Minimal incision face-lifting.

Rhytidectomy has been performed for over 100 years, but only more recently has it become generally accepted by society. Recent improvements in access to information has produced more public awareness of the possible aesthetic enhancements. Additionally, there has been a trend for the younger patient to seek cosmetic surgery, often requesting procedures with minimal incisions and less downtime. The mini-lift, with its decreased operating time and expense, rapid recovery, as well as more limited incisions and tissue elevation, is an ideal procedure for patients with a smaller degree of cheek and neck laxity. We describe our concept of the mini-lift and address what results can be expected.

Extended lower eyelid skin muscle blepharoplasty.

A patient presenting to a facial plastic surgeon with lower eyelid aging often has accompanying midface descent. Many surgical options exist to address these deformities. Blepharoplasty techniques include both the transcutaneous skin-muscle flap as well as the transconjunctival approach. The midface can be addressed via a multitude of techniques, including percutaneous suspension of the malar fat pad, deep plane dissections, subperiosteal and endoscopic midface lifts, and transorbital approaches. Patients who have some midface ptosis but do not meet the standard criteria for formal midface lifting, or who want to avoid the extended recovery associated with such techniques, could benefit from less invasive procedures. We propose the extended skin muscle blepharoplasty to address midface descent and lower lid aging to patients as an alternative to formal midface lifting. The extended skin muscle blepharoplasty is an excellent technique for patients with orbicularis hypertrophy, skin redundancy, a tear trough deformity, and premalar ptosis, as it addresses each of these deformities with minimal downtime. Results for patients with mild but visible midface descent are gratifying.

Rhabdomyoma of the larynx: case report and clinical and pathologic review.

We describe a case involving a 79-year-old man with symptoms of slowly progressive hoarseness resulting from a rhabdomyoma originating deep to the right true and false vocal folds. We also review the pathology and radiologic findings of rhabdomyoma.

Metastasis to the submandibular gland in head and neck carcinomas.

BACKGROUND: The purpose of this retrospective chart review was to determine whether and how the submandibular gland is involved in metastases of squamous cell carcinoma of the head and neck. METHODS: We reviewed the records of all patients for whom pathology specimens were available after neck dissection for primary head and neck cancers at two institutions. RESULTS: One hundred sixty-nine patients were included in the study, 27 underwent bilateral neck dissections, and 196 submandibular glands were resected and sent for pathology. One hundred forty-four glands had normal histologic findings. Normal or benign histologic changes were present in 187 glands. Three submandibular glands showed invasion from a locally involved lymph node, and six had direct extension from a primary lesion. The primary lesions were all ipsilateral to the involved gland and originated from cancers of the floor of the mouth, alveolar ridge, and tongue. No submandibular glands showed pathologic evidence of metastases. CONCLUSIONS: Because the submandibular gland has no intraparenchymal lymph nodes, its involvement in upper aerodigestive tract carcinomas must be through extension from a locally involved lymph node or the primary tumor. Previous work has demonstrated that the submandibular gland can undergo transplantation out of the neck with subsequent reimplantation, as a possible means of protection from the effects of radiation. We demonstrated the submandibular gland to be involved only in cases of ipsilateral oral cavity tumors or metastasis to ipsilateral level I lymph nodes. We conclude that it is oncologically sound to consider transplantation and replantation of the contralateral submandibular gland for patients with head and neck squamous cell carcinoma when level I lymph nodes are unlikely to be involved.