The Journal of craniofacial surgery
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Randomized Controlled Trial
The effects of sevoflurane and isoflurane in nasal septal surgery.
The objective of this study was to evaluate the effect of sevoflurane and isoflurane in nasal septal surgery in terms of intraoperative blood loss, operation time, recovery time, and especially postoperative pain. ⋯ Sevoflurane, which is one of the volatile anesthetics, leads to a lower amount of intraoperative bleeding, postoperative pain, and operation time than isoflurane during nasal septal surgery.
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The aim of this study is to follow longitudinally the prominent ears treated by percutaneous adjustable closed otoplasty (PACO) and evaluate this procedure in terms of technical efficiency, recurrence, complications, and patient satisfaction. ⋯ Percutaneous adjustable closed otoplasty is an efficient surgical procedure with positive outcome, low recurrence, and high patient satisfaction. In prominent ear deformities with soft cartilage, PACO should be the preferred surgical choice because of its advantages of shorter time in surgery, lack of need for prolonged postoperative compressive dressing, and allowing patients to view the results immediately after surgery. In contrast to the previously described techniques, auriculocephalic distances are adjustable while tightening the mattress sutures. Besides, it is a reversible technique, if the surgeon not satisfied with the result of the surgery can either redo the procedure or revert to CST. Percutaneous adjustable closed otoplasty does not cause serious complications, contour deformities, hematoma, or incision scars. For ear deformities presenting with stiff helical cartilage and conchal hyperthrophy, surgical indications can be extended by scoring and conchal resection, respectively.
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A zygomaticomaxillary complex fracture is a facial bone fracture that commonly occurs as a centrally and laterally protruding zygomatic area. The exact reduction of the displaced fracture is the most important task in the treatment of a zygomatic fracture, from the aesthetic point of view. In some types of zygomaticomaxillary complex fracture, however, it is somewhat difficult to maintain the reduction after the surgery using 3-point fixation. In addition, surgery using 3-point fixation may cause malunion or nonunion. Thus, 4-point fixation using the coronal approach is alternatively considered. The authors performed 4-point fixation using the preauricular approach to counter the disadvantages of the coronal approach. The results and usefulness of 4-point fixation using the preauricular approach are reported in this study. ⋯ Exact reduction and internal fixation of a fracture site are required to restore the appearance and functions of the normal face and to reduce complications such as malunion or nonunion in patients with a zygomaticomaxillary complex fracture. If a complex fracture of the zygomatic body or facture of the zygomaticomaxillary buttress is accompanied by a fracture of the inferior orbital rim, and thus, if incomplete reduction or malunion is anticipated, 4-point fixation using the easier-to-manipulate preauricular approach would be more useful than the conventional method that uses the coronal approach.
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Case Reports
Transdermal scopolamine and perioperative anisocoria in craniofacial surgery: a report of 3 patients.
Postoperative nausea and vomiting (PONV) is a common complaint after plastic and reconstructive surgery. Transdermal scopolamine is a commonly used agent for prevention of PONV. ⋯ Given the various causes and potentially grave implications of unilateral mydriasis, we discourage the use of transdermal scopolamine in craniofacial surgery, and especially in orbital surgery. However, if transdermal scopolamine is decided to be used for PONV prophylaxis, we recommend educating the patient, the operating room staff, and the surgical team regarding this potential adverse effect and to avoid finger-to-eye contamination after patch manipulation.
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Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. The most common predisposing risk factor for mucormycosis is diabetes mellitus. ⋯ Diabetic ketoacidosis is the most common and serious acute complication of diabetic patients. We herein report 2 cases of fatal rhino-orbito-cerebral mucormycosis in a patient with diabetic ketoacidosis.