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At least 829 records · Page 46Linked to original sources
PubMed1983

[Traumatic lesions of the nose-ethmoid-forehead region].

The treatment of this kind of lesion further remains difficult and requires work of several specialists: Neurosurgeon, Ophthalmologist, and ENT-surgeon. As for our opinion the reconstruction of anatomy and normal function of the frontal sinus is unequivocal, and performing it in the majority of cases renders in outstanding results.

Ethmoid Bone↗
PubMed1998

Reassessment of the coronal incision and subgaleal dissection for foreheadplasty.

Thirty years ago, the aging upper face was generally ignored by surgeons performing facial rejuvenation surgery. Ultimately, the coronal incision forehead lift technique became an accepted procedure, with most surgeons raising the forehead flap at the subgaleal plane. These surgeons found the subgaleal plane to be the "natural" or most accessible dissection plane to use, and it continues to be the most commonly used dissection plane for foreheadplasty today. However, some surgeons have begun to advocate using the subperiosteal plane, and controversy surrounds the question of which dissection plane is more surgically sound for raising a forehead flap. On the basis of 25 fresh cadaver dissections and more than 20 years of clinical experience with foreheadplasty, the author concludes that dissection done at the subperiosteal rather than the subgaleal plane provides greater benefit to the patient. Although both subgaleal and subperiosteal planes can provide relative ease of dissection, elevation of the forehead flap at the subperiosteal plane can maximally preserve blood supply for the forehead flap and predictably preserve long-term frontoparietal scalp sensation. The deep division of the supraorbital nerve, which provides sensation to the frontoparietal scalp, is placed at risk for transection with subgaleal elevation of the forehead flap. The skin incision approach chosen for the forehead flap can also affect postoperative frontoparietal scalp sensation. The deep division of the supraorbital nerve will always be transected by a coronal incision approach for forehead flap elevation, with dissection done at either the subgaleal or the subperiosteal level. Only limited scalp incisions placed to avoid the course of the deep division of the supraorbital nerve can avoid transecting this nerve, and only subperiosteal dissection of the forehead flap can predictably preserve this nerve while elevating the forehead flap.

Endoscopy↗
PubMed2004

[Evaluation of methods for total nasal reconstruction].

OBJECTIVE: To evaluate the advantages, disadvantages and their indications of total nasal reconstruction with different techniques. METHODS: A series of total nasal reconstruction were treated with four methods from 1975 to 2003. These methods were tubed flap of arm,midline forehead flap with skin graft, midline forehead flap with bilateral frontotemporal flaps for repairing the donor site, and expanded forehead flap. RESULTS: All of the patients were treated successfully. The shape and function of the reconstructed noses were satisfactory. However, the traditional forehead flap with skin graft may leave a unsightly big and black scar on the forehead. The technique of the tubed flap of arm could provide enough tissue without remaining forehead scar and be easily shaped, but it required long period, multiple procedures and body fixation for three weeks. CONCLUSIONS: Midline forehead flap with bilateral frontotemporal flaps for repairing the donor site may be good for small nose reconstruction while expanded forehead flap could reconstruct a big nose. Tubed flap of arm may be used to the patients who do not wish to leave any scar on the forehead. Forehead flap with skin graft to repair the donor sit- should generally be avoided for nose reconstruction.

Adolescent↗
PubMed2000

Reconstruction of nasal defects larger than 1.5 centimeters in diameter.

OBJECTIVE: To review the repair of larger nasal defects (> 1.5 cm in diameter) and the vascular supply to the forehead flap. STUDY DESIGN: Retrospective chart review (1994-1999) and cadaver analysis of forehead flap vasculature. METHODS: Chart review was made of patients with cutaneous nasal defects greater than 1.5 cm in diameter. An intravascular silicone cast was used to detail the arterial supply to forehead flaps focusing on contribution from the supratrochlear and angular vessels. RESULTS: In 127 patients with nasal defects, 76 defects were greater than 1.5 cm in diameter and were repaired with a midline forehead flap (44 [58%]), paramedian forehead flap (3 [4%]), single-stage midline forehead flap (8 [11%]), interpolated melolabial flap (5 [7%]), local nasal flap (7 [9%]), or skin graft (9 [12%]). All original defects were modified to some degree with an aggressive application of the nasal esthetic subunit principle. Forty-three patients (57%) had cartilage grafts, 18 (24%) had a full-thickness defect requiring repair of the internal lining, and 11 (14%) had some degree of complication, although no patient had full-thickness necrosis of a flap or required a second flap. Analysis of the vascular pedicle to the midline and paramedian forehead flaps demonstrated significant contributions from the angular artery. Skin paddles from a midline and paramedian forehead flap had similar vascular arcades. CONCLUSIONS: Nasal reconstruction has reached a standard of consistent esthetic results with restoration of nasal function. The midline forehead flap is dependable and robust and leaves a donor site scar consistent with the principle of esthetic units.

Adult↗