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Face flap

Joseph Catapano, Daniel R B Demsey, Emily S Ho, Ronald M Zuker, Gregory H Borschel
Smiling is an important aspect of emotional expression and social interaction, leaving facial palsy patients with impaired social functioning and decreased overall quality of life. Although there are several techniques available for facial reanimation, staged facial reanimation using donor nerve branches from the contralateral, functioning facial nerve connected to a cross-face nerve graft (CFNG) is the only technique that can reliably reproduce an emotionally spontaneous smile. Although CFNGs provide spontaneity, they typically produce less smile excursion than when the subsequent free functioning muscle flap is innervated with the motor nerve to the masseter muscle...
September 2016: Plastic and Reconstructive Surgery. Global Open
Min Seok Kang, Eun Jung Lee, Ji Seop Kim, In Sik Yun, Hyung Kwon Byeon
Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous adenocarcinoma that typically occurs in the head and neck, particularly at the central face. There are only slightly more than 300 patients reported worldwide, and most patients occur in Caucasians. A 72-year-old man was referred to our hospital for definitive treatment of known MAC from previous biopsy. Wide excision of nasal tip and reconstruction of nasal defect with paramedian forehead flap and nasolabial flap transposition were performed rather than conventional Mohs surgery, due to grossly evident disease...
October 14, 2016: Journal of Craniofacial Surgery
Baoqiang Song, Jianwu Chen, Xianjie Ma, Yang Li, Juan Zhang, Shuzhong Guo
BACKGROUND: The anterior chest is an excellent donor site for cervicofacial reconstruction. Studies of chest flaps began as early as 1988 at our institution. We identified a new branch of the supraclavicular artery that nourishes the anterior chest, and on the basis of this finding, we created a new flap called the subclavicular flap. Unlike the supraclavicular flap, which is pedicled by the deltoid branch, this flap is primarily pedicled by the thoracic branch, and it shares similar vascular territory with the deltopectoral flap...
September 23, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Mara C Modest, Eric J Moore, Kathryn M Van Abel, Jeffrey R Janus, John R Sims, Daniel L Price, Kerry D Olsen
OBJECTIVES/HYPOTHESIS: Discuss current techniques utilizing the scapular tip and subscapular system for free tissue reconstruction of maxillary defects and highlight the impact of medical modeling on these techniques with a case series. STUDY DESIGN: Case review series at an academic hospital of patients undergoing maxillectomy + thoracodorsal scapula composite free flap (TSCF) reconstruction. Three-dimensional (3D) models were used in the last five cases. METHODS: 3D modeling, surgical, functional, and aesthetic outcomes were reviewed...
October 12, 2016: Laryngoscope
Harriet Kiwanuka, Mario A Aycart, David F Gitlin, Elaine Devine, Bridget J Perry, Thet-Su Win, Ericka M Bueno, Muayyad Alhefzi, Nicco Krezdorn, Bohdan Pomahac
BACKGROUND: Facial self-inflicted gunshot wounds (SIGSWs) cause a devastating midfacial defect and pose a challenging problem to the reconstructive surgeon. Face transplantation (FT) has the potential for near-normal restoration in otherwise non-reconstructible defects. Two out of 7 FT recipients at Brigham and Women's Hospital (BWH) sustained SIGSWs. In this study, we illustrate the role of FT in the management of SIGSWs through an aesthetic, functional, and psychosocial examination of outcomes...
September 8, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Samir M Kumta, Rajendra Nehete, Leena Jain
Management of mutilating hand injury is a challenge for any hand surgeon. Delay in presentation makes management even more challenging, usually because of inadequate initial assessment, inadequate debridement leading to infection, and secondary loss of tissues from exposure and desiccation. The aim is to obtain a functional hand by radical debridement, adequate assessment of the injury, appropriately timed reconstruction, and physiotherapy and rehabilitation. The hand surgeon must pay attention to the appearance of the hand by elimination of deformities, unsightly scars and bulky flaps to help to restore confidence in the patient to face the demands of daily living...
November 2016: Hand Clinics
Mario A Aycart, Muayyad Alhefzi, Maximilian Kueckelhaus, Nicco Krezdorn, Ericka M Bueno, Edward J Caterson, Julian J Pribaz, Bohdan Pomahac
BACKGROUND: Face transplantation has emerged as a viable option for certain patients in the treatment of devastating facial injuries. However, as with autologous free tissue transfer, the need for secondary revisions in face transplantation also exists. The authors' group has quantified the number of revision operations in their cohort and has assessed the rationale, safety, and outcomes of posttransplantation revisions. METHODS: A retrospective analysis of prospectively collected data of the authors' seven face transplants was performed from April of 2009 to July of 2015...
October 2016: Plastic and Reconstructive Surgery
P Guerreschi, P-E Gabert, D Labbé, V Martinot-Duquennoy
Facial palsy (FP) in children is congenital or acquired. When present at birth (congenital), etiologies are mostly traumatic and rarely developmental. Acquired FP needs investigation. Research on the etiology helps to determine prognostic and treatment. At most times, no specific cause is found. Treatment of idiopathic FP consists of early oral corticosteroid therapy and ocular protection. Treating the sequelae is essential and the physician has to consider the dynamic balance of both sides of the face. Dynamic rehabilitation should mainly concern the inferior facial third...
October 2016: Annales de Chirurgie Plastique et Esthétique
Tiziana Vitagliano, Lucia Stella Curto, Antonio Greto Ciriaco, Pietro Gareri, Diego Ribuffo, Manfredi Greco
BACKGROUND: The lips are a common site prone to squamous cell carcinomas, which arise in the facial region. There are different techniques to reconstruct the excised lip region, according to dimensions, area, and position of the tumor. The authors describe a new technique of lip reconstruction born from a combination between a nasolabial flap and adipose tissue transplant. METHODS: The study was lead in the Plastic and Reconstructive Surgery Department of the University of Catanzaro...
September 9, 2016: Journal of Craniofacial Surgery
Yasser A Noureldin, Sero Andonian
OBJECTIVES: Percutaneous renal access (PCA) is a challenging step during percutaneous nephrolithotomy. The aim of this study is to review the literature for different types of simulators described for PCA. METHODS: Databases of Medline, Embase, Cochrane Library, OvidSP, and Google Scholar were systematically searched until May 2016. The studies were analyzed regarding the type of simulator (nonbiologic, biologic, live animal, and virtual reality [VR]), type of validity (face, content, construct, and predictive), cost-effectiveness, and whether these simulators have been used for training and/or assessment of PCA...
October 11, 2016: Journal of Endourology
M-P Vazquez, N Kadlub, V Soupre, E Galliani, C Neiva-Vaz, I Pavlov, A Picard
Facial traumas are common in children but often unconsidered. Facial injury is responsible of impressive bleeding because of the rich vascularization of the face; this bleeding is often underestimated because of the immediate arterial vasoconstriction that is very strong for children. The blood volume is 80ml/kg for a newborn, with a total of 250ml, reaching 70ml/kg at one year of age. The evaluation must be rigorously performed due to the risk of a sudden decompensation. Regarding the wounds, the primary repair must be performed directly neat or optimal in case of damaged tissues...
October 2016: Annales de Chirurgie Plastique et Esthétique
Emanuel A Shapera, Paul D Kim
A 50-year-old African American male with Discoid Lupus Erythematosus (DLE) presented to the dermatology clinic for a rapidly enlarging left cheek mass. The mass failed to resolve with conservative measures. A biopsy revealed poorly differentiated Squamous Cell Carcinoma (SCC). He was referred to Head and Neck Surgery and successfully underwent a resection with free flap reconstruction. Postoperatively he did well. Squamous cell skin carcinomas arising from lesions of Discoid Lupus are rare and aggressive tumors with greater likelihood of metastases...
2016: Case Reports in Surgery
Nidal Farhan Al Deek, Fu-Chan Wei, Chung-Kan Tsao
Fistulas, either between oral cavity and external face or between oral and nasal cavity, are major complications after microsurgical head and neck reconstruction. Any flaw in surgical planning, design, and execution may lead to this untoward outcome. Once fistula develops, it may interface with oncologic treatment, endanger the reconstruction, and increase overall patient suffering. This article analyzes individual factors involved in development of fistulas in spite of successful transfer of a free flap and proposes treatment guideline...
October 2016: Clinics in Plastic Surgery
Alessandro Innocenti, Marco Innocenti
BACKGROUND: Paramedian forehead flap represents a workhorse in facial soft tissue reconstruction but always requires a second step in order to interrupt the skin bridge. Direct visualization and dissection of vascular pedicle may avoid this drawback. METHODS: Twenty one patients were treated between January 2012 and January 2014: 6 underwent nasal reconstruction and 15 full thickness defect of medial canthus of an orbital region. The follow-up ranges between 6 months and 2 years...
July 29, 2016: Journal of Cranio-maxillo-facial Surgery
H Jiang, A T Liu
Postburn facial scar contracture, which can cause disfigurement and functional impairment, is a major therapeutic challenge. Except for some scars with severe functional impairments such as ectropion of lid, obstruction of nostril, microstomia, and so on, other kinds of facial scars are recommended to be reconstructed after they become sufficiently softened. The selection of specific methods depends on the characteristics of the facial scar. The methods includ direct closure after resection, full or split-thickness skin transplantation, pedicled flap, distant flap, and free flap transfer, and tissue expansion...
August 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
S Touzet-Roumazeille, L Jayyosi, Y Plenier, E Guyot, T Guillard, C François
Children represent a population at risk, because of their short size, their naivety and their attraction to animals. The face and hands are the most specific locations in young children. Wounds are often multiple. In more than half the cases, the child knows the animal, which are dogs and cats by frequency argument. The bite episode occurs mostly when the child is alone with the pet without direct supervision, while playing or stroking the animal. As in all bites, pediatric lesions are infectious, functional and aesthetic emergencies, but the goal of this work was primarily to make a point on principles of surgical management of animal bites in children, highlighting pediatric specificities...
October 2016: Annales de Chirurgie Plastique et Esthétique
A K Bartella, M Ghassemi, F Hölzle, A Ghassemi
We compared the result of replacement using a modified face-lift technique with those of other commonly used surgical techniques for the treatment of defects of the soft tissue of the infraorbital and cheek region. We made a retrospective observational study of 86 patients who had defects of the facial soft tissue after excision of malignant tumours. Procedures used for reconstructions included non-vascularised skin grafts, local flaps, facelift technique, and microvascular free flaps, and we evaluated morbidity; duration of hospital stay; the need for, and duration of stay in, the intensive care unit (ICU); and functional and aesthetic outcomes...
August 16, 2016: British Journal of Oral & Maxillofacial Surgery
Roi Harel, Olivier Duriez, Orr Spiegel, Julie Fluhr, Nir Horvitz, Wayne M Getz, Willem Bouten, François Sarrazin, Ohad Hatzofe, Ran Nathan
Natural selection theory suggests that mobile animals trade off time, energy and risk costs with food, safety and other pay-offs obtained by movement. We examined how birds make movement decisions by integrating aspects of flight biomechanics, movement ecology and behaviour in a hierarchical framework investigating flight track variation across several spatio-temporal scales. Using extensive global positioning system and accelerometer data from Eurasian griffon vultures (Gyps fulvus) in Israel and France, we examined soaring-gliding decision-making by comparing inbound versus outbound flights (to or from a central roost, respectively), and these (and other) home-range foraging movements (up to 300 km) versus long-range movements (longer than 300 km)...
September 26, 2016: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
Baoguo Chen, Huifeng Song, Minghuo Xu, Quanwen Gao
PURPOSE: A high-quality flap is necessary for repairing faciocervical scar contractures. The supraclavicular region and chest wall are the preferred choices for reconstruction. The supraclavicular island flap (SIF) pedicled by the transverse cervical artery (TCA) has been reported. Compared to the traditional SIF flap, another type of flap pedicled by the anterior perforator of transverse cervical artery (ap-TCA) is more convenient for transfer to the faciocervical area. In this article, we use this type of perforator flap and expanded perforator flap to repair the faciocervical contracture...
September 2016: Journal of Cranio-maxillo-facial Surgery
Zeeshan Sheikh, Abdul Samad Khan, Nima Roohpour, Michael Glogauer, Ihtesham U Rehman
Periodontal disease if left untreated can result in creation of defects within the alveolar ridge. Barrier membranes are frequently used with or without bone replacement graft materials for achieving periodontal guided tissue regeneration (GTR). Surface properties of barrier membranes play a vital role in their functionality and clinical success. In this study polyetherurethane (PEU) membranes were synthesized by using 4,4'-methylene-diphenyl diisocyanate (MDI), polytetramethylene oxide (PTMO) and 1,4-butane diol (BDO) as a chain extender via solution polymerization...
November 1, 2016: Materials Science & Engineering. C, Materials for Biological Applications
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