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Il ruolo del chirurgo maxillo-facciale nelle malformazioni del distretto cranio facciale
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Lemmo's Flap for Nasal Dorsum Reconstruction
No full textPurpose: Reconstruction of nasal defects is an antique challenge for surgeons. The first reported technique is dated 600 B.C. Since then a number of reconstructive options have been proposed in the literature. Some principles, first stated by Buget and Menick must be always taken into account when planning such reconstructions. In detail, every reconstruction should respect the subunit principle and the scars should always be well hidden in the passage between adjacent subunits. The flap proposed in the present paper adheres to the cited principles and leads to optimal nasal dorsum reconstruction in selected cases. Materials and Methods: From April 2008 to March 2009, 5 patients were reconstructed with Lemmo's flap after local excision of 3 basal cell carcinomas and 2 squamous cell carcinomas affecting the the skin of the nasal dorsum in its caudal portion. Results: In all cases a pleasing aesthetic result was obtained, no postoperative deformity was observed and all the scars were unnoticeable. Conclusions: The Lemmo's flap described in the present paper can be considered a valid choice for nasal dorsum skin reconstruction and is preferable over other techniques for reconstruction of small to medium sized defects of the skin of the caudal dorsum
The role of maxillary osteotomy in the treatment of arhinia
No full textPurpose: Arhinia is a very rare malformation, and only 41 cases are described in the literature. Given its rarity, there is no standardized surgical protocol. This article describes our preferred treatment, which underlines the importance of maxillary osteotomy for obtaining satisfactory results. Methods: We observed 3 girls with arhinia, 2 of whom were treated by a 2-step surgical protocol. During the first phase, the patients underwent maxillary osteotomy with the creation of a new epithelium-lined nasal cavity. A skin expander was also placed in the forehead. During the second step, an external nose was created in both patients from the expanded forehead flap with local perinasal flaps and costochondral grafts. Results: Both reconstructions were viable and esthetically acceptable. No internal nose restenosis was observed. Conclusions: On the basis of our experience, maxillary osteotomy should be considered part of an integrated approach in treating arhinia
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