Single-stage reconstruction of skin-involving nasal paraffinoma with pericraniosubgaleal flap.

BACKGROUND: The removal of a paraffinoma over the nasal bridge may result in thinning and even loss of involved skin as well as a saddle nose deformity. For nasal reconstruction, a variety of techniques using a free graft of autogenous tissue such as fascia, dermofat, or cartilage have been used, either in immediate, single-stage or in delayed, multiphase treatment. However, such reconstructions can be challenging largely due to absorption of the grafted tissue and poor blood supply to the surrounding nasal tissue infiltrated with paraffin. This article reports the successful clinical outcomes of immediate, single-stage reconstructions by wrapping a pericraniosubgaleal flap over the nasal implant after removing a paraffinoma. METHODS: Eleven patients with a paraffinoma showing a palpable lump, redness, or telangiectasia over the nasal skin were treated between November 1998 and March 2011. The mean follow-up period was 20.1 months. As much of the paraffinoma as possible was removed via a bidirectional approach (open rhinoplasty and frontal hairline incision), and the resulting deformity was reconstructed simultaneously using a pericraniosubgaleal flap and turning it over the sculpted nasal implant (ePTFE; GORE-TEX(®) in nine cases and silicone in two cases). RESULTS: Nine patients (81.8%) were treated successfully without complications and were satisfied with their results. However, the other two patients complained of incomplete removal of the paraffinoma requiring additional removal. Telangiectasia over the nose improved in four out of six patients after surgery. CONCLUSION: Nasal reconstruction using a pericraniosubgaleal flap is one of the most reliable surgical options for treating skin-involving nasal paraffinomas. The advantage of such a method is that a well-vascularized and durable flap, which is resistant to infection, is wrapped over the sculpted nasal implant in a single step. It also reinforces the thinned skin, which makes it easier to form various shapes, producing excellent cosmetic results. Finally, it can also serve as a tolerable graft bed in the case of overlying skin loss.

Unconventional method for morphology-controlled carbonaceous nanoarrays based on electron irradiation of a polystyrene colloidal monolayer.

An unconventional and straightforward route to fabricate morphology-controlled 2D ordered carbonaceous nanoarrays is presented. This route is based on the electron irradiation of a polystyrene colloidal monolayer followed by thermal decomposition. This strategy has the advantages of low-cost fabrication and easy manipulation compared to conventional lithography technique and furthermore overcomes the disadvantage of the self-assembly technique that generally has the defect of irregular units in ordered arrays. Various nanoarrays with irregular units, including network-like and star-like ordered arrays as well as hexagonal non-close-packed dot arrays, were fabricated by this novel route. These ordered arrays can be used as templates or masks to fabricate other ordered structures and then can be removed completely by thermal decomposition at a high temperature. Additionally, these arrays are carbonaceous materials that have higher thermal stability and higher refractive index compared with those of the pristine polymer, which are important for real applications such as optical devices. This method might also be used for the fabrication of other unique ordered arrays if different polymer precursor materials are used.