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Highlights of Archives of Facial Plastic Surgery
April 2002

Highlights of Archives of Facial Plastic Surgery

Arch Facial Plast Surg. 2002;4(2):72. doi:
The Quantification of Surgical Changes in Nasal Tip Support

Mark M. Beaty, MD, Wallace K. Dyer, MD, and Matthew W. Shawl, MD, Article study nasal tip support in surgical patients and cadavers using a custom-built tension meter. The authors were able to quantitate the decrease in tip support when ligamentous attachments to the lateral crura were divided, and to document that reconstruction of these ligamentous attachments and columellar strut placement augmented tip support measured postoperatively. This excellent experimental study is based on the theoretical concepts developed by Dr Dyer in which he applies the basic principles of architectural engineering to the nasal tip and its surgical alteration.

Tissue Response to Expanded Polytetrafluoroethylene and Silicone Implants in a Rabbit Model

Rami K. Batniji, MD, and associates Article report that expanded polytetrafluoroethylene (ePTFE) and silicone are safe and commonly used implant materials in facial plastic surgery. They compare a modified form of ePTFE reinforced with fluorinated ethylene propylene to silicone. The modified ePTFE may provide increased pliability and material integrity. The implants were placed in the subperiosteal pockets in rabbits and histological analysis was performed 7, 30, and 90 days after implantation. Both implant materials were well tolerated. The silicone implants elicited significantly thicker capsules and less neovascularization. This modified ePTFE shows good biocompatility and deserves further study as an implant material.

Orbital Blowout Fractures: Experimental Evidence for the Pure Hydraulic Theory

John S. Rhee, MD, and colleagues Article studied the biomechanics of orbital blowout fractures in fresh cadavers. They provided standardized mechanical impact in a relatively physiologic situation and determined injury patterns with high-speed videography, direct visualization, and computed tomographic scans. Their studies provided support for the "hydraulic theory" and evidence against the role of direct globe-to-wall contact in the pathogenesis of orbital blowout fractures. The orbital floor was found to have a lower threshold for fracture than the medial wall and threshold values for fracture occurrence and soft tissue displacement were obtained.

Pharyngeal Flap and the Internal Carotid in Velocardiofacial Syndrome

Sherard A. Tatum III, MD, and colleagues Article report on 20 patients with velocardiofacial syndrome who received comprehensive imaging studies of internal carotid artery prior to pharyngeal flap surgery. In all cases there were abnormalities of the major neck vessels, but 5 of these anomalies were significant enough to place the vessels directly deep to the donor site for the pharyngeal flap. The authors present their technique to safely perform pharyngeal surgery in patients with the velocardiofacial syndrome.

Simplicity Is Complexity Itself

Sleeping Muse I by Constantin Brancusi. Article Article