Comparison of the effects of spreader graft and overlapping lateral crural technique on rhinoplasty by rhinomanometry.

BACKGROUND: Nasal valve collapse and especially internal nasal valve insufficiency is a common cause of nasal airway obstruction. This study compares the effects of spreader graft and overlapping lateral crural technique on rhinoplasty by rhinomanometry. METHODS: Fifty patients were randomly assigned into two groups and underwent spreader graft or overlapping lateral crural technique. Objective assessment was performed by clinical examination and rhinomanometry before and after rhinoplasty. RESULTS: Nasal obstruction had no significant difference before and after rhinoplasty and no significant difference was observed between surgical techniques. Right, left and total nasal flow and resistance were different before and after surgery but were not significant. Base of the nose was not significantly different between two groups, but nasal projection was 2 mm in the the group who underwent overlapping lateral crura technique and the difference was statistically significant. Our study showed that both overlapping lateral crura and spreader graft technique were beneficial in rhinoplasty and they could provide enough internal nasal valve support. The overlapping lateral crura was an appropriate surgical technique for tip projection in comparison to spreader graft. CONCLUSION: The overlapping lateral crura technique was shown to be a better surgical way for tip projection in comparison to spreader graft.

Huge retroperitoneal liposarcoma.

Liposarcoma are one of the common soft tissue sarcomas of adulthood which are remarkable because of their frequently large size. We report a case with an extremely large well-differentiated retroperitoneal liposarcoma that weighted 32 kilograms. The patient had relapse about one year later and two recurrent tumors were successfully excised.

Ultrasonic liposuction versus surgical lipectomy.

Obesity is a serious problem in our century. Nowadays, the incidence of obesity has been increased to 35%. Two common methods for surgical treatment of obesity are surgical lipectomy and ultrasound-assisted liposuction (UAL). This study included 40 patients in two groups, 20 patients in the surgical lipectomy group and 20 patients in the UAL group. Abdominal surgical lipectomy was done in 20 patients (12 female, 8 male), with ages ranging 28-60 years. Abdominal UAL was done in 20 patients (11 females, 9 male), with ages ranging 20-55 years. General anesthesia was used for surgical lipectomy. Tumescent anesthesia was used for 13 UAL patients and general anesthesia was used for the remaining 7. The average time for surgical lipectomy was shorter than that for UAL. The average hospital stay for the surgical lipectomy group was almost five times longer than for UAL. The UAL group also recovered four times faster and required analgesics half as long. The average amount of fat removed in each case was 2.22 kg with UAL and 1.97 kg with surgical lipectomy. The UAL group received analgesic drugs for five days, whereas the surgical lipectomy group received analgesic drugs for 10 days because they sustained more pain. In this study, I do not discuss or compare the major complications of each method because the groups were not large enough. However, there were some minor UAL complications, echymosis in 80%, orthostatic hypotension for three or four days in 75%, infection in one patient, postoperative epidermal loss in small area of the abdomen in two patients, and cellulitis in 75%. All were resolved after one month. UAL is a special method with fewer major complications and shorter hospital stays than surgical lipectomy. The incisions in UAL are smaller, but the operation lasts much longer than surgical lipectomy.