Kei Yoneda

Reconstruction of the entire upper eyelid area with a subcutaneous pedicle flap based on the orbicularis oculi muscle.

Lagophthalmos caused by trauma or inflammation may damage the cornea and, if not adequately treated, may result in loss of eyesight. Hence surgical intervention is required at the earliest possible stage. We have developed a subcutaneous pedicle flap elevated from the temporozygomatic area and rotated 180 degrees around a small pedicle base that contains the orbicularis oculi muscle. With this flap, the entire upper eyelid can be reconstructed as an aesthetic unit in one stage so that the result is satisfactory not only functionally, but also cosmetically. The operative procedure is presented along with case reports.

Secondary correction of bilateral cleft lip deformity with simultaneous Abbé flap and nasal repair

For secondary repair of a bilateral cleft lip deformity with a short columella and defective upper lip, simultaneous correction of the lip and nose is ideal. We perform a nasal repair through a bilateral reverse-U incision and columella elongation using the upper lip. An Abbé flap is then transferred to the upper lip defect. This procedure enables total reconstruction of characteristic bilateral cleft lip deformities in one stage. We have applied this method to 15 patients (9 males and 6 females) with an average age of 18.7 years. Although some patients need jaw surgery, all have been satisfied with the results.

Augmentation of skin flap survival by selective intraarterial infusion of prostaglandin E1: experimental and clinical studies.

Prostaglandin E1 has been proven to be useful in the treatment of vascular diseases of the lower leg. Plastic surgeons have been aware of its usefulness in augmenting flap survival and have used it intraarterially or intravenously. We attempted to enhance the effect of prostaglandin E1 with heparin by local continuous intraarterial infusion of both drugs. First, we assessed the viability area of an experimental island flap model on rabbit abdomen, and confirmed the usefulness of this method. Next, we attempted to develop clinical cases using Seldingers method. By this method, we were able to rescue the flaps with circulatory insufficiency and gain a larger survival area of an axial pattern flap.

Use of the palatal mucosal graft for reconstruction of the eye socket

Hard palate mucosa is thick and rigid. Grafted with its periosteal layer, it can be a supportive material. Simultaneously, wound healing of the palatal donor site is very rapid and the patient does not experience any pain. Such characteristics of the palatal mucosal graft have led to its use in reconstruction of the eyelids, including the tarsal plate. Nevertheless, there have been very few reports on its use in this are of the face. Herein we report the use of the palatal mucosal graft in reconstruction of the eye sockets.

Correction of cryptotia using a subcutaneous pedicled flap

Cryptotia is a relatively common deformity of the ear among orientals. Although many methods for correcting this deformity have been reported, there is no one perfect method. We have developed a method using a subcutaneous pedicle flap raised from the retroauricular region, where relative abundance of skin exists. We have treated 9 ears of 7 patients by the method reported herein. Results are satisfactory in all cases.

Reconstruction of the upper vermilion employing combined flaps

SummaryReconstruction in the vermilion area presents a variety of difficulties, mostly because of donor site limitations. We have obtained good results, including color and texture, using a cross-lip vermilion flap for repair of large defects of the upper vermilion and an advancement vermilion myocutaneous flap for closure of its donor site. Although the operation requires two stages, this method seems very useful for reconstruction of the upper vermilion area.