: The pedicled nasoseptal flap may not be a viable option for EEA reconstruction in children <10 years of age. This flap is a reliable option in patients >14 years of age, as their septums are comparable to adults. Patients 10 years to 13 years of age require careful consideration of facial analysis and preoperative radioanatomic evaluation on an individual basis. Laryngoscope, 2009.

The paramedian forehead flap is used to reconstruct medium to large nasal defects. The staged nature, with its vascular pedicle bridging the medial eyebrow to the nose, results in significant facial deformity. Earlier division lessens this morbidity. OBJECTIVES To quantify flap neovascularization 2 weeks after the initial flap transfer and to describe an algorithm for earlier division of the flap pedicle in select patient populations.

No abstract

Three-dimensional endoscopy may improve depth perception and performance for novices. The 3D endoscope is a safe and feasible tool for endoscopic sinus and skull base surgery; it is promising for improving microneurosurgical dissection precision transnasally.

Objective-The pathophysiologic mechanisms resulting in hearing loss during electrode implantation are largely unknown. To better understand the functional implications of electrode implantation, we recorded the effects of cochlear damage on acoustically evoked intracochlear measurements using normal-hearing gerbils.Methods-A metal electrode was placed on the surface of the round window and recordings of the cochlear microphonic (CM) and compound action potential (CAP) were made in response to stimulation with tone bursts at various frequencies in one-octave intervals and at intensities of 15-72 dB SPL. The electrode was then advanced incrementally, with CM and CAP measurements taken at each step. These data were compared to data taken at the round window, and the electrode was withdrawn when a significant change was observed. Following electrophysiological analysis, the cochlea was examined histologically. Results-Resultsshow that upon electrode insertion, loss of amplitude in the CM and CAP occurs after damage to cochlear structures. Loss of activity was typically first apparent in the CAP rather than the CM.Conclusions-These results suggest that a reduction of the CAP can be an early marker of interaction of the electrode with cochlear structures. Such measurements are potentially available with slight modifications to current cochlear implant technology.