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At least 181 records · Page 10Linked to original sources
PubMed1998

The subperiosteal endoscopic laser forehead (SELF) lift.

The subperiosteal endoscopic laser forehead lift is shown to be an effective tool for plastic surgeons. By combining the use of the carbon dioxide laser with the already established technique of endoscopic forehead lift, improved results are achieved. The technique of endoscopic forehead lifting lends itself to new advancements in laser technology. Through the use of flexible laser wave guides or rigid laser extensions, the efficiency and safety of the procedure is proven. Skin excision and fixation have not been necessary. Twenty patients have undergone this procedure successfully; long-lasting results are demonstrated.

Adult↗
PubMed1999

Turnover forehead flap combined with composite crus of helix graft for partial nasal reconstruction.

Partial lateral nasal defects challenge the plastic surgeon both technically and aesthetically. Many methods for reconstruction of these defects have been described. We have used a turnover forehead flap in conjunction with composite auricular graft for the reconstruction of nasal defects. The forehead flap is turned over so that the forehead skin serves as internal lining in the nose. The composite auricular graft serves as external nasal lining and provides mechanical support to the ala. The technique was used in seven patients and is presented here with illustrations, selected cases, results, and conclusions concerning patient selection.

Aged↗
PubMed2005

Endoscopic correction of eyebrow asymmetry in associated forehead soft-tissue injuries.

Supported by anatomical principles, a subgaleal endoscopically assisted selective myotomy of the forehead and glabellar muscles was used to achieve eyebrow symmetry in patients with unilateral facial nerve palsy and associated forehead soft-tissue injuries. Selective myotomy equalizes the agonist-antagonist muscle relationship on both sides of the forehead, thereby allowing the untouched muscle to exert its activity without opponent restriction. Selective myotomy allows for the management of the muscles' group action as well as individual manipulation of each muscle in accordance with its participation in the eyebrow deformity.

Adult↗
PubMed2006

Endoscopic forehead rejuvenation: I. Limitations, flaws, and rewards.

BACKGROUND: The efficacy of endoscopic forehead rejuvenation has been questioned. However, many proponents of the technique are convinced that this procedure is indeed an optimal choice for the majority of patients desiring forehead rejuvenation and have found the means of preventing adversities. METHODS: The purpose of this article is to discuss the common features and reasons for suboptimal endoscopic forehead rejuvenation outcomes and avoidance of these flaws based on the author's experience with 372 procedures. RESULTS: These imperfections include inadequate muscle resection, under- or overelevation of the eyebrows, asymmetry, glabellar dimpling or depression, displeasing eyebrow arch, and excessive separation of the eyebrows. CONCLUSIONS: In this report, the details of these flawed outcomes are discussed, and the ways in which they can be avoided or corrected are reviewed to improve the learning curve for less-experienced surgeons and to aid in producing more predictable and pleasing results.

Endoscopy↗
PubMed1991

Pulse oximeter probes. A comparison between finger, nose, ear and forehead probes under conditions of poor perfusion.

The performances of 10 pulse oximeters using finger probes were compared with the same pulse oximeters using alternative probes (eight finger probes, two nose probes and a forehead probe) in poorly perfused patients. All readings were then compared with directly measured arterial blood oxygen saturations. The mean difference (bias, 'accuracy'), standard deviation (precision) and 'drop out' rate for each pulse oximeter combination was determined. An overall ranking of performance of each pulse oximeter was calculated using five criteria (accuracy, precision, number of readings within 3% of standard, percentage of readings given within 3% of standard, expected overread limit in 95% of cases). Nose and forehead probes performed poorly. Some ear probes performed well compared to some finger probes, but the overall performance of probes in other sites compared to finger probes was worse, (p = 0.05). Two of eight ear probes and no nose or forehead probes would be expected to be within 4% of the reference value in 95% of readings. The use of finger probes rather than probes in other sites is recommended in the patient with poor peripheral perfusion.

Adult↗
PubMed2006

Late-onset eccrine angiomatous hamartoma on the forehead.

A 71-year-old Korean man presented with a solitary erythematous plaque on his forehead (Fig. 1). It was first noticed by the patient 1 year previously and had slowly increased in size over that time. Physical examination revealed a slightly elevated, 1.5 cm x 1.5 cm erythematous plaque on the upper midline of the forehead. Sweating was not evoked by physical work or emotional stress. There was no pain or tenderness associated with the lesion. The patient had no history of trauma to the forehead. Histopathologic examination of the lesion showed increased numbers of eccrine glands, as well as dilated vascular channels in the deep dermis and subcutaneous tissue (Fig. 2). An immunohistochemical study showed that these eccrine glands stained positively for S-100 and carcinoembryonic antigen (CEA), and the vascular channels for the antifactor VIII-related antigens. These findings are consistent with eccrine angiomatous hamartoma. There was no change in the lesion during the 1-year follow-up period.

Aged↗
PubMed2006

Ultrastructural effects of an infrared handpiece on forehead and abdominal skin.

BACKGROUND: Collagen fibril contraction has been shown to be associated with tissue tightening by nonablative skin rejuvenation. Transmission electron microscopy has proven to be an effective method for characterizing collagen contraction delivered by ablative and nonablative devices used on human skin. OBJECTIVE: The purpose of this two-part study was to evaluate ultrastructural changes in cadaveric forehead skin and live abdominal skin by transmission electron microscopy for different fluence levels using the Titan infrared handpiece (Cutera, Inc., Brisbane, CA). This device is a noncoherent selectively filtered infrared device operating in the 1,100- to 1,800-nm bandwidth, intended to provide dermal heating. METHODS AND MATERIALS: Cadaveric forehead skin at 37 degrees C was treated with a 1x1.5-cm spot at fluences of 50 and 100 J/cm2. Informed consent was obtained and abdominal skin of one patient (before abdominoplasty) was treated in vivo with a 1x1.5-cm spot at fluences of 30, 45, and 65 J/cm2. Punch biopsies of the treatment areas and a control area were obtained immediately after treatment. Transmission electron microscopy at depths of 0 to 1 and 1 to 2 mm was performed for each biopsy to evaluate morphologic alterations of collagen fibrils in treated areas compared to the control area. RESULTS: In the cadaveric forehead skin samples, the collagen fibril alteration was greatest in the depth range of 1 to 2 mm for both fluence settings. In the abdominal skin samples, collagen fibril alteration was not seen in the control site but was observed at all treatment levels at both the 0 to 1 and the 1 to 2-mm depths, with the least alteration seen at the shallow depth and the lowest fluence. CONCLUSIONS: Our findings suggest that collagen fibril denaturation, consistent with fibril thermocontraction, occurs immediately after infrared tissue tightening. Collagen denaturation occurs at a depth range appropriate for deep dermal treatments. The peak in collagen fibril alteration at 1 to 2 mm is consistent with contact cooling protecting the more superficial layers of the skin.

Abdomen↗
PubMed1977

Metabolism of testosterone by forehead skin of the roebuck (Capreolus capreolus).

Roebucks have a specialized region of skin on the forehead which contains sebaceous and apocrine glands that produce secretions used in territorial marking. These glands enlarge during the breeding season and regress after the rut as the testes regress. The metabolism of testosterone by this forehead skin in vitro was studied in two captive roebucks over the period of glandular enlargement and subsequent regression, and compared with that of dorsal skin. In May, June and July, both areas of skin actively metabolized testosterone and the metabolites detected were androstenedione, androstanedione, dihydrotestosterone, epiandrosterone, androsterone and 5alpha-androstanediols. There were no major differences in testosterone metabolism between the two body sites, although dorsal skin appeared to be more active in total metabolism than forehead skin. There was a peak in the extent of metabolism in June/July, with a subsequent gradual decline to December. The decline in metabolism occurred at a time when the associated glands were still enlarged, which suggests that the availability of androgen to the skin glands is determined not only by the amount of testosterone in the circulation, but also by a decrease in the metabolizing capacity of the tissue.

Androstenedione↗
PubMed1978

Distribution of androgen metabolizing enzymes in isolated tissues of human forehead and axillary skin.

The distribution of androgen metabolism in human skin was studied using tissues isolated either by direct dissection of axillary skin or by dissection of collagenase-digested forehead and axillary skin. All tissues (epidermis, sweat glands, sebaceous glands, hair follicles and dermis) were found to contain 17beta-, 3beta- and 3alpha-hydroxysteroid dehydrogenase (HSD) activities, 3beta-hydroxysteroid dehydrogenase-delta4--5 isomerase (delta5-3beta-HSD) activity and 5alpha-reductase activity. All tissues converted testosterone into 5alpha-dihydrotestosterone. In confirmation of previous histochemical studies, over 90% of the delta5-3beta-HSD of forehead skin was found in the sebaceous glands. In forehead skin, 40--66% of the 5alpha-reductase activity was in the sebaceous glands, while in axillary skin 50--70% was in the sweat glands, especially the apocrine glands. There was a more even distribution of 17beta-HSD activity in skin tissues than histochemical studies have indicated previously. Knowledge of the distribution of these enzymes has helped in the understanding of the function of androgen metabolism in skin.

Adult↗
PubMedDate not supplied

Occlusion effect: bone conduction speech audiometry using forehead and mastoid placement.

The occlusion effect (OE) was determined for bone conduction speech reception thresholds (SRTs) in 24 normally hearing subjects using forehead and mastoid placement. Results indicated that the OE was about 3 dB greater using forehead as opposed to mastoid placement. The intersubject variability of the OE is similar for the forehead and mastoid positions. The formula for effective masking for bone conduction speech should be equal to the minimum masking level for bone conduction speech plus the air-bone gap of the nontest ear plus 18 dB to account for the OE when using mastoid placement.

Acoustic Stimulation↗
PubMed1997

Limits for the use of forehead flaps for small and extensive midface reconstructions including septum/columella reconstructions.

I describe six selected cases of challenging reconstructions in the midface including a small deepithelialised and tunnelled flap for volume-replacement and conjunctiva-reconstruction in the orbit and a case of septum/columella reconstruction with a tunnelled paramedian forehead flap. Big flaps for extensive complex reconstructions in the midface (cheek, lip, and nose) emphasis the efficiency of the flaps. In extensive reconstructions the paramedian forehead might primarily be used for lining. Indian forehead flaps should be dissected to the base in the upper eyelid to increase their strength and for greater versatility. The base can be de-epithelialised without threatening its viability. This procedure allows the flap to be tunnelled and increases the mobility of the flap. Long flaps can even be folded without delay.

Aged↗
PubMed2001

Polymethyl-methacrylate implants in forehead and supraorbital arches reconstruction: retrospective study.

Frontobasal injuries and some other diseases of frontal sinuses sometimes require radical surgery with the obliteration of the sinus. A cosmetic correction of the forehead and supraorbital arches has to be performed after such a procedure. Nowadays, there is a wide choice of alloplastic materials on the market. We tried polymethyl methacrylate implants in correction of the exterior appearance of the forehead and supraorbital arches and followed the behaviour of the implants up to 25 years after surgery. The result was 18 (94.7%) successful implantations and one failure (5.3%) with a mild sagging of the borders of the implant. Polymethyl-methacrylate proved pliable for work and modelling, not invasive for the organism and stable. In conclusion, the cure of some frontobasal injuries and diseases with the first surgical step followed by cosmetic correction of the forehead and supraorbital arches (2nd surgical step) using this alloplastic material provides a safe, durable and aesthetically satisfactory solution for the patient.

Adult↗
PubMedDate not supplied

[Reconstruction of nasal cutaneous defects with the use of supratrochlear artery-based paramedian forehead flap].

OBJECTIVES: We evaluated oncologic and functional results of paramedian forehead flap in the reconstruction of nasal cutaneous defects. PATIENTS AND METHODS: Supratrochlear artery-based paramedian forehead flap was employed in 14 patients (13 men, 1 woman; mean age 57 years; range 46 to 63 years) for the reconstruction of nasal cutaneous defects resulting from excision of squamous or basal cell carcinoma. No other treatment modalities were performed other than removal of the primary lesion. The mean follow-up was 42.4 months (range 8 to 83 months). RESULTS: None of the patients developed flap necrosis, local recurrences, or distant metastasis. Airway problems of varying extent were observed in 10 patients (71.4%), the severity of which became attenuated in time as the flap gained proper contraction. CONCLUSION: Acceptable functional and successful oncologic results can be obtained in the reconstruction with the use of paramedian forehead flap.

Arteries↗
PubMed2004

Persistence of pain induced by startle and forehead cooling after sympathetic blockade in patients with complex regional pain syndrome.

BACKGROUND: Stimuli arousing sympathetic activity can increase ratings of clinical pain in patients with complex regional pain syndrome (CRPS). OBJECTIVE: To determine whether the increase in pain is mediated by peripheral sympathetic activity. METHODS: The effect of sympathetic ganglion blockade on pain evoked by a startle stimulus and cooling the forehead was investigated in 36 CRPS patients. RESULTS: Loss of vasoconstrictor reflexes and warming of the limb indicated that sympathetic blockade was effective in 26 cases. Before sympathetic blockade, pain increased in 12 of these 26 patients when they were startled. Pain increased in seven of the 12 patients and in another five cases when their forehead was cooled. As expected, pain that increased during sympathetic arousal generally subsided in patients with signs of sympathetic blockade. However, pain still increased in three of 12 of patients after the startle stimulus and in six of 12 of patients during forehead cooling, despite indisputable sympathetic blockade. CONCLUSIONS: These findings suggest that stimuli arousing sympathetic activity act by a central process to exacerbate pain in some patients, independent of the peripheral sympathetic nervous system. This may account for the lack of effect of peripheral sympathetic blockade on pain in some CRPS patients.

Adult↗
PubMed1992

The coronal forehead lift--modifications and results.

The coronal forehead lift has produced excellent results in the rejuvenation of the upper face. The problem of brow and glabellar ptosis, as well as the problem of frontoglabellar rhytids, are directly addressed with this procedure while producing no visible scars. In addition, the pretrichial modification of it can be used without alteration in the hairline. The success and low morbidity of the coronal forehead lift has made it the procedure of choice for upper facial rejuvenation in females, and many male patients. A review of 41 coronal forehead lifts performed by the senior author is presented, with emphasis placed on the results and the refinements brought to the surgical technique. A discussion comparing this procedure to other brow lift procedures is also presented, outlining their respective advantages and disadvantages.

Adult↗
PubMed1989

Cancer of the forehead and temple regions.

Several characteristics inherent in tumors of the forehead and temple provide therapeutic challenges for the physician. These include spread along anatomic structures, a propensity toward aggressive growth patterns, the risk of nerve damage, and the preservation of important cosmetic landmarks. As a result of these problems, Mohs micrographic surgery is often indicated in the treatment of skin cancer of the forehead and temple. The high cure rates afforded by micrographic surgery, even for aggressive tumors, and tissue conservation are benefits to the patient. Although most BCCs and SCCs in this region can be handled by a dermatologic surgeon, patients may present with aggressive or neglected tumors exhibiting extensive invasion. These patients may require a cooperative approach between the dermatologic and head and neck surgeon to achieve complete tumor extirpation or appropriate reconstruction. In this article, we have tried to indicate the rationale behind the use of Mohs micrographic surgery for tumors of the forehead and temple. In selected tumors, a team approach between the micrographic and other surgeons will maximize both tumor excision and functional and cosmetic repair for the patient.

Aged↗
PubMed1987

Hyperventilation-induced changes in periodic oscillations in forehead skin blood flow measured by laser Doppler flowmetry.

Rhythmic oscillations in forehead skin blood flow were studied with the laser Doppler technique in thirteen healthy subjects. During voluntary hyperventilation, a three-fold increase in relative amplitude of the spontaneous rhythmic oscillations in forehead skin blood flow was observed, whereas mean blood flow decreased by 15%. During hyperventilation, the relative amplitude of the oscillations was on average 36% of the mean blood flow value. The mean incidence of the oscillations increased significantly, from 68% of the measuring time before, to 96% of the measuring time during hyperventilation. The oscillation frequency was not affected by hyperventilation. Before, during and after hyperventilation the average oscillation frequency was 0.140 Hz (8.4 min-1), 0.145 Hz (8.7 min-1) respectively. The application of heat or a local anaesthetic to the skin attenuated the relative amplitude of the oscillations in forehead skin blood flow during hyperventilation as well as before and after.

Adult↗