Cervicofacial Flap: Can We Save Patient's Sideburns?

BACKGROUND: The conventional cervicofacial flap may cause the aesthetic problem of sideburns with a mismatched shape and arrangement. We developed a modified method with the goals of minimizing the destruction of the shape and arrangement of the sideburns and minimizing complications in comparison with the conventional method. METHODS: The incision line was designed to descend just in front of the sideburns, without passing through them, and then to ascend with the sideburns posteriorly when a cervicofacial flap is performed, unlike the conventional method. Patients in whom this method was applied (group B) and patients who underwent surgery using the conventional method (group A) were investigated in a retrospective study. The method was evaluated by assessing changes in the arrangement of the sideburns and patients' satisfaction, and differences in the complication rate. RESULTS: In group A, 23 of the 31 patients experienced changes in the arrangement of their sideburns. Most patients who experienced a change in the arrangement of their sideburns were dissatisfied with the change. The patients in group B did not experience such changes, and the defects were well reconstructed. Most of them were satisfied with the final sideburn arrangement. CONCLUSION: A novel method was used to preserve the sideburns while performing a cervicofacial flap. As a result, the appearance of the sideburns was well preserved and the satisfaction of patients was also high. Moreover, this technique could also prove useful for reconstruction without any increase in complications compared to the conventional method.

Analysis of Orbital Volume Measurements Following Reduction and Internal Fixation Using Absorbable Mesh Plates and Screws for Patients With Orbital Floor Blowout Fractures.

INTRODUCTION: Hinge-shaped fractures are common type of orbital floor blowout fractures, for which reduction and internal fixation is ideal. Nonetheless, orbital floor reconstruction using alloplastic materials without reducing the number of bone fragments is the most frequently used procedure. Therefore, this study analyzed and compared the outcomes between open reduction and internal fixation using absorbable mesh plates and screws, and orbital floor reconstruction, by measuring the orbital volume before and after surgery. METHOD: Among patients with orbital floor blowout fractures, this study was conducted on 28 patients who underwent open reduction and internal fixation, and 27 patients who underwent orbital floor reconstruction from December 2008 to September 2015. The mechanism of injury, ophthalmic symptoms before and after surgery, and the degree of enophthalmos were examined; subsequently, the volumes of the affected and unaffected sides were measured before and after surgery based on computed tomography images. This study compared the degree of recovery in the correction rate of the orbital volume, ophthalmic symptoms, and enophthalmos between the 2 groups. RESULT: The patients who underwent open reduction and internal fixation, and the patients who underwent orbital floor reconstruction showed average correction rates of 100.36% and 105.24%, respectively. Open reduction and internal fixation showed statistically, significantly superior treatment outcomes compared with orbital floor reconstruction. The ophthalmic symptoms and incidence of enophthalmos completely resolved in both groups. CONCLUSION: For orbital floor blowout fractures, open reduction and internal fixation using absorbable mesh plates and screws was a feasible alternative to orbital floor reconstruction.