Transnasal correction of choanal atresia.

A simple life-saving modification of the transnasal approach, which does not require endotracheal anesthesia or preoperative tracheostomy, is described. The use of polyethylene tubes, flanged at the distal end and split at the proximal end, is the most significant feature of this technique. In 14 of the 16 cases of choanal atresia presented, this was the definitive corrective procedure, and further revisions or a later transpalatal approach were not required. The advantages of this technique are that it is simple, it may be used in the first 24 hours of life or at any age, the patient may be released from the hospital in 1 to 2 weeks, and minimal postoperative care is required.

Benign pleomorphic adenoma of the larynx. A case report.

Minor salivary gland tumors of the larynx are relatively rare. Morphologically the majority of them are adenoid cystic carcinomas and the overwhelming location is the subglottic larynx. Benign pleomorphic adenomas are rare minor salivary gland tumors of the larynx which usually occur at the glottic and subglottic levels. We present only the sixth case of a supraglottic benign pleomorphic adenoma that we could find in the literature. A preoperative laryngogram localized the tumor to the supraglottic larynx and the intact mucosa suggested a specific differential diagnosis. The tumor was removed by a lateral pharyngotomy with retention of good laryngeal function. The relatively asymptomatic presentation of our case is a somewhat unusual finding which, however, was previously noted in similar case reports.

Intraoral augmentation mentoplasty with a hinged silastic implant.

Considerable concern has been expressed in the past ten years of bone resorption secondary to alloplastic chin implants. Therefore, I describe a modification of the surgical technique and a type of implant. Twenty-five patients underwent augmentation metoplasty for moderate to severe microgenia during the past three years. Surgery was performed with insertion of a modified type of Safian's solid silicone implant with triangular wedges that were removed on the posterior surface, and the spaces that were created were replaced with soft, pore-closed, whit silicone sponge. All implants were inserted intraorally, since the central body was supraperiosteal, and the lateral extensions were subperiosteal. Two implants of the 25 cases were removed postoperatively because of infection. Nine patients were followed up for one to three years postoperatively with serial xerographic analysis of the chin implants.

Comparative histological study of mini pig skin after chemical peel and dermabrasion.

Although individual studies of the histological changes after chemical peel and dermabrasion have been reported, there has not been a comparative study of these modalities in the same animal mode. Using the mini pig, whose skin most closely resembles human skin, a study was performed of histological changes 24 hours to 16 weeks after dermabrasion and chemical peel. A considerable increase in thickness of the new collagen layer was noted after chemical peel in contrast to that seen in skin after dermabrasion. The skin surface after chemical peel appeared smoother after 16 weeks, suggesting that chemical peel may be a more effective modality for treatment of the fine wrinkles of aging skin.