Persistent lower eyelid lymphedema after Le Fort III maxillary fracture

Hole-retaining Lobeplasty for Type I Ear Lobe Deformities

Background

The aesthetic aspect of Type I incomplete split ear lobe is underestimated. Most of the hole-retaining techniques described for large and split ear lobes are difficult to perform in Type I deformity.

Aim

(1) To conduct a pilot study based on the postoperative review of the cases of Type I ear lobe deformities surgically managed with hole-retaining lobeplasty in a tertiary care centre in South India.(2) To assess the postoperative outcome of the hole retaining lobeplasty based on the Global aesthetic improvement scale and Patient satisfaction in Likert scale.

Materials and Methods

A pilot study of hole-retaining lobeplasty technique was done based on the postoperative review of 6 patients with bilateral type1 incomplete split ear lobes who were operated in our institution with the same. The results were validated based on descriptive statistics and postoperative outcomes using GAIS score and Patient Satisfaction Score measured in a Likert scale.

Results

None of the patients had any postoperative complications. At six months follow up, all patients had centrally placed, circular ear holes, well settled support flap and rounded lobe contour with an average GAIS score of 4.83 ± 0.38. All the patients were satisfied with their newly created ear hole and lobe contour, with an average Patient Satisfaction Score of 4.8 ± 0.4.

Conclusion

Hole- retaining lobeplasty is a simple, cost effective, single staged, day-case procedure for repair of Type I large ear holes, that can be easily duplicated by young plastic surgeons with is aesthetically better, circular and centrally placed ear hole with a more rounded ear lobe with support to prevent recurrence.

Repair of Pediatric Split Earlobe Deformity With Anterior Straight-Line Closure and Posterior Z-Plasty: Surgical Technique and Review of 26 Cases

BACKGROUND

Split earlobe deformity typically results from earring-related trauma or, less commonly, from congenital malformation. Several surgical approaches to repair the earlobe have been described, with the goals of reconstructing normal contour of the earlobe, avoiding notching of the free margin, and minimizing scar visibility.

METHODS

The authors reviewed 26 consecutive patients who underwent earlobe reconstruction using the senior author's novel technique, which involves anterior straight-line closure paired with a posterior Z-plasty. Baseline demographic characteristics, etiology of split earlobe, follow-up, outcomes, and rate of complications were analyzed.

RESULTS

The median age at surgical repair was 8.04 (interquartile range, 4.53-12.84) years. Most patients had acquired split earlobe deformity secondary to trauma. Median follow-up was 86.5 (interquartile range, 29-385.5) days. Only 4 patients had less than satisfactory results, 3 having residual contour abnormality and 1 noting earlobe asymmetry. None of these patients desired revision. No keloid formation, dehiscence, or other postoperative complications were reported.

CONCLUSIONS

The authors describe a novel and effective surgical technique that successfully reconstructs split earlobe deformity. This technique minimizes visible scarring with an anterior straight-line repair combined with posterior Z-plasty to avoid notching.

Edemas of the face and lymphoscintigraphic examination

Facial edemas not secondary to surgery and/or radiotherapy for head and neck cancer are relatively uncommon. Our aim is to report a retrospective analysis of the lymphoscintigraphic and SPECT-CT investigations obtained in patients with such facial edema. Retrospective review of exams (planar imagings in all and with SPECT-CT in 5) obtained after the subcutaneous injection of 99mTc HSA Nanosized colloids between the eyebrows in five men and seven women. Four main lymphatic pathways were identified on sequential planar imagings: para-nasal left and right and supra- ocular left and right. For eleven patients, the absence of visualization of lymphatic drainage and/or their delayed appearance correlated well with the localisation of the edematous areas. In two patients with post-traumatic and post- surgical edemas, SPECT-CT showed one deep left sided cervical lymph node (LN) in front of the first cervical vertebra. This lymphoscintigraphic approach represents a simple and valuable way to assess the lymphatic drainage pathways of the face and to establish the diagnosis of facial lymphedema.