Long-term follow-up of a patient diagnosed with Crouzon syndrome who underwent Le Fort I and III distraction osteogenesis using a rigid external distractor system.

OBJECTIVE: This case report describes the successful treatment of a patient with Crouzon syndrome with severe midfacial deficiency and malocclusion, including reverse overjet. MATERIALS AND METHODS: In Phase I treatment, maxillary lateral expansion and protraction were performed. In Phase II treatment, after lateral expansion of the maxilla and leveling of the maxillary and mandibular dentition, an orthognathic approach including simultaneous Le Fort I and III osteotomies with distraction osteogenesis (DO) was used to improve the midfacial deficiency. RESULTS: After DO, 12.0 mm of the medial maxillary buttress and 9.0 mm of maxillary (point A) advancement were achieved, which resulted in a favorable facial profile and stable occlusion. CONCLUSION: Even after 8 years of retention, the patient's profile and occlusion were preserved without any significant relapse.

Exposure of a microvascular anastomotic coupler in head and neck reconstruction: a case report.

OBJECTIVE: We present a case of exposure of a microvascular anastomotic coupler. METHODS: We performed venous anastomoses using microvascular anastomotic couplers in head and neck reconstruction. RESULTS: A microvascular anastomotic coupler was exposed in the seventh month postoperation, and an anastomosed vein was disrupted. CONCLUSIONS: Although the usefulness of the microvascular anastomotic coupler in microsurgical flap reconstruction is not in doubt, as described previously, we believe that it is necessary to remember that use of a microvascular anastomotic coupler involves potential risks of exposure and anastomosed vessel disruption.

Simple volume estimation of the latissimus dorsi musculocutaneous flap in Asian breast reconstruction.

Breast reconstruction is surgery where aesthetics are of the utmost importance, and to achieve symmetry is the ultimate goal. Preoperative volume estimation of a transfer flap can be helpful to achieve symmetry. This study demonstrated a simple volume estimation of the latissimus dorsi musculocutaneous (LDMC) flap. It recorded each patient's body weight, height, and body mass index (BMI) and the weight of the LDMC flap in 21 cases of breast reconstruction, and examined the association between flap weight and patient body weight, height, and body mass index by linear regression analysis. Statistical association was found between flap weight and body weight and between flap weight and BMI. Linear regression analysis also revealed that the weight of the flap could be estimated from the patient's body weight and BMI.

Full-thickness eyelid reconstruction using orbicularis oculi musculocutaneous flap raised from lateral orbital region.

Among many methods to reconstruct a full-thickness eyelid defect, we have applied a new design of orbicularis oculi musculocutaneous flap for the anterior wall reconstruction in 7 cases. In all cases, flap survived without any complications. In the design proposed in the article, the flap was raised from the lateral orbital region and the pivot point was placed around the lateral canthus. The method was considered to be safe, easy, and reliable, and at the same time, effective in minimizing the donor site morbidity.

One-stage vermilion switch flap procedure for the correction of thin lips in patients with bilateral cleft lips.

In this article, we describe the operative method for correction of thin lips in patients with bilateral cleft lips. Two transverse triangular flaps were designed in the lower vermilion and elevated along with the labial arteries and the surrounding tissues. These flaps were inserted into the recipient site on the upper vermilion through the subcutaneous tunnels at the oral commissure through a one-stage process; the donor site was closed directly. Two patients with bilateral cleft lip underwent this operation for thin lips, and satisfying results with less morbidity were obtained. The upper lip retained its volume postoperatively, and the donor-site scar was inconspicuous. Our method enabled both the augmentation of the upper vermilion and the reduction of the lower vermilion in a one-stage procedure.

Stabilization of a mobile premaxilla by cementing a bite splint with 1-stage bilateral alveolar bone grafting.

This study describes a method for stabilizing maxillary segments by performing bilateral alveolar bone grafting with an acrylic splint with a flat undersurface to reduce the occlusal pressure to the premaxilla. After premaxilla repositioning and bilateral alveolar bone grafting, the splint was attached to the maxillary teeth with glass ionomer cement. In 6 bilateral cleft cases, premaxilla repositioning and bilateral alveolar bone grafting were performed in 1-stage manner, and successful results were obtained. This easy and cost-effective procedure enabled rigid fixation of the insecure premaxilla with no complications during the treatment period.