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Oral Presentations to Address Developments in Facial Plastic and Reconstructive Surgery

A number of oral presentations regarding the latest developments in facial plastic and reconstructive surgery will take place from 10:30 am to 11:50 am today in West 208-209.

Oral presentations are five to eight minutes each, and part of a broader moderated session.

During his presentation, Randall Bly, MD, Seattle, will share findings during “Tension Pneumocephalus After Endoscopic Sinus Surgery: A Technical Report of Multiportal Endoscopic Skull Base Repair.”

Large skull base defects and cerebrospinal fluid leak repairs are traditionally performed through a transnasal endoscopic approach or an open craniotomy approach. While this is often successful, when the defect is adjacent to the crista galli, it can be difficult to seal the medial portions of the defect.

“Our objective is to report our experience using a novel multiportal (transnasal and transorbital) endoscopic technique to repair large, bilateral anterior cranial fossae defects using an intracranial ‘brain sling,’” Dr. Bly said.

Endoscopic transnasal and transorbital repair of large bilateral anterior cranial fossae skull base defects was performed using acellular radiated cadaver dermis and collagen matrix through a multiportal approach. The visualization and surgical access through transorbital portals permitted an intracranial extradural/intradural repair using a single, large section of reconstruction material.

It was introduced through a portal distant to the site of injury to avoid enlarging the region of damage, and fashioned so forces of gravity maintained its proper position. All leaks were repaired successfully with one surgical procedure, and there were no surgical complications in the cohort.

The ‘brain sling’ technique is applicable to the reconstruction of large skull base defects of any etiology and may be important for oncologic reconstruction,” Dr Bly said. “By using a multiportal approach, instrumentation could be performed without blocking the endoscopic view, and multiple viewing angles of the pathology could be used to improve the surgical efficacy.”

James P. Bonaparte, MD, MSc, FRCSC, Ottawa, Canada, will present “A Prospective Assessment of Biomechanical Changes in Skin after the Injection of Onabotulinum Toxin.”

“My presentation will be about the effect of onabotulinum toxin (Botox) on the elasticity of the skin,” Dr. Bonaparte said. “We assessed patients’ skin elasticity using a device called the Cutometer, which has the ability to assess many biomechanical skin properties. This research was based on the evidence that has been accumulating suggesting that botulinum toxin has an effect that appears to be more than muscle paralysis. This study demonstrated that after injecting the medication, patients’ skin showed a 20 percent increase in elasticity up to two months after injection.”

The session is for people who are interested in facial plastic surgery or the use of botulinum toxin. People who are interested in the basic science associated with botulinum toxin, particularly the effect of botulinum toxin on fibroblasts may also be interested.

“They should attend as it provides up-to-date, cutting-edge evidence suggesting that botulinum toxin has an effect that goes beyond its effect on neuromuscular tissue,” Dr. Bonaparte said.

He added that the presentation would provide attendees with the most up-to-date information.

“This is the first time this evidence has been investigated, so it is very timely,” he said.