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Monique Vanaman Wilson, Sabrina Guillen Fabi, Ryan Greene
Importance: The pivotal approval trial for a smooth, highly cohesive, viscous, 20-mg/mL hyaluronic acid filler demonstrated sustained aesthetic improvement, with a mean injection volume of 6.65 mL. In daily practice, however, it is not often practical or necessary to use large injection volumes to achieve the desired cosmetic outcome. Objective: To assess the efficacy, longevity, and patient satisfaction associated with correction of age-related midface volume loss using the low volumes of hyaluronic acid filler more commonly used in day-to-day practice...
October 20, 2016: JAMA Facial Plastic Surgery
Herman Vercruysse, Luc Van Nassauw, Joan San Miguel-Moragas, Eva Lakiere, Sten Stevens, Geert Van Hemelen, Mirco Raffaini, Nasser Nadjmi
INTRODUCTION: Postoperative flattening of the upper lip with loss of lip pout and down turning of the corners of the mouth is often seen after Le Fort I surgery. We aim to determine which facial muscles are involved in this phenomenon to update the literature on this subject. METHODS: In 6 cadavers, a unilateral Le Fort I incision was executed. After removal of the skin, all individual facial muscles were identified and submitted to bilateral tactile traction, comparing incised sides with non-incised sides...
September 22, 2016: Journal of Cranio-maxillo-facial Surgery
Shao-Rui Liu, Xue-Fei Song, Zheng-Kang Li, Qin Shen, Xian-Qun Fan
OBJECTIVE: With orbital floor fracture incidence rates increasing year by year, many patients require surgical treatment to improve diplopia, limitation of extraocular muscle movement (EOM), enophthalmos, and midface appearance. With the use of high-density polyethylene, titanium screws, titanium plate, and titanium mesh to repair an orbital floor fracture, enophthalmos and midfacial deformity correction procedures have made great progress. However, attenuating diplopia and the limitation of EOM are still difficult problems to prevent...
October 14, 2016: Journal of Craniofacial Surgery
Christopher M Runyan, Vishal Sharma, David A Staffenberg, Jamie P Levine, Lawrence E Brecht, Leonard H Wexler, David L Hirsch
BACKGROUND: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction. METHODS: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality...
October 14, 2016: Journal of Craniofacial Surgery
Juliana Dreyer da Silva de Menezes, Lucas Borin Moura, Renato Parsekian Martins, Eduardo Hochuli-Vieira
Porous polyethylene implants have been used as an alternative in the treatment of patients with zygomatic and paranasal projections deficiency. These implants promote a facial rejuvenating effect due to the attenuation of the nasal and chin prominences. The advantages of porous polyethylene include biocompatibility, dimensional stability, easy adaptation and fixation, low complication rate, and its availability in different sizes and shapes. A 27-year-old woman presenting vertical deficiency associated with midface hypoplasia was treated with orthognathic surgery...
October 14, 2016: Journal of Craniofacial Surgery
Ashraf Raslan, Gerd Fabian Volk, Martin Möller, Vincent Stark, Nikolas Eckhardt, Orlando Guntinas-Lichius
OBJECTIVES/HYPOTHESIS: To examine by intraoperative electric stimulation which peripheral facial nerve (FN) branches are functionally connected to which facial muscle functions. STUDY DESIGN: Single-center prospective clinical study. METHODS: Seven patients whose peripheral FN branching was exposed during parotidectomy under FN monitoring received a systematic electrostimulation of each branch starting with 0.1 mA and stepwise increase to 2 mA with a frequency of 3 Hz...
October 18, 2016: Laryngoscope
Simone Schulz, Bernd Koos, Kathrin Duske, Franka Stahl
OBJECTIVES: The purpose of this work was to employ both cephalometric and tensor analysis in characterizing the skeletal changes experienced by patients with Angle Class II/1 malocclusion during functional orthodontic treatment with the functional regulator type II. METHODS: A total of 23 patients with Class II/1 malocclusion based on lateral cephalograms obtained before and after treatment with the functional regulator type II were analyzed. Another 23 patients with Angle Class II/1 malocclusion who had not undergone treatment were included as controls...
October 17, 2016: Journal of Orofacial Orthopedics, Fortschritte der Kieferorthopädie
Tomasz Smektala, Ewelina Staniszewska, Agata Sławińska, Katarzyna Sporniak-Tutak, Marcin Tutak, Marcin Jędrzejewski, Małgorzata Chrusciel-Nogalska, Raphael Olszewski
OBJECTIVES: The aim of this study was to create an evidence-based three-dimensional cephalometric analysis of orbits in order to perform time-efficient measurements of postoperative orbital morphology changes. MATERIALS AND METHODS: The authors used 23 (11 bilateral and 1 unilateral) anatomical landmarks. Based on these, 6 planes, 12 angular and 16 linear measurements were determined. A three dimensional analysis was performed twice by two observers on pre and post-operative computed tomography scans of six patients who had undergone midface advancement...
September 2016: Journal of Maxillofacial and Oral Surgery
Keiko Shimojima, Yumiko Ondo, Mayumi Matsufuji, Nozomi Sano, Hisashi Tsuru, Tatsuki Oyoshi, Nayuta Higa, Hiroshi Tokimura, Kazunori Arita, Toshiyuki Yamamoto
A female patient presented with developmental delay, distinctive facial features, and congenital anomalies, including a heart defect and premature lambdoid synostosis. The patient showed a paternally inherited 16p13.11 microduplication and a de novo 19p13.3 microdeletion involving the mitogen-activated protein kinase kinase 2 gene (MAP2K2), in which mutations cause the cardio-facio-cutaneous (CFC) syndrome. Reports of patients with overlapping 19p13.3 microdeletions of this region describe similar clinical manifestations including distinctive facial features: prominent forehead, horizontal/down-slanting palpebral fissures, long midface, pointed chin/angular jaw, sparse eyebrows, and underdeveloped cheekbones...
October 14, 2016: European Journal of Medical Genetics
D Rolski, J Kostrzewa-Janicka, P Zawadzki, K Życińska, E Mierzwińska-Nastalska
Morphological and functional disturbances induced by postsurgical defects and loss of tissues in the stomatognathic system due to the treatment of tumors in the maxillofacial region determine the therapeutic needs of patients. The study aimed at clinical and epidemiological evaluation of patients under prosthetic treatment in order to establish the algorithm for rehabilitation. The study group was composed of the patients after midface surgery (45.74%); surgery in a lower part of the face (47.38%); mixed postoperative losses (3...
2016: BioMed Research International
Jordan J Allensworth, Scott H Troob, Tyler S Weaver, Javier D Gonzalez, Daniel Petrisor, Mark K Wax
OBJECTIVE: Acute invasive fungal sinusitis (AIFS) is a frequently fatal infection for which extensive and debilitating surgical debridement is a mainstay of therapy. Resulting defects are often composite in nature, mandating free tissue-transfer reconstruction. Outcomes data for free flap reconstruction are limited. The purpose of this study was to examine surgical outcomes and survival in patients undergoing free flap transfer following invasive fungal sinusitis. STUDY DESIGN: Retrospective case series...
October 12, 2016: Laryngoscope
Amel Ibrahim, Michael Suttie, Neil W Bulstrode, Jonathan A Britto, David Dunaway, Peter Hammond, Patrizia Ferretti
BACKGROUND: Midface hypoplasia as exemplified by Treacher Collins Syndrome (TCS) can impair appearance and function. Reconstruction involves multiple invasive surgeries with variable long-term outcomes. This study aims to describe normal and dysmorphic midface postnatal development through combined modelling of skeletal and soft tissues and to develop a surgical evaluation tool. MATERIALS AND METHODS: Midface skeletal and soft tissue surfaces were extracted from computed tomography scans of 52 control and 14 TCS children, then analysed using dense surface modelling...
September 2, 2016: Journal of Cranio-maxillo-facial Surgery
Daniel Alam, Yaseen Ali, Christopher Klem, Daniel Coventry
Orbito-malar reconstruction after oncological resection represents one of the most challenging facial reconstructive procedures. Until the last few decades, rehabilitation was typically prosthesis based with a limited role for surgery. The advent of microsurgical techniques allowed large-volume tissue reconstitution from a distant donor site, revolutionizing the potential approaches to these defects. The authors report a novel surgery-based algorithm and a classification scheme for complete midface reconstruction with a foundation in the Gillies principles of like-to-like reconstruction and with a significant role of computer-aided virtual planning...
November 2016: Facial Plastic Surgery Clinics of North America
Aditi A Bhuskute, Travis T Tollefson
Cleft lip and palate are the fourth most common congenital birth defect. Management requires multidisciplinary care owing to the complexity of these clefts on midface growth, dentition, Eustachian tube function, and lip and nasal cosmesis. Repair requires planning, but can be performed systematically to reduce variability of outcomes. The use of primary rhinoplasty at the time of cleft lip repair can improve nose symmetry and reduce nasal deformity. Use of nasoalveolar molding ranging from lip taping to the use of preoperative infant orthopedics has played an important role in improving functional and cosmetic results of cleft lip repair...
November 2016: Facial Plastic Surgery Clinics of North America
Lauren A Bohm, James D Sidman, Brianne Roby
This article reviews the presentation of children with craniofacial anomalies by the most common sites of airway obstruction. Major craniofacial anomalies may be categorized into those with midface hypoplasia, mandible hypoplasia, combined midface and mandible hypoplasia, and midline deformities. Algorithms of airway interventions are provided to guide the initial management of these complex patients.
November 2016: Facial Plastic Surgery Clinics of North America
Manouk van der Steen, Rolph Pfundt, Stephan J W H Maas, Willie M Bakker-vanWaarde, Roelof J Odink, Anita C S Hokken-Koelega
BACKGROUND: Some children born SGA show advanced bone age (BA) during GH treatment. ACAN-gene mutations have been described in children with idiopathic short stature and advanced BA. OBJECTIVE: To determine presence of ACAN-gene mutations in short SGA children with advanced BA and to assess the response to GH treatment. METHODS: BA assessment in 290 GH-treated SGA children and ACAN-sequencing in 29 children with advanced BA of ≥0.5 years compared to calendar age...
October 6, 2016: Journal of Clinical Endocrinology and Metabolism
Gabriela Kopacheva-Barsova, Nikola Nikolovski
BACKGROUND: Nasal septal surgery and rhinoplasty are controversial in children. Traditionally, an attitude of restraint has been employed by most surgeons till an empirical age of 16 to 18 years. This is to avoid the possible adverse effects that the growth spurts may have on the nose and midface region. AIM: The aim of this paper was to present the results of rhinoplasty in children in order to restore the anatomy and function or to promote normal development and outgrowth of the nose...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
A Di Martino, P Bonavolontà, G Dell'Aversana Orabona, F Schönauer
Wide resection of recurrent basal cell carcinoma (BCC) in the peri-orbital-infraorbital-nasal area may include periosteum resection with maxillary or nasal bone exposure. The absence of vascularized periosteum makes the defect ungraftable and local flaps are often required. As an alternative to a large single flap or a combination of flaps, it is possible to turn the ungraftable portion of the defect into a graftable one. The suborbicularis oculi fat (SOOF) flap is an advancement flap that is used in aesthetic surgery for midface rejuvenation...
September 30, 2016: International Journal of Oral and Maxillofacial Surgery
J Weichert, M Gembicki, J Ribbat-Idel, D R Hartge
PURPOSE: To scrutinize the validity of a novel angle (maxilla-mandible-nasion angle, MMN) as objective proof of midfacial hypoplasia in trisomy 21 fetuses. MATERIALS AND METHODS: Volume data sets of 2(nd) trimester fetuses were reviewed in this retrospective study. After achievement of the correct midsagittal position, the fetal profile line (FP line) and the mandibulo-maxillary line (MML) were applied and the resulting angle was calculated. Additionally, the prefrontal space ratio (PFSR) was assessed...
May 2016: Ultrasound Int Open
Harry Mittelman, Summit Kundaria, Herman P Lam
The aging face results in increase in laxity of the skin and the underlying supporting tissue. There is a fundamental volume loss in the face and it is most apparent in the midface. A traditional superficial musculoaponeurotic system (SMAS) rhytidectomy addresses the laxity of the face but not volume loss. Multivector high SMAS plication allows for natural excess tissue to be placed into the area of volume loss, thereby addressing midface volume loss. This technique is easy to perform, reproducible, and effective with the added benefit of helping to volumize the lower face...
October 2016: Facial Plastic Surgery: FPS
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