Evaluation of argon laser surgery in children under 13 years of age

Argon laser surgery is an effective treatment for ectasias and congenital port-wine stains; however, its use in children under the age of 13 is controversial. This paper reviews 202 children under the age of 13 who underwent argon laser treatments for congenital port-wine stains, spider angiomas, epidermal nevi, and lentigines. The clinical characteristics of port-wine stains in 170 children are discussed. Good to excellent results (moderate to complete clearing) in port-wine stains were obtained in 60 percent of patients and seemed to correlate best with lack of blanchability on pressure. Hypertrophic scarring was seen in only 7 children, all of whom had undressed wounds; no significant scarring has been seen in any subsequent child who had maintained a dressed wound postoperatively.     

Vascularized full-thickness parietal bone grafts in maxillofacial reconstruction: the role of the galea and superficial temporal vessels

Reconstruction of bony structures of the face is always a problem as big as the defect and the function that must be replaced. Everything from simple grafts to sophisticated distant bone flaps has been used. Based on the studies of Cutting et al., Psillakis et al., and Casanova et al., we have developed the full-thickness galeoparietal bone flap, initially for mandibular reconstruction, but of great use for all maxillofacial reconstructions. From July of 1987 to December of 1988, 14 patients have been operated on. The experience with this flap is shown in four patients as follows: primary reconstruction of a mandible as a result of ameloblastoma, secondary reconstruction of a mandible with associated old fractures and malalignment of segments, bilateral malar reconstruction in a patient with Treacher Collins syndrome, and severe sequelae of an already treated Romberg case. Small variations could be made to best accommodate the technique used to the defect we were treating. Some technical details, the experience, the results, and possible sequelae or complications are also discussed.