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A Surgical Algorithm Using Open Rhinoplasty for Correction of Traumatic Twisted Nose
Scientific Posters
P154 The Effectiveness of SCM Flap in Preventing Frey’s Syndrome Following Parotidectomy Il-Seok Park, MD PhD (presenter); Young-Soo Rho, MD PhD; Hwoe Young Ahn, MD Seoul South Korea; Seoul South Korea; Seoul South Korea
Objectives: Frey’s syndrome is one of the potential sequelae of parotidectomy. Various medical and surgical treatments have been used in attempt to avoid this embarrassing condition. Recently, interposing barriers between the overlying skin flap and the parotid bed, such as the sternocleidomastoid (SCM) muscle flap, have been used to prevent this condition. The purpose of this study was to evaluate the impact of using this flap on Frey’s syndrome and to identify the grading difference of this syndrome between the use of SCM flap and no muscle flap. Methods: Forty patients who underwent superficial parotidectomy from June 1996 to August 2003 were divided into two groups. One group had SCM flap reconstruction (n⫽20), and the other did not (n⫽20). A subjective clinical questionnaire and the objective Minor’s starch test were used to evaluate the incidence of this syndrome. A grading system was used to divide Frey’s syndrome into mild or severe Frey’s syndrome to determine its severity. The test of Pearson-x2 was applied. Results: The association between sweating, flushing, or pain and the use of the flap was not significant. Also, there was no significant association with Minor Results: s starch test and the use of the flap. But, there was a significant association with severity of Frey Results: s syndrome and the presence of the flap (p⫽0.014). Conclusion: From our study, it would seem that the sternocleidomastoid muscle flap does not reduce the incidence of Frey’s syndrome, but does decrease the degree of severity in Frey’s syndrome.
P155 Transantral Endoscopic Orbital Floor Fracture Repair Using a Flexible Endoscope Holder Stephen C. Maturo, MD (presenter); Joe B Wiseman, MD San Antonio TX; San Antonio TX
Objectives: Endoscopic techniques have become very popular over the past decade. Previous papers have documented an endoscopic approach to fixing orbital floor fractures, yet a common problem is the difficulty in manipulating instruments using a transantral approach. Determine ease of use and functionality of a flexible endoscope holder in the dissection and placement of a surgical implant for repair of orbital floor fractures. Methods: A cadaver study was performed to determine the usefulness of using a flexible endoscope holder (MITAKA Point Setter, Mitaka USA) in visualization and repair of
orbital floor fractures through a transantral approach. Four fresh cadaver heads were dissected through an antrotomy incision using a 30-degree endoscope attached to a flexible holder. MEDPOR Surgical implant (POREX SURGICAL INC, USA) was placed to restore the normal anatomy. Results: All orbital floor fractures were identified in their entirety and completely reduced with alloplastic material using an exclusive endoscopic approach. Conclusion: Using a flexible endoscope holder provides clearer visibility, easier instrument mobility, and an overall superior dissection and placement of implants. A flexible endoscope holder is a useful aid for facilitating an endoscopic approach to orbital floor fractures. P156 A Surgical Algorithm Using Open Rhinoplasty for Correction of Traumatic Twisted Nose Chuan-Hsiang Kao, MD (presenter); Yu-Che Hsiao, MD; HsingWon Wang, MD; Kris S Moe, MD Taipei Taiwan (Republic of China); Taipei Taiwan (Republic of China); Taipei Taiwan (Republic of China); La Jolla CA
Objectives: Successful correction of traumatic twisted nose is a challenging clinical problem. The purpose of this study is to present our experience in correction of traumatic twisted nose by open rhinoplasty in the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital. Use of this detailed surgical algorithm to correct the traumatic twisted nose leads to predictable, highly satisfactory outcomes. Methods: Ninety-two patients with traumatic twisted nose underwent surgical correction by open rhinoplasty between August 1, 2001 and June 1, 2004. They were treated using the same treatment algorithm which includes managements of the nasal pyramid, nasal septum, nasal tip, skin/soft tissue, and closure/casting in sequence. These cases were retrospectively reviewed. Results: All patients (87 males and five females) underwent open rhinoplasty under general anesthesia. Their ages ranged from 15 to 53 years with a mean age of 28 years. The postoperative recoveries were uneventful, and there were no wound infections or other complications. Conclusion: We propose an efficacious surgical algorithm using open rhinoplasty to correct the traumatic twisted nose deformity. This algorithm, adaptable to individual variations in anatomic deformity, will yield consistently satisfactory functional and aesthetically pleasing results. P157 Computer Modeling in Maxillofacial Reconstruction Annette Mai Pham, MD (presenter); Jennifer McLevy, MD; E Bradley Strong, MD Sacramento CA; Sacramento CA; Sacramento CA
Objectives: Reconstitution of facial symmetry after com-
POSTERS
P248
Otolaryngology– Head and Neck Surgery August 2005
P154 The Effectiveness of SCM Flap in Preventing Frey’s Syndrome Following Parotidectomy Il-Seok Park, MD PhD (presenter); Young-Soo Rho, MD PhD; Hwoe Young Ahn, MD Seoul South Korea; Seoul South Korea; Seoul South Korea
Objectives: Frey’s syndrome is one of the potential sequelae of parotidectomy. Various medical and surgical treatments have been used in attempt to avoid this embarrassing condition. Recently, interposing barriers between the overlying skin flap and the parotid bed, such as the sternocleidomastoid (SCM) muscle flap, have been used to prevent this condition. The purpose of this study was to evaluate the impact of using this flap on Frey’s syndrome and to identify the grading difference of this syndrome between the use of SCM flap and no muscle flap. Methods: Forty patients who underwent superficial parotidectomy from June 1996 to August 2003 were divided into two groups. One group had SCM flap reconstruction (n⫽20), and the other did not (n⫽20). A subjective clinical questionnaire and the objective Minor’s starch test were used to evaluate the incidence of this syndrome. A grading system was used to divide Frey’s syndrome into mild or severe Frey’s syndrome to determine its severity. The test of Pearson-x2 was applied. Results: The association between sweating, flushing, or pain and the use of the flap was not significant. Also, there was no significant association with Minor Results: s starch test and the use of the flap. But, there was a significant association with severity of Frey Results: s syndrome and the presence of the flap (p⫽0.014). Conclusion: From our study, it would seem that the sternocleidomastoid muscle flap does not reduce the incidence of Frey’s syndrome, but does decrease the degree of severity in Frey’s syndrome.
P155 Transantral Endoscopic Orbital Floor Fracture Repair Using a Flexible Endoscope Holder Stephen C. Maturo, MD (presenter); Joe B Wiseman, MD San Antonio TX; San Antonio TX
Objectives: Endoscopic techniques have become very popular over the past decade. Previous papers have documented an endoscopic approach to fixing orbital floor fractures, yet a common problem is the difficulty in manipulating instruments using a transantral approach. Determine ease of use and functionality of a flexible endoscope holder in the dissection and placement of a surgical implant for repair of orbital floor fractures. Methods: A cadaver study was performed to determine the usefulness of using a flexible endoscope holder (MITAKA Point Setter, Mitaka USA) in visualization and repair of
orbital floor fractures through a transantral approach. Four fresh cadaver heads were dissected through an antrotomy incision using a 30-degree endoscope attached to a flexible holder. MEDPOR Surgical implant (POREX SURGICAL INC, USA) was placed to restore the normal anatomy. Results: All orbital floor fractures were identified in their entirety and completely reduced with alloplastic material using an exclusive endoscopic approach. Conclusion: Using a flexible endoscope holder provides clearer visibility, easier instrument mobility, and an overall superior dissection and placement of implants. A flexible endoscope holder is a useful aid for facilitating an endoscopic approach to orbital floor fractures. P156 A Surgical Algorithm Using Open Rhinoplasty for Correction of Traumatic Twisted Nose Chuan-Hsiang Kao, MD (presenter); Yu-Che Hsiao, MD; HsingWon Wang, MD; Kris S Moe, MD Taipei Taiwan (Republic of China); Taipei Taiwan (Republic of China); Taipei Taiwan (Republic of China); La Jolla CA
Objectives: Successful correction of traumatic twisted nose is a challenging clinical problem. The purpose of this study is to present our experience in correction of traumatic twisted nose by open rhinoplasty in the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital. Use of this detailed surgical algorithm to correct the traumatic twisted nose leads to predictable, highly satisfactory outcomes. Methods: Ninety-two patients with traumatic twisted nose underwent surgical correction by open rhinoplasty between August 1, 2001 and June 1, 2004. They were treated using the same treatment algorithm which includes managements of the nasal pyramid, nasal septum, nasal tip, skin/soft tissue, and closure/casting in sequence. These cases were retrospectively reviewed. Results: All patients (87 males and five females) underwent open rhinoplasty under general anesthesia. Their ages ranged from 15 to 53 years with a mean age of 28 years. The postoperative recoveries were uneventful, and there were no wound infections or other complications. Conclusion: We propose an efficacious surgical algorithm using open rhinoplasty to correct the traumatic twisted nose deformity. This algorithm, adaptable to individual variations in anatomic deformity, will yield consistently satisfactory functional and aesthetically pleasing results. P157 Computer Modeling in Maxillofacial Reconstruction Annette Mai Pham, MD (presenter); Jennifer McLevy, MD; E Bradley Strong, MD Sacramento CA; Sacramento CA; Sacramento CA
Objectives: Reconstitution of facial symmetry after com-
POSTERS
P248
Otolaryngology– Head and Neck Surgery August 2005