Polymethyl-methacrylate implants in forehead and supraorbital arches reconstruction: retrospective study.

Frontobasal injuries and some other diseases of frontal sinuses sometimes require radical surgery with the obliteration of the sinus. A cosmetic correction of the forehead and supraorbital arches has to be performed after such a procedure. Nowadays, there is a wide choice of alloplastic materials on the market. We tried polymethyl methacrylate implants in correction of the exterior appearance of the forehead and supraorbital arches and followed the behaviour of the implants up to 25 years after surgery. The result was 18 (94.7%) successful implantations and one failure (5.3%) with a mild sagging of the borders of the implant. Polymethyl-methacrylate proved pliable for work and modelling, not invasive for the organism and stable. In conclusion, the cure of some frontobasal injuries and diseases with the first surgical step followed by cosmetic correction of the forehead and supraorbital arches (2nd surgical step) using this alloplastic material provides a safe, durable and aesthetically satisfactory solution for the patient.

The role of electromyography in the diagnosis of velopharyngeal insufficiency: our experiences.

The subject of this study is the electromyographic investigation of the velopharyngeal sphincter structures. Seventy-five patients underwent examination, both patients with symptoms of velopharyngeal insufficiency and patients who were thought to have latent pathological sphincter changes based on local findings. A control group of 10 healthy examinees was also investigated. On the basis of electromyographic findings we divided patients into 2 groups: 57 patients without neuromuscular disorders and 18 patients with neuromuscular disorders of the velopharyngeal sphincter. Twelve patients from the latter group had acute, and 6 had chronic lesions of the velopharyngeal sphincter. Particular cases of illness within these 2 groups were investigated further. This study shows the usefulness of electromyography for diagnosing the exact causes of velopharyngeal insufficiency and for choosing the best approach to treatment.

[Percutaneous tracheostomy]. / Perkutana traheostomija.

In the last few years numerous reports from intensive care units confirm that a nonsurgical percutaneous tracheostomy has successfully replaced elective conventional (surgical) tracheostomy. The majority of authors point out the advantages over surgical technique such as: the speed of procedure, the possibility of doing it at bedside thus excluding transport and the need for operating theatre, less infections around stoma, minor cosmetic defects and finally, more economical price. The article describes three, according to pertinent literature most often utilized techniques, i.e. percutaneous dilatation tracheostomy with dilators, percutaneous dilatation tracheostomy with forceps, and translaryngeal tracheostomy. Main differences, advantages and defects of each method are presented. Contraindications and eventual complications are discussed, as well as the utility of supporting methods for safer placement of tracheostomy tubes, such as endoscopy and ultrasonography.

[Secondary rhinoplasty (analysis of failures over a 5-year period)]. / Sekundarna rinoplastika (analiza petogodisnjih neuspjeha).

It is well known that secondary or revised rhinoplasty is big problem in plastic surgery. During the five year period (1987-1991) 273 rhinoplastic surgeries were done at the ORL-clinic in Rijeka, out of which 42 have been submitted to revision (15.2%). We divided the postsurgical deformations, according to the anatomical criterion, into 3 groups; the upper, the lower and the middle part of the nose. The most frequent deformations of the lower, middle and upper third of the nose are acute septolabial angle, i.e. a dependent tip (19%), pollybeak (33%) and excessive dorsal removal (21%), respectively. The cases have been systematically studied out.