura were divided, and to document that reconstruction of
these ligamentous attachments and columellar strut placement augmented tip
support measured postoperatively. This excellent experimental study is based
on the theoretical concepts developed by Dr Dyer in which he applies the basic
principles of architectural engineering to the nasal tip and its surgical
alteration.
Tissue Response to Expanded Polytetrafluoroethylene and Silicone Implants
in a Rabbit Model
Rami K. Batniji, MD, and associates (SEE ARTICLE) report that expanded polytetrafluoroethylene (ePTFE) and silicone are safe
and commonly used implant materials in facial plastic surgery. They compare
a modified form of ePTFE reinforced with fluorinated ethylene propylene to
silicone. The modified ePTFE may provide increased pliability and material
integrity. The implants were placed in the subperiosteal pockets in rabbits
and histological analysis was performed 7, 30, and 90 days after implantation.
Both implant materials were well tolerated. The silicone implants elicited
significantly thicker capsules and less neovascularization. This modified
ePTFE shows good biocompatility and deserves further study as an implant material.
Orbital Blowout Fractures: Experimental Evidence for the Pure Hydraulic
Theory
John S. Rhee, MD, and colleagues (SEE ARTICLE) studied the biomechanics of orbital blowout fractures in fresh cadavers. They
provided standardized mechanical impact in a relatively physiologic situation
and determined injury patterns with high-speed videography, direct visualization,
and computed tomographic scans. Their studies provided support for the "hydraulic
theory" and evidence against the role of direct globe-to-wall contact in the
pathogenesis of orbital blowout fractures. The orbital floor was found to
have a lower threshold for fracture than the medial wall and threshold values
for fracture occurrence and soft tissue displacement were obtained.
Pharyngeal Flap and the Internal Carotid in Velocardiofacial Syndrome
Sherard A. Tatum III, MD, and colleagues (SEE ARTICLE) report on 20 patients with velocardiofacial syndrome who
received comprehensive imaging studies of internal carotid artery prior to
pharyngeal flap surgery. In all cases there were abnormalities of the major
neck vessels, but 5 of these anomalies were significant enough to place the
vessels directly deep to the donor site for the pharyngeal flap. The authors
present their technique to safely perform pharyngeal surgery in patients with
the velocardiofacial syndrome.
Simplicity Is Complexity Itself
Sleeping Muse I by Constantin Brancusi. (SEE ARTICLE)
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