Our data suggest that with transplantation of noncentrifuged adipose tissue more active preadipocytes are applied which could possibly lead to better potential chances of survival and even de novo development of fat.

No abstract

INTRODUCTION: Bell’s palsy causes lagophthalmos of the involved eyelids. Secondary to the atonicity of the eyelids, xerophthalmia, conjunctivitis and epiphora develops. There are dynamic (muscle transfers) and static (gold weights, tarsorrhaphy) approaches to alleviate these problems. The GOALS of this study are to present a technical note for a surgical method for lengthening the retracted upper eyelid with autogenous temporalis fascia and elevation of the lower eyelid with transplantation of autogenous morselized conchal cartilage graft via standard blepharoplasty incisions. MATERIAL AND METHODS: The proposed technique is illustrated in details with an example of a patient with paralytic lagophtalmos. The 4 years follow up of the case operated by this technique shows a stable occlusion of the eyelids with a lowering of the upper eyelid and elevation of the lower eyelid margin. CONCLUSION: If the paralysis is complete this technique will not accomplish adequate relieve of symptoms. In this cases re-animation of the eyelids with either temporalis muscle transfers or free micro neurovascular muscle transfers are indicated.

Adequate reconstruction of defects that are consequences of glossectomy is of primary importance for achieving satisfactory functional results and improving the quality of life. AIM: The aim of this study was to report a case of free fl ap reconstruction of a subtotal glossectomy defect and discuss it in relation to other available methods. CASE REPORT: A 48-year-old woman was operated on for a T4N0M0 squamous cell carcinoma of the tongue. A subtotal glossectomy via mandibular swing procedure with bilateral supraomohyoid neck dissection and reconstruction with a radial forearm free fl ap (RFFF) was performed. Surgery was followed by adjuvant radiotherapy. RESULTS: The post-operative period was uneventful. The patient resumed intelligible speech evaluated as "excellent" and oral feeding. The donor site morbidity was acceptable. Present reconstructive options of the tongue include two categories: to maintain mobility or to provide bulk. In glossectomy with 30 to 50 percent preservation of the original musculature, maintaining the mobility of the remaining tongue by a thin, pliable fl ap is preferred. This can be achieved by infrahyoid myofascial, medial sural artery perforator fl ap, RFFF, anterolateral thigh and ulnar forearm fl ap. When the post-resectional volume is less than 30 percent of the original tongue, the reconstruction shifts to restoration of bulk to facilitate swallowing by providing contact of the neotongue with the palate. Flaps providing bulk include the free TRAM fl ap, latissimus dorsi myocutaneous free fl ap, pectoralis major musculocutaneous fl ap and trape ius island fl ap. CONCLUSION: Surgical treatment of advanced tongue cancer requires adequate reconstruction with restoration of speech, swallowing and oral feeding. Free tissue transfer seems to achieve superior functional results with acceptable donor site morbidity when indicated.

No abstract