Biomedical subjects
Publications and source records attributed to R M Woolf.
An operation for the repair of prominent ears is presented that includes the best features of the cartilage incision and cartilage suturing techniques. By using the best of several procedures, an operation has been developed which gives consistent, reproducible results in the treatment of prominent ears; and which is easily adaptable for children.
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Forty-four patients with Class III malocclusion, who were operated on for prognathism, have been reviewed. In spite of the associated problems of pain, nausea, fear, relapse, additional orthodontia, lip numbness, lip weakness, and 8 weeks with their teeth wired together, only one patient of the 44 said he (or she) would decline this surgery if it were to be considered anew. The surgeon must make a strong effort to keep the vertical cut in the bony ramus posterior to the lingula, to avoid postoperative lip numbness. He should also keep traction on the soft tissues minimal, to avoid postoperative weakness of the lower lip. A significant relapse was uncommon in this series, and the facial symmetry was greatly enhanced. Most of these 44 patients (66 percent) said the improvement in their self-image and personal appearance was far more important to them than the improvement in their bite.
Twenty-six cases which had been operated upon for retrognathia are reviewed. Most of these patients were unmarried, young individuals, and the improvement in their self-image and appearance was the major benefit from the surgical procedure: a lesser number felt the improvement in their bite and function was more important. Relapse, weakness of the lower lip, and numbness of the lower lip were the 3 most common complications. They occurred with sufficient frequency to encourage us to find a surgical approach with less morbidity for this problem of skeletal asymmetry. Perhaps a "C" cut (as champion;ed by Hinds), a forward block of the mandible with cartilage (as described by Trauner), or a vertical cut of the ramus with the posterior fragment notched into the anterior fragment (Mehnert), would yield results with fewer undesirable effects.
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It is not expected that patients who have this correction for inverted nipples can nurse, but neither could they preoperatively. Their hygiene problems are solved. The deformity, their prime concern, has been corrected through a direct trans-nipple-areolar incision with nipple augmentation by flaps of breast tissue.