Consent from new patient at first registration

Just as the patient can take a proper decision only if full information is available to him/her, the doctor can take the most appropriate decision for a patient only if the patient provides full and up-to-date information. Unfortunately this does not happen all the time. The Ministry of Health and Family Welfare recommends the Charter of Patients Rights which also includes a specific section on responsibilities of patients and their family members. Based on the legal principle that consent is a contract between two parties, we followed a systematic procedure to develop consensus recommendation for obtaining patient consent in the normal practice setting at first registration/ presentation.

Internal cantholysis for full thickness eyelid defects

Eyelid reconstruction requires an understanding of normal eyelid anatomy and function. A thorough understanding of the basic anatomy, contour, and mobility of the eyelids is essential in restoring the tissue to its presurgical level. There are many different surgical options to assist in the repair of full thickness eyelid defects involving the margin. Direct wound closure depends on eyelid laxity and is often possible with smaller defects. Moderate to larger sized defects are often under undue wound tension if direct closure is attempted. We have developed a new technique for closure of eyelid defects using a transconjunctival cantholysis to release the lateral canthal tendon cruces, thereby avoiding the external incision while still allowing for eyelid mobility. Using this technique for defects 15 mm in horizontal eyelid margin length or greater, we have found positive results. Direct closure of eyelid defects represents the most straightforward technique to repair any full-thickness eyelid defect and provides maximal functional and cosmetic results. Internal cantholysis represents an excellent option for repairing smaller and even larger full thickness eyelid defects. Eyelid mobility increases by 4-10 mm, sometimes more, and allows for closure of defects larger than even 20 mm

Surgical Treatment of Facial Paralysis

The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.

Anesthesia and neuromuscular diseases

This presentation presents a short review of some disease entities affecting the neuromuscular system. Most of these diseases are rare, but many have a direct implication for anesthetic management and the anesthesiologist should be aware of them and the interaction of the patient's disease and the physician's drugs