1,720,964 research outputs found
Parry-Romberg syndrome: Volumetric regeneration by structural fat grafting technique
No full textThe use of adipose tissue transfer for correction of maxillo-facial defects was reported for the first time at the end of the 19th century and has since been the subject of numerous studies. Structural Fat Grafting (SFG) differs from other fat grafting techniques in both the harvesting and placement of the fat. The main indications for SFG are for the restoration and rejuvenation of the face. Recent applications include the correction of localised tissue atrophy, loss of substance due to trauma, post-tumour, congenital complex craniofacial deformities, burns, and hemifacial atrophy. The authors describe a case of a 20-year-old woman with right Parry-Romberg syndrome (PRS) treated over many years with many different surgical reconstructive techniques with poor results. After five SFG (three complete procedures and two minor revisions) over three years, the authors obtained a good aesthetic result with complete patient satisfaction. SFG can be an excellent technique for facial reconstruction and re-contouring, with natural and long-lasting results. © 2010 European Association for Cranio-Maxillo-Facial Surgery
Frontal linear scleroderma: Long-term result in volumetric restoration of the fronto-orbital area by structural fat grafting
No full textFrontal linear scleroderma (also known as “en coup de sabre”) is a congenital deformity characterized by a linear band of atrophy and a furrow in the skin that occurs in the frontal or frontoparietal area. The authors present a case of a 34-year-old woman with history of en coup de sabre. In different steps, volumetric restoration of the fronto-orbital region has been obtained by structural fat grafting technique. After 3 reconstructive surgeries, morphologic, functional, and aesthetic long-term results have been obtained. © 2012 Lippincott Williams & Wilkins, Inc
Contouring of the forehead irregularities (washboard effect) with bone biomaterial
No full textCalvarial vault defects may be repaired with autologous bone or alloplastic materials, such as methyl methacrylate, hydroxyapatite, titanium, or porous polyethylene. The criterion standard for repairing small cranial defects is autogenous bone from iliac crest or split calvarial grafts. However, autogenous grafts may result in donor-site morbidity, increased operative time, reabsorption, blood loss, and additional time for recovery. An alloplastic material should have some ideal properties, including easy adaptation, biocompatibility, which permit ingrowth of new tissue, stability of shape, and low rate of reabsorption. An implant in this area should be easily shaped and positioned, allowing an easy tissue in growth.The authors report the case of a 50-year-old man with a deformity of the frontal region as a result of a frontonaso-orbitoethmoidal fracture after reduction and fixation of the fractures and right frontal sinus cranialization with frontal craniotomy via coronal approach. The deformity caused the typical aspect (washboard effect). Correction and reconstruction were performed by using Cerament (Bonesupport AB, Lund, Sweden), alloplastic biphasic material, composed of 60% α-hemihydrate of calcium sulfate and 40% hydroxyapatite. Four years after the surgery, the patient had recovered with satisfactory morphology of the forehead as well as disappearance of the frowning look in the frontal region. Copyright © 2012 by Mutaz B. Habal, MD
Craniofacial surgical strategies for the correction of pneumosinus dilatans frontalis
No full textIntroduction: Pneumosinus dilatans is a rare condition and different techniques have been proposed for its management and correction. The abnormally expanded, aerated frontal sinus has been described in the literature as: frontal sinus hypertrophy, pneumosinus dilatans, pneumosinus frontalis, aerocele, pneumocele, sinus ectasia, hyperpneumatization and others. The precise aetiology and pathogenesis of the condition is unknown, although several basic hypotheses have been proposed Material and methods: The authors report two cases of frontal bossing and supraorbital ridge deformity correction using craniofacial surgical principles. Discussion: Functional and morphological results are discussed and compared with other open procedures. Conclusion: A variety of surgical procedures have been proposed for the correction of the pneumosinus dilatans frontalis. The craniofacial approach is advocated to reproduce the normal anatomy of the forehead in the upper part, the supraorbital rim and glabellar area. © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved
Piezosurgery: A new and safe technique for distraction osteogenesis in Pierre Robin sequence review of the literature and case report
No full textIntroduction Pierre Robin sequence (PRS) is characterized by microgenia and retrognathia. Cleft palate and glossoptosis are frequently associated with airway obstruction and difficulty in swallowing. Distraction osteogenesis with micro-distractors has recently been considered as a surgical option during the neonatal age. Case presentation A 6-week-old female with PRS underwent mandibular lengthening in neonatal age. Mandibular osteotomies were performed with the piezoelectric scalpel. Discussion Piezosurgery represents an innovative technique as it offers the maxillofacial surgeon the opportunity to make precise bone cuts without damaging the soft tissue, minimizing the invasiveness of the surgical procedure, and the opportunity of working in a field which is almost totally blood free. Conclusion The use of a piezoelectric device to perform this kind of surgery provides clinical and surgical results which would be difficult with traditional instruments, not only for the patient's benefit but also for the surgeon's. Preservation of the original bony structure, especially of the cancellous bone, will benefit the bone healing process due to its high estrogenic potential
Temporomandibular Joint Ankylosis after Early Mandibular Distraction Osteogenesis: A New Syndrome?
No full textDistraction osteogenesis (DO) has been one of the most innovative concepts in cranio-maxillofacial syndromology and surgery over the last 25 years. Early mandibular distraction in severe micrognathia has recently been recognized as an effective treatment option to safely relieve upper airway obstruction associated with mandibular deficiency. An increased incidence in temporomandibular joint complications during DO in neonates has recently been reported, especially in syndromic patients. The authors report 2 children affected by severe micrognathia and severe respiratory distress at birth. Early DO was performed during the first 2 months of the life in another institution with the aim of increasing mandibular length and upper airway size. Both the patients had severe restricted jaw opening after DO and mandibular abnormalities. Temporomandibular joint ankylosis after early mandibular distraction could be a considered a new pathological entity
Endocrine orbitopathy (Basedow-Graves' disease): Deformity after bony decompression according to Matton. Tissue regeneration with lipostructure
No full textEndocrine Ophthalmopathy (EO) also known as Graves' Disease is a chronic, multisystem disorder characterized by increased intraorbital fat tissue and hypertrophic extraocular muscles caused by an autoimmune process. EO may be associated with the following main clinical findings: diplopia, exophthalmos, conjunctivitis, photophobia, chemosis, lagophthalmos, tearing, keratitis, upper and lower eyelid retraction, corneal ulceration resulting from the inability to close the eyelid, headache, retrobulbar pain, glaucoma and optic neuropathy caused by the increased intraorbital pressure. Different surgical techniques can be used: transpalpebral decompression by intraorbital fat removal (Olivari 's technique), three-wall bony decompression and in severe cases the complete removal of the lateral wall of the orbit (bony decompression according Matton). The aim of surgery is to reduce endo-orbital pressure and its consequences and clinical symptoms. The authors report a case of a patient with EO treated with bilateral transpalpebral decompression by intraorbital fat removal (Olivari's technique), bilateral three-wall bony decompression and at a secondary stage, left lateral orbital wall decompression according Matton. Matton decompression contour deformity of the left lateral orbital region was reconstructed with Lipostructure according to Coleman
Endocrine orbitopathy (graves disease): Transpalpebral fat decompression in combination with 3-wall bony expansion
No full textEndocrine orbitopathy (EO) is a chronic, multisystem autoimmune disorder caused by lymphocyte infiltration, edema, and proliferation of endo-orbital connective tissue. These conditions involve the extraocular muscles, intraconal and extraconal fat, and, to a lesser extent, the lacrimal gland.Endocrine orbitopathy may be associated with toxic diffuse goiter and/or pretibial myxedema (Graves disease) and may appear without alterations in thyroid function (euthyroidism). It is characterized by antibodies that stimulate a general fibroblastic reaction (thyroid gland and lower extremities) and involves orbital fat tissue and muscles. The clinical signs and symptoms of EO reflect the mechanical consequences of increased orbital tissue volume and pressure within the orbit. Endocrine orbitopathy is marked by chronic evolution and, at times, a malignant outcome. © 2010 by Mutaz B. Habal, MD
Treatment of exophthalmos and strabismus surgery in thyroid-associated orbitopathy.
No full textEndocrine orbitopathy (EO) can have important consequences, such as exophthalmos and restrictive strabismus. A retrospective study was performed of 35 patients with EO who underwent orbital decompression surgery and restrictive strabismus correction. Two surgical techniques for orbital decompression were analyzed: fat decompression by Olivari technique and three-wall bony expansion with fat decompression. Strabismus surgery was performed using adjustable or non-adjustable sutures under topical anaesthesia. Patients were divided into two groups according to the type of intra-orbital decompression performed, and the postoperative values resulting from the different fat decompression techniques were recorded. The preoperative and postoperative mean degrees of exophthalmos were 22.3 and 19.9mm, respectively, for the fat decompression group, and 24.3 and 19.8mm, respectively, for the bony expansion with transpalpebral fat decompression (combined form) group. The difference in residual prism dioptres between adjustable and non-adjustable suture techniques in patients who had previously undergone combined decompression was statistically significant. The management of patients with EO requires a multidisciplinary approach based on the collaboration of maxillofacial surgeons, ophthalmologists, and orthoptists. These results will allow the development of a more adequate strategy for the surgical treatment of restrictive strabismus in EO patients
Endoscopy in the removal of frontal osteomas
No full textOsteomas are benign bone lesions, characterized by bony excrescences, usually arising in membranous bones. They appear to be well circumscribed, localized, sessile, or pedunculated. Their origin is clearly not neoplastic, but traumatic. A 3:1 female to male ratio has been noted; most osteomas appear as a painless, slowly enlarging, hard lump, and, quite often, patients seek a solution for cosmesis only. Osteomas have a predilection for young adults, most commonly from the second to fifth decade, so patients have a keen interest in getting a good cosmetic result. They can be completely excised by way of a direct incision of the lesion, but this inevitably leaves a scar. Aesthetic considerations are important features in the craniomaxillofacial region. Especially for patients who are not willing to accept the risk of a prominent forehead scar. Endoscopic excision is minimally invasive and contributes to an improved aesthetic appearance. The advantages of forehead endoscopy are multiple: reduces postoperative pain, shortens hospital stays, and diminishes periods of disability. Our purpose is to describe the clinical experience with the removal of forehead masses in five patients
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