ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

COSM13: Complex Cases, High Stakes Pose Challenge for Plastic Surgeons

by Thomas R. Collins • May 1, 2013

  • Tweet
  • Email
Print-Friendly Version

The best way to re-establish occlusion is to use arch bars, even though there are many “shortcuts” available. “One of the biggest pitfalls, in fact, is represented by a lot of the shortcuts that people are utilizing today to establish occlusion,” he said.

You Might Also Like

  • Nonstandard Thinking Required to Meet the Challenge of Complex Sinus Conditions
  • Wound Management Following Facial Plastic Surgery
  • Managing Expectations: Facial plastic surgeons emphasize the limits of injectable fillers
  • High-Volume Hospitals, Surgeons Better Predictors of Overall Survival in Head, Neck Cancer
Explore This Issue
May 2013

Not knowing what is normal is a big issue. An occlusion that might be perfectly normal “according to the textbook” might not be right for a particular patient, he said.

When dealing with pan-facial fractures, Dr. Kellman said he starts with re-establishing the occlusion and then works from the periphery to the center, from the mandible to the frontal and front-zygomatic area to the fronto-nasal area to the zygomatic-maxillary area to the orbital bones to the naso-orbital-ethmoidal/nasoethmoidal complex.

He said wires can make aligning bones much easier. “Just because we use plates doesn’t mean we should forget that you can also use wires,” he said. “By wiring a lot of fragmented bones into position at first, before you plate them, you re-establish very difficult positions … like a chain-link fence.”

He added that he gets ophthalmology consults in 100 percent of orbital fractures, figuring that trauma bad enough to have broken those bones might have been enough to cause an injury he wouldn’t recognize.

Understanding the Anatomy

Russell Ries, MD, chair of facial plastic surgery at Vanderbilt University in Nashville, began his talk on otoplasty pitfalls with a case he wishes he’d done differently.

A man had come to him with large, prominent ears and wanted an improvement. Dr. Ries did make an improvement but, later on, the problem happened again. “I unwisely just addressed the antihelical folds, leaving the conchal bowl unchanged,” Dr. Ries said. “I didn’t recognize and adequately diagnose pre-operatively what needed to be done.”

That was an error of inadequate correction. Surgeons can also fall into the pitfall of loss of correction, in which an improvement is lost due to use of an inadequate technique. He said that when addressing conchal bowl excess and making an adjustment to the antihelical fold, it’s best to deal with the conchal bowl first. “If you do the reverse order, you can have overcorrection and then conchal undercorrection,” he said.

He also emphasized that when you are dealing with a “cartilage-sparing” technique in which no cartilage is excised, and with the use of Mustardé sutures, you must overcorrect. “There’s elastic recoil, especially in the superior fold,” he said.

Pages: 1 2 3 | Single Page

Filed Under: Facial Plastic/Reconstructive, Features, Practice Focus Tagged With: annual meeting, COSM13, plastic surgery, Triological SocietyIssue: May 2013

You Might Also Like:

  • Nonstandard Thinking Required to Meet the Challenge of Complex Sinus Conditions
  • Wound Management Following Facial Plastic Surgery
  • Managing Expectations: Facial plastic surgeons emphasize the limits of injectable fillers
  • High-Volume Hospitals, Surgeons Better Predictors of Overall Survival in Head, Neck Cancer

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Weaning Patients Off of PPIs
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Vertigo in the Elderly: What Does It Mean?
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.