A New Modification of Fan Flap for Large Lower Lip Defects.

BACKGROUND AND AIMS: The reconstruction of the lower lip defects which may result from malignancy, trauma, and burn is necessary for mastication, oral competence, salivary retain, articulation, and aesthetic appearance of the face. While small (30% of the lower lip) and medium (30%-80% of the lower lip) size defects are reconstructed using primary repair and local flaps, reconstruction of the large defects including total and near-total of the lower lip is very challenging entity. We introduce a new modification of the fan flap named extended fan flap for reconstruction of the total and near-total lower lip defects. MATERIAL AND METHODS: The extended fan flap was used for 12 patients with defects involving more than 80% of the lower lip due to squamous cell carcinoma excision. Most of the patients were males (80.9%) with an average age of 66.8 years (range, 47-82 years). RESULTS: No major complication is observed in the postoperative period. The functional and aesthetic results were satisfactory. The sphincter function for normal mastication, eating, and salivary retain was reestablished. No microstomy was seen and insertion of artificial dentition was possible for patients. CONCLUSION: We believe that the unilateral extended fan flap is a reliable and safe option with satisfactory functional and aesthetic results for total and near-total (more than 80%) lower lip defects.

Surgical treatment and functional outcomes of multicomponent soft tissue injuries of the wrist.

The aim of this study was to emphasize the importance of early surgical treatment of multicomponent soft tissue injuries of the wrist. A retrospective review was performed on 156 patients with multicomponent soft tissue injuries of the wrist who were treated between July 2007 and July 2015. All the patients included in the study were operated within the first 36hours of the injury and were hospitalized after the surgery based on the extent of their injury. The patients were evaluated in terms of age, gender, etiology, injured structures, total number of damaged structures, mean follow-up time, complications and reoperation. The results were evaluated based on tendon function, opposition, intrinsic muscles, deformities and sensation. According to these criteria, excellent results were obtained in 81.6% to 88.8% of the patients. Poor results were found in less than 4 percent of the patients. In conclusion, we believe that early surgical management of multicomponent soft tissue injuries of the wrist, a meticulous approach and regular physical therapy are required to achieve good functional outcomes.

Is pneumatization of middle turbinates compensatory or congenital?

OBJECTIVE: To determine the frequency of concha bullosa (CB) and the association between the degree of pneumatization and the severity of septum deviation in both paediatric and adult groups by CT evaluation and to investigate whether the pneumatization of middle turbinates is compensatory or congenital. METHOD: We retrospectively reviewed digitally stored paranasal sinus CT images of 86 paediatric and 204 adult patients. The severity of the deviation and cross-sectional area of the pneumatized area of the CB were determined using tomography images. The septums were divided into three groups according to the severity of deviation. The cross-sectional area of the contralateral side divided by the cross-sectional area of the deviation was calculated and described as the interturbinate ratio. RESULTS: When bilateral CB was found, the pneumatization of the CB was more prominent on the contralateral side than on the deviation side in both the paediatric and the adult groups. However, we found that the interturbinate ratios were not statistically different between the paediatric and adult groups. Also, the interturbinate ratios were independent degrees of deviation in children and adults. The frequency of CB was low in the adult group compared with the paediatric group. CONCLUSION: Interturbinate ratios were not statistically different between paediatric and adult groups and were independent of the severity of deviation. These findings suggest that the pneumatization process is not compensatory.