ABSTRACT
Angiomyolipomas are usually found in the kidneys of patients with tuberous sclerosis. They occur less frequently in organs such as the liver, the oral cavity, the nasal cavity, the heart, the large intestines, and the lungs. Angiomyolipomas of the skin are extremely rare, and cutaneous angiomyolipomas generally occur on the elbow, the ends of digits, the ear, and the glabella. Herein we present a rare case of angiomyolipoma occurring on the face—specifically, the right upper eyelid. We propose that upper eyelid angiomyolipoma is a hamartomatous, rather than neoplastic, lesion. Although angiomyolipoma in the periocular area is rare, it should be considered in the differential diagnosis of clinically benign masses. and regular follow-up is warranted.
ABSTRACT
The cheek, a highly visible and significant aspect of an individual’s appearance, is situated adjacent to several structures involved in facial expressions, including the eye, mouth, and surrounding facial muscles. Consequently, aesthetic reconstruction for large cutaneous defects of the cheek remains a challenge for plastic surgeons. We experienced a case of an 83-year-old woman with a large (7×10 cm) facial defect following the removal of squamous cell carcinoma. We elevated a cervicofacial skin flap containing the superficial layer of the superficial musculoaponeurotic system and a blood supply via the dermal plexus in a random pattern. Through this method, we achieved aesthetically favorable reconstruction of a large facial defect using a cervicofacial transposition skin flap. By avoiding extensive dissection, we achieved adequate coverage for even a quite sizable facial defect, with a short recovery time. This method prevented facial nerve injury and made it possible to simultaneously obtain an aesthetically favorable outcome.
ABSTRACT
Background@#Soft tissue fillers are increasingly used to rejuvenate and beautify the body and face. Unknown foreign materials that have not always been proven to be safe for human use have been used for injections in the past. Various commercial injectable materials have since been developed and are used; however, the number of complications has increased as soft tissue fillers have increased in use. @*Methods@#A retrospective study of 39 patients with facial foreign body complications who underwent surgical treatment between March 2012 and February 2021 was conducted. Patient information was analyzed, and patient satisfaction was evaluated using a questionnaire after surgical treatment. A comparative statistical analysis was undertaken. @*Results@#Patients who underwent procedures performed by unlicensed practitioners tended to be older at the time of presenting to the hospital (P=0.004). The degree of satisfaction after surgical repair was significantly lower following the direct approach than after the indirect approach using a bypass incision (P=0.044). The degree of satisfaction significantly decreased (P=0.001) as the number of operations the patient received increased. @*Conclusions@#When treating complications caused by foreign material injections, surgical removal is a more reliable method than treatment with medication or further injections; however, treatment decisions should be made thoughtfully, and many factors must be considered. Patient satisfaction can be improved by reducing the number of operations and making the appropriate corresponding incisions or excisions to treat the full range of symptoms caused by foreign substances and by indirectly using bypass incisions to mitigate post-surgery scars.
ABSTRACT
Malignant peripheral nerve sheath tumors (MPNSTs) are rare and aggressive soft tissue sarcomas of neural origin. Approximately 50% of MPNSTs are associated with neurofibromatosis type 1 (NF1), a neurocutaneous condition characterized by skin discoloration. MPNSTs occur in approximately 4% of patients with NF1. Malignancy should be suspected when a large mass consistent with a neurofibroma is observed with heterogeneity on a radiologic examination. In our case, immunohistochemistry revealed the presence of antigens for both the tumor protein p53 and the proliferation marker Ki-67 (MKI67). In particular, MKI67 positivity helped to differentiate MPNST from neurofibroma. Complete surgical resection is the standard treatment. After surgery, radiation therapy is typically administered to the resection area to reduce the likelihood of recurrence. Following treatment, patients should undergo regular clinical follow-up using a combination of magnetic resonance imaging, computed tomography, and bone scanning for several years to monitor them for possible metastasis.
ABSTRACT
Background@#It is difficult to completely fix nasal bone fractures with closed reduction, as it is often accompanied by septal cartilage damage, and this often results in postoperative secondary deformities. Thus, patients are often reluctant to undergo closed reduction surgery. The present study aimed to evaluate aesthetic and functional satisfaction, as well as satisfaction with and complications of closed reduction, according to nasal bone fracture type. @*Methods@#The subjects were patients who underwent closed reduction under general anesthesia from January 2017 to December 2018. Based on the modified Murray classification, patients were classified into five groups according to the fracture site, septal fracture, and deviation. A total of 211 patients were sent a web-based survey on postoperative satisfaction and complications, as well as intention for revision and cosmetic surgery. Sixty-one patients (28.9%) responded. @*Results@#There were no significant differences in aesthetic and functional satisfaction or satisfaction with closed reduction according to the fracture type, site, or severity. Postoperative functional complications developed in 14 of 61 patients (22.95%). With 10 out of 24 (41.67%) patients (p = 0.044), the bilateral fracture with septal fracture or prominent septal deviation type had a higher incidence of complications than the other types. @*Conclusion@#The incidence of complications is higher for bilateral fracture with septal fracture or prominent septal deviation compared to the other nasal bone fracture types. Therefore, long-term follow-up after closed reduction surgery for this fracture type can aid in establishing additional postoperative treatment plans and improving patient satisfaction.
ABSTRACT
Background@#Posttraumatic acquired facial deformities require surgical treatment, with optionsincluding scar revision, fat grafts, implant insertion, and flap coverage. However, each techniquehas specific advantages and disadvantages. @*Methods@#From 2016 to 2018, 13 patients (eight with scar contracture and five with a depressedscar) were treated using dermofat grafts from the groin. The harvested dermofat was then insertedinto the undermined dead space after the contracture was released, and a bolster suture wasdone for fixation considering the patient’s contour and asymmetry. A modified version of the VancouverScar Scale and satisfaction survey were used to compare deformity improvements beforeand after surgery. @*Results@#In most cases, effective volume correction and an aesthetically satisfactory contourwere maintained well after dermofat grafting, without any major complications. In some cases,however, lipolysis proceeded rapidly when inflammation and infection were not completely eliminated.A significant difference was found in the modified Vancouver Scar Scale before and aftersurgery, with a p-value of 0.001. The average score on the satisfaction survey was 17.07 out of 20points. @*Conclusion@#A dermofat graft with the groin as the donor site can be considered as an effectivesurgical option that is the simplest and most cost-effective method for the treatment of acquiredfacial deformities with scar contracture.