Correction of Post-Traumatic Enophthalmos and Temporal Depression Using Rib Cartilage and Fat / 대한이비인후과학회지

Posttraumatic enophthalmos is one of the common complications of facial bone fracture, leading to serious functional and esthetic sequele. However, the correction of this complication is a challenging procedure. A 62-year old patient was injured in a traffic accident, resulting in enophthalmos of the right orbit, which had been uncorrected by a previous correction surgery. The patient showed prominent enophthalmos, ptosis of right orbit, and temporal area depression without complaining diplopia. Under general anesthesia, the correction of enophthalmos of right orbit was done using diced coastal cartilage and an absorbable mesh plate. The depressed right temporal and the frontal area were reinforced using harvested abdominal fat. Three months after the surgery, additional fat injection was introduced to supplement under local anesthesia. Currently, 12 months after the surgery, the patient is in stable state without any complications.

An Animal Model of Tracheal Stenosis Induced by an Endotracheal Segmented Tube / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Various methods to induce tracheal stenosis in an animal model have been introduced. However, most methods use non-physiologic mechanical or chemical injury to tracheal mucosa or cartilage. In this study, we sought to develop an animal model of tracheal stenosis using a segmented endotracheal tube. MATERIALS AND METHOD: Nine New Zealand White Rabbits were included in this feasibility study. A segmented 1.5 cm LEVIN-Tube (16 French) was inserted into tracheal lumen via tracheotomy site and fixed with a nylon tape circumferentially tied around the trachea. The tube was removed transorally one week later and the tracheal lumen was observed with bronchoscopy every week. Rabbits were sacrificed two weeks after the tube removal and the trachea was evaluated with histologic image. Three rabbits underwent tracheotomy and closure only to evaluate possible impact of tracheotomy procedure to tracheal stenosis (sham surgery). RESULTS: None of the 6 rabbits showed significant complications or death during the study. No significant change of tracheal lumen was identified in 3 sham models. The mean grade of stenosis was 57.2±9.9% (range, 43-70%). Histologic image showed thickening and fibrosis of lamina propria with relatively intact tracheal cartilage framework. CONCLUSION: We developed an animal model of tracheal stenosis using a segmented endotracheal tube fixed with a nylon tape. Since this model has similar pathophysiology to prolonged endotracheal intubation, it may be used in various studies related to tracheal stenosis.