Considerations in Forehead Reduction for Men.

Although frontal prominence is an infrequent benign defect that causes no sequelae, it gives the patient distress due to its unaesthetic visual aspect. Proper surgical recontouring of the forehead can radically change one's appearance. In consequence, different techniques have been proposed for its management and correction. The aim of this study is to describe a surgical algorithm to treat male patients with forehead reduction to soften the "forceful" look. An observational cross-sectional study was conducted at the head and neck surgery ward of a general hospital between 2019 and 2022. We performed 35 forehead reduction operations on male patients. The median age was 29 years (range, 26-32 years). The forehead reduction procedures performed was categorized as follows: 27 anterior table osteotomy and 8 anterior table osteotomy contouring. Median forehead reduction was 2.7 mm (range, 2-3.2 mm). The average medical follow-up for patients was 6 months, with an interval ranging from 4 to 8 months. Surgery of the forehead in properly selected male patients is sufficiently safe that it can be done for entirely aesthetic reasons. The choice of surgical technique depends on the presence or absence of the pneumatized frontal sinus. If the frontal sinus is not pneumatized, an anterior table contouring is performed and if the frontal sinus is pneumatized, an anterior table osteotomy is preferred.

Surgical Treatment and Reconstruction of Nasal Defects According to the Aesthetic Subunits Principles.

The aim of this study was to determine the prevalence of nasal skin cancer, its location by facial aesthetic subunits and the type of reconstructive procedures performed for each nasal subunit after excision for nasal skin tumors. Observational cross-sectional study of all consecutive patients with the diagnosis of skin tumor located in the nasal unit, treated from 2018 to 2019 by the department of head and neck surgery of a general hospital. 60 patients were treated with nasal skin tumors excisions. A total of 52 patients (86,6%) had basal cell skin cancer, 7 (11,6%) had squamous cell skin cancer and 1 (1,6%) had melanoma. Fifty-nine patients (98.33%) presented a primary tumor and just 1 case (1,66%) recived a previous surgical treatment. Regardless of the type of tumor, the tip subunit was the most often involved with 29 (48,33%) cases in total. Despite of the nasal aesthetic subunit affected, the most frequent type of procedure used for reconstruction was the rotation or advancement flap, based on aesthetic nasal subunits, which was performed in 39 cases (65%). Nasal reconstruction after skin cancer can be very complex, especially since all patients have high expectations about the results. In order to achieve good results, there is a necessity for careful analysis of the defect, correct planning and excellent technical execution of the procedures Frequently, staged procedures will be needed to achieve an optimal result.

Fracturas del tercio medio facial de trazo unilateral / Midface fractures unilateral stroke

Las fracturas del tercio medio facial de trazo unilateral son las más frecuentes del macizo óseo-facial en general; dentro de estas, las del maxilar superior son las de mayor incidencia. Se producen como consecuencia de traumatismo severos. Este tipo de fractura se determina por edad, sexo y agente causal importante para su manejo. Se pueden presentar en forma combinada con otro tipo de fractura facial. El tercio medio del macizo óseo-facial está conformado por un complejo de huesos unidos unos a otros, dentro de los que tenemos principalmente a los maxilares superiores, huesos propios nasales, malares y temporales. Se ha elaborado una clasificación que incluye las estructuras óseas mencionadas y a la vez es comprensible y de fácil aplicación. Para la realización del estudio se revisaron historias clínicas de los pacientes portadores de fracturas unilaterales del tercio medio facial, desde junio 1999 hasta junio 2006. Se empleó una ficha de recolección de datos necesarios para la investigación. Se realizó un estudio tipo observacional descriptivo. Se revisaron 267 historias clínicas, el 84% corresponde al sexo masculino y el 67% estuvo entre 21-40 años de edad. El 45% fue causado por accidentes de tránsito y 23% agresiones por robo.

Manejo quirúrgico conservador de un caso de fibroma osificante juvenil / Conservative surgery management in a case of juvenile ossifying fibroma

El fibroma osificante juvenil es considerado una neoplasia fibro-benigna, de crecimiento rápido, más comúnmente diagnosticada en edades entre los cinco y los quince años. Nosotros reportamos un caso de fibroma osificante juvenil con retención de canino en maxilar superior, en una paciente mujer de 22 años de edad. El tratamiento consistió en extirpación del tumor, endodoncias y apicectomías en las piezas dentarias involucradas en la lesión.