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Hypoglossal-facial anastomosis.
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[A case of vertigo accompanied by facial paralysis].
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[Prevention of complications in the radiation therapy of maxillofacial neoplasms].
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Ocular risks from sunlight exposure.
Relinquishing the desire to acquire a tan will be difficult for many people. To many individuals, a tan is a symbol of health, fashion and attractiveness. Even when informed about the risks of sunlight exposure, many people ignore the advice to change their behaviors and decrease their risks. Adoption of safe sunlight precautions depends on individual preference, age, work requirements, gender, and perception of personal risk. Many people selectively adhere to certain protective behaviors which do not conflict with social norms. Reinforcement of how sunlight can damage the eyes and skin needs to be continually provided so that public attitudes can adapt to all the necessary appropriate behaviors. Ophthalmic health care professionals have an important part in public education. They can customize their patient's personal protective requirements to match the type of risks uncovered in the clinical work up. The ocular and social history should include the patient's sunlight exposure risk profile and document pre-existing sunlight damage to the eyes and facial areas. All follow-up visits should reinforce sunlight exposure information and document compliance or non-compliance. Only in this way can the eye care delivery system support preventative measures to decrease ocular injuries from sunlight radiation.
A large retinoblastoma detected in a fetus at 21 weeks of gestation.
The facial tumour described here is the first reported case of a large retinoblastoma detected early in pregnancy and adds another item to the differential diagnosis of facial tumours visualized by prenatal ultrasound examination. Ultrasound examination of the fetal eyes can be offered in cases of retinoblastomas where prenatal DNA diagnosis is otherwise impossible.
Interstitial brachytherapy of periorificial skin carcinomas of the face: a retrospective study of 97 cases.
PURPOSE: To analyze outcomes after interstitial brachytherapy of facial periorificial skin carcinomas. PATIENTS AND METHODS: We performed a retrospective analysis of 97 skin carcinomas (88 basal cell carcinomas, 9 squamous cell carcinomas) of the nose, periorbital areas, and ears from 40 previously untreated patients (Group 1) and 57 patients who had undergone surgery (Group 2). The average dose was 55 Gy (range, 50-65 Gy) in Group 1 and 52 Gy (range, 50-60 Gy) in Group 2 (mean implantation times: 79 and 74 hours, respectively). We calculated survival rates and assessed functional and cosmetic results de visu. RESULTS: Median age was 71 years (range, 17-97 years). There were 29 T1, 8 T2, 1 T3, and 2 Tx tumors in Group 1. Tumors were <2 cm in Group 2. Local control was 92.5% in Group 1 and 88% in Group 2 (median follow-up, 55 months; range, 6-132 months). Five-year disease-free survival was better in Group 1 (91%; range, 75-97) than in Group 2 (80%; range, 62-90; p = 0.23). Of the 34 patients whose results were reassessed, 8 presented with pruritus or epiphora; 1 Group 2 patient had an impaired eyelid aperture. Cosmetic results were better in Group 1 than in Group 2 with, respectively, 72% (8/11) vs. 52% (12/23) good results and 28 (3/11) vs. 43% (10/23) fair results. CONCLUSIONS: Brachytherapy provided a high level of local control and good cosmetic results for facial periorificial skin carcinomas that pose problems of surgical reconstruction. Results were better for untreated tumors than for incompletely excised tumors or tumors recurring after surgery.
[Facial hemangioma associated with arterial anomalies, coarctation of the aorta, and eye abnormalities: PHACES syndrome].
BACKGROUND: Hemangiomas are frequent in childhood. Their association with dysmorphic anomalies is rare. Recently, the acronym "PHACES syndrome" was proposed to emphasize the association of Posterior fossa malformations, Hemangiomas, Arterial anomalies, Coarctation of the aorta and cardiac defects, Eye abnormalities, and Sternal malformations. CASE REPORT: A female child, 3 months old, had a large facial hemangioma. The physical examination was normal otherwise. A choroidal hemangioma and a papillary abnormality, causing amblyopia, were detected. The brain magnetic resonance imaging was normal. A subglottic hemangioma was found at endoscopy. At the age of 16 months, physical examination disclosed a heart murmur and coarctation of the aorta was detected. Moreover, the cardiac angiography showed diffuse arterial lesions. Strict surveillance was decided as there were no manifestations. DISCUSSION: Different abnormalities have been described to be associated with large facial hemangiomas. Frieden has grouped these abnormalities under the acronym PHACES. She described 43 hemangiomas and found 74 p. 100 Dandy Walker malformations and other posterior fossa malformations, 41 p. 100 arterial anomalies, 26 p. 100 cardiac or aortic malformations, 23 p. 100 ophthalmologic abnormalities. There is a high risk for the hemangiomas to develop in an airway localization. The prevalence of facial hemangiomas associated with other malformations is, to our knowledge, not known. In our department, 56 children were treated with corticosteroid therapy for severe facial hemangioma. 11 p. 100 had a cerebral abnormality. There were no cases with cardiac malformation or dysmorphism. PHACES syndrome is very rare but easy to remember. Thus in patients presenting a large facial hemangioma, it is important to conduct an attentive neurological examination completed by brain imaging and an extensive cardiovascular exploration. Special attention should be given to the ophthalmologic and sternal examinations as well as the search for hemangiomas in an airway localization.
Birthmarks of the eye and eyelids as indicators of ocular or systemic tumors.
1. Some birthmarks and acquired ocular-facial lesions indicate the presence of or potential to develop intraocular and/or systemic tumors. 2. Facial nevus flammeus is commonly associated with an ipsilateral diffuse choroidal hemangioma. 3. Ocular and oculodermal melanocytosis appear to be associated with an increased risk of ipsilateral primary intraocular malignant melanoma of the uveal tract. 4. Aniridia is occasionally associated with Wilms' tumor, a potentially fatal primary abdominal malignancy of children. If detected early, Wilms' tumor can offer be cured.
[Radiotherapy problems by skin tumors in the facial folds].
The clinical observations of the higher incidence of recurrence after irradiation of skin cancer in the more furrowed and more articulated regions of the face are explained in part by physical-dosimetric measurements. We believe that the higher ratio of recurrences in these areas is attributable to several factors, such as the unfavorable patho-anatomical structure and the inherent difficulties in radiation therapy and to the inadequate determination of the tumor's depth extension.
Superpulse CO2 laser treatment of facial syringomata.
Eight patients with facial syringomata have been treated with the superpulse CO2 laser and followed for periods up to 3 years. Superpulse capability allows satisfactory photovaporization of overlying skin and exposure and liberation of the underlying cyst. Healing was satisfactory with minimal scarring and no persistence or recurrence of syringomata in five of eight cases.
Eyelid tumour and juvenile hyaline fibromatosis.
We report the case of a 2-year-old boy suffering from juvenile hyaline fibromatosis. Our patient had all the main clinical features of the disease, i.e. multiple cutaneous facial nodules, gingival fibromatosis and osteolytic lesions in the proximal metaphysis of the tibia and humerus symmetrically. However, he also presented an eyelid tumour scalloping the superior orbital osseous rim, causing blepharoptosis. The histopathology confirmed this very rare condition. After 6 months, our patient has improved functionally and cosmetically following surgical resection of the eyelid tumours without recurrence.
Facial bone changes with vascular tumors in children.
Deformities of the adjacent facial bones are common with large vascular tumors. Most hemangiomas will resolve spontaneously, but the incidence of resolution appears to be quite low when the adjacent bones are affected. In these, we have used high dosage corticosteroid therapy in the early cases, particularly those involving the orbit. Surgical excision has been used in most of the other cases, with reasonable improvement.
Facial nerve function after parotidectomy for neoplasms with deep localization.
PURPOSE: To determine whether the deep location of a parotid gland neoplasm is specific risk factor for facial nerve paralysis after parotidectomy. METHODS: We retrospectively reviewed 88 patients, including 59 with a benign superficial neoplasm of the parotid treated by superficial parotidectomy (group 1); 5 with a benign deep neoplasm treated by total parotidectomy (group 2); 20 with a malignant superficial neoplasm treated by total parotidectomy (group 3); and 4 with a malignant deep neoplasm treated by total parotidectomy (group 4). RESULTS: Temporary facial nerve paralysis developed in 10.3%, 20%, 10%, and 50% of groups, 1, 2, 3, and 4, respectively. Permanent facial nerve paralysis developed in 0%, 0%, 10% and 50% of groups 1, 2, 3, and 4, respectively. CONCLUSION: The risk factor associated with nerve damage resulting from surgery for parotid neoplasms were malignancy and deep localization. However, the deep location of a benign tumor was not a major risk factor for permanent paralysis.
[Epithetical management of tumor-induced facial defects].
Defects of the face are mostly due to operations of tumours of the head. In the present study, indications for epistheses are discussed and the possibilities of episthetical treatment are reported. In 54 own cases different methods of attachment for epistheses are described with special reference to the possibility of fixation with adhesives. Moreover, making of epistheses is described as well as the handling of these artificial parts by the bearer. Advantages and disadvantages of epistheses are pointed out.
[Clinico-radiological aspects of neurinoma of the facial nerve with endocranial involvement].
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[Methods for resolving facial carcinomatosis].
This study presents the case of a patient of 57 years old, hospitalized in the Dept. Ophthalm. of the City Hospital of Arad, presenting a face carcinomas with the following locations: the inferior left eyelid, the area between the eyebrows, the nose pyramid, the right nasogenian area, the right preauricular area. The surgical intervention was made in one step the had oncologic free borders, and the recovery of the skin and of the mucous membranes were performed through plastic surgeries. After one year from the intervention, the patient did not present recurrence.
Bilateral choroidal hemangiomas and facial nevus flammeus.
Two patients presented with the rare combination of bilateral diffuse choroidal hemangiomas and bilateral facial nevus flammeus. In one eye of one patient, an associated serous retinal detachment was treated with xenon arc photocoagulation in an attempt to delimit the subretinal fluid. Clinicians should be aware of the subtle clinical findings of diffuse choroidal hemangiomas as well as the possibility of bilateral occurrence. Early recognition and treatment may prevent progression of total retinal detachment and neovascular glaucoma.