Kirschner Wire Fixation for the Treatment of Comminuted Zygomatic Fractures

BACKGROUND: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. METHODS: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, Kwire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). RESULTS: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. CONCLUSION: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.

Immediate Direct-To-Implant Breast Reconstruction Using Anatomical Implants

BACKGROUND: In 2012, a new anatomic breast implant of form-stable silicone gel was introduced onto the Korean market. The intended use of this implant is in the area of aesthetic breast surgery, and many reports are promising. Thus far, however, there have been no reports on the use of this implant for breast reconstruction in Korea. We used this breast implant in breast reconstruction surgery and report our early experience. METHODS: From November 2012 to April 2013, the Natrelle Style 410 form-stable anatomically shaped cohesive silicone gel-filled breast implant was used in 31 breasts of 30 patients for implant breast reconstruction with an acellular dermal matrix. Patients were treated with skin-sparing mastectomies followed by immediate breast reconstruction. RESULTS: The mean breast resection volume was 240 mL (range, 83-540 mL). The mean size of the breast implants was 217 mL (range, 125-395 mL). Breast shape outcomes were considered acceptable. Infection and skin thinning occurred in one patient each, and hematoma and seroma did not occur. Three cases of wound dehiscence occurred, one requiring surgical intervention, while the others healed with conservative treatment in one month. Rippling did not occur. So far, complications such as capsular contracture and malrotation of breast implant have not yet arisen. CONCLUSIONS: By using anatomic breast implants in breast reconstruction, we achieved satisfactory results with aesthetics better than those obtained with round breast implants. Therefore, we concluded that the anatomical implant is suitable for breast reconstruction.

The Use of a Transparent Corneal Protector Permits Early Detection of Mydriasis to Prevent Blindness during Orbital Wall Fracture Surgery

No abstract available.

A One Stage Reconstruction of Defective Type Cleft Earlobe: Infra-auricular Transposition Flap

PURPOSE: Reconstruction of the cleft earlobe is challenging. Several procedures are available to reconstruct congenital earlobe deformities. However, for large defective type, surgical procedures and designs are complex and tend to leave a visible scar. We present a simple method of reconstruction for defective type congenital cleft earlobe using a one stage technique with infra-auricular transposition flap. This allows for easy and accurate size estimation and good aesthetic outcomes. METHODS: A 4-year-old male patient has congenital cleft earlobe and antihelical deformity. Otoplasty for antihelical deformity correction and one stage infra-auricular transposition flap for earlobe reconstruction were performed. The flap was designed from the inferoanterior margin of the earlobe. The size of the flap was determined based on the normal side, and the width and length of the flap was 1 cm and 3 cm in size, respectively. An incision was made at the midline of the defective lobule. Further, the elevated flap was inserted. The elevated flap and the incision margins of the lobule were sutured together. Then, the donor site was closed primarily. RESULTS: The volume and shape of the reconstructed earlobe were natural. There was no flap necrosis. The donor site had no morbidities and scar was not easily notable. CONCLUSION: Infra-auricular transposition flap can be designed easily and offer sufficient volume of earlobe. Furthermore, the scar is inconspicuous. In conclusion, infra-auricular transposition flap can be a good option for reconstructing a large defect type cleft earlobe.

A Case of Lymphoepithelial Cyst of Palatine Tonsil / 대한이비인후과학회지

Lymphoepithelial cysts of the oral cavity are rare lesions. The incidence when the number of lymphoepithelial cysts was compared to the total number of oral biopsies was 0.09 percent. Especially, the number of lymphoepithelial cysts originated from palatine tonsil was very small. They have been reported as branchial cleft cysts, branchiogenic cysts and pseudocysts because microscopically resemble each other. The lesions present as a small, well circumscribed, yellowish elevated nodule lined with stratified squamous epithelium surrounded by lymphoid tissue, usually on the floor of the mouth or the ventral or posterolateral surface of the tongue. Less frequent locations include the soft palate, mandibular vestibule, anterior pillar, and retromolar pad. We present a case report of a patient with an lymphoepithelial cyst in the right palatine tonsil presenting with throat discomfort.