Soft-tissue reconstruction for atypical microtia malformations and trauma.

OBJECTIVE: To provide customized reconstructions of atypical microtia malformations and trauma via 1- or 2-stage procedures. DESIGN: Case reports. SETTING: Academic otolaryngology specialty hospital. PATIENTS: Pediatric patients with rare and unique ear malformations. INTERVENTIONS: Customized auricular reconstruction using contralateral postauricular donor grafts (skin and cartilage) as well as ipsilateral tissue (flaps and bone). MAIN OUTCOME MEASURES: Postoperative results. RESULTS: Surgical procedures were completed in 1 or 2 stages with minimal morbidity. No donor scars were visible, in contrast to traditional reconstructive methods. The completed auricular appearance was realistic. CONCLUSION: Selected patients can benefit from soft-tissue reconstruction of the auricle that feels normal to the touch and lacks the morbidity and scarring of traditional reconstructive methods.

Podcasting: contemporary patient education.

Portable video technology is a widely available new tool with potential to be used by pediatric otolaryngology practices for patient and family education. Podcasts are media broadcasts that employ this new technology. They can be accessed via the Internet and viewed either on a personal computer or on a handheld device, such as an iPod or an MP3 player. We wished to examine the feasibility of establishing a podcast-hosting Web site. We digitally recorded pediatric otologic procedures in the operating room and saved the digital files to DVDs. We then edited the DVDs at home with video-editing software on a personal computer. Next, spoken narrative was recorded with audio-recording software and combined with the edited video clips. The final products were converted into the M4V file format, and the final versions were uploaded onto our hospital's Web site. We then downloaded the podcasts onto a high-quality portable media player so that we could evaluate their quality. All of the podcasts are now on the hospital Web site, where they can be downloaded by patients and families at no cost. The site includes instructions on how to download the appropriate free software for viewing the podcasts on a portable media player or on a computer. Using this technology for patient education expands the audience and permits portability of information. We conclude that a home computer can be used to inexpensively create informative surgery demonstrations that can be accessed via a Web site and transferred to portable viewing devices with excellent quality.

Cantotomia lateral: tratamento simples para uma complicação grave de cirurgia micro-endoscópica naso-sinusal / Lateral Canthotomy: Simple Treatment for a Serious Complication of Micro-Endoscopic Sinus Surgery

A cirurgia microendoscópica naso-sinusal pode resultar em complicações maiores e menores. Entre estas, as complicações orbitárias - incluindo o hematoma e o enfisema orbitário - são as mais temidas. Um caso de enfisema orbitário tratado com sucesso via cantotomia lateral é apresentado. A patogênese destas complicações potencialmente graves é discutida e um algoritmo de tratamento é proposto. Este caso demonstra que a cantotomia lateral é um procedimento rápido e seguro para reduzir a pressão intra-ocular.

Micro-endoscopic sinus surgery can result in both minor and major complications. Orbital complications - including orbital hematoma and orbital enphysema - are, among these, the most feared. A case of orbital enphysema successfully treated by lateral canthotomy is presented. The pathogenesis-of these potencially serious complications are discussed. A sequencial treatment algorithm is presented. This case demonstrate that lateral canthotomy constitutes a safe and fast surgical procedure to decrease intra-orbital pressure.