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Microsurgery is one of the highly interesting surgical procedures that can be performed using different applications and in different specialties, including plastic surgery. The endoscope is a popular instrument used in many fields, including plastic surgery. Although the operating microscope is still a must for microsurgical performance, microsurgery could be performed, depending on the experiences and facilities, by using other visual-assisting equipment. From this point of view, the authors tried to find less costly and more widespread equipment suitable for performing microsurgery that can, furthermore, be applied in special situations and indications, such as operating in an optical cavity. The authors investigated this issue with the endoscope. In this experimental project, the authors performed vascular microsurgical anastomoses of the rats' femoral vessels to create an optical cavity in a prefabricated skin retraction model in the groin area of 10 Sprague-Dawley male rats. The microsurgical anastomoses of the femoral vessels and nerves were performed easily in a reasonable time, without recorded difficulties, and with maximum physical and visual comfort for the surgeon. The authors spent a mean time of 28.1, 27.3, and 19.2 minutes for the arterial, venous, and neural anastomoses, respectively. In this group of animals, 90 percent vascular patency and 100 percent accurate neural anastomoses were recorded. The advantage the authors noted was that this new technique of operating in the field of microsurgery, with its feasibility and difficulties, would be a point of research and application for the young generations of microsurgeons.

No abstract

The columella is unique as a nasal subunit. The nasal columella has traditionally been a difficult subunit to repair because of its unique contours, tenuous vascularity, and limited availability of adjacent skin. Columellar defects can significantly impair aesthetic appearance. Columellar damage can be caused by congenital loss, ischemic injuries, trauma, tumor resection, and vascular malformations. Columella reconstruction can be very challenging for plastic surgeons.Defects of the nasal columella can be repaired using various methods including composite free grafts from the ear (1,2), nasolabial flaps (3), nasofacial sulcus flaps (4), forehead flaps (5), extended Abbe flaps (6), and free flaps (7).Auricular chondrocutaneous composite grafts have been reported in the literature. The main advantage of these grafts are avoidance of facial scars and provision of tip support. However, risk of composite graft loss was reported as a main complication.Herein, we report two cases of columellar defect reconstructions in children using a custom-made columella from a conchal composite graft with the tongue-in-groove principle. The main advantages of this technique are that it is a onestage method; the custom-made columella depends on the dimensions of the defect, so it can be tailored according to the dimension of the columellar defect; the use of the tonguein-groove principle increases the contact surface between the graft and recipient, therefore, increase the possibility of survival of the reconstructed columella; with minimal donor site morbidity.