- Email: [email protected]
Alar Base Augmentation and Rhinoplasty in Asians
P148
Otolaryngology-Head and Neck Surgery, Vol 143, No 2S2, August 2010
developed a fall detection system by using a tri-axial accelerometer module. METHOD: We recruited 26 healthy and 12 vertigo patients for this study. The accelerometer module used a tri-axial ADXL330 accelerometer; the signals were transmitted by a 2.4G Hz wireless link to a PC-side receiver via a radio frequency transmit module. The amounts of acceleration changes (AAC) were calculated. Four accelerometer modules (attached on head, waist, left thigh, and right thigh) were used to calculate simulated falls and activities of daily living (sitting, standing, rolling, and walking) from healthy subjects. We recorded the Romberg, stepping, and Tandem gait tests data from both healthy and vertigo patients. RESULTS: For each daily activity and its reciprocal activity, there was no significant AAC difference among most of the accelerometers (p⬎0.05). ROC curve showed that waist sensor would identify real fall event with sensitivity of 0.98, and the head sensor would identify not-real fall event with specificity of 0.97. Comparing Romberg test data between healthy and vertigo patients, there were significant AAC differences in head (3.38 vs. 1.74, p⬍0.05), left thigh (1.89 vs. 1.56, p⬍0.05), and right thigh (2.24 vs. 1.55, p⬍0.05) accelerometers recordings. CONCLUSION: Tri-axial accelerometer module with AAC algorithm is able to produce norm discriminative information for daily activities from fall incidence. Waist worn accelerometers show ideal sensitivity and specificity. Head sensor is preferred to differentiate Romberg test performances between healthy and vertigo patients. Financial Relationship: This study was sponsored by the joint research fund of the National Central University and the Cathay General Hospital, Taiwan.
Facial Plastic and Reconstructive Surgery Alar Base Augmentation and Rhinoplasty in Asians Jin Hwan Kim, MD, PhD (presenter); Si Whan Kim, MD OBJECTIVE: To evaluate the results of alar base augmentation in Asians performed during rhinoplasty. METHOD: Retrospective chart review and telephone interview in a tertiary hospital. 23 patients in whom alar base augmentation was performed at the time of rhinoplasty with a follow-up of more than 6 months were included in this study. Patient characteristics, surgical techniques used, and complications were analyzed, as well as objective and subjective results using pre-and postoperative standardized photographs and questionnaire. RESULTS: There were 15 female and 8 male patients with an average age of 31 (22-46). Mean follow-up period was 9 months (6-32). Intraoral incision was performed in 5 cases (19%) and intranasal incision in 18 patients (81%). Silicone implants were used in 20 patients (90%), followed by e-PTFE
implant in 2 patients and autologous rib cartilage in 1 patient. Complications such as infection or extrusion occurred in 3 patients (2 silicone, 1 e-PTFE) which were all performed through the intraoral incision. Excluding the patients with complications, objective improvement was seen in 17 patients (78%) and subjective improvement (scale of 0-3) yielded an average score of 2.8, with everyone responding a positive effect to the concurrently performed rhinoplasty. CONCLUSION: Alar base augmentation performed during rhinoplasty in Asians can improve patient satisfaction. We recommend the intranasal incision when using alloplastic implants to reduce chances of complications. Arteriovenous Malformations of the Head and Neck Cody Koch, MD, PhD (presenter); Sivakumar Chinnadurai, MD; Steven Olsen, MD; Eric Moore, MD OBJECTIVE: The purpose of this study was to review the clinical presentation, management and prognosis of arteriovenous malformations of the head and neck at a tertiary referral center. METHOD: Retrospective review of all arteriovenous malformations of the head and neck presenting to a tertiary referral center from January 1988 through December 2008. RESULTS: 42 patients were identified during the time period studied. The median age at which the lesion was identified was 16 years (birth-70 years). The most common presenting symptoms were an enlarging mass (86%) followed by bleeding (26%). Based on the Schobinger classification there were no Stage I patients, 31 Stage II patients (74%), 11 Stage III patients (26%) and no Stage IV patients. Twenty-four patients (57%) received treatment at our institution while 7 patients (17%) were observed and 11 patients (26%) pursued treatment elsewhere. Of those treated, 3 patients (12.5%) underwent embolization only, 8 patients (33.3%) surgery only and 13 patients (54.2%) were managed with pre-operative embolization followed by surgical excision. In patients managed surgically there was one patient (5%) with recurrence and one patient (5%) whose lesion could only be partially excised. Two patients (8.3%) died due to complications of their disease. CONCLUSION: Arteriovenous malformations have an unpredictable course that can cause serious morbidity for patients. Stage I and II lesions can be successfully treated with minimal morbidity, complications or risk of recurrence. Stage III lesions are difficult to treat, requiring more aggressive surgical intervention (free-tissue transfer, etc.) and carry a higher risk of complications and death. Clinical Factors Associated with Poor Outcome in Free Flaps Wojciech Mydlarz, MD (presenter); Yuval Patel, BS; Cassandra Villegas, MPH; Adam Iddriss; Jeremy Richmon, MD
Otolaryngology-Head and Neck Surgery, Vol 143, No 2S2, August 2010
developed a fall detection system by using a tri-axial accelerometer module. METHOD: We recruited 26 healthy and 12 vertigo patients for this study. The accelerometer module used a tri-axial ADXL330 accelerometer; the signals were transmitted by a 2.4G Hz wireless link to a PC-side receiver via a radio frequency transmit module. The amounts of acceleration changes (AAC) were calculated. Four accelerometer modules (attached on head, waist, left thigh, and right thigh) were used to calculate simulated falls and activities of daily living (sitting, standing, rolling, and walking) from healthy subjects. We recorded the Romberg, stepping, and Tandem gait tests data from both healthy and vertigo patients. RESULTS: For each daily activity and its reciprocal activity, there was no significant AAC difference among most of the accelerometers (p⬎0.05). ROC curve showed that waist sensor would identify real fall event with sensitivity of 0.98, and the head sensor would identify not-real fall event with specificity of 0.97. Comparing Romberg test data between healthy and vertigo patients, there were significant AAC differences in head (3.38 vs. 1.74, p⬍0.05), left thigh (1.89 vs. 1.56, p⬍0.05), and right thigh (2.24 vs. 1.55, p⬍0.05) accelerometers recordings. CONCLUSION: Tri-axial accelerometer module with AAC algorithm is able to produce norm discriminative information for daily activities from fall incidence. Waist worn accelerometers show ideal sensitivity and specificity. Head sensor is preferred to differentiate Romberg test performances between healthy and vertigo patients. Financial Relationship: This study was sponsored by the joint research fund of the National Central University and the Cathay General Hospital, Taiwan.
Facial Plastic and Reconstructive Surgery Alar Base Augmentation and Rhinoplasty in Asians Jin Hwan Kim, MD, PhD (presenter); Si Whan Kim, MD OBJECTIVE: To evaluate the results of alar base augmentation in Asians performed during rhinoplasty. METHOD: Retrospective chart review and telephone interview in a tertiary hospital. 23 patients in whom alar base augmentation was performed at the time of rhinoplasty with a follow-up of more than 6 months were included in this study. Patient characteristics, surgical techniques used, and complications were analyzed, as well as objective and subjective results using pre-and postoperative standardized photographs and questionnaire. RESULTS: There were 15 female and 8 male patients with an average age of 31 (22-46). Mean follow-up period was 9 months (6-32). Intraoral incision was performed in 5 cases (19%) and intranasal incision in 18 patients (81%). Silicone implants were used in 20 patients (90%), followed by e-PTFE
implant in 2 patients and autologous rib cartilage in 1 patient. Complications such as infection or extrusion occurred in 3 patients (2 silicone, 1 e-PTFE) which were all performed through the intraoral incision. Excluding the patients with complications, objective improvement was seen in 17 patients (78%) and subjective improvement (scale of 0-3) yielded an average score of 2.8, with everyone responding a positive effect to the concurrently performed rhinoplasty. CONCLUSION: Alar base augmentation performed during rhinoplasty in Asians can improve patient satisfaction. We recommend the intranasal incision when using alloplastic implants to reduce chances of complications. Arteriovenous Malformations of the Head and Neck Cody Koch, MD, PhD (presenter); Sivakumar Chinnadurai, MD; Steven Olsen, MD; Eric Moore, MD OBJECTIVE: The purpose of this study was to review the clinical presentation, management and prognosis of arteriovenous malformations of the head and neck at a tertiary referral center. METHOD: Retrospective review of all arteriovenous malformations of the head and neck presenting to a tertiary referral center from January 1988 through December 2008. RESULTS: 42 patients were identified during the time period studied. The median age at which the lesion was identified was 16 years (birth-70 years). The most common presenting symptoms were an enlarging mass (86%) followed by bleeding (26%). Based on the Schobinger classification there were no Stage I patients, 31 Stage II patients (74%), 11 Stage III patients (26%) and no Stage IV patients. Twenty-four patients (57%) received treatment at our institution while 7 patients (17%) were observed and 11 patients (26%) pursued treatment elsewhere. Of those treated, 3 patients (12.5%) underwent embolization only, 8 patients (33.3%) surgery only and 13 patients (54.2%) were managed with pre-operative embolization followed by surgical excision. In patients managed surgically there was one patient (5%) with recurrence and one patient (5%) whose lesion could only be partially excised. Two patients (8.3%) died due to complications of their disease. CONCLUSION: Arteriovenous malformations have an unpredictable course that can cause serious morbidity for patients. Stage I and II lesions can be successfully treated with minimal morbidity, complications or risk of recurrence. Stage III lesions are difficult to treat, requiring more aggressive surgical intervention (free-tissue transfer, etc.) and carry a higher risk of complications and death. Clinical Factors Associated with Poor Outcome in Free Flaps Wojciech Mydlarz, MD (presenter); Yuval Patel, BS; Cassandra Villegas, MPH; Adam Iddriss; Jeremy Richmon, MD