1,721,021 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
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
Peripheral ameloblastoma: case report
No full textAmeloblastoma is a benign tumour of the odontogenic tissues which may be aggressive in the involved area with a high rate of recurrence if not adequately removed, and represents 1% of all tumours of the mouth, generally appearing in the bones of the jaw. Although it is fairly rare, tumours with such histopathology have been described in the soft tissue and are named peripheral or extraosseus ameloblastoma. Potential cells of origin are ondontogenic residue of the dental lamina, pluripotent cells in the basal layer of the epithelial mucosa, and pluripotent cells of the minor salivary glands. Seven cases of extraosseus ameloblastoma in the extragengival area, unrelated to dental germs, have been described, six of which in the buccal mucosa and one in the mouth floor. We report a case of extraossous, extragengival ameloblastoma which originated in the subzygomatic area
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
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
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
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
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
Vertigo and balance disorders - The role of osteopathic manipulative treatment: A systematic review
No full textBackground: Balance disorders are among the most frequent reasons for consultation and referral to specialist care. Osteopathic Manipulative Treatment (OMT) can influence the proprioceptive system by inducing alterations in the proprioceptive stimuli, hence affecting postural control. Objective: The present systematic review aimed to explore the effects of OMT in managing patients with vertigo and balance disorders. Methods: MEDLINE (PubMed), ScienceDirect, and Google Scholar were searched. Clinical trials and prospective observational studies were considered. Only studies that considered OMT as the main intervention, provided alone or combined with other interventions, were included. The methodological quality of the evidence was assessed with a modified version of the Newcastle-Ottawa Scale. Results: Five studies that enrolled a total of 114 subjects met our inclusion criteria. Overall, it has been observed that there is a positive effect on balance disorders through different outcomes in all of the included studies. Only two studies (9 subjects) mentioned low to moderate adverse events after OMT. Conclusions: OMT showed weak positive effects on balance function, encouraging the connection of conventional medicine and evidence-based complementary medicine for integrative clinical practice and interprofessional work. However, full-sized adequately powered randomized trials are required to determine the effectiveness of OMT for vertigo and balance disorders
Endoscopy in the removal of frontal osteomas [L'endoscopia nell'asportazione di osteomi frontali]
No full textOsteomas are benign bone lesions, characterized by bone escrescences, usually arising in membranous bones. They appear to be well circumscribed, localized, sessile or peduncolated. 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 decadee, so patients have a keen interst 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. Expecially for patients who are not willing tgo 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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