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At least 613 records · Page 34Linked to original sources
PubMed1989

The forehead lift: techniques to avoid complications and produce optimal results.

This discussion of forehead lifting, based on modifications of Vinas, Caviglia, and Cortinas, shares the authors' methods of patient evaluation, diagnostic details, architectural planning, and surgical concepts for forehead rhytidectomy along with correction of malpositioned and ptosis of the eyebrows and also glabellar frown problems. In addition, the nasal deformities associated with the sagging of the skin and subcutaneous tissue onto the upper fourth of the nose may make the nose look too short for a pleasing balance of the face and the upper fourth may appear disagreeably wide. A contribution to this excessive width is made by a sometimes thick and wide procerus muscle along with bilateral thick depressor supercilii muscles. When this nasal deformity is corrected, glabellar frown problems are also corrected. Attention to the details of the above-mentioned factors results in very long-lasting, sometimes permanent, and almost complication-free results that please the surgeon and the patient. Complications such as adherence of the dermis to the underlying pericranium, lack of motion in a portion of or the entire forehead, hyperactivity around areas of immobility, muscle irregularities, and also surgically produced depressions which require grafting, skin sloughing, permanent nerve injury, persistent sensory nerve loss, and short-term improvement have been avoided by paying attention to diagnosis, surgical planning, and technique, and postoperative care. Most patients can return to work in four or five days with minimal discoloration and swelling if they have not had aspirin or vitamin E one month before surgery, and there is hemostasis and the use of drains when indicated. Minimizing detection of the surgical incisions is accomplished by detailed preoperative planning of their location, architectural design development and drawing at the time of surgery, special surgical techniques, and excision of the skin or scalp. For patients with male pattern baldness use of specially designed V-Y advancement flaps with the browlift procedure improve the appearance of the hair's thickness and distribution.

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↗
PubMed1984

Suprazygomatic SMAS in rhytidectomy.

A personal method for the treatment of the suprazygomatic SMAS and its results are presented. By acting on the suprazygomatic fibromuscular layer in the rhytidectomy, the surgeon can avoid tension on the cutaneous layer, and possible consequences thereof, as well as diminish the probabilities of damaging the facial nerve. At the same time, desired effects as a result of pulling on "crow's feet," wrinkles, lateral eyebrows, and wrinkles on the lateral forehead are enhanced.

Face↗
PubMed1995

Optimal sites for forehead oscillometric blood pressure monitoring.

OBJECTIVE: Blood pressure is usually measured noninvasively with a cuff on the arm of the leg. Circumstances exist, however, when an alternative site for blood pressure measurement is desirable. This study is designed to identify a location on the forehead where blood pressure can be reliably measured noninvasively. METHODS: We mapped the superficial temporal artery and/or the supraorbital artery in 65 volunteers and found a rectangular area where an adhesive pressure pad could be placed over each artery. Oscillometric signals were recorded from four different locations over the forehead in 19 of the 65 volunteers to compare the amplitude of the signal and mean blood pressure between locations. RESULTS: The course of the supraorbital artery is quite consistent. It passed through a 2.5- x 1-cm rectangular area on the forehead in all volunteers in which it was mapped. The medial border of the rectangle is 0.5-cm medial and 1-cm above the medial corner of the left eyebrow. The course of the superficial temporal artery differed remarkably from person to person. We could not find an area of reasonable size to cover the artery in all wounds. Mean blood pressures were the same in all forehead locations. The signal was the weakest on the center of the forehead and strongest directly over the superficial temporal artery. CONCLUSIONS: Our results show that the supraorbital artery, an end-artery of the internal carotid artery, which emerges through the supraorbital foramen and cross the forehead near the center, is the preferred site to monitor blood pressure noninvasively on the forehead with an adhesive pressure bladder.

Adult↗
PubMed1988

Transethmoidal decompression of the optic nerve in the case of craniocerebral trauma.

Over a period of ten years, 39 patients who had suffered optic nerve compression after a craniocerebral trauma underwent transethmoidal decompression surgery. The operation was performed bilaterally on 5 patients. Fifty percent of patients involved suffered a blunt head or brain injury, the others brain compression or contusion. On the side of optic nerve compression, we found specific signs and symptoms of the compression such as negative or sluggish direct light reaction of the pupil, wounds on the lateral side of the eyebrow, bleeding from the nose, eyelid hematoma, skull fractures and intracranial hematomas. Since radiological and intraoperative findings were the same in only 67% of cases ophthalmological findings such as lack of direct pupil reaction occurring together with preserved consensual light reaction and progressive loss of vision after a traumatic incident are used as guideline for performing transethmoidal decompression of the optic nerve. Surgery produced restitution of visual function in about 10% more cases than conservative therapy reported in the literature.

Adolescent↗
PubMed1989

Measurement of pain threshold in patients with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and healthy controls.

Pain threshold was measured using a pressure algometer in 126 subjects, of whom 54 were females and 72 males. These subjects included 18 males and 18 females with rheumatoid arthritis, 18 males and 18 females with osteoarthritis, 18 males with ankylosing spondylitis, and 18 male and 18 female healthy control volunteers. Six points were studied on each side of the body: 2 cm above the eyebrow on the forehead, lateral aspect of the arm at the insertion of the deltoid muscle, midpoint of the ulna, hypothenar eminence in the palm, midpoint of the quadriceps muscle, and midpoint of the antero-medial aspect of the tibia. None of these points corresponded to the "trigger" points in fibromyalgia. The pain threshold was statistically significantly higher in patients with ankylosing spondylitis than in patients with osteoarthritis, and these in turn were statistically higher than in the normal subjects. Patients with rheumatoid arthritis had significantly lower pain thresholds than the normal subjects. No laterality in pain threshold was identified, but females had in general a lower pain threshold.

Adult↗
PubMed1987

Tricho-rhino-phalangeal syndrome type I in a Belgian family.

We report three cases of tricho-rhino-phalangeal syndrome (TRPS) type I in a Belgian family. They presented typical characteristics such as a pear-shaped nose, and short, deformed fingers with cone-shaped epiphyses of some middle phalanges of the hands. Hair growth was practically normal in our patients, except for some narrowing of the lateral part of the eyebrows. Perthes-like hip dysplasia was documented in two of our cases. The proband presented at the age of 31 with Kienböch's disease of the right wrist. Blood and urine analysis showed no clear anomalies. In this patient, echography revealed a renal cyst containing a stone. The relationship of these findings to TRPS is discussed.

Adult↗
PubMed1993

The subperiosteal lift.

The subperiosteal lift developed by Tessier is a technique for rejuvenating the face and emphasizing beauty. It is performed using two approaches: intraoral and bicoronal or precapillary. It entails a total subperiosteal undermining of the face beginning 2 cm over the orbits and continuing on the orbital rims, the zygomatic arches, and the malar bones. This allows total lifting of the soft tissues of the face (DMAS, deep musculo aponeurotic system). The lateral and vertical traction allows elevation of the superior two thirds of the face, eyebrows, and cheeks. Lifting pulls up from the forehead to the mandibular line. The fixation of the superficial layer of the temporal aponeurosis in traction to the upper part also has an effect on tissue elevation. The best candidates for this procedure are women in their late 30s or early 40s but can be used on those from 30 to 50 and more. It is highly specialized operation which requires substantial surgical experience both in selecting the patient and in execution.

Adult↗
PubMed1997

Primary Lymphoma of Pituitary Gland: A Neoplasm of Acquired Malt?

A 66-yr-old man presented with presyncopal episodes, dizziness, anorexia, nausea, and weight loss and was noted to have low blood pressure with a postural drop and sparse eyebrows. Laboratory investigations revealed evidence of hypopituitarism. Magnetic resonance imaging (MRI) revealed a non-enhancing mass arising from the adenohypophysis. The neurohypophysis was displaced laterally but appeared otherwise normal. The lesion was thought to be a nonfunctioning pituitary adenoma and a trans-sphenoidal hypophysectomy was performed. Histologically, this lesion was a diffuse large B-cell lymphoma that had features of a high grade mucosa associated lymphoid tissue (MALT)-type lymphoma arising in association with low-grade B-cell lymphoma of MALT type. There was no clinical or radiological evidence of lymphoma in other sites and there was no evidence of an immunocompromised state. Only one previous case of primary malignant lymphoma of the pituitary has been reported and this patient presented with compression of the optic chiasm. We describe the clinical and pathological features of a patient who presented with hypopituitarism and was found to have a pituitary lymphoma. This is the first reported case of a pituitary lymphoma presenting with pituitary failure and the first case characterized by lymphocyte-marker studies that confirmed it to be a B-cell lymphoma.

Journal Article↗
PubMed2006

[Piercing complications in the facial area].

From the ENT specialist's view, the wearing of piercing jewelry on the outer ear, the tongue, the lips, the nose or the eyebrows is the cause of many and sometimes serious local and also systemic complications. Especially on the outer ear allergic reactions, keloid formation, traumatic tears or embedding of the piece of jewelry can occur in addition to simple, superficial infections or perichondritis. Through specific advice, early detection and treatment of complications, serious health damage to the wearer of piercing jewelry can be avoided.

Body Piercing↗
PubMed1995

[Universal dermatophytosis (tinea incognito) caused by Trichophyton rubrum].

An 84-year-old male presented with a dermatophyte infection that had spread over nearly the entire body surface. The first signs had developed 48 years before. After treatment with galenic and corticosteroid preparations for diagnoses of "eczema" and "psoriasis", the lesions gradually extended over the body and to the nails. The cutaneous symptoms had worsened in recent year after the patient had started systemic cortisone treatment for bronchial asthma. He also developed diabetes mellitus, papulonodular lesions on the face and limbs, thinning of his hair and eyebrows and hyperkeratosis of the soles and palms.

Aged↗
PubMed1997

[D-penicillamine in treatment of scleroderma "en coup de sabre"].

A ten year old boy with linear erythema above the right eyebrow and a groove in the underlying skull bone is described. Histological examination of a biopsy revealed a spotty, periadnexal, perivascular, lymphocytic infiltrate. The papillary dermis was almost absent and the collagen fibres were slightly thickened. Based on the clinical appearance and the histology a diagnosis of linear scleroderma (en coup de sabre) was made. As the signs and symptoms were progressive, treatment with D-penicillamine was started. Subsequently the erythema disappeared. The shallow groove in the skull bone remained palpable. After thirteen months, treatment was stopped. The patient is currently free of signs and symptoms after a follow-up period of three and a half years. We feel that the strong clinical improvement is due to treatment with D-penicillamine rather than to the natural course of the disease.

Adolescent↗
PubMed2002

[Kossard frontal fibrosing alopecia in a man].

In 1994 Steven Kossard described a new and peculiar type of hair loss that he named postmenopausal frontal fibrosing alopecia. In 6 elderly women he observed a symmetric regression of the frontal hair line. Often the eyebrows were also affected. Histology showed lichen planopilaris. There were no clinical signs of lichen planus on the rest of the body. Since the original description by Kossard, several cases of frontal fibrosing alopecia have been described--almost all of them in elderly women. We report a man with frontal fibrosing alopecia of the Kossard type.

Aged↗
PubMed2004

[Niikawa-Kuroki (Kabuki) syndrome and hearing impairment].

The Niikawa-Kuroki syndrome is a rare syndrome characterized by multiple congenital anomalies, mental retardation, postnatal growth deficiency, dermatoglyphic abnormalities and a characteristic facial appearance. More than 100 cases of the syndrome have been described in Europe. Here we report a 10 year old girl with this syndrome. Recurrent infections of the middle ear as well as delayed motor and speech development were present. The physiognomy since early infancy showed a flat profil, long palpebral fissures, long eyelashes, high arched eyebrows, missing lateral incisors and persistent fetal pads on the fingers. The patient was referred to us because of hearing impairment. Her parents also described a delayed motor development, mental retardation and a language impairment. Audiometry demonstrated a pantonal hearing loss. Since children affected by this syndrome may also have a severe hearing impairment early testing is mandatory.

Abnormalities, Multiple↗
PubMed1998

Microstimulation of movements from cerebellar-receiving, but not pallidal-receiving areas of the macaque thalamus under ketamine anaesthesia.

The motor thalamic areas receiving input from the globus pallidus (VA) and the cerebellar nuclei (VL) appear to have different roles in the generation and guidance of movements. In order to further test these differences, we used electrical stimulation to map the ventro-anterior and ventro-lateral nuclei of the thalamus in three ketamine anaesthetised monkeys. Movements were readily evoked from VL at currents of down to 10 microA. The movements were typically multijoint, and stimulation could evoke arm and trunk or arm and facial movement at the same current threshold. Evoked arm movements often involved multiple joints, with or without finger movements. Facial movements included the lips, tongue, jaw, eyebrows and, occasionally, the eyes. The thalamic map was topographic, but complex with at least two separate regions related to arm movement. Very few sites within the VA could stimulate movement, even at high currents. We therefore suggest that the cerebellar projections to motor regions of the cortex, which pass through the VL thalamic nuclei, have a different relationship and are closer to movement execution than the projections from basal ganglia via the ventro-anterior nucleus.

Anesthetics, Dissociative↗
PubMedDate not supplied

Severe intrauterine growth retardation, aged facial appearance, and congenital heart disease in a newborn with Johanson-Blizzard syndrome.

We report a female newborn with Johanson-Blizzard syndrome associated with extreme intrauterine growth retardation, aged facial appearance, and atrial septal defect. Other features are microcephaly, prominent veins over the scalp, alopecia over the vertex, wide-open fontanelle, high forehead, antimongoloid slant, edematous eyelids, the absence of eyebrows and eyelashes, beaked nose with alae nasi, low-set ears, thin lips, and micrognathia. Investigations revealed deafness and congenital hypothyroidism. We believe that this association of severe intrauterine growth retardation and congenital heart disease represents the components of this syndrome.

Congenital Hypothyroidism↗
PubMedDate not supplied

Long-term prospective follow-up of botulinum toxin treatment for facial rhytides.

Some wrinkles and unsightly facial expressions are due to hyperactivity of the underlying facial musculature. Clostridium botulinum type A exotoxin reversibly paralyzes selected muscles and is a safe, helpful adjunct to many other treatments for facial rejuvenation. Fifty-two patients were treated and all data recorded in a prospective fashion. Only areas requested by the patient were treated. The dosage and dilution given in each area were carefully noted and all patients had pretreatment and posttreatment photographs. The effect of botulinum toxin injections on the horizontal brow rhytides was recorded by measuring the distance from the frontal hairline to the superior edge of the eyebrow in the mid-pupillary line. Patients were followed for one to three years (mean 16.3 months). One patient was not responsive to botulinum toxin in spite of repeated injections. Three further patients required touch-up injections two weeks after the initial treatment due to a weak initial response. Repeat injections were required every three to six months (mean 4.05) to maintain the desired improvement. Asymmetry of the brow was seen in two patients and corrected with further administration of botulinum toxin. Twenty-five patients had their forehead rhytides injected and the appropriate measurements taken. Brow ptosis occurred in 22 of the 25 patients and varied 1-6 mm with a mean value of 2.3 mm. This difference was statistically significant (paired t-test p <0.001). Two patients reported dryness and flakiness of the frontal area after injections. No cases of eyelid ptosis or hypersensitivity were seen. Botulinum toxin injections are safe and all undesired effects are reversible. Great care has to be taken not to aggravate the degree of brow ptosis. Injection of the forehead depressors minimizes the risk of brow ptosis. Careful planning of injection sites and doses avoids a mask-like upper face. The use of botulinum toxin provides a useful adjunct to laser and surgical procedures for facial rejuvenation.

Adult↗
PubMed2003

Ptosis: causes, presentation, and management.

Drooping of the upper eyelid (upper eyelid ptosis) may be minimal (1-2 mm), moderate (3-4 mm), or severe (>4 mm), covering the pupil entirely. Ptosis can affect one or both eyes. Ptosis can be present at birth (congenital) or develop later in life (acquired). Ptosis may be due to a myogenic, neurogenic, aponeurotic, mechanical or traumatic cause. Usually, ptosis occurs isolated, but may be associated with various other conditions, like immunological, degenerative, or hereditary disorders, tumors, or infections. Besides drooping, patients with ptosis complain about tired appearance, blurred vision, and increased tearing. Patients with significant ptosis may need to tilt their head back into a chin-up position, lift their eyelid with a finger, or raise their eyebrows. Continuous activation of the forehead and scalp muscles may additionally cause tension headache and eyestrain. If congenital ptosis is not corrected, amblyopia, leading to permanently poor vision, may develop. Patients with ptosis should be investigated clinically by an ophthalmologist and neurologist, for blood tests, X-rays, and CT/MRI scans of the brain, orbita, and thorax. Treatment of ptosis depends on age, etiology, whether one or both eyelids are involved, the severity of ptosis, the levator function, and presence of additional ophthalmologic or neurologic abnormalities. Generally, treatment of ptosis comprises a watch-and-wait policy, prosthesis, medication, or surgery. For minimal ptosis, Müller's muscle conjunctival resection or the Fasanella Servat procedure are proposed. For moderate ptosis with a levator function of 5-10 mm, shortening of the levator palpebrae or levator muscle advancement are proposed. For severe ptosis with a levator function <5 mm, a brow/frontalis suspension is indicated. Risks of ptosis surgery infrequently include infection, bleeding, over- or undercorrection, and reduced vision. Immediately after surgery, there may be temporary difficulties in completely closing the eye. Although improvement of the lid height is usually achieved, the eyelids may not appear perfectly symmetrical. In rare cases, full eyelid movement does not return. In some cases, more than one operation is required.

Blepharoplasty↗