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PubMedDate not supplied

Subperiosteal brow and midface lifts.

The subperiosteal browlift and midface lift combination is a total mobilization of the composite full-thickness soft tissues from the bony skeleton with superior suspension. The object is to correct midfacial ptosis and the "tired" look of the lateral eyelids. It is done in conjunction with a browlift so that a composite correction of the upper and midface is achieved. When indicated, a modified lower cheeklift and the usual procedures for correcting neck deformities are utilized in combination. We believe the procedure is safe and the results reported are natural and long-lasting. This review of 130 cases also stresses technical aspects and the safety of the procedure.

Aged↗
PubMed1987

[Initial management of severe facial injuries].

Severe facial injuries may be treated within the first 12-h-period or delayed for several days while the patient is transferred to an appropriate hospital. The goal of treatment should be optimal primary reconstruction of all the damaged structures. Specialized experience, instruments and a well-equipped operative theatre are necessary. Adequate primary treatment may so prevent functional losses or deficits and mutilations and reduce secondary plastic surgical interventions to a minimum. Typical case examples are demonstrated.

Facial Bones↗
PubMed1993

Radiographic findings in 13q-syndrome.

Of 169 children with retinoblastoma treated at our institution between 1962 and 1993, 5 had concurrent severe mental retardation, hypotonia, and abnormalities of constitutional chromosome 13. The associated skeletal abnormalities of these 5 children are described and include delayed skeletal maturation, metaphyseal abnormalities, microcrania, facial bone abnormalities, and gracile long bones.

Abnormalities, Multiple↗
PubMed1993

Findings on magnetic resonance imaging of the spine and femur in a case of McCune-Albright syndrome.

Polyostotic fibrous dysplasia, a major osseous change in McCune-Albright syndrome, is seen in the cranium, facial bones, bones of the extremities, and ribs, but rarely in the spine. Spinal X-rays revealed no abnormalities in an 8-year-old girl with this syndrome, but 99mTc-methylene diphosphonate bone scintigraphy disclosed high-density areas in the thoracic and lumbar vertebrae. Multiple well-circumscribed areas of low signal intensity were seen on T1-weighted magnetic resonance imaging (MRI) of the spine. Although MRI spine scans in this disease have never been reported, our findings in this case proved interesting for evaluating osseous lesions. MRI made it possible to differentiate between fibrous lesions (low signal intensity on T1- and T2-weighted MRI) and cartilaginous lesions (low signal intensity on T1-weighted MRI and high signal intensity on T2-weighted MRI).

Child↗
PubMed1983

Clinical versus autopsy diagnosis of cranio-cerebral injury.

The accuracy of the clinical diagnoses of the victims who died at the Department of Neurosurgery, Helsinki University Central Hospital in 1975 and 1976 of a lethal injury to the head was investigated. Standard clinical and X-ray means were used without computed tomography whose value as an additional tool will be reported later. Most of the patients were traffic accident victims of which 71% died within 24 h after trauma. The rate of the correct diagnoses of fractures was 87% in the vault, 76% at the base of the skull, and 67% in the facial bones. Of all intracranial lesions, 75% were correctly and 9% partially diagnosed. The discrepancy would have been more marked if such entities as cerebral contusion and laceration and hemorrhage had been presented separately. This study indicates that many head injuries remained undiagnosed by standard clinical means. The value of X-ray examination also appeared small in the postmortem diagnostics of skull fractures and intracranial lesions.

Adolescent↗
PubMed2000

[Management of mid-facial fractures].

In the past, treatment of maxillofacial fractures was characterized by low incidences of midface fractures, while severe cases were associated with a high death rate. Over the last decades the application of new techniques has provided a successful outcome in the management of these more frequently observed injuries. With the introduction of antibiotics and the principles of modern anesthesiology, conservative methods of fracture treatment such as intermaxillary fixation and the application of extension devices were increasingly replaced by surgical techniques. The development of different osteosynthesis plate and screw systems in the early 1970s has made three-dimensional reconstruction a standard of care in the surgical treatment of midface fractures. With the recent introduction of commercially available bioresorbable systems, removal of osteosynthesis material has become an unnecessary procedure. Further research in innovative techniques of maxillofacial surgery and imaging, such as image-guided surgery by computer navigation, may be warranted to minimize surgical approaches and decrease incidences of perioperative morbidity.

Adult↗
PubMed2003

[Advanced transfacial approach to extensive sellar adenoma of the pituitary gland].

The excision of tumors of the pituitary gland is usually achieved via a transsphenoidal transnasal approach. In the past, alternative approaches were described for macroadenomas. Especially in tumors surrounding the internal carotid artery (ICA) and the optic nerve, the selection of the appropriate approach is of importance. We demonstrate the case of a second extensive relapse of a macroadenoma after primary transsphenoidal resection and radiation therapy. As the tumor enclosed both the ICA and left optic nerve, a median external approach via the upper midface was chosen. After the median skin incision and translocation of the upper parts of the nasal structure, the papyraceous lamina was removed bilaterally. The orbital tissue was laterally exposed with retractors, achieving a wide access to both carotids and optic nerves. The functional and aesthetic results were satisfactory. Compared with other approaches, this one provides a good exposure of both the ICA and optic nerve.

Adenoma↗
PubMed1999

CT and MRI of congenital sinonasal ossifying fibroma.

We report a 9-year-old boy with a sinonasal ossifying fibroma, probably congenital, with atypical findings on CT and MRI. CT revealed a soft-tissue density mass in the sphenoethmoidal sinuses, nasal cavity and right maxillary sinus with a few foci of calcification and with remodelling and destruction of the adjacent facial bones. MRI showed high signal on T2- and intermediate signal on T1-weighted images. A thin, partly enhancing outer shell and some nonenhancing septa were visible on contrast-enhanced images. MRI also showed the tumour to extend into the anterior cranial fossa. Subtotal removal was performed. We compare our findings with reports in the literature and discuss the differences from fibrous dysplasia.

Child↗
PubMedDate not supplied

Multidisciplinary and multistage treatment of complex facial trauma: case report.

The improved performance of modern automobiles often results in higher driving speeds, rendering traffic accidents much more devastating. Many of our facially injured patients require multidisciplinary and multistage treatment, which is often both sophisticated and radical. We present a patient with complex facial trauma, discuss his injury characteristics and the multistage treatment performed, and review the literature.

Accidents, Traffic↗
PubMed2001

Bare lymphocyte syndrome: imaging findings in an adult.

Bare lymphocyte syndrome (BLS) is a rare primary immune disorder characterized by defective expression of human leukocyte antigen (HLA) on lymphocytes, often resulting in extensive and recurrent multi-organ infections. We describe a previously undiagnosed case of an adult woman who presented with radiological findings of severe bronchiectases, near-total granulomatous destruction of facial bones, and osteomyelitis. Diagnosis of BLS should be considered when evaluating children with unexplained bronchiectases or adults with long history of chronic multi-organ infections.

Female↗
PubMed1999

Imaging features of thalassemia.

Thalassemia is a kind of chronic, inherited, microcytic anemia characterized by defective hemoglobin synthesis and ineffective erythropoiesis. In all thalassemias clinical features that result from anemia, transfusional, and absorptive iron overload are similar but vary in severity. The radiographic features of beta-thalassemia are due in large part to marrow hyperplasia. Markedly expanded marrow space lead to various skeletal manifestations including spine, skull, facial bones, and ribs. Extramedullary hematopoiesis (ExmH), hemosiderosis, and cholelithiasis are among the non-skeletal manifestations of thalassemia. The skeletal X-ray findings show characteristics of chronic overactivity of the marrow. In this article both skeletal and non-skeletal manifestations of thalassemia are discussed with an overview of X-ray findings, including MRI and CT findings.

Adrenal Glands↗
PubMed2005

A rare case of nasal glioma in the sphenoid sinus of an adult presenting with meningoencephalitis.

Nasal gliomas are rare embryologic development defects that commonly present shortly after birth. Very few cases have ever been reported in adults. Of those presenting in adult life, most were casual findings in patients with no symptoms. Rare localizations have been described in the nasopharynx, soft palate, orbital cave and scalp. We present an unusual case of a 56-year-old man who initially presented with meningoencephalitis and was found to have nasal glioma in the sphenoid sinus. Having discussed their embryology and histology, we conclude that MRI scanning is the preferred method of investigation. However, radiological evaluation preoperatively should not lead to any sense of security if no bony defect (and thus, the possibility of intracranial extension) is demonstrated. Extirpation via a functional surgical approach is the treatment of choice to prevent deformities in the facial bones. This can range from direct incision over the gliomata to removal transnasally by endoscopy or using a lateral rhinotomy approach depending on the location, size and involvement of the glioma.

Glioma↗