Faculty Bibliography

More men are undergoing rhytidectomy now. This operation is specifically different in the preoperative planning, the surgical procedure, the postoperative complications, and the final results (compared to rhytidectomy in females). Large hematomas occurred in our male patients more than twice as often as in females

Although not a frequent occurence, when present a prominent nasal spine contributes to unpleasing septolabial and columella-alar angles which detract from the overall aesthetic quality of the face. It is important to recognize and correct this deformity. In some patients the necessity for spine resection may be subtle. Resection of the nasal spine must be conservative

We report on a patient with severe renovascular hypertension associated with massive spontaneous mediastinal hemorrhage. Differentiation of this entity from aortic dissection, as well as establishing the cause of the severe hypertension, was possible only through the aid of angiography. Following exploratory thoracotomy, renal artery revascularization was carried out, with resolution of the hypertension. To our knowledge, this complication of renovascular hypertension has not been reported. Prompt recognition and appropriate therapy were possible only after angiographic evaluation

The sonogram of a patient with an intrauterine gestation revealed a partial posterior placenta praevia and a hydatidiform mole within the praevia portion of the placenta

Eleven cases of lipoma in the parotid region have been reviewed. Nine tumors were found to be compressing the lateral surface of the parotid gland (periparotidlipoma). One lesion was totally surrounded by salivary tissue, and another involved both the superficial and the deep lobes of a parotid gland (intraparotid lipoma). The tail of the gland was involved most frequently (six patients). The tumors were predominantly right sided (eight cases). All patients were treated by surgical excision. Only one tumor has recurred and this has apparently been successfully treated by a reexcision

Our presently inadequate knowledge of the functional anatomy of the deep branch of the ulnar nerve handicaps our management of ulnar nerve lesions. The extensive anatomical variations in the distribution of this nerve preclude adherence to a textbook pattern of innervation. Electrophysiological recordings of single sensory fibers in monkeys along with fascicular stimulation studies provided novel information about the functional organization of the deep branch of the ulnar nerve: (1) there is a wide range of sensory fibers not currently recognized by textbook descriptions; (2) the innervation pattern is far more diffuse and covers greater areas than previously suspected; (3) at the distal forearm level the motor component of the deep ulnar branch is distributed throughout the entire ulnar nerve and is not restricted to specific fascicles; (4) contrary to previous assumptions, the deep branch of the ulnar nerve is mixed, and not purely motor. In fact, it may be mostly sensory. Afferent fibers arise from muscle, joints, deep subcutaneous tissues and even skin. These findings suggest that it is unwise to look at any nerve as purely motor or having a set innervation pattern, and emphasize the pressing need for objective preoperative and/or intraoperative functional assessment in peripheral nerve surgery

Previous work concerning the efficacy of different types of nerve repair has been reviewed. We describe a model in which epineurial and perineurial suture techniques were studied by quantitative ultramicroscopy and electrophysiology. In this model, we believe suture of the perineurium was shown to have a slight advantage over suture of the epineurium. Microscopic control and fascicular alignment are advocated to increase the percentage of axons growing into the distal stump and the periphery. The model described should lend itself to the study of other traumatic peripheral neuropathies

Moebius syndrome is uncommon, as reported in the literature. A patient with Moebius syndrome is reported, showing a 30-year follow-up after initial surgical treatment by bilateral partial transfers of the Masseter muscles