ABSTRACT
La Parálisis Facial (PF) es una condición infrecuente en pacientes pediátricos, representa un problema clínico relevante y conlleva diversas implicaciones. Tanto el curso natural como el tratamiento y pronóstico no se encuentran bien documentados en la literatura, más aún en sujetos sometidos a cirugía. Se presentan 2 casos de PF sometidos a cirugía reconstructiva, niño de 9 años y niña de 8, ambos casos revisados de forma retrospectiva. Se planteó un bordaje y evaluación kinésica estructurado como tratamiento para estos pacientes. El sistema de graduación facial Sunnybrook (SGFS) fue usado para evaluar resultados funcionales. Durante el seguimiento los sujetos mostraron mejoras continuas con una ganancia promedio de 30 puntos en el SGFS. En nuestra experiencia, la rehabilitación kinésica estructurada con el enfoque presentado, parece ser un coadyuvante efectivo en potenciar el proceso de recuperación de la función muscular y simetría facial en sujetos con PF sometidos a cirugía reconstructiva.
Facial Palsy (FP) is an uncommon condition in pediatric patients, it represents a serious linical problem and carries various implications. Both the natural course, as well as the treatment and prognosis are not well documented in the literature especially in subjects undergoing surgery. Two cases of FP undergoing reconstructive surgery are presented, a 9-year-old boy and an 8-year-old girl, both cases reviewed retrospectively. A structured kinesic approach and valuation was proposed as a treatment for these patients. The Sunnybrook Facial Grading System (SGFS) was applied to evaluate functional outcomes. During follow-up the subjects showed continuous improvement with an average increment of 30 points in the SGFS. In our experience, structured kinesic rehabilitation with the approach presented, seems to be an effective adjunct in enhancing the process of recovery of muscle function and facial symmetry in subjects with FP undergoing reconstructive surgery.
Subject(s)
Humans , Male , Female , Child , Postoperative Period , Facial Paralysis/rehabilitation , Physical Therapy Modalities , Plastic Surgery Procedures , Recovery of FunctionABSTRACT
Surgical reconstruction of large facial defects may not be always possible, therefore extraoral maxillofacial prosthesis is a good restorative option. The oculopalpebral prosthesis has a natural appearance however it can be easily noticed because its eyelids do not move. For esthetic purposes, it is desirable that the prosthetic eyelids open and close synchronously with the contralateral eye, which provides a challenge to the prosthetic reconstruction of the oculopalpebral region. To improve the esthetic outcome, an oculopalpebral prosthesis prototype with mechanical and electric features allowing synchronization of the eyelid motion with the sound eye was planned, designed, and built. An oculopalpebral prosthesis was made in thermoactivated acrylic resin. A gap was created to accommodate an electrical system and allow free motion of a thin eyelid made of silicone attached to the appliance. The movable eyelid was made with medical grade silicone (SILASTIC® MDX4-4210) and connected to an electrical and electronic system responsible to command the opening and closing movements. This mechanical and electrical prototype with the system connected to a sensor, successfully captured the eyelid motion of the contralateral sound eye. The proposed mechanical and electrical system attached to an oculopalpebral prosthesis could successfully establish and synchronize the eyelid movements with the sound eye.
A reconstrução cirúrgica de grandes defeitos faciais pode não ser sempre possível, portanto, a prótese bucomaxilofacial extra-oral é uma boa opção restauradora. A prótese oculopalpebral tem uma aparência natural, mas pode ser facilmente notada pois as pálpebras não se movimentam. Para fins estéticos, é desejável que as pálpebras protéticas se abram e se fechem em sincronia com o olho contralateral, o que representa um desafio para a reconstrução protética da região oculopalpebral. Para melhorar o resultado estético, um protótipo de prótese oculopalpebral com características mecânicas e elétricas permitindo a sincronização do movimento da pálpebra com o olho sadio foi planejado, projetado e construído. Uma prótese oculopalpebral foi confeccionada em resina acrílica termoativada. Um nicho foi criada para acomodar umsistema elétrico e permitir o movimento livre de uma pálpebra fina confeccionada em silicone preso ao sistema. A pálpebra móvel foi confeccionada com silicone de grau médico (SILASTIC® MDX4-4210) e conectada a um sistema elétrico e eletrônico responsável por comandar os movimentos de abertura e fechamento. Esteprotótipo mecânico e elétrico com o sistema conectado a um sensor capturou com sucesso o movimento das pálpebras do olho acústico contralateral. O sistema mecânico e elétrico proposto, fixado a uma próteseoculopalpebral, conseguiu estabelecer e sincronizar os movimentos da pálpebra com o olho sadio.
Subject(s)
Prostheses and Implants , Rehabilitation , Eye , EyelidsABSTRACT
Introduction: It is the most superficial of the adductor group of muscles. Gracilis muscle is used oftenly inreconstructive plastic surgery,because ofits reliable vascular and neurological pedicles and the minimal donorsite morbidity.Materials and Methods: The present study was conducted on 40 cadaveric lower limbs (22 males and 18 females)in the Deptartment of Anatomy of VIMS&RC.Metrical and non-metrical characteristics of gracilis muscle andvascular pedicles were analyzed.Results: All the parameter were more in males compared to females. distal tendon length was more than proximaltendon length. P value was significant in all the measurements. The ratios between various components ofmuscle remain fairly constant. Main vascular primary pedicle was arising from profund femoral artery in 60 %& 40% from Medial circumflex femoral artery .Presence of proximal secondary pedicle was only in 30% of thespecimens arising from profunda femoral artery or Medial circumflex femoral artery. Distal secondary pediclesarising from 5% of femoral artery.Conclusion: These parameters will help the reconstructive surgeon in assessing the length of muscle belly ortendon available for reparative procedures before undertaking surgery like Anterior Cruciate Ligament graft,Restoration of sphincteric function in anogenital area, Repair of ano-vaginal or recto-vaginal fistulas, Facialrehabilitation, Upper limb and lower limb defects, Groin wounds and autologous breast reconstruction.
ABSTRACT
A reabilitação protética facial é uma importante ferramenta para os pacientes mutilados que não têm a possibilidade de reconstrução cirúrgica do órgão perdido, pois melhora a estética e a função, e exerce um importante papel psicossocial no paciente que, na maioria das vezes, tem sua qualidade de vida e convívio social comprometidos. Este trabalho apresentou o relato clínico de uma reabilitação auricular com prótese implantossuportada de silicone, para um paciente adulto do sexo feminino. Foram utilizados implantes nacionais e sistema de retenção por magnetos. Depois de nove meses, a prótese não demonstrou alterações de cor e os implantes encontram-se estáveis.
Facial prosthetic rehabilitation is an important tool for handicapped patients with no possibilities to reconstruct the lost organ due to the improvements on esthetics and function, its associated psychosocial issue, and oftentimes impairment on quality of life and social behavior. This paper illustrates a case report where an adult female patient victimized by physical trauma was rehabilitated by means of an auricular prosthesis with dental implants and magnetic attachments. After 9 months, the prosthesis has demonstrated no color alterations and the implants are stable
Subject(s)
Humans , Female , Adult , Correction of Hearing Impairment , Prosthesis ImplantationABSTRACT
A lo largo de la historia han existido diferentes mecanismos de rehabilitación para afecciones del pabellón auricular por defectos congénitos, traumáticos u oncológicos; en Colombia existe muy poca literatura y escasos estudios sobre el tema, por ello se ha querido realizar un estudio observacional descriptivo tipo serie de casos llevado a cabo entre julio de 2007 y diciembre de 2010 con pacientes a los cuales se les ha rehabilitado con prótesis de pabellón auricular, analizando aspectos como lateralidad de la prótesis, número de prótesis adaptada por paciente, patología de base, sistema deretención utilizado, necesidad de restauración, vitalidad de los implantes, complicaciones observadas, resultados obtenidos y grado de satisfacción de los pacientes en los primeros 6 meses pos-adaptación. Igualmente este artículo pretende sugerir algunos puntos de importancia relacionados con la rehabilitación protésica facial en diferentes momentos de la rehabilitación de los pacientes con el fin de obtener los mejores beneficios posibles para estos pacientes con base en la experiencia obtenida por el autor tanto en los procedimientos quirúrgicos como de la elaboración de estas prótesis faciales.
Throughout history there have been different conditions rehabilitation mechanisms of the ear by congenital defects, trauma or cancer, in Colombia there is very little literature and few studies on the subject, so we have tried to make a descriptive study of serial cases carried out between July 2007 andDecember 2010 with patients who have been rehabilitated with prosthetic ear, analyzing issues such as laterality of the prosthesis, prosthesis adapted number per patient, underlying disease, restraintused, need for restoration and vitality of the implants, observed complications, results and satisfaction of patients in the first 6 months post-adaptation. Likewise, this article tries to suggest some important points related to the facial prosthetic rehabilitation at different stages of the rehabilitation of patients in order to obtain the best possible benefits for these patients based on the experience gained by the author in both surgical procedures and the processing of these facial prostheses.
Subject(s)
Ear Auricle/surgery , Ear Auricle/injuriesABSTRACT
El objetivo de esta investigación es establecer las relaciones morfométricas presentes en las regiones periorbitarias utilizadas para la instalación de implantes craneofaciales. Se diseñó un estudio descriptivo utilizando 40 cráneos humanos de entre 20 y 60 años del Laboratorio de Anatomía del Departamento de Morfología de la Facultad de Odontología de Piracicaba de la Universidad Estadual de Campinas. Fueron realizadas tomografías volumétricas cone beam y a partir de la reconstrucción virtual se precisaron los puntos de análisis, basados en la literatura científica, tanto clínica como anatómica de la región. Se realizaron divisiones de la órbita respetando distancias mínimas y reparos anatómicos como el seno frontal y seno maxilar. En las mediciones realizadas, se observó que el área supraorbitaria presentaba una distancia ósea sagital de 8,14mm +/- 1,91mm, el reborde infraorbitario de 7mm +/- 1,71mm y el área lateral de órbita un promedio de 7,91mm +/- 1,15mm. Considerando que los implantes de mayor dimensión son de 6mm, la instalación de implantes en estas regiones está totalmente asegurada en términos de requerimientos de cantidad ósea regional.
The aim of this research was to study the morphometric relation present in periorbital region, used in the installation of craniofacial implants. A descriptive study was carried out using 40 skulls between 20 and 60 years of age from the Laboratório de Anatomia do Departamento de Morfologia da Facultade de Odontologia de Piracicaba da Universidade Estadual de Campinas. Volumetric tomography with cone beam technique was used along with virtual reconstruction, with the point of analysis being selected based on the clinical and anatomical scientific literature. Orbital division was realized with minimal distance from the frontal and maxillary sinus. During measurement it was observed that the superior orbital rim presented a sagittal bone distance of 8.14mm +/- 1.91 mm; inferior orbital rim of 7mm +/- 1.71 mm, and the lateral orbital presented an average of 7.91 mm +/- 1.15 mm, considering that craniofacial implants present up to 6 mm in length, the installation of implants in this area is considered safe in terms of regional bone quantity requirements.