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Book Details
Abstract
Fully updated to meet the demands of the 21st-century surgeon, Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery, Volume 3 of Plastic Surgery, 3rd Edition, provides you with the most current knowledge and techniques across your entire field, allowing you to offer every patient the best possible outcome. Access all the state-of-the-art know-how you need to overcome any challenge you may face and exceed your patients’ expectations.
- Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability. Compatible with Kindle®, nook®, and other popular devices.
- Apply the very latest advances in craniofacial, head, neck, and pediatric plastic surgery and ensure optimal outcomes with evidence-based advice from a diverse collection of world-leading authorities.
- Purchase this volume individually or own the entire set, with the ability to search across all six volumes online!
- Master the newest procedures in pediatric plastic surgery, including conjoined twinning.
- Apply the latest clinical evidence and surgical techniques to facilitate the decision-making process for craniofacial patients, and optimize outcomes in the correction of congenital, oncologic, traumatic, and acquired deformities.
- Know what to look for and what results you can expect with over 2,000 photographs and illustrations.
- See how to perform key techniques with 28 surgical videos online.
- Access the complete, fully searchable contents online, download all the tables and figures, and take advantage of additional content and images at www.expertconsult.com!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Plastic Surgery | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Video Contents | xi | ||
| Foreword | xvi | ||
| Preface | xvii | ||
| List of Contributors | xviii | ||
| Acknowledgments | xl | ||
| Dedication | xli | ||
| 1 Craniofacial, head and neck surgery: Eduardo D. Rodriguez | 1 | ||
| 1 Anatomy of the head and neck | 3 | ||
| The fascial planes of the head and neck and the facial nerve | 3 | ||
| The fascia in the face | 5 | ||
| The fascia in the temporal region | 6 | ||
| The fascia in the neck | 8 | ||
| Retaining ligaments and adhesions of the face | 8 | ||
| The prezygomatic space | 10 | ||
| The malar fat pad | 10 | ||
| The buccal fat pad | 10 | ||
| The facial nerve | 11 | ||
| Frontal (temporal) branch | 12 | ||
| Zygomatic and buccal branches | 13 | ||
| Marginal mandibular | 13 | ||
| Cervical branch | 13 | ||
| Connection with sensory nerves | 14 | ||
| The scalp | 14 | ||
| The musculature | 14 | ||
| Frontalis, galeal fat pad, and the glide plane | 14 | ||
| Corrugators | 15 | ||
| Procerus | 15 | ||
| Depressor supercilii | 15 | ||
| Midfacial muscles | 16 | ||
| Muscles of mastication | 16 | ||
| The temporalis muscle | 16 | ||
| The masseter muscle | 16 | ||
| The medial pterygoid muscle | 16 | ||
| The lateral pterygoid muscle | 16 | ||
| Actions of muscle of mastication | 16 | ||
| The pterygomasseteric sling | 16 | ||
| The aesthetic importance of the masseter and the temporalis muscle | 17 | ||
| The sensory innervation | 17 | ||
| Anatomy of the ear | 19 | ||
| Anatomy of the eyelids | 19 | ||
| Anatomy of the nose | 21 | ||
| References | 22.e1 | ||
| I Craniofacial Trauma | 23 | ||
| 2 Facial trauma: | 23 | ||
| Introduction | 23 | ||
| History | 23.e1 | ||
| Basic science | 23 | ||
| Global considerations | 23 | ||
| Diagnosis and patient presentation | 24 | ||
| Evaluation for immediate life-threatening injuries | 24 | ||
| Systematic evaluation of the head and neck | 24 | ||
| Eye examination | 25 | ||
| Ear examination | 25 | ||
| Nose examination | 25 | ||
| Cheek examination | 25 | ||
| Oral cavity and mouth | 25 | ||
| Neck examination | 25 | ||
| Diagnostic studies | 26 | ||
| Plain films | 26 | ||
| CT | 26 | ||
| Consultation with other providers | 26 | ||
| Ophthalmology | 26 | ||
| Dental/OMFS | 26 | ||
| Treatment and surgical techniques | 26 | ||
| Anesthesia for treatment | 26 | ||
| Topical | 26 | ||
| Local infiltration | 26 | ||
| Facial field block | 26 | ||
| Forehead, anterior scalp to vertex, upper eyelids, glabella (supraorbital, supratrochlear, infratrochlear nerves) | 26 | ||
| Lateral nose, upper lip, upper teeth, lower eyelid, most of medial cheek (infraorbital nerve) | 27 | ||
| Lower lip and chin (mental nerve) | 27 | ||
| Posterior auricle, angle of the jaw, anterior neck (cervical plexus: great auricular, transverse cervical) | 27 | ||
| Ear (auriculotemporal nerve, great auricular nerve, lesser occipital nerve, and auditory branch of the vagus (Arnold’s) nerve) | 27 | ||
| General treatment considerations | 29 | ||
| Irrigation and debridement | 29 | ||
| Abrasions | 29 | ||
| Traumatic tattoo | 29 | ||
| Simple lacerations | 30 | ||
| Complex lacerations | 31 | ||
| Avulsions | 31 | ||
| Secondary intention healing | 32 | ||
| Treatment of specific areas | 33 | ||
| Scalp | 33 | ||
| Eyebrows | 34 | ||
| Local flap | 36 | ||
| Local graft | 38 | ||
| Eyelids | 38 | ||
| Ears | 39 | ||
| Anatomy | 40 | ||
| Hematoma | 40 | ||
| Lacerations | 41 | ||
| Auditory canal stenosis | 41 | ||
| Partial amputation with a wide pedicle | 42 | ||
| Partial amputation with a narrow pedicle | 42 | ||
| Complete amputation of all or part of the ear with the amputated part available | 42 | ||
| Nose | 42 | ||
| Abrasions | 43 | ||
| Lacerations | 43 | ||
| Lining | 43 | ||
| Framework | 43 | ||
| Skin covering | 43 | ||
| Avulsions | 43 | ||
| Amputation | 44 | ||
| Cheek | 44 | ||
| Repair of parotid duct | 45 | ||
| Facial nerve injury | 45 | ||
| Mouth and oral cavity | 45 | ||
| The oral cavity | 46 | ||
| Oral mucosa repair | 46 | ||
| The lips | 46 | ||
| Neck | 46 | ||
| Conclusion | 46 | ||
| References | 48.e1 | ||
| 3 Facial fractures | 49 | ||
| Introduction | 49 | ||
| History | 49.e1 | ||
| Initial assessment | 49 | ||
| Timing of treatment | 49 | ||
| Clinical examination of the face | 50 | ||
| Blunt trauma craniofacial injuries | 50 | ||
| Computerized tomographic scans | 51 | ||
| Upper facial fractures | 51 | ||
| Frontal bone and sinus injury patterns | 51 | ||
| Clinical examination | 51 | ||
| Nasofrontal duct | 51 | ||
| Radiography | 51 | ||
| Surgical treatment | 52 | ||
| Complications | 53 | ||
| Orbital fractures | 53 | ||
| Surgical anatomy of the orbit | 53 | ||
| Orbital physical examination | 53 | ||
| Radiographic evidence of fracture | 54 | ||
| Indications for surgical treatment | 54 | ||
| Blow-out fractures of the floor of the orbit | 54 | ||
| Blow-out fractures in younger individuals | 54 | ||
| Surgical treatment | 54 | ||
| The timing of surgical intervention | 55 | ||
| Operative technique for orbital fractures | 55 | ||
| Endoscopic approaches for orbital floor fractures | 55 | ||
| Cutaneous exposures | 55 | ||
| Surgical treatment | 55 | ||
| The forced duction test | 55 | ||
| Restoration of continuity of the orbital floor | 55 | ||
| Bone grafts for orbital floor reconstruction | 55 | ||
| Inorganic implants | 56 | ||
| Postoperative care | 56 | ||
| Complications of orbital fractures | 56 | ||
| Diplopia | 56 | ||
| Enophthalmos | 56 | ||
| Retrobulbar hematoma | 56 | ||
| Ocular (globe) injuries and blindness | 56 | ||
| Implant migration, late hemorrhage around implants and implant fixation | 56 | ||
| Ptosis of the upper lid | 57 | ||
| Scleral show, ectropion and entropion: vertical shortening of the lower eyelid | 57 | ||
| Lid lamellae and their relation to contracture | 57 | ||
| Infraorbital nerve anesthesia | 57 | ||
| The “superior orbital fissure” syndrome and the “orbital apex” syndrome | 57 | ||
| Midfacial fractures | 57 | ||
| Nasal fractures | 57 | ||
| Types and locations of nasal fractures | 57 | ||
| Fractures and dislocations of the nasal septum | 58 | ||
| The treatment of nasal fractures | 59 | ||
| Open reduction and the use of supporting K wires | 59 | ||
| Treatment of fractures and dislocations of the septum | 59 | ||
| Complications of nasal fractures | 60 | ||
| Nasoethmoidal orbital fractures | 60 | ||
| Surgical pathology | 60 | ||
| Interorbital space | 60 | ||
| Traumatic telecanthus and hypertelorism | 60 | ||
| Clinical examination | 60 | ||
| Radiographs | 61 | ||
| Classification of nasoethmoidal orbital fractures | 61 | ||
| Treatment of nasoethmoidal orbital fractures | 61 | ||
| The importance of the “central fragment” in nasoethmoid orbital fractures | 63 | ||
| Canthal reattachment | 63 | ||
| Lacrimal system injury | 63 | ||
| Complications of nasoethmoidal orbital fractures | 63 | ||
| Fractures of the zygoma | 63 | ||
| Physical diagnosis and surgical pathology of zygoma fractures | 64 | ||
| Classification of zygoma fractures | 65 | ||
| Anterior approach | 65 | ||
| “Minimalist” approach for fractures without zygomaticofrontal suture diastasis | 65 | ||
| Endoscopic confirmation of orbital floor integrity | 65 | ||
| Fractures with Z-F suture diastasis | 65 | ||
| Posterior approach (coronal incisions) | 66 | ||
| Treatment of fractures of the zygoma | 66 | ||
| Closed reduction | 66 | ||
| Buttress articulations and alignment | 66 | ||
| Methods of reduction | 67 | ||
| Reduction through the maxillary sinus | 67 | ||
| Temporal approach | 67 | ||
| Dingman approach | 67 | ||
| Fixation required to achieve stability | 67 | ||
| “High energy” zygoma fractures | 67 | ||
| The maxillary sinus approach, with and without endoscopic assistance | 68 | ||
| The intraoral approach | 68 | ||
| Compound comminuted fractures of the zygoma | 69 | ||
| Delayed treatment of fractures of the zygoma | 69 | ||
| Complications of zygomatic fractures | 69 | ||
| Bleeding and maxillary sinusitis | 69 | ||
| Late complications | 69 | ||
| Orbital complications | 69 | ||
| Numbness | 69 | ||
| Oral-antral fistula | 70 | ||
| Plate complications | 70 | ||
| Midface buttresses | 70 | ||
| Clinical examination | 70 | ||
| Inspection | 70 | ||
| Palpation | 71 | ||
| Digital manipulation | 71 | ||
| Malocclusion of the teeth | 71 | ||
| Cerebral spinal rhinorrhea or otorrhea | 71 | ||
| Radiological examination | 71 | ||
| Treatment of maxillary fractures | 71 | ||
| Alveolar fractures | 71 | ||
| Le Fort classification of facial fractures | 71 | ||
| Goals of Le Fort fracture treatment | 71 | ||
| Transverse (Guerin) fractures or Le Fort I level fractures | 71 | ||
| Pyramidal fractures or Le Fort II level fractures | 73 | ||
| Craniofacial dysjunction or Le Fort III fractures | 73 | ||
| Le Fort I level fractures | 73 | ||
| Le Fort II level fractures | 73 | ||
| Le Fort III fractures | 74 | ||
| Postoperative care of maxillary fractures | 74 | ||
| Complications of maxillary fractures | 74 | ||
| Airway | 74 | ||
| Bleeding | 74 | ||
| Infection | 74 | ||
| CSF rhinorrhea | 74 | ||
| Blindness | 74 | ||
| Late complications | 74 | ||
| Nonunion and bone grafting | 74 | ||
| Malunion | 74 | ||
| Malocclusion | 74 | ||
| Nasolacrimal duct injury | 75 | ||
| Lower facial fractures | 75 | ||
| Mandible fractures | 75 | ||
| Dental wiring and fixation techniques | 75 | ||
| Arch-bars | 75 | ||
| IMF screws | 75 | ||
| Classification of mandibular fractures | 76 | ||
| Clinical examination and diagnosis | 76 | ||
| Diagnosis | 76 | ||
| Muscles influencing mandibular movement | 76 | ||
| The temporomandibular joint | 76 | ||
| Fractures influencing displacement of fractured mandibular segments | 77 | ||
| Direction and angulation of the fracture line | 77 | ||
| The presence or absence of teeth in the fractured segments | 77 | ||
| Treatment principles of mandibular fractures | 77 | ||
| Treatment of class I fractures | 77 | ||
| General principles of reduction and fixation | 78 | ||
| Treatment of class II fractures | 78 | ||
| Comminuted fractures | 78 | ||
| Treatment of class III fractures | 78 | ||
| Extraoral approach to open reduction | 78 | ||
| Intraoral approach to open reduction | 79 | ||
| Indications for ORIF of mandibular fractures | 79 | ||
| Selection of internal fixation devices for mandibular fractures | 80 | ||
| Champy or miniplate system | 80 | ||
| Lag screw technique | 81 | ||
| Third molars in mandibular angle fractures | 81 | ||
| Antibiotic use | 82 | ||
| Antibiotic prophylaxis for mandibular fractures | 82 | ||
| Complications after fracture treatment | 82 | ||
| Malocclusion | 82 | ||
| Hardware infection and migration | 82 | ||
| Increased facial width and rotation of the mandible | 82 | ||
| Nonunion | 82 | ||
| Osteomyelitis | 82 | ||
| Condylar and subcondylar fractures | 83 | ||
| Edentulous mandible fractures | 83 | ||
| The panfacial injury | 84 | ||
| The treatment of panfacial fractures | 84 | ||
| Order of procedure | 84 | ||
| Complications of panfacial fractures | 84 | ||
| Postoperative care | 85 | ||
| Gunshot wounds of the face | 85 | ||
| Low velocity gunshot wounds | 85 | ||
| Intermediate and high velocity ballistic injuries to the face | 86 | ||
| Treatment | 86 | ||
| References | 88.e1 | ||
| 4 TMJ dysfunction and obstructive sleep apnea | 89 | ||
| Temporomandibular joint dysfunction | 89 | ||
| Key points | 89 | ||
| Historical perspective | 89.e1 | ||
| Basic science/disease process | 89 | ||
| Anatomy | 89 | ||
| Myofascial problems | 90 | ||
| Inflammation | 90 | ||
| Osteoarthritis | 90 | ||
| Rheumatoid arthritis | 90 | ||
| Condylar problems | 90 | ||
| Internal derangement | 91 | ||
| Diagnosis | 92 | ||
| History and physical examination | 92 | ||
| Diagnostic imaging | 92 | ||
| Patient selection | 92 | ||
| Treatment | 93 | ||
| Noninvasive management | 93 | ||
| Surgical management | 94 | ||
| Postoperative care | 94 | ||
| Outcomes, prognosis, and complications | 95 | ||
| Secondary procedures | 95 | ||
| Obstructive sleep apnea | 96 | ||
| Key points | 96 | ||
| Historical perspective | 96.e1 | ||
| Basic science/disease process | 96 | ||
| Diagnosis/patient presentation | 96 | ||
| Patient selection | 97 | ||
| Treatment/surgical technique | 97 | ||
| Surgical preparation | 97 | ||
| Nasal procedures | 98 | ||
| Uvulopalatopharyngoplasty | 98 | ||
| Genioglossus advancement | 98 | ||
| Mandibulomaxillary advancement | 100 | ||
| Postoperative management | 101 | ||
| Outcome | 102 | ||
| Secondary procedures | 103 | ||
| References | 104.e1 | ||
| II Head and Neck Reconstruction | 105 | ||
| 5 Scalp and forehead reconstruction | 105 | ||
| Introduction | 105 | ||
| Historical perspective | 105.e1 | ||
| Basic science/disease process | 105 | ||
| Anatomy | 105 | ||
| Anatomy of the temporal region | 106 | ||
| Blood supply | 107 | ||
| Nerves | 107 | ||
| Aesthetic units of the scalp and forehead | 108 | ||
| Hair structure and cycle | 109 | ||
| Disorders of the scalp and forehead | 109 | ||
| Cicatricial alopecia | 109 | ||
| Aplasia cutis congenita (ACC) | 110 | ||
| Nevus sebaceous of Jadassohn (sebaceous nevus) | 111 | ||
| Nevoid basal cell carcinoma syndrome (NBCCS) | 112 | ||
| Xeroderma pigmentosum (XP) | 112 | ||
| Giant hair nevus – congenital nevomelanocytic nevus (CNN) | 112 | ||
| Dysplastic nevus | 113 | ||
| Linear scleroderma – en coup de sabre | 114 | ||
| Discoid lupus erythematosus (DLE) | 115 | ||
| Cutaneous sarcoidosis | 115 | ||
| Neoplasms | 116 | ||
| Lipoma | 116 | ||
| Epidermoid cyst | 116 | ||
| Trichoepithelioma | 117 | ||
| Syringoma | 117 | ||
| Basal cell carcinoma | 117 | ||
| Cutaneous squamous cell carcinoma (cSCC) | 118 | ||
| Malignant melanoma | 119 | ||
| Infections | 119 | ||
| Physical trauma and burns | 119 | ||
| Diagnosis/patient presentation | 120 | ||
| Patient selection | 120 | ||
| Treatment/surgical technique | 121 | ||
| Reconstructive options | 121 | ||
| Closure by secondary intention | 121 | ||
| Vacuum-assisted closure | 121 | ||
| Primary closure | 121 | ||
| Tissue expansion | 121 | ||
| Skin graft | 123 | ||
| Local flaps | 123 | ||
| Regional flaps | 127 | ||
| Microsurgical reconstruction | 128 | ||
| Scalp replantation | 130 | ||
| Facial transplantation | 131 | ||
| Postoperative care | 131 | ||
| Outcome, prognosis, and complications | 131 | ||
| Potential complications | 131 | ||
| Secondary procedures | 132 | ||
| References | 133.e1 | ||
| 6 Aesthetic nasal reconstruction | 134 | ||
| Introduction | 134 | ||
| Historical perspective | 134.e1 | ||
| Cover | 134.e1 | ||
| Lining | 134.e1 | ||
| Support | 134.e2 | ||
| Basic science/disease process | 134 | ||
| Diagnosis/patient presentation and patient selection | 135 | ||
| Planning an aesthetic nasal reconstruction | 135 | ||
| The traditional approach | 135 | ||
| False principles | 135 | ||
| Design the flap from a pattern of the defect | 135 | ||
| Take extra tissue to be safe | 135 | ||
| Make the flap smaller to preserve the donor site | 135 | ||
| Employ a tissue expander to conserve the donor site | 135 | ||
| Never throw anything away | 135 | ||
| The presence and number of scars determine the final result: place incisions in existing scars, minimize scars, fear scars | 135 | ||
| Place a supportive framework and debulk excess tissue secondarily after the soft tissues have healed and matured | 135 | ||
| One hole, one flap, and (often) one operation | 136 | ||
| The modern approach to nasal reconstruction | 136 | ||
| The concept of peripheral and central facial units | 136 | ||
| Peripheral units | 136 | ||
| Central units | 136 | ||
| Principles of regional unit repair | 138 | ||
| The “subunit principle” | 138 | ||
| Use the contralateral normal or the ideal as a guide | 138 | ||
| Replace tissues in exact dimensions and outline | 138 | ||
| Employ templates | 138 | ||
| Choose ideal donor materials and employ an ideal method of tissue transfer | 138 | ||
| Understand wound healing and tissue transfer | 138 | ||
| Build on a stable platform | 139 | ||
| Restore a subcutaneous framework of hard and soft tissue | 139 | ||
| Disregard old scars | 139 | ||
| Employ surgical staging to advantage | 139 | ||
| Consider a preliminary operation | 139 | ||
| Classification of defects | 139 | ||
| Small defect | 139 | ||
| Superficial defect | 139 | ||
| Adversely located defect | 139 | ||
| Large defect | 140 | ||
| Deep defect | 140 | ||
| Composite defects | 140 | ||
| Treatment/surgical technique and postoperative care | 140 | ||
| Zones of nasal skin quality | 140 | ||
| Restoring nasal cover | 140 | ||
| Small, superficial defects | 140 | ||
| Healing by secondary intention | 140 | ||
| Primary repair | 141 | ||
| Skin grafting | 141 | ||
| Preauricular and postauricular skin grafts | 141 | ||
| Full-thickness forehead skin graft (Figs 6.2–6.6) | 141 | ||
| Skin graft technique | 141 | ||
| Local flaps | 142 | ||
| The single-lobe transposition flap (Fig. 6.7) | 143 | ||
| The dorsal nasal flap | 143 | ||
| The geometric bilobed flap | 143 | ||
| The one-stage nasolabial flap (Fig. 6.8) | 145 | ||
| Large, deep, and adversely located defects | 146 | ||
| The superiorly based two-stage subunit nasolabial flap (Figs 6.9–6.11) | 146 | ||
| Stage 1 | 146 | ||
| Stage 2 | 146 | ||
| The forehead flap | 148 | ||
| The two-stage forehead flap (Figs 6.13–6.16) | 148 | ||
| Technique of the two-stage forehead flap | 148 | ||
| Stage 1: flap transfer | 148 | ||
| Stage 2 | 151 | ||
| The three stage full-thickness forehead flap (Fig. 6.17) | 151 | ||
| Technique of a three-stage full-thickness forehead flap (Figs 6.18–6.27) | 152 | ||
| Stage 1 | 152 | ||
| Stage 2: the intermediate operation | 153 | ||
| Stage 3: pedicle division | 155 | ||
| Handling the forehead donor site | 155 | ||
| Primary closure of the forehead | 155 | ||
| Scars within the forehead territory | 156 | ||
| Surgical delay of a forehead flap | 157 | ||
| Technique of surgical delay | 158 | ||
| Expansion of the forehead | 158 | ||
| Expansion and delay | 159 | ||
| Technique of forehead expansion | 159 | ||
| Guidelines for harvesting multiple forehead flaps | 160 | ||
| Restoring nasal contour and support: recreating a subsurface architecture | 160 | ||
| Hard-tissue support replacement | 160 | ||
| Timing | 160 | ||
| Design | 160 | ||
| Materials | 160 | ||
| Harvest | 161 | ||
| Graft fixation | 161 | ||
| Soft-tissue support and contouring | 161 | ||
| Restoring nasal lining | 161 | ||
| Composite skin grafts | 161 | ||
| Advancement of residual lining | 161 | ||
| The prelaminated forehead flap | 162 | ||
| Hingeover lining flaps | 162 | ||
| Indications for hingeover lining flaps | 162 | ||
| Use of a second flap for lining | 162 | ||
| The nasolabial flap | 163 | ||
| A second forehead flap | 163 | ||
| The facial artery myomucosal (FAMM) flap | 163 | ||
| Intranasal lining flaps | 163 | ||
| Intranasal lining flap technique (Figs 6.29–6.33) | 166 | ||
| Isolated unilateral mid-vault lining loss | 166 | ||
| Unilateral lining loss | 168 | ||
| The modified folded forehead flap for lining (Figs 6.34–6.41) | 170 | ||
| Skin grafts for lining | 172 | ||
| Microvascular lining with distant tissue | 173 | ||
| Principles of free flap nasal reconstruction | 173 | ||
| The midfacial defect with an inadequate platform | 174 | ||
| Restoring nasal lining with a free flap | 174 | ||
| Defects of the mid-vault alone | 174 | ||
| Subtotal and total nasal defects – lining for the vault, columella, and nasal floor | 174 | ||
| Operation 1 | 174 | ||
| Operation 2 | 177 | ||
| Operation 3 | 177 | ||
| Operation 4 | 178 | ||
| Operation 5 | 178 | ||
| Outcomes, prognosis, and complications | 179 | ||
| Secondary procedures | 181 | ||
| The minor revision | 181 | ||
| The major revision | 184 | ||
| The redo | 184 | ||
| References | 186.e1 | ||
| 7 Reconstruction of the ear | 187 | ||
| Introduction | 187 | ||
| Historical perspective | 187.e1 | ||
| Anatomy | 187 | ||
| Practical embryology and understanding the middle-ear problem | 187 | ||
| Etiology | 189 | ||
| Incidence | 189 | ||
| Hereditary factors | 189 | ||
| Specific factors | 189 | ||
| Diagnosis | 189 | ||
| Classification | 189 | ||
| Associated deformities | 190 | ||
| Microtia | 190 | ||
| Clinical characteristics | 190 | ||
| General considerations | 191 | ||
| Author’s method of repair | 192 | ||
| Staging the auricular construction | 192 | ||
| Preoperative consultation | 192 | ||
| Planning, preparation, and correlation with the correction of other facial deficiencies | 192 | ||
| First stage of reconstruction | 194 | ||
| Obtaining the rib cartilage | 194 | ||
| Framework fabrication | 194 | ||
| Framework modifications in older patients | 195 | ||
| Framework implantation | 195 | ||
| Immediate postoperative care and management of complications | 196 | ||
| Postoperative activities and care | 197 | ||
| Other stages of auricular construction | 197 | ||
| Rotation of the lobule | 197 | ||
| Tragal construction and conchal definition | 197 | ||
| Detaching the posterior auricular region | 198 | ||
| Managing the hairline | 201 | ||
| Variations in total ear reconstruction technique | 202 | ||
| Secondary reconstruction | 202 | ||
| Bilateral microtia | 204 | ||
| The constricted ear | 204 | ||
| Cryptotia | 204 | ||
| Prominent ear | 204 | ||
| Pathology | 204 | ||
| Treatment | 206 | ||
| Conchal alteration | 206 | ||
| Restoration of the antihelical fold | 206 | ||
| Altering the medial cartilage surface | 207 | ||
| Altering the lateral cartilage surface | 207 | ||
| Acquired deformities | 207 | ||
| Replantation of the amputated auricle | 209 | ||
| Replantation of auricular tissue attached by a narrow pedicle | 209 | ||
| Replantation of auricular tissue as a composite graft | 210 | ||
| Replantation of auricular cartilage | 210 | ||
| Replantation of the dermabraded amputated auricle | 211 | ||
| Replantation of the amputated auricle upon removal of postauricular skin and fenestration of cartilage | 212 | ||
| Replanting the ear cartilage and immediately covering it with a fascial flap and skin graft | 212 | ||
| Microsurgical ear replantation | 212 | ||
| Deformities without loss of auricular tissue | 212 | ||
| Irregularities in contour | 212 | ||
| Otohematoma: “cauliflower ear” | 212 | ||
| Stenosis of the external auditory canal | 212 | ||
| Deformities with loss of auricular tissue | 214 | ||
| Loss of auricular skin | 214 | ||
| Full-thickness defects of the auricle | 214 | ||
| Major auricular loss following trauma | 214 | ||
| The skin covering | 215 | ||
| Auricular prostheses | 217 | ||
| Partial auricular loss | 217 | ||
| Utilization of residual tissues | 217 | ||
| Structural support | 217 | ||
| Contralateral conchal cartilage | 217 | ||
| Ipsilateral conchal cartilage | 217 | ||
| Composite grafts | 218 | ||
| Specific regional defects | 218 | ||
| Helical rim | 218 | ||
| Upper-third auricular defects | 219 | ||
| Middle-third auricular defects | 220 | ||
| Lower-third auricular defects | 220 | ||
| Acquired earlobe deformities | 220 | ||
| Tumors of the auricle | 221 | ||
| Benign tumors | 221 | ||
| Malignant tumors | 221 | ||
| Reference | 225.e1 | ||
| 8 Acquired cranial and facial bone deformities | 226 | ||
| Introduction | 226 | ||
| Key points | 226 | ||
| Basic science/disease process | 226 | ||
| Access incisions | 226 | ||
| Coronal incisions | 226 | ||
| Lower eyelid incisions | 227 | ||
| Intraoral incisions | 227 | ||
| Bone grafts | 227 | ||
| Soft-tissue cover | 227 | ||
| Treatment/surgical technique | 228 | ||
| Treatment of specific defects | 228 | ||
| Cranium | 228 | ||
| Nose | 228 | ||
| Nasoethmoid area | 232 | ||
| Orbitozygomatic region | 232 | ||
| Posttraumatic enophthalmos | 234 | ||
| The irradiated orbit | 235 | ||
| Maxilla | 236 | ||
| Maxillary reconstruction | 238 | ||
| Mandible | 238 | ||
| Mandibular reconstruction | 240 | ||
| Chin | 240 | ||
| Postoperative care | 240 | ||
| Outcomes, prognosis, and complications | 242 | ||
| Secondary procedures | 242 | ||
| References | 242.e1 | ||
| 9 Midface reconstruction | 243 | ||
| Introduction | 243 | ||
| History | 243.e1 | ||
| Basic science/disease process | 243 | ||
| Diagnosis/patient presentation | 244 | ||
| Type I: limited maxillectomy defects | 244 | ||
| Type II: subtotal maxillectomy defects | 244 | ||
| Type III: total maxillectomy defects | 245 | ||
| Type IV: orbitomaxillectomy defects | 245 | ||
| Functional and aesthetic outcomes | 252 | ||
| Speech | 252 | ||
| Diet | 252 | ||
| Globe position and function | 252 | ||
| Oral competence | 253 | ||
| Aesthetic results | 253 | ||
| Conclusions | 253 | ||
| References | 253.e1 | ||
| 10 Cheek and lip reconstruction | 254 | ||
| Introduction | 254 | ||
| History | 255.e1 | ||
| Anatomic and functional considerations in lip reconstruction | 255 | ||
| Lip function | 256 | ||
| Patient selection and presentation | 256 | ||
| Goals of lip reconstruction | 256 | ||
| Operative technique | 257 | ||
| Defect-specific reconstruction of the lip | 257 | ||
| Defects of the vermillion | 257 | ||
| Small full-thickness defects | 258 | ||
| Intermediate full-thickness defects | 259 | ||
| Large full-thickness defects | 265 | ||
| Secondary procedures | 268 | ||
| Complications | 270 | ||
| Postoperative care | 271 | ||
| Cheek reconstruction | 271 | ||
| Operative technique: General principles | 271 | ||
| Local flaps for cheek reconstruction | 271 | ||
| Cheek rotation advancement flap | 271 | ||
| The submental artery flap | 272 | ||
| Free tissue transfer | 272 | ||
| Soft tissue cheek reconstruction | 272 | ||
| Scapular and parascapular flaps | 273 | ||
| Anterolateral thigh flap | 274 | ||
| Other flaps | 274 | ||
| The facial nerve | 274 | ||
| Composite defects | 274 | ||
| Conclusion | 274 | ||
| References | 277.e1 | ||
| 11 Facial paralysis | 278 | ||
| Introduction | 278 | ||
| Historical perspective | 278 | ||
| Basic science | 278 | ||
| The facial nerve | 278 | ||
| Facial musculature | 280 | ||
| Diagnosis and patient presentation | 282 | ||
| Classification | 284 | ||
| Patient selection | 284 | ||
| Treatment: nonsurgical and surgical | 285 | ||
| Planning, priorities, and expectations | 285 | ||
| Nonsurgical management | 285 | ||
| Surgical management | 286 | ||
| Brow | 286 | ||
| Upper eyelid | 287 | ||
| Lower eyelid | 289 | ||
| Nasal airway | 291 | ||
| Upper lip and cheek: smile reconstruction | 291 | ||
| Nerve transfers: principles and current use | 291 | ||
| Microneurovascular muscle transplantation | 292 | ||
| Smile analysis | 292 | ||
| Technique options | 292 | ||
| Authors’ preferred method: two-stage microneurovascular transplantation | 293 | ||
| Cross-facial nerve graft | 293 | ||
| Gracilis muscle transplantation | 295 | ||
| Muscle transplantation in the absence of seventh-nerve input | 297 | ||
| Regional muscle transfer | 298 | ||
| Static slings | 300 | ||
| Soft-tissue rebalancing | 302 | ||
| Lower lip | 302 | ||
| Postoperative care | 303 | ||
| Outcomes, prognosis, and complications | 303 | ||
| Secondary procedures | 304 | ||
| Further considerations | 304 | ||
| Conclusions | 305 | ||
| References | 306.e1 | ||
| 12 Oral cavity, tongue, and mandibular reconstructions | 307 | ||
| Introduction | 307 | ||
| Historical perspective | 307.e1 | ||
| Basic anatomy/disease process | 308 | ||
| Diagnosis/patient presentation | 308 | ||
| Patient selection and decision-making | 308 | ||
| Patient factors (Table 12.4) | 308 | ||
| Defect factors (Table 12.4) | 310 | ||
| Skin graft | 311 | ||
| Local/regional flap | 311 | ||
| Free tissue transfer | 311 | ||
| Decision making for buccal reconstruction (Table 12.2) | 311 | ||
| Decision making for tongue reconstruction (Table 12.3) | 313 | ||
| Decision making for mandibular reconstruction | 315 | ||
| Treatment/surgical technique | 316 | ||
| Part I: Soft-tissue flaps | 316 | ||
| Local flaps | 316 | ||
| Submental flap | 316 | ||
| Regional flaps | 318 | ||
| Deltopectoral flap | 318 | ||
| Pectoralis major myocutaneous flap | 319 | ||
| Free fasciocutaneous or musculocutaneous flaps | 319 | ||
| Radial forearm flap | 319 | ||
| Ulnar forearm flap | 320 | ||
| Lateral arm flap | 321 | ||
| Rectus abdominis musculocutaneous flap | 321 | ||
| Anterolateral thigh fasciocutaneous or musculocutaneous flap | 321 | ||
| Thoracodorsal artery perforator (TAP) flap | 322 | ||
| Medial sural artery perforator (MSAP) flap | 322 | ||
| Part II: Bone-carrying flaps | 322 | ||
| Pedicled osteocutaneous flaps | 322 | ||
| Pectoralis major osteomusculocutaneous flap | 322 | ||
| Trapezius osteomusculocutaneous flap | 322 | ||
| Temporalis osteomuscular flap | 322 | ||
| Vascularized osteocutaneous flaps | 322 | ||
| Circumflex iliac osteocutaneous flap | 322 | ||
| Scapular osteomusculocutaneous flap | 323 | ||
| Radius with radial forearm flap | 323 | ||
| Fibula osteoseptocutaneous flap | 323 | ||
| Surgical technique: fibula osteoseptocutaneous flap for mandibular reconstruction (Tables 12.6–12.8) | 323 | ||
| Assessment of mandibular defects and custom-made templates | 323 | ||
| Recipient site preparation | 324 | ||
| Donor site selection | 324 | ||
| Osteomyocutaneous peroneal artery combined flap harvest | 328 | ||
| Osteotomies | 331 | ||
| Flap inset | 331 | ||
| Plating | 331 | ||
| Ischemia time | 331 | ||
| Temporomandibular joint reconstruction | 331 | ||
| Dental rehabilitation: osseointegrated dental implants | 332 | ||
| Postoperative care | 332 | ||
| Outcome, prognosis, and complications | 333 | ||
| Complications post buccal and tongue reconstructions | 333 | ||
| Acute complications | 333 | ||
| Chronic complications | 333 | ||
| Complications post mandibular reconstruction | 334 | ||
| Acute complications | 334 | ||
| Chronic complications | 334 | ||
| Secondary procedures | 334 | ||
| Acknowledgment | 334 | ||
| References | 335.e1 | ||
| 13 Hypopharyngeal, esophageal, and neck reconstruction | 336 | ||
| Introduction | 336 | ||
| Historical perspective | 336.e1 | ||
| Basic science/anatomy | 337 | ||
| Patient selection | 337 | ||
| Preoperative evaluation | 337 | ||
| Medical evaluation | 337 | ||
| History of radiotherapy and surgery | 338 | ||
| Donor site evaluation | 338 | ||
| Choice of flaps | 338 | ||
| Surgical technique | 339 | ||
| Reconstruction with the anterolateral thigh flap | 339 | ||
| Flap design and harvesting | 339 | ||
| Flap insetting | 342 | ||
| Reconstruction with the radial forearm flap | 347 | ||
| Flap design | 347 | ||
| Flap harvesting | 347 | ||
| Reconstruction with the jejunal flap | 349 | ||
| Flap harvesting | 349 | ||
| Flap insetting | 350 | ||
| Recipient vessel choices | 351 | ||
| Managing a frozen neck during pharyngoesophageal reconstruction | 352 | ||
| Reconstruction of postlaryngectomy pharyngocutaneous fistulas | 353 | ||
| Reconstruction of isolated cervical esophageal defects with an intact larynx | 354 | ||
| Postoperative care | 354 | ||
| General postoperative care | 354 | ||
| Oral diet | 355 | ||
| Voice rehabilitation | 356 | ||
| Outcomes and complications | 356 | ||
| Outcomes | 356 | ||
| Managing postoperative complications | 357 | ||
| Pharyngocutaneous fistula | 357 | ||
| Anastomotic strictures | 357 | ||
| Neck wound infection | 358 | ||
| Secondary procedures | 358 | ||
| Flap debulking | 358 | ||
| Tracheal stomaplasty | 358 | ||
| References | 359.e1 | ||
| 14 Salivary gland tumors | 360 | ||
| Introduction | 360 | ||
| Basic science/disease process | 360 | ||
| Anatomy | 360 | ||
| Parotid gland | 360 | ||
| Submandibular gland | 361 | ||
| Sublingual gland | 361 | ||
| Minor salivary glands | 361 | ||
| Epidemiology | 361 | ||
| Diagnosis/patient presentation | 362 | ||
| Fine-needle aspiration | 363 | ||
| Imaging modalities | 363 | ||
| Computed tomography | 363 | ||
| Magnetic resonance imaging | 364 | ||
| Ultrasound | 364 | ||
| Technetium scan | 364 | ||
| Sialography | 364 | ||
| Classification of tumors | 365 | ||
| Nonneoplastic lesions | 365 | ||
| Sialadenosis | 365 | ||
| Sialadenitis | 365 | ||
| Sialolithiasis | 365 | ||
| Mucocele | 365 | ||
| Necrotizing sialometaplasia | 366 | ||
| Benign neoplastic lesions | 366 | ||
| Pleomorphic adenoma | 366 | ||
| Monomorphic adenoma | 367 | ||
| Warthin’s tumor (papillary cystadenoma lymphomatosum) | 367 | ||
| Oncocytoma | 368 | ||
| Hemangioma | 368 | ||
| Malignant neoplastic lesions | 370 | ||
| Mucoepidermoid carcinoma | 370 | ||
| Adenoid cystic carcinoma (cylindroma) | 370 | ||
| Acinic cell carcinoma | 370 | ||
| Adenocarcinoma | 370 | ||
| Malignant mixed tumors | 370 | ||
| Squamous cell carcinoma | 370 | ||
| Oncocytic carcinoma | 370 | ||
| Lymphoma | 370 | ||
| Metastatic tumors | 371 | ||
| Treatment/surgical technique | 371 | ||
| Nonneoplastic lesions | 371 | ||
| Necrotizing sialometaplasia | 371 | ||
| Benign neoplastic lesions | 371 | ||
| Pleomorphic adenoma | 371 | ||
| Monomorphic adenomas | 372 | ||
| Warthin’s tumors | 372 | ||
| Oncocytoma | 373 | ||
| Hemangiomas | 373 | ||
| Malignant neoplastic lesions | 373 | ||
| Mucoepidermoid carcinoma | 373 | ||
| Adenoid cystic carcinoma | 374 | ||
| Acinic cell carcinoma | 375 | ||
| Adenocarcinomas | 376 | ||
| Mixed malignant tumors | 376 | ||
| Oncocytic carcinoma | 377 | ||
| Lymphoma | 377 | ||
| Outcomes, prognosis, and complications | 377 | ||
| Malignant neoplastic lesions | 377 | ||
| Mucoepidermoid carcinomas | 377 | ||
| Adenoid cystic carcinomas | 377 | ||
| Acinic cell carcinomas | 377 | ||
| Adenocarcinomas | 377 | ||
| Mixed malignant tumors | 377 | ||
| Squamous cell carcinomas | 377 | ||
| Frey syndrome | 377 | ||
| References | 379.e1 | ||
| 15 Tumors of the facial skeleton: | 380 | ||
| Introduction | 380 | ||
| Historical perspective | 380.e1 | ||
| Basic science/disease process | 380 | ||
| Diagnosis/patient presentation | 382 | ||
| Patient selection | 382 | ||
| Treatment/surgical technique | 383 | ||
| Nonsurgical treatment | 383 | ||
| Preoperative considerations | 383 | ||
| Timing of operation | 383 | ||
| Surgical approach | 385 | ||
| Zone 1 | 385 | ||
| Operative approach | 385 | ||
| Optic nerve decompression | 386 | ||
| Zone 2 | 387 | ||
| 2 Pediatric plastic surgery: Joseph E. Losee | 501 | ||
| I Clefts | 501 | ||
| 22 Embryology of the craniofacial complex | 503 | ||
| Introduction | 503 | ||
| What is unique about craniofacial development? | 503 | ||
| The initiation of craniofacial development | 504 | ||
| Gastrulation and the establishment of the craniocaudal and mediolateral axes | 504 | ||
| Disruptions in mediolateral patterning produce severe HPE phenotypes | 505 | ||
| Neurulation and the generation of the neural crest | 506 | ||
| Migration of the cranial neural crest into the facial prominences | 507 | ||
| Establishment and fusion of the facial prominences | 508 | ||
| The frontonasal prominence | 508 | ||
| The lateral nasal prominences | 508 | ||
| The maxillary prominences | 508 | ||
| The mandibular prominences | 509 | ||
| Advances in understanding the molecular causes of facial clefting | 509 | ||
| Differentiation defects: the role of the TGF-β3 in palatal fusion | 509 | ||
| Inadequate growth of the facial prominences: defects in Wnt signaling and clefting | 509 | ||
| Mutation in FOXE1 associated with cleft lip and palate | 510 | ||
| IRF genes and facial clefting | 511 | ||
| Growth and ossification of the neurocranium | 511 | ||
| The cartilaginous neurocranium | 511 | ||
| The membranous neurocranium | 511 | ||
| Normal and pathological development of the sutures | 512 | ||
| Balancing osteogenesis and cell proliferation: the molecular basis for craniosynostoses | 512 | ||
| Development of the viscerocranium | 512 | ||
| Organization of the pharyngeal arches | 512 | ||
| Disorders of arch development | 514 | ||
| Teratogens and their effects of craniofacial development | 514 | ||
| Retinoids and retinoid-induced embryopathies | 514 | ||
| Alcohol effects | 515 | ||
| Perturbations in cholesterol biosynthesis and metabolism | 515 | ||
| References | 516.e1 | ||
| 23 Repair of unilateral cleft lip | 517 | ||
| Introduction | 517 | ||
| Basic science/disease process | 517 | ||
| Prenatal diagnosis | 517 | ||
| Genetics | 517 | ||
| Classification of the clefts | 518 | ||
| Diversity of the cleft pathology | 519 | ||
| Diagnosis/patient selection | 519 | ||
| Lip measurements and markings | 520 | ||
| Cupids bow and vermillion | 520 | ||
| The base of the cleft-side philtral column | 520 | ||
| Evaluation of tissue deficiency or excess | 521 | ||
| Peaking of Cupid’s bow | 522 | ||
| Lateral lip length and height | 522 | ||
| Columella and nasal floor skin | 522 | ||
| Deficient vermillion beneath the Cupid’s bow | 522 | ||
| Treatment/surgical technique | 522 | ||
| Overall cleft treatment plan in the Chang Gung Craniofacial Center | 522 | ||
| The surgical approach | 522 | ||
| Treatment after lip repair | 522 | ||
| Presurgical alveolar and nasoalveolar molding | 523 | ||
| Alveolar molding: external taping with or without dental plate | 523 | ||
| Nasoalveolar molding | 524 | ||
| Liou’s method | 524 | ||
| Grayson’s method | 524 | ||
| Discussion of presurgical orthopedics | 525 | ||
| Surgical technique | 525 | ||
| Adhesion cheiloplasty: two-staged repair | 525 | ||
| The advantages and disadvantages of a two-stage nasolabial adhesion cheiloplasty | 525 | ||
| Nasolabial adhesion cheiloplasty: surgical technique | 526 | ||
| Markings | 526 | ||
| Elevation and insertion of C flap mucosa | 527 | ||
| Lateral lip incisions | 527 | ||
| Mucosal flaps | 527 | ||
| Nostril floor closure | 527 | ||
| Muscle and skin closure | 527 | ||
| Definitive cheiloplasty after adhesion | 527 | ||
| Rotation advancement cheiloplasty for complete clefts | 527 | ||
| Medial incisions | 530 | ||
| Adequate rotation | 530 | ||
| C-flap and footplate of medial crura | 531 | ||
| Lateral lip incisions | 531 | ||
| L-flap and inferior turbinate flap | 532 | ||
| Orbicularis muscle dissection and alar base mobilization | 532 | ||
| Elevation of orbicularis marginalis flap | 532 | ||
| Correction of piriform deficiency | 532 | ||
| Nasal floor reconstruction and alar base repositioning | 532 | ||
| Muscle reconstruction | 533 | ||
| Philtral column reconstruction | 533 | ||
| Incisions for triangular vermillion flap | 533 | ||
| Closure of the free border of the lip | 534 | ||
| Incisions on nasal floor | 534 | ||
| Final skin closure | 535 | ||
| Adequacy of rotation (small triangular flap) | 535 | ||
| Semi-open rhinoplasty | 535 | ||
| Incision | 536 | ||
| Release of fibrofatty tissue from LLCs | 536 | ||
| Repositioning of LLCs | 536 | ||
| Trimming the excessive skin | 536 | ||
| Alar base position | 536 | ||
| Creation of the alar-facial groove | 537 | ||
| Adjustments at cheiloplasty | 537 | ||
| Long vertical length of cleft side lip | 537 | ||
| Short vertical length of cleft side lip | 539 | ||
| Long horizontal length of cleft side lip | 539 | ||
| Short horizontal length of cleft side lip | 539 | ||
| Long vertical height of noncleft side lip | 539 | ||
| Free border of the lateral lip | 539 | ||
| Rotation advancement cheiloplasty for incomplete clefts | 539 | ||
| Markings and incisions | 539 | ||
| Nasal floor incision | 540 | ||
| Dissection and release of muscle and elevation of OM flap | 540 | ||
| Nasal floor reconstruction | 540 | ||
| Muscle reconstruction | 540 | ||
| Nasal correction | 540 | ||
| Excessive free border | 540 | ||
| Microform cleft lip | 542 | ||
| Pathology | 542 | ||
| Discussion of different techniques | 542 | ||
| Postoperative care | 542 | ||
| Postoperative maintenance of nasal shape | 542 | ||
| Outcomes, prognosis and complications | 542 | ||
| Long-term results of lip morphology | 542 | ||
| Long-term result of nasal morphology | 543 | ||
| Satisfaction of patients | 545 | ||
| Complications | 545 | ||
| Secondary procedures | 545 | ||
| Notching on Cupid’s bow | 545 | ||
| Vertical discrepancy of the lateral lip | 545 | ||
| Horizontal shortness of the lateral lip | 546 | ||
| Vermillion and free border problems | 546 | ||
| Wide nostril | 546 | ||
| Nostril hood at soft triangle | 547 | ||
| Inadequate correction of the LLC | 547 | ||
| Flared ala-facial groove | 547 | ||
| Vestibular webbing | 547 | ||
| Infrasill depression | 547 | ||
| Secondary rhinoplasty | 547 | ||
| Summary | 548 | ||
| References | 549.e1 | ||
| 24 Repair of bilateral cleft lip | 550 | ||
| Introduction | 550 | ||
| Principles | 550 | ||
| Third and fourth dimensions | 551 | ||
| Historical review | 550.e1 | ||
| The premaxilla | 550.e1 | ||
| Labial closure | 550.e1 | ||
| Muscular closure | 550.e1 | ||
| Nasal inattention | 550.e1 | ||
| Secondary nasal correction | 550.e2 | ||
| Primary repair of the bilateral cleft lip nasal deformity | 550.e2 | ||
| Presentation | 551 | ||
| Preoperative dentofacial orthopedics | 552 | ||
| Operative techniques | 553 | ||
| Bilateral cleft, complete cleft lip and palate | 553 | ||
| Markings | 553 | ||
| Labial dissection | 554 | ||
| Alveolar closure | 555 | ||
| Labial closure | 555 | ||
| Nasal dissection and positioning the lower lateral cartilages | 556 | ||
| Final touches | 556 | ||
| Postoperative care | 557 | ||
| Technical modifications for bilateral variations | 557 | ||
| Late presentation of bilateral complete cleft lip/palate | 557 | ||
| Binderoid bilateral complete cleft lip/palate | 558 | ||
| Bilateral complete cleft lip and intact secondary palate | 558 | ||
| Bilateral incomplete cleft lip | 559 | ||
| Asymmetrical bilateral (complete/incomplete) cleft lip | 560 | ||
| Outcomes | 563 | ||
| Photography | 563 | ||
| Revision-rate | 564 | ||
| Direct anthropometry | 565 | ||
| Indirect anthropometry | 565 | ||
| Photogrammetry | 565 | ||
| Stereophotogrammetry | 567 | ||
| Conclusion | 568 | ||
| References | 568.e1 | ||
| 25 Cleft palate | 569 | ||
| History | 569.e1 | ||
| Basic science | 569 | ||
| Embryology | 569 | ||
| Anatomy | 569 | ||
| Ear pathology | 570 | ||
| Patient presentation | 570 | ||
| Cleft palate with cleft lip and alveolus | 570 | ||
| Clefts of the secondary palate | 571 | ||
| Submucous cleft palate | 571 | ||
| Pierre Robin sequence | 572 | ||
| Syndromes | 572 | ||
| 22q chromosomal deletion | 572 | ||
| Growth | 573 | ||
| Feeding and swallowing | 573 | ||
| Index | i1 | ||
| A | i1 | ||
| B | i11 | ||
| C | i30 | ||
| D | i51 | ||
| E | i53 | ||
| F | i59 | ||
| G | i79 | ||
| H | i82 | ||
| I | i95 | ||
| J | i99 | ||
| K | i99 | ||
| L | i100 | ||
| M | i108 | ||
| N | i120 | ||
| O | i131 | ||
| P | i136 | ||
| Q | i149 | ||
| R | i149 | ||
| S | i158 | ||
| T | i172 | ||
| U | i187 | ||
| V | i195 | ||
| W | i199 | ||
| X | i202 | ||
| Y | i203 | ||
| Z | i203 | ||
| Index | e1 | ||
| A | e1 | ||
| B | e3 | ||
| C | e5 | ||
| D | e15 | ||
| E | e15 | ||
| F | e17 | ||
| G | e24 | ||
| H | e24 | ||
| I | e26 | ||
| J | e26 | ||
| K | e26 | ||
| L | e26 | ||
| M | e27 | ||
| N | e32 | ||
| O | e34 | ||
| P | e37 | ||
| Q | e40 | ||
| R | e40 | ||
| S | e42 | ||
| T | e45 | ||
| U | e49 | ||
| V | e50 | ||
| W | e51 | ||
| X | e51 | ||
| Z | e51 |