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Symptom Oriented Otolaryngology—Head & Neck Surgery: Rhinology and Facial Plastics (Volume 2)
Zahoor Ahmad, Randall P Morton, Malcolm Giles
SECTION 1: RHINOLOGY
1:
Clinical Anatomy of the Nose and Sinuses
1.1 OVERVIEW
1.2 DEVELOPMENT
1.3 HISTOLOGY OF THE NASAL CAVITY AND SINUSES
1.4 ANATOMY
Lateral Nasal Wall
Nasal Septum
Sinonasal Blood Supply and Drainage
Neural Innervation
Sinus Anatomy (Figs. 1.3 and 1.4
Hiatus Semilunaris
Ethmoid Infundibulum
Nasolacrimal Duct
1.5 RADIOLOGIC ANATOMY OF THE SINUSES
Maxillary Sinus
Sinus Lateralis
Ethmoid Sinuses
Posterior Ethmoid Sinuses
Other Ethmoid Cells
Frontal Sinus
The Frontal Recess
Accessory Cells in the Frontal Recess
Sphenoid Sinuses
Types
Fovea Ethmoidalis
Skull Base Conformations
Ethmoid Bulla
Agger Nasi
Uncinate Process
1.6 IMAGING
Computer-Assisted Tomography
Magnetic Resonance Imaging
Endoscopy
2:
Acute General Nasal Symptoms
DIAGNOSTIC SUMMARY OF SYMPTOMS
2.1 NASAL FOREIGN BODY
Epidemiology and Pathogenesis
Clinical Features
Features in Clinical History
Typical Findings on Examination
Investigations
Preferred Treatment
Complications of Treatment
Complications of Disease
2.2 ODONTOGENIC
Epidemiology and Pathogenesis
Clinical Features
Features in Clinical History
Typical Findings on Examination
Investigations
Preferred Treatment
Complications of Disease
2.3 ACUTE RHINOSINUSITIS
Epidemiology and Pathogenesis
Clinical Features
Features in Clinical History
Typical Findings on Examination
Investigations
Preferred Treatment (Flowchart 2.2)
Complications of Treatment
Complications of Disease
2.4 CSF RHINORRHEA
Epidemiology and Pathogenesis
Clinical Features
Features in Clinical History
Typical Findings on Examination
Investigations
Preferred Treatment
Complications of Disease
Complications of Treatment
2.5 RHINITIS
Epidemiology and Pathogenesis
Clinical Features
Features in Clinical History
Typical Findings on Examination
Investigations
Preferred Treatment (Flowchart 2.3)
Complications of Disease
Complications of Treatment
2.6 ADENOIDITIS
Epidemiology and Pathogenesis
Clinical Features
Features in Clinical History
Typical Findings on Examination
Preferred Treatment
Complications of Treatment
Complications of Disease
2.7 SEPTAL ABSCESS
Epidemiology and Pathogenesis
Clinical Features
Features in Clinical History
Typical Findings on Examination
Preferred Treatment
Complications of Disease
2.8 FACIAL CELLULITIS
Epidemiology and Pathogenesis
Clinical Features
Features in Clinical History
Typical Findings on Examination
Preferred Treatment
Complications of Disease
2.9 ALLERGIC REACTION
Epidemiology and Pathogenesis
Clinical Features
Features in Clinical History
Typical Findings on Examination
Investigations
Preferred Treatment
3:
Nasal Congestion and Nasal Obstruction
3.1 INTRODUCTION
3.2 ALLERGIC RHINITIS
Epidemiology/Pathogenesis
Clinical History
Clinical Examination
Investigations
Treatment Options
Treatment Outcomes and Prognosis
Possible Complications and Side Effects
3.3 NONALLERGIC RHINITIS (CHAPTER 7)
Epidemiology/Pathogenesis
Clinical History
Typical Examination Findings
Investigations
Treatment Options
Idiopathic Rhinitis
Occupational Rhinitis
Medication-induced Rhinitis
Nonallergic Rhinitis with Eosinophilia Syndrome
Rhinitis Medicamentosa
Hormone-induced Rhinitis
Atrophic Rhinitis
3.4 ADENOID HYPERTROPHY (SEE PEDIATRIC CHAPTERS ON NASAL OBSTRUCTION AND SNORING)
Epidemiology/Pathogenesis
Clinical History
Typical Examination Findings
Investigations
Treatment Options
Treatment Outcomes and Prognosis
Possible Complications and Side Effects
3.5 UNILATERAL CHOANAL ATRESIA
Epidemiology/Pathogenesis
Clinical History
Typical Examination Findings
Inspect the Oral Cavity
Investigations
Treatment Options
Treatment Outcomes and Prognosis
3.6 NASAL SEPTAL DEVIATION
Epidemiology/Pathogenesis
Clinical History
Typical Examination Findings
Treatment
Treatment Outcomes and Prognosis
Possible Complications of a Septal Deviation
Possible Complications from Surgery
3.7 NASAL VALVE COLLAPSE (CHAPTER 17)
Epidemiology/Pathogenesis
Clinical History
Typical Examination Findings
Investigations
Treatment Options
3.8 NASAL POLYPS
Epidemiology/Pathogenesis
Clinical History
Typical Examination Findings
Investigations
Treatment Options
Grading of Nasal Polyps
Treatment Outcomes and Prognosis
Possible Complications and Side Effects
3.9 FOREIGN BODY
Epidemiology/Pathogenesis
Clinical History
Typical Examination Findings
Investigations
Treatment Options
Possible Complications and Side Effects
3.10 ACUTE RHINOSINUSITIS
Epidemiology/Pathogenesis
Clinical History
Typical Examination Findings
Investigations
Treatment Options
Treatment Outcomes and Prognosis
Possible Complications and Side Effects
Extracranial
Preseptal Cellulitis
Orbital Cellulitis
Subperiosteal Abscess
Orbital Abscess
Cavernous Sinus Thrombosis
Intracranial
3.11 COMMON COLD
Epidemiology/Pathogenesis
Clinical History
Typical Examination Findings
Investigations
Treatment Options
3.12 NASAL MASSES
Epidemiology/Pathogenesis
Congenital Masses
Inflammatory Masses
Neoplastic Masses
Clinical History
Typical Examination Findings
Investigations
Treatment Options
3.13 THIS IS HOW WE DO IT (NICK BHAT (USA) APPROACH)
4:
Nasal Discharge
4.1 DEFINITION OF RHINORRHEA
What to Elicit in the History?
Examination
Diagnostic Flowcharts
4.2 CLEAR RHINORRHEA
Allergic Rhinitis
Clinical Features
Examination
Investigation
Management
Nonallergic Rhinitis
Management
Cerebrospinal Fluid Rhinorrhea
Clinical Features
Investigation
Management
4.3 MUCOPURULENT RHINORRHEA
Rhinosinusitis
Acute Rhinosinusitis
Investigation
Management
Chronic Rhinosinusitis
Clinical Features
Investigations
Management
Foreign Body in the Nasal Cavity
Choanal Atresia
4.4 BLOODY RHINORRHEA
Granulomatous Diseases of the Nose
Wegener's Granulomatosis
Sarcoidosis
Sinonasal Tumors
Inverted Papilloma
Sinonasal Malignancies
Epistaxis
Clinical Features
Investigation
Management
5:
Postnasal Drip
5.1 INTRODUCTION
5.2 DIAGNOSIS
5.3 CLINICAL FEATURES
5.4 INVESTIGATIONS
5.5 DIAGNOSTIC SUMMARY
5.6 RHINOLOGIC
Inflammatory
5.7 CHRONIC RHINOSINUSITIS
Epidemiology and Pathogenesis
Clinical Features
Investigations
Symptom Scores
Preferred Treatment
Topical Therapies
Other Topical Therapies
Systemic Therapies
5.8 ALLERGIC RHINITIS
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
5.9 VASOMOTOR RHINITIS
Clinical Features
Preferred Treatment
5.10 IRRITANTS/TOXINS/OCCUPATIONAL RHINITIS
5.11 ANATOMICAL ABNORMALITIES
Septal Deviations
Epidemiology and Pathogenesis
Preferred Treatment
Accessory Ostia and Mucous Recirculation
Epidemiology and Pathogenesis
Preferred Treatment
Complications of Surgery
Residual Disease
Mucosal Stripping
Preferred Treatment
5.12 OTHER
Thornwaldt Cyst
Preferred Treatment
Adenoid Hypertrophy
Preferred Treatment
Future Directions
5.13 REFLUX-RELATED
Gastroesophageal Reflux
Epidemiology and Pathogenesis
Laryngopharyngeal Reflux
Epidemiology and Pathogenesis
Features in Clinical History
Findings on Clinical Examination
Investigations
Preferred Treatment
Outcomes of Treatment
SUMMARY
6:
Facial Pain
6.1 INTRODUCTION
6.2 HISTORY
Is It Only on One Side or Both?
Please Describe to Me What the Pain Feels Like
How Often Does It Occur?
Have You Noticed Anything Else that Accompanies the Pain?
Have You Noticed Anything that Might Trigger the Pain or Make It Worse?
What Makes the Pain Better? Or What Do You Do to Lessen the Pain?
6.3 CLINICAL EXAMINATION
6.4 SPECIFIC CONDITIONS CAUSING FACIAL PAIN
Sinogenic Pain
Dental Pain
Temporomandibular Joint Dysfunction
Myofascial Pain
Vascular Pain
Migraine
Cluster Headache
Paroxysmal Hemicrania
Sluder's Neuralgia
Arteritis (Giant Cell Arteritis)
Neuralgias
Trigeminal Neuralgia
Glossopharyngeal Neuralgia
Postherpetic Neuralgia
6.5 MIDFACIAL SEGMENT PAIN (TENSION-TYPE FACIAL PAIN)
6.6 ATYPICAL FACIAL PAIN
6.7 PAIN DUE TO MALIGNANCY
7:
Sneezing
7.1 RHINITIS
Allergic Rhinitis
Epidemiology and Pathogenesis
Clinical Features
Nonallergic Rhinitis
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Treatment Outcomes
Complications of Treatment
7.2 PHOTIC SNEEZE REFLEX
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Complications of Disease
7.3 NEUROGENIC SNEEZING
Epidemiology and Pathogenesis
7.4 PSYCHOGENIC SNEEZING
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Treatment Outcomes
Complications of Disease
7.5 SNATIATION REFLEX
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Complications of Disease
7.6 SEXUAL IDEATION/ORGASM
Clinical Features
Investigations and Treatment
Complications of Disease
8:
Disorders of Smell
8.1 INTRODUCTION
8.2 DEFINITION OF OLFACTION
8.3 PHYSIOLOGY OF OLFACTION
8.4 CLINICAL EVALUATION OF THE PATIENT WITH DYSOSMIA
History
Clinical Examination
Investigations
Radiologic Evaluation of Olfactory Dysfunction
Olfactory Testing
8.5 CAUSES OF OLFACTORY LOSS
Causes
8.6 MANAGEMENT OF OLFACTORY DISORDERS
8.7 QUALITY-OF-LIFE ISSUES
9:
Bleeding Nose (Epistaxis)
9.1 INTRODUCTION
9.2 EPIDEMIOLOGY AND CLASSIFICATION
9.3 VASCULAR ANATOMY
9.4 HISTORY TAKING AND EXAMINATION
9.5 STOPPING THE BLEEDING
9.6 CAUSES AND ASSOCIATED CONDITIONS ASSESSMENT
Mucosal Insults
Infection and Inflammation
Little's Area
Clinical Features
Investigations
Preferred Treatment
Treatment Outcomes
Complications of Treatment
Complication of Disease
Septal Perforation and Ulcers
Clinical Features
Investigations
Preferred Treatment
Treatment Outcomes
Complications of Treatment
Foreign Body
Trauma
Clinical Features
History and Examination
Investigations
Preferred Treatment
Treatment Outcomes
Complications of Treatment
Complications of Disease
Hemostasis Alterations
Clinical Features
History, Examination, and Investigations
Preferred Treatment
Treatment Outcomes
Complications of Treatment
Complications of Disease
Sinonasal Tumors
Clinical Features
Investigations
Vascular Malformations
Hereditary Hemorrhagic Telangiectasia
Clinical Features
Investigations
Preferred Treatment
Treatment Outcomes
Complications of Treatment
Complications of Disease
10:
Sleep-Disordered Breathing
10.1 PEDIATRIC SNORING AND SLEEP-DISORDERED BREATHING
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Treatment Outcomes
10.2 ADULT SLEEP-DISORDERED BREATHING
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Complications of the Disease
Complications of Surgery
10.3 TIPS AND PEARLS
11:
Functional and Aesthetic Analysis of the Nose
11.1 NOSE—A COMPLEX ORGAN
11.2 FIVE BUILDING BLOCKS OF PREOPERATIVE WORKUP
Medical Rhinology
Psychological Assessment of a Patient
Body Dysmorphic Disorder (BDD)
Clinical Assessment
Functional Evaluation
Aesthetic Analysis
11.3 TECHNICAL CHALLENGE
SUMMARY
12:
Trauma to Nose
12.1 NASAL ANATOMY
Nerve Supply
Trigeminal Nerve
Arterial Supply
12.2 APPLIED ANATOMY
Skin and Soft Tissues
Internal Nasal Valve Area
Keystone Area (Rhinion)
Tip Support Mechanism
Major Tip Support Mechanisms
Minor Tip Support Mechanisms
12.3 EPIDEMIOLOGY
12.4 PATHOPHYSIOLOGY OF NASAL TRAUMA
Septal Hematoma
12.5 SYMPTOMS
12.6 CLINICAL FEATURES
Typical Findings on Examination
12.7 INVESTIGATIONS
Conventional Radiography
Computed Tomography
High-Resolution Ultrasound
Nasal Endoscopy
12.8 TREATMENT
Timing of Treatment
Closed Reduction
Under Local Anesthesia
Under General Anesthesia
Septorhinoplasty
Open- versus Closed-Approach Septorhinoplasty
12.9 HOW I DO IT?
13:
Crooked Nose
13.1 INTRODUCTION
13.2 HISTORY
13.3 PHYSICAL EXAMINATION AND ANALYSIS
13.4 PREOPERATIVE PLANNING
13.5 SEPTUM
13.6 NASAL TIP
13.7 CONTRAINDICATIONS
13.8 SURGICAL TECHNIQUES
13.9 POSTOPERATIVE MANAGEMENT
13.10 COMPLICATIONS
14:
Saddle Nose
14.1 INTRODUCTION
14.2 ETIOLOGY AND PREOPERATIVE EVALUATION
14.3 CLASSIFICATION AND TREATMENT
Type 1
Type 2
Type 3
Type 4
Type 5
SUMMARY
15:
The Patient Wanting to Alter Asian Nose
15.1 INTRODUCTION
15.2 ANATOMY
Frontal View
Profile View
Alar-Columella Relation
Basal View
Asian Skin
Septal Cartilage
Internal Nasal Valve (INV)
Associated Structures
15.3 PRINCIPLES IN ASIAN RHINOPLASTY
15.4 SPECIFIC SURGICAL TECHNIQUES
Radix and Dorsal Augmentation
Humpectomy
Intermediate Osteotomies in Asians
Spreader Grafts
Tip Surgery and Structural Grafting
Reducing the Bulbous Asian Tip
Alar Base Surgery
Retracted Columella
Hanging Ala
Paranasal Augmentation
Skin Thickness
CONCLUSION
16:
Prominent Nose
16.1 INTRODUCTION
16.2 DEFINITION AND CLINICAL PRESENTATIONS
16.3 CLINICAL ASSESSMENT
Inspection
Palpation
Nasal Endoscopy
16.4 FACIAL PHOTOGRAPHY
16.5 SURGICAL PLANNING
16.6 SURGICAL SOLUTIONS
SUMMARY
17:
Nasal Valve Collapse
17.1 INTRODUCTION
17.2 PHYSIOLOGY
17.3 ETIOLOGY
17.4 DIAGNOSIS
17.5 TREATMENT
Conservative
Surgical Principles
First-Line Treatment of NVC
Isthmus Nasi Corrections
Spreader Techniques
Upper Lateral Splay Grafts
Flaring and Suspension Sutures
Intranasal Flaps
Opening of Pyriform Aperture Stenosis
Alar Reinforcement and Reconstruction
Lateral Crura of LLC
Alar Grafts
Lateral Crura Remodeling
Spanning and Suspension Sutures
Medial Crura of LLC
Footplate Reshaping
Caudal Septoplasty
Nasal Sill Correction
The Ptotic Tip
CONCLUSION
ACKNOWLEDGMENT
18:
Septoplasty
18.1 INTRODUCTION
18.2 ETIOLOGY AND PREVALENCE OF SEPTAL DEVIATION
18.3 INDICATIONS
18.4 DIAGNOSTIC ASSESSMENT
18.5 SURGICAL ANATOMY
18.6 SURGICAL TECHNIQUE
Preparation
Surgical Approaches
Killian Incision
Hemitransfixion Incision
External Approach
Septoplasty Techniques
Specific Problems
Caudal Septal Deviation
High Dorsal Deflection
Closure
18.7 COMPLICATIONS
Septal Hematoma/Abscess
Septal Perforation
Saddle Deformity
CSF Leak
18.8 RESULTS
19:
Septal Perforation
19.1 ANATOMY OF NASAL SEPTUM
19.2 ETIOLOGY
19.3 SYMPTOMS OF NASAL SEPTAL PERFORATION
19.4 INVESTIGATIONS
19.5 TREATMENT
Conservative Treatment
Surgical Treatment
Surgical Technique
SECTION 2: FACIAL PLASTICS
20:
Analysis of Aging Face
20.1 INTRODUCTION
20.2 AGE-RELATED CHANGES IN FACIAL STRUCTURES
Skin
Fat and Muscles
Facial Bones
Exocrine Glands
20.3 CONSULTATION
20.4 FACIAL ASYMMETRY
20.5 CLINICAL EXAMINATION
Upper Third of Face
Midface
Lower Face
Neck
SUMMARY
21:
Facial Aging and Role of Botulinum Toxin in Aging Face
21.1 INTRODUCTION
21.2 INITIAL ASSESSMENT OF PATIENTS
21.3 CLINICAL EXAMINATION— LOOK FOR SIGNS OF AGING
21.4 PATIENT COUNSELLING— CHOOSE YOUR WEAPONS WISELY AND CORRECTLY
21.5 BOTULINUM TOXIN
What Is It?
Storage and Reconstitution
Technique of Botulinum Toxin Injection (Fig. 21.1)
Frontalis Muscle
Corrugator Muscles
Procerus Muscle
Orbicularis Oculi
Transverse Nasalis
Levator Labii Superioris Alaeque Nasi Muscle
Depressor Angular Oris
Orbicularis Oris
Platysma
Masseter
Postinjection Care
Complications
General
Specific
Lip and Cheek Ptosis
Drooling and Oral Incompetence
Masseter Weakness
21.6 FILLERS INJECTION
What are Fillers?
What are the Types of Fillers?
Preparation (Fig. 21.4)
Specific Preparations for Poly-L-lactic Acid (Fig. 21.5)
Technique of Filler Injection
Linear Threading (Fig. 21.6)
Fanning (Fig. 21.7)
Cross-hatching (Fig. 21.8)
Layering
Depot (Fig. 21.9)
Forehead
Temple
Tear Trough
Nasolabial Fold
Marionette Line
Chin
Nose
After Injection
Pitfalls and Precautions
Follow-up Visits and Repeated Injections
Complications and their Management
Bruising
Blindness
Skin Necrosis
Infection
Formation of Nodules
Asymmetry/Undercorrection/Overcorrection
CONCLUSION
22:
Lasers and IPL in Facial Plastics
22.1 INTRODUCTION
22.2 ESSENTIAL CONCEPTS
Laser
Ablative versus Nonablative Lasers
Intense Pulsed Light
Other Heat Technologies
22.3 REGION: FACE
Anatomy of the Skin
Fitzpatrick Skin Types
22.4 PRESENTATION: RHYTIDS
Aging Process
Classification of Rhytids
Treatment Options
Ablative Laser Skin Resurfacing
Complications of Ablative Lasers
Nonablative Lasers
Fractional Resurfacing
22.5 PRESENTATION: VASCULAR LESIONS
Port Wine Stains
Treatment Options
Pulsed-Dye Laser
Complications of PDL
Intense Pulsed Light
Hemangioma
Treatment Options
Pulsed-Dye Laser
Intense Pulsed Light
Interstitial Laser
Telangiectasia
Treatment Options
22.6 PRESENTATION: UNWANTED FACIAL HAIR
Classification of Patients with Excess Hair
Hair Biology
Treatment Options
22.7 PRESENTATION: FACIAL DYSCHROMIA
Treatment Options
22.8 PRESENTATION: HYPERTROPHIC SCARS
Treatment Options
22.9 FUTURE TRENDS
23:
Brow Ptosis and Its Management
23.1 INTRODUCTION
23.2 SURGICAL ANATOMY OF THE FOREHEAD, BROW, AND EYE
Layers of Scalp
Neurovascular Bundles
Temporal Branch of the Facial Nerve
Sensory Innervation of the Forehead
Brow Elevator and Depressors
Orbital Retaining Ligaments
Brow Anatomy
23.3 BROW AESTHETICS
Ideal Male Brow
Female Brow
23.4 AGE-RELATED CHANGES IN BROW'S SHAPE AND POSITION
Hairline and Scalp
Eyebrows
Eyes
23.5 MANAGEMENT
Nonsurgical Rejuvenation of Brow and Forehead
Surgical Rejuvenation of Brow and Forehead
Surgical Management
Percutaneous Suspension Antiptosis (APTOS) Suture Lifting
Surgical Approaches
Temporal Lift
Temporal Extension of Rhytidectomy Incision
Transblepharoplasty Browpexy
Direct Brow Lift
Midforehead Lift
Coronal Forehead Lift
Endoscopic Brow Lift
Pretrichophytic and Trichophytic Approach
23.6 POSTOPERATIVE CARE
23.7 COMPLICATIONS
Headaches
Loss of Forehead and Scalp Sensation
Hematoma
Alopecia
Facial Nerve Paralysis
Brow Asymmetry
Lagophthalmos
SUMMARY
24:
Mid-Face Lift
24.1 INTRODUCTION
24.2 SURGICAL ANATOMY
Midfacial Aging
Aging of the Lower Face and Neck
24.3 PREOPERATIVE ASSESSMENT
24.4 MIDFACIAL REJUVENATION
Injectable Fillers
Fat Transfer
Midface Lift Operative Techniques
Temporal Approach
Orbital Approach
Deep Plane and Composite Facelift
Rhytidectomy Techniques
Minimal Access Cranial Suspension Lift
Deep Plane and Composite Rhytidectomy Approach
24.5 SURGICAL TECHNIQUES FOR FACELIFT
24.6 NONSURGICAL TECHNIQUES FOR FACELIFT
Thread Lift
24.7 COMPLICATIONS
Midface Lift
Nerve Injury
Alopecia
Distortion of Eyelid and Lateral Canthus
Brow Asymmetry
Facelift
Hematoma
Infection
Flap Necrosis
Sensory and Motor Nerve Injury
Poor Scars and Alopecia
Distortion of Ear Lobe
25:
Aesthetic Surgery of the Neck and Submental Region
25.1 INTRODUCTION
25.2 RELATIONSHIP BETWEEN NECK CONFIGURATION AND AESTHETICS
25.3 ANATOMY AND CLASSIFICATION
25.4 PATIENT EVALUATION
25.5 AUGMENTATION OF THE MENTUM
Surgical Technique
25.6 SUBMENTAL LIPOSUCTION
Surgical Technique
25.7 SUBMENTAL PLATYSMAPLASTY
Surgical Technique
SUMMARY
26:
Correction of Lids (Blepharoplasty)
26.1 INTRODUCTION
26.2 EYELID ANATOMY
Upper Eyelid Anatomy—Key Points
Eyelid Measurements
Blood Supply and Lymphatic Drainage of the Upper Eyelids
Lower Eyelid Anatomy—Key Points
Asian Eyelid Anatomy—Key Points
26.3 INDICATIONS FOR BLEPHAROPLASTY
Upper Blepharoplasty
Lower Blepharoplasty
Asian Blepharoplasty
26.4 FEATURES IN CLINICAL HISTORY
Upper Blepharoplasty—Clinical Features
Lower Blepharoplasty—Clinical Features
Asian Blepharoplasty—Clinical Features
26.5 TYPICAL FINDINGS IN EXAMINATION
Upper Blepharoplasty—Examination Findings
Lower Blepharoplasty—Examination Findings
Asian Blepharoplasty (Figs. 26.5A and B)—Examination Findings
26.6 INVESTIGATIONS
26.7 PREFERRED TREATMENT
Upper Blepharoplasty (Figs. 26.5A to B4)—Surgical Procedure
Lower Blepharoplasty—Surgical Procedure
Asian Blepharoplasty—Surgical Procedure
26.8 COMPLICATIONS OF TREATMENT
Blepharoplasty Complications
Lower Blepharoplasty Complications
Asian Blepharoplasty Complications
27:
Drooping Eyelids (Ptosis)
27.1 PRESENTATION: PTOSIS
27.2 ANATOMY—KEY POINTS
27.3 PTOSIS CAUSES
27.4 DIAGNOSTIC SUMMARY
27.5 INVOLUTIONAL PTOSIS
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Complications of Treatment
Complications of Disease
27.6 THIRD CRANIAL NERVE PALSY
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Complications of Treatment
Complications of Disease
27.7 SYMPATHETIC NERVE PALSY (HORNER'S SYNDROME)
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Complications of Treatment
Complications of Disease
27.8 MYASTHENIA GRAVIS AND PTOSIS
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Complications of Treatment
Complications of Disease
27.9 MECHANICAL PTOSIS
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Complications of Treatment
Complications of Disease
27.10 CONGENITAL PTOSIS
Epidemiology and Pathogenesis
Clinical Features
Investigations
Preferred Treatment
Complications of Treatment
Complications of Disease
27.11 MYOGENIC PTOSIS
28:
Correction of Ears (Otoplasty)
28.1 INTRODUCTION
28.2 ANATOMY
28.3 MEASUREMENTS AND DIAGNOSIS
28.4 PREVENTION
28.5 TREATMENT
Incision
Cutting
Conchal Setback
Cartilage Excision
Cartilage Scoring
Cartilage Sparing
Incisionless Otoplasty
Combination of Techniques
Protruding Lobule
28.6 COMPLICATIONS
Hematoma and Infection
Unsatisfactory Cosmetic Outcome
Skin Necrosis
Keloid Formation
29:
Correction of Small Ears (Microtia)
29.1 INTRODUCTION
29.2 EMBRYOLOGY OF EXTERNAL EAR
29.3 EPIDEMIOLOGY AND ETIOLOGY
29.4 NORMAL PINNA
29.5 TYPES OF MICROTIA
29.6 CLASSIFICATION OF MICROTIA
29.7 CLASSIFICATION OF EXTERNAL AUDITORY CANAL ATRESIA
29.8 ASSESSMENT OF THE PATIENT
29.9 TREATMENT OPTIONS
Audiological Treatment
Surgical Treatment
Brent Technique
Nagata Technique
Prosthetic Pinna
30:
Facial Weakness
30.1 INTRODUCTION
30.2 EPIDEMIOLOGY AND CLASSIFICATION OF FACIAL PARALYSIS
Bell's Palsy/Idiopathic Facial Paralysis
Ramsay-Hunt Syndrome
Complication of Otitis Media
Trauma
Neoplasms
30.3 ANATOMY AND PATHOPHYSIOLOGY OF FACIAL NERVE PARALYSIS
30.4 ASSESSMENT OF THE FACIAL PARALYSIS PATIENT
30.5 ELECTRODIAGNOSTIC STUDIES
30.6 MANAGEMENT
Bell's Palsy
Trauma
Neoplasms
Malignant Tumors
Eye Protection
Physical Therapy
Botulinum Toxin
30.7 SURGICAL REANIMATION PROCEDURES
Eye Reanimation
Neural Procedures
Primary Repair
Nerve Substitution
Muscle Transfer
Static Procedures
Adjunctive Procedures
SUMMARY
31:
Pigmented and Nonpigmented Lesions of the Face
31.1 BASAL CELL CARCINOMA
Epidemiology and Pathogenesis
Clinical Features
Pathological Diagnosis
Preferred Treatment
Surgical
Nonsurgical
Treatment Outcomes
Complications of Disease
Prevention and Early Detection
31.2 SQUAMOUS CELL CARCINOMA
Epidemiology and Pathogenesis
TNM Classification
31.3 INTERMEZZO AK AND BOWEN'S DISEASE
Bowen's Disease
Investigations
Preferred Treatment
Treatment Outcome(s)
Complications of Disease
Prevention and Early Detection
31.4 MELANOMA SKIN CANCER
Epidemiology and Pathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Histopathological Diagnosis
Preferred Treatment
Treatment Outcome(s) and Complications of Disease
Prevention and Early Detection
32:
Mohs’ Micrographic Surgery
32.1 INTRODUCTION
32.2 MOHS’ SURGERY VERSUS CONVENTIONAL EXCISION
Indications
Technique
Reconstruction
Slow-Mohs’ Surgery
Complications
33:
Local Flaps for Facial Reconstruction
33.1 PRINCIPLES OF FLAP DESIGN
33.2 DEFECT ANALYSIS
33.3 TYPES OF LOCAL FLAPS
Advancement Flaps
Unipedicle Advancement Flaps
V-Y and Y-V Advancement Flaps
Pivotal Flaps
Rotation Flaps
Transposition Flaps
Interpolated Flaps
Island Flaps
Hinge Flaps
34:
Correction of Facial Scars
34.1 INTRODUCTION
34.2 SKIN ANATOMY—KEY POINTS (BICHAKJIAN AND JOHNSON, 2007)
34.3 NORMAL WOUND-HEALING PATHOPHYSIOLOGY
34.4 EVIDENCE-BASED TECHNIQUES TO IMPROVE SCAR OUTCOMES
34.5 UNSATISFACTORY AND PATHOLOGIC SCARRING
Hypertrophic and Keloid Scars
Nonpathologic Intrinsically Unsatisfactory Scars
Extrinsically Unsatisfactory Scars
SUMMARY
35:
Frontal Sinus Fracture
35.1 EPIDEMIOLOGY AND PATHOGENESIS
35.2 CLINICAL FEATURES
Clinical History
Typical Findings on Examination
35.3 INVESTIGATIONS
35.4 PREFERRED TREATMENT
35.5 COMPLICATIONS OF DISEASE
Early Complications
Late Complications
35.6 COMPLICATIONS OF TREATMENT
Early Complications
Late Complications
36:
Midface and NOE Fractures
36.1 CLINICAL FEATURES
36.2 INVESTIGATIONS
Imaging
Beta-2 Transferrin
36.3 CLASSIFICATION OF MIDFACE FRACTURES
Le Fort Classification
Markowitz Classification of NOE Fractures
36.4 PREFERRED TREATMENT
NOE Fractures
Orbital Fractures
Zygomatic Complex Fractures
Maxillary Fractures
36.5 TREATMENT OUTCOME(S)
APPENDIX 36.1: FACIAL TRAUMA ANALYSIS
History
Past Medical History
Examination
Inspection
Palpation
37:
Orbital Floor Fracture
37.1 INTRODUCTION
37.2 EPIDEMIOLOGY OF ORBITAL FLOOR FRACTURES
37.3 ANATOMY OF THE ORBITAL FLOOR
37.4 PATHOPHYSIOLOGY OF ORBITAL FLOOR FRACTURES
37.5 ASSESSMENT OF PATIENT WITH ORBITAL FLOOR FRACTURE
Clinical History
Clinical Examination
37.6 INVESTIGATIONS
37.7 TREATMENT
Indications for Surgery
Surgical Repair of Orbital Floor Fracture
37.8 POSTOPERATIVE CARE
37.9 POSTOPERATIVE COMPLICATIONS
38:
Mandible Fracture
38.1 ETIOLOGY
38.2 ANATOMY OF THE MANDIBLE AND ITS RELATED STRUCTURES
Mandible Osteology
Nerve
Facial Nerve
Facial Vessels
Dental Occlusion
38.3 CLASSIFICATION OF MANDIBULAR FRACTURES
38.4 SIGNS AND SYMPTOMS OF MANDIBULAR FRACTURES
38.5 RADIOGRAPHIC INVESTIGATIONS FOR MANDIBULAR FRACTURES
38.6 TREATMENT PRINCIPLES
38.7 BIOMECHANICS OF THE MANDIBLE
Principle of Fracture Reduction
Single-Plate Fixation
Two-Plate Fixation
38.8 TREATMENT OPTIONS FOR MANDIBULAR FRACTURES
Closed Reduction with Intermaxillary Fixation
Open Reduction and Internal Fixation (Load Sharing versus Load-Bearing Osteosynthesis)
38.9 SOFT TISSUE APPROACHES TO MANDIBULAR FRACTURES
38.10 CONDYLAR FRACTURES
38.11 COMPLICATIONS
39:
Cleft Lip and Palate
39.1 EPIDEMIOLOGY AND PATHOGENESIS
39.2 CLINICAL FEATURES
Features in Clinical History
39.3 TYPICAL FINDINGS ON EXAMINATION
39.4 PREFERRED TREATMENT
39.5 COMPLICATIONS
40:
Craniosynostosis
40.1 EPIDEMIOLOGY AND PATHOGENESIS
40.2 CLINICAL FEATURES
Features in Clinical History
Typical Findings on Examination
Investigations
40.3 PREFERRED TREATMENT
40.4 POSTOPERATIVE CARE
40.5 COMPLICATIONS OF TREATMENT
INDEX
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