Preoperative lip taping in the cleft lip.

For the past 16 years, the senior author has used a nonsurgical method of mobilizing and approximating the soft tissues of the lip, nose, and maxilla before primary cleft lip repair. This has been accomplished effectively and inexpensively with the use of surgical tape applied to the lip across the cleft shortly after birth. The method used in applying the tape will be described. In addition to the positive soft-tissue effects, we found that lip taping effectively narrows, remodels, and approximates the alveolar arch, eliminating the need for initial orthodontia in all patients except those born with maxillary collapse. Lip taping accomplishes all of the goals of surgical lip adhesion at a fraction of the cost and eliminates the potential risk involved in one additional operation.

Corpus callosum surface area across the human adult life span: effect of age and gender.

This magnetic resonance (MR) imaging study analyzed and provides normative data on the midsagittal surface area of the corpus callosum (CC) across the human adult life span in 200 normal volunteers. Using MR imaging scans, CC midsagittal surface area was quantified, along with midsagittal intracranial surface area and total intracranial volume (measures of cranial size). Results demonstrate that when head size is controlled, no major changes associated with normal aging are evident in the CC during the more active years of adult life span (up through 65). Overall, females had significantly larger CC relative to total intracranial volume. Results are discussed in terms of potential gender differences in CC size and the clinical application of this normative data.

Comparison of skin necrosis in rats by using a new microneedle electrocautery, standard-size needle electrocautery, and the Shaw hemostatic scalpel.

"Microneedle" electrocautery was compared against the standard-size needle electrocautery and the Shaw hemostatic scalpel to determine the differences in tissue necrosis when used as a cutting instrument. Incisions were made on the dorsal skin of anesthetized white rats using each of the three devices with the no. 15 scalpel as control. The specimens were submitted for histological evaluation. The microneedle caused less necrosis than the standard-size needle electrocautery (0.18 vs 0.27 mm, p < 0.01) and less necrosis than the Shaw hemostatic scalpel set at 220 degrees F (0.18 vs 0.25 mm, p < 0.05). The microneedle electrocautery was also found to be an instrument that causes very little tissue distortion during fine dissection and helps to minimize blood loss in craniofacial and neurosurgical operations.

Submuscular transposition of the ulnar nerve.

A retrospective study of 26 submuscular ulnar nerve transpositions was performed with the specific use of grip and pinch analysis to evaluate this form of objective testing. Twenty-six patients were treated by submuscular transposition of the ulnar nerve between 1981 and 1985 and were followed an average of 21 months. Preoperative and postoperative analysis consisted of subjective questioning, clinical examination, quantitative two-point discrimination, quantitative pinch and grip analysis, and electromyographic (EMG) and nerve conduction velocity (NCV) evaluation. Many of the patients suffered from associated problems such as alcohol abuse, diabetes mellitus, and concurrent Guyon's canal compression, which adversely affected the outcome. Subjectively, 62% were improved, 31% were no better, and 7% were worse. Clinical examination demonstrated 46% improved, 35% no better, and 19% worse. Quantitative two-point discrimination was better in 59%, unchanged in 26%, and worse in 15%. Quantitative pinch and grip analysis revealed 28% improved, 56% with little improvement, or the same, and 16% worse, while EMG/NCV showed one-third of the patients in each category postoperatively. Quantitative pinch and grip analysis provided good preoperative and postoperative documentation, which is absent from previous studies in the literature concerning ulnar nerve transportation.