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The disparity between an individual's self-perception and how he or she is observed by others can be significant and very illuminating. In rhinoplasty, the extent of this difference is often the primary determinant in patient satisfaction and commonly the motivational force behind patients seeking surgical revision. Kathy Yu, MD, andcolleagues prospectively studied 104 consecutive patients seeking revision rhinoplasty. Systematic analysis of functional and aesthetic concerns, from both patient and physician perspectives, are presented as well as the most frequent reasons cited by patients for not returning to their primary surgeon.
For many facial plastic surgeons, reduction rhinoplasty exemplifies the balance of aesthetic form and desired function while employing a complex understanding of nasal anatomy and airway dynamics. Daniel Timperley, MBChB,and colleagues discuss their approach in the refinement of the bulbous or boxy nasal tip in their prospective, 100-patient study. Multiple subjective and objective outcome measures are used, including nasal peak inspiratory flow; Sino-Nasal Outcome Test; nasal obstruction score; 36-Item Short Form (SF-36), version 2; and anchor scores. The authors further detail their surgical perspectives with clear illustrations, operative photographs, and case examples.
Traumatic increases of orbital volume are often associated with bony disruption of the orbital floor as well as varying degrees of diplopia, enophthalmos, and soft-tissue entrapment. The surgical challenge in orbital trauma is to not only address the anterior facial skeleton but also restore the posterior bony orbit. Olivier Lieger, MD, DMD, and colleagues review a series of 8 cases in which autologous calvarial bone and irradiated rib cartilage grafts were used in the restoration of orbital volume. The authors review their operative technique and surgical outcomes while candidly presenting the challenges of persistent diplopia after orbital volume correction.
Facial nerve injury is often associated with significant functional and emotional loss because complete physical recovery is rarely achieved. Considerable advances have been made in the understanding and treatment of facial nerve injury, but clinical outcomes are complicated by aberrant regeneration and synkinesis. Christina K. Magill, MD,and colleagues present a novel transgenic rat model (Thy1-GFP) that constitutively expresses a heritable green fluorescent protein within its axons and Schwann cells. The results of this pilot study highlight the considerable potential of a transgenic animal model that affords direct visualization of neural anatomy, injury, and recovery with confocal microscopy.
Portrait of General Giles by Joseph Wright.
This issue's Highlights were written by James Ridgway, MD.
Highlights of Archives of Facial Plastic Surgery. Arch Facial Plast Surg. 2010;12(5):287. doi:10.1001/archfacial.2010.64