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At least 271 records · Page 15Linked to original sources

The hinged-door composite septal flap as structural support and lining of nasal reconstruction by a forehead flap.

In this paper we describe four patients who underwent extensive nasal surgery for carcinoma in the nasal vestibule. Two patients underwent salvage surgery after radiotherapy, whereas the other two patients were treated with primary surgery. In all cases the nasal defect was reconstructed using a composite hinged-door septal flap for structural support and internal lining combined with a paramedian forehead flap which supplied the skin coverage. All patients had a pleasing aesthetic and good functional result. The combination of a paramedian forehead flap with a composite hinged-door septal flap is an excellent reconstruction procedure for defects of the lateral nasal wall and alar region.

Aged↗

[One-stage reconstruction with the pedicle skin flap of forehead for defective tissue of head-neck tumors dissection].

OBJECTIVE: To discuss the feasibility on reconstructing the defective tissue with the pedicle skin flap of forhead after head-neck tumors dissection. METHOD: 14 patients with advanced head-neck tumors were studied, whose defective tissues were reconstructed by their forehead skin flaps. The flap area ranged from 5 cm x 11 cm to 7 cm x 16 cm. RESULT: 2 cases of them were partial necrosis, 3 years and 5 years survival rates were 76.9% and 63.6% respectively. The function of breath through nose or mouth and the function of swallow were satisfactory. CONCLUSION: The forehead skin flap should be a good selection for the reconstruction of defective tissue after basicranial and nasalfacial dissection.

Adolescent↗

An unusual presentation of a giant frontal sinus mucocele manifesting with a subcutaneous forehead mass.

INTRODUCTION: To describe the unusual manifestation of a giant frontal sinus mucocele. CLINICAL PICTURE: A 33-year-old female presented with blurring of vision in the left eye, periorbital swelling and a painless forehead mass. There was proptosis, partial ptosis, and an elongated, soft, subcutaneous mass over the left side of the forehead. CT scan showed a mass arising from the frontal sinus with both intraorbital and intracranial extension. TREATMENT: Surgical excision of the mass confirmed the diagnosis of a mucocele. OUTCOME: Postoperatively, the patient was asymptomatic. CONCLUSIONS: A subcutaneous soft-tissue mass may be the presenting complaint of a frontal mucocele. Careful examination of the surrounding skin may suggest the diagnosis of sinus-related disease and thus direct appropriate investigations.

Adult↗

Repetitive junctional rhythm during forehead-lift surgery--a case report.

Forehead lift plastic surgery is regarded as a rather safe operation without serious cardiovascular complications. Although cardiac arrhythmias (e.g., sinus bradycardia) during such an esthetically plastic surgery have been sporadically reported in literature, repetitive junctional rhythm has not ever been recounted. In this case report, we present a 45-year-old woman who developed repetitive junctional rhythm during forehead lift plastic surgery. The possible offenders causative of the arrhythmia (e.g., oculocardiac reflex induced by repeated surgical manipulation) and the principle of perioperative management were discussed in the text.

Arrhythmias, Cardiac↗

[The endoscopically assisted forehead lift using skull cortical tunnel fixation--a report of 19 cases].

OBJECTIVE: To study the effect of the fixation on skull and thorough mobilization of the brow area on the results of the endoscopically assisted subperiosteal forehead lift. METHODS: The operation procedure included adequate subperiosteal dissection, especially at the frontotemporal transition area; complete mobilization of the brow area and fixation of the incised scalp to the skull through a cortical tunnel without tension. 19 patients received the operation. RESULTS: Long-term follow-up showed that all the 19 patients were satisfied with the surgical results. A transient frontal branch paresis happened in one case, which resolved in 3 months spontaneously without sequelae. CONCLUSIONS: Cortical tunnel fixation well keeps the brows at a lifted position and achieves persistent rejuvenation of the forehead.

Adult↗

Forehead tissue expander.

The use of the forehead flap for nasal reconstruction has long been used by reconstructive surgeons. A case is presented in which comprised forehead skin is utilized following expansion by a tissue expander.

Basal Cell Carcinoma↗

Influence of repeated washings with soap and synthetic detergents on pH and resident flora of the skin of forehead and forearm. Results of a cross-over trial in health probationers.

Ten healthy individuals washed their forehead and forearm twice a day over consecutive periods of four weeks with soap and synthetic detergents or vice versa (cross-over design). In general the pH values were higher during the period when soap was applied (the mean pH differed by 0.3 units, p less than 0.01). As a rule the counts of coagulase-negative staphylococci were not much altered. The number of propionibacteria, however, was markedly higher when soap was used (p = 0.02 and 0.01 resp.). At the forehead there was a clear correlation between bacterial counts and skin pH both with propionibacteria (0.56, p less than 0.001) and staphylococci (0.51, p less than 0.001). At the forearm only the former proved true (0.24, p less than 0.05). Thus the skin pH seems to be open to long-standing changes according to the preferred washing habits which may also be of major influence on the composition of the cutaneous bacterial flora.

Adult↗

[Acute epidural hematoma of the posterior fossa caused by forehead impact].

A rare case of acute epidural hematoma of the posterior fossa caused by forehead impact is reported. This 36-year-old man fell from a truck and hit his face. He was conscious and was brought to our center 30 minutes after the injury. On admission, a contused wound of the right forehead was noticed. He was restless and had severe pain in the neck and upper extremities. Skull X-ray showed a linear fracture of the frontal bone and computed tomography (CT) scan was normal. He continued to be restless and sudden respiratory arrest and pupillary dilation occurred 10 hours after the admission. A CT scan revealed a lenticular high density area in the left posterior fossa which extended to the supratentorial region. The 4th ventricle was compressed and displaced to the right and also the quadrigeminal and ambient cisterns were not visualized at all. Immediate surgery disclosed a 30 g epidural hematoma of the left posterior fossa and the supratentorium and the clot was completely evacuated. The source of bleeding could not be identified. Opening of the dura revealed contusion in the occipital lobe. He died on the 17th postoperative day. The possible mechanism in the production of the posterior fossa hematoma in this case is discussed.

Adult↗

The precise midline forehead flap in reconstruction of the nose.

The midline forehead flap has been a preferred choice for nasal repair in our practice for over 20 years, with no significant complication ever having developed (Figs. 9 to 11). The abundance and length of tissue it provides is remarkable, given the inconspicuous defect remaining in the forehead area. Its use is economical of tissue, time, and expense to the patient. Most importantly, the midline flap provides superior aesthetic and reconstructive repair in a relatively short period of time without resorting to more complicated, and therefore more risky, flap designs.

Adult↗

Radical forehead remodeling for craniostenosis.

A normal forehead has two parts, shaped differently: (1) the lower part (corresponding to the supraorbital rim and glabellar area) set at a steep angle to the nose; (2) the upper part, sloping gently backward. To reproduce this normal anatomy in cases of cranostenosis affecting the frontal area, we found it essential to mobilize and reshape a supraorbital bar of bone and to transfer a suitable piece of the cranial vault in one piece to make a new upper forehead. By this method we have treated 18 patients with oxycephaly since 1973, with good results. We have also operated on babies with craniostenosis to try to solve simultaneously the functional and the cosmetic problems. In faciocraniostenosis, there are dominant malformations at the base of the skull, but an isolated frontal advancement of two cm has produced gratifying early results.

Acrocephalosyndactylia↗

Augmentation rhinoplasty by subcutaneous midline forehead flap simultaneous with implant removal.

Implant exposure after augmentation rhinoplasty with alloplastic materials is usually associated with some degree of infection, and it is commonplace to remove the implant and wait for several months before re-augmentation. However, some patients cannot accept the resultant deformity after implant removal. We introduced the midline forehead flap for augmentation simultaneous to the removal and obtained favorable results, even when considering the donor site scar on the forehead. We report the surgical technique and two patients treated with this procedure. The advantages and disadvantages of this procedure are also discussed.

Aged↗

[Subperiosteal endoscopic forehead facelifting].

The use of endoscopic techniques in facelifts has had a significant effect in recent two years. To reduce operation complications and trauma, the authors performed 31 endoscopic forehead rejuvenation procedures with corrugator-procerus resection and eyebrow elevation at a desired level in Chirurgie Esthetique Europeenne in Strasbourg, France from January to November 1995. Three to six months' follow-up revealed satisfactory operation results. Subperiosteal endoscopic forehead facelifting using resection and elevation of the muscle of the eyebrow is one of the best operations for facelifting.

Adult↗

Rhythmical changes of the cutaneous blood flow in the forehead region under the condition of hypnoid relaxation.

BACKGROUND: A characteristic and stable blood flow rhythm can be detected for the skin of the forehead and ear lobes with frequencies of approx. 0.15 Hz (9/min), which were primarily not related to the respiratory rhythm. PATIENTS AND METHODS: The perfusion of the skin in the forehead region was investigated non-invasively with laser Doppler fluxmetry in ten healthy subjects before and during Hypnoid Relaxation (HyR). The HyR-state was induced by suggesting formulas regarding to the well known Autgeneous Training. RESULTS: In all test subjects rhythmical fluctuations of bloodflow with a frequency of approx. 0.15 Hz could be observed both, before and during HyR. We found that the amplitude of these fluctuations clearly (> 20% from individual baseline) increased in five of ten test subjects under the condition of HyR. Furthermore, in three of ten cases the spontaneous respiration under HyR adjusted to the frequency of the described bloodflow rhythm, which exists both, before and during HyR. CONCLUSIONS: These phenomena suggest an individually stabil and autonomous rhythm which is effected by alterations in the level of conciousness and which may be caused by the close linkage between the nerval structures for control of respiratory and circulatory systems. May be, this autonomic rhythm could be used as a trigger for breathing therapies or as a parameter for the impact of relaxation techniques on hemodynamics, e.g. in complementary therapy of vascular diseases like systemic sclerosis.

Adolescent↗

Endoscopic excision of a forehead mass.

Endoscopic applications in facial plastic surgery have recently increased with the advent of new instrumentation and as surgeons have become more accustomed to their use. We report the first case (to our knowledge) of an endoscopic removal of a forehead soft tissue mass. The endoscopic approach allows the surgeon access to the forehead area with placement of a skin incision in the hair-bearing scalp. This type of approach is especially of value in patients with a predisposition to unusual scar formation or in those with smooth skin in which a direct incision would yield a noticeable scar.

Adult↗

Palatal reconstruction utilizing retrieved forehead flap.

Ablation of tumors involving the tonsil and retromolar trigone complex often require partial resection of the soft palate. The pharyngeal wall defect is well reconstructed with the forehead flap. We have used the distal portion of the severed inserted forehead flap to reconstruct the soft palate defect successfully in 35 cases. The nasopharyngeal surface is lined with a book-flap from the remaining palate. This provides full palatal reconstruction with nasopharyngeal mucosa lining: thus preventing flap contracture and the unwanted sequelae of nasopharyngeal air and fluid reflux.

Humans↗