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At least 1,495 records · Page 83Linked to original sources
PubMed1981

Reconstruction of lateral nasal defects.

In planning reconstruction of a lateral nasal soft tissue defect, the surgeon should be aware of alternative methods and select the one most appropriate for the patient. Variables to be considered include the extent, depth, and location of the defect, the age, sex, and tissue laxity of the patient, and the availability of donor tissue. Surface defects are often best corrected with full-thickness skin grafts: upper eyelid, preauricular, postauricular, or supraclavicular, depending on which portion of the nose is being treated. Anterior superior helix composite grafts serve quite nicely to restore full-thickness alar losses, and other such defects are better reconstructed with a nasolabial flap. The midline forehead flap is quite useful but in certain situations has drawbacks. For larger skin and soft tissue defects, a transverse forehead flap based on the superficial temporal vessel provides appropriate reconstruction.

Ear Cartilage↗
PubMed1982

Effect of solid detergent washing on values of skin electrical impedance.

We have studied the electrical behaviour of the skin on 20 volunteers, before and after cleaning with solid detergent. The aim was to study one of the possible variables of the measurements. The results have shown that the cleaning has globally reduced the electrical skin parameters of the forehead, without influencing other parts examined (dorsal and palmar surfaces of the hand). The result has been attributed to the elimination of the hydrolipidic film of the surface and in particular that of the sebum of the forehead. The data give an idea as to how to obtain more homogeneous final results, as well as studying the sebum production function.

Adolescent↗
PubMed1982

[Transcutaneous bilirubin determination in the newborn infant. Recommendations of the Swiss Neonatology Group].

The clinical usefulness of transcutaneous bilirubinometry with the Minolta-Air Shield bilirubinometer was evaluated at four obstetrical neonatology units (Basle, Berne, Lucerne and Zurich). Transcutaneous bilirubin (TcB), expressed as bilirubin index, was compared with simultaneous serum bilirubin estimations in healthy Caucasians babies born at term with a birth weight of more than 2500 g. TcB measured over the forehead: 926 determinations in 629 newborns. TcB measured over the sternum: 404 estimations in 260 newborns. TcB estimations over the sternum produced a closer correlation (r = 0.93) with serum bilirubin than estimations over the forehead (r = 0.81). Mean serum bilirubin value as well as the corresponding 5th and 95th percentiles were calculated for each TcB index. From the data obtained the following practical conclusions can be drawn: TcB estimations are reliable for giving the indication to perform serum bilirubin determinations. In patients with risk factors for kernikterus serum bilirubin should be determined at a TcB index of greater than or equal to 18, in babies without risk factors at a TcB index of greater than or equal to 21.

Bilirubin↗
PubMed1981

Current surgery of craniofacial anomalies.

Craniofacial dysplasia is a term covering all types of skeletal anomalies. Craniofacial surgery has made possible the movement of any bone of the face or skull to correct such deformities. Such surgery is a new and separate subspecialty and should be limited to a few regional centers. There are numerous osteotomies available. The common ones are the Le Fort I, II, and III for advancement of different segments of the midface, orbital hypertelorism correction converting each orbit into a box, which moves medially together with the eyeball, and advancement of the forehead to correct premature coronal synostosis in infancy or forehead recession in Crouzon's or Apert's syndrome. In hemifacial microsomia, the asymmetrical skeleton is rotated about the facial midline to produce symmetry, and the mandibular ascending ramus and temporomandibular joint are constructed if absent. Combinations of the various osteotomies are possible, depending upon the type of deformity as assessed by the craniofacial team. Psychosocial study indicates that surgical correction should be undertaken as early as is technically feasible. The four main complications are death, blindness, brain damage, and infection.

Adolescent↗
PubMed1981

[A huge frontal sinus pyocele extending into the cerebral falx - a case report (author's transl)].

A 50-year-old male was admitted to us presenting a bulging of 5 X 6 cm in size on the forehead. His general condition was excellent and neurological status was normal. The mass in the forehead was soft and showed a fluctuation. On the plain skull films, a lobulated bone defect of 5 X 4 cm in size was noticed in the frontal bone and the frontal sinus completely disappeared. Carotid angiograms revealed posterior displacement of the supraclinoid portion of the internal carotid arteries and the proximal part of the anterior cerebral arteries, and elevation and posterior displacement of both frontopolar arteries. Capillary and venous phase of the carotid angiograms demonstrated an avascular area in the frontal cranial fossa. Branches of the anterior cerebral artery were stretched and displace surrounding the avascular mass. These angiographic findings indicated a huge avascular both frontal lobes posterolaterally. CT scanning revealed a large isodensity mass and the periphery of the mass was enhanced in a ring-like fashion with contrast medium. The mass protruded as a subcutaneous mass through the defect of the frontal bone. The content of the mass was surgically evacuated. The mass was a pyocele containing thick yellowish purulent fluid. It arose from the frontal sinus and extended into the anterior cranial fossa through the destroyed posterior wall of the sinus to separate the falx into two leaves of the dura mater and displace both frontal lobes laterally and posteriorly. Extension of the frontal sinus mucocele and pyocele to the anterior cranial fossa was discussed.

Cerebral Angiography↗
PubMed1995

[A rare case of cranial metastasis from hepatocellular carcinoma].

This is the first reported case of magnetic resonance imaging (MRI) findings of cranial metastasis from hepatocellular carcinoma. A 53-year-old male was admitted to our hospital on August 23, 1994, complaining of severe headache and a subcutaneous mass on the forehead. He was diagnosed as hepatocellular carcinoma in February, 1994, at another hospital. Because of multiple intrahepatic metastasis, he was inoperable and received transarterial embolization (TAE) on February 15, 1994. He had noticed the subcutaneous mass two months prior to admission, and its recent rapid growth, and morning headache. On admission, there was no abnormality observed by neurological and physical examination except the subcutaneous mass on his forehead, 5 x 7 cm in size. It was elastic soft and unmovable, and he felt tenderness. Laboratory examination showed only mild liver dysfunction. HBsAg was negative, and alpha-fetoprotein and PIVKA-II (Protein Induced by Vitamin K Antagonists) were within normal limit. Skull X-ray showed a round bone defect in the frontal bone. Computerized tomographic (CT) scan showed bone destruction and a well-circumscribed high density mass extending from the frontal subcutaneous region into the cranial cavity. MRI showed the tumor compressing the left frontal lobe on T1 weighted image as isointense and T2 weighted image showed a slight low intense mass. The tumor was clearly enhanced on both CT scan and MRI. Left external carotid angiogram demonstrated that the hypervascular tumor mainly fed by a frontal branch of the left superficial temporal artery in the frontal region. Tumor and bone scintigram revealed multiple bone metastasis. Lung CT scan showed no metastasis.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Hepatocellular↗
PubMedDate not supplied

[Moya-moya disease in a child with multiple malformations].

Moya-Moya disease is an obstruction of the internal carotids and of the afferent and efferent channels of Willis's polygon, which causes a collateral circulation, responsible for the typical angiographic image of a "puff of smoke" (Moya-Moya, in Japanese). Its etiology is unknown, and it might be congenital or acquired. It has been associated with congenital diseases such as Neurofibromatosis and disease of the falciform cells, among others. It usually appears as an alternating hemiplegia. We report here on the case of a 4-year-old boy with alternating hemiplegia (initially on the left, later on the right and then back on the left) and angiographic alterations which are characteristic of Moya-Moya. This patient had been examined in our hospital in the neonatal period as he had malformative stigmas, basically consistent with a flat angioma on the forehead, upper eyelids, and base of the nose, a previous wide fontanella which expanded to the whole of the methopic suture, aplasia, forehead level skin and abnormal implantation of the skin in that region. What draws attention in this case is the association of middle line craniofacial lesions (angioma, skin aplasia) and the later development of Moya-Moya.

Brain Ischemia↗
PubMed1995

[The removal of folds and wrinkles in the glabella area].

Analysis of late results of operations performed in 160 patients to remove excessive skin and wrinkles on the forehead showed that good results were attained in only 40% cases. This was because surgical interventions to remove skin excess on the forehead and to repair the eyebrows in ptosis did not include resection of the muscles which created folds in the glabella. Resection of the muscles moving the eyebrows together helped appreciably improve the remote results of surgery.

Blepharoptosis↗
PubMed1995

Evaluation of the effect of early mobilization of the supraorbital bar on the frontal sinus and frontal growth.

Consequences of early frontocranial remodeling are controversial. It has been said that secondary operations are more difficult and that the frontal sinus does not develop well, with an adverse effect on forehead aesthetics. Some illustrative cases are presented, among 820 operated craniosynostoses, to demonstrate that (1) an early, well-performed frontal advancement and/or remodeling is followed by satisfactory reossification and permits easy secondary surgery, (2) frontal sinus development, which is always impaired in anterior craniosynostosis, is only moderately diminished by early supraorbital bar remodeling (when the frontal bar is repositioned after remodeling, as with trigonocephaly, the frontal sinus develops in 83 percent of cases, whereas when the advancement is significant, as with brachycephaly, the development of the frontal sinus is observed in only 50 percent of the cases), and (3) forehead aesthetics are not linked closely to the development of the frontal sinus. After a significant advancement, even if the sinus does not develop, the frontal bar projection can remain satisfactory.

Child↗
PubMedDate not supplied

[Nasal reconstruction by frontal flaps].

A series of 51 nasal reconstructions using diverse forehead flaps is reviewed: the authors report their experience as well as the choices they made among various reconstructive procedures. 6 forehead flaps were selected in anticipation of solving most of the cases. The technical procedures devoted to the reconstruction of the inner plane and osteocartilagenous support are discussed. The complications are reported. Evaluation of the aesthetic result is quite subjective and thus rather difficult to quantify: limited defects give rather good results whereas more extended amputations such as those reaching the maxilla do not give accurate results.

Humans↗
PubMed1994

[Contribution of videoendoscopy to the surgery of face rejuvenation].

After a delay of several years, endoscopic surgery was introduced into cosmetic surgery of the face in 1992. Initially, its indications were very limited as they only concerned resection of corrugator muscles for the treatment of wrinkles between the eyebrows. Today, it has a new lease of life, with the ambition of replacing classical forehead facelift, by constituting a surgical approach. It replaces the bicoronal incision by means of 5 small incisions which allow detachment and resection of the depressor supercilii muscles similar to that obtained via a bicoronal incision. The skin or scalp excess is absorbed by various techniques. However, endoscopy now has other ambitions: functional fronto-orbital surgery. It tries to achieve a new muscular equilibrium by resection of the depressor supercilii muscles and release of the levators: occipitofrontal muscle. In this way, this new technique achieves an entirely natural repositioning of the eyebrow. The authors describe all of the technical possibilities by endoscopy, median frontal endoscopy, endoscopic frontal facelift, endoscopic extraperiosteal masklift and endoscopic subperiosteal masklift, in the case of the forehead. A special technique has been developed: temporomalar facelift. Lastly, although cervicofacial dissection is technically possible using videoendoscopy, there nevertheless remains a major stumbling block: the excess skin. Based on an experience of more than a hundred cases over a period of more than 18 months, this technique provides extremely encouraging results leading the authors to adopt this technique definitively.

Endoscopy↗
PubMed1994

Fluid recruitment from shell tissues of the body during haemodialysis.

Patients with kidney failure are prone to accumulate fluids within the superficial tissues, leading to a puffiness of the face, hands, and feet. After dialysis these symptoms disappear. It was the aim of this study to quantify these changes. With the help of A-mode ultrasound in 49 patients (20 females, 29 males) the tissue thickness in the forehead and tibia was measured during dialysis. In the forehead the tissue thickness before dialysis was 4.01 mm (females) and 3.87 mm in the males, decreasing continuously during dialysis by 13.6% and 12.8% respectively (P < 0.001). In the tibia the tissue thickness was 3.87 mm (females) and 3.07 mm (males) and decreased by 12.8% and 23.9% respectively. The sex difference was significant (P < 0.05). From these values it was calculated that 45% of fluid withdrawn came from the superficial shell tissues of the body. It was concluded that these tissues serve as water stores in the interdialytic phase.

Adult↗
PubMed1976

Multiple tumors in a renal transplant recipient.

The case of a 54-year-old man who developed multiple epithelial tumors during his sixth year post-renal transplantation is reported. The tumors included keratoacanthomas of the forehead and neck, squamous carcinoma of the forehead, basal cell carcinoma of the cheek, multiple colonic adenomatous polyps and multiple ileal carcinoids. In addition, he had marked parathyroid hyperplasia in spite of good renal function, and pancreatic islet cell hyperplasia. Although there is a 5-6% incidence of de novo malignant neoplasms in immunosuppressed organ homograft recipients who were apparently free of cancer before and at the time of transplantation, multiple tumors are infrequent in these patients. A review of the literature reveals that this is the first case in which more than two cancers have occurred concurrently and it is also the first report of carcinoid tumors occurring in a transplant recipient.

Autopsy↗
PubMed1994

Physiological variations in the pigmentation of newborn infants.

Skin pigmentation is a physiological feature of great value and usefulness from both an anthropological point of view and a clinical point of view. This article is a first approach to the study of the skin pigmentation of 126 full-term newborn infants (37-42 weeks gestational age) at the Maternity Hospital "La Paz" (Madrid, Spain) using the reflectance method. We provide the normal patterns, which have to be taken into account when applying this method to detect transcutaneous bilirubin and some physiopathological conditions, such as hyperbilirubinemia, anemia, plethora, and hormonal disturbances. Measurements of the reflectance were taken at the forehead, the internal and external aspects of the arm, the thorax, and the gluteus with blue, green, and amber tristimulus filters. With all filters the least pigmented zone was the thorax, and the most pigmented zone was the forehead; the internal aspect of the arm, the gluteus, and the external aspect of the arm were intermediate in increasing order. Our data confirm a higher pigmentation at birth than during the first year. We think that the idea of cephalocaudal progression of hyperbilirubinemia must be rejected. Our results also indicate that the thickening of the skin with gestational age is one of the most important factors in the skin color changes of newborn infants with an apparently different rhythm in males than in females.

Analysis of Variance↗
PubMed1994

Small cell carcinoma of the lung in a patient with rheumatoid arthritis: a case report.

We describe an occurrence of small cell carcinoma of the lung in a 37-year-old woman with rheumatoid arthritis who did not receive any kind of cytotoxic agents for the rheumatic condition. There seemed to have no predisposing factor for the development of malignancy. The diagnosis of small cell carcinoma was based on repeated hemoptysis and cytologic finding of a rapidly growing mass over the forehead. The patient responded dramatically to chemotherapy with rapid resolution of forehead mass, relief of arthritis in the hands, and decrease of serum rheumatoid factor from 4800U/ml to 1200U/ml. This appeared to be the first report of small cell carcinoma of the lung developing in a patient with rheumatoid arthritis.

Adult↗
PubMed1993

Lack of ossification after cranioplasty for craniosynostosis: a review of relevant factors in 592 consecutive patients.

The Center for Craniofacial Anomalies of Necker-Enfants-Malades Hospital presents a retrospective study of the outcome of 592 patients who were operated on for craniosynostosis between 1976 and 1991. The quality of ossification 1 year after operation is reported, with a focus on influencing factors. The lack of ossification rate was 5% (30 of 592). Three parameters are identified as increasing the risk of poor osseous wound healing: local postoperative infection; forehead advancement, especially when accomplished with resorbable osteosynthesis; and brachycephaly. In contrast, repaired tears of the dura mater do not seem to pose a risk. Seventy-five percent of patients with local infection and 12.4% with forehead advancement presented a lack of ossification, which is statistically significant (p < 0.001). Lack of ossification can compromise aesthetic and functional results. Decreasing postoperative infection and stable fixation may help promote ossification.

Adolescent↗
PubMed1994

[Two cases of traumatic intracerebral pneumocephalus].

Two cases of traumatic intracerebral pneumocephalus, a rare complication of head trauma, are presented. Case 1: A 14-year-old boy had a strong concussion in his forehead due to a motorbike accident. Slightly obtunded on admission showing GCS 10, he became conscious in several days. Head CT performed after 17 days showed a round air image in the right frontal lobe which kept increasing in size thereafter. Bilateral frontal craniotomy was performed 31 days after the injury. A craniodural defect with a herniated brain was found in the superior wall of the posterior ethmoid sinus and repaired. Case 2: A 55-year-old man received a left forehead concussion when his motorbike ran into a car from behind. Although he had been conscious ever since admission, head CT after 15 days showed a round air image in the left frontal lobe. MRI demonstrated the air to be located in the cerebral parenchyma distinctly and the brain to have herniated into the frontal sinus. As the air showed a tendency to increase in volume and mild psychic and memory disturbances appeared, bilateral frontal craniotomy was performed 34 days after the injury. A craniodural defect with a herniated brain was detected in the posterior wall of the frontal sinus and repaired. These two patients showed a small amount of cerebrospinal fluid (CSF) rhinorrhea before the operation. Following the surgical repair, no recurrence of pneumocephalus and CSF rhinorrhea has been seen in either case. Intracerebral pneumocephalus secondary to closed head trauma was thought to have been due to herniation of contused brain into a craniodural defect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[A nasal reconstruction via the expansion of the tissue].

The techniques that offer the best results in total nasal reconstruction are those that use frontal skin. Even if traditional procedures meet most of the reconstructive needs, they are often limited by the size of the tissues to be transplanted and by the scarring they leave in the donor area. The stiffness and scarce pliability of the frontal skin hinder fine modelling of the alae, of the columella and of the nasal tip. Expanded forehead flaps to day offer a substantial advantage. In the period from 1986 to 1991 total nasal reconstruction was performed in 12 patients (4 males and 8 females). Their ages ranged from 4 to 69 years. Four patients presented a recurrence of a basal cell carcinoma, 1 patient presented a trichoepithelioma. In 3 cases an arteriovenous vascular malformation was present, in 1 there were radiodermatitic lesions while in another 3 cases there was extensive scarring. In all cases a rectangular skin expander without base and with a remote filling port was used. The nominal volume ranged from 100 cc to 260 cc. All expanders were introduced through a vertical hair incision in the subgaleal plane, except in 1 case in which it was placed over the frontal muscle. The mean time of expansion was 79 day. The mean volume at the end of the expansion was 283 cc. The results obtained are presented and the advantages of the technique are exposed. These are: 1) the possibility of obtaining forehead flaps wide enough to cover large defects, 2) the direct closure of the donor area even if large flaps are raised, and 3) the improved pliability of the expanded frontal skin. A minor complication present in all the patients treated was moderate pain during inflation of the expander, easily controlled with common analgesics. A bony crest was frequently observed around the base of the skin expander which, however, was easily removed with a curette. Only in one case was a major complication observed; that of a preoperative infection necessitating removal of the expander, which was reapplied a few months later in order to complete the initial reconstructive program.

Adolescent↗