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Biomedical subjects

Jonathan M Sykes

Publications and source records attributed to Jonathan M Sykes.

14 recordsLinked to original sources
PubMed2005

Management of the cleft lip deformity.

A congenital cleft lip is a deformity that has significant physical and psychologic impact. Many surgical repairs have been proposed for reconstruction of unilateral cleft lip deformities, including straight-line repairs and various forms of geometric flap repair. This article classifies cleft deformities and describes the history and specific techniques of unilateral cleft lip repair. Understanding and application of these techniques can aid the cleft surgeon in maximizing function and appearance of a child born with a cleft lip deformity.

Cleft Lip↗
PubMed2005

The full-thickness forehead flap for complex nasal defects: a preliminary study.

OBJECTIVE: To report a new technique using a bivalved, full-thickness paramedian forehead flap. The unique vascular anatomy of the supratrochlear artery allows the skin and subcutaneous tissue to be separated from the frontalis muscle and pericranium. The deep layers serve as a pliable, vascularized intranasal lining. Bone and cartilage grafts can be placed as "sandwich" grafts between the deep and superficial layers of the flap. STUDY DESIGN: A retrospective review of 5 cases. RESULTS: All flaps survived. Four minor complications occurred in 3 patients. These resolved with minimal treatment. CONCLUSIONS: The full-thickness forehead flap is a viable option for large defects or for the difficult situation in which intranasal local flaps are not an option. SIGNIFICANCE: The gold standard for replacement of the intranasal lining is a septal mucosal or vestibular local flap. The full-thickness forehead flap is an option in patients for whom other lining flaps are not available. EBM RATING: C-3.

Adult↗
PubMed2002

Anatomy and physiology of the upper airway.

Normal respiration involves a highly detailed neurophysiologic process that results in the exchange of inspired and expired air through various anatomic structures. An understanding of these structures is important to the clinician involved in maintaining or reestablishing the normal airway. The following anatomic discussion focuses on the features crucial for the establishment and maintenance of a tracheal airway.

Humans↗
PubMed2002

Correction of the cleft-lip nasal deformity.

Correction of the cleft-lip nasal deformity is a difficult task that requires a clear understanding of the associated complex anatomic abnormalities. These deformities tend to accentuate as nasal growth continues. Primary tip rhinoplasty in the unilateral deformity improves nasal tip symmetry and decreases the need for intermediate surgery. Intermediate rhinoplasty in the bilateral deformity is performed when nasal tip projection is markedly diminished. In both the unilateral and bilateral deformity, definitive rhinoplasty utilizing the open-structure rhinoplasty approach allows maximum exposure for placement of structural grafts to improve tip projection, definition, support, and function. In this article, the pathologic anatomy of the unilateral and bilateral cleft nasal deformity is described. The philosophy and timing of repair are discussed. Finally, the techniques used by the authors to address both the aesthetic and functional problems are outlined.

Adolescent↗
PubMedDate not supplied

Dorsal onlay cartilage autografts: comparing resorption in a rabbit model.

OBJECTIVE: To compare the resorption characteristics of dorsal onlay cartilage autografts from the septum, auricle, and rib. METHODS: Fourteen New Zealand white rabbits underwent harvesting of equal-sized septal, auricular, and costal cartilage grafts free of perichondrium. All autografts were implanted subcutaneously on the nasal dorsum and then removed after 3 months. Graft mass, chondrocyte density, and histologic features from hematoxylin-eosin-stained sections were compared before and 3 months after implantation. RESULTS: At 3 months after implantation, septal cartilage grafts averaged 30.8% resorption by weight, followed by auricular (23.1%) and costal (7.6%) cartilage. All 3 groups demonstrated similar changes in chondrocyte density and minor calcification at 3 months. There was no evidence of necrosis or inflammatory changes in any of the specimens. CONCLUSIONS: Although the septum is often the preferred source of autogenous cartilage for nasal reconstruction, short-term resorption of septal cartilage appears to be higher for dorsal onlay grafts. The low resorption of costal cartilage may be due in part to its compact shape compared with septal and auricular cartilage. It remains to be seen whether these differences in resorption persist in the long term.

Animals↗
PubMedDate not supplied

Evaluation and treatment of vertical microgenia.

OBJECTIVE: To evaluate treatment of vertical microgenia in patients with chin deformities. METHODS: Twenty-one patients were included in this retrospective review. The 3 authors performed a lengthening genioplasty with or without interpositional grafting on each patient in either an academic or a private practice setting. RESULTS: Subjective analysis suggests a substantial improvement of lower face aesthetics in all patients. The degree of subjective change depended on the type of deformity, whether there was vertical microgenia alone or in combination with a sagittal (horizontal) deficiency, and the morphologic characteristics of the labiomental sulcus. There were no significant complications. CONCLUSION: Vertical lengthening of the chin should be considered in patients with the combination of a vertically short lower facial height, deepened labiomental fold, recessive chin, and recessive and/or procumbent lower lip.

Adult↗
PubMedDate not supplied

The effect of rhytidectomy on the nasal valve.

OBJECTIVES: To determine the effect of deep-plane rhytidectomy on the cross-sectional area of the nasal cavity in the vicinity of the nasal valves and to compare this quantitative measure with patients' subjective assessment of their postoperative nasal airway. DESIGN: An inception cohort of 17 patients undergoing rhytidectomy (either cheek-lift or face-lift) for facial rejuvenation was evaluated with acoustic rhinometry. Initial measurements were taken approximately 1 week prior to surgery, followed by postoperative measurements at 1 week and again at 1 month (a total of 18 measurements per patient). Patients undergoing simultaneous nasal procedures were excluded. Control subjects consisted of patients undergoing facial plastic procedures other than rhytidectomy or septorhinoplasty (n = 3). The main outcome measure was cross-sectional area of both the internal and external valve regions as determined by acoustic rhinometry. The setting was an ambulatory surgery center at a large academic institution. RESULTS: Seventy percent of patients (12 of 17) reported subjective improvement of their nasal airway patency following rhytidectomy, whereas no control subjects (0%) reported any such change. Eighty-eight percent of patients (15 of 17) had a substantial increase in the dimension of their internal nasal valve area as measured with acoustic rhinometry at 1 week, with 70% of patients demonstrating increase at 1 month. Fifty-three percent of patients (9 of 17) demonstrated an increase in their external valve area at 1 week, and 59% had a persistent increase as measured at 1 month. No control subjects demonstrated any significant nasal valve area increases at either time. There was no correlation between age or body mass index and the measurement outcomes among participants. CONCLUSIONS: While there is a statistically significant increase in both the internal and external nasal valve cross-sectional areas at 1 month after rhytidectomy, the permanency of this effect is unknown. In support of these findings, a sizable proportion of patients undergoing rhytidectomy subjectively report an increase in their ability to breathe through their noses, lending credence to a postrhytidectomy melonasal effect.

Adult↗
PubMedDate not supplied

Cleft lip-palate deformities in Western China: epidemiology, surgical reconstruction, and cost.

A series of 46 procedures (42 patients) was performed on youth with cleft lip-palate deformities in Lanzhou, China. Patients' ages ranged from 6 months to 18 years. There were no short-term complications in this series, which included many advanced cases. The estimated cost per patient was 1590 US dollars. Youth with unrepaired cleft lip-palate in western China can be treated in a cost-effective manner.

Adolescent↗