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At least 415 records · Page 23Linked to original sources

The forehead flap for nasal reconstruction: how we do it.

The forehead flap is a useful technique to reconstruct deep and large nasal defects. It can safely be performed under local anesthesia in an outpatient setting. Advantages of this flap include the fact that it provides an excellent color and texture match to the missing nasal skin. Disadvantages include the fact that it is at least a two-stage procedure and that often patients require "touch up" surgeries to provide the best possible cosmetic outcome.

Forehead↗

[Case of clear cell hidradenoma with mucinous metaplasia in the forehead--immunohistochemical analysis of the mucin].

Mucinous metaplasia rarely develops in the non-neoplastic skin or its appendages, and almost exclusively confined to the genitalia, palms and soles. Similarly, mucinous metaplasia is quite uncommon in the cutaneous neoplasms and only few cases of clear cell hidradenomas and squamous cell carcinomas with mucinous metaplasia have been reported in the literature. Here we report a new case of clear cell hidradenoma with mucinous metaplasia in the forehead. Our immunohistochemical analysis revealed MUC5AC in the mucinous metaplastic cells of this tumor as in the extramammary Paget's disease, and expression of this gastric foveolar epithelial mucin core protein in these two neoplastic conditions seem to related to their common apocrine origin.

Adenoma, Sweat Gland↗

[Nasal reconstruction: a comparative study between the Converse scalping flap and expanded median forehead flap].

The authors, reviewing a series of 16 at least subtotal nasal reconstructions over the past 4 years, discuss the respective advantages of the two methods, which both give good results for this purpose. Nowadays, the balance favors expansion despite its duration and complexity for the very significant aesthetic benefits in terms of forehead scarring. The guidelines concerning this technique employed in 6 cases are described and reviewed in detail. Nevertheless, the Converse scalping flap remains a simple and quick solution especially after cancer resection in the elderly; some details seem important to diminish its sequelae.

Basal Cell Carcinoma↗

Removal of wrinkles and redundant skin in the region of the forehead.

On the basis of an analysis of recent results in 160 patients operated on for the purpose of removing wrinkles and redundant skin from the region of the forehead, and of an analysis of the author's own material in 80 patients operated on by means of a method elaborated by the author conclusions were drawn concerning the incision used in this operation. The incision is carried out depending on the height of the frontal region. Indications for the intervention on the frontal muscle were determined. Directions concerning the extent of the operation were revised. It has been found that a more extensive, wide mobilization of tissues including the bridge of the nose, the regions of the eyebrows and the temples along with the frontal region, yields more pronounced and lasting results.

Forehead↗

Excision of squamous cell carcinoma of forehead.

By the time 77-year-old Mr Mack was admitted to the plastic surgery ward, the 10-week-old recurrent swelling on the right side of his forehead was about 6 cm in diameter and cystic in appearance. Histologically confirmed as a squamous cell carcinoma, the growth did not appear to be fixed to the underlying bone, but nor was it fully mobile which suggested that the malignancy may have spread to the deep fascia. Red and shiny on top, two or three discharging puncti were evident.

Aged↗

Aesthetic surgery of the facial skeleton: the forehead.

The skeleton of the upper third of the face is seldom considered as an area for aesthetic improvement. The author reports his experience with alteration of the skeleton of the forehead by recontouring or augmenting for aesthetic purposes. Also the experience with subperiosteal face lifts performed through coronal incisions is reported.

Bone Transplantation↗

[Primary malignant lymphoma of the skull presenting as a growing mass in the forehead; a case report].

A rare case of primary malignant lymphoma of the skull was reported. A 74-year-old woman was admitted to our hospital complaining of a growing mass in her forehead where she had had minor trauma one month previously. On admission, neurological findings were normal and an elastic hard tumor (6 x 6 x 2 cm) was found in the right frontal region. Computed tomography (CT) showed a large soft tissue mass in the subcutaneous tissue and a small mass in the ethmoid sinus, with erosion at the inner and outer tables of the frontal bone. Magnetic resonance imaging revealed a low intensity area in the bone marrow beneath the tumor. Right carotid angiography showed that the tumor was fed by branches of the ophthalmic artery in the arterial phase and stained in the capillary phase. Partial excision of the tumor was performed, but the affected bone was left because of her advanced age, even though thinning and spicular formation of the frontal bone were observed beneath the tumor in places. Pathological examination showed the tumor to be a malignant lymphoma of non-Hodgkin and diffuse mixed type. Postoperatively, systemic examinations were performed by 99mTechnetium-MDP bone scanning, 67Gallium citrate scanning, bone marrow puncture, and CT scanning, without any evidence of systemic lymphoma. The patient received postoperative chemotherapy with Cyclophosphamide, Doxorubicin HCl, Vindesine Sulfate, Prednisolone, and complete remission has been achieved for the 8 months since the operation.

Aged↗

[Expanded forehead flap for reconstruction of the nose].

Eight cases of reconstruction of nose by using skin expander are reported in detail in this article. In which, 6 cases were total nose reconstruction, 2 were upper partial reconstruction. The results were good in all cases. It is considered that the forehead flap is the place of choice in nasal reconstruction. It gives good shape contour and best color match. After application of tissue expander it could provide more skin for reconstruction, and prove more advantages in repairing the donor site. It has been observed that the reconstructed nose contour was satisfactory, with no obvious constriction after more than a year follow up. The methods and advantages of operation and some typical cases are presented.

Adult↗

Sweating patterns in humans: II. Heat-induced forehead sweating and cutaneous temperature in healthy individuals.

A comparison of heat-induced forehead sweating and cutaneous temperature patterns has been carried out in 17 healthy individuals (a total of 54 measurements). Only minor asymmetries in facial sweating and temperature were observed. No significant correlation between sweating and cutaneous temperature was found. The reproducibility of the method was excellent.

Adult↗

The forehead lift: refinements in surgical technique.

The forehead lift has recently received increased interest as a most rewarding procedure in aging face surgery. Following its introduction, many surgical techniques to achieve the desired result have been developed. This paper presents the surgical anatomy of the procedure, and its indications and contraindications. The surgical technique as developed over more than 100 cases is described, including peri-operative care and operative surgical precautions. The advantages and disadvantages of this procedure, including complications, are outlined.

Dermatologic Surgical Procedures↗

[Osteoma cutis of the forehead].

A 61-year-old woman with a focus of lamellar bone with bone-marrow in the corium of the forehead skin, the socalled Osteoma Cutis is reported. A review of the literature revealed 416 reports of bone structure in the integument. Osteosis Cutis Faciei is a rare and a harmless illness occurring in women aged 40-80. While the clinical diagnosis causes great problems, the histological appearances of a cutaneous bone-structure can be clearly recognised. The therapy of the cutaneous bone structure is confined to biopsy excision with a good margin of healthy tissue.

Facial Neoplasms↗

[Comparison of the sebaceous secretions of the skin of the forehead under the treatment with three oral contraceptives. Diane, Neogynon and Lyndiol (author's transl)].

Ten women who took oral contraceptives for six months or longer were investigated. The women took in a randomized sequence cyproteronazetate 2 mg. ethinyloestradiol 50 mcg. (Diane), D-Norgestrel 0.25 mg., ethinyloestradiol 50 mcg. (Neogynon), and Lynestrenol 2.5 mg. with ethinyloestradiol 50 mcg. (Lyndiol). During each treatment cycle at four defined pounts the sebaceous secretions from the skin of the forehead was measured. Since each patient received one cycle of each of the oral contraceptives each patient served as her own control. With Diane and Neogynon the sebaceous secretions were the same. With ingestion of Lyndiol there was a significantly higher sebaceous secretion than with the other two oral contraceptives (p less than 0.05, t-test for paired observations).

Adult↗

[Use, in craniology, of vectors for the demonstration of the degree of forehead and face inclination in the chimpanzee and present-day and fossilized man].

It is demonstrated, by mathematical method using vectors, that: (1) the inclination of the forehead, the sign of which is negative (simian type) in all Apes studied here, changes its sign and becomes positive (human type) in Plesianthropus, La Ferrassie I and contemporary Man. It remains negative (simian type) in Sinanthrope XI and La-Chapelle-aux-Saints; (2) the inclination of the face has a positive sign (simian type) in all Apes and Plesianthropus, but becomes negative (human type) in the genus Homo; (3) the fronto-gnathic angle which always remains less than 90 degrees in all Simians, becomes greater than 90 degrees in the genus Homo, and Plesianthropus.

Animals↗

The anchor subperiosteal forehead lift.

The coronal incision used for brow lift procedure has a high rate of localized alopecia, widening, and depression of the scar at the suture line. Other sequelae of the standard coronal brow lift incision procedure are "stretch-back" with a recurrent brow ptosis, poor brow elevation, and numbness beyond the incision line. Factors causing alopecia are tension, use of a monopolar cautery, use of key sutures with undue tension, one-layer closure, and sutures left too long. Recurrent brow ptosis may be due to anterior displacement of the posterior scalp flap, stretching of the anterior frontal skin flap, or insufficient power of the weakened frontalis muscle. Poor brow elevation may be due to unsatisfactory dissection on the glabella and orbital rims. Numbness and itching beyond the incision line are due to a low coronal incision. To avoid these problems, the following principles were followed: (1) If not contraindicated, the incision is made high on the vertex of the head, posterior to a biauricular line. (2) The pericranium is included in the frontal flap starting at the incision lines. (3) The subperiosteal dissection is continued down to the orbital rims and nasal bones. (4) The release of the periosteum at the arcus marginalis or just above allows repositioning of the brow structures. (5) The inelastic pericranium maintains the position of the elevated structures and avoids stretching of the frontal skin. (6) The integrity of the frontalis muscle is maintained completely. (7) Two large triangles of scalp resected in the posterior flaps allow fixing the position of the posterior scalp and match better the length of the anterior flap. (8) The galea periosteal rim flap allows anchoring of the frontal flap to the undersurface of the posterior scalp flap. This stabilizes the closure with minimal tension on the hair-bearing portion of the scalp. The wide surface of contact avoids depression and widening at the suture line. (9) Closure with skin staples avoids constriction of the hair follicles. (10) Hemostasis is done with a bipolar cautery. (11) No through-and-through key sutures are used. Some of these principles were introduced to the endoscopic subperiosteal forehead lift. The modifications mentioned above have been used in 92 open brow/face lift procedures with excellent aesthetic and functional results and minimal complications.

Adult↗

[Reconstruction of the nose by forehead skin flaps (author's transl)].

On introduction the advantages and disadvantages of forehead skin in reconstructive rhinoplasty are presented. The median frontal flap described by Kazanjian, a horizontal or slightly oblique frontal flap, the frontotemporal flap described by Schmid and the scalp flap described by Converse are discussed. After detailed description together with illustration of various techniques it is shown that each method can be used for specific indications. The choice of method by the less experienced is therefore facilitated. A. The median frontal flap is especially indicated for the grosser perforating defects of the external nose. B. The fronto-temporal flap is especially indicated for subtotal or total defects of the nasal alae, tip and columella of the younger patients who expects a good cosmetic result. C. The horizontal or slightly oblique frontal flap is especially indicated for subtotal or total defects of the nasal alae or tip of the older patient, who cannot undergo repeated surgery or prolonged hospitalisation. D. The frontal scalp flap is especially indicated for the grosser subtotal defects of the external nose.

Age Factors↗

[Repair of lower nasal defect with compound skin flap from forehead with trochlear artery and subcutaneous tissue pedicle].

This article reports the repair of lower nasal defect with forehead compound skin flap consisting of the trochlear artery and subcutaneous tissue pedicle in one stage in 11 patients. The repaired area ranged from 2 x 2 to 4 x 3 cm and the frontal bone area 1.5 x 1 cm. This operation had achieved good results, and the frontal bones were not absorbed, except 1 case, after 1 year follow-up. The methods of this flap design and operation were described. The merits, demerits and points for attention were discussed.

Adolescent↗