Rationale:Tissue augmentation of facial depression deformities can be achieved by volume replacement with autologous fat injection, dermal filler injection, etc. Here, we report a case of tissue augmentation of a facial depression deformity using a pedicled buccal fat pad (BFP).Patient concerns:A 64-year-old woman was referred with a chief complaint of facial depression deformity.Diagnoses:Her molars had been removed at another hospital 12 years prior to this referral, and the patient suffered from a left cheek depression deformity as a sequela of a postextraction infection.Interventions:An incision was made in the left gingivobuccal sulcus under local anesthesia, and BFP was carefully excised from its normal location. The subcutaneous scar tissue was dissected, and a pocket was created via the same mucosal incision. BFP was then pushed into the pocket.Outcomes:The depression deformity immediately disappeared postoperatively. The transplanted BFP remained unabsorbed and soft 43 months postoperatively. The patient did not have any complications.Lessons:This novel procedure has 2 advantages. First, the pedicled BFP is a vascularized tissue and is not absorbed postoperatively; control of contour is easy, and only 1 treatment session is required. Complications associated with fat necrosis can be avoided. Second, only a single intraoral incision is required; the risk of donor-site morbidity is very low, and scar formation does not occur on exposed skin. Third, this procedure can be performed without special instruments and equipment. The main disadvantages are limited rotation arc and volume of pedicled BFP. Despite its limited application, this procedure is simple and useful, with low invasiveness.

No abstract

Objective: Sacrificing the auricle has severe postoperative impacts on patients with temporal bone malignancy who have undergone en bloc temporal bone resection. The auricular complications following en bloc temporal bone resection remain unclear. Therefore, this study aimed to examine auricular complications following en bloc temporal bone resection and reveal the associated risk factors. Study Design: Case series with chart review. Setting: Single tertiary care medical center Participants: Our study includes all cases who underwent en bloc temporal bone resection with preserved auricle for temporal bone malignancy from January 1993 to July 2020. The resulting dataset contained 64 patients during the review period. Main outcome measures: We examined the relationship of auricular complications with surgical procedures and patient profiles. Results: Three of 64 cases (4.7%) showed postoperative auricular complication. The cause in all three cases was venous congestion. Postoperative bloodletting to relieve the congestion effectively salvaged the auricle in two of these cases. Insufficient bloodletting to relieve the auricular congestion in the remaining case led to auricular necrosis. Pre-/infra-auricular lymph node dissection is correlated with auricular complications with statistical significance. Conclusions: Temporal bone resection causes auricular congestion due to vascular insufficiency, particularly insufficient venous outflow. An immediate and continuous application of bloodletting can improve venous drainage after temporal bone resection to prevent auricle necrosis.