1,720,990 research outputs found
Nonsurgical Rhinoplasty: Diamond Injection Technique for Nasal Tip Contouring
No full textBackground: A more pleasing nasal tip appearance is becoming the most frequent reason for nonsurgical aesthetic rhinoplasty procedures. Objective: To present the ‘‘Diamond Injection Technique,’’ an innovative 4-point hyaluronic acid (HA) filler injection procedure for nasal tip refinement and to assess its aesthetic outcomes and efficacy. Methods: Data were collected from a prospective single-center cohort of patients undergoing nonsurgical rhinoplasty with injectable fillers. Anthropometric measurements, the 5-point Global Aesthetic Improvement Scale (GAIS), and a patient-reported questionnaire were used to evaluate the aesthetic outcomes and treatment efficacy before treatment and 6 months later. Results: The study included 107 patients; 82 were women. The median age was 35 (18–47) years. The mean volume of HA filler injected was 0.12 mL (range: 0.05–0.2). At 6 months, the GAIS-calculated outcome was excellent in 90.65% of patients, with a high degree of patient satisfaction and objectively pleasant changes in anthropometric measurements. Conclusions: The ‘‘Diamond Injection Technique’’ proves to be a safe, comprehensive, and effective procedure for refining the nasal tip to a pleasing diamond shape, satisfying a high percentage of patients
Customized orbital implant versus 3D preformed titanium mesh for orbital fracture repair: A retrospective comparative analysis of orbital reconstruction accuracy
No full textThis study aimed to compare the accuracy of inferomedial orbital fracture restoration using customized orbital implant versus 3D preformed titanium mesh. Patients were divided into two groups. Group 1 underwent surgery with customized orbital implants and intraoperative navigation, while group 2 was treated using 3D preformed titanium meshes with preoperative virtual surgical planning (VSP) and intraoperative navigation. Reconstruction accuracy was assessed by: (1) comparing the postoperative reconstruction mesh position with the preoperative VSP; and (2) measuring the difference between the reconstructed and unaffected orbital volume. Pre- and postoperative diplopia and enophthalmos were also evaluated. Fifty-two patients were enrolled (25 in group 1 vs 27 in group 2). The mean difference between final plate position and ideal digital plan was 0.62 mm (SD = 0.235) in group 1 and 0.69 mm (SD = 0.246) in group 2, with no statistical difference between the groups (p = 0.282). The mean volume differences between the reconstructed and unaffected orbits were 0.95 ml and 1.02 ml in group 1 and group 2, respectively, with no significant difference between the groups (p = 0.860). Overall clinical improvements, as well as complications, were similar. 3D preformed titanium meshes can reconstruct inferomedial fractures with the same accuracy as customized implants. Therefore, in clinical practice, it is recommended to use 3D preformed meshes for this type of fracture due to their excellent results and the potential for reducing time and costs
Orbital Fractures: A New CT-Based Protocol to Guide the Surgical Approach and Reconstruction Material Decision-Making
No full textPreoperative computer-assisted planning and intraoperative navigation are becoming popular for orbital fracture treatment. However, not all institutions currently have access to these computer-aided applications. The authors present a simple and intuitive operative algorithm to guide orbital fracture reconstructions. The operative algorithm was based on linear measurements of orbital defects on high-resolution Computer tomography (CT) scans using specific axial, coronal, and sagittal plane images. The fractures were then divided into 3 types based on site and defect-size area. For each type, the authors suggested a surgical approach and material reconstruction. Between February 2022 and January 2023, 57 patients were treated according to the described CT-based protocol. The quality of reconstruction was classified as ideal, satisfactory, acceptable, and poor based on postoperative CT. Diplopia, enophthalmos, and postoperative complications were assessed. Fifty-seven patients were included. Forty-four (77.2%) patients were included in the type 1 group, 4 (7.01%) in the type 2 group, and 9 (15.79%) in the type 3 group. The reconstruction was considered ideal in 54 (94.7%) cases, satisfactory in 2 (3.5%), and acceptable in 1 (1.8%). No revision surgery was required. In all cases, preoperative diplopia was settled out, and only 1 patient reported postoperative enophthalmos. No complications occurred, with good clinical results and orbital symmetry. The linear CT measurement-based protocol is a simple and reliable workflow to guide the surgeon's choice of reconstruction material and surgical approach for primary orbital reconstruction. It allows good management of orbital trauma and could help standardize treatment decisions with an imaging technique available in all institutions
Buccal Fat Pad Flap in Orthognathic Surgery: Facial Soft Tissue Volume's Redistribution Strategy to Improve the Esthetic Outcomes
No full textTraditional osteotomic procedures can fail to restore the natural appearance of the face and can sometimes highlight the intrinsic decrease in the volume of soft tissues; in these cases, soft-tissue-improving procedures should be considered. The authors describe a new strategy that can help redistribute facial soft tissues and enhance facial esthetics in orthognathic surgery using a pedicled buccal fat flap to increase the volume of the malar soft tissue envelope. Between January 2017 and January 2021, 47 patients with dentoskeletal deformity who needed to increase the projection of the cheekbone contour underwent orthognathic surgery with simultaneous pedicled buccal fat pad flap for malar augmentation. Preoperative and postoperative facial appearance was evaluated by clinical examination and analysis of photographs to assess the occlusal and esthetic outcomes. A patient questionnaire was used to assess self-evaluation satisfaction scores. A good projection of the cheekbone contour was obtained, and noticeable postoperative facial esthetic improvement was observed in all patients. The overall esthetic improvement was considered "excellent" by 89.36% of patients, and facial esthetic improvement was assessed as "very much improved" or "much improved" by the clinicians in 95.7% of cases. The buccal fat pad flap is a promising and easy technique in orthognathic surgery that helps harmonize the malar region; improve esthetic outcomes with predictable and lasting long-term stability; and ensure very low morbidity and great esthetic satisfaction
Hand-dominance and fracture laterality in maxillofacial traumas: a retrospective study
No full textObjective: In maxillofacial trauma, injuries are known to predominantly affect the left side of the face. This study aimed to investigate the relationship between hand dominance and the laterality of craniofacial fractures. Methods: Clinical records of 513 patients with maxillofacial fractures from January 2019 to December 2022 were retrospectively analyzed. A total of 401 right-handed and 112 left-handed patients were evaluated. Accidental falls were the most common cause of injury (50.4%). In patients with fractures on the side opposite the hand dominat, accident falls (78%) and assaults (71%) were the leading causes. The average Facial Injury Severity Score (FISS) was 1.93. A statistically significant association between hand dominance and fracture laterality was found (p-value <0.01) with a phi coefficient of 0.566, indicating a moderate correlation. Conclusion: The results suggest that hand dominance may play a significant role in determining fracture laterality with 86.5% of patients sustained trauma on the side of their non-dominant hand
New Tunneled Buccal Fat Pad Flap for Palatal Reconstruction
No full textIn the palatal defects due to surgical resection, flap selection is very important for a correct reconstruction. Different methods have been suggested over the time, however the pedicled buccal fat pad is a simple, effective, reliable flap for reconstruction after palate tumor resection. The aim of the present study is to introduce a new surgical technique for palate reconstruction with pedicled buccal fat pad flap exposing the advantages. The Authors performed this procedure in 17 patients in order to treat medium-sized oncologic surgical defect of palate region in the period between 2016 and 2019. Complete wound healing after only 4 weeks without complication after 12 months follow-up was observed. This is the first cases series described with this new technique
Hypoglossal Nerve Palsy Misdiagnosed as Tongue Tumor: A Rare Case of Calcified Hypoglossal Schwannoma
No full textThe authors hereby present a case of a calcified schwannoma of the hypoglossal nerve, which led to hypoglossal nerve palsy initially misinterpreted as a tongue tumor. This paper reviews the presentation of schwannoma of the hypoglossal nerve and offers a novel perspective on this rare condition. Diagnostic pitfalls and the diagnostic-therapeutic value are also discussed
Metastasizing Pleomorphic Adenoma of Parotid Gland: A Case Report and Literature Review
No full textThe authors hereby present a case report of metastasizing pleomorphic adenoma (MPA) of the parotid gland with multiple metachronous cervical lymph node metastases and sternocleidomastoid muscle infiltration. Diagnostic evaluation, surgical management, and follow-up are discussed along with a brief review of the literature
Customized and Navigated Primary Orbital Fracture Reconstruction: Computerized Operation Neuronavigated Surgery Orbital Recent Trauma (CONSORT) Protocol
No full textCombined orbital medial wall and floor fractures and large isolated orbital floor fractures commonly require surgical treatment due to the high probability of diplopia and enophthal-mos. Primary reconstruction of these orbital fractures requires a high-level surgeon with a great amount of technical surgical skill. The use of novel technology can greatly improve the accuracy of reconstruction and achieve satisfactory clinical outcomes. Hence, the authors aimed to present our findings and overall experience with respect to extensive floor and medial wall orbital fracture reconstruction according to the Computerized Operation Neuronavigated Surgery Orbital Recent Trauma (CONSORT) protocol, a workflow designed for the primary reconstruction of orbital fractures with customized mesh and intraoperative navigation. A total of 25 consecutively presenting patients presenting with unilateral extensive orbital floor fractures and orbital floor and medial wall fractures were treated following the CONSORT workflow from January 2017 to March 2020. Fractures were surgically treated with a customized implant and intraoperative navigation. Patients underwent surgery within 14 days of the trauma injury. Preopera-tive and postoperative functional and aesthetic outcomes are described herein. All fractures were successfully reconstructed. Postoperatively, all 19 patients with preoperative diplopia reported the resolution of diplopia. Enophthalmos resolved in 18/20 cases. No patients had major complications during follow-up. Thus, the authors conclude that the CONSORT protocol introduced by the authors is an adaptable and reliable workflow for the early treatment of orbital fractures and can clearly optimize functional and aesthetic outcomes, reduce costs and intensive time commitments, and make customized and navigated surgery more available for institutions
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