Even an experienced surgeon must always keep in mind that serious complications can occur in sinus surgery. One must constantly be alert to the possibility of anatomical variants or specific pathologic findings.

Over the past 25 years external rhinoplasty has become increasingly popular. Some rhinosurgeons recommend its use widely, even in routine cases. In our view, however, the classical endonasal approaches remain the first choice. Open rhinoplasty offers an excellent visualization and therefore facility of precise correction, but causes a larger area of wound and scarring. It should, therefore, be restricted to cases of particular difficulties. In the era of minimal invasive surgery, external rhinoplasty advocated as a standard procedure seems to be a drawback, particularly if the aesthetic problem is the leading one. Every facial plastic surgeon should master closed and external rhinoplasty to be able to decide which approach is the most suitable in each situation from the patient's point of view.

No abstract

Rehabilitation of the oral region is best managed with a temporalis muscle flap because of its favourable vector of tension and its broad, flat form. Masseter muscle transposition is particularly indicated if a temporalis muscle transfer is not possible or if resection of the facial nerve because of malignancy of the parotid gland has to be performed and nerve reconstruction is not advisable.

The case of a 24-year-old woman with a plunging ranula is reported. Primarily, the patient noticed extensive swelling of the neck, which had developed 3 months previously. The polycystic, firmly attached tumor and the sublingual and submandibular glands of the right side of the neck were surgically removed. Pathological examination showed a retention cyst by means of a plunging ranula. The etiology, pathogenesis, clinical aspect and diagnostic procedures for the plunging ranula are described. Various therapeutic possibilities are discussed in regard to their value. We prefer surgical treatment with a histological examination to verify the diagnosis. The plunging ranula originates on the sublingual gland; therefore, its simultaneous extirpation is recommended to avoid recurrences. In extensive cases, the additional removal of the submandibular gland can be advised.