[Quality of life after functional aesthetic septorhinoplasty in primary surgery vs. revision surgery-a monocentric study]. / Lebensqualität nach funktionell-ästhetischer Septorhinoplastik in primärer Operation vs. in Revisionsoperation ­ eine monozentrische Studie.

BACKGROUND: Subjective assessments of quality of life (QOL) as an important aspect of outcome research have gained in importance over the past few decades. The number of prospective studies on postoperative QOL in septorhinoplasty using disease-specific instruments is sparse. The aim was to assess and compare patient QOL after primary and revision septorhinoplasty performed by a single surgeon in an ENT center. MATERIAL AND METHODS: All patients completed two disease-specific QOL instruments preoperatively and at least 1 year postoperatively: the Rhinoplasty Outcome Evaluation (ROE) and the Nasal Obstruction Symptoms Evaluation (NOSE) scores. General demographic and clinical information (age, gender, medical and surgical history) were collected from all patients. All operations were performed by a single surgeon (F. R.). RESULTS: A total of 237 patients were included in the study, 208 (87.8%) female and 29 (12.2%) male. The average age was 30.3 ± 8.9 years. The average observation period was 19.3 ± 7.4 months. Using the measurement tool NOSE there was a significant improvement in obstruction in the overall collective (preoperative 49.8 ± 26.2, postoperative 19.1 ± 21.3; p < 0.001) with no significant difference in primary versus revision surgery. The ROE score showed a significant improvement and both collectives (primary and secondary surgery) showed a significant improvement after the intervention. The patients with a primary intervention had a significantly higher postoperative QOL (p < 0.001). CONCLUSION: The disease-specific QOL showed a significant increase after primary septorhinoplasty as well as after revision surgery. The NOSE score increased significantly in both intervention groups postoperatively.

[Correction of complex facial scars]. / Die Behandlung komplexer Narben im Gesicht.

Correction of complex facial scars frequently requires individualized, multimodal strategies, which are composed of various therapeutic measures. This report provides information on techniques for correction of contractures, atrophic scars, scars within hair-bearing regions of the face and auricular keloids. Additionally, we present adjuvant procedures in a subject-related manner.

Management of an epidermoid cyst in the nasal tip of a child: aesthetic and surgical considerations.

BACKGROUND: A simple subcutaneous lesion such as an epidermoid cyst can present a challenge when located in the nasal tip, as regards aesthetic surgical management. Even when performed parallel to relaxed skin tension lines, a direct transcutaneous incision (commonly used for epidermoid cyst removal) distorts the nasal tip subunit, resulting in a conspicuous, disfiguring scar. This should be avoided, especially in children. CASE REPORT: A 13-year-old girl was referred by her dermatologist for diagnosis and treatment of a slowly progressive dermoid cyst located on the tip of her nose. The cyst was removed using a subcutaneous open rhinoplasty approach, leaving the aesthetic nasal tip subunit intact. CONCLUSION: For aesthetic reasons, open rhinoplasty should be considered as a treatment option in patients with subcutaneous lesions in the nasal tip.

[Electrosurgical concepts in ENT medicine. History, fundamentals and practice]. / Elektrochirurgische Konzepte in der HNO-Heilkunde. Geschichte, Grundlagen und Praxis.

The beneficial use of heat in the context of medical treatments was documented even in ancient times. The development of high-frequency alternating current generators led to actual electrosurgery, in which primary heating of the tissue takes place. In day-to-day clinical practice electrosurgery is used for coagulation and for electrotomies. There are both unipolar and bipolar techniques for these procedures. When a unipolar technique is used the active electrode is in the tip of the instrument and the patient plate is usually affixed to the patient's skin at a site outside the operating field. The bipolar technique differs in that there are no electrodes that need to be attached externally; both poles are contained inside the operating instrument, e.g. in the two prongs of a forceps. In radiofrequency surgery high-frequency electrical energy is applied directly into the tissue by a unipolar or bipolar technique. In this way it is possible to cause interstitial tissue lesions while sparing the superficial mucous membranes.