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O.305 Ear reconstruction, the antia buch chondrocutaneous flap revisited
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Journal of Cranio-Maxillofacial Surgery 34(2006) Suppl. S1
Thursday, 14 September 2006, 8.30−9.20
Hall 5
Aesthetic: miscellaneous O.302 Analysis and strategies for unfavourable cases of prominent mandibular angles osteotomy L. Gui, T. Song, Z. Zhang, L. Huang, F. Niu, J. Jin, B. Yu. Department of Plastic and Cranio-Maxillo-Facial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Si-jing-shan-qu, Beijing 100041, China Objective: To classify unfavourable cases in osteotomy for prominent mandibular angles and to find out strategy of repair of unfavourable results. Method: Two groups were divided. One was of cases of favourable results (30 cases), and the other was of cases of unfavourable results (13 cases). X-rays of these cases were measured and compared. Strategic methods of unfavourable results repairing included curved osteotomy, angle splitting, mandibular border grinding and artificial materials implant. Result: There were 4 cases of undercorrection, 5 cases of overcorrection and 4 cases of asymmetry. Effect of operation was satisfactory. Conclusion: There are obvious differences between measurement of two groups. Through strategy of curved osteotomy, angle splitting, mandibular border grinding and artificial materials implant, cases of unfavourable prominent mandibular angles osteotomy can get a satisfactory facial contour. O.303 Free fat transplantation for augmentation of the face V. Malakhovskaya, A. Korgunov. Russian Medical Academy of Advance Education, Moscow, Russia Autologous fat injection have been widely used for face augmentation. However, the survival rates of the transplanted fat grafts are unpredictable, depending on the harvesting and transfer techniques. Up to now there is no universal ideal methodology of lipofilling. The purpose of this study was to determine the efficacy of lipofilling in different parts of the face, using a simple method of autologous fat injection. Autologous fat transplantation has been performed with 76 patients over the last 4 years. The age of the patients varied from 15 to 65 years, of woman mostly (53). In 45 cases the lipofilling was fulfilled for correcting the age changes, and in 31 cases was performed for its volume-contour plastic, on the patients having soft tissue deficiency. The recipient sites encluded cheeks, lips, periorbital region, forehead, mentum, malar and temporal areas, naso-labial, mentolabial folds and glabella. We started our work, using the Coleman technique, but then we refused centrifugation. Our procedure included standard collecting, open purification with lactated Ringer’s solution, using a sieve. The concentrated fat was then transferred to syringes and injected in the proper places. We evaluated the results by using observance and ultra-sonic examination over 1.5 years after the procedure. In all cases we have achieved positive results, except two cases of cyst formation in periorbital region. The survival rates of the fat grafts depended not only on the methodology of fat transplantation, but also on the zone of the injection and its blood circulation.
Abstracts, EACFMS XVIII Congress O.305 Ear reconstruction, the antia buch chondrocutaneous flap revisited E. Sorrel Dejerine. Paris, France In 1967 Antia and Buch presented a new chondrocutaneous advancement flap for marginal defect of the ear(3 cases). By its simplicity, safety, and the excellent results obtained, this flap became popular. We present a series of 46 consecutives cases. The mean followup is 22 months, and the rate of complications very low (1 case: 1 haematoma). All these cases were operated under local anesthesia on an ambulatory basis. Results are considered good to excellent, aesthetically and functionally, for this one-time procedure. Technical points and modifications of the original description are emphazised. This large series make this flap, at least in our hands, the procedure of choice for the reconstruction of a marginal defect of the ear. O.306 Auriculoplasty in case of the congenital and acquired deformations and defects U.R. Kamalov, A.M. Suleimanov, N.E. Selsky. Republican Centre of the Maxillofacial Surgery, Ufa, Russia Introduction: The reconstruction of the auricle in case of the congenital and acquired defects is one of the plastic surgery problems since the auricle is a difficult model for reconstructive operations. Many features caused by its complicated configuration refer to these difficulties, such as a complex relief, variety of flexures, thin integument, as well as an attachment peculiarity to the cranial lateral surface tissues. In this case the construction of the spatial three-dimensional basis is limited by the twodimensional possibilities of the covering skin (Brent B., 1985). Material and Method: Four microtia patients of the 3rd degree have been operated on with the use of the Alloplant biomaterial in the Republican Centre of the maxillofacial surgery of the Ufa hospital No.21. Anotia and microtia of the 3rd degree are characterized by a complete absence of the auricle and external acoustic meatus. Only a lobule or skin-cartilage cushion with the lobule are retained in the place of the auricle. It is always problematic to form the auricle due to the absence of its orientation points. To determine the location of the future auricle we have used a three-dimensional computer programme 3D Max with the aid of which the task of planning in the preoperative period is made easier and which helps to precisely model the auricle skeleton. Four patients have been operated on using the given programme. Four patients have been under our supervision and the first stages of auriculoplasty were performed on a woman, aged 35 years, and on her 10-yearold son, both from the group under supervision. In this case an autosomal-dominant inheritance was revealed. For this type of the inheritance the presence of the pathologic feature is characterized for one of the parents who transmits it to 50% of his/her descendants. In the two-children family, for example, there might be no affected childs or there might be one or two affected children. And still for each pregnancy the risk for the child to have the same feature makes up 50%. A bilateral microtia was observed in the other patient. The 1st stage of the plasty (implantation of the skeleton) was performed on 7 December 2004, and the 2nd stage (construction of the three-dimensional auricle and formation of the lobule) on 20 April 2005. The post-operative rehabilitation period took place in a favourable way with the sutures being removed on the 7th day. During the Examination the clearance between the auricle and soft tissues
Journal of Cranio-Maxillofacial Surgery 34(2006) Suppl. S1
Thursday, 14 September 2006, 8.30−9.20
Hall 5
Aesthetic: miscellaneous O.302 Analysis and strategies for unfavourable cases of prominent mandibular angles osteotomy L. Gui, T. Song, Z. Zhang, L. Huang, F. Niu, J. Jin, B. Yu. Department of Plastic and Cranio-Maxillo-Facial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Si-jing-shan-qu, Beijing 100041, China Objective: To classify unfavourable cases in osteotomy for prominent mandibular angles and to find out strategy of repair of unfavourable results. Method: Two groups were divided. One was of cases of favourable results (30 cases), and the other was of cases of unfavourable results (13 cases). X-rays of these cases were measured and compared. Strategic methods of unfavourable results repairing included curved osteotomy, angle splitting, mandibular border grinding and artificial materials implant. Result: There were 4 cases of undercorrection, 5 cases of overcorrection and 4 cases of asymmetry. Effect of operation was satisfactory. Conclusion: There are obvious differences between measurement of two groups. Through strategy of curved osteotomy, angle splitting, mandibular border grinding and artificial materials implant, cases of unfavourable prominent mandibular angles osteotomy can get a satisfactory facial contour. O.303 Free fat transplantation for augmentation of the face V. Malakhovskaya, A. Korgunov. Russian Medical Academy of Advance Education, Moscow, Russia Autologous fat injection have been widely used for face augmentation. However, the survival rates of the transplanted fat grafts are unpredictable, depending on the harvesting and transfer techniques. Up to now there is no universal ideal methodology of lipofilling. The purpose of this study was to determine the efficacy of lipofilling in different parts of the face, using a simple method of autologous fat injection. Autologous fat transplantation has been performed with 76 patients over the last 4 years. The age of the patients varied from 15 to 65 years, of woman mostly (53). In 45 cases the lipofilling was fulfilled for correcting the age changes, and in 31 cases was performed for its volume-contour plastic, on the patients having soft tissue deficiency. The recipient sites encluded cheeks, lips, periorbital region, forehead, mentum, malar and temporal areas, naso-labial, mentolabial folds and glabella. We started our work, using the Coleman technique, but then we refused centrifugation. Our procedure included standard collecting, open purification with lactated Ringer’s solution, using a sieve. The concentrated fat was then transferred to syringes and injected in the proper places. We evaluated the results by using observance and ultra-sonic examination over 1.5 years after the procedure. In all cases we have achieved positive results, except two cases of cyst formation in periorbital region. The survival rates of the fat grafts depended not only on the methodology of fat transplantation, but also on the zone of the injection and its blood circulation.
Abstracts, EACFMS XVIII Congress O.305 Ear reconstruction, the antia buch chondrocutaneous flap revisited E. Sorrel Dejerine. Paris, France In 1967 Antia and Buch presented a new chondrocutaneous advancement flap for marginal defect of the ear(3 cases). By its simplicity, safety, and the excellent results obtained, this flap became popular. We present a series of 46 consecutives cases. The mean followup is 22 months, and the rate of complications very low (1 case: 1 haematoma). All these cases were operated under local anesthesia on an ambulatory basis. Results are considered good to excellent, aesthetically and functionally, for this one-time procedure. Technical points and modifications of the original description are emphazised. This large series make this flap, at least in our hands, the procedure of choice for the reconstruction of a marginal defect of the ear. O.306 Auriculoplasty in case of the congenital and acquired deformations and defects U.R. Kamalov, A.M. Suleimanov, N.E. Selsky. Republican Centre of the Maxillofacial Surgery, Ufa, Russia Introduction: The reconstruction of the auricle in case of the congenital and acquired defects is one of the plastic surgery problems since the auricle is a difficult model for reconstructive operations. Many features caused by its complicated configuration refer to these difficulties, such as a complex relief, variety of flexures, thin integument, as well as an attachment peculiarity to the cranial lateral surface tissues. In this case the construction of the spatial three-dimensional basis is limited by the twodimensional possibilities of the covering skin (Brent B., 1985). Material and Method: Four microtia patients of the 3rd degree have been operated on with the use of the Alloplant biomaterial in the Republican Centre of the maxillofacial surgery of the Ufa hospital No.21. Anotia and microtia of the 3rd degree are characterized by a complete absence of the auricle and external acoustic meatus. Only a lobule or skin-cartilage cushion with the lobule are retained in the place of the auricle. It is always problematic to form the auricle due to the absence of its orientation points. To determine the location of the future auricle we have used a three-dimensional computer programme 3D Max with the aid of which the task of planning in the preoperative period is made easier and which helps to precisely model the auricle skeleton. Four patients have been operated on using the given programme. Four patients have been under our supervision and the first stages of auriculoplasty were performed on a woman, aged 35 years, and on her 10-yearold son, both from the group under supervision. In this case an autosomal-dominant inheritance was revealed. For this type of the inheritance the presence of the pathologic feature is characterized for one of the parents who transmits it to 50% of his/her descendants. In the two-children family, for example, there might be no affected childs or there might be one or two affected children. And still for each pregnancy the risk for the child to have the same feature makes up 50%. A bilateral microtia was observed in the other patient. The 1st stage of the plasty (implantation of the skeleton) was performed on 7 December 2004, and the 2nd stage (construction of the three-dimensional auricle and formation of the lobule) on 20 April 2005. The post-operative rehabilitation period took place in a favourable way with the sutures being removed on the 7th day. During the Examination the clearance between the auricle and soft tissues