RESUMO
The authors report a new surgical technique of myoplasty of the temporalis muscle applied to the treatment of permanent peripheral facial paralysis. It consists of a muscle lengthening, using the totality of the temporalis muscle and the transfer of its tendon attached to the coronoid process directly to the lips, therefore modifying the temporal fixed point and respecting the deep temporal pedicles. Ten cadaver dissections were performed for a better understanding of the muscle fiber redistribution during surgery to measure the distance between coronoid process and lip commissure and to measure the width of the temporal tendon. The results in 10 patients have been very encouraging. This technique was performed on ten cases of permanent facial paralysis of various etiologies, by the same surgeon, with a 4-year follow-up.
Assuntos
Paralisia Facial/cirurgia , Lábio/cirurgia , Músculo Temporal/cirurgia , Adolescente , Adulto , Idoso , Expressão Facial , Paralisia Facial/etiologia , Paralisia Facial/fisiopatologia , Feminino , Humanos , Lábio/fisiopatologia , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Modalidades de Fisioterapia , Cuidados Pós-Operatórios , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/reabilitação , Técnicas de Sutura , Músculo Temporal/fisiopatologiaRESUMO
Sebaceous carcinoma of the eyelids is a rare malignancy of which most cases require extensive excision followed by usually complete eyelid reconstruction. We report a case developed from the Meibomius glands of the lower eyelid. Complete excision was achieved by removing the entire eyelid 'en bloc'. Reconstruction was with a composite, chondromucosal septal graft layered on an upper eyelid, musculocutaneous, transposition flap based on a lateral pedicle. After a brief review of the relevant literature, the advantages and disadvantages of the various methods of complete lower eyelid reconstruction are discussed.
Assuntos
Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/cirurgia , Blefaroplastia/métodos , Neoplasias Palpebrais/diagnóstico , Neoplasias Palpebrais/cirurgia , Glândulas Tarsais , Neoplasias das Glândulas Sebáceas/diagnóstico , Neoplasias das Glândulas Sebáceas/cirurgia , Retalhos Cirúrgicos , Idoso , Biópsia , Humanos , Masculino , Septo Nasal/transplante , Tomografia Computadorizada por Raios XRESUMO
We present a case report of an anterior gingival epithelioma cuniculatum in place of teeth 41 and 42, with osseous mandibular extension for which a one time reconstruction with an osteocutaneous free fibula flap was performed with three dental osseointegrated implants. We reviewed the literature on this type of carcinoma and discuss the diagnosis difficulty. Radical surgical treatment is required.
Assuntos
Carcinoma Verrucoso/patologia , Neoplasias Gengivais/patologia , Neoplasias Mandibulares/patologia , Transplante Ósseo/métodos , Carcinoma Verrucoso/cirurgia , Implantação Dentária Endóssea , Implantes Dentários , Feminino , Fíbula , Seguimentos , Neoplasias Gengivais/cirurgia , Humanos , Neoplasias Mandibulares/cirurgia , Pessoa de Meia-Idade , Invasividade Neoplásica , Transplante de Pele/métodos , Retalhos CirúrgicosRESUMO
We report on Gorlin-Goltz syndrome observed in 4 patients belonging to three generations of the same family. We present the clinical findings and emphasize recent genetic discoveries. We discuss the difficulty in following these patients and propose a series of simple explorations which can be helpful.