One-stage extracranial repair and reconstruction for frontoethmoidal encephalomeningocele: a new simple technique.

Forty-five patients born with frontoethmoidal encephalomeningoceles were treated using the craniofacial technique of one-stage extracranial repair and reconstruction. The operation begins with a bicoronal scalp flap, involving frontonasosuperomedial orbital wall osteotomy, reduction of the interorbital distance by nasal bone segment removal, hernial sac amputation and dural repair, medial orbital wall mobilization, medial canthopexy, and rib augmentation rhinoplasty. The result was very satisfactory. This new method has undoubtedly contributed in a major way to the improved results in frontoethmoidal encephalomeningocele treatment. We believe that the main advantages of this technique are that it offers a simple procedure for simultaneous correction of both soft tissue and bony deformities. The direct and external access to the neck of the hernial sac renders more secure dural repair with almost negligible cerebrospinal fluid leakage and eventually none of the postoperative brain sequelae. The postoperative course is less eventful and requires a shorter hospital stay than previous procedures.

Pattern of burn injuries in Thailand.

This paper presents a review of the current status of burn injuries in Thailand with respect to incidence, causes, mortality and identification of management problems. This study analyses the treatment of 1078 burns patients seen over a period of 13 years from 1968 to 1980 at Chulalongkorn Hospital, Bangkok, combined with information made available through personal communication with surgeons at major hospitals in the Bangkok Metropolitan area. It needs to be emphasized that this study does not represent the complete and correct status of burn injuries for the whole country. However, it will demonstrate some aspects of burns and its problems in Thailand. The medical facilities in the Bangkok Metropolitan hospitals serve a population of about 10 million from Bangkok and nearby cities and this figure represents one fifth of the total population of Thailand.