Surgical Roundtable Clinics

and function. Techniques of open rhinoplasty are in- References eluded in the presentation.

Patients needing soft and hard tissue reconstructive procedures will benefit from well planned surgical inter- vention which will maximize the cosmetic result. Second- ary techniques, such as dermabrasion and scar revision, will provide improved cosmesis.

Cases will be discussed providing representative treat- ment modalities to improve overall results. Techniques such as open rhinoplasty, scar revision, and dermabra- sion will be detailed to offer the surgeon adjunctive esthetic modalities for orthognathic and reconstructive surgical candidates.

References

Thomas, J.R., Holt, G.R.: Facial scars: incision, revision, and camouflage. St. Louis, MO, Mosby, 1989

McCollough, E.G., Langsdon, P.R.: Dermabrasion and Chemical Peel: Theme Medical Publishers, 1988

Rhinoplasty. Otolatyngol Clin North Am 28(4), 1987

SRC 120 Reconstructive Preprosthetic Surgery Bill C. Terry, DDS, Chapel Hill, NC

More than 24 years of reconstructive preprosthetic surgical experience has led to the following firm convic- tions:

1. Corrective procedures must be based on individ- ual patient needs and exact diagnostic criteria.

2. Basic surgical principles must be followed. 3. Results are predictable within identifiable ranges. 4. Communication, coordination and cooperation

between the patient, surgeon and clinician respon- sible for the prosthetic rehabiliation are impera-

Macintosh, R., Obwegeser, H.: Preprosthetic surgery: A scheme for its effective employment. J Oral Surg 25, September 1967

Hopkins, R.: A Colour Atlas of Preprosthetic Oral Surgery. London, Wolf Medical Publications Ltd, 1987

Harle, F.: Atlas der Praprothetischen Operationen. Munich, Carl Hanser Verlag, 1989

SRC 121 Open TMI Surgery and Rehabibtim of Joint Function Robert V. Walker, DDS, Dallas, TX

Open surgery of the TMJ has become safe and predictable when the principles of effective surgery for any joint are followed. Most TMJ surgery is related to management of intra-articular changes linked to dysfunc- tion caused by mechanical interference of the disc and/or the subsequent alteration of the joint to degrada- tion called osteoarthritis. Importantly, the changes of mandibular symmetry caused by long-term jaw hypomo- bility (via ankylosis) in the young, condylar dysplasias, and tumors require careful planning, reconstruction, and rehabilitation to assure satisfactory results for patients. All conditions will be discussed and well illustrated through a number of case reports representa- tive of the problems associated with TMI surgery.

References

Merrill, R.G. (ed): Disorders of the TMJ II: Arthrotomy. Oral Maxillofac Surg Chn North Am December 1989

Poswillo, D.E.: Surgery of the temporomandibular joint. Oral Sciences Reviews 6:87-118,1974b

Walker, R.V.: Silastic implant as a part of temporomandibular joint arthroplasty. Evaluation of its efficacy. Br J Oral Maxillofac Surg 25227~236,1987

SRC 122 tive.

5. Long term followup and careful observations are Primary Rhinoplusties

essential for optimal patient care and scientific Brent D. Kennedy, DDS, MD, Murray, UT

progress. Obwegeser was the first clinician who insisted that the

selected preprosthetic surgical procedures must be based on specific diagnostic criteria and when properly accom- plished would provide predictable results. This SRC will stress that philosophy and include innovations in vestib- uloplasty and augmentation procedures that can be applied to both implant and non-implant patients being rehabilitated with removable prostheses. Every effort will be made to provide practical, clearly illustrated information that can be utilized by the practicing sur- geon.

A step by step method of performing rhinoplasty is presented. Patient selection for primary rhinoplasty and local anesthesia of the nose are discussed. A systematic method of esthetic nasal evaluation is integrated into formulation of surgical goals and surgical treatment plans. The effect of the basic rhinoplastic manuevers are discussed in terms of changes in nasal morphology and function. Surgery of the nasal septum will be included in a discussion of nasal obstruction and contributions of the nasal septum in the outcome of primary esthetic rhinoplasty. Post-operative management and care is briefly covered. Illustrative cases of primary and revi-

18 MOM8 . 1991