Faculty Bibliography

In a review of thyroid surgery during the past 12 years, total thyroidectomy was performed in 20% of the cases. Forty percent were done for malignant disease and 60% for benign disease. Our indications for using this operation in benign thyroid disease include bilateral nodular goiter, Graves' disease, chronic thyroiditis, and cases in which the rapid frozen diagnosis is equivocal for carcinoma. We feel that the risks of reoperation for recurrent thyroid disease are greater than the risks of a total thyroidectomy as the initial surgical procedure. With the increased use of total thyroidectomy the incidence of permanent hypoparathyroidism can be decreased. We reviewed our preoperative work-up, indications for total thyroidectomy, surgical technique, diagnostic accuracy of needle biopsy, accuracy of rapid frozen section reports, and postoperative complications.

A through-and-through defect of the cheek is a reconstructive challenge--functionally, technically, and cosmetically. The goal of reconstruction is to reliably and expediently bridge a poorly vascularized gap with healthy tissue. Since 1979, five patients have undergone folded trapezius flap reconstruction of the cheek. Despite a history of radiation in four of the five, all flaps have healed and complications have been minimal. The key to success seems to be careful attention to the venous drainage. This technique provides a one-stage reconstruction of a difficult surgical defect