The pectoralis minor vascularized muscle graft for the treatment of unilateral facial palsy

A series of 10 pectoralis minor vascularized muscle transfers to reanimate the face in unilateral facial palsy are presented. The procedure is carried out in two stages. The first stage constitutes a nerve graft from the functional contralateral facial nerve to the preauricular region of the paralyzed side. Six months later, the pectoralis minor is transferred to the denervated side of the face with restoration of its neurovascular pedicle. The muscle is well suited to its new position with respect to length and bulk, as well as its fanlike shape. The diameter of its vascular pedicle is comparable with the facial vessels. The results demonstrate function in 8 of the 10 grafts, the two failures relating to early vascular thrombosis rather than an inability to reinnervate the muscle grafts.     

Bone resorption of the pubis and preauricular area in humans and nonhuman mammals

Some innominates of adult human females show areas of bone resorption on the dorsal aspect of the pubic corpus and preauricular area of the ilium. For both sites, many studies have shown a positive association between degree of resorption and parity. The present study tested hypotheses concerning resorption of the pubis and preauricular area. Samples of innominates from three prehistoric Amerindian populations were used. Within each population, only a minority of females, in general, showed resorption more severe than that which characterized males. The severity of resorption of the pubis was not significantly associated with that of the preauricular area. Pitting of the pubis, but not of the preauricular area, was significantly correlated with age-at-death in each sample of Amerindian females. Also, sacral angulation was not significantly associated with resorption of the preauricular area. Observations on resorption of the pubis and preauricular area in samples of Pan troglodytes and Gorilla gorilla are reported. In previous studies on resorption of the pubis and preauricular area in the human innominate, the proposed etiologies involve ligamentous hyperplasia and joint trauma. However, a number of studies on resorption of the pubis in the nonhuman mammalian innominate have been overlooked by anthropologists. These latter studies demonstrate that estrogen alone can induce resorption of the mammalian pubis by stimulating the synthesis of osteoclastic enzymes. Partial resorption of the pubis may be obstetrically advantageous in some mammals, as resorption would delay or inhibit synostosis of the interpubic joint. The relationship between estrogen and the preauricular area is an issue that requires further research.     

Combined rhytidectomy and full-face laser resurfacing

A series of patients undergoing a combined face lifting procedure with simultaneous laser resurfacing is described. Although resurfacing is accepted as safe for deep-plane face lifts and forehead lifts, there are reports of preauricular skin loss with a standard face lift. In this series, 26 consecutive cases are described. A superficial musculoaponeurotic system (SMAS) face lift technique was used. A skin flap was developed no more than 3.0 cm from the preauricular area, and most of that was excised. Full-face laser resurfacing was done with the SilkTouch laser. An 8-mm square pattern was used at 16 to 18 W. Three to four passes were done. Care was taken, however, to do very superficial lasering of the periphery, especially over the small amount of undermined skin that remained. There was no preauricular skin loss. This series demonstrates the safety of combining laser resurfacing with the SMAS technique face lift in regard to preauricular skin loss.     

Correction of sunken and/or multiply folded upper eyelid by fascia-fat graft

Sunken and/or multiply folded upper eyelid is one of the common, troublesome complications that can occur after Oriental blepharoplasty. In addition to orbital volume depletion, the traumatic surgical procedure of excessive fat removal might result in a varying degree of adhesion and injury to the orbital septum. Adhesiotomy followed by a restoration of volume is generally believed to be the logical way to correct such deformity. To restore volume and prevent re-adhesion, local tissues of the upper eyelid, free-fat graft, and dermis-fat graft have been used. However, local tissues are usually insufficient because of previous surgery, and the survival rate of grafted fat is often unpredictable. Moreover, the heaviness of the dermis-fat composite makes it a less than satisfactory choice. The authors value the use of free fascia-fat composite grafts for the treatment of such disfigurements. The fascia-fat composite is expected to have a better survival rate than free fat alone and to be lighter than a dermis-fat composite. In addition, the fascia-fat composite is abundant throughout the body and provides anatomical structure more similar to that of the repair site, namely, the damaged orbital septum and fat. The authors prefer the mons pubis, preauricular, and temporal areas for the donor site depending on the status of the damage. They treated 13 patients with sunken and/or multiply folded upper eyelids by fascia-fat composite grafts and obtained satisfactory results.     

The radiographic preauricular groove: its non-relationship to past parity

Deep preauricular sulci were identified on abdominal radiographs in 29 of 190 (15%) adult females and in none of 110 adult males. To assess the value of the deep preauricular sulcus as an index of past pregnancy, we examined gravidity and parity records of 190 women, using standard films that included the sacroiliac region. Deep, radiographic preauricular grooves were identified in 4 of 41 (10%) nulliparous women and in 25 of 149 (17%) women with positive pregnancy histories. We also examined radiographs obtained before and after pregnancy in six primigravidas. No evidence of radiographic changes in the preauricular grooves was seen in any of the six women. We conclude that the presence of a deep, radiographic preauricular sulcus is not necessarily an indication of past pregnancy.     

先天性耳前瘘管二次手术68 例治疗体会

目的:探讨先天性耳前瘘管术后复发原因,以及二次手术临床治疗的效果。方法:回顾性分析我院自2006年1月至2010年12月的共诊断收治的68例复发先天性耳前瘘管病例,观察其二次手术效果。结果:68例先天性耳前瘘管复发患者中,66例Ⅰ期愈合,治愈率97.06%。结论:再次手术是治疗先天性耳前瘘管术后复发的有效途径,完全切除残余的瘘管及上皮组织是防止再复发的关键。     

Fibroblast-mediated contraction in actinically exposed and actinically protected aging skin

The changes in skin morphology over time are a consequence of both chronologic aging and the accumulation of environmental exposure. Through observation, we know that actinic radiation intensifies the apparent aging of skin. We have investigated the effects of aging and actinic radiation on the ability of fibroblasts to contract collagen-fibroblast lattices. Preauricular and postauricular skin samples were obtained from eight patients aged 49 to 74 undergoing rhytidectomy. The samples were kept separate, and the fibroblasts were grown in culture. Lattices constructed with preauricular fibroblasts consistently contracted more than lattices containing postauricular fibroblasts. The difference in amount of contraction in 7 days between sites was greatest for the younger patients and decreased linearly as donor age increased (r = -0.96). This difference may be due to preauricular fibroblasts losing their ability to contract a lattice as aging skin is exposed to more actinic radiation.     

Sideburn relationship in the male face lift.

The importance of preserving the non-hairbearing preauricular skin in a male face-life is described and illustrated.     

Observations of external ear—An Indian study

Somatoscopy of the external ear provides a general idea of the shape of an ear, form of the helix, presence (or absence) of Darwin's tubercle and of the attachment of an ear lobe to a cheek, etc. It is of great importance not only to physical anthropologists but also to plastic surgeons, physicians and forensic scientists. There is no detailed somatoscopic study of the ear morphology concerning the entire Indian subcontinent. Hence, in the present study an attempt has been made to report the frequency of various somatoscopic features of various parts of the auricle of adult males and females who live in the central region of India.In both sexes oval-shaped ears and normally rolled helix were most common. The preauricular region was found to be clear with very few cases of the occurrence of pits and sinuses. Free lobules were more frequent among females than males but it was vice versa for Darwin's tubercle. The position of the ear's upper edge was most commonly located at the eyebrow tail while its lower edge was located at an upper lip level in both sexes. Hypoplastic lobules were noted in one-fifth of males but were very rare among females. Very few cases of lop ear, preauricular appendage and preauricular pit were observed.Some of these somatoscopic features act as soft biometric traits that improve the performance of the primary biometric system of personal identification. Somatoscopy of external ear acts as an aid to surgeons while reconstructing deformed ears and also helps physicians in detecting anomalies, for example, Edward's, cleft lip/cleft palate syndromes.     

Morphology of the pubis and preauricular area in relation to parity and age at death in Macaca mulatta

Some adult human females show bone resorption (pitting) at the dorsal aspect of the pubis and preauricular area of the ilium. The etiology of pelvic bone resorption is attributed alternatively to reproduction and to pelvic anatomy. While most researchers infer that pelvic pitting is related to reproduction, only a few studies are based on women of known parity. Degree of pubic resorption is directly associated with both parity (Suchey et al.: Am. J. Phys. Anthropol. 51:517-539, 1979; Bergfelder and Hermann: J. Hum. Evol. 9:611-613, 1980) and age (Suchey et al.: Am. J. Phys. Anthropol. 51:517-539, 1979). The relationship between parity and degree of resorption of the preauricular area is equivocal, found to be significant by Dunlap (A Study of the Preauricular Sulcus in a Cadaver Population, Ph.D. dissertation, East Lansing, Michigan State University, 1981) but not by Spring et al. (Am. J. Phys. Anthropol. 79:247-252, 1989); both studies report that age is not associated with resorption of the preauricular area. Other mammals evidence public resorption, but the morphology of the preauricular area is less well known. This study addresses the issue on the etiology of pelvic bone resorption using a sample of Macaca mulatta (the free-ranging population from Cayo Santiago) for which parity and age at death are known for all specimens. The following results are reported. Resorption of the pubis is common among females but infrequent among males. Contrary to Rawlins (Am. J. Phys. Anthropol. 42:477-488, 1975), the degree of pubic resorption in female macaques is significantly related to both parity and age at death.(ABSTRACT TRUNCATED AT 250 WORDS)     

Molecular Genetic Causes and Clinical Description of Branchio-Oto-renal Syndrome

Russian Journal of Genetics - Branchio-oto-renal (BOR) syndrome is an autosomal dominant disease characterized by a combination of hearing impairment with preauricular pits, cervical fistulas or...     

Earlobe reconstruction with a preauricular flap.

We describe a one-stage technique for reconstructing earlobe deformities of congenital and acquired origin, using preauricular flaps.     

Reconstruction of the crus helicis in mild microtia using a preauricular tag

A preauricular tag accompanying a mild microtia was utilized in reconstruction of the anterior aspect of the helix and the crus helicis. We believe that three-dimensional reconstruction of the crus helicis with a deep cymba conchae in microtia reconstruction is an important component in achieving a normal-looking auricle.     

Infracture technique for reduction malarplasty with a short preauricular incision

The infracture technique for reduction malarplasty has been widely used as an aesthetic surgical procedure in northeast Asia. Since 1988, the authors' original method of infracture technique was performed through the combined approach of intraoral and temporopreauricular incision, which may leave a rather long scar on the temporal region. To shorten the external scar, a new technique using a short preauricular incision instead of a long temporopreauricular incision was developed. From September of 2000 to June of 2001, this new approach was applied to 142 patients for correction of prominent zygoma. In this procedure, anteriorly, incomplete fracture of the zygomatic body was performed through an intraoral approach for bending inward. Posteriorly, full-thickness cutting of the zygomatic arch was performed through a preauricular incision. Then, lateral bulging of the zygomatic arch was reduced with infracturing, and the infractured site was fixed in a new position with a microplate and three screws. The advantages of this technique are reduction of the operation time, reduction of the length of the external scar, and reduction of postoperative edema around the operative region. With this combined approach, the authors were able to sufficiently expose the zygomatic arch and body and able to change the lateral convex arch into a concave one. Under direct vision, the authors could effectively and precisely perform the infracture technique through a much shorter preauricular incision that did not result in a long, conspicuous external scar.     

Epidermal cyst originating from the preauricular sinus

Epidermal cysts are the benign tumors which are found in various regions. We experienced a rare case in which the preauricular sinus was the origin of the epidermal cyst.     

Frey's syndrome: diagnosis in geriatric dentistry

Frey's syndrome, is characterized by warmth, flushing and sweating of the face, most of time in the preauricular region, initiated by any gustatory stimulus. It is frequently related to parotid surgery. A case of Frey's syndrome in a 81‐year‐old female whose long‐delayed clinical onset post‐parotidectomy is presented.     

Male rhytidectomy incisions

Because the preauricular segment of a face lift incision is less noticeable when located behind the tragus, it is our preferred method in females. The desirability of preserving the normal hairless strip between the ear and sideburn precluded using the technique in males. In this report we describe a method of utilizing the retrotragal location in males. This has been accomplished by direct excision of the hair follicles and hair shafts.     

Prevention and correction of temporal hair loss in rhytidectomy

Routine incisions in the temporal area for rhytidectomy often remove hair-bearing skin anterior to the ear. This results in a cosmetic deformity, making the surgical intervention clearly visible. This is especially problematic for revision rhytidectomy or for patients with naturally high hairlines. This article describes a systematic approach to the temporal hairline and introduces a novel, hair-bearing, transposition flap that corrects iatrogenic loss of the preauricular tuft of hair.     

Comparison of Avar period anthropological series

This study concerns human skeletal remains recovered from nine Avar period cemeteries from two regions, one in Northern Hungary and the other from Backa in Yugoslavia. Regional differences are compared using Penrose's generalised distance method, Alexeyeva's indices and preauricular facio-cerebral indices.