Satisfactory surgical reconstruction of the external ear and nose is still a major challenge for the plastic surgeon. Therefore, the use of prosthesis in selected cases should be considered as viable alternative. During the period from December, 1995 to January, 1998, 10 patients, including 9 patients of ear defect and 1 patient of nose defect resulting from the resection of recurrent tumor ablation, were reconstructed by using osseointegration and prosthesis. The surgery was performed in two stages. All procedures were performed under local anesthesia and on an outpatient. At the first stage, the fixtures of titanium implant were placed in the mastoid process and maxilla. These implants were then left for 3 months before the second stage takes place, in which the skin penetrating abutments were attached. After 3-4 weeks, the impression of the defect area were taken and the silicone prosthesis was made by Anaplastologist. Two patients had focal infection but healed without problem. One patient had soft tissue infection, then flap was excised and skin graft performed. There was one loss from 20 fixtures, that was 3 years after implantation. We have concluded that osseointegration for reconstruction of the ear and nose defect is simple, soft, reliable method, which is more than autologous reconstruction and provides excellent aesthetic results.
Anesthesia, Local ; Ear ; Ear, External ; Focal Infection ; Humans ; Mastoid ; Maxilla ; Nose* ; Osseointegration* ; Outpatients ; Prostheses and Implants ; Silicones ; Skin ; Soft Tissue Infections ; Titanium ; Transplants

The present study was designed to evaluate the diagnostic efficacy and the clinical usefulness of quantitative analysis of interf erence pattern in differentiating the neuromuscular diseases. To obtain the normal control value, the automatic turns/amplitude analysis of interference pattern in biceps brachii and tibialis anterior muscle was done in 30 healthy normal subjects. The same procedure was performed in 16 patients with myopathy and 14 neuropathy to determine the diagnostic sensitivity of this method. Original pairs of turns/amplitude data obtained from controls converted into the logarithmic scale and linear regression equation, were calculated. Boundary of normal cloud was defined by the + 2 S. D. lines, maximum turn and amplitude. The result was considered abnormal if two or more turns/amplitude values were outside the zone normal cloud. The values of myopathic patients shifted toward the right lower quadrant meaning high turns and small amplitudes, but those of neuropathic patients shifted toward the left upper quadrant meaning few turns and large amplitudes. In all subjects of each patient group, at least two turns/amplitude values were outside the zone of normal cloud. In addition, the sequential changes of mean turns/amplitude ratio were well correlated with the disease activity. These results suggest that this method of automatic turns/amplitude analysis could be used not only as a supplementary diagnostic tool in differentiating the neuromuscular disorders, but also a parameter of monitoring the disease activity.
Humans ; Linear Models ; Muscular Diseases ; Neuromuscular Diseases*