fb.comSachYHocAmazon Hotline: 0966285892PDF Principles and Practice of Pediatric Plastic Surgery, Second Edition Two Volume Set 2nd 2016 PDFISBN13: 9781482241372ISBN10: 1482241374Principles and Practice of Pediatric Plastic Surgery provides exhaustive coverage of both common and rare congenital and acquired pediatric conditions. Covering the full spectrum of pediatric surgery, this is one of the most comprehensive books in the field.A wealth of information is presented for clinical decision making and for honing the skills required to restore form and function to structures marred by deformity, written by experts who lead the way in both research and clinical practice. Through their aggregated wisdom, this group of surgeons share detailed accounts of the techniques that are crucial for excellent results. Detailed text is supplemented with numerous photographs, illustrations, operative techniques, tables, and comprehensive references. An eBook with operative videos demonstrate the technical nuances of key procedures discussed in the book.With seven new chapters covering some of the most recent topics in the field, such as global health issues and alveolar bone grafting, this invaluable reference covers the latest advances in pediatric surgical theory, technology, and technique.
Principles and Practice of Pediatric Plastic Surgery, Second Edition - Two Volume Set, 2nd Edition Page of v Front Matter Dedication For Kim, Gretchen, Alex, and Eric, who continue to make it hard to be at work, because it is so fun being at home M.L.B To my wife, Sally, for unwavering support throughout my career, and acceptance of her role as muse for my creative efforts, both surgical and artistic; to my family, Erik and Mandy; and to my grandsons, Carson and Graham, who continue to provide an example of how to keep life in balance B.S.B To my parents, Philip and Esther, who allowed and encouraged me to pursue my dreams; to my wife, Gail, who keeps me focused and on track; to my children, Jeremy, Andrew, and Philip, for their energy and inspiration; and to my adorable grandchildren, Jack, Ryan, and Luke, for making it all worthwhile R.M.Z v vi EXECUTIVE EDITOR Sue Hodgson SENIOR PROJECT EDITING MANAGER Carolyn Reich SENIOR DEVELOPMENTAL EDITOR Megan Fennell DEVELOPMENTAL EDITOR Kathleen Sartori GRAPHICS MANAGER Brett Stone DIRECTOR OF ILLUSTRATION AND DESIGN Brenda Bunch ILLUSTRATORS Brenda Bunch, Christopher Smith, Jennifer N Gentry, Eric Olson, Morgan Noonan SENIOR MANAGING EDITOR Suzanne Wakefield PROJECT MANAGER Glenn Floyd MANUSCRIPT EDITORS Idelle Winer, Rebecca Sweeney, Glenn Floyd PRODUCTIONISTS Susan Trail, Debra Clark, Chris Lane Principles and Practice of Pediatric Plastic Surgery, Second Edition - Two Volume Set, 2nd Edition Page of PROOFREADER Linda Maulin INDEXER Matthew White Principles and Practice of Pediatric Plastic Surgery, Second Edition - Two Volume Set, 2nd Edition vi Page of 499 21 Secondary Deformities of the Cleft Lip and Nose Jeremy P Warner Bruce S Bauer Most cleft lip patients seen for revision have relatively minor deformities, because the principles described in Chapters 19 and 21 were followed for the primary repair, with attention to the critical landmarks and meticulous technique A cleft lip nasal deformity may be the most visible evidence of a prior cleft Busy cleft surgeons see patients whose lip repairs were carried out by less skilled surgeons and whose complications of healing and scar management have resulted in quite significant deformity Revisions range from minor realignment of landmarks with direct excision or Z-plasty to major revisions involving full-thickness layered repair or Abbé flap reconstruction This chapter presents a review of the more common minor revision procedures and a discussion of the principles of major lip revision The main focus is an in-depth discussion of the treatment of secondary deformities of the cleft lip nose We think that a thorough understanding of the nasal deformities seen and the procedures required to correct them best begins with a brief discussion of the primary deformities of unilateral and bilateral clefts Surgeons’ opinions vary regarding the appropriate degree of primary correction and how much of the deformity remains for secondary correction Most surgeons who routinely perform cleft lip repair agree that an uncorrected nasal deformity will belie even the best lip repair and invisible scar Excessive dissection in a primary nasal repair may affect long-term nasal growth Surgeons respect this to various degrees depending on their comfort level Therefore the spectrum of secondary nasal deformities varies from minor asymmetries to marked asymmetry, hypoplastic growth, and airway obstruction at skeletal maturity 499 500 SECONDARY LIP DEFORMITIES Isolated secondary lip deformities can develop in an otherwise well-performed lip repair and can be corrected by minor revisions When a primary repair was not performed optimally, these deformities may not be isolated and are better addressed by a major revision Lip shape, symmetry, movement, and associated nasal symmetry are dependent not only on alignment of the soft tissue landmarks, but also on the bony support beneath the lip and nose Proper release of the soft tissues during a repair may provide excellent symmetry even in the presence of underlying maxillary hypoplasia, but failure to fully release the lip and nasal structures can result in significant collapse of the soft tissue with increased deformity even when the lip has been well repaired otherwise Most lip revision procedures are relatively straightforward, whereas others defy simple explanation For these cases, surgeons need to “separate the parts” and occasionally rely on basic plastic surgical ingenuity to place them in the final symmetrical position (Fig 21-1) Principles and Practice of Pediatric Plastic Surgery, Second Edition - Two Volume Set, 2nd Edition Page of Fig 21-1 A, Relatively minor asymmetry with fullness of the vermilion and mucosa, symmetrical lip length and shape of the Cupid's bow, and drift of the alar base B, Symmetry of the lip and nose is overshadowed by the significant collapse of the alar base and heminose, which resulted from a pronounced deficiency of the underlying bone C, Although the nose is relatively symmetrical, the repair did little to align the lip landmarks or correct the underlying muscle What remains is similar to an occult cleft D, Initially, this appeared to be a slightly short cleft side with a displaced columella It was actually related to the whole lip being oriented off midline, with the columella vertically in line with the high point of the Cupid's bow E, In this case, the deformity of the lip and nose are from an atypical shift of the columella to overlie the normal peak of the Cupid's bow This may have happened secondary to early overresection in the nostril floor on the noncleft side The lip is elongated on the normal side to a greater degree than it is short on the cleft side F, This bilateral repair is similar to a lip adhesion, because it lacks a muscle repair and alignment of the vermilion-cutaneous or vermilion-mucosal junction to augment the central tubercle 500 Principles and Practice of Pediatric Plastic Surgery, Second Edition - Two Volume Set, 2nd Edition Page of ... Lane Principles and Practice of Pediatric Plastic Surgery, Second Edition - Two Volume Set, 2nd Edition Page of PROOFREADER Linda Maulin INDEXER Matthew White Principles and Practice of Pediatric. .. repair and alignment of the vermilion-cutaneous or vermilion-mucosal junction to augment the central tubercle 500 Principles and Practice of Pediatric Plastic Surgery, Second Edition - Two Volume Set, ... Principles and Practice of Pediatric Plastic Surgery, Second Edition - Two Volume Set, 2nd Edition vi Page of 499 21 Secondary Deformities of the Cleft Lip and Nose Jeremy P Warner Bruce S Bauer