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1.
J Craniofac Surg ; 24(3): 896-9, 2013 May.
Article in English | MEDLINE | ID: mdl-23714905

ABSTRACT

Facial paralysis in the midface causes loss of cheek tonus, asymmetry at rest, and inability to smile. Static suspension is generally performed in patients who cannot tolerate time-consuming dynamic reanimation. Current methods for static slings are overly simplistic. A sling, which is generally fascia lata or palmaris tendon, is placed between the modiolus and the zygomatic arch or the temporalis fascia, with further extension to the midline of the upper end lower lips in 1 vector. Recently, sutures are placed in a multivectorial approach, but suture failure via breakage is the main problem. In this study, the long, thin, and powerful plantaris tendon was used and divided into 3 slips. Placement of these slips and their tension adjustment were revised to provide strong and long-lasting upper lip and the modiolus pull, along with creation of a well-defined nasolabial fold, and to create sufficient cheek tonus. The first slip was positioned at 35 to 45 degrees to the horizontal plane between the modiolus and the upper preauricular area, second slip at 55 to 60 degrees between the upper lip and the deep temporal fascia, and the third slip at 0 to 10 degrees between the lower lip and lower preauricular area with gradually decreasing tension from above to below in 9 patients. Upper 2 slings were also sutured to the dermis of the nasolabial fold to define it optimally. Results were assessed both objectively and subjectively. Symmetry at rest, sufficient cheek tightness to prevent drooling, and a well-defined fold were obtained.


Subject(s)
Facial Paralysis/surgery , Tendons/transplantation , Adult , Facial Asymmetry/physiopathology , Facial Asymmetry/surgery , Facial Muscles/physiopathology , Facial Muscles/surgery , Facial Paralysis/physiopathology , Fasciotomy , Female , Follow-Up Studies , Foot/surgery , Humans , Lip/surgery , Male , Middle Aged , Muscle Tonus/physiology , Nasolabial Fold/surgery , Patient Satisfaction , Temporal Muscle/surgery , Transplant Donor Site/surgery , Treatment Outcome
2.
J Craniofac Surg ; 24(3): e211-3, 2013 May.
Article in English | MEDLINE | ID: mdl-23714963

ABSTRACT

Basal cell carcinoma is the most common malignant tumor of the skin. The most important feature is its very slow growth rate. It takes many years to reach gigantic dimensions. Various syndromes have been defined in which basal cell carcinoma exists in multiple localizations in a single patient. A case of basal cell carcinoma with multiple localizations and gigantic dimensions which is not classified as a syndrome is described in this case report.


Subject(s)
Carcinoma, Basal Cell/diagnosis , Head and Neck Neoplasms/diagnosis , Neoplasms, Multiple Primary/diagnosis , Scalp/pathology , Skin Neoplasms/diagnosis , Carcinoma, Squamous Cell/diagnosis , Diagnosis, Differential , Female , Humans , Middle Aged
3.
J Craniofac Surg ; 22(4): 1358-60, 2011 Jul.
Article in English | MEDLINE | ID: mdl-21772181

ABSTRACT

There have been considerable advances in the management of craniomaxillofacial injuries in children. Conservative approaches such as close observation, a liquid-to-soft diet, and analgesics can be used for the management of mandibular fractures without displacement and malocclusion. However, displaced fractures need to be an anatomic reduction and immobilization. The basic principle of displaced mandibular fractures in both children and adults is the stabilization of fracture fragments forming the pretraumatic contour and occlusion state until osteosynthesis occurs. The major differences of pediatric fractures from adults are the flexibility of bones and very rapid healing pattern. Therefore, reduction in pediatric age group must be accomplished earlier. This case was an 11-year-old boy presented with a severely displaced parasymphyseal mandibular fracture resulting from a fall. He was given a soft diet and analgesic, given anti-inflammatory treatment of edema, and scheduled for operation. Subsequently, it was surprisingly observed that there was a significant improvement in the fracture line on the 12th posttraumatic day. The comparison of maxillofacial computed tomographic scans of the first and 12th posttraumatic days revealed a noteworthy remodeling and a remarkable approximation of the fracture lines. It can be concluded that bone remodelization in the pediatric age groups is perfect and very rapid, even in severely displaced fractures.


Subject(s)
Bone Remodeling/physiology , Fracture Healing/physiology , Joint Dislocations/physiopathology , Mandibular Fractures/physiopathology , Accidental Falls , Analgesics/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Child , Diet , Follow-Up Studies , Humans , Jaw Fixation Techniques , Joint Dislocations/therapy , Male , Mandibular Fractures/therapy , Tomography, X-Ray Computed
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