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https://www.readbyqxmd.com/read/28207466/the-subunit-principle-in-scar-face-revision
#1
Ahmed Elshahat, Riham Lashin
Facial scaring is considered one of the most difficult cosmetic problems for any plastic surgeon to solve. The condition is more difficult if the direction of the scar is not parallel to relaxed skin tension lines. Attempts to manage this difficult situation included revisions using geometric designs, Z plasties or W plasties to camouflage the straight line visible scaring. The use of long-lasting resorbable sutures was tried too. Recently, the use of botulinum toxin during revision improved the results. Fractional CO2 lasers, microfat grafts, and platelet-rich plasma were added to the armamentarium...
February 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28203499/sandwich-fascial-anterolateral-thigh-flap-in-head-and-neck-reconstruction-evolution-or-revolution
#2
Mario Cherubino, Jens Berli, Mario Turri-Zanoni, Paolo Battaglia, Francesca Maggiulli, Martina Corno, Federico Tamborini, Edoardo Montrasio, Paolo Castelnuovo, Luigi Valdatta
INTRODUCTION: The anterolateral thigh perforator flap (ALT) represents the workhorse for most reconstructive efforts in the head and neck regions. The main advantages of this flap are its versatility, the length of the pedicle, and the low morbidity of the donor site. The major drawback is the bulkiness of this flap with the frequent need for secondary revisions. To overcome this, we have developed a novel way to harvest and inset the ALT, called the sandwich fascial ALT flap (SALT). METHODS: All patients undergoing head and neck reconstruction using the SALT flap from January 2013 to March 2016 were included in this retrospective analysis...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28202996/-surgical-reconstruction-of-maxillary-defects-using-a-computer-assisted-techniques
#3
W B Zhang, Y Yu, Y Wang, X J Liu, C Mao, C B Guo, G Y Yu, X Peng
The maxilla is the most important bony support of the mid-face skeleton and is critical for both esthetics and function. Maxillary defects, resulting from tumor resection, can cause severe functional and cosmetic deformities. Furthermore, maxillary reconstruction presents a great challenge for oral and maxillofacial surgeons. Nowadays, vascularized composite bone flap transfer has been widely used for functional maxillary reconstruction. In the last decade, we have performed a comprehensive research on functional maxillary reconstruction with free fibula flap and reported excellent functional and acceptable esthetic results...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28163451/overview-of-local-flaps-of-the-face-for-reconstruction-of-cutaneous-malignancies-single-institutional-experience-of-seventy-cases
#4
Jagdeep K Rao, Kaustubh Sharad Shende
CONTEXT: The most common malignant tumours of the face are basal cell carcinoma, squamous cell carcinoma and melanoma. While the results of skin graft are less than satisfactory for large areas to cover, distant flaps are bulky with a poor colour match. Local fasciocutaneous flaps provide reasonable option for reconstruction of facial defects with good colour and texture match and good success rate. AIMS: This study aimed to analyse the various modalities of reconstruction after resection of facial malignancies and their advantages and disadvantages...
October 2016: Journal of Cutaneous and Aesthetic Surgery
https://www.readbyqxmd.com/read/28100473/delineating-the-phenotypic-spectrum-of-bainbridge-ropers-syndrome-12-new-patients-with-de-novo-heterozygous-loss-of-function-mutations-in-asxl3-and-review-of-published-literature
#5
M Balasubramanian, J Willoughby, A E Fry, A Weber, H V Firth, C Deshpande, J N Berg, K Chandler, K A Metcalfe, W Lam, D Pilz, S Tomkins
BACKGROUND: Bainbridge-Ropers syndrome (BRPS) is a recently described developmental disorder caused by de novo truncating mutations in the additional sex combs like 3 (ASXL3) gene. To date, there have been fewer than 10 reported patients. OBJECTIVES: Here, we delineate the BRPS phenotype further by describing a series of 12 previously unreported patients identified by the Deciphering Developmental Disorders study. METHODS: Trio-based exome sequencing was performed on all 12 patients included in this study, which found a de novo truncating mutation in ASXL3...
January 18, 2017: Journal of Medical Genetics
https://www.readbyqxmd.com/read/28089208/the-reconstructive-options-for-oropharyngeal-defects-in-the-transoral-robotic-surgery-framework
#6
Giuseppe Meccariello, Filippo Montevecchi, Rossella Sgarzani, Andrea De Vito, Giovanni D'Agostino, Riccardo Gobbi, Chiara Bellini, Claudio Vicini
Transoral robotic surgery (TORS) is a fascinating new technique that has been proved to be a safe and feasible for selected oropharyngeal cancers. Furthermore, TORS offers several advantages in the treatment of locoregionally advanced cancers. Nevertheless, the careful selection of patients is the keypoint for a successful application of this therapeutic modality. However, the reconstruction of large oropharyngeal defects is challenging due to the restoration of velopharyngeal competency and swallowing. Moreover, the absence of mandibular splitting increases the difficulties faced by reconstructive surgeons...
January 11, 2017: Oral Oncology
https://www.readbyqxmd.com/read/28048327/su-f-p-58-squamous-cell-and-basal-cell-carcinoma-of-the-skin-treated-with-a-freiburg-flap-applicator
#7
K Dou, B Li, M Jacobs, B Laser
PURPOSE: To treat squamous cell and basal cell carcinoma of the skin with the Freiburg flap applicator using a high dose rate modality of an Elekta Flexitron or MicroSelectron for radiation delivery by compensating the dose deviation resulting from the incomplete scatter environment. METHODS: Patients were selected to have lesions greater than or equal to 2cm. A mask might be needed depending on special locations. The lesions on the eyelid and face presented in this research were, however, treated without a mask...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045815/reconstruction-of-skin-defects-on-the-mid-and-lower-face-using-expanded-flap-in-the-neck
#8
Xiaogen Hu, Gao Zeng, Yang Zhou, Cheng Sun
BACKGROUND: The reconstruction of major burn and other deformities resulting from significant soft tissue deficits of the face is a continuing challenge for surgeons. In the study, the authors introduce our 5-year experiences using expanded flap in the neck for reconstruction on the mid and lower face. METHODS: From 2008 and 2013, 12 tissue expanders were used in 12 patients for face resurfacing. The operation consisted of 2 steps. In the first step, the expander was placed subcutaneously under the skin of the neck and they were expanded timely to create adequate superfluous skin and soft tissue...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28041765/-the-thin-alt-perforator-flap-for-oropharyngeal-robotic-assisted-reconstruction
#9
Q Qassemyar, P Aguilar, S Temam, F Kolb, P Gorphe
Since a few years, the transoral robotic surgery reduced the morbidity of oropharyngeal tumors excision. Large posterior tumors can now be removed without any scar visible on the face. In this context and to respect the thinness required for reconstructions at the junction of the upper aerodigestive tract, the free radial forearm flap still remains the solution of choice. However, if the transoral robotic surgery respects the anatomy and the aesthetics of patients at the visible and social area that represents the face, the forearm flap provides visible scars on the other region of social interaction that represents the upper limb...
December 29, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28039499/omega-%C3%AE-advancement-flap-a-circular-flap-design-for-the-aesthetic-closure-of-circular-skin-defect
#10
Enver Arpaci, Serdar Altun, Nilgün Markal Ertas, Ahmet Cagri Uysal, Emre Inozu
BACKGROUND: Most skin defects that require reconstruction with a local skin flap have a circular- or oval-shaped pattern. The majority of the skin flaps are planned in an angled shape. Therefore, it may be necessary to modify the shape of the defect or the distal flap border to minimize tissue distortion. We have designed a circular-shaped advancement flap to be compatible with the circular defect. METHODS: Eighteen cases of reconstruction of skin defects in the face, chest wall, hand and buttock area were performed using the omega advancement flap between 2010 and 2014...
December 30, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28033633/rhytidoplasty-smas-imbrication-vector-comparison
#11
Fernando Pedroza, Luis Fernando Pedroza, Daniel Correal Gentry, Juan Guillermo Erazo Cordoba, Guillermo Arturo Landinez Cepeda
To determine if there are aesthetic differences in patients who have undergone a SMAS lifting with predominantly oblique-horizontal vectors versus predominantly oblique-vertical vectors. To determine if there are aesthetic differences in the results of the neck using sutures placed in specific areas of the platysmal muscle versus randomly placed sutures for platysmal plication to the mastoid. Comparative, retrospective, blind, and randomized study. Evaluation of preoperative and postoperative photographs of 54 patients who underwent predominantly oblique-horizontal SMAS lifting versus 53 patients who underwent predominantly oblique-vertical traction of the SMAS flap, reviewed by three external, unbiased facial plastic surgeons in a blind study...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28005812/microcystic-adnexal-carcinoma-of-the-nasal-tip-treated-with-surgical-excision-and-rotational-forehead-skin-flap
#12
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...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005772/correction-of-residual-static-and-dynamic-labial-deviations-in-a-paralyzed-face-after-free-gracilis-muscle-transplantation
#13
Ricardo Horta, Inês Correia-Sá, Ricardo Nascimento, Alvaro Silva, José Amarante
Free muscle flap transfer is currently the procedure of choice for longstanding facial paralysis to restore symmetry both at rest and when smiling. However, movements obtained are generally localized, unidirectional, and philtrum centralization and lower lip movement is not proportionally achieved. The stability of free flap insertion at the lips also interferes with the results, as gradual disinsertion and shifting of the nasolabial fold can be caused by repetitive movements. Asymmetry of smile can also be caused by lip depressor inactivity due to marginal mandibular paralysis, and both dynamic and static procedures are often required after dynamic reanimation...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005741/two-thirds-lip-defects-a-new-combined-reconstructive-technique-for-patients-with-epithelial-cancer
#14
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...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27991024/-cooperation-between-the-plastic-surgery-and-the-head-neck-surgery-departments-in-the-treatment-of-unusual-cases-veszpr%C3%A3-m-hungary-2010-2015
#15
Zoltán Lóderer, József Piffkó, Károly Somlai, Gábor Bognár, Gábor Sándor
INTRODUCTION: Handling problems in the head and neck region often requires a close cooperation between allied professions, just as in the challenging cases presented by us. Cases and methodology: With the first patient, we performed a radical surgery on the left side of the face due to recidivious basal cell carcinoma, followed by reconstruction using a Type I chimeric anterolateral thigh flap (ALT), while in the case of the second patient, we carried out a radical surgery on the right side of the face due to epithelial carcinoma and reconstruction with a Type I chimeric thoracodorsal flap...
December 2016: Magyar Sebészet
https://www.readbyqxmd.com/read/27975013/free-medial-plantar-flap-connection-with-a-posterior-tibial-artery-flap-in-reconstruction-of-fore-mid-foot-skin-defect
#16
Hao Wu, Jia-Gen Sheng, Chang-Qing Zhang
BACKGROUND: Although there are many surgical treatments for covering the skin defect of the fore-mid foot, how to reconstruct the weight-bearing region remains a challenge. The weight-bearing region of the sole needs to withstand the pressure and shearing stresses of walking, so the plantar skin is anatomically different from other skins in the areas of texture, thickness, subcutaneous tissue, etc. Medial plantar flaps that are harvested from the instep region are regarded as the first choice for weight-bearing region reconstruction because of their excellent functional and aesthetic long-term result...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27974011/use-of-anteromedial-thigh-perforator-flap-and-immunological-implications-of-gorlin-goltz-syndrome-a-case-study
#17
A Scalise, R Calamita, C Tartaglione, E Bolletta, G Di Benedetto, M Pierangeli
Gorlin-Goltz syndrome is mainly characterised by the development of numerous multicentric and relapsing cutaneous basal cell carcinomas (BCCs). A major problem for patients with Gorlin-Goltz syndrome is the large amount of BCCs that can invade the deep underlying structures, especially the face. Here, we describe the case of a 23-year-old male affected by Gorlin-Goltz syndrome. He had recurrent BCCs on a hairless scalp and dorsum since he was 17 years old and underwent four surgical procedures to excise BCCs, including a reconstruction with anteromedial thigh perforator flap...
December 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27956720/indication-for-and-limitation-of-the-facial-dismasking-flap-approach-for-skull-base-surgery-to-achieve-the-best-esthetical-and-functional-results
#18
Tomoyuki Yano, Mutsumi Okazaki, Kentaro Tanaka, Atsunobu Tsunoda, Masaru Aoyagi, Seiji Kishimoto
BACKGROUND: The facial dismasking flap (FDF) approach to operations on the deep skull base region consists of a coronal incision and a circumpalpebral incision. This approach provides a wide surgical field for extirpation of deep extended craniofacial tumors without leaving any undesirable scars on the face. Therefore, the FDF approach can provide satisfactory esthetical and functional results. Meanwhile, in some cases, especially in patients with a history of skull base surgery or orbital extension, patients are not fully satisfied even when the FDF approach is used...
January 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27927508/kyphectomy-in-children-with-severe-myelomeningocele-related-kyphosis
#19
R N Dunn, L N Bomela
STUDY DESIGN: Retrospective review of prospectively maintained database. OBJECTIVES: To review myelomeningocele patients with severe kyphosis undergoing kyphectomy surgery in terms of complications and clinical and radiographic outcomes. SUMMARY OF BACKGROUND DATA: Because of posterior element abnormality in myelomeningocele, the extensor muscles act as perverted flexors, driving progressive kyphosis that resulted in sitting, respiratory, and skin breakdown problems...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27920067/injectable-diphenhydramine-used-as-anaesthetic-for-wide-local-excision-with-flap-closure
#20
Laura E Pickett, Jillian Macdonald
BACKGROUND: Lidocaine-allergic patients pose a challenge for cutaneous surgical procedures. We present a case of a successful wide local excision with flap closures on the face using topical tetracaine followed by infiltration with 1% diphenhydramine. CASE SUMMARY: An 84-year-old woman, with a lidocaine intolerance, presented to the Mohs surgery clinic for wide local excision of a nodular basal cell carcinoma on her right medial cheek. Successful anaesthesia was achieved using topical 4% tetracaine followed by intradermal and subcutaneous injection of 1% diphenhydramine...
December 5, 2016: Journal of Cutaneous Medicine and Surgery
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