Reconstruction of the perioral and perinasal defects with facial artery perforator flaps.

Perioral and perinasal regions are important aesthetic subunits of the face. Numerous traditional flaps supplied by the facial artery are well known and have widespread use in these regions. Elevation of these flaps based on the perforator branches of the facial artery can make them more mobile, reliable and adaptable. This report presents the authors' experience using a facial artery perforator flap in the reconstruction of perioral and perinasal defects. Twelve clinical cases with 14 perioral and perinasal skin defects resulting from malignant or benign skin tumour excision were reconstructed using facial artery perforator flaps. Surgical technique was planned by adhering, as much as possible, to the principle of aesthetic unit for facial reconstruction. The donor-site scars were designed parallel to the facial wrinkles when possible. As an adjunct procedure, a lower lip buccal mucosal V-Y advancement flap was used in some patients who had defects that included lower lip mucosa. In all cases, favourable cosmetic and functional results were obtained with a single-stage procedure that did not require secondary revisions. The aesthetically pleasing donor site based on the facial artery perforators offers a versatile tailor-made flap, because of the reliable presence of perforators, with a large arc of rotation. The quality of the results obtained using this flap represents a considerable advance in facial reconstruction.

An unusual auricular malformation accompanied by accessory tragus: macrotragus.

Definition of malformations of the tragus is important for terminology and treatment. Most common entities are the skin tag, accessory tragus, preauricular sinus, and cyst, whereas macrotragus is an uncommon and unaddressed deformity that should be distinguished from these. In this report, three cases with diagnosis of the macrotragus are presented. The tragus was uniformly large and displaced anteriorly, and external auditory meatus was not obliterated in all cases. For correction, excision of the excess tragal cartilage and skin was performed. In all cases, bilaterally symmetric tragus was achieved. There were no complications in the early postoperative period and there was no enlargement after 6months of observation. Macrotragus and accessory tragus are different entities that should be distinguished for accurate diagnosis. They have similar histopathological but distinct anatomical characteristics. Although both are treated by a simple excision, in the case of macrotragus, special effort should be taken to leave enough cartilage to restore normal tragal contours.

Congenital absence of flexor pollicis longus tendon without associated anomalies of thumb hypoplasia: a case report and review of the literature.

In this paper, we report a case of a 14-year-old girl with congenital aplasia of the flexor pollicis longus tendon who had no other associated anomalies of thumb hypoplasia and no trauma history. Flexor pollicis longus tendon anomalies are rare; several types of this congenital anomaly have been reported in the literature. The diagnosis should be considered if a patient is unable to flex the interphalangeal joint of the thumb. A hypoplastic thumb or an absent interphalangeal joint crease may be a diagnostic feature in such cases. Besides physical examination, we also used direct radiography and magnetic resonance imaging to diagnose this rare congenital anomaly in our patient.