A computerized nasal analysis system.

Critical analysis of an aesthetic surgeon's presurgical and postsurgical photographs may provide an excellent tool for self-assessment, research, and teaching. Techniques are presented that allowed precise definition by personnel other than the surgeon of each patient's deformities and the effects of surgery on them. Trigonometric formulas were developed and a computer was programmed to use the X and Y coordinates for facial landmarks to perform many calculations providing distances, angles, projections, and rotations relating to the rhinoplastic surgery. Cases are reported showing typical changes and some results not readily apparent in the photographs. Such data provide not only current analysis of individual cases, but they eventually will become a large data base that may be used to select groups of rhinoplastic cases having common degrees of deformity or of postoperative changes.

Conchal bowl and postauricular flaps for reconstruction of the external auditory canal.

Two techniques for reconstructing the external auditory canal are presented; to our knowledge they have not been described previously. The first technique can be used for disease that does not affect the conchal bowl. The canal is reconstructed with an inferiorly based conchal bowl flap. A second inferiorly based postauricular flap, tunneled through the conchal cartilage, resurfaces the conchal bowl. The postauricular defect is closed primarily. The second technique can be used for disease affecting the conchal bowl. A posteriorly based flap that includes skin overlying the mastoid and posterior surfaces of the pinna is tunneled through the conchal cartilage and resurfaces the conchal bowl and external auditory canal. The defect on the posterior surface of the pinna is closed with tissue advanced from the anterior surface of the pinna at the conchal bowl-antihelical fold junction. The remainder of the retroauricular defect is closed primarily. The advantages of these techniques over current methods are described and illustrative cases presented.

Computerized axial-tomography in the preoperative evaluation of an angiofibroma.

Computerized axial tomography (CAT) of the head provides the otolaryngologist with an effective diagnostic tool. This technique is particularly useful when used in the preoperative evaluation of head and neck pathology and may be used to define the extent of disease and to direct the surgical approach. The case of a 16-year-old male with an extensive angiofibroma involving the paranasal sinuses and nasopharynx is presented as an example of CAT in preoperative planning of the surgical procedure. Computerized tomography was used initially to define the tumor margins. Serial CAT scans were also obtained at intervals during the patient's preoperative estrogen therapy. Evidence was obtained which suggests CAT may be used to monitor the effects of preoperative hormone management of angiofibromas and in the definition of the optimal time for surgery. In the case presented the final CAT scan provided a detailed and accurate description of the tumor margins which were confirmed at surgery. Our experience with a case of an extensive nasopharyngeal angiofibroma demonstrates the CAT scan to be a useful objective diagnostic method for preoperative planning.