ABSTRACT
Asian rhinoplasty differs from traditional rhinoplasty approaches in preoperative analysis, patient expectations, nasal anatomy, and surgical techniques used. Platyrrhine nasal characteristics are common, with low dorsum, weak lower lateral cartilages, columellar retraction, and thick sebaceous skin often noted. Typically, patients seek augmentation of these existing structures rather than reductive procedures. Autologous cartilage, in particular use of costal cartilage, has been shown to be a reliable technique, which, when executed properly, produces excellent long-term results. An understanding of cultural perspectives, knowledge of the nasal anatomy unique to Asian patients, and proficiency with augmentation techniques are prerequisites in attaining the desired results for patient and surgeon.
Subject(s)
Asian People , Nose/surgery , Rhinoplasty/methods , Cartilage/transplantation , Esthetics , Humans , Preoperative Care , Ribs/transplantation , Tissue and Organ Harvesting , Transplantation, AutologousABSTRACT
OBJECTIVE: To discuss disaster planning, didactic reorganization, and clinical realignments useful in rebuilding academic otolaryngology residency programs after disaster. SUMMARY: We describe our reorganization and analysis of objective measures in resident education before and after Hurricane Katrina. Post-Katrina, the number of full-time faculty and part-time clinical instructors/gratis faculty has decreased (4 vs 9 and 36 vs 43, respectively), but the number of part-time LSU faculty (private-academic partnership) has increased (0 vs 3) with overall improved resident supervision. Resident complement decreased by 9.3%. Surgical case loads are essentially unchanged. Reorganization of the didactic schedule has increased attendance and maintained examination scores above national averages. Establishment of two new practice sites provided an adequate number of patients for residency training. CONCLUSION: Poststorm reorganization has maintained or exceeded pre-Katrina performance standards. Establishment of communication and data retrieval proved irreplaceable and demand advance preparation.
Subject(s)
Disaster Planning , Internship and Residency/organization & administration , Otolaryngology/education , Biomedical Research/organization & administration , Curriculum , Disaster Planning/organization & administration , Disasters , Faculty, Medical/supply & distribution , Humans , LouisianaABSTRACT
OBJECTIVES: 1. Case report of foreign body and associated orbitoethmoid and skull base mucocele following orbital blowout fracture repair. 2. Literature review of orbital fracture repair complications and endoscopic removal of paranasal sinus and anterior skull base foreign body. DESIGN: Case report and literature review. SETTING: Tertiary-care academic otolaryngology practice. RESULTS: Foreign body involvement of the orbit, paranasal sinuses, and skull base are relatively rare entities. In contrast, orbital blowout fractures are relatively common facial fractures. We report skull base involvement of a previously placed orbital floor implant complicated by mucocele formation and exophthalmos. Successful endoscopic removal and decompression of foreign body and associated mucocele were accomplished. Review of orbital floor fracture repair complications and paranasal sinus and skull base foreign body endoscopic removal were also performed. CONCLUSIONS: Transnasal endoscopic removal of complicated foreign bodies involving the orbit, paranasal sinuses, and anterior skull base can be successfully accomplished given appropriate patient selection and careful technique.
