ABSTRACT
INTRODUCTION: Many surgical techniques have already been described to repair full thickness defects of the inferior part of the nose. The Schmid-Meyer fronto-temporal flap procedure, a little known technique, is based on the old principle of autonomization of a cutaneous flap and uses a tailor-made composite cartilaginous graft placed in the temporal region. This graft is progressively detached and allows mucosal/cartilaginous/and cutaneous nasal repair. Can this technique still be used for nasal full-thickness reconstruction? PATIENTS AND METHOD: Nine cases of nasal reconstruction using this procedure were performed. The 4-steps of the operative technique were described and the results were analyzed retrospectively. RESULTS: This procedure allows, for some specific indications, excellent reconstruction of the ala, the columella or the nasal tip. In eight cases out of nine, the result was judged good or very good by both patients and physicians. In 78%, the reconstruction was performed under local anesthesia. DISCUSSION: The Schmid-Meyer flap procedure may still be used for full-thickness reconstruction of the lower third of the nose because it allows a high quality of nasal reconstruction and few scar sequels.
Subject(s)
Ear Cartilage/transplantation , Nose/surgery , Rhinoplasty/methods , Skin Transplantation/classification , Surgical Flaps/classification , Aged , Esthetics , Female , Follow-Up Studies , Humans , Male , Middle Aged , Nasal Cartilages/surgery , Nose/injuries , Nose Neoplasms/surgery , Patient Satisfaction , Retrospective Studies , Surgical Flaps/pathology , Surgical Flaps/transplantation , Treatment Outcome , Young AdultABSTRACT
OBJECTIVES: Retrospective analysis of the oncological results and morbidity of ethmoid sinus adenocarcinoma surgery, and identification of survival factors. MATERIAL AND METHODS: Forty-two patients were treated from 1990 to 2009. The study covered clinical presentation, medical imaging, histologic data, TNM grade, treatment, morbidity and overall recurrence-free survival. RESULTS: Forty-one men and one woman, with mean age at diagnosis of 61.5 years, were included. 85.7% had been exposed to wood dust. Twenty patients (47.6%) were graded T4 at diagnosis. Thirty-three (78.5%) were treated by surgery followed by radiation therapy; nearly half of these showed recurrence. Overall specific 5-year survival was 44.2% at 5 years and recurrence-free 5-year survival 46.4%. The factors of poor prognosis found were cerebromeningeal or orbital invasion and local recurrence. CONCLUSION: This series confirms the epidemiological literature on ethmoid adenocarcinoma and the influence of poor prognosis factors. Survival depended directly on local tumor control and seemed to be enhanced on an isolated transfacial approach.
Subject(s)
Adenocarcinoma/mortality , Adenocarcinoma/therapy , Ethmoid Sinus/pathology , Paranasal Sinus Neoplasms/mortality , Paranasal Sinus Neoplasms/therapy , Adenocarcinoma/pathology , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Dust , Ethmoid Sinus/surgery , Female , Humans , Male , Middle Aged , Neoadjuvant Therapy , Neoplasm Metastasis , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/therapy , Occupational Exposure/adverse effects , Paranasal Sinus Neoplasms/pathology , Radiotherapy, Adjuvant , Retrospective Studies , Wood/adverse effectsABSTRACT
OBJECTIVES: To evaluate the efficacy of treatment of drooling by ultrasound-guided botulinum toxin injection of the salivary glands and to determine the optimal modalities of this procedure. PATIENTS AND METHODS: This study is a retrospective review of patients treated for drooling by injection of 100 units of Botox(®) into the parotid and submaxillary glands between 2002 and 2008. Efficacy was evaluated by a quality of life questionnaire six weeks after the injections. RESULTS: One hundred and eleven injection sessions were performed in 70 patients aged one to 84 years with a beneficial effect in 66% of cases. The most effective protocol was injection of 20 units of botulinum toxin into each submaxillary gland and 30 units of toxin into each parotid gland. CONCLUSION: The treatment of drooling by Botox(®) injections into salivary glands is effective. The authors propose ultrasound-guided injection of both submaxillary glands and both parotid glands. These injections can be repeated in the case of recurrence of drooling.
Subject(s)
Botulinum Toxins, Type A/administration & dosage , Neurotoxins/administration & dosage , Parotid Gland , Sialorrhea/drug therapy , Submandibular Gland , Ultrasonography, Interventional , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Injections , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
INTRODUCTION: Juvenile ossifying fibroma is a rare, benign fibro-osseous tumour. In the light of a clinical case, the authors review the diagnosis, treatment and histological classification of these tumours. CASE REPORT: A seven-year-old child presented with a naso-orbito-ethmoidal trabecular juvenile ossifying fibroma. Complete surgical resection via a transfacial approach was performed after a preoperative work-up comprising head and neck CT and MRI. DISCUSSION: A review of the literature reveals that treatment of this aggressive tumour must comprise complete surgical resection via an incision determined by local tumour extension. CONCLUSION: Patients with juvenile ossifying fibroma tumour require long-term follow-up due to the high recurrence rate.