Biomedical subjects
Publications and source records attributed to N Tabbal.
The lips are key features to be considered in facial balance. Correction of lip atrophy in Romberg's disease, therefore, contributes significantly to restoration of facial symmetry. Along with other ancillary surgical procedures used for facial reconstruction in hemifacial atrophy, tongue flaps provide an excellent means of correction of the lip deformity with minimal morbidity and good results.
Patients with severe mandibular prognathism are best managed with a combined orthodontic-surgical approach. In our patients, the orthodontic treatment consisted of six to eighteen months of presurgical preparation, which in some patients may accentuate the dental deformity. This is done to provide two well-aligned dental arches that will fit accurately at surgery. The surgical procedure used was an oblique subcondylar osteotomy. This was followed by six to eight months of orthodontic treatment to complete dental alignment. Thirty patients were treated using this combined approach, with excellent results and few complications.
The skin-muscle flap technique in blepharoplasty has, in our opinion, distinct advantages over the classic skin flap operation. Morbidity is diminished by avoiding dead space and preserving the integrity of the skin-muscle intimate attachments. Excessive muscle, an entity of which we are becoming more aware, can be handled simultaneously by cautious excision. Finally, secondary operations to correct recurrent skin excess can be performed in virgin territory at the level of the skin-muscle interface. Even though this technique is applicable to the vast majority of patients, certain deformities in which a marked excess of skin is the chief anatomic problem are best corrected with a classic skin flap procedure.
A case report of successful microvascular replantation of a totally avulsed scalp is presented. The scalp itself, in good condition, was used as a free flap. Following operation, the right temporal artery was patent; the left was not. Repair of the left temporal artery was not attempted but large thrombi were milked from the scalp veins. Excellent perfusion of the scalp was provided through the right side. Hair growth began soon after operation, spotty at first but eventually excellent.