Unusual complication after augmentation genioplasty: Odontogenic infection requiring implant removal.

Augmentation genioplasty is a common surgical procedure with extremely low infection rates. We present the case of a healthy middle-aged woman who experienced years of chronic infection after chin implantation due to an exposed mandibular canine root, which is exceedingly rare. Awareness of this potential complication may reduce patient morbidity.

Pediatric nasal valve surgery: short-term outcomes and complications.

OBJECTIVES: To examine the short-term outcomes and complications of open nasal valve surgery in children under 16 years of age. STUDY DESIGN: case series and chart review study setting: an urban, tertiary, pediatric otolaryngology practice. METHODS: Children under 16 years of age who had undergone nasal valve surgery with cartilage grafting for functional indications were identified. Patients with cleft-related nasal deformities were excluded. Charts were reviewed for indications and short-term outcomes (patient satisfaction and postoperative complications within the first 90 days). A literature review assessed prior outcomes in adult nasal valve patients. RESULTS: Fifteen pediatric patients, 15 years old or younger, were identified as having undergone open nasal valve repair utilizing septal or auricular cartilage grafts. Patient age ranged from 6 to 15 years. Surgical indications were nasal obstruction with nasal valve stenosis related to either previous trauma (n=10), congenital deformity (n=3), iatrogenic injury (n=1) or hemangioma of infancy (n=1). All patients noted improvement of symptoms at the 90 day interval or later. There was one episode of self-limited epistaxis, which occurred on postoperative day 7 following splint removal. CONCLUSIONS: In children, an obstructive nasal breathing pattern may be caused by nasal valve collapse, which can be addressed with nasal valve surgery. This small series suggests that short-term results in children may be similar to those observed in the adult population. Pediatric nasal valve surgery outcomes have not been described previously; studies focused on long-term outcomes following pediatric nasal valve surgery are needed. LEVEL OF EVIDENCE: 4.

Brow-lift: subgaleal vs subperiosteal flap adherence in the rabbit model.

OBJECTIVE: To analyze and compare the postoperative adherence qualities between the subperiosteal layer approach and the subgaleal layer approach for brow elevation using a rabbit model. METHODS: Twelve New Zealand white rabbits (weight, 3.1-3.5 kg) were evenly divided into 2 groups and underwent forehead flap elevation via subperiosteal or subgaleal dissection, depending on the group assignment. Two rabbits were not operated on and served as controls. Histologic and biomechanical testing (tensiometer) was performed at 2, 4, 6, 8, and 10 weeks to assess adherence and wound strength. RESULTS: The subgaleal flap strength was greater than that of the subperiosteal flap at each time point. The mean flap strength for the subgaleal and subperiosteal control subjects were 208 g and 706 g, respectively. These values approximately correspond with the postelevation subgaleal flap strength regained at 2 weeks and the postelevation subperiosteal flap strength regained at 8 weeks. On histologic analysis, the subgaleal specimen showed less intervening space and a greater degree of connective tissue proliferation than the subperiosteal specimen at as early as 4 weeks. CONCLUSION: This study supports our hypothesis that rapid healing and early fixation occurs when the subgaleal approach is used for surgical brow elevation.

Lower lid blepharoplasty and canthal surgery.

Lower lid blepharoplasty is an effective procedure to address aging changes of the eyes and periorbital regions. Success requires a thorough understanding of the relevant anatomy, proper patient selection, and meticulous surgical technique. When performed skillfully, the transcutaneous and transconjunctival approaches can offer the patient excellent results with a low risk of complications.

Biomechanical properties of tissue-engineered cartilage from human and rabbit chondrocytes.

OBJECTIVE: To describe tissue-engineered cartilage from rabbit and human chondrocytes. STUDY DESIGN AND SETTING: Chondrocytes from rabbit and human ears were seeded onto a template and implanted for 8 or 16 weeks of in vivo incubation. RESULTS: For the 8-week and 16-week groups, the UTS for cartilage was 3.8 MPa and 3.7 MPa, stiffness was 62.4 MPa and 51.8 MPa, and resilience was 181.8 J/m(3) and 109.1 J/m(3), respectively. Experimental cartilage was significantly different from controls. From 5 human specimens, the UTS was 5.4 MPa, stiffness was 6.6 MPa, and resilience was 2.0 J/m(3). The control had UTS of 8.8 MPa, stiffness of 12.2 MPa, and resilience of 2.9 J/m(3). Histology showed mature cartilage but with a fibrovascular infiltrate and increased cellularity. CONCLUSIONS: Mechanical properties of tissue-engineered cartilage can be quantified and are less than that of controls.