1,720,970 research outputs found
Total facial rehabilitation: The evolving concept of reconstructive surgery
No full textTotal facial rehabilitation requires an understanding of the contributing components of the so-called aging face syndrome. This syndrome may be due to atrophy of the jaws or may result from ablative surgery for cancer. The aging face requires correction of every anatomic component (i.e., facial skeleton, dentoalveolar processes, and soft tissue). The surgical armamentarium includes maxillofacial osteotomies, autogenous bone grafts, biomaterials, internal rigid fixation, and other ancillary procedures. The introduction of osseointegrated implants has allowed the surgeon to use a stable base on which a prosthesis can be built with functional and aesthetic long-lasting results. Last, but not least, repositioning of the facial mask is the "final touch" for these complex reconstructive procedures. The concept of total facial rehabilitation may be considered an evolution of reconstructive surgery. Surgical strategies, new technologies, as well as clinical cases will be presented
Dismantling and reassembling of the facial skeleton in tumor surgery of the craniomaxillofacial area. History, surgical anatomy, and notes of surgical technique: Part 1
No full textIn recent years, access osteotomies have been suggested to reach areas of the craniofacial skeleton that hitherto would not have been easily resectable. Some techniques of disassembling of the facial skeleton have been described in the past. In some cases, however, when the bony fragments were not pedicled to the soft tissue, reabsorption was noted. For this reason, new dismantling techniques with adequate blood supply to the bony fragments have been developed. Apart from the maxillo cheek flap, other composite flaps have been described. These flaps may be combined if necessary in selected cases. An overview of the surgical anatomy and surgical strategies will be presented. These reported techniques may be considered a major step forward in the treatment of deeply localized tumors in the craniomaxillofacial area
The use of the temporalis muscle flap in facial and craniofacial reconstructive surgery. A review of 182 cases
No full textThe authors report on their 16-year experience of reconstruction with the temporalis myofascial flap in 182 cases. All aspects of reconstructive cranio-maxillofacial surgery are covered: trauma, deformities, tumours, TMJ ankylosis, facial paralysis. The temporalis myofascial flap was used both as a single and as a composite flap with cranial bone, coronoid process or skin island. Major complications were not observed. On the basis of their experience, the authors confirm the reliability, versatility and reproducibility of the use of this flap. This is due both to its rich blood supply and to its proximity to the reconstruction site. It is suggested that the use of the temporalis muscle flap should be taken into consideration before deciding on more extensive reconstructive procedures
Use of the microsystem in craniomaxillofacial surgery: Preliminary report
No full textThe last few years have been astonishing technological advances in craniomaxillofacial surgery, with particular regard to the introduction of internal rigid fixation. This technique has allowed craniomaxillofacial surgeons to achieve more precise preoperative planning and use of modern techniques of fixation during surgery. As a result, rigid internal fixation has become popular and currently represents a keystone in maxillofacial surgery for trauma, deformities, orthognathic surgery, as well as reconstruction procedures following tumor resection. We review a 2-year experience with the use of microsystem in 45 patients
Cranio-facial resections
No full textFour basic steps should be considered in craniofacial tumor surgery: dismantling and re-assembling of preservable bone structures to reach the tumor; en bloc resection of the "box" in malignancies (i.e., the unaffected boundaries surrounding and including the tumor), internal rigid fixation and, reconstruction by using whenever possible regional structures. In benign tumors and so-called pseudotumors, the treatment is total removal and immediate reconstruction of all structures, including the bone. The primary goal of craniofacial surgery for malignancies is to create an entrance to the box that is to be resected. This necessitates the dismantling and reassembly of some uninvolved skeletal structures. Among these are the nose, the maxilla, the nose and maxilla en bloc, the nose and the maxilla bilaterally to the mandible. The introduction of internal rigid fixation by using plates and screws has facilitated the realignment of the pedicled bone fragments in a correct position. After cranial base resection, the communication between neuro- and splanchno-cranium must be closed with viable flaps. Many techniques have been described. The horizontal forehead flap is certainly effective but results in a significant secondary defect. Where there is an orbital resection en bloc with the cranial base, the temporalis muscle flap is effective in providing vascularized coverage and simultaneously obliterating the orbital cavity. The galeal frontal flap is versatile and easy to use. It has been used to cover anterior and lateral defects with good results. The orbit is another area that requires immediate reconstruction so that there is no resulting external defect. The temporalis muscle flap, with or without a skin island, can be used to repair it. Distant flaps can likewise be used. If the resection includes the maxilla, reconstruction of the defect can be performed immediately, or it can be delayed. The authors prefer to use the temporalis muscle flap if it has not already been used. On the basis of 10 years of experience in craniofacial surgery the following conclusions can be drawn: 1. Craniofacial surgery is not a single concept. Therefore, the surgeon who deals with facial tumors involving the cranial base must have expertise in the entire field. Oncology must be part of his basic biological education. 2. Complications functional and aesthetic consequences are minimal if some basic principles are applied, both in the resection and the primary reconstructive phase. 3. In the past few years, surgical techniques have been modified and improved considerably, resulting in an operation that combines an excellent approach, oncological resection, low postoperative morbidity, good aesthetic results and improved prognosis
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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