Repair of Tessier 7 Cleft Lip Deformity

The most common of the rare craniofacial clefts, Tessier’s No. 7 cleft is represented by a deficiency of tissue that may span from the oral commissure to the ear. (1)  The repair of the cleft of the lip must include especial attention to restoring continuity of the orbicularis oris muscle as well the vermillion.  This case is presented as an example of the repair of the Tessier 7 cleft lip deformity.

DOI #: http://dx.doi.org/10.17797/4h2edlts5zz

ND:YAG Laser Therapy of Tongue Venous Malformation

This is a visual representation of the treatment of a venous malformation within the substance of the tongue. The laser directly treats the venous malformation via selective photothermolysis while preventing injury to the tongue itself. Venous malformations infiltrate normal tissue as a birthmark but continue to grow with time and show no evidence of regression. Instead of excising the venous malformation with some of the tongue itself this is a way of controlling the lesion. As seen, the ND:YAG laser set at 25 Watts and 1.0 sec duration is used to shrink the venous malformation. The laser is fired in a polkadot fashion in order to prevent mucosal sloughing. The surface is relatively protected as the laser selective penetrates the VM.

DOI: http://dx.doi.org/10.17797/938qzyj3uh

Tonsillectomy Using Electrocautery

Contributors: Conor Smith (Arkansas Children’s Hospital)  and Gresham Richter M.d. (Arkansas Children’s Hospital)

The removal of tonsils is most often indicated by tonsillar hypertrophy contributing to obstructive sleep apnea or chronic/recurring throat infections from pathogens such as streptococcal bacteria. Electrocautery is the most commonly used technique to safely and effectively excavate the tonsils.

DOI: http://dx.doi.org/10.17797/cb233d20mk

Temporal (Gillies) Approach to a Zygomatic Arch Fracture

This video documents the steps typically followed during open reduction of isolated, depressed zygomatic arch fractures.  The patient’s hair was shaven for clarity and for proper marking of key anatomic landmarks. Such landmarks are shown and discussed in sequence with the key surgical steps.

Marcus Couey, DDS, MD; Eric Reimer, DDS; Andrew Bhagyam, DDS; Phillip Freeman, DDS, MD; Jose M Marchena, DMD, MD

The University of Texas Health Science Center at Houston, School of Dentistry, Department of Oral & Maxillofacial Surgery

Submental Intubation

Presented is a case of submental intubation performed prior to maxillomandibular advancement for the treatment of obstructive sleep apnea. Submental intubation is a viable alternative to tracheostomy for cases in which nasal intubation is contraindicated (e.g. trauma), or uninterrupted access to the oral cavity is preferred. [1] Briefly, the technique consists of performing oral intubation, and then exteriorizing the endotracheal tube through a tract created from the floor of mouth to the submental triangle. At the end of the case, the tube can be passed into the oral cavity, returning to an oral intubation.

Surgeon: Raj C. Dedhia, MD, MSCR, Department of Otolaryngology, Emory University School of Medicine

Video Production: Clara Lee, MS4, Emory University School of Medicine

Retroseptal Transconjunctival Approach to Orbital Floor Blowout Fracture

The transconjunctival approach was first described by Bourquet in 1924 and then modified by Tessier in 1973 for exposure of the orbital floor and maxilla for the treatment of facial trauma.

This approach can be carried out either in a preseptal plane by separating the orbital septum from within the eyelid (preseptal approach) or posterior to the septum and eyelid (retroseptal approach) by making an incision through the bulbar conjunctiva directly above the orbital rim.

The main advantage of the retroseptal approach is that it does not involve dissection and disruption of the eyelid itself, therefore, reducing the incidence of post-operative lid laxity and position abnormalities.

This video will show a retroseptal approach to an orbital floor blowout fracture. A lateral inferior cantholysis is performed to facilitate eversion and retraction of the lower eyelid.

How to Perform Salivary Gland Massage: Instructional Video

Title: How to perform a salivary gland massage – an instructional video

Delaney Sheehan, MS; David Thompson, MS; Brittany Foret, MS; Michael Olejniczak, MS; Rohan R. Walvekar, MD*

*Corresponding and Senior Author

MS – Medical Student

Louisiana State University Health Sciences Center, Department of Otolaryngology Head & Neck Surgery, New Orleans, LA 70112

Introduction: Education is a vital component to patient compliance. Salivary gland conditions like sialadenitis, dry mouth and postoperative protocols for sialendoscopy procedures among other procedures on the salivary glands often require a protocol of salivary gland massage; which forms a vital part of salivary gland hygiene i.e. salivary gland massage, hydration and sialogogues. In our search, we did not find a specific educational video demonstrating salivary gland massage. Funding: No external funding. Methods: The Ear Nose and Throat Interest Group at Louisiana State University Health Sciences Center in New Orleans under the supervision of senior author compiled the patient education and instructional video. Summary: Educational video on salivary gland massage is a way to disseminate a resource that can be easily accessed by patients and can be helpful in standardizing technique and also compliance.

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