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At least 199 records · Page 11Linked to original sources
PubMed1995

Endoscopic forehead lift. Aesthetics and analysis.

The endoscope already has revolutionized aesthetic forehead surgery by reducing the morbidity rate associated with the forehead lift operation. The ability to do the operation through a minimally invasive approach is predicated on the illumination and magnification that the endoscope provides. It is this same illumination and magnification that is being brought to bear on the aesthetics, analysis, goals, and techniques that have guided the classical procedure. Both patients and surgeons will benefit from this renewed focus on aesthetic surgery of the forehead.

Blepharoptosis↗
PubMedDate not supplied

Forehead flap periorbital reconstruction.

OBJECTIVE: To evaluate functional and aesthetic results of periorbital defect repair using forehead flaps. DESIGN: Retrospective review of patients who received periorbital defect repair by 3 of us with a paramedian forehead flap alone or in conjunction with other local or regional flaps, bone grafts, or cartilage grafts. Flap survival, functional results, and postoperative complications were determined by physical examination at regular follow-up. Three experienced surgeons other than us quantified aesthetic outcomes using a 10-cm visual analog scale. RESULTS: Eighteen patients underwent periorbital defect repair between August 1, 1989, and December 31, 2000. Defects ranged from 8 to 300 cm(2) (mean, 46.8 cm(2)) in area. The most commonly involved primary structures were the medial canthus, lacrimal drainage system, and medial upper eyelid. The mean improvement on a 10-cm visual analog scale was 1.6 from before resection to after reconstruction and 3.8 from tumor resection to after reconstruction. In all relevant cases, globe coverage and lacrimal drainage system patency were excellent. No patients experienced fistula formation or eyelid retraction. CONCLUSION: The reliability, versatility, and relative technical simplicity of the forehead flap provide excellent cosmetic and functional results in reconstruction of intermediate-sized periorbital defects, especially those associated with nasal defects.

Adolescent↗
PubMed1996

Reflectance pulse oximetry at the forehead of newborns: the influence of varying pressure on the probe.

OBJECTIVE: Transmission pulse oximetry (TPO) is not a practical method of intrapartum fetal monitoring of arterial oxygen saturation. Reflectance pulse oximetry (RPO) requires a sensor applied to the skin of the fetal head and may be a useful technique. During labor, various degrees of pressure will be exerted on the RPO sensor. Previous studies have shown that moderate pressure on the sensor can improve the RPO signal. At increasing pressure, however, blood flow underneath the sensor will be occluded. This study examines the influence of pressure applied to the RPO sensor on the signal from the forehead of healthy newborns as a model for the fetal situation. METHODS: After institutional approval, 12 healthy newborns were studied. The RPO probe was placed at the forehead. Pressure on the probe was increased stepwise from 0 to 80 mmHg, and the effect on the ratio between the relative changes of the red and infrared light intensities (R/IR, inversely related to oxygen saturation) and pulse sizes was evaluated. Additionally, the effect of firm pressure (> 150 mmHg) on the probe was evaluated. RESULTS: R/IR values remained virtually unchanged when pressure onto the probe was increased from 0 to 80 mmHg, although the standard deviation slightly decreased. The pulse size increased as pressure on the probe increased. During firm pressure on the probe (> 150 mmHg), plethysmographic signals remained detectable, but R/IR values markedly increased. CONCLUSIONS: In newborns, mild to moderate pressure on the probe has little influence on the RPO signal at the forehead. Even during firm pressure, RPO can be used to obtain pulsatile signals, that presumably derive from tissue underneath the skull, such as the cerebral circulation.

Fetal Monitoring↗
PubMedDate not supplied

Referred pain to the ipsilateral forehead and orbit: An unusual phenomenon during bronchial artery embolization.

PURPOSE: We report an unusual pattern of referred pain to the ipsilateral forehead and orbit observed during bronchial artery embolization (BAE) for massive hemoptysis due to pulmonary tuberculosis (TB) and postulate possible neural mechanisms for its occurrence. METHODS: Seven men, from a series of 194 patients (171 men, 23 women) undergoing BAE (right bronchial artery 4, left 3) with gelatin sponge for control of massive hemoptysis due to pulmonary TB form the subject of this report. RESULTS: Embolization was successful in achieving control of hemoptysis in these patients and there were no complications following the embolization. Transient, moderately severe, ipsilateral supraorbital and/or retroorbital pain occurred only during the injection of the gelatin sponge contrast mixture into the bronchial artery. The pain did not occur during the injection of heparinized saline or ionic contrast medium. CONCLUSIONS: Referred pain during BAE is an unusual phenomenon. Acute vessel distension triggering visceral sensations is probably the causative mechanism. Sympathetic afferents from the bronchi coursing through the posterior pulmonary plexus eventually pass to the trigeminal ganglion via the carotid sympathetic chain. The ophthalmic and maxillary divisions of the trigeminal nerve then mediate pain sensation to the ipsilateral forehead and orbit. Similarly, parasympathetic afferents from the pulmonary plexus crossing the nucleus of the spinal tract of the trigeminal nerve may be responsible for interexchange of impulses to the neurons in this nucleus. Sensory fibers of the ophthalmic and maxillary nerves relaying in this nucleus are then involved in this pain being referred to the forehead and orbit.

Adult↗
PubMed1990

Family history of hypertension and cardiovascular reactivity to forehead cold stimulation in black male children.

The effects of family history of hypertension on cardiovascular reactivity to forehead cold stimulation was examined in 16 black males from 11 to 14 years of age. Measures of blood pressure, heart rate, cardiac output, stroke volume and systemic vascular resistance were obtained during baseline, forehead cold stimulation and recovery phases. Diastolic blood pressure and systemic vascular resistance increases to the forehead cold stimulation were significantly greater in subjects with positive family histories of hypertension than in those with negative family histories. These findings are compared with the results of adult studies and discussed in terms of racial differences in alpha and beta-adrenergically mediated cardiovascular reactivity.

Adolescent↗
PubMed1990

Fourier analysis of the forehead shape of skull and sex determination by use of computer.

The forehead shape of the skull was quantified with the Fourier analysis method by using 100 male and 100 female radiographic lateral views of the skull, and sex difference in the forehead shape was studied. Furthermore to predict the sex of cranial specimens, an automated sexing computer system based on the quantification was created. The effectiveness of the system was evaluated by checking 56 male and 56 female specimens of skulls. This system was proved to discriminate male and female skulls from forehead shapes with 85% accuracy.

Adult↗
PubMed2005

The full-thickness forehead flap for complex nasal defects: a preliminary study.

OBJECTIVE: To report a new technique using a bivalved, full-thickness paramedian forehead flap. The unique vascular anatomy of the supratrochlear artery allows the skin and subcutaneous tissue to be separated from the frontalis muscle and pericranium. The deep layers serve as a pliable, vascularized intranasal lining. Bone and cartilage grafts can be placed as "sandwich" grafts between the deep and superficial layers of the flap. STUDY DESIGN: A retrospective review of 5 cases. RESULTS: All flaps survived. Four minor complications occurred in 3 patients. These resolved with minimal treatment. CONCLUSIONS: The full-thickness forehead flap is a viable option for large defects or for the difficult situation in which intranasal local flaps are not an option. SIGNIFICANCE: The gold standard for replacement of the intranasal lining is a septal mucosal or vestibular local flap. The full-thickness forehead flap is an option in patients for whom other lining flaps are not available. EBM RATING: C-3.

Adult↗
PubMed2001

Reconstruction of the inner canthus region with a forehead muscle flap: a report on three cases.

We report our experience of using a forehead flap to repair the defect left by the excision of skin tumours in the medial canthal region involving both eyelids in three patients. Both eyelids and the inner canthus were reconstructed using a myofascial flap taken from the forehead, combined with septal chondro-mucosal grafts, oral mucosa and skin grafts. After a careful anatomical study of the vascularisation of the frontal region, we used only the frontal myofascial portion, a part of the forehead muscle vascularised by the deep branch of the supraorbital artery and by the supratroclear artery; the skin left behind is adequately nourished by the fine mesh of anastomoses in the area between the two supratroclear arteries, the supraorbital artery and the terminal vessels of the superficial temporal artery. The particularly thin, elastic and resistant features of this flap enabled us to repair a loss of substance in a difficult area with a successful outcome in terms of morphology, function and cosmetic appearance.

Aged↗
PubMed2000

Detection of cannabis in oral fluid (saliva) and forehead wipes (sweat) from impaired drivers.

Saliva and sweat have been presented as two alternative matrices for the establishment of drug abuse. The noninvasive collection of a saliva or sweat sample, which is relatively easy to perform and can be achieved under close supervision, is one of the most important benefits in a driving-under-the-influence situation. Moreover, the presence of certain analytes in saliva is a better indication of recent use than when the drug is detected in urine, so there is a higher probability that the subject is experiencing pharmacological effects at the time of sampling. We developed an original procedure using gas chromatography-mass spectrometry to test for delta9-tetrahydrocannabinol (THC), the psychoactive ingredient of cannabis, in oral fluid and forehead wipes, collected with Sarstedt Salivettes and cosmetic pads, respectively. Blood, urine, oral fluid, and forehead wipes were simultaneously collected from 198 injured drivers admitted to an Emergency Hospital in Strasbourg, France. Of the 22 subjects positive for 11-nor-9-carboxy-THC (THCCOOH) in urine, 14 and 16 were positive for THC in oral fluid (1 to 103 ng/Salivette) and forehead wipe (4 to 152 ng/pad), respectively. 11-Hydroxy-THC and THCCOOH were not detected in these body fluids. Two main limitations of saliva and sweat are apparent: the amount of matrix collected is smaller when compared to urine, and the levels of drugs are higher in urine than in saliva and sweat. A current limitation in the use of these specimens for roadside testing is the absence of a suitable immunoassay that detects the parent compound in sufficiently low concentrations.

Adolescent↗
PubMed1982

The forehead-brow lift.

The forehead-brow lift, though generally thought to achieve very little and for only a brief time, corrects ptosis of the eyebrows, redundancy of the upper eyelids, and skin wrinkles on the forehead, nasoglabellar, and lateral canthal regions. Other aesthetic improvements include restoration of the contour of the root of the nose and elevation of the nasal tip. However, careful attention to complete release of the frontalis-galea unit from the underlying orbital rims and zygomatic arches is essential for long-term success. A forehead-brow lift technique is described and the results and complications in 34 patients reviewed.

Face↗
PubMed2004

Nasal reconstruction with a forehead flap in children younger than 10 years of age.

Nasal reconstruction has been analyzed extensively in adults but not in children. The purpose of this article is to review the authors' experience with the forehead flap for nasal reconstruction in 10 children under the age of 10 during a 10-year period. Outcomes were assessed by an objective grading system for cosmetic surgical results. Subjective criteria were also applied by an assistant surgeon and by the patients' relatives. Appropriate results were obtained by the following principles: (1) A modified approach that considers three subunits consisting of the dorsum, tip, and ala was used; (2) a forehead flap is the best option for an entire subunit or a full-thickness defect repair; (3) the forehead flap design should be paramedian, oblique, and opposite to the major defect to avoid the hairline and allow better caudal advancement; (4) ear or costal cartilages are good options for structural support (the septum is a nasal growth center that should not be touched); (5) infundibular undermining of vestibular mucosa, turnover flaps, and skin grafts are good options for internal lining; (6) reconstruction is a three-stage procedure (an intermediate operation is added to thin the flap and perform secondary revisions for lining and support); (7) reconstruction should be completed before the child is school aged, to achieve good aesthetic results immediately and avoid psychosocial repercussions; and (8) the reconstructed nose, with skin, lining, and support, will grow with the child (no final surgery should be planned at the age of 18, other than revisions of late complications).

Child↗
PubMed2005

Brow fixation with the Endotine Forehead device in endoscopic brow lift.

BACKGROUND: The Endotine Forehead device (Coapt Systems, Inc., Palo Alto, Calif.) is an implantable bioabsorbable fixation device designed to provide intuitive, multipoint, distributed tension and repeatable and predictable brow fixation during endoscopic and open browplasty. The purpose of this study was to evaluate early results in a series of endoscopic brow lift cases using the Endotine Forehead device. METHODS: Two versions of the Endotine device were used in this study. One was composed of polylactic acid, and the other was a smaller version consisting of 82/18 L-lactide/glycolide). In a consecutive series of endoscopic brow lift cases, preoperative and postoperative standardized photographs were taken in the Frankfort horizontal plane and three measurements were compared: midpupil to superior brow, midpupil to hairline, and lateral canthus to superior brow. RESULTS: A total of 21 patients (19 women and two men) underwent endoscopic browplasty. Photographs were obtained preoperatively and 54 to 174 days postoperatively. Brow elevation measurements were obtained postoperatively. No significant adverse events were encountered in the follow-up period. CONCLUSION: The Endotine Forehead device provides significant and reproducible brow elevation, with no significant adverse events, as measured at three points in excess of 14 weeks postoperatively.

Endoscopy↗
PubMed2006

Efficacy and safety of 3- and 5-injection patterns (30 and 50 U) of botulinum toxin A (Dysport) for the treatment of wrinkles in the glabella and the central forehead region.

OBJECTIVE: To investigate the efficacy and safety of 2 injection site patterns (3- and 5-injection patterns [30 and 50 U]) of botulinum toxin A (Dysport; Ipsen Pharma, Ettlingen, Germany), in the treatment of glabellar and central forehead wrinkles. DESIGN: Multicenter, double-blind, placebo-controlled, randomized, 16-week trial. SETTING: Twenty-three German dermatologic centers. PATIENTS: Two hundred twenty-one patients with moderate or severe glabellar wrinkles when frowning maximally. Intervention Centers were randomly assigned to the 3-injection site pattern (3 injections of 10 U of botulinum toxin A or placebo) or 5-injection site pattern (5 injections of 10 U of botulinum toxin A or placebo). All centers used 3 sites in the procerus and corrugator muscles; the 2 additional sites were approximately 1-cm cranial from the corrugator sites. MAIN OUTCOME MEASURE: Wrinkle severity was graded by 4 independent experts blinded to the treatment received using digital photographs and a standardized clinical scale (range, 0 [no wrinkles] to 3 [severe wrinkles]). A reduction of at least 1 point between weeks 0 and 4 was considered a therapeutic success (responder). RESULT: One hundred ten patients (73 receiving botulinum toxin A vs 37 receiving placebo) received 3 injections; 111 patients (73 receiving botulinum toxin A vs 38 receiving placebo) received 5 injections. After 4 weeks, the proportions of responders were 86.1% vs 18.9% and 86.3% vs 7.9%, respectively (P<.001 for both). No major adverse effects were observed. CONCLUSIONS: The 3 central injection sites are essential for the treatment of glabellar wrinkles. The 2 additional injection sites in the forehead region, targeting the frontalis muscle, did not significantly improve efficacy.

Adolescent↗
PubMedDate not supplied

Temporal artery-based forehead flap.

The historical development of the forehead flap is reviewed, and an operative experience using delayed and nondelayed techniques in 30 cases is described. The reliability of the forehead flap is evaluated with regard to patient morbidity and correction of deformity and dysfunction in such sites as the cheek, lip, corner of the mouth, floor of the mouth, tongue, pharyngeal wall, and tonsil. Analyses include length of hospital stay and complications, as well as the relationship of these factors to the methods employed in the reconstructive processes. The advantages and disadvantages of the various techniques are illustrated using individual cases.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Endoscopic forehead lift: the subperiosteal pulling stitch.

The endoscopic-assisted forehead lift has overtaken the coronal approach since 1992. One of the controversial points was the fixation of the flap in the elevated position. This article presents a simple pulling stitch using resorbable thread, subperiosteally. The mobile forehead after muscle resection is tracted up and back and fixed to the attached periosteum of the occipital bone. This fixation is strong for 3-4 months until the thread has melt. Long-term results of 3 years confirm the strength and longlasting of this subperiosteal pulling stitch (SPPS).

Endoscopy↗
PubMed1994

Bicoronal forehead lift.

Although aesthetic surgery on the upper third of the face has received relatively little attention in recent literature, it is an extremely important component of facial aesthetic surgery and often yields results that are quite dramatic. Periorbital rejuvenation, either alone or in conjunction with other aesthetic surgical procedures, offers facial enhancement to younger patients. In addition, older patients may benefit from a "forehead lift" performed in conjunction with lower facial surgery. This benefit is derived because lower facial surgery may create facial disharmony by yielding a more youthful lower face while leaving a more mature upper face. In these cases a forehead lift serves to unify the patient's facial appearance. The coronal browlifting technique described here is a personal interpretation and modification of periorbital rejuvenation techniques. This approach represents an ideal aesthetic procedure: It is a technically straightforward operation that yields results which are predictable, natural appearing, and long lasting with minimal morbidity.

Adult↗
PubMed1990

The "biplanar" forehead lift.

A new technique of forehead rhytidectomy is presented that combines the best features of the coronal incision with those of the anterior hairline incision. The plane of dissection is formed by an anterior subcutaneous plane dissecting a lateral subgaleal plane. This approach is particularly valuable in patients with high foreheads, severe static wrinkling, and asymmetrical eyebrows.

Follow-Up Studies↗
PubMed1996

Adrenergic receptors in the forehead microcirculation.

The presence of alpha- and beta-adrenoceptors in the forehead microcirculation was investigated in 49 healthy subjects. Local vascular responses to noradrenaline, isoprenaline and adrenergic antagonists, administered transcutaneously by iontophoresis, were monitored via laser Doppler flowmetry. Iontophoresis of the alpha-adrenergic antagonist phentolamine induced a persistent increase in skin blood flow, whereas iontophoresis of saline induced a minor increase in skin blood flow which subsided rapidly. Skin blood flow increased moderately after the iontophoresis of the beta-adrenergic antagonist propranolol. Pretreatment of the experimental site with phentolamine blocked the normal vasoconstrictor response to noradrenaline, and unmasked a minor vasodilator component of response in some subjects. Iontophoresis of the beta-adrenergic agonist isoprenaline induced dose-dependent vasodilatation which was antagonised by propranolol. These findings indicate that alpha-adrenoceptors in the forehead microcirculation normally mediate a vasoconstrictor response to iontophoretically-applied noradrenaline. In addition, beta-adrenoceptors appear to mediate a minor vasodilator component of response.

Adolescent↗