From our own experience and a review of the literature, we present a few techniques which, in our eyes, give the surgeon the possibility to treat most encountered cases of stenosis of the nasal vestibule. During 1991 to 1998 the author in Stuttgart (W.G.) performed simple z-plasty combined with local flaps in 6 patients and composite grafts only in 12 cases, to correct nasal vestibule stenosis. The author in Lausanne (R.M.), who first described the paranasal myocutaneous flap to correct not only nasal vestibule stenosis but also alar base malposition has treated over 50 patients with this technique and with composite grafts during the last 20 years.

We present three cases of mucous cyst as a rare postrhinoplasty complication that were seen in our clinic during the last 16 years. They were located in three different positions of the nose: bony and cartilaginous part of the dorsum of the nose as well as over the alar cartilage part of the nose. We were able to treat all three patients successfully by excision of the cyst through intranasal or open approaches. In reviewing the literature and from our own experience we come to the conclusion that postoperative clearing of all tissue remnants, especially mucous parts, and a careful, atraumatic operation by forming an intact mucoperichondrial tube for intransal osteotomy as well as for hump removal are the best prevention of postrhinoplasty complications such as mucous cysts.

Based on a review of the literature and our own experience, we propose criteria for the site of implantation that, in our eyes, is suitable for a silicon implant or a cartilage transplant. Special interest is focused on rhinoplasty and chin augmentation, as both determine the facial profile of the patient. During the last 17 years we have treated 443 patients with augmentation rhinoplasty, of whom 360 received autologous ear cartilage grafts and 83 received autologous rib cartilage grafts. At the same time we saw 30 patients requiring removal of artificial implant materials that were used by other surgeons for rhinoplasty augmentation purposes. Since 1986 we have performed 60 chin augmentations with anatomically shaped silicone implants (McGhan), of which 40 patients had a combined rhinomentoplasty done.

A total of 307 central venous access devices were implanted by open surgery in 268 pediatric oncology patients. Their data were retrospectively evaluated from a surgical point of view. The cumulative duration of implantation of 116 subcutaneous tunneled Catheter (STC) was 12,206 days and 45,524 days for 191 portsystems. According to the duration in each group, ports were superior to STC when infection, complication and occlusion were taken into consideration. Infection of the ports was more frequent in children under 3 years than in older patients. Conversely, in the STC-group, children over 10 years presented with the highest rate of infection episodes. The number of complications was high in young children for both types of catheter, decreasing with age. Occlusion rates were similar for both systems and were not age related. However, thrombolysis was more successful in portsystems and few catheters had to be removed for this reason. The age-related data of the presented study are discussed with regard to the surgical procedure. Recommendations are made concerning the adequate choice of catheter system, the surgical technique and postoperative management. Additionally, the medicotechnical aspect of different catheter types is discussed and some suggestions and/or requests are directed to the industrial developing laboratories.

Ear cartilage is an important source of grafts for rhinoplasty. The majority of cartilage grafts is harvested from the concha of the ear. We describe indications in which the tragal cartilage is a more favorable graft source than conchal cartilage. The technique is fast, simple, and does not require special dressings.