"Functional Rhinofiller": Improvement of Nasal Airflow with Rhinofiller-A Retrospective Review.

INTRODUCTION: Rhinofiller is an aesthetic medical technique that can significantly enhance facial aesthetics by employing hyaluronic acid infiltration. The aim of this study is to review the impact of aesthetic rhinofiller on nasal airflow. METHODS: This is a retrospective review of 63 consecutive patients. The evaluation of the change in nasal respiratory flow was performed subjectively using a Likert questionnaire and objectively using a rhinomanometer, which enabled active anterior rhinomanometry (AAR). Data were collected at pre-intervention, post-intervention, and at 6-month follow-up. RESULTS: Among the 63 patients, the questionnaire responses resulted statistically significant both after the treatment and at the 6-month follow-up (p=0.00001). A statistically significant improvement was also observed at the rhinomanometric evaluation between pre-intervention and post-intervention (p=0.006 at 74 Pa, p=0.002 at 100 Pa, and p=0.001 at 150 Pa) and at the 6-month follow-up (p=0.008 at 74 Pa, p=0.003 at 100 Pa, and p=0.002 at 150 Pa). Differences between results were established with a Student's t-test. All p-values were two-tailed, and a value < 0.05 was considered significant. CONCLUSIONS: Rhinofiller can be a valuable aid in enhancing both nasal airflow and facial aesthetics. Based on our experience, it resulted in an immediate post-operative improvement in nasal airflow that remains stable in the subsequent 6 months. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . IV: Non-Surgical Procedures.

Personal Technique of Microinfiltration With Botulin Toxin: The SINB Technique (Superficial Injection Needling Botulinum).

The superficial injection needling botulinum (SINB) technique is the dermal injection of microdoses of botulin toxin, not by traditional syringe but with needling technique that consists in multiple microdroplets by electrical device. The intention is to decrease sweat and sebaceous gland activity to improve skin texture and sheen and to target the superficial layer of muscles that find attachment to the undersurface of the dermis causing visible rhytides. The technique is for treatment of face and neck by the injection of the botulin toxin into the dermis or in subdermal plane to improve skin texture, smoothen horizontal creases, and decrease vertical banding of the neck as well as to achieve better apposition of the platysma to the jawline and neck, improving contouring of the cervicomental angle. The botox solution is hyperconcentrated when compared to traditional dilution or compared to microbotox or mesobotox. Furthermore, the injection technique is different because spreading superficial microdroplets are not performed, but small, homogeneous, and controlled amounts of solution are injected. Each 0.8-mL syringe contains 50 units of onabotulinumtoxinA. The solution is delivered intradermally, using an electrical needling pen and setting the depth penetration of the needles at 3 to 3.5 mm. The 2 conjugated techniques play a 2-fold action on the skin. The technique was applied to a group of 63 patients dealing with face, forehead, cheekbones, and neck.

La technique d'injection superficielle de botuline à l'aiguille (SINB d'après l'acronyme anglais) consiste à procéder à l'injection dermique de microdoses de toxine botulique, non pas à l'aide de la seringue habituelle, mais d'une technique à l'aiguille constituée de multiples microgouttes injectées par un dispositif électrique. On vise ainsi à réduire l'activité sudoripare et sébacée pour améliorer la texture et la brillance de la peau et cibler la couche superficielle des muscles attachés à la face inférieure du derme, responsables de rhytides visibles. La technique vise le traitement de la face et du cou par l'injection de toxine botulique dans le derme ou le plan sous-cutané pour améliorer la texture de la peau, lisser les plis horizontaux, réduire les bandes verticales du cou, obtenir une meilleure apposition du muscle peaucier sur les maxillaires et le cou et ainsi améliorer le contour de l'angle cervicomentonnier. La solution de botox est hyperconcentrée par rapport à la dilution habituelle ou à la dilution au microbotox ou au mésobotox. De plus, la technique d'injection est différente puisqu'on n'étend pas de microgouttes superficielles, mais qu'on injecte de petites quantités de solutions homogènes et contrôlées. Chaque seringue de 0,8 mL contient 50 unités d'onabotulinum toxine A. La solution est administrée par voie intradermique au moyen d'un stylo injecteur électrique dont la profondeur d'insertion se situe entre 3,0 et 3,5 mm. Les deux techniques conjuguées ont une double action sur la peau. La technique a été utilisée dans un groupe de 63 patients, sur le visage, le front, les pommettes et le cou.

Efficacy of bovine lactoferrin in the post-surgical treatment of patients suffering from bisphosphonate-related osteonecrosis of the jaws: an open-label study.

Osteonecrosis of the jaws is an emerging pathological condition characterized by un-exposure or exposure of the necrotic bone, independently from the etiology. This term is usually referred to medication-related osteonecrosis of the jaws due to severe adverse reaction to certain medicines, as bisphosphonates, used for the treatment of cancer and osteoporosis. The management of patients with Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ) remains challenging because surgical and medical interventions may not eradicate this pathology. The goal of treatment of patients at risk of developing BRONJ or of those who have active disease is the preservation of quality of life by controlling pain, managing infection, and preventing the development of new areas of necrosis. The treatment of osteonecrosis consists in the surgical removal of necrotic bone followed by antibiotic therapy and application of sterile greasy gauze until the wound closure. The classical medical treatment has been compared with the innovative one consisting in the application of sterile greasy gauze soaked with bovine lactoferrin (bLf) after surgery. Here, for the first time, bLf efficacy on wound repair in subjects suffering from BRONJ with the progressive destruction of bone in the mandible or maxilla has been demonstrated. The positive results consist in a significant shorter time of wound closure (1 or 2 weeks) compared to that observed with classical surgical treatment (2-3 months). These promising results are an interesting tool for the innovative treatment of this pathology and for increasing the quality of life of these patients.

Fronto-ethmoidal osteoma. Open treatment.

INTRODUCTION: Osteoma is a benign tumour, composed of mature compact or cancellous bone, which can arise in any facial bone. Among the paranasal sinuses, the frontal and ethmoid sinuses are most frequently involved. Osteoma grows very slowly and small lesions are often not symptomatic. On the other hand, sometimes patients present with symptoms such as sinusitis, headache or ophtalmologic manifestations. These findings are secondary to obstruction of the involved sinus cavity with secondary mucocele formation or occasionally an expansile lesion with distortion of the facial contour. MATERIALS AND METHODS: From 2005 to 2010, twenty-one (21) patients affected with non-syndromic fronto-ethmoidalosteomas were evaluated in our Department. Collected data include patients' age at the time of disorders, gender, presenting signs and symptoms, primary diagnosis, type and characteristics of the treatment performed, radiological findings and post-treatment results. All patients were investigated by CT scans in axial and coronal planes. The treatment and outcomes of this group were reviewed. RESULTS: All patients of the study underwent surgery and had a follow-up of at least 5 years. Surgical excision of the tumour was undertaken. Postoperative CT scans in axial and coronal planes showed complete removal of the tumour in all cases. No complications or recurrences were observed. DISCUSSION: Small, asymptomatic osteomas probably do not need to be treated but should be observed periodically. Surgical management remains the mainstay of treatment for these tumours. It requires total excision via an adequate approach, depending upon the site of presentation. CONCLUSION: A purely endoscopic endonasal approach has the risk of incomplete excision. In our experience open technique provides a wide exposure and better control. Even frontal osteomas can be safely removed by careful open surgery KEY WORDS: Ethmoidal sinus, Frontal sinus, Open treatment, Osteoma, Paranasal sinuses.

Surgical treatment of temporomandibular joint ankyloses: meniscus conservation and relocation.

Ankylosis of the temporomandibular joint is a serious complication, mainly after trauma and local or systemic infection. In rare cases, ankylosis is associated with systemic disease such as ankylosing spondylitis, rheumatoid arthritis, and psoriasis. According to the functional restriction and the provoked disturbances of facial growth in the youth, an early and effective therapy is desirable. There is a wide variety of surgical approaches to temporomandibular joint ankylosis, ranging from chondro-osseous grafts to prothesis. In the article the authors present the clinical case of a 60-year-old patient who, at the age of 6, accidentally fell from a height of about 2 m. In 60 years old, after removing the temporomandibular ankylosis with surgical technique, patient showed a marked improvement of mandibular kinetics.

Compression and stretching in Graves orbitopathy: emergency orbital decompression techniques.

Visual loss from orbital compression and stretching of the optic nerve is an infrequent but well-recognized cause of dysthyroid optic neuropathy, occurring in less than 5% of thyroid eye disease cases. Another important but less recognized cause of vision loss due to thyroid-associated optic neuropathy is protracted stretching of the optic nerve. Of the reported cases of compression and stretch optic neuropathy, none have documented the rate of vision loss due to continuous stretching of the optic nerve.

Dermoid cyst: unusual localization.

Dermoid cysts are embryonic lesions usually observed in the lateral eyebrow region and the midline nose and neck areas. Communication of these lesions with the central nervous system is rare and occurs in the nasal region. There are few clinical reports of temporal dermoid cysts presenting with intracranial extension, and we present a 15-year-old girl with a fronto-orbital dermoid cyst with intracranial extension and bone erosion. Her presenting symptom was a lacrimation reduction of the left eye. Excision of the cyst was done using a coronal approach because of its extension and localization.