No abstract

Summary: Composite defects in the middle third of the face have devastating effects on a patient’s life and social impacts. Several techniques have been described for the restoration of facial defects. The dynamic reconstruction of such defects mainly comprises a complex two-stage procedure and/or microsurgery, functional muscle transfer for restoration of facial animation, and filling the defects. A novel idea for the dynamic reconstruction of the complex segmental midfacial defects includes employing a fascial interposition graft to bridge the gap between the proximally innervated remnants of the facial muscle supplied by the facial nerve and the distal paralyzed perioral muscle, which is simultaneously combined with lipofilling to obtain a good contour and functional restoration.

Chyluria is a primary chylous (white milky viscid) disorder that is observed during urination, whereas chylorrhea refers to continuous chylous discharge from a urethral opening that is unrelated to urination. Chylorrhea is an extremely rare condition, which particularly occurs due to congenital causes, such as lymphangioma circumscriptum (LC). LC is a rare lymphatic channel anomaly that is presented by multiple thin translucent vesicles, which are most commonly noted in the trunk, axilla, thigh, buttocks, and oral cavity. LC rarely occurs on the penis, which has been reported in approximately 30 cases up to 2018. The discharge can impair the patient's quality of life, and the lymphatic vesicles may rupture and become a site for bacterial infection, thereby causing cellulitis or lymphangitis. [1][2][3][4] Conservative management, cryotherapy, microlymphatic venous shunt, sclerotherapy, electrodesiccation, electrocoagulation, and laser coagulation are some of the numerous treatment options available for penile LC. Medical care for LC is not yet established; however, surgical excision is the treatment of choice for LC. 4,5