A 32-year-old woman has near complete paralysis of the lower portion of the left side of the face 3 years after onset of Bell’s palsy. There has been no return of nerve function for the past year. Examination shows adequate function of the orbicularis oculi muscle and a good Bell’s reflex. Which of the following is the most appropriate management?
Neurotized free muscle transfer using innervation from cross-face grafts.
References:
Calcification of the ear occurs in all except:
Neurofibromata and keloids.
A 7-year-old has cryptotia. Which of the following operative techniques is most appropriate for correction?
Separation of the superior auricle from the temporal skin with placement of a retro-auricular skin graft.
With regards to tracheostomies:
A Bjork flap is an inferiorly-based U-shaped flap of anterior tracheal wall. Entering the trachea above the first cartilaginous ring would lead to vocal cord damage. The rings are below the cricoid cartilage. The parathyroids are not usually seen during the procedure, and there are blood vessels and the isthmus of the thyroid that cross the midline.
Concerning acute rejection in composite tissue transplantation, which one of the following statements is incorrect?
Topical immunosuppressives have no role in its treatment. This statement is incorrect. Acute rejection is mediated by T-lymphocytes. There is also a high correlation between the clinical and histopathological findings of acute rejection. Acute rejection in the early stages is characterised by perivascular infiltration of lymphocytes in the upper and mid dermis. Early diagnosis and immunosuppressive adjustment result in high reversibility of acute rejection episodes. Topical drugs (tacrolimus, steroids or both) in combination with systemic immunosuppressives have been used successfully in the treatment of acute rejection in previous composite tissue transplantations.