Flipped Nasal Bone Fracture: Peculiar Fracture Pattern in a Pediatric Patient.

Fractures to the facial bone in the pediatric population often show a different fracture pattern from that of the adult population. In this brief report, the authors share their experience with a nasal bone fracture in a 12-year-old child showing a bizarre fracture pattern, an inside-out displacement of the nasal bone. The authors share the detailed findings of this fracture and describe the method for reducing the fracture back to the proper position.

Modified gluteal fold V-Y advancement flap for vulvovaginal reconstruction.

The gluteal fold V-Y advancement flap is a good option for the reconstruction of a vulvovaginal defect because it is thin, sensate, reliable, and has matched local skin quality. However, in situations where wider and deeper vulvovaginal reconstruction is needed, advancement of the flap alone may not be sufficient to create tension-free closure. To overcome these limitations, we designed a modified gluteal V-Y advancement flap, which has 1 or 2 additional transposition flaps at the base of the conventional advancement flap.This study includes a total number of 16 patients who had received vulvovaginal reconstruction with our new technique between March 2008 and April 2011. The causes of the defects were vulvar cancer in 13 patients and extramammary Paget disease in 3 patients. We examined the location and size of the defect, the flap design, and postoperative clinical courses. The mean follow-up period was 10.6 months, and the defect sizes ranged from 8 × 6 to 15 × 12 cm. Overall, 11 of 16 patients were reconstructed with bilateral modified gluteal fold V-Y advancement flaps, and 5 patients were treated with a unilateral flap. All flaps survived without major complications, and the aesthetic and functional results were satisfactory. The modified gluteal fold V-Y advancement flap is useful and reliable for the reconstruction of wide and deep vulvovaginal defects. It can cover the defect without tension, and the complications associated with it are rare.

Pott puffy tumor appearing with a frontocutaneous fistula.

Pott puffy tumor is defined as a forehead-localized swelling with overlying subperiosteal abscess and osteomyelitis of the frontal bone. It is an uncommon disease entity and more rarely reported with its frontocutaneous fistula. We report the unusual case of Pott puffy tumor appearing with a frontocutaneous fistula. We performed a frontal sinus surgery using a combined endonasal and percutaneous approach and frontal bone reconstruction with a resorbable mesh plate and bone cement. During a follow-up 1 year after the surgery, there was no recurrence, and we achieved excellent result from the aesthetic point of view.

Fibrolipoma of the tip of the nose.

Fibrolipoma is a rare benign tumor that usually presents as an asymptomatic, slowly growing mass with a firm or soft consistency clinically. Histopathologic findings show the proliferation of normal mature fat and fibrous tissue. We report a first case of the fibrolipoma of the nasal tip in a 24-year-old man. The lesion was totally excised and showed no evidence of recurrence after 6 months of follow-up.

Adult-onset kaposiform hemangioendothelioma with neurofibromatosis type 1: A case report and literature review.

Kaposiform hemangioendothelioma (KHE) is a very rare, locally aggressive vascular neoplasm. It occurs mostly in children and is rarely observed in adults. It typically originates on the skin, later affecting the deep soft tissue of the extremities, head or neck, and retroperitoneum by infiltrative growth. It is locally aggressive, does not regress spontaneously, and tends to metastasize locally as well as to the regional lymph nodes. In this article, we report a case of adult-onset KHE with neurofibromatosis type 1. The patient presented to our department with a 2-month history of a painful ulceration in her left popliteal area. Since KHE had not previously been reported in patients with neurofibromatosis, the diagnosis was difficult due to the similarity of the skin manifestation to neurofibromatosis-associated lesions. We share our experience of diagnosing and treating this rare case of adult-onset KHE.