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Salem SA, Seoudy WM, Abd El-Rahman NS, Afify AA. Different Dilutions of Mesobotox in Facial Rejuvenation: Which is Better? Aesthetic Plast Surg 2024:10.1007/s00266-024-04029-7. [PMID: 38714537 DOI: 10.1007/s00266-024-04029-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/26/2024] [Indexed: 05/10/2024]
Abstract
BACKGROUND Microbotulinum toxin A treatment is a technique of delivering multiple intradermal injections of diluted botulinum toxin type A into the dermis or the interface between the dermis and the superficial layer of the facial muscles to preserve the facial mobility. The current study aimed to evaluate and compare the clinical effect of different dilutions of microbotulinum toxin A in periorbital and mid-facial rejuvenation. METHODS This randomized prospective interventional study included 30 female patients with different types of wrinkles in periorbital and/or mid-face. Patients were divided into three groups: group I (10 patients): 100U botulinum toxin in 5 ml saline, group II (10 patients): 100U botulinum toxin in 7 ml saline and group III (10 patients): 100U botulinum toxin in 10 ml saline. RESULTS A statistically significant better global esthetic improvement scale (GAIS) scores after 1 month were observed in group I compared to groups II and III. Also, after 6 months better GAIS scores were observed in group I compared to group II and in group II compared to group III. Assessment of different esthetic parameters measured by the Antera 3D camera revealed a statistically significant improvement in all parameters (periorbital and mid-face) in group I and in most of parameters (periorbital and mid-face) in groups II and III with more evident improvement after 1 month compared to after 6 months. CONCLUSION Intradermal microbotulinum toxin A is a cost-effective method for improving periorbital and mid-face wrinkles with a better effect of 1:5 than 1:7 and 1:10 dilutions. Facial wrinkles possess a great burden on patients' psychological status, and the emergence of novel rejuvenation technique with minimal side effects is necessary. MicroBoNT-A usage in the literature was through variety of dilutions and concentrations. Therefore, a conclusive and comparative study was essential to compare the effect of different microBoNT-A dilutions. In this context, the current study aimed to evaluate and compare the clinical effect of different dilutions of microBoNT-A in periorbital and mid-facial rejuvenation. LEVEL OF EVIDENCE III 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 .
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Affiliation(s)
| | - Wael Mohamed Seoudy
- Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt
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Smith K, Wilkinson C. The Doppelgänger effect? A comparative study of forensic facial depiction methods. Forensic Sci Int 2024; 356:111935. [PMID: 38325246 DOI: 10.1016/j.forsciint.2024.111935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/11/2023] [Accepted: 01/14/2024] [Indexed: 02/09/2024]
Abstract
This study attempted to assess the reproducibility of 2D and 3D forensic methods for facial depiction from skeletal remains (2D sketch, 3D manual, 3D automated, 3D computer-assisted). In a blind study, thirteen practitioners produced fourteen facial depictions, using the same skull model derived from CT data of a living donor, a biological profile and relevant soft tissue data. The facial depictions were compared to the donor subject using three different evaluation methods: 3D geometric, 2D face recognition ranking and familiar resemblance ratings. Five of the 3D facial depictions (all 3D methods) demonstrated a deviation error within ± 2 mm for ≥ 50% of the total face surface. Overall, no single 3D method (manual, computer assisted, automated) produced consistently high results across all three evaluations. 2D comparisons with a facial photograph of the donor were carried out for all the 2D and 3D facial depictions using four freely available face recognition algorithms (Toolpie; Photomyne; Face ++; Amazon). The 2D sketch method produced the highest ranked matches to the donor photograph, with overall ranking in the top six. Only one 3D facial depiction was ranked highly in both the 3D geometric and 2D face recognition comparisons. The majority (67%) of the facial depictions were rated as limited or moderate resemblance by the familiar examiner. Only one 2D facial depiction was rated as strong resemblance, whilst two 2D sketches and two 3D facial depictions were rated as good resemblances by the familiar examiner. The four most geometrically accurate 3D facial depictions were only rated as limited or moderate resemblance to the donor by the familiar examiner. The results suggest that where a consistent facial depiction method is utilised, we can expect relatively consistent metric reliability between practitioners. However, presentation standards for practitioners would greatly enhance the possibility of recognition in forensic scenarios.
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Affiliation(s)
- Kathryn Smith
- Centre for Anatomy & Human Identification, University of Dundee, DD1 4HN, UK; Department of Visual Arts, Stellenbosch University, Victoria Street, Stellenbosch 7600, South Africa; Face Lab, G05 Aquinas Building, Liverpool John Moores University, L1 5DE, UK
| | - Caroline Wilkinson
- Centre for Anatomy & Human Identification, University of Dundee, DD1 4HN, UK; Face Lab, G05 Aquinas Building, Liverpool John Moores University, L1 5DE, UK.
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Mataro I, La Padula S. Adverse Events Associated with Hyaluronic Acid Filler Injection for Non-Surgical Facial Aesthetics: A Systematic Review of High Level of Evidence Studies. Aesthetic Plast Surg 2024; 48:742-744. [PMID: 37794200 DOI: 10.1007/s00266-023-03685-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023]
Abstract
The article titled "Adverse Events Associated with Hyaluronic Acid Filler Injection for Non-surgical Facial Aesthetics: A Systematic Review of High Level of Evidence Studies" by Kyriazidis et al.in Aesthetic Plastic Surgery presents a systematic review focused on categorizing complications linked to hyaluronic acid (HA) dermal fillers. However, concerns arise about the methodologies employed in the reviewed studies. Precise knowledge of the active substance's properties is vital for treatment standardization. Gaining a comprehensive understanding of the key characteristics of the employed HA is of paramount importance to ascertain whether an association exists between these properties and the risk of complications. Understanding the rheological properties of HA, including viscosity, elasticity, and cohesiveness, is crucial for optimal facial filler selection. Acknowledging the authors' contributions, further analysis should encompass these factors.Level of Evidence V 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 .
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Affiliation(s)
- Ilaria Mataro
- Department of Plastic Reconstructive Surgery and BURNS, AORN A. Cardarelli, Via Antonio Cardarelli, 9, 80131, Napoli, NA, Italy.
| | - Simone La Padula
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
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Kyriazidis I, Spyropoulou GA, Zambacos G, Tagka A, Rakhorst HA, Gasteratos K, Berner JE, Mandrekas A. Adverse Events Associated with Hyaluronic Acid Filler Injection for Non-surgical Facial Aesthetics: A Systematic Review of High Level of Evidence Studies. Aesthetic Plast Surg 2024; 48:719-741. [PMID: 37563436 DOI: 10.1007/s00266-023-03465-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/11/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Hyaluronic acid (HA) dermal fillers are widely used in aesthetic medicine. While generally safe, potential complications can arise. OBJECTIVE This systematic review aims to identify and classify potential complications linked to the use of HA dermal fillers, as informed by high-quality, low-risk-of-bias studies. METHODS This review follows the Cochrane review standards for clinical systematic reviews. This systematic review analyzed 48 high level of evidence studies on the use of hyaluronic acid (HA) dermal fillers in non-surgical facial aesthetics and the adverse events that occurred.The inclusion criteria were randomized control studies on HA dermal fillers and their complications. Excluded were case reports, case series, observational studies, and other non-randomized research due to their inability to provide generalized conclusions and their inherent publication bias. RESULTS Adverse events were classified into three categories: expected reactions, product or technique-related adverse events, and severe adverse events. Most adverse events were short-lived injection site reactions, which resolved spontaneously. Specific HA fillers and injection techniques influenced the occurrence of adverse events, which generally resolved within weeks without treatment. Severe adverse events were rare, persisting for months and requiring active medical intervention. DISCUSSION This classification system can enhance understanding, prevention, and treatment of HA filler complications, and support patient education. The common complications were injection site reactions, with persistent symptoms treated with topical steroids, NSAIDs, or hyaluronidase. Severe complications included severe edema, angioedema and others, often necessitating specific treatments. CONCLUSION HA dermal fillers are generally safe and effective, with most adverse events being transient and mild to moderate in severity. Severe adverse events, although rare, do occur and are generally non-treatment related. Informed consent, patient education, and professional training are crucial for safe and successful outcomes. Level of Evidence II 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 .
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Affiliation(s)
- Ioannis Kyriazidis
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56403, Thessaloniki, Greece.
| | - Georgia-Alexandra Spyropoulou
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56403, Thessaloniki, Greece
| | | | - Anna Tagka
- First Department of Dermatology and Venereology, Andreas Syggros Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Hinne A Rakhorst
- Department of Plastic, Reconstructive and Hand Surgery, Medisch Spectrum Twente/Ziekenhuisgroep Twente, Haaksbergerstraat, Enschede, The Netherlands
| | - Konstantinos Gasteratos
- Department of Plastic Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56403, Thessaloniki, Greece
| | - Juan Enrique Berner
- Plastic Surgery Department, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
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Yazbeck M, Msheik A, Berjaoui C, Dabboucy B, Comair Y. Severe hyponatremia and bilateral sequential facial palsy: A case report. Radiol Case Rep 2023; 18:4062-4065. [PMID: 37701361 PMCID: PMC10493881 DOI: 10.1016/j.radcr.2023.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 08/09/2023] [Indexed: 09/14/2023] Open
Abstract
Facial palsy (FP) is a known consequence of head trauma, manifesting either immediately at the time of injury or with delayed onset, typically occurring 2 days or more post-trauma. Unilateral FP is the more common presentation and is often attributed to partial or complete transection of facial nerves or delayed onset edema. Conversely, bilateral facial palsy is a rare occurrence, reported in only a small number of cases, accounting for approximately 3% of patients presenting with bilateral weakness. In this report, we present the case of a previously healthy 28-year-old female who suffered a closed head injury during the Beirut Port Blast. Four days following the incident, the patient exhibited right-sided peripheral FP, which was consistent with a right temporal bone fracture. Subsequently, on the fifth day, the right-sided FP worsened, accompanied by the development of new FP on the left side, characterized by sparing of the frontal region, indicating a central origin for the left-sided FP. Laboratory investigations revealed severe hypovolemic hyponatremia with a sodium level of 105 mmol/L. As isotonic saline fluid replacement was initiated, there was progressive improvement in the left-sided FP. The right-sided palsy also resolved gradually with the implementation of facial rehabilitation therapy. It is important to note that severe head trauma, particularly with a concussive injury, can lead to facial paralysis through various mechanisms. Furthermore, severe hyponatremia should be considered a potential cause of central facial palsy, particularly in the presence of bilateral facial involvement. A thorough evaluation is encompassing assessment of palsy patterns, comprehensive imaging studies, and metabolic investigations is crucial for accurate diagnosis and timely intervention, resulting in successful treatment.
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Affiliation(s)
- Mohamad Yazbeck
- Department of Neurosurgery, Clemenceau Medical Center, Beirut, Lebanon
| | - Ali Msheik
- Department of Neurosurgery, Lebanese University Faculty of Medical Sciences, Beirut, Lebanon
| | | | - Baraa Dabboucy
- Department of Neurosurgery, Lebanese University Faculty of Medical Sciences, Beirut, Lebanon
| | - Youssef Comair
- Department of Neurosurgery, Clemenceau Medical Center, Beirut, Lebanon
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Capote R, Preston K, Kapadia H. Cranio facial Growth and Development: A Primer for the Facial Trauma Surgeon. Oral Maxillofac Surg Clin North Am 2023; 35:501-513. [PMID: 37302949 DOI: 10.1016/j.coms.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Understanding craniofacial growth and development is important in the management of facial trauma in the growing pediatric patient. This manuscript is a review of craniofacial growth and development and clinical implications of pediatric facial fractures.
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Affiliation(s)
- Raquel Capote
- Department of Oral and Maxillofacial Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Cleft and Craniofacial Program, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
| | - Kathryn Preston
- Center for Cleft and Craniofacial Care, Phoenix Children's Hospital, Phoenix, AZ, USA; Department of Orthodontics, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA
| | - Hitesh Kapadia
- Craniofacial Center, Seattle Children's Hospital, Seattle, WA, USA; Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, WA, USA; Department of Orthodontics, School of Dentistry, University of Washington, Seattle, WA, USA
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Taylor JQ, Hopkins E, Yang R, Abramowicz S. Epidemiology and Etiology of Facial Injuries in Children. Oral Maxillofac Surg Clin North Am 2023; 35:515-519. [PMID: 37302950 DOI: 10.1016/j.coms.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Pediatric Trauma results in over 8 million emergency department visits and 11,000 deaths annually. Unintentional injuries continue to be the leader in morbidity and mortality in pediatric and adolescent populations in the United States. More than 10% of all visits to pediatric emergency rooms (ER) present with craniofacial injuries. The most common etiologies for facial injuries in children and adolescence are motor vehicle accidents, assault, accidental injuries, sports injuries, nonaccidental injuries (eg, child abuse) and penetrating injuries. In the United States, head trauma secondary to abuse is the leading cause of mortality among non-accidental trauma in this population.
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Affiliation(s)
- Jeffrey Quinn Taylor
- Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, NE, Building B, Suite 2300, Atlanta, GA 30322, USA; Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, NE, Building B, Suite 2300, Atlanta, GA 30322, USA.
| | - Elizabeth Hopkins
- Johns Hopkins Children's Center Specialists, 6420 Rockledge Drive, Suite 2300, Bethesda, MD 20817, USA
| | - Robin Yang
- Johns Hopkins Children's Center Specialists, 6420 Rockledge Drive, Suite 2300, Bethesda, MD 20817, USA
| | - Shelly Abramowicz
- Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, NE, Building B, Suite 2300, Atlanta, GA 30322, USA; Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, NE, Building B, Suite 2300, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 2105 Uppergate Drive, Atlanta, GA 30307, USA
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Tuleasca C, Kotecha R, Sahgal A, de Salles A, Fariselli L, Paddick I, Pollock BE, Régis J, Sheehan J, Suh JH, Yomo S, Levivier M. Single-fraction radiosurgery outcomes for large vestibular schwannomas in the upfront or post-surgical setting: a systematic review and International Stereotactic Radiosurgery Society (ISRS) Practice Guidelines. J Neurooncol 2023; 165:1-20. [PMID: 37843727 PMCID: PMC10638172 DOI: 10.1007/s11060-023-04455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/17/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE To perform a systematic review of literature specific to single-fraction stereotactic radiosurgery (SRS) for large vestibular schwannomas (VS), maximum diameter ≥ 2.5 cm and/or classified as Koos Grade IV, and to present consensus recommendations on behalf of the International Stereotactic Radiosurgery Society (ISRS). METHODS The Medline and Embase databases were used to apply the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. We considered eligible prospective and retrospective studies, written in the English language, reporting treatment outcomes for large VS; SRS for large post-operative tumors were analyzed in aggregate and separately. RESULTS 19 of the 229 studies initially identified met the final inclusion criteria. Overall crude rate of tumor control was 89% (93.7% with no prior surgery vs 87.7% with prior surgery). Rates of salvage microsurgical resection, need for shunt, and additional SRS in all series versus those with no prior surgery were 9.6% vs 3.3%, 4.7% vs 6.4% and 1% vs 0.9%, respectively. Rates of facial palsy and hearing preservation in all series versus those with no prior surgery were 1.3% vs 3.4% and 34.2% vs 40.4%, respectively. CONCLUSIONS Upfront SRS resulted in high rates of tumor control with acceptable rates of facial palsy and hearing preservation as compared to the results in those series including patients with prior surgery (level C evidence). Therefore, although large VS are considered classic indication for microsurgical resection, upfront SRS can be considered in selected patients and we recommend a prescribed marginal dose from 11 to 13 Gy (level C evidence).
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Affiliation(s)
- Constantin Tuleasca
- Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland.
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.
- Ecole Polytechnique Fédérale de Lausanne (EPFL, LTS-5), Lausanne, Switzerland.
| | - Rupesh Kotecha
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Arjun Sahgal
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Antonio de Salles
- University of California Los Angeles, USA, NeuroSapiens and Rede D'Or São Luiz, São Paulo, Brazil
| | - Laura Fariselli
- Department of Neurosurgery, Unit of Radiotherapy, Fondazione IRCCS Istituto Neurologico C Besta, Milan, Italy
| | - Ian Paddick
- Medical Physics Ltd, Queen Square Radiosurgery Centre, London, UK
| | | | - Jean Régis
- Department of Functional and Stereotactic Neurosurgery, Assistance Publique-Hôpitaux de Marseille, Timone Hospital, Marseille, France
- Institut Neurosciences des Systèmes, Aix-Marseille University, Institut National De La Santé Et De La Recherche Médicale, Marseille, France
| | - Jason Sheehan
- Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA
| | - John H Suh
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Shoji Yomo
- Division of Radiation Oncology, Aizawa Comprehensive Cancer Center, Aizawa Hospital, Nagano, Japan
| | - Marc Levivier
- Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
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Udayakumar SIV, Kim D, Choi SY, Kwon TG. 3D simulation of interosseous interference in sagittal split ramus osteotomy for mandibular asymmetry. Maxillofac Plast Reconstr Surg 2023; 45:32. [PMID: 37718330 PMCID: PMC10505600 DOI: 10.1186/s40902-023-00400-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/03/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the pattern of predicted interosseous interference and to determine the influencing factor to volume of bony interference using a computer-assisted simulation system. This retrospective study recruited 116 patients with mandibular prognathism who had undergone sagittal split ramus osteotomy (SSRO) with or without maxillary osteotomy. The patients were divided into 3 groups according to the amount of menton (Me) deviation: less than 2 mm (Group 1), 2-4 mm (Group 2), and more than 4 mm (Group 3). Changes in the distal segments following BSSRO and the volume of the interosseous interference between the proximal and distal segments were simulated after matching preoperative occlusion and postoperative expected occlusion with the cone-beam computed tomography data. Ramal inclinations and other skeletal measurements were analyzed before surgery, immediately after surgery, and at least 6 months after surgery. RESULTS The anticipated interosseous interference was more frequently noted on the contralateral side of chin deviation (long side) than the deviated site (short side) in Groups 2 and 3. More interference volume was predicted at the long side (186 ± 343.9 mm3) rather than the short side (54.4 ± 124.4 mm3) in Group 3 (p = 0.033). The bilateral difference in the volume of the interosseous interference of the osteotomized mandible was significantly correlated with the Me deviation (r = - 0.257, p = 0.009) and bilateral ramal inclination (r = 0.361, p < 0.001). The predictor variable that affected the volume of the osseous interference at each side was the amount of Me deviation (p = 0.010). CONCLUSION By using the 3D simulation system, the potential site of bony collision could be visualized and successfully reduced intraoperatively. Since the osseous interference can be existed on any side, unilaterally or bilaterally, 3D surgical simulation is necessary before surgery to predict the osseous interference and improve the ramal inclination.
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Affiliation(s)
- Santhiya Iswarya Vinothini Udayakumar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-Daero, Jung-Gu, Daegu, 41940, Republic of Korea
| | - Dohyoung Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-Daero, Jung-Gu, Daegu, 41940, Republic of Korea
| | - So-Young Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-Daero, Jung-Gu, Daegu, 41940, Republic of Korea
| | - Tae-Geon Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-Daero, Jung-Gu, Daegu, 41940, Republic of Korea.
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Adriaenssens J, Vaesen Bentein H, Jacobs R, Politis C, Van der Cruyssen F. Prospective oro facial quantitative sensory testing data of the human face and mouth. Data Brief 2023; 49:109316. [PMID: 37360670 PMCID: PMC10285537 DOI: 10.1016/j.dib.2023.109316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
Quantitative sensory testing (QST) is a valuable tool in the assessment of orofacial somatosensory function and dysfunction. QST is a method where thermal and mechanical stimuli are applied to the area of interest in a noninvasive way. The QST technique can detect patterns of loss of sensation that may happen in case of hypoesthesia, hypoalgesia, anesthesia, or gain of sensation in the context of allodynia, hyperalgesia or spontaneous pain. Normal values have already been recorded for some parts of the face and mouth, but not for the complete innervation area of the trigeminal nerve. This dataset involves orofacial QST gathered from ten healthy volunteers, a standardized QST battery was applied to 24 regions (14 extraoral and 10 intraoral) innervated by the trigeminal nerve. Descriptive statistics were applied to compare the different regions. This dataset can be used to inform future studies involving orofacial sensory function, pain studies and pharmacological trials.
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Affiliation(s)
- Julie Adriaenssens
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Hannah Vaesen Bentein
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Leuven, Belgium
- Department of Oral Health Sciences, KU Leuven and Department of Dentistry, University Hospitals, Leuven, Belgium
- Department of Dental Medicine, Karolinksa Institutet, Stockholm, Sweden
| | - Constantinus Politis
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Leuven, Belgium
| | - Fréderic Van der Cruyssen
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Leuven, Belgium
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Putra MDP, Putra GFA, Soewoto W, Yarso KY, Aktama G, Sarasati SA. Bilobed flap technique as alternative for patient with eccrine spiradenoma: A rare case report. Int J Surg Case Rep 2023; 109:108549. [PMID: 37517252 PMCID: PMC10400849 DOI: 10.1016/j.ijscr.2023.108549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/10/2023] [Accepted: 07/15/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE OF CASE Eccrine spiradenoma (ES) is a rare benign skin adnexal tumor. ES resembles many other dermal lesions and is commonly found at the face. Hence, proper diagnosis and treatment with aesthetic considerations are needed. CASE PRESENTATION Here we reported a case of a 47 years old male who came with a mole-like mass on the lower side of the left eye socket. The histopathological examination showed small basaloid cells surrounding the larger, paler epithelial cells, a characteristic feature of spiradenoma. The surgery was then performed using bilobed flap technique, considering that the pathological mass was oval-shaped. CLINICAL DISCUSSION Bilobed flap technique preserves skin color and texture, providing excellent tissue match and minimizes donor site complication. This technique distributes skin tension along a wider, curved area of the site. CONCLUSION Bilobed flap technique can be used in round or oval-shaped facial tumor such as ES.
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Affiliation(s)
| | | | - Widyanti Soewoto
- Department of Surgery, Oncology Surgery Subdivision, Universitas Sebelas Maret, Indonesia
| | - Kristanto Yuli Yarso
- Department of Surgery, Oncology Surgery Subdivision, Universitas Sebelas Maret, Indonesia
| | - Galih Aktama
- Department of Surgery, Universitas Sebelas Maret, Indonesia
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12
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Ahmed OA. Is congenital asymmetric crying facies really due to absence of the depressor anguli oris? J Plast Reconstr Aesthet Surg 2023; 82:235-236. [PMID: 37201314 DOI: 10.1016/j.bjps.2023.04.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/20/2023]
Affiliation(s)
- Omar A Ahmed
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
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13
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Lee SY, Kang DH, Kim YS, Lee J, Lee SJ, Huh S, Kim JY, Chung HY. Efficacy and safety of transarterial bleomycin sclerotherapy of early-stage facial arteriovenous malformation: Single-center multidisciplinary team experience. J Plast Reconstr Aesthet Surg 2023; 77:379-387. [PMID: 36623374 DOI: 10.1016/j.bjps.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 12/01/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND To evaluate the efficacy and safety of transarterial bleomycin sclerotherapy of early-stage facial arteriovenous malformation (AVM). METHODS A retrospective review was performed of patients who underwent bleomycin sclerotherapy for early-stage AVM (Schobinger stage I or II) in a single-referral vascular anomalies center. Bleomycin was slowly infused transarterially with flow control techniques to prolong the effects of bleomycin. Procedure details, AVM characteristics, and previous treatments were reviewed. Initial therapeutic outcomes were determined by 5 categories using both radiological and clinical findings in a 6-month follow-up. Further follow-up outcomes were reviewed to evaluate the long-term efficacy and safety of the treatment. Procedure-related complications were also analyzed. RESULTS Nineteen patients (mean age 22.4 ± 14.0 years, 14 females) with 31 sessions of sclerotherapies were enrolled. All AVMs were Cho-Do classification type III (type IIIa [n = 13], type IIIb [n = 2], and type IIIa+b [n = 4]). Patients received a mean of 1.6 (range, 1-4) sessions of treatment. The mean cumulative bleomycin dose was 23,600 IU ± 14,500 (range, 8000 - 60,000 IU). The results showed that 14 patients (74%) were responsive to transarterial bleomycin sclerotherapy, including complete response (n = 3), marked improvement (n = 1), and partial improvement (n = 10). The remaining 5 (26%) showed no response. During a mean follow-up of 32.6 months, 5 (26%) showed slight progression compared with 6-month outcomes and 14 (74%) were stable. There were only 2 minor complications [hyperpigmentation (n = 1) and cellulitis (n = 1)]. CONCLUSIONS Transarterial bleomycin sclerotherapy using flow control techniques can be a safe and feasible alternative treatment option for facial early-stage AVM.
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Affiliation(s)
- Sang Yub Lee
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea; Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Dong Hun Kang
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea; Department of Neurosurgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Yong Sun Kim
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Jongmin Lee
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Seok Jong Lee
- Department of Dermatology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Seung Huh
- Department of Surgery, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Ji Yoon Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Ho Yun Chung
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea.
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Talanker MM, Fallah KN, Hartline CA, Freet DJ. Total Reconstruction of Lower Lip and Chin Following Firework Injury Using Composite Bilateral Radial Forearm-Fascia Lata Flaps: A Case Report. Eplasty 2023; 23:e5. [PMID: 36817361 PMCID: PMC9912048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Background Primary explosion injuries with fireworks can lead to devastating and geometrically complex facial traumas that present a challenge to the reconstructive surgeon. Our patient, a woman in her early thirties, was hit directly in her chin by a large artillery shell firework. This caused complete soft tissue loss of the lower lip and chin beyond the oral commissures, complicated further by a comminuted mandible fracture. Methods After external fixation, our patient underwent a 2-stage reconstruction with a novel composite flap arrangement. Soft tissue coverage and lip reconstruction were performed with opposing bilateral radial forearm free flaps. The outer flap constituted the soft tissue of the new chin and outer lower lip, whereas the inner flap composed the intraoral lining. In the second stage, portions of the inner upper lip mucosa and superior orbicularis oris muscle were flipped down as a bipedicle, axial pattern "bucket-handle" type flap to the lower lip to reconstruct the vermilion. A graft of fascia lata was attached to the modioli of the orbicularis oris and interpositioned beneath the vermilion flap and the radial forearms to restore static and some dynamic sphincter control. One month later, the mandibular fractures underwent open reduction and internal fixation. Results Two months after soft tissue reconstruction with no complications, our patient had satisfactory aesthetic outcomes, oral competence, and speech. Conclusions This case has shown that use of bilateral, fascia lata-reinforced radial forearm flaps may be an effective choice for soft tissue reconstruction and oral competence restoration in cases of severe facial explosion trauma.
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Affiliation(s)
- Michael M Talanker
- Division of Plastic Surgery, Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX
| | - Kasra N Fallah
- Division of Plastic Surgery, Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX
| | - Cassie A Hartline
- Division of Plastic Surgery, Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX
| | - Daniel J Freet
- Division of Plastic Surgery, Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX,Correspondence: Daniel J Freet, MD;
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15
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Safi M. Assessing Discomfort Levels During Facial Neuromuscular Electrical Stimulation Using Discomfort Level Scale: A Preliminary Study. Indian J Otolaryngol Head Neck Surg 2022; 74:5275-5279. [PMID: 36742910 PMCID: PMC9895512 DOI: 10.1007/s12070-020-02173-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023] Open
Abstract
The primary aim of the current study was to evaluate discomfort levels of facial NMES in healthy volunteers. Eight participants completed the Discomfort Level Scale (DLS) following each motor level facial neuromuscular electrical stimulation (NMES) session. Each participant completed 12 sessions of facial NMES for a total of 96 NMES treatments. Pearson product-moment correlation coefficient demonstrated a significant correlation between the facial NMES intensity level and DLS (p < 0.001). This study demonstrated that the DLS is a useful tool to check for discomfort levels in patients who receive facial NMES. Further, this study provides strong support for the tolerability of facial NMES.
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Affiliation(s)
- Mohammed Safi
- Speech Language Pathology, United Arab Emirates University, Al Ain, UAE
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Del Rosso JQ, Lain E, York JP, Alexis A. Trifarotene 0.005% Cream in the Treatment of Facial and Truncal Acne Vulgaris in Patients with Skin of Color: a Case Series. Dermatol Ther (Heidelb) 2022; 12:2189-2200. [PMID: 35994159 PMCID: PMC9464295 DOI: 10.1007/s13555-022-00788-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022] Open
Abstract
The clinical appearance of acne vulgaris (AV) and the response to therapeutic agents may vary in people with skin of color (SoC) compared with those with lighter skin types. Given the heightened potential for postinflammatory hyperpigmentation and keloid development, effective and timely AV treatment in patients with SoC is especially important. However, these patients are frequently underrepresented in clinical trials, and SoC photographs are generally underrepresented in dermatology. Trifarotene 0.005% cream is a retinoid approved for the once-daily topical treatment of AV, and was studied in large-scale clinical trials that assessed the treatment of AV on both the face and trunk. For severe AV, a topical retinoid may be used in combination with an oral antibiotic, such as doxycycline. Five subjects covering Fitzpatrick skin phototypes III, IV, V, and VI were selected from two larger studies to visually demonstrate treatment of clinically diagnosed AV with trifarotene 0.005% cream. Two subjects received 24 weeks of treatment with trifarotene 0.005% cream for moderate AV on the face and trunk, while three subjects received 12 weeks of treatment with trifarotene 0.005% cream in association with 120 mg oral doxycycline with modified polymer coating for severe facial AV. This case series supports the favorable efficacy and safety of facial and truncal AV treatment with trifarotene 0.005% cream, with or without oral doxycycline, in subjects with SoC (phototypes III–VI).
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Affiliation(s)
- James Q Del Rosso
- JDR Dermatology Research/Thomas Dermatology, Las Vegas, NV, USA. .,Advanced Dermatology and Cosmetic Surgery, Maitland, FL, USA.
| | - Edward Lain
- Austin Institute for Clinical Research, Pflugerville, TX, USA
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Maithri M, Raghavendra U, Gudigar A, Samanth J, Murugappan M, Chakole Y, Acharya UR. Automated emotion recognition: Current trends and future perspectives. Comput Methods Programs Biomed 2022; 215:106646. [PMID: 35093645 DOI: 10.1016/j.cmpb.2022.106646] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 12/25/2021] [Accepted: 01/16/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Human emotions greatly affect the actions of a person. The automated emotion recognition has applications in multiple domains such as health care, e-learning, surveillance, etc. The development of computer-aided diagnosis (CAD) tools has led to the automated recognition of human emotions. OBJECTIVE This review paper provides an insight into various methods employed using electroencephalogram (EEG), facial, and speech signals coupled with multi-modal emotion recognition techniques. In this work, we have reviewed most of the state-of-the-art papers published on this topic. METHOD This study was carried out by considering the various emotion recognition (ER) models proposed between 2016 and 2021. The papers were analysed based on methods employed, classifier used and performance obtained. RESULTS There is a significant rise in the application of deep learning techniques for ER. They have been widely applied for EEG, speech, facial expression, and multimodal features to develop an accurate ER model. CONCLUSION Our study reveals that most of the proposed machine and deep learning-based systems have yielded good performances for automated ER in a controlled environment. However, there is a need to obtain high performance for ER even in an uncontrolled environment.
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Affiliation(s)
- M Maithri
- Department of Mechatronics, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India
| | - U Raghavendra
- Department of Instrumentation and Control Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India
| | - Anjan Gudigar
- Department of Instrumentation and Control Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India.
| | - Jyothi Samanth
- Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India
| | - Murugappan Murugappan
- Department of Electronics and Communication Engineering, Kuwait College of Science and Technology, 13133, Kuwait
| | - Yashas Chakole
- Department of Instrumentation and Control Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India
| | - U Rajendra Acharya
- School of Engineering, Ngee Ann Polytechnic, Clementi 599489, Singapore; Department of Biomedical Informatics and Medical Engineering, Asia University, Taichung, Taiwan; Department of Biomedical Engineering, School of Science and Technology, SUSS University, Singapore
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Yue S, Ju M, Su Z. A Systematic Review And Meta-Analysis: Botulinum Toxin A Effect on Postoperative Facial Scar Prevention. Aesthetic Plast Surg 2022; 46:395-405. [PMID: 34609526 DOI: 10.1007/s00266-021-02596-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/13/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Postoperative facial scarring can be a significant psychological burden for patients to carry after surgery, often resulting in prolonged mental health dysfunction. Currently, there is no established method to prevent facial scar formation; however, there are several methods to prevent facial scar hyperplasia and improve scar quality. Botulinum toxin A (BTA) has been widely used due to its properties of muscle paralysis and known success in plastic surgery and cosmetology. This meta-analysis aimed to evaluate the efficacy of BTA in preventing postoperative facial scar hyperplasia and improving scar quality. METHODS PubMed, MEDLINE, EMBASE, web of science, and Cochrane libraries were searched for randomized controlled trials (RCTs) (published before May 2021) wherein BTA was used for the treatment of facial scars. The efficacy and safety of BTA were evaluated by the following scales: the Vancouver Scar Scale (VSS), Visual Analog Scale (VAS), Observer Scar Assessment Scale (OSAS), Patient Scar Assessment Scale (PSAS), and Stony Brook Scar Evaluation Scale (SBSES); the BTA effect on scar width and complications was also assessed. RESULTS Ten RCTs involving 114 cases were included. Through quantitative analysis, the BTA injection group had a higher VAS score, lower VSS score, lower OSAS score, and smaller scar width. However, no significant difference was noted in the incidence of postoperative complications between the two groups. CONCLUSIONS This meta-analysis demonstrated that BTA can safely improve the appearance of postoperative facial scars by significantly inhibiting scar hyperplasia and improving scar quality. LEVEL OF EVIDENCE III 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 .
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Affiliation(s)
- Shuai Yue
- Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China.
| | - Mengran Ju
- Department of Plastic and Reconstructive Surgery, Chengdu Badachu Medical Aesthetics Hospital, Chengdu, 610000, China
| | - Zhe Su
- Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China
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Zhang LC, Yang J, Huang YB, Huang Z, Bi MY. Post treatment care in photodynamic therapy (PDT) of large facial port-wine stain (PWS) birthmarks. Photodiagnosis Photodyn Ther 2021; 36:102604. [PMID: 34715369 DOI: 10.1016/j.pdpdt.2021.102604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/08/2021] [Accepted: 10/22/2021] [Indexed: 11/21/2022]
Abstract
Photodynamic therapy (PDT) has been proved to be an effective and safe treatment for port-wine stain (PWS) birthmarks in China, especially for lager facial lesions. However, excessive treatment, improper nursing and human errors can cause serious adverse reactions that might result in high risks of infection, thick scabs and scar formation. The understanding and implementing of good post treatment care play a critical role in preventing and minimizing adverse reactions. This article will discuss details of good practice for the post treatment care in PDT of PWS birthmarks.
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20
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Boffano P, Pau A, Dosio C, Ruslin M, Forouzanfar T, Rodríguez-Santamarta T, de Vicente JC, Tarle M, Dediol E, Pechalova P, Pavlov N, Daskalov H, Doykova I, Kelemith K, Tamme T, Kopchak A, Yu RA, Corre P, Bertin H, Bourry M, Guyonvarc'h P, Jezdić Z, Konstantinovic VS, Starch-Jensen T, Brucoli M. Quality of life following maxillo facial trauma in the elderly: a multicenter, prospective study. Oral Maxillofac Surg 2021. [PMID: 34499265 DOI: 10.1007/s10006-021-01003-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND/AIMS When facial trauma involves elderly patients, the possible presence of frailty and comorbidities in victims of trauma may worsen the posttraumatic symptoms and decrease quality of life. The aim of this multicenter study was to assess the quality of life following surgical or non-operative management of maxillofacial trauma in elderly patients. MATERIALS AND METHODS This cohort study was based on the administration of validated self-administered questionnaires to all the geriatric patients (70 years or more) with facial fractures from the involved maxillofacial surgical units across Europe, since 1st January 2019 to 31st June 2019. The following questionnaires were administered: SF36 questionnaire; the VFQ-25 questionnaire; the Oral Health Impact Profile - 14 (OHIP14). Outcome variables were VFQ-25 and OHIP-14 results. RESULTS A total of 37 patients (14 male and 23 female patients) met the inclusion criteria and were included in the study. Elderly patients had an improvement in almost all the categories examined by the SF-36 questionnaire 6 months after trauma, with the only exception of a worsening as for role limitations due to physical health. An improvement was observed in almost all the categories at SF-36 test. A worsening of scores of OHIP-14 for all the considered dimensions in the whole study population was observed too. CONCLUSIONS Elderly patients following facial trauma experience significant emotional, social, and functional disturbances. We observed that emotional problems, energy/fatigue, social functioning, and generally social limitations played a great role in the decrease of QoL in elderly patients following maxillofacial trauma.
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21
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Kruse C, Bruce JL, Bekker W, Clarke DL. The management of ocular and peri-ocular trauma needs to be co-ordinated according to ATLS principles and requires multi-disciplinary collaboration. Injury 2021; 52:2606-2610. [PMID: 33593527 DOI: 10.1016/j.injury.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION This project set out to focus on ocular (globe) and peri-ocular trauma and to describe the spectrum of injuries seen in a busy South African trauma unit and to document their management and outcome. RESULTS During the period November 2012 to April 2020, a total of 12 115 patients were managed by the Pietermaritzburg Metropolitan Trauma Service (PMTS) at Greys Hospital in Pietermaritzburg, South Africa. Of these 2194 (11%) sustained ocular or peri-ocular injury. Of these 2194 patients, 1069 (83%) were male. 83% of injuries (n=1076) were classified as primarily blunt injury and 17% as a primarily sharp/penetrating mechanism. A substantial number of patients required a life-saving emergency intervention. These included resuscitation in 242 cases (19%) and active airway intervention was in 290 (22%). In total 919 (71%) patients required urgent surgery to the peri-ocular region. Slightly over half (55%) of these the surgery was performed by a single discipline. The rest needed procedures by two or more disciplines. The disciplines involved included ophthalmology, maxillofacial, plastic, ENT and neurosurgery. Plastic surgery was involved in 683 cases (53%). A total of 341 distant surgeries were required - These included orthopaedic operations, laparotomy and vascular operations. Of the 1294 cases in this study, 42 (3%) died before discharge and 99 (8%) were discharged with a GCS lower than 10. The primary skill set for management of these injuries is identified. CONCLUSION Although the management of immediate life and organ threatening injuries takes priority, ocular and peri-ocular trauma may damage a number of important structures and their comprehensive management requires a multi-disciplinary team of specialists or, in austere environments, a font-line medical team with a diverse skill set.
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Affiliation(s)
- C Kruse
- Department of Ophthalmology, Grey's Hospital, Pietermaritzburg; University of KwaZulu-Natal, KwaZulu-Natal, South Africa.
| | - J L Bruce
- Department of Surgery, Grey's Hospital, Pietermaritzburg; University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - W Bekker
- Department of Surgery, Grey's Hospital, Pietermaritzburg; University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - D L Clarke
- Department of Surgery, Grey's Hospital, Pietermaritzburg; University of KwaZulu-Natal, KwaZulu-Natal, South Africa; Department of Surgery, University of the Witwatersrand, Johannesburg
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Dinakaran J, Hariganesgh P, Shamala S, Dhivya K, Saranya V, Saranya M. Stature Estimation of an Individual Using Nasal, Facial, and Palatal Height among Tamil Nadu Population. J Pharm Bioallied Sci 2021; 13:S751-S756. [PMID: 34447195 PMCID: PMC8375831 DOI: 10.4103/jpbs.jpbs_595_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 10/29/2020] [Accepted: 11/30/2020] [Indexed: 11/04/2022] Open
Abstract
Background Stature estimation in human identification has a significant forensic importance. The stature correlates positively with bones or human body parts. Measurements of various body parts such as the arm, leg, feet, and finger can be used to estimate stature. This study is done to correlate the stature of person with facial, nasal, and palatal height among Tamil Nadu population. Aim and Objective The aim and objective was to determine an individual's stature using facial, nasal, and palatal height and to find out the most reliable parameter to determine the stature of the person. Materials and Methods Anthropometer, Vernier caliper, and palatometer were used for the analysis. The initial pilot study included 20 individuals. The representative study included 100 individuals of age 21-25 years. (Group 1 - males, Group 2 - females). Values of the three parameters (nasal, facial, and palatal) are calculated and related to that of the person's stature. Results The quantitative data collected from the subjects are studied using (Pearson correlation) statistical analysis. The quantitative data availed from nasal height were found to be more reliable compared to the other two data in stature prediction. Correlation between stature and nasal height shows a significant positive correlation among the female group (2) with (P- value = 0.57). Conclusion This study may play a significant role in case of human identification immediately after mass disasters and certain criminal investigations. Further studies with larger samples may produce more reliable values.
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Affiliation(s)
- J Dinakaran
- Department of Oral Pathology, Adhiparasakthi Dental College and Hospital, Chennai, Tamil Nadu, India
| | - P Hariganesgh
- Department of Oral Pathology, Adhiparasakthi Dental College and Hospital, Chennai, Tamil Nadu, India
| | - S Shamala
- Department of Oral Pathology, Adhiparasakthi Dental College and Hospital, Chennai, Tamil Nadu, India
| | - K Dhivya
- Department of Oral Pathology, Adhiparasakthi Dental College and Hospital, Chennai, Tamil Nadu, India
| | - V Saranya
- Department of Oral Pathology, Adhiparasakthi Dental College and Hospital, Chennai, Tamil Nadu, India
| | - M Saranya
- Department of Oral Pathology, Vivekanandha Dental College for Women, Thiruchengode, Tamil Nadu, India
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Erdim I, Gurbuz V, Sapmaz E, Cetin S, Gevrek F. Microanatomic analyses of extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve. Braz J Otorhinolaryngol 2021; 89:14-21. [PMID: 34348859 PMCID: PMC9874283 DOI: 10.1016/j.bjorl.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/11/2021] [Accepted: 06/12/2021] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To investigate microanatomic organizations of the extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve. METHODS Nerve samples were dissected in 12 postmortem autopsies, and histomorphometric analyses were conducted. RESULTS There was no significant difference between the right and left sides of the nerve samples for the nerve area, fascicle area, number of fascicles and average number of axons. The lowest mean fascicle number was found in the hypoglossal nerve (4.9 ± 1.4) while the highest was in great auricular nerve (11.4 ± 6.8). The highest nerve area (3,182,788 ± 838,430 μm2), fascicle area (1,573,181 ± 457,331 μm2) and axon number (14,772 ± 4402) were in hypoglossal nerve (p < 0.05). The number of axons per unit nerve area was higher in the facial nerve, truncus temporofacialis, truncus cervicofacialis and hypoglossal nerve, which are motor nerves, compared to the sural nerve and great auricular nerve, which are sensory nerves (p < 0.05). The number of axons per unit fascicle area was also higher in motor nerves than in sensory nerves (p < 0.05). CONCLUSION In the present study, it was observed that each nerve contained a different number of fascicles and these fascicles were different both in size and in the number of axons they contained. All these variables could be the reason why the desired outcomes cannot always be achieved in nerve reconstruction.
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Affiliation(s)
- Ibrahim Erdim
- Tokat Gaziosmanpasa University, Health Education and Training Hospital, Otorhinolaryngology Department, Tokat, Turkey.
| | - Veysel Gurbuz
- Turkey Republic the Ministry of Justice, Tokat Forensic Medicine Department, Tokat, Turkey
| | - Emrah Sapmaz
- Tokat Gaziosmanpasa University, Health Education and Training Hospital, Otorhinolaryngology Department, Tokat, Turkey
| | - Selcuk Cetin
- Tokat Gaziosmanpasa University, Health Education and Training Hospital, Forensic Medicine Department, Tokat, Turkey
| | - Fikret Gevrek
- Tokat Gaziosmanpasa University, Medical Faculty, Histology Deparment, Tokat, Turkey
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Chiesa-Estomba CM, Echaniz O, Sistiaga Suarez JA, González-García JA, Larruscain E, Altuna X, Medela A, Graña M. Machine Learning Models for Predicting Facial Nerve Palsy in Parotid Gland Surgery for Benign Tumors. J Surg Res 2021; 262:57-64. [PMID: 33548674 DOI: 10.1016/j.jss.2020.12.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/03/2020] [Accepted: 12/16/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Despite the increasing use of intraoperative facial nerve monitoring during parotid gland surgery (PGS) and the improvement in the preoperative radiological assessment, facial nerve injury (FNI) remains the most severe complication after PGS. Until now, no studies have been published regarding the application of machine learning (ML) for predicting FNI after PGS. We hypothesize that ML would improve the prediction of patients at risk. METHODS Patients who underwent PGS for benign tumors between June 2010 and June 2019 were included. RESULTS Regarding prediction accuracy and performance of each ML algorithm, the K-nearest neighbor and the random forest achieved the highest sensitivity, specificity, positive predictive value, negative predictive value F-score, receiver operating characteristic (ROC)-area under the ROC curve, and accuracy globally. The K-nearest neighbor algorithm achieved performance values above 0.9 for specificity, negative predictive value, F-score and ROC-area under the ROC curve, and the highest sensitivity and positive predictive value. CONCLUSIONS This study demonstrates that ML prediction models can provide evidence-based predictions about the risk of FNI to otolaryngologists and patients. It is hoped that such algorithms, which use clinical, radiological, histological, and cytological information, can improve the information given to patients before surgery so that they can be better informed of any potential complications.
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Mendes SDL, Ribeiro ILA, de Castro RD, Filgueiras VM, Ramos TB, Lacerda RHW. Risk factors for anterior open bite: A case-control study. Dent Res J (Isfahan) 2020; 17:388-394. [PMID: 33343848 PMCID: PMC7737827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Anterior open bite (AOB) is noteworthy because it is a complex dysplasia, and clinical studies on this malocclusion are usually epidemiological studies or experimental models with small samples and no control group, which renders the data on AOB incomplete and therefore inconclusive. The objective this study was to assess the risk factors involved in developing AOB. MATERIALS AND METHODS A case-control study was provided with a total of 96 lateral cephalometric radiographs of male and female patients aged between 8 and 14 years were used, regardless of facial type. The dependent variable was the presence or absence of AOB, which divided the participants into case and control groups, respectively; these groups were matched for gender and age. The case and control groups data were analyzed by descriptive and inferential analysis by binary logistic regression using at the 5% significance level. RESULTS The occurrence of AOB was associated with the presence of deleterious oral habits (P = 0.014; Chi-square test) and was approximately three times (odds ratio = 3.04) more likely to occur in participants with AOB. No significant association between the presence of mouth breathing and the occurrence of AOB was found (P = 0.151; Chi-square test). The odds associated with tongue interposition were 10.51 times higher than those of participants with no such deglutition. The odds associated with the dolichofacial pattern were 5.74 times those of participants with a nondolichofacial pattern. CONCLUSION Tongue interposition and dolichocephalic facial pattern were risk factors for developing AOB.
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Affiliation(s)
- Suellen de Lima Mendes
- Brazilian Dental Association, University Hospital Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
| | - Isabella Lima Arrais Ribeiro
- Graduate Program in Dentistry, University Hospital Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brazil,Address for correspondence: Dr. Isabella Lima Arrais Ribeiro, University of Paraíba, João Pessoa, Paraíba, Brazil. E-mail:
| | - Ricardo Dias de Castro
- Graduate Program in Dentistry, University Hospital Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
| | - Vitor Marques Filgueiras
- Graduate Program in Dentistry, University Hospital Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
| | - Tânia Braga Ramos
- Brazilian Dental Association, University Hospital Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
| | - Rosa Helena Wanderley Lacerda
- Brazilian Dental Association, University Hospital Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brazil,Graduate Program in Dentistry, University Hospital Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
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Mendelson B, Wong CH. Changes in the Facial Skeleton With Aging: Implications and Clinical Applications in Facial Rejuvenation. Aesthetic Plast Surg 2020; 44:1151-1158. [PMID: 32844267 DOI: 10.1007/s00266-020-01823-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 02/09/2012] [Indexed: 10/23/2022]
Abstract
In principle, to achieve the most natural and harmonious rejuvenation of the face, all changes that result from the aging process should be corrected. Traditionally, soft tissue lifting and redraping have constituted the cornerstone of most facial rejuvenation procedures. Changes in the facial skeleton that occur with aging and their impact on facial appearance have not been well appreciated. Accordingly, failure to address changes in the skeletal foundation of the face may limit the potential benefit of any rejuvenation procedure. Correction of the skeletal framework is increasingly viewed as the new frontier in facial rejuvenation. It currently is clear that certain areas of the facial skeleton undergo resorption with aging. Areas with a strong predisposition to resorption include the midface skeleton, particularly the maxilla including the pyriform region of the nose, the superomedial and inferolateral aspects of the orbital rim, and the prejowl area of the mandible. These areas resorb in a specific and predictable manner with aging. The resultant deficiencies of the skeletal foundation contribute to the stigmata of the aging face. In patients with a congenitally weak skeletal structure, the skeleton may be the primary cause for the manifestations of premature aging. These areas should be specifically examined in patients undergoing facial rejuvenation and addressed to obtain superior aesthetic results.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 .
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Johnson SM, Chavda R, DuBois JC. Subject Satisfaction with Trifarotene 50 μg/g Cream in the Treatment of Facial and Truncal Acne Vulgaris: A Case Series. Dermatol Ther (Heidelb) 2020; 10:1165-1173. [PMID: 32623660 PMCID: PMC7477054 DOI: 10.1007/s13555-020-00417-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Indexed: 12/17/2022] Open
Abstract
There is a paucity of literature covering patient-reported outcomes of treatments for truncal acne. Trifarotene 50 μg/g cream is a novel retinoid molecule approved for once-daily topical treatment of facial and truncal acne vulgaris. As physicians are starting to gain real-world experience with this retinoid treatment, their access to reporting from the patient’s perspective provides a valuable adjunct to the pivotal studies. We report a case series of three subjects with moderate facial and truncal acne treated with trifarotene 50 μg/g cream on the face, shoulders, upper back and upper anterior chest for 12 weeks and evaluated by satisfaction questionnaires. This case series illustrating the treatment of facial and truncal acne with trifarotene 50 μg/g cream, in the form of real-world data, describes high overall satisfaction and excellent tolerability to support the use of this new retinoid molecule in the treatment of acne vulgaris on both the face and trunk.
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Perrillat A, Foletti JM, Lacagne AS, Guyot L, Graillon N. Facial pressure ulcers in COVID-19 patients undergoing prone positioning: How to prevent an underestimated epidemic? J Stomatol Oral Maxillofac Surg 2020; 121:442-444. [PMID: 32565264 PMCID: PMC7301820 DOI: 10.1016/j.jormas.2020.06.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/15/2020] [Indexed: 01/15/2023]
Abstract
Prone positioning is an adjuvant therapy used to treat COVID-19 pneumonia complicated by acute respiratory distress syndrome. However, prolonged pressure on facial skin at the level of the bony structures may be responsible for facial pressure ulcers. In the context of severe COVID-19 pneumonia, we hypothesized that hypoxemia, microvascular injury and thrombosis can increase the risk of pressure ulcers. We described two cases in order to emphasize the risk of facial pressure ulcers as a result of prone positioning, so as to discuss their physiopathology and highlight the importance of appropriate preventive measures.
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Affiliation(s)
- A Perrillat
- Department of oral and maxillofacial surgery, CHU Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - J-M Foletti
- Department of oral and maxillofacial surgery, CHU Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; IFSTTAR, LBA UMR_T24, Aix-Marseille university, boulevard Pierre-Dramard, 13916 Marseille, France
| | - A-S Lacagne
- Department of oral and maxillofacial surgery, CHU Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - L Guyot
- Department of oral and maxillofacial surgery, CHU Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; CNRS, EFS, ADES, Aix-Marseille university, boulevard Pierre-Dramard, 13344 Marseille, France
| | - N Graillon
- Department of oral and maxillofacial surgery, CHU Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; IFSTTAR, LBA UMR_T24, Aix-Marseille university, boulevard Pierre-Dramard, 13916 Marseille, France.
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Sherwood RG, Murphy N, Kearns G, Barry C. The use of 3D printing technology in the creation of patient-specific facial prostheses. Ir J Med Sci 2020; 189:1215-21. [PMID: 32424604 DOI: 10.1007/s11845-020-02248-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Personalised medicine aims to optimise patient outcomes by tailoring treatments and interventions to the individual. While this approach can offer a number of benefits, it can be accompanied by significant overheads in terms of resources. Prostheses exist in order to restore and replicate the normal functions and appearance of the body but if these are not individually tailored to the patient's needs then a true restoration cannot be fully achieved. Traditionally a labour intensive process, the fabrication of craniofacial prostheses, involves taking a plaster cast of the area to be treated, hand carving wax models of the restoration and multiple meetings with the patient to alter this wax restoration before making a final prosthesis in silicone. AIMS Utilising the patient's pre-existing computed tomography (CT) images and 3D printing technology, a patient-specific prosthesis can be created with improved efficiency and accuracy. METHODS This study demonstrates methods used to create a patient-specific orbital prosthesis using CT images. These images were manipulated in a way which allowed for the intact orbit to be mirrored and used to develop a 3D printed model which acted as the starting point to create a silicone prosthesis. RESULTS The benefits of using this method include reduced manufacturing time, decreased outpatient appointments, improved personalised outcomes and a repeatable process allowing multiple prostheses to be made. CONCLUSIONS 3D printing is a valuable tool which can provide significant savings in time and improve patient outcomes by offering a tailored approach to each individual's treatment.
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Ramos-Gallardo G, Carballo-Zarate AA, Cuenca-Pardo J, Cárdenas-Camarena L, Solano-Genesta M, Beltrán JAC, Gallagher-Hernandez S, Contreras-Bulnes L, Vélez-Benitez E, Bucio-Duarte JJ, Cedillo-Alemán EJ. What is the Evidence of Lymphoma in Patients with Prostheses Other Than Breast Implants? Aesthetic Plast Surg 2020; 44:286-294. [PMID: 31844943 DOI: 10.1007/s00266-019-01569-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 12/03/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Medical devices such as hip, knee, breast, vascular prostheses, among others, are very useful in different pathologies. We cannot doubt that their use is a great tool, besides being an advance in medicine; they provide a change in the quality of life of many patients; however, they are not exempt from adverse reactions and events. METHODS We conduct a systematic review about lymphoma in the presences of prostheses other than breast implants. RESULTS We selected 21 publications with a total of 24 patients. The largest number of prostheses was related to long bones in a total of 13 prostheses. The most frequent symptoms were: pain (52%), inflammation (24%), visible or palpable mass 20%. The most frequent type of lymphoma was non-Hodgkin B cell lymphoma in 14 cases. DISCUSSION The presence of microparticles make biological degradation and wear of the implants, with macrophage and lymphocyte activation and the consequent production of proinflammatory cytokines such as tumor necrosis factor α, interleukin-1β, interleukin-6, and prostaglandin 2 (PGE2). CONCLUSION Lymphoma is not a common disease in patients with prostheses, and more data are needed to identify risk factors and make proper diagnoses. LEVEL OF EVIDENCE III 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.
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Affiliation(s)
- Guillermo Ramos-Gallardo
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico.
- Centro Universitario de la Costa, Universidad de Guadalajara, Puerto Vallarta, Mexico.
| | | | - Jesús Cuenca-Pardo
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | - Lázaro Cárdenas-Camarena
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | | | | | | | - Livia Contreras-Bulnes
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | - Estela Vélez-Benitez
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | - José Javier Bucio-Duarte
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
| | - Enrique Javier Cedillo-Alemán
- Asociación Mexicana de Cirugía Plástica, Estética y Reconstructiva, Safety Committee, Flamencos N° 74 esquina con Félix Parra Col. San José Insurgentes Delegación, 03900, Benito Juárez, Distrito Federal, Mexico
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Mittal HK, Bist SS, Harsh M. Atypical Facial Chondroid Syringoma, A Rare Clinical Entity: Case Report with Review of Literature. Indian J Otolaryngol Head Neck Surg 2020; 72:274-7. [PMID: 32551288 DOI: 10.1007/s12070-019-01779-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/26/2019] [Indexed: 10/25/2022] Open
Abstract
Chondroid syringoma (CS) is a rare mixed tumor of sweat gland origin with a reported incidence of less than 0.1%. The tumor is mostly benign and usually seen in males. It comprises of both epithelial and mesenchymal elements. The usual presentation and clinical course of this condition makes it liable to be confused with other commoner skin conditions. We hereby present a case of facial CS in a young female patient.
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Alamri AA, AlJehani R, Alnefaie MN, Moshref S, Fida AR. Perception and Knowledge of Facial Plastic Surgery Among Health Care Professionals at Tertiary Care Center, Jeddah, Saudi Arabia: Cross Sectional Study. Mater Sociomed 2019; 31:181-185. [PMID: 31762699 PMCID: PMC6853726 DOI: 10.5455/msm.2019.31.181-185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction: Plastic surgery is a medical specialty involving the restoration, reconstruction, or alteration of the body. Knowledge about facial plastic surgery among doctors is limited according to some literatures and enriched according to others, depending on the country and study population. Aim: Aim of the study was to evaluate level of knowledge of health care professionals regarding facial plastic surgery. Material and Methods: A cross-sectional study included total of 261 health care professionals (consultants, specialists and residents in training) at King Abdul-Aziz University Hospital (KAUH) from all subspecialties during July 2018. The data collected using pre-designed questionnaire and analyzed using professional statistics software. Results: Among 261 participants, sex distribution shows a male-female ratio of 2.78:1. The majority (62.8%) of participants were residents. Mean age (± SD) of participants was 32.28 ± 8.43. Pediatrics, internal medicine, and general surgery were the most common specialties. Among participants, 75.5% agreed that taking training in plastic surgery program is a requirement to be a facial plastic surgeon whether it should be accompanied with at least one other surgery training (23%) or more than one other training (22.2%). The majority (97.7%) have never undergone a facial plastic surgery operation and 78.2% were not willing to undergo one. Conclusion: The study concludes that the knowledge and perception among healthcare professionals in KAUH regarding facial plastic surgeries is on relatively good basis but needs more updates and trainings.
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Affiliation(s)
| | - Reham AlJehani
- Medical intern, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Sabah Moshref
- Medical student, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulkareem R Fida
- Consultant Plastic surgeon, Department Surgery, King Abdulaziz University, Saudi Arabia
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Affiliation(s)
- David B Powers
- Duke Craniomaxillofacial Trauma Program, Duke Craniomaxillofacial Trauma and Reconstructive Surgery, Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, DUMC Box 2955, Durham, NC 27710, USA.
| | - John Breeze
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Medical Centre, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Formerly, Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC, USA
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Alamri AA, AlJehani R, Alnefaie MN, Moshref S, Fida AR. Perception and Knowledge of Facial Plastic Surgery Among Health Care Professionals at Tertiary Care Center, Jeddah, Saudi Arabia: Cross Sectional Study. Mater Sociomed 2019; 31:125-129. [PMID: 31452638 PMCID: PMC6690406 DOI: 10.5455/msm.2019.31.125-129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction: Plastic surgery is a medical specialty involving the restoration, reconstruction, or alteration of the body. Knowledge about facial plastic surgery among doctors is limited according to some literatures and enriched according to others, depending on the country and study population. Aim: Aim of the study was to evaluate level of knowledge of health care professionals regarding facial plastic surgery. Methods: A cross-sectional study included total of 261 health care professionals (consultants, specialists and residents in training) at King Abdul-Aziz University Hospital (KAUH) from all subspecialties during July 2018. The data collected using pre-designed questionnaire and analyzed using professional statistics software. Results: Among 261 participants, sex distribution shows a male-female ratio of 2.78:1. The majority (62.8%) of participants were residents. Mean age (± SD) of participants was 32.28 ± 8.43. Pediatrics, internal medicine, and general surgery were the most common specialties. Among participants, 75.5% agreed that taking training in plastic surgery program is a requirement to be a facial plastic surgeon whether it should be accompanied with at least one other surgery training (23%) or more than one other training (22.2%). The majority (97.7%) have never undergone a facial plastic surgery operation and 78.2% were not willing to undergo one. Conclusion: The study concludes that the knowledge and perception among healthcare professionals in KAUH regarding facial plastic surgeries is on relatively good basis but needs more updates and trainings.
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Affiliation(s)
| | | | | | - Sabah Moshref
- Department Surgery, King Abdulaziz University, Saudi Arabia
| | - Abdulkareem R Fida
- Department of Otolaryngology Head and Neck surgery, King Abdulaziz University, Saudi Arabia
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Piquero-Casals J, Hexsel D, Mir-Bonafé JF, Rozas-Muñoz E. Topical Non-Pharmacological Treatment for Facial Seborrheic Dermatitis. Dermatol Ther (Heidelb) 2019; 9:469-477. [PMID: 31396944 PMCID: PMC6704200 DOI: 10.1007/s13555-019-00319-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Indexed: 11/26/2022] Open
Abstract
Facial seborrheic dermatitis (FSD) is a chronic and relapsing inflammatory skin disorder occurring in areas of the face rich in sebaceous glands. It clinically manifests as erythematous scaly macules or plaques, often associated with pruritus. Although the pathogenesis of seborrheic dermatitis is not yet fully understood, Malassezia yeast, hormones, sebum levels, and immune response are known to play important roles. Additional factors including drugs, cold temperatures, and stress may exacerbate the condition. Currently, the available treatments do not cure the disease but relieve symptoms. Various pharmacological treatments are available, including antifungal agents, keratolytics, topical low-potency steroids, and calcineurin inhibitors. All of them provide several benefits, but they also have potential side effects. Seborrheic dermatitis tends to have a chronic, recurrent course. To avoid the long-term use of drugs, topical non-pharmacological products such as cosmetics or medical devices may improve clinical outcomes. Products with antimicrobial and anti-inflammatory ingredients such as zinc, piroctone olamine, dihydroavenanthramide, biosaccharide gum-2, and stearyl glycyrrhetinate may speed FSD recovery and avoid flare-ups. Finally, the use of specific cleansers, moisturizers, and sunscreens formulated as light creams or gel/creams should be strongly recommended to all FSD patients. We provide a brief review of the most used non-pharmacological cleansers, topical gel/creams, and specific sunscreens in the management of FSD.
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Affiliation(s)
- Jaime Piquero-Casals
- Department of Dermatology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
| | - Doris Hexsel
- Brazilian Center for Studies in Dermatology, Porto Alegre, RS, Brazil
| | | | - Eduardo Rozas-Muñoz
- Department of Dermatology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
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Abstract
BACKGROUND Functional and cosmetic outcomes affect reconstruction of the face more than any region of the body. To use a predetermined perforator flap freely designed allowing a wide range of movement and manipulation can give us an optimum outcome. We present our clinical experience with free style facial perforator flaps, surgical technique, and complications. METHODS Thirty patients with post-tumor resection of the face were reconstructed with free style local perforator flaps between January 2014 and November 2016. Doppler was used to identify the perforator vessels preoperatively. RESULTS Twenty-two clinical cases had no complications. Four had venous congestion that resolved spontaneously, three had a distal 1/3 superficial necrosis, and one suffered from hematoma. CONCLUSION Freestyle perforator flaps were applied to get better cosmetic facial reconstruction, allowing one stage procedure and decreasing donor site morbidity. Modern anatomical understanding, good planning, and meticulous surgical technique can affect clinical results.
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Affiliation(s)
- Nader Elmelegy
- Department of Plastic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt.,Department of Plastic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Sameh Elghamry
- Department of Plastic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Tarek Shoukr
- Department of Plastic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
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Manfredonia J, Bangerter A, Manyakov NV, Ness S, Lewin D, Skalkin A, Boice M, Goodwin MS, Dawson G, Hendren R, Leventhal B, Shic F, Pandina G. Automatic Recognition of Posed Facial Expression of Emotion in Individuals with Autism Spectrum Disorder. J Autism Dev Disord 2019; 49:279-93. [PMID: 30298462 DOI: 10.1007/s10803-018-3757-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Facial expression is impaired in autism spectrum disorder (ASD), but rarely systematically studied. We focus on the ability of individuals with ASD to produce facial expressions of emotions in response to a verbal prompt. We used the Janssen Autism Knowledge Engine (JAKE®), including automated facial expression analysis software (FACET) to measure facial expressions in individuals with ASD (n = 144) and a typically developing (TD) comparison group (n = 41). Differences in ability to produce facial expressions were observed between ASD and TD groups, demonstrated by activation of facial action units (happy, scared, surprised, disgusted, but not angry or sad). Activation of facial action units correlated with parent-reported social communication skills. This approach has potential for diagnostic and response to intervention measures.Trial Registration NCT02299700.
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Abstract
There exist several known anthropometric differences between the male and female facial skeleton and soft tissues. In general, the female face is less robust, rounder or heart shaped, with a shorter forehead, no supraorbital bossing, a smaller nose, more pronounced zygomatic prominences, fuller lips, a smaller mandibular width, and a more tapered chin. A method for analyzing these differences is critical for offering facial gender confirming surgery to the gender dysphoric patients, both for preoperative planning, as well as for setting postoperative expectations.
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Affiliation(s)
| | - Michael T Somenek
- Advanced Facial Plastic Surgery, 2440 M Street Northwest #507, Washington, DC 20037, USA.
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Rappl T, Wurzer P, May S, Tuca AC, Cambiaso-Daniel J, Parvizi D, Kamolz LP, Lumenta DB. Three-Dimensional Evaluation of Static and Dynamic Effects of Botulinum Toxin A on Glabellar Frown Lines. Aesthetic Plast Surg 2019; 43:206-212. [PMID: 30311033 DOI: 10.1007/s00266-018-1230-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The use of injectable solutions for aesthetic purposes has increased tremendously, but lacks objective support. We aimed at assessing static and dynamic effects of botulinum toxin A (BoNTA) on glabellar lines by use of an objective three-dimensional methodology. METHODS We prospectively collected three-dimensional stereographic photographs of two different facial expressions (pretreatment, 30 and 90 days posttreatment) in 21 patients, receiving a total of 20 units of BoNTA in both corrugator supercilii muscles. The primary endpoint was the three-dimensional static and dynamic surface irregularity, and secondary endpoints were the glabellar line scale and overall patient satisfaction. Blinded retrospective data analysis and statistical evaluation were performed with p < 0.05 considered statistically significant. RESULTS Static glabellar lines (neutral facial expression) were significantly reduced by - 17% and - 24% on day 30 and 90 posttreatment, respectively (vs. pretreatment; both p < 0.0001). Dynamic glabellar frown lines (firmest possible bilateral eye closure) demonstrated a reduction of surface irregularity by - 26% and - 21% on day 30 and 90 posttreatment, respectively (vs. pretreatment; both p < 0.0001). The subjective dynamic glabellar line scale documented a statistically significant improvement on day 30 posttreatment (mean ± SD: 1.5 ± 0.8; p < 0.05) versus pretreatment (2.8 ± 1.0). Polled patients confirmed a subjective wrinkle improvement 90 days posttreatment. CONCLUSION The presented setup detected even subtle changes of BoNTA treatment for facial wrinkling and is a promising asset for scientific evaluations of clinical studies analyzing the outcome and duration of efficacy of injectable solutions on the face. 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 .
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Guyot L, Saint-Pierre F, Bellot-Samson V, Chikhani L, Garmi R, Haen P, Jammet P, Meningaud JP, Savant J, Thomassin JM, Thiery G. Facial surgery for cosmetic purposes: Practice guidelines. J Stomatol Oral Maxillofac Surg 2019; 120:122-127. [PMID: 30685344 DOI: 10.1016/j.jormas.2019.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/11/2019] [Accepted: 01/20/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Facial surgery for cosmetic purposes aims to improve the physical appearance and self-image of normal individuals. The aim of the guidelines is to answer questions related to legislation, patient evaluation and motivations, relevance and risk assessment, patient information and patient follow-up. METHODOLOGY Analysis and synthesis of the medical literature through research of bibliographic databases in French and English from 2000 to 2017. Research and use of guidelines from evaluation agencies and academic societies. Drafting of guidelines with indications on levels of evidence. RESULTS 24 guidelines with levels of evidence B (scientific presumption), C (low level of evidence) or EO (expert opinion) were selected to answer the questions. Cosmetic facial surgery must be performed by certified, qualified professionals in authorized structures. It must follow certain specific rules as well as a charter and code of ethics so as to enforce the rules of practice.
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Affiliation(s)
- L Guyot
- Maxillofacial surgery unit, North university hospital, 13015 Marseille, France.
| | | | - V Bellot-Samson
- Maxillofacial surgery Private practice, 13008 Marseille, France
| | - L Chikhani
- Maxillofacial surgery, Private practice, 75016 Paris, France
| | - R Garmi
- Maxillofacial surgery unit, Caen university hospital, Caen, 14000 France
| | - P Haen
- Maxillofacial surgery unit, armed forces health Laveran Hospital, 13013 Marseille, France
| | - P Jammet
- Maxillofacial surgery unit, Lapeyronie university hospital, 34000 Montpellier, France
| | - J-P Meningaud
- Maxillofacial and plastic surgery unit, 94000 Creteil, France
| | - J Savant
- Maxillofacial surgery Private practice, 84000 Avignon, France
| | | | - G Thiery
- Maxillofacial surgery Private practice, 38043 Marseille, France
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Struhsaker TT, Angedakin S, Landsmann A. Facial and genital lesions in baboons (Papio anubis) of Kibale National Park, Uganda. Primates 2019; 60:109-12. [PMID: 30666470 DOI: 10.1007/s10329-019-00715-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 01/05/2019] [Indexed: 10/27/2022]
Abstract
We describe and document with digital images two adult male baboons (Papio anubis) from the Kibale National Park, Uganda who were infected with some kind of disease having clinical signs suggestive of Treponema pallidum. One of these males was missing his premaxilla, part of the maxilla, upper incisors, canines, and possibly the first premolars. The condition of his scrotum was not seen. The other adult male had prominent inflammation of his scrotum and, to a lesser extent, his penis. Otherwise, both males appeared normal and healthy and were apparently well integrated into the same social group. These observations suggest that an earlier report of an adult female baboon living in the same area who was missing her entire premaxilla and nose and most of her maxilla may have been suffering from a similar infection, rather than a congenital disorder, as previously speculated. If these lesions were due to T. pallidum infections, then this disease has a greater geographical distribution among non-human primates than previously known.
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Ptaszyńska-Sarosiek I, Dunaj J, Zajkowska A, Niemcunowicz-Janica A, Król M, Pancewicz S, Zajkowska J. Post-mortem detection of six human herpesviruses (HSV-1, HSV-2, VZV, EBV, CMV, HHV-6) in trigeminal and facial nerve ganglia by PCR. PeerJ 2019; 6:e6095. [PMID: 30643675 PMCID: PMC6330031 DOI: 10.7717/peerj.6095] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/10/2018] [Indexed: 12/14/2022] Open
Abstract
Background Among over 100 types of Herpesviridae viruses, eight can infect humans: herpes simplex viruses (HSV-1, HSV-2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesviruses 6, 7, and 8 (HHV-6, HHV-7, HHV-8). After initial infection, the viruses remain latent for the lifetime of the host. The aim of this study was to determine the distribution of six different herpesviruses: HSV-1, HSV-2, VZV, EBV, CMV, and HHV-6 in trigeminal and facial nerve ganglia among a random group of Polish population. Methods The studied group consisted of 47 individuals (40 male, seven female); mean age of 47.4 ± 16.5 years) who died of independent causes (suicide, traffic accident, and poisoning, among others). Bilateral trigeminal and facial nerve ganglia of each cadaver were collected during the autopsy. Herpesviruses were detected using multiplex polymerase chain reaction technique. Results Herpesviruses were found in trigeminal and/or facial ganglia in 30/47 (63.8%) of cadavers. HHV-6 was the most prevalent of the herpesviruses and was found in nearly half of cadavers (n = 22; 46.8%), followed by HSV-1 (n = 7; 14.9%), VZV (n = 4; 8.5%), EBV (n = 4; 8.5%), HSV-2 (n = 2; 4.3%), and CMV (n = 1; 2.1%). Facial nerve ganglia (n = 23; 48.9%) were more often infected than trigeminal ganglia (n = 13; 27.7%). Discussion The results of this study have revealed a common presence of the herpesviruses in trigeminal and facial nerve ganglia among a random group of Polish population. Furthermore, the data also demonstrate simultaneous infection of the ganglia with different herpesviruses. This study has contributed to the knowledge of prevalence and localization of herpesviruses in different structures of the nervous system.
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Affiliation(s)
| | - Justyna Dunaj
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Białystok, Poland
| | - Agata Zajkowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | - Monika Król
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Białystok, Poland
| | - Sławomir Pancewicz
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Białystok, Poland
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Białystok, Poland
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Abstract
Introduction Traumatic injuries are the leading cause of death among <40 year olds, a good part of the working age population. Traumatic injuries are also the leading cause of lost productivity, causing more lost working days than cancer or vascular cardiomyopathy. Materials and Methods We retrospectively and statistically analyzed the characteristics of facial fractures treated between June 2010 and December 2016 at the Maxillofacial Adult Surgery Unit, Spedali Civili Brescia, Italy. Discussion Facial fractures are common in polytrauma patients, due to exposure of the cephalic end. The incidence of concomitant facial injuries with major trauma is 15%-24% in England (between Liverpool and London) and up to 34% in Washington, based on a large database of 87,174 patients. High-energy trauma frequently involving multiple traumatic injuries often leads to complex facial fractures, affecting different portions of the splanchnocranium. Conclusions Treatment of facial fractures often focuses on functional or esthetic outcomes, and the outcomes are often substantially worse than those of other trauma treatments. Given the esthetic value of the face, facial trauma often leads to heightened emotional distress.
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Affiliation(s)
| | - Andrea Castellani
- Maxillo-Facial Surgery Unit, Asst Spedali Civili Brescia, Brescia, Italy
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Abstract
Appropriate medical care for a patient with a facial fracture can not only optimize aesthetic outcomes but also prevent the potential morbidity and mortality of delayed treatment. In this article, we focus on the clinical presentations, physical examination findings, diagnostic imaging, consultations, and follow-up that patients with facial fractures need related to their emergency department management. Specifically, we address the nuances of evaluating frontal, orbital, nasal, maxillofacial, and mandibular fractures.
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Affiliation(s)
- Steve Chukwulebe
- Department of Emergency Medicine, Northwestern Medicine, Northwestern University Feinberg School of Medicine, 259 East Erie, Suite 1300, Chicago, IL 60611, USA
| | - Christopher Hogrefe
- Department of Emergency Medicine, Northwestern Medicine, Northwestern University Feinberg School of Medicine, 259 East Erie, Suite 1300, Chicago, IL 60611, USA; Department of Medicine, Northwestern Medicine, Northwestern University Feinber School of Medicine, 259 East Erie Street, Suite 1300, Chicago, IL 60611, USA; Department of Orthopaedic Surgery, Northwestern Medicine, Northwestern University Feinberg School of Medicine, 259 East Erie Street, Suite 1300, Chicago, IL 60611, USA; Department of Orthopaedic Surgery, 259 East Erie Street, Suite 1300, Chicago, IL 60611, USA.
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Mantelakis A, Iosifidis M, Al-Bitar ZB, Antoniadis V, Wertheim D, Garagiola U, Naini FB. Proportions of the aesthetic African-Caribbean face: idealized ratios, comparison with the golden proportion and perceptions of attractiveness. Maxillofac Plast Reconstr Surg 2018; 40:20. [PMID: 30206536 PMCID: PMC6123330 DOI: 10.1186/s40902-018-0161-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/25/2018] [Indexed: 11/15/2022] Open
Abstract
Background In the absence of clear guidelines for facial aesthetic surgery, most surgeons rely on expert intuitive judgement when planning aesthetic and reconstructive surgery. One of the most famous theories regarding “ideal” facial proportions is that of the golden proportion. However, there are conflicting opinions as to whether it can be used to assess facial attractiveness. The aim of this investigation was to assess facial ratios of professional black models and to compare the ratios with the golden proportion. Methods Forty photographs of male and female professional black models were collected. Observers were asked to assign a score from 1 to 10 (1 = not very attractive, 10 = very attractive). A total of 287 responses were analysed for grading behaviour according to various demographic factors by two groups of observers. The best graded photographs were compared with the least well-graded photographs to identify any differences in their facial ratios. The models’ facial ratios were calculated and compared with the golden proportion. Results Differences in grading behaviour were observed amongst the two assessment groups. Only one out of the 12 facial ratios was not significantly different from the golden proportion. Conclusions Only one facial ratio was observed to be similar to the golden proportion in professional model facial photographs. No correlation was found between facial ratios in professional black models with the golden proportion. It is proposed that an individualistic treatment for each ratio is a rather better method to guide future practice.
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Affiliation(s)
| | | | - Zaid B Al-Bitar
- 3Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Jordan, Amman, Jordan
| | | | - David Wertheim
- 5Faculty of Science, Engineering and Computing, Kingston University, London, UK
| | - Umberto Garagiola
- 6Maxillofacial and Odontostomatology Unit, School of Dentistry, University of Milan, Milan, Italy
| | - Farhad B Naini
- Kingston and St George's Hospitals and St George's Medical School, Blackshaw Road, London, SW17 0QT UK
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Youssef P, Povolotskiy R, Mukherjee TJ, Kandinov A, Paskhover B. Pediatric facial injuries: Hitting close to home. J Craniomaxillofac Surg 2018; 46:1539-1543. [PMID: 30196858 DOI: 10.1016/j.jcms.2018.05.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/20/2018] [Accepted: 05/31/2018] [Indexed: 10/14/2022] Open
Abstract
PURPOSE The aims of this study were as follows: To determine the national incidence of facial fractures among infants, toddlers, and children; to evaluate the types of facial fractures; and to analyze common products/activities associated with the fractures. MATERIALS AND METHODS A retrospective review was conducted to explore patterns of facial fractures among infants (<1 year), toddlers (1-3 years), and children (3-5 years), using the National Electronic Injury Surveillance System (NEISS) from the Consumer Product Safety Commission (CPSC). The database was searched for emergency department (ED) visits involving facial fractures sustained by children 1 month through 5 years of age from 2004 through 2016 and analyzed for patient demographics, primary diagnosis and associated products/activities. Subset analyses were performed between age groups to determine the relationship between causes of injury and age using extrapolated national incidences. RESULTS A total of 1507 ED visits for facial fractures among infants, toddlers, and children were obtained and extrapolated to an estimated total of 39,388 ED visits, averaging 3030 annually. The majority of these ED visits were for facial fractures that occurred at home. Most facial fractures sustained at the age period of 1 month-5 years old were nasal fractures. Facial fractures in infants were caused most commonly by floors or flooring materials, likely due to falls, while household items/furniture-related injuries were the most common cause of facial fractures in both toddlers and children. Facial fractures from playground equipment and riding toys were more common in children than in the other age groups. CONCLUSION The reported trends in the incidence by age group and types of fracture can assist physicians by serving as supplement for clinical history and examination when encountering this challenging patient population. Our findings highlight preventative opportunities, particularly in baby care items and beds for reducing facial fractures in infants. Similarly, preventative opportunities are highlighted in household items and furniture for lowering the incidence of facial fractures in toddlers and children. Our study also suggests ensuring safe handling of playground equipment and riding toys for the prevention of facial fractures in children.
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Affiliation(s)
- Pavly Youssef
- Rutgers New Jersey Medical School, Department of Otolaryngology, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA.
| | - Roman Povolotskiy
- Rutgers New Jersey Medical School, Department of Otolaryngology, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA
| | - Thayer J Mukherjee
- Rutgers New Jersey Medical School, Department of Otolaryngology, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA
| | - Aron Kandinov
- Rutgers New Jersey Medical School, Department of Otolaryngology, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA
| | - Boris Paskhover
- Rutgers New Jersey Medical School, Department of Otolaryngology, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA
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Comps JN, Tuleasca C, Goncalves-Matoso B, Schiappacasse L, Marguet M, Levivier M. Upfront Gamma Knife surgery for facial nerve schwannomas: retrospective case series analysis and systematic review. Acta Neurochir (Wien) 2018; 160:987-996. [PMID: 29492656 DOI: 10.1007/s00701-018-3503-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 02/19/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Facial nerve schwannomas are rare tumors and account for less than 2% of intracranial neurinomas, despite being the most common tumors of the facial nerve. The optimal management is currently under debate and includes observation, microsurgical resection, radiosurgery (RS), and fractionated radiotherapy. Radiosurgery might be a valuable alternative, as a minimally invasive technique, in symptomatic patients and/or presenting tumor growth. METHODS We review our series of four consecutive cases, treated with Gamma Knife surgery (GKS) between July 2010 and July 2017 in Lausanne University Hospital, Switzerland. Clinical and dosimetric parameters were assessed. Radiosurgery was performed using Leksell Gamma Knife Perfexion. We additionally performed a systematic review, which included 23 articles and 193 treated patients from the current literrature. RESULTS The mean age at the time of the GKS was 44.25 years (median 43.5, range 34-56). Mean follow-up period was 31.8 months (median 36, range 3-60). Two cases presented with facial palsy and other two with hemifacial spasm. Pretherapeutically, House-Brackmann (HB) grade was II for one case, III for two, and VI for one. The mean gross tumor volume (GTV) was 0.406 ml (median 0.470 ml, range 0.030-0.638 ml). The mean marginal prescribed dose was 12 Gy at the mean 54% isodose line (median 50%, range 50-70). The mean prescription isodose volume (PIV) was 0.510 ml (median 0.596 ml, range 0.052-0.805 ml). The mean dose received by the cochlea was 4.2 Gy (median 4.1 Gy, range 0.1-10). One patient benefited from a staged-volume GKS. At last follow-up, tumor volume was stable in one and decreased in three cases. Facial palsy remained stable in two patients (one HB II and one HB III) and improved in two (from HB III to II and from HB VI to HB III). Regarding hemifacial spasm, both patients presenting one pretherapeutically had a decrease in its frequency and intensity after GKS. All patients kept stable Gardner-Robertson class 1 at last follow-up. CONCLUSION In our experience, RS and particularly GKS, using standard, yet low doses of radiation, appear to be a safe and effective therapeutic option in the management of these rare tumors. The results as from our systematic review are also encouraging with satisfactory rates of clinical stabilization and/or improvement and high rate of tumor control. Complications are infrequent and mostly transient.
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Affiliation(s)
- Jean-Nicolas Comps
- Neurosciences Department, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland
| | - Constantin Tuleasca
- Neurosciences Department, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland.
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
- Swiss Federal Institute of Technology, Signal Processing Laboratory (LTS5), Lausanne, Switzerland.
| | | | - Luis Schiappacasse
- Radiotherapy Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Maud Marguet
- Institute of Radiation Physics Lausanne, Lausanne, Switzerland
| | - Marc Levivier
- Neurosciences Department, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Rue du Bugnon 44-46, BH-08, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Affiliation(s)
- Ryan M Diepenbrock
- Oral and Maxillofacial Surgery, David Grant USAF Medical Center, 101 Bodin Cir, Travis AFB, CA 94535, USA; Diepenbrock Facial Cosmetic Surgery, 171 Butcher Road, Suite A, Vacaville, CA 95687, USA.
| | - J Marshall Green
- Oral and Maxillofacial Surgery, Naval Medical Center Portsmouth, 620 John Paul Jone Cir, Portsmouth, VA 23708, USA; Coastal Facial Aesthetic Surgery, 5408 Discovery Park Boulevard #101, Williamsburg, VA 23118, USA
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Bhat TA, Gulzar A, Bhat AA, Bhat TA, Ali Z. A review of upper limb injuries in bear maul victims: Consistent pattern and inverse relation in severity with facial and scalp injuries. Chin J Traumatol 2018; 21:38-41. [PMID: 29402720 PMCID: PMC5857895 DOI: 10.1016/j.cjtee.2017.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/05/2017] [Accepted: 11/15/2017] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Bear maul injuries are the most common wild animal inflicted injuries in India. More than 300 bear maul injuries report to our hospital per year. METHODS Twenty-one consecutive patients over a period of 1 year reported to our department for orthopaedic management of bear maul injuries. All the patients were referred either from peripheral hospitals or from other surgical departments of our hospital. RESULTS All the patients had facial/scalp injuries of variable severity. In all the patients the severity of limb and facial trauma was inversely proportional to each other. Pattern of upper limb trauma in most of the patients was similar. Fifteen patients had either fractures of distal humerus or mid shaft/proximal forearm bone fracture. Two had distal forearm bone fracture, 2 had carpal/metacarpal fractures and 1 had clavicle fracture. Only 1 had lower limb fracture. Thirteen out of 21 patients had associated neurovascular injury of the involved limb. The characteristic feature was extensive soft tissue involvement of the affected limb. CONCLUSION Upper limb injuries in bear maul patients usually have similar pattern. The severity of upper limb and facial/scalp trauma is inversely proportional to each other. Multistage orthopaedic surgeries are needed for such complex limb injuries.
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Affiliation(s)
- Towseef Ahmad Bhat
- Department of Orthopaedics, Pt. Jawahar Lal Nehru Govt. Medical College, Chamba, Himachal Pradesh, India,Corresponding author.
| | - Amara Gulzar
- Department of Emergency Medicine, SKIMS Medical College, Bemina, Srinagar, India
| | | | - Tariq Ahmad Bhat
- Department of Orthopaedics, Govt. Sub District Hospital Chadora, Srinagar, India
| | - Zameer Ali
- Department of Orthopaedics, New City Hospital, Srinagar, India
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Abstract
Zebrafish are well-established as a model of vascular development. The genetic tractability, external development, permeability to small molecules and optical transparency of zebrafish larvae are all attributes that make this model attractive to the vascular biologist. There are an increasing number of lymphatic reporter lines that enable the visualization of zebrafish lymphatic vessel growth in vivo; these tools, coupled with either forward or reverse genetics, have provided new insights into the process of lymphatic specification and development. Zebrafish larvae have three main lymphatic networks: the trunk lymphatics, the intestinal lymphatics, and the facial lymphatics and it is therefore possible to use zebrafish to determine network-specific roles for molecules implicated in lymphatic development. This chapter provides protocols for visualization and analysis of facial lymphatic development in the zebrafish and may be applied in developmental or drug discovery studies.
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