Peripheral osteoma of the nasal bone after laser treatment: A case report.

INTRODUCTION: Peripheral osteoma, which arises from the periosteum, commonly develops in the head and neck region and is found frequently in the mandible, maxilla, and paranasal sinuses. However, osteoma of the face, especially from the nasal bone, is quite rare. PATIENT CONCERNS: A 34-year-old female visited our outpatient department with a small mass on the nose. She had n laser treatment of nevus at the same spot 14 years before, and it had enlarged slowly since 10 years before. DIAGOSIS: Computed tomography scan revealed a 0.7 × 0.5 cm sized radio-opaque tumor of the nasal bone. INTERVENTIONS: Under general anesthesia, surgical excision was performed through a transcolumellar and infracartilaginous incision. The excised tumor was a 0.7 × 0.5 cm sized hard mass. OUTCOMES: Biopsy confirmed it as a peripheral osteoma. After tumor removal, structural stability of nasal framework including bone and cartilage was maintained, and symmetry of the nasal dorsum was acquired. CONCLUSION: Chronic osteoma can compress the abutting structures. In the case of the nose, either structural instability or asymmetry can occur. By applying open rhinoplasty techniques, postoperative scars could be hidden and additional correction of the affected structure could be carried out if necessary. As a result, the surgeon can achieve the functional and esthetic outcomes simultaneously.

The Relationship between Explanation and Patient Compliance in Hirudotherapy.

BACKGROUND: The use of leeches can effectively increase the salvage rate of flap congestion. However, the first reaction from patients and carers in using leeches in clinical fields is strong aversion. This can be due to the fact that development of our culture from agriculture to industrial society, coming across leeches became fairly rare. Also because of the biological traits that leeches carry; staying attached to a leg or other body parts of the host, sucking blood, and leaving wounds. METHODS: This study was conducted through questionnaires, divided into many subgroups. We scaled the compliance of the two therapies, with or without leech. Maximum scale of 10 showing no rejective response to the therapy and minimum scale of 0 showing the greatest rejective response. RESULTS: Overall subjects' compliance was improved after explaining the benefits of hirudotherapy. Irrelevant to the explanation, there was no significant difference in general compliance between male and female. Young-aged group and medical personnel or people studying medicine showed higher compliance over older-aged group and the general public. CONCLUSION: In the terms of general social cognition, recognizing leech as a therapeutic material may not be welcomed at first, but provided with proper information and explanations, overall compliance of patients and carers can be improved and consequently result in superior outcomes in flap salvage.

Microvascular eyebrow transplantation.

Eyebrow reconstruction is a challenge because eyebrow hair is unique. Although various surgical methods have been used to reconstruct eyebrow defects, to the best of our knowledge, the use of eyebrow free flaps for eyebrow reconstruction has not been reported. We describe the successful reconstruction of a large eyebrow defect using a supraorbital artery perforator free flap and show that microvascular eyebrow transplantation is another tool for reconstructing large eyebrow defects. Accordingly, we recommend that microvascular eyebrow transplantation be considered a useful option for the reconstruction of large eyebrow defects.

Microsurgical replantation of a partial helix of the ear.

Microsurgical ear replantation is a significant challenge because vessel sizes are diminutive. Furthermore, as ear vessels are larger in the medial portion than in the lateral portion, microsurgical replantation of a replant including only the helix is extremely difficult. The authors replanted a partial helix of the ear using a single arterial anastomosis. As no suitable veins could be identified, medicinal leech therapy and systemic heparinization were used to achieve venous drainage. The replanted helix survived completely and the cosmetic result was excellent. Microsurgical replantation should be considered the treatment of choice in helix amputation cases, even though amount of replant is small. (c) 2009 Wiley-Liss, Inc. Microsurgery 2009.