Yohko Yoshimura

Early repair of unilateral cleft lip employing a small triangular flap method and primary nasal correction

We describe a technique for early unilateral cleft lip and nose repair in the neonatal period which we have used successfully in 84 cases. Some other children have had the same method used at a later time. The method has some advantages which we believe are particularly useful in neonatal repair.

Surgical and conservative repair of Stahl's ear.

Surgical and non-surgical procedures for the correction of Stahls ear anomaly, more commonly found in Oriental races, are presented. The final postoperative appearance is aesthetically pleasing, acceptable, and encouraging to the patient with this deformity.

One-stage reconstruction of full-thickness lower eyelid defects using a subcutaneous pedicle flap lined by a palatal mucosal graft

The authors previously reported a subcutaneous pedicle flap pivoting on the lateral canthus to reconstruct the skin of a whole eyelid as an aesthetic unit. A palatal mucosal graft was added to line the conjunctival side of the flap to make a one-stage reconstruction of the full-thickness eyelid. Although it is becoming popular to use the palatal mucosa as a conjunctival substitute, there are very few reports on the one-stage reconstruction of the eyelid. Two patients with total defects of the lower eyelid resulting from resection of malignant skin tumours have been treated using this technique. The functional and aesthetic results have been excellent in both cases.

Simple line closure for macrostomia repair

In repair of macrostomia, many authors have used a Z-plasty to prevent postoperative scar contracture. We found that the Z-plasty scar may be conspicuous when the patients open their mouths. Here we present a method of nearly straight line closure resulting in an inconspicuous scar even when the patients move their mouths.

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.

Comprehensive treatment of bilateral cleft lip by multidisciplinary team approach

Repair of bilateral cleft lip presents numerous problems, and in our opinion, it is better to begin treatment at the earliest age possible. At Fujita Health University Hospital, we utilise a multidisciplinary team approach to cleft lip. Nonsurgical correction of the nasal deformity using a nose retainer and preoperative orthodontics using a Kuwahara-modified Hotzs palatal plate begins soon after birth. Surgical repair of the lip is done within the first 2 months of life, by the time the nose, alveolus and projecting prolabium are adequately reformed. A one-stage surgical procedure, including restoration of muscle union, labial sulcus construction and nasal correction is performed. After lip repair, lip and tongue pressure are well balanced by the plate, and a good alignment of the alveolus can be achieved. A total of 27 cases of bilateral cleft lip were treated from August 1986 to October 1990. In all cases, the postoperative course was uneventful, and no complications due to early surgery were encountered.

Treatment and therapeutic devices in the management of frontal sinus fractures: Our experience with 42 cases*

Summary Forty-two cases with frontal sinus fractures were treated at the Department of Plastic and Reconstructive Surgery of Fujita-Gakuen Health University Hospital between December, 1978 and December, 1987; this experience and a discussion of our management of these cases are presented herein. Our concept of fundamental treatment is based on not obliterating the sinus, but rather removing the devitalized mucosa and establishing permanent drainage to the nose. During the operation, we use a cold light source, which provides a fine operative field, and a special cutting saw which allows us safely to perform bone grafts. Up to now we have experienced no significant complications and have achieved uniformly good results, both functionally and aesthetically.

Mechanical strength and in vitro antibiotic release profile of antibiotic-loaded calcium phosphate bone cement

AbstractSome case reports described the usage of bone cement mixed with antibiotics. However, there are few studies that referred to experimental research of calcium phosphate cement with antibiotics. Thus, we mixed vancomycin and amikacin with bone cement in various concentrations and examined its characterization and antibacterial activity. As a result, 6.25 wt% over the concentration could not mix with cement. With an increase in the antibiotic content, the hardening time was prolonged and the compressive strength tended to decrease. In consistency, vancomycin mixed cement increased, whereas amikacin mixed cement decreased. The elution of antibiotics showed sustained release. In conclusion, the characteristics of the bone cement changed based on the amount of antibiotics added, and calcium phosphate cement is useful as a drug carrier.

Anterior cranial base reconstruction using a hydroxyapatite-tricalciumphosphate composite (Ceratite®) as a bone substitute

The craniofacial approach to cranial base tumors has widened the operability of tumors with intracranial invasion. However, the resulting skull base defect must be reconstructed adequately to prevent postoperative morbidity and mortality. We use hydroxyapatite-tricalciumphosphate ceramic (Ceratite) as a bone substitute material to reconstruct the skull base defect in combination with the pericranial flap, ensuring separation between the sinonasal cavity and epidural cavity. Although the nasal surface of the Ceratite block is left exposed directly to the sinonasal cavity, it was shown to be epithelialized within 6 months postoperatively. Our method is less invasive than any other conventional method and may offer more chance of curative resection of tumors with anterior skull base invasion.

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.