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Outcomes and complications of supramaximal levator resection

This is a report of 35 children with unilateral congenital ptosis who underwent a supramaximal levator resection, involving extensive dissection of levator including cutting Whitnall’s ligament. The average preoperative margin reflex distance to the upper lid (MRD1) was 0.5mm, and...

Topical phenytoin effect on pressure ulcers healing: A literature review of the evidence

A pressure ulcer (PU) is a localised injury to the skin and / or underlying tissue usually over a bony prominence, because of pressure, or pressure in combination with shear (EPUAP/ NPUAP 2009/PPPPIA 2014). Bennett et al. [1] claimed total...

Letter from Hong Kong (13 April 2020)

Now is not the time to start spreading blame. There will be time for that later. At the same time, now, is the time to recognise the great courage required in true leadership.

Gross Negligence Manslaughter in Healthcare: The medico-legal dilemma (part 17) – A mystery

There are things that we just do not know because it is now too late to find out: what were the oxygen saturation levels, for example? But there are other things we do not know although they are known. Where did Dr Kwan go when she left the operating room?

Bone grafting in orthognathic surgery

This is a systematic review from Belgium and Saudi Arabia of 48 articles. They reviewed the complication, stability, aesthetics and healing of Le Fort I, sagittal split, chin and zygomatic osteotomies. They concluded that there was strong evidence that bone...

When to treat a fractured mandible?

This is a prospective study from Brisbane of 215 patients with a total of 359 fractures of the mandible. Nine outcome variables were analysed with a further 19 included to adjust for potential confounding. Treatment delay was found not to...

The double-half bilobed flap or traditional bilobed flap – which is better?

Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various sub-units to achieve best results. The traditional superiorly based...

Otologic concerns for cleft lip and palate

The management of patients with cleft lip and palate includes a focus on effective speech and language function. Poor eustachian tube function and middle ear dysfunction mean over 90% of children suffer from otitis media with effusion. This article provides...

Extranodal NK/T cell lymphoma in the head and neck

The authors present a retrospective single institution review of patients with a very rare variant of non-Hodgkin lymphomas (NHL). They report on the occurrence, clinical course and outcomes of their patients with natural killer/T-cell lymphoma (NKTCL) nasal type. Sixty-three patients...

Vascularised composite allotransplantation: an update

Vascularised composite allotransplantation (VCA) includes transplantation of multiple tissues in a single vascularised unit, such as the upper limb, or most dramatically the face. Truly remarkable results have been achieved, such as the one illustrated in this article. More than...

Complications of otoplasty

Otoplasty has a long history. Currently, two schools of thought predominate, which can be summarised as cartilage cutting and cartilage sparing techniques. The former includes removal of cartilage and the scoring of cartilage, whereas the latter involves contouring by placement...

How I Do It - Lip augmentation: a multi-product approach

Dr Beatriz Molina shares her technique for lip enhancement using a multi-product approach in both younger and more mature patients. Lips are an important feature of the face which can be treated with non-surgical interventions. Millenials are looking for lip...