Ann Acad Med Singap
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The pathology, clinical features, indications for surgery and the results of intrathoracic aneurysm are analysed in thirty-nine consecutive patients who underwent surgery at Singapore General Hospital from January 1986 through December 1990. There were twenty cases of non-dissecting aneurysm and nineteen cases of dissecting aneurysm or aortic dissection. The 30 day survival for the twenty patients with non-dissecting aneurysm was sixteen patients (80%). ⋯ The overall 30-day survival for the nineteen patients with aortic dissection was twelve patients (64%). The mortality was especially high in patients with acute aortic dissection (46%). Recent advances in the management of these aneurysms make early recognition and diagnosis mandatory to achieve the best results.
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Fifteen Oriental noses were examined macrosurgically and microscopically. Five soft tissue layers overlying the osseocartilaginous framework are identified: the skin, the subcutaneous areolar plane, the vascular-fibromuscular layer, the deep areolar plane and perichondrium/periosteum. Two natural planes of dissection are represented by these areolar planes which separate the nose into an overlying skin envelope, a vascular-fibromuscular layer and an underlying osseocartilaginous framework. ⋯ Injection studies of the blood supply reveal many arterial variations but always a distinct alar artery, columellar artery and alar plexus that have not been previously named. The alar groove is a junction between the alar lobule which is soft tissue alone and the tip which is soft tissue, supported by cartilage. The alar groove lies over the lateral edge of the tip cartilage and here there is muscular attachment to the fibromuscular layer.