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At least 1,477 records · Page 82Linked to original sources
PubMed1990

Painful ophthalmoplegia caused by neurotropic malignant melanoma.

Progressive cranial nerve palsies and painful ophthalmoplegia developed in a 76-year-old man with lentigo maligna of the forehead 18 months after the excision of a spindle cell tumour of the forehead that proved on immunohistochemical study to be a malignant melanoma. The signs and symptoms were caused by neurotropic spread of the malignant melanoma into the cavernous sinus and subsequent neurosarcomatous transformation of the orbital metastasis.

Aged↗
PubMed1990

Effects of electrode placement on the auditory brainstem response using ear canal electrodes.

The effects of electrode placement on the latency and amplitude of the auditory brainstem response (ABR) were investigated in normal-hearing subjects. Ear canal (EC) electrodes were used in conjunction with surface electrodes to obtain ABRs. Three electrode combinations were evaluated: (1) vertex-EC-EC; (2) vertex-EC-neck; and (3) forehead-EC-neck. Absolute and interwave latencies and absolute and relative amplitudes were computed for Waves I, III, and V at 75 dB SL. Standard errors of measurement (SEmeas) revealed excellent test-retest reliability for latency (SEmeas = 0.06 ms) but only fair reliability for amplitude (SEmeas = 55 nv). No reliability differences were observed among the three electrode combinations. No significant latency or interwave latency differences were found among the three montages. No amplitude differences were found for Waves I and III among the montages. However, the Wave V amplitude was larger for the vertex-EC-EC and vertex-EC-neck montages than for the forehead-EC-neck montage. Because the vertex-EC-EC montage does not require additional electrodes on the contralateral neck, this montage is recommended.

Acoustic Stimulation↗
PubMed1990

Regional flaps in facial reconstruction.

Soft-tissue defects of the head and neck that are too extensive to be reconstructed with local flaps without excessive impairment of either form or function usually require repair by some type of regional flap. Selection of a specific regional flap depends on the type of defect, i.e., its size and location, and on the intrinsic properties of the regional flap. Single pedicle peninsular or island axial pattern flaps are usually selected because of their improved blood supply compared with random flaps. For most skin defects of the face and neck requiring reconstruction with a regional flap, a medially based deltopectoral flap is usually preferable to musculocutaneous flaps because it is less bulky and produces less donor-site functional impairments. Likewise, for large defects of the upper or lower lip, a deltopectoral flap in most instances is the regional flap of choice for reconstruction. Nasal defects that require regional flaps for repair are reconstructed with various types of forehead flaps. The median flap remains the most useful because the donor site can be closed primarily, leaving a thin midline scar that is camouflaged relatively easily. For nasal defects that require a longer flap that can be provided by a median flap, the oblique forehead flap provides additional length sufficient to reach the base of the columella. Larger defects of the oral cavity and oral pharynx usually require regional or microsurgical flaps for reconstruction of soft-tissue deficits. In addition, mandibular reconstruction may be necessary. The pectoralis major musculocutaneous flap is the author's preferred choice of a regional flap for reconstruction of such defects. The flap readily reaches the oral cavity and oral pharynx and the muscle provides good coverage of the carotid artery when neck dissection has been accomplished. A great advantage of the flap is the ability to achieve reconstruction in one stage without the need for a controlled salivary fistula. Although the deltopectoral flap is the author's preferred regional flap for reconstruction of major defects of the hypopharynx, the pectoralis major musculocutaneous flap is the regional flap of choice when patients are severely malnourished or cachetic. Both flaps provide a source of nonirradiated skin and provide sufficient tissue for total reconstruction of the hypopharynx and cervical esophagus. Both methods of reconstruction, however, have a relatively high rate of stenosis of the distal anastomoses.

Face↗
PubMed1990

A new approach to sinus relief.

You suffer from "sinus". Medical treatment isn't getting you better, and now you need surgery. It is better that you be treated surgically today rather than as in the past. Five years ago, surgery meant an incision through the eyebrow, with probable numbing of the forehead, in order to relieve the pain of acute frontal sinusitis; or a long eyebrow incision, or shaving the front part of the scalp and pulling down the forehead skin from the skull was the procedure of choice for chronic disease in these sinuses. If the cheek sinuses were chronically diseased, an incision was made through the gums above the upper teeth, often resulting in numbing of the teeth and marked swelling of the cheek.

Adult↗
PubMed1990

[Histologic studies of cartilaginous structures in the anterior region of the head of the sperm whale Physeter macrocephalus].

Recently discovered cartilaginous structures in the forehead of the sperm whale (Behrmann and Klima 1985) were investigated histologically. The largest and most important of these structures is the nasal roof cartilage which can be derived from the tectum nasi, a part of the embryonic nasal capsule (Klima et al. 1986). In the investigated sperm whale fetuses, this structure consists of embryonic hyaline cartilage which is well suited for morphogenetic processes and fast growth. In the investigated adult sperm whale, the originally hyaline cartilage has been transformed into a special kind of elastic cartilage. The arrangement of cells, territories, and extracellular substance resembles hyaline cartilage. This component represents an adaptation to pressure load. The appearance and arrangement of elastic fibres resembles elastic cartilage. This component is an adaptation to distortion forces. Obviously, pressure and distortion are the strongest mechanical strains that the nasal roof cartilage is exposed. We see the function of this cartilage structure therein that, being a pressure-elastic skeletal support and following the left nasal meatus along its whole extension through the massive and soft forehead, it secures the only direct respiratory passage. Additionally, fibre bundles of transversely striated muscles are anchored in the perichondrium of the nasal roof cartilage. The function of this delicately interwoven muscle system is seen by us in the fine tuning of contraction and dilatation of the respiratory passage. Moreover, a possible function as a sound conducting cartilaginous structure serving the echolocation system is considered (c.f. Pilleri et al. 1983).

Animals↗
PubMed1990

Insidious hypothermia during raft use.

It is commonly thought that increasing protection against cold water results in greater physiological efficiency in maintaining core temperature. To examine the relationship of physiological changes resulting from cold exposures as a function of increased insulation, five subjects (4 males, 1 female) wearing anti-exposure ensembles covering the entire body and head were exposed in a pool to water temperatures (Twater) = 4.4 degrees C and air temperatures (Tair) = 5.6 degrees C. Trials consisted of subjects undergoing either head-out immersions with mean exposure time (t = 150 +/- 9 S.E.M. min) or enclosed within a raft (t = 398 +/- 126 min). Rectal temperatures were higher, and their relative change from baseline (delta Tre) smaller, for 3 of the 5 subjects at minute 122 in the water than in the raft. While no correlation was found between mean weighted skin temperature (Tsk), hand temperature (Thand), or foot temperature (Tfoot) with Tre, close correlation was found between delta Tre and forehead temperature (Tfore) (r = 0.97, p less than 0.05) and change in forehead temperature (r = 0.97, p less than 0.05). The results suggest that, during cold exposure, increased insulation, under specific conditions, may result in a lower Tre.

Adult↗
PubMed1989

Pain mechanisms underlying vascular headaches. Progress Report 1989.

Vascular headaches are among the most prevalent yet poorly understood problems in clinical neurology. Headaches may develop in association with hypertension, seizures, stroke or without a recognizable pathophysiology such as during migraine and cluster headaches. Cephalic blood vessels (pial and dural vessels) are implicated as the most important source for all headaches and are innervated by sensory fibers which arise from ganglia innervating the forehead, scalp and neck. Sensory fibers contain vasoactive neuropeptides which become released from peripheral (perivascular) and central terminations to mediate vasodilation and pain, respectively. The presence of vascular headache implies activation of this final common pain pathway which we have termed the trigeminovascular system. The presence of vascular headache implies activation of this final common pain pathway which we have termed the trigeminovascular system. The existence of such a system a) clarifies certain pain patterns which develop following stimulation of cephalic blood vessels, b) suggests a mechanism to explain the referral of pain to the forehead, c) provides a mechanism to explain the action of certain antimigraine drugs, d) suggests a local mechanism which enhances blood flow under certain pathological conditions. Hence, this review will update existing knowledge about the trigeminovascular system and its role in headache pathophysiology.

Animals↗
PubMedDate not supplied

The localization of the initial pain of attack. A comparison between classic migraine and cervicogenic headache.

Twenty-two patients with classic migraine and eleven patients with cervicogenic headaches were questioned about the localization of the initial and late pain during attack. Twenty of the classic migraine patients (91%) felt the initial pain in the forehead and temporal areas, whereas an ocassional, solitary primary involvement of the neck was found in one case (5%). As the attack evolved, there was a co-involvement of more areas. An initial involvement of the forehead and temporal area occurred in only 3 patients (27%) with cervicogenic headache, whereas 8 (73%) felt the initial pain in the neck. Also in the cervicogenic headache patients there was subsequent coinvolvement of more areas as the attack evolved. In the full-blown attack, the pain seemed very similar in the two patient groups. The localization of initial pain may be a useful feature in pattern recognition in headache diagnostics.

Adolescent↗
PubMed1985

[Quantitative analysis of skin surface lipids using a sebumeter method. Random lipid levels on the skin surface during therapy with 13-cis-retinoic acid, minocycline hydrochloride and UVA rays].

The Sebumeter method used in this study for quantitative analysis of skin surface lipids differs from previous techniques in simple handling and quick practicability and is therefore helpful in the clinical routine. Sebumetrical measurements carried out on healthy persons revealed symmetrical distribution of skin surface lipids. The highest levels were found on the forehead; young people generally showed higher values than older persons. During therapy with 13-cis retinoic acid on acne patients for 6 months (0.5 mg/kg daily), we found reduction of the random level in the first month, particularly in the forehead region. During therapy with minocycline on 3 acne patients for 3 months (2 X 50 mg daily), there was no variation of the random level observed. UVA irradiation on the face for 10 minutes daily (0.55 J/cm2/min) over a period of 3 weeks resulted in continuous reduction of the random level in most of the tested persons; a small part of them reacted by fluctuating values.

Acne Vulgaris↗
PubMed1988

[Fundamental studies on transcutaneous bilirubinometry in newborn infants using an organ scanning spectrophotometer].

In vivo reflectance spectra in the visible region were recorded on the blanched skin on the foreheads, chests, arms and legs of 140 newborn infants using an organ scanning spectrophotometer, and corresponding total serum bilirubin levels were determined. An elevation in the absolute spectra was observed in the 460 nm region for the higher bilirubin level, and the isosbestic point was located in the 510 nm region. A linear relationship was observed between the reflectance spectra difference and the serum bilirubin level. Although the best analysis results were obtained from the measurements of the reflectance spectra difference between 460 nm and 510 nm on the chests (r = 0.954, Y = 40.62X + 1.36), or on sums of 4 measuring sites (r = 0.973, Y = 46.59X + 0.61), there was no statistical difference from the values obtained between 460 nm and 550 nm on the foreheads (r = 0.913, Y = 33.55X + 5.30). The slopes and the Y-intercepts of the linear regressions differed considerably at various measuring sites. Marked decreases in the reflectance spectra differences were observed during the phototherapies and prominent rebounds followed for 24 hours after the cessation of phototherapies. The noninvasive and simple reflectance method was sensitive to the bilirubin level in the tissue and might be a better indicator of neonatal risk of kernicterus. However, the optical method has a certain limitations in representing the bilirubin concentration in the blood stream, especially during, and for 24 hours, after phototherapies.

Bilirubin↗
PubMed1979

Flaps used for nasal reconstruction: a perspective based on 180 cases.

Flap reconstruction of the nose is historically one of the earliest surgical operations. In spite of this long experience, little has been reported on the viability and durability of the various flaps and the time involved in the reconstruction, including the number of operative procedures required for total reconstruction of the nose. One hundred eighty patients were involved in this retrospective study dating from 1940. The midline forehead flap, used for partial nasal reconstruction, was specifically excluded from this study and will be reported separately later. The arm flap (Tagliacozzi), the total forehead flap, the sickle flap, and the acromiopectoral flap are reviewed in terms of the complications encountered, the total number of operations required, and the time involved in the complete reconstruction. The various nasal defects have been classified into five types, and the flaps usually used for reconstruction have been correlated with these defects. Eighty percent of the patients were treated because of a cutaneous malignancy of the nose. However, because these malignancies are currently being treated earlier and more efficiently, there is a significant decrease in present-day experience with this type of surgery.

Humans↗
PubMed1985

[A case of chondromyxoid fibroma of the frontal bone].

A case of chondromyxoid fibroma of the skull is reported. A 20-year-old boy visited our clinic on December, 1982 because of a recurrent forehead tumor. He had a 4 X 4 X 1.5 cm tumor on the right side of forehead and a 3 X 3 X 0.5 cm tumor on the left. Neurological examination showed no abnormalities. Skull X-ray film showed a large round radiolucent area with clear sclerotic margin in the frontal bone and right orbit. Right carotid angiogram showed marked posterior displacement of the anterior cerebral artery, but no tumor stain. Plain CT scan showed a mass with iso to low density area in the frontal region. It was markedly and irregularly enhanced with contrast media. Surgery was performed entirely in the epidural space, and the tumor was completely removed. The post-operative clinical course was uneventful. Histologically, the three components of chondroid, myxomatous and fibrous tissues in this tumor led to the diagnosis of "chondromyxoid fibroma."

Adult↗
PubMed1979

Angiolymphoid hyperplasia with eosinophilia.

Angiolymphoid hyperplasia with eosinophilia (AHE) is a distinct clinical and pathologic entity that demonstrates proliferation of endothelial cells associated with varying degrees of lymphocytic, histiocytic, and eosinophilic infiltration. Lymphoid hyperplasia with germinal centers often is present in older lesions and the patients may have an associated blood eosinophilia. Multiple deep nodules developed in a young man on the palmar aspect of the left hand, and subsequently the forehead, histologically diagnostic of AHE. Direct immunofluorescence of the tumor removed from the forehead demonstrated granular deposits of IgA, IgM, and C3 associated with small vessels. Cryoglobulins (IgA, IgM, and IgG) were found in the patient's serum. This new information lends support to the hypothesis that AHE is an inflammatory reactive lesion, possibly secondary to an immunologic injury, rather than a true vascular neoplasm with an associated inflammatory reaction.

Adult↗
PubMed1977

[Aneurysmal bone cyst of the frontal bone (author's transl)].

A six year-old boy. He complained of a swelling of the left forehead since October of 1971, the region of his upper eyelid has then been gradually swollen. He was admitted to our institute on the 24th of February, 1973, without the past history of head trauma. We found that the swollen region had a diameter of about 4 centimeters covered from the left upper eyelid to the forehead with a slight tenderness on pressure. We had no neurological findings. According to the results of skull X rays, the superior margin of left orbit and zygomatic process of frontal bone were swollen and like honey combs. An irregular, long and narrow osteolytic legion was found, which was about 4 centimeters long and 5 centimeters wide. According to the results of the left selective external carotid angiography, after injection of 60% Urografin, for more than 2.5- 10 seconds, at the left frontal bone an abnormal shadow (patchy contrast filling) was noted, which was about 4 centimeters long and 5 centimeters wide. After the direct injection of Urografid into the lesion, the cyst of one centimeter long and 3 centimeters wide was observed at the zygomatic process of the frontal bone. Operation was performed to excise the outer plate of the swollen bone and to curette the lesion after the ligature of the left external carotid artery. Histological examination showed many blood lakes and some multinuclear giant cells in the specimens and we diagnosed it was an aneurysmall bone cyst. This case is the first one of aneurysmall bone cyst confirmed by the selective external carotid angiography and the direct puncture of lesion.

Bone Cysts↗
PubMed1978

[Fronto-cranial remodeling for craniostenosis with mobilisation of the supra-orbital barr (author's transl)].

33 cases of fronto-cranial remodeling by osteotomies are reported by the authors. Since 1973, 19 oxycephalies have been operated according to an original technique based on two principles:--rocking and advancement of the supra-orbital barr, with an easy lateral retention by a Z-bony cut.--transposition of free bone flaps to rebuild a forehead of the appropriate curvature. The good results obtained have encouraged the authors to operate on young children or even babies in order to solve simultaneously the functionnal and the aesthetic problems. Three plagiocephalies, two trigonocephalies have thus been treated, as well as 5 facio-craniostenosis for whom a 2 cm forehead advancement has been done, the following results being very encouraging.

Child↗
PubMed1983

[Radiation exposure during x-ray angiography].

During 73 cardiac angiographies and 10 angiograms of the abdomen and extremities, the x-ray doses were determined at the arm and forehead (eyes) of the radiologists and assistant staff. The results are discussed and compared with the recommendations of the ICRP and valid legislation. It is recommended to use an additional dosimeter at the forehead if higher frequencies are employed.

Angiography↗
PubMed1980

Reconstruction of the burned nose.

Nasal reconstruction is one of the most important elements in rehabilitation of the patient suffering from the devastating deformities of full-thickness facial burns. When possible we use a single pedicle for complete nasal reconstruction. The forehead furnishes the best donor area. More distant donor sites are used if the forehead is not available. In lesser deformities, resurfacing with composite grafts or full-thickness skin grafts gives satisfactory results.

Aged↗
PubMed1980

Suture tarsorrhaphy system to control keratopathy after ptosis surgery.

Four tarsorrhaphy sutures are placed through the lower eyelid and brow following ptosis surgery in a system designed for patients with external ophthalmoplegia, third nerve paralysis, and myashenia gravis. Three of the sutures connect the lower eyelid to the forehead, and the fourth suture is passed through the lower eyelid and taped to the cheek. The three lid-brow sutures are released during the first two postoperative weeks, one by one, and topical ointment instillations are gradually tapered. The tarsorrhaphy system allows the cornea to adapt gradually to the lagophthalmos that follows ptosis surgery. It also keeps the eyelids partially closed during the first two postoperative weeks in patients with frontalis sling surgery who have marked difficulty lowering their eyebrow and closing their eyelids because of early postoperative forehead edema and pain. The tarsorrhaphy system has prevented serious keratopathy in six patients with ptosis associated with abnormal ocular motility and in one patient with lagophthalmos following trauma. It also allowed the six ptosis patients to have full, rather than partial, correction of their ptosis.

Blepharoptosis↗