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The purpose of this article is twofold: (1) to investigate the histomorphology of cartilaginous proliferation using three different otoplasty techniques and (2) to determine whether recurrence is related either to the method of otoplasty or the duration of suture fixation. Eighteen 6-week-old New Zealand white rabbits were divided into three equal groups. In each animal, a skin pocket was developed on the posterior surface of both ears; the perichondrium of the left ear was stripped off, whereas the perichondrium of the right ear was left undisturbed. Otoplasties were performed by inserting permanent mattress sutures with (Converse-Wood-Smith) or without (Mustardé) cartilaginous incisions or by scoring of the anterior cartilaginous surface of the antihelix (Stenstrom). In each group, sutures were cut at 1, 2, 4, and 6 weeks and the animals killed 1 week later. Histomorphometric analysis was performed. Perichondrial stripping stimulated cartilaginous proliferation in all groups. The antihelical fold maintained its shape best in group 3, in which the anterior perichondrium was rasped; a fibrocartilaginous cap formed over the rasped convex surface of the antihelical fold, reinforcing and stabilizing the newly created fold. Groups 1 and 2, in contrast, demonstrated significantly less anterior cartilaginous proliferation than did group 3, and cap formation was not observed. No significant differences were apparent between groups 1 and 2 in either the quantity or quality of cartilaginous proliferation in any of the time periods. Cutting the sutures at 1 week resulted in loss of shape or "flattening" of the fold in all groups; however, increased cartilaginous proliferation between 2 and 6 weeks stabilized the fold, minimizing deformability.(ABSTRACT TRUNCATED AT 250 WORDS)

It is widely held that neonates are obligatory nasal breathers. Although cleft lip repair may compromise the nasal airway, respiratory distress following such a procedure is rarely reported. A review of the literature reveals that only a minority of neonates are obligatory nasal breathers. When the nasal airway is compromised in these patients, however, respiratory distress may result. Two patients with this complication are presented, and their successful treatment with a nasopharyngeal airway is described.

This review emphasizes two of the difficult problems associated with electrical injury to the hand and forearm. Early wound closure to preserve important vascular, nerve, and tendon structures in the hand must be considered, recognizing the tendency for continued necrosis of tissue in this type of injury. Tissue fibrosis, even in areas of the hand not grossly injured, may develop, progressively compromising function. Five patients are presented to illustrate the early care and rehabilitation of these patients.