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Microvascular reconstruction currently offers the best chance of survival for an ear segment reimplanted after amputation. Unfortunately, this technique is possible only when ear and scalp vessels remain intact. Direct reattachment of the amputated segment as a composite graft is less reliable because survival is poor for grafts larger than 2 cm in diameter. However, if survival could be improved, direct reattachment would be an attractive alternative in situations in which microsurgical revascularization is not possible. Certain pharmacologic agents have been shown to enhance the survival of composite grafts. This study demonstrated that hyperbaric oxygen, dimethylthiourea, and melatonin significantly affected the survival of reimplanted auricular composite grafts at day 7. However, by day 21 the average percentage of survival for all groups approached 13% to 14%. Dimethylthiourea had the most beneficial effect on survival early in the postoperative period, whereas the hyperbaric oxygen group demonstrated the poorest survival.

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Volume 113 Number 2 Scientific Posters P 18 ! symptoms in the development of sphenoid sinus mucocele as well as the need for early and aggressive surgical intervention to avoid catastrophic consequences. The English literature on sphenoid sinus mucocele is reviewed with emphasis on the etiology of mucocele formation, the common presenting symptoms and signs, differential diagnosis, and various surgical approaches available to the surgeon.