A Novel Treatment for Convex Lateral Crura: The Inverted Spanning Suture.

Rhinoplasty is one of the most complex and challenging procedures in plastic surgery, even for experienced surgeons. Among the steps leading to an aesthetic and functional nose, there is the nasal tip improvement. Today's approach to nasal tip is the product of different techniques shifting through time, mainly from a resection tendency, to preservation and suture use to reshape cartilages. Addressing the lateral crura is vital to an aesthetic nasal tip and it is frequently obtained by adequate suture techniques. The alar-spanning suture described by Perkins is one of such. Regardless of its importance, it was not able to improve convex crura in some cases. The inverted alar-spanning suture (ISS) is an adaptation designed to treat those cases with the suture alone. ISS is a novel technique that can lead to better results treating the convex lateral crura by distributing the force vector in a more effective way. New techniques in rhinoplasty have multiplied, bringing this procedure to a new level and keeping up with the updated notion of restoration instead of excision the ISS is a new, precise, approach to an old problem.

The Horn Technique for Nasal Tip Support in Rhinoplasty.

Introduction The predictability of nasal tip projection and rotation after aesthetic surgery is a challenge. Tongue-in-groove (TIG) is an effective technique to control tip projection and rotation, but there may be a small loss of projection and rotation of the tip lobe due to lack of support between the anterior septal angle and the domus, since this region is sustained by medial crusts suture-linked and interdomus sutures. Objective To describe a new surgery technique in an attempt to correct the lack of support for the nasal tip after lowering the nasal dorsum. Methods The horn technique consists in preserving a square of cartilage during the removal of the nasal dorsum and septum excess in patients with long and projected nose. This piece will give greater support to the TIG technique and greater predictability of the rotation and projection of the nasal tip. Results Between 2016 and 2018, 50 patients with long and projected noses were submitted to the "horn technique" surgery. They were submitted to the TIG technique associated to the horn technique. A retrospective review of the preoperative and postoperative photographs (3 months to 1 year) of these patients treated with the horn technique were analyzed and showed better support of the nasal tip. Conclusion The horn technique provides greater support to the projection and rotation of rhinoplasties in patients with long and projected nose.

Imperfuraçäo coanal bilateral: a propósito de 9 casos / Bilateral choanal imperforation: a report of 9 cases

Os autores comentam brevemente sobre as atresias coanais uni ou bilaterais, bem como sua incidência com relaçäo ao sexo, raça e idade. Lembram as classificaçöes anátomo-histológicas clássicas e a clínica proposta por WILLIAMS(2) para a atresia coanal bilateral. Apresentam nove casos de atresia coanal bilateal em pacientes com idades superiores a 3 anos, discutindo o diagnóstico, a incidência, o tratamento e os resultados obtidos

A via translabiríntica na cirurgia do neuroma do acústico / The translabirintine approach in acoustic neuroma surgery

Os autores apresentam 43 casos de neuroma do acústico operados através da via translabiríntica na clínica ORL do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo e em clínica privada de 1984 a 1988. Foram operados 18 pacientes do sexo masculino e 25 do sexo feminino, sendo 19 do ouvido esquerdo e 24 do ouvido direito. A técnica translabiríntica utilizada propöe a abertura do conduto auditivo interno em sua parede lateral com incisäo da dura-máter e descolamento do tumor do nervo facial. A obliteraçäo do canal foi realizada com músculo, gordura e cola de fibrina. Os resultados das cirurgias apresentam 18.60% de pacientes com fístula liquórica no pós-operatório, com todos os casos controlados. 69.76% dos pacientes evoluíram com paralisia facial no pós-operatório imediato, sendo que 4.65% ainda permaneciam com paralisia facial após 1 ano e seis meses de follow-up. A via translabiríntica é a via de escolha, em nossa opiniäo, para neurinomas do acústico até 3 cm de diâmetro, pois representa uma baixa incidência de tumor e de morbidade em comparaçäo com outras técnicas descritas na literatura

Hemangioma ósseo de seio maxilar: relato de um caso / Bone hemangioma of maxillary sinus: report of a case

Relata-se um caso de hemangioma ósseo de seio maxilar e tecem-se comentários sobre a patologia e o seu diagnóstico