Otoplasty: Combined techniques

Protruding ears is the most common congenital deformity in the head and neck region. There are over 170 techniques described in the literatures. The surgeon should be able to select the best features of the most useful technique for correction of the deformity to provide excellent results. This work present combined techniques, which consists of skin excision of post auricular redundant skin, scoring of the anterior surface of the auricular cartilage, correction of antihelix by Mustarde's sutures, concha- mastoid sutures which correct the excessively deep concha and finally correction of prominent ear lobule. 29 patients with prominent ears were included in this study, [20 patients with bilateral prominent and 9 patients with unilateral prominent ears]. They were 20 males and 9 females. Their ages range from 3-18 years with an average of 7 years. Patients were followed up from 6 months to two years with an average 14 months. There were no infection, hematoma, skin necrosis one case of keloid formation at the site of post auricular incision. Adequate symmetry was achieved in all patients. Our procedure is simple, versatile and applicable to all age groups, as well as it is easy, safe and less time consuming with fewer complications

Computerized morphometric analysis of muscular structure in pelviureteric junction obstruction [PUJO] based on aetiology and duration of obstruction

The pathophysiology of pelviureteric junction obstruction [PUJO] is unknown. Abnormalities of smooth muscle and/or collagen fibers in PUJ were reported by light and electron microscopes. Computerized image analysis was used to objectively quantify the percentage of smooth muscle fibers in surgical specimens of PUJ obtained from 45 patients [28 male and 17 female], aged 1- 53 years mean age 27.48 +/- 12.27, after surgical repair using dismembered technique of pyeloplasty. Control materials were obtained from 10 patients [aged 40-70 years] in whom nephrectomy was done for other pathology than PUJO. Twenty different fields were examined for each tissue section, which were stained by Masson trichrome stain for smooth muscle fibers. In patients with PUJO the percentage of smooth Muscle fibers [SMFs] ranged between 16 and 44% with a mean 26.08 +/- 5.68 while in control group, the Percentage of SMFs was ranging between 41 and 89%with amean 64.22 +/- 13.13 In 34 patients with intrinsic PUJO the percentage of SMFs ranged from 15 to 49% with a mean 24.71 +/- 4.74 while in 11 patients with extrinsic PUJO it ranged between 15 and 49% with a mean 30.31 +/- 6.47. Out of 34 patients with intrinsic PUJO, in patients below I6 years [n=10] the percentage of SMF ranged between 17 and 44% with a mean 27.83 +/- 4.3 and while in patients above 16 years [n=24] the percentage of SMF ranged between 15 and 49% with a mean 23.41 +/- 4.33. The significant difference between mean percentage of smooth muscle fibers in PUJO group 26.08% and control group 64.22% indicate the role of SMF in pathogenesis of PUJO. The difference between percentage of SMF in intrinsic PUJO 24.71% and those of extrinsic causes 30.3 1%, confirm this finding. The difference in percentage of SMFs in patients with intrinsic PUJO below 16 years 27.83% and those above 16 years 23.41% indicate that the duration of obstruction may affect the muscular structure