Plasmonic-enhanced carbon nanotube infrared bolometers.

Plasmonic nanoantennas show significant potential in photodetection applications, but the extent to which their full potential can be realized is dictated by the volume and location of the active materials within the plasmonic structure. Carbon nanotubes (CNTs) have been used as a novel material in photodetection application due to their excellent electronic and optoelectronic properties. However, difficulties in the integration of CNTs in the gaps of nanoantennas have limited the investigation of antenna-coupled CNT detectors. Here, we demonstrate a unique plasmonic approach for selectively growing CNTs in the gap of nanoantenna arrays for fabrication of plasmonic infrared bolometers operating at room temperature. Strong concentration of light at the tips of nanoantennas was utilized for localized heating and growth of CNTs. Moreover, interaction of this strong optical field with the small volume of CNTs enhanced the photoresponse of the bolometers. Consequently, a high responsivity of about 800 V W(-1) was achieved at room temperature.

Reconstruction of large nasal defects.

Large nasal defects resulting from trauma or oncologic resection are a difficult reconstructive challenge, requiring special structural and aesthetic considerations. This article reviews reconstructive options by anatomic site and discusses techniques that address more complex defects, such as those involving multiple aesthetic units.

Management of congenital nasal anomalies.

Congenital nasal anomalies are rare disorders that may present challenges to the facial plastic and reconstructive surgeon. These anomalies are extremely varied and result from a wide range of disordered embryonic development. A basic understanding of nasal and facial development is helpful in understanding these anomalies. In addition, proper respect for the unique challenges of nasal surgery on infants and children is crucial to best serve the patient. This allows a proper work-up and consideration of appropriate treatment options before surgical repair.

Prospective comparison of panoramic tomography (zonography) and helical computed tomography in the diagnosis and operative management of mandibular fractures.

This prospective study compared the sensitivity of panoramic tomography (zonography) and helical computed tomography (CT) in diagnosing 73 mandibular fractures in 42 consecutive patients and correlated the results with known surgical findings. The purpose of the study was to determine the optimal radiologic examination for the diagnosis and operative management of mandibular fractures. The attending surgeons' interpretations of panoramic tomograms and helical CT images in the axial plane were compared with the patients' known surgical findings. A series of questions assessed the relative contribution of these two radiologic examinations in formulating an optimal operative plan for each patient. In the 42 patients studied, the sensitivity of helical CT was 100 percent in diagnosing mandibular fractures; this compared with 86 percent (36 of 42) for panoramic tomography, in which significantly more fractures were missed (p = 0.0412). In the six patients with fractures not visualized, the operative management was altered because of the new fracture visualized on helical CT. Of the seven missed fractures, six were in the posterior portion of the mandible. Comparing fracture detection by region, seven fractures found on helical CT were not visualized on panoramic tomography. Helical CT improved the understanding of the nature of mandibular fractures by providing additional information regarding fracture displacement and comminution and by locating injuries missed using panoramic tomography. This study suggests that helical CT alone may be more diagnostic than panoramic tomography alone in evaluating mandibular fractures. Helical CT sufficiently demonstrated details of fractures in 41 of 42 patients; in one patient, the nature of a dental root fracture was better delineated by panoramic tomography.

Contribution of conventional axial computed tomography (nonhelical), in conjunction with panoramic tomography (zonography), in evaluating mandibular fractures.

Previous studies comparing the sensitivity between different radiological exams have concluded that conventional axial computed tomography (CT; nonhelical) is unsuitable in the assessment of mandibular fractures. Axial CT was shown to have a reduced sensitivity compared with plain radiographs and panoramic tomography because it missed nondisplaced fractures in the posterior portion of the mandible. Because the resolution of CT has improved from the time of these previous studies, the authors were interested in assessing whether axial CT (nonhelical) could now provide additional clinically useful information and enhance our understanding of mandibular fractures, beyond that obtained from panoramic tomography alone. In their study, 5 staff surgeons initially evaluated the panoramic tomograms and then the CT scans of 39 patients with 66 fractures. A series of four questions assessed the relative contribution of these two radiological exams in formulating an optimal operative plan for each patient. The authors found that axial CT provided supplementary information regarding missed fractures, comminution, and the exact size and degree of displacement of fracture fragments. This additional data could have changed the operative plan in a substantial proportion of patients (17 of 39). Axial CT demonstrated two missed parasymphyseal fractures (2 of 39 patients) that were not seen on these patients' panoramic tomograms. Axial CT also revealed undiscovered comminution or demonstrated fracture displacement more precisely in 39% of patients (15 of 39) and 24% of fractures (16 of 66). This study demonstrates that axial CT was clinically useful as an additional investigation to panoramic tomography. Axial CT helped elucidate further the nature of suspected mandibular fractures.

The use of unilateral deep plane neck lifting to improve the aesthetic appearance of the neck dissection deformity.

The primary concerns of head and neck cancer surgeons are, and should remain, the complete extirpation of tumor and the prevention of tumor recurrence. In recent years, numerous advances have been made in the reconstruction of this patient population, significantly improving their functional and aesthetic outcomes. In this article, with an illustrative case example, we present our technique of unilateral deep plane neck lift that may be considered when one is attempting to achieve better symmetry in patients after radical neck dissection.

A reliable absorbable intranasal bolster for proper maintenance of fractured nasal bone position.

The maintenance of comminuted or otherwise unstable nasal bones in proper position following adequate operative reduction, may, on occasion, be a frustrating experience for both the patient and the surgeon. Migration of the fragments may compromise the aesthetic and functional results of well executed corrective nasal surgery. In this article, we will outline our successful, inexpensive approach to this occasionally challenging problem utilising an absorbable intranasal customised Surgicel bolster.

Effective step-by-step technique for the surgical treatment of protruding ears.

OBJECTIVE: Techniques of otoplasty may be arbitrarily divided into cartilage-molding or cartilage-splitting categories. In this article, we describe our personal experience in over 100 otoplasties using a combination of these two methods. We highlight the step-by-step approach, as well as a number of previously unreported techniques, that have enabled us to consistently achieve permanent, esthetically pleasing results in both younger patients, as well as in older adults.

The in vitro evaluation of a local pedicled osteomyocutaneous mandibular flap for the reconstruction of composite mandibular defects.

PURPOSE: The purpose of this study was to develop and assess the potential feasibility of reconstructing composite defects of the mandible with a local pedicled osteomyocutaneous mandibular flap. MATERIALS AND METHODS: The flap design was established based on anatomic principles. A prospective evaluation of the flap was then performed in a fresh cadaver model, and, subsequently, its vascular integrity was documented with angiography. RESULTS: The pedicled osteomyocutaneous mandibular flap was technically simple to raise and had an exceptionally long arc of rotation, which should enable it to fill most compound segmental defects of the mandible. Angiographic studies of the harvested flaps done under fluoroscopic guidance confirmed that excellent vascularity of all components of the flap was present. CONCLUSIONS: The pedicled osteomyocutaneous mandibular flap appears to have a sound anatomic basis. Clinical evaluation is needed to fully elucidate its potential role in head and neck reconstruction.

The AAFPRS Web site.

Technology is changing the way the world communicates. With the Internet in its infancy, the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) understands that utilization of the World Wide Web (WWW) can dramatically help us communicate with each other, with our patients, and with the public. The Web site offers many services to nonmembers and members alike. It is rapidly undergoing changes to achieve the level of excellence that we as facial plastic surgeons have relied upon. This article reviews the current status of the Web site, describes current nonmember and member benefits, and discusses some of the short-term goals for the future at www.aafprs.org.

A new flap for reliable nasal reconstruction.

OBJECTIVE: In this article, we describe a new flap for use in lower nasal reconstruction. METHOD: This technique consists of a planned heminasal transposition rotation flap, with both laterally based and glabellar components. Esthetically favourable incisions are made to follow at the junction between the esthetic subunits. RESULTS: Gratifying early results are achievable, resulting in little postoperative edema due to maintenance of laterally based lymphatic and venous outflow. Likewise, pleasing long-term outcomes have been noted in each of the ten patients in whom we have utilized this flap for nasal reconstruction. Complete flap survival has been noted in every patients. CONCLUSIONS: Our experience with the use of this flap technique suggests that it provides consistently rewarding, esthetically pleasing results in patients with cutaneous defects of the lower half of the nose.

The role of ethmoid sinus surgery in the treatment of the twisted nose.

The correction of the twisted nose remains a challenge from both the functional and aesthetic points of view. It is well recognized that complete correction of this nasal deformity often necessitates not only reconfiguration of the external nasal framework, but also realignment of the septum. The occasional patient will, in addition, require concurrent middle turbinate resection and/or ethmoidectomy to enable one to achieve full correction of both his/her external and septal deformities. We will briefly outline the rationale for this approach w ith an illustrative case example.

A convenient and efficient moldable dressing for skin grafts.

In this paper we present our positive experience with use of Aquaplast thermoplastic as a tie-down dressing for securing and maintaining skin grafts in good position against their nutrient recipient beds. This unique polymer is safe to use, simple to apply, and maintains uniform pressure across the entire surface of the skin graft, no matter how contoured the shape of the anatomical region.

Aquaplast thermoplastic (Opti-Mold). A unique moldable tie-down dressing for full-thickness skin grafts.

Aquaplast thermoplastic (Opti-Mold), a unique moldable "tie-down" dressing, can be heated, shaped, and sutured in place over full-thickness skin grafts. It allows for excellent uniform pressure over a skin graft while also allowing for drainage from the graft bed, and is particularly useful for the contoured surfaces of the nose and ears.

Hereditary agenesis of nasal cartilage. Surgical implications.

In the evaluation of a patient for cosmetic surgery, an underlying congenital origin for the deformities noted, with possible expression in multiple organ systems, should always be considered. In this case, a 19-year-old woman requesting rhinoplasty exhibited facial anomalies: lack of quadrangular and lower lateral cartilages, small bony dorsum, underdeveloped aural cartilage, and infantile larynx and trachea. Otherwise healthy, she recalled having recurrent bouts of croup until she was 15 years old, exercise limitation secondary to stridor, and a family history of nasal hypoplasia. Genetic referral diagnosed her condition as Opitz-BBB/G compound syndrome (oculogenitolaryngeal syndrome), and we here review its head and neck manifestations. Suspected agenesis of nasal cartilage, unreported in previous literature (to our knowledge), was confirmed intraoperatively and presented a unique challenge for reconstruction, including a restricted choice of anesthesia and a need for banked cartilage.

Laser therapy of dysphonia plica ventricularis.

Dysphonia plica ventricularis involves the faulty participation of the ventricular folds in the act of phonation. The speech disorder was one of the first to be described with the use of indirect laryngoscopy. This dysphonia can occur as a compensation for anatomic or physiologic alterations within the larynx (vicarious type) or as isolated ventricular fold hypertrophy unaccompanied by other obvious laryngeal disorders (usurpative type). Conservative phoniatric therapy has been the primary modality of treatment for dysphonias resulting from ventricular fold hypertrophy, with surgical intervention being reserved for those patients not responding to speech therapy. We describe the successful use of the carbon dioxide laser in the excision of the hypertrophied false vocal cords in a patient who failed conservative management with speech therapy.

Computed tomography in the diagnosis of cochlear otosclerosis.

Twelve patients with surgically proven otosclerosis and sensorineural hearing loss were studied with high-resolution computed tomography (CT). The purpose was to identify abnormal bony changes that could be diagnostic of cochlear otosclerosis. Of the 24 temporal bones thus studied, 10 showed positive findings. The findings in our study--as well as those of others--show a pericochlear zone of radiolucency. The precise origin of this is undetermined.