Combined pulsed dye laser and Q-switched Nd:YAG laser intraumatic facial tattoo removal: A case series.

Traumatic tattoos can be treated with several methods, including mechanical and chemical devices. However, they are rarely used due to the high risk of permanent side effects such as scarring and depigmentation. Recently, laser devices, especially the Q-switched (QS) laser and the pulsed dye laser (PDL), applied in combination, have achieved complete clearance of the lesions without any risk of side effects. Herein, we reported three cases of traumatic facial tattoos successfully treated with combined PDL and QS Nd:YAG laser.

Management of chronic posttraumatic headache: a multidisciplinary approach.

Although the definitions and possible treatments of posttraumatic headache have been discussed in the literature, treatment of this condition is not standardized. In addition, though various reviews and case studies have supported the use of spinal manipulation in the treatment of tension-type headaches and migraines, few describe the use of osteopathic manipulative treatment for patients with posttraumatic headache. In describing a 38-year-old woman with posttraumatic headache, we illustrate a multidisciplinary approach-including the use of osteopathic principles and practice-to treating patients with posttraumatic headache.

Facial scars after a road accident--combined treatment with pulsed dye laser and Q-switched Nd:YAG laser.

We report the case of a woman who presented with several facial scars following a road accident. Treatment was carried out using combined laser treatment with pulsed dye laser (PDL) and Q-switched neodymium:yttrium-aluminum-garnet laser (QS Nd:YAG laser). No side effects or complications from treatment were noted or reported. The patient had very good cosmetic results with this combined technique. A variety of facial scars - erythematous, pigmented, atrophic, and hypertrophic - may occur as a result of trauma, surgery, burns, and skin disease. Surgery with other adjunctive methods including radiotherapy, intralesional steroids, and pressure therapy have shown variable results. Laser treatment has been attempted for scar revision since the 1980s. The PDL is the optimal treatment for reducing scar bulk and symptoms. It also decreases erythema and telangiectasia associated with scars, normalizes the skin surface texture, and improves the scar pliability. The QS Nd:YAG laser (1064 nm) is highly effective for traumatic tattoo removal, resulting in complete clearance in the majority of cases.

Unusual case of resistant actinomycosis following facial trauma.

A case of actinomycosis is reported which appeared as a complication of a ski-pole injury of the face. A 16-year-old girl was treated for 10 years for resistant actinomycosis. She took long-term antimicrobial therapies, underwent repeated excisions, hyperbaric oxygen therapy, repeated skin grafting, immunological treatment, and free flap transfer. The conservative antibiotic treatment was complicated by mycosis and pseudomembranous colitis. After the defect healed up, satisfactory contour of the face was restored with additional free flap transfer. The patient has also been satisfied with the final aesthetic result. The authors highlight the importance of early diagnosis and proper antimicrobial treatment in combination with surgical excisions of granulation tissue preserving vital structures.

Artistic assault: an unusual penetrating head injury reported as a trivial facial trauma.

The authors report a case of penetrating head injury that presented with a deceptively mild complaint. To our knowledge, it is the first report of a paint brush penetrating the brain. The patient reported being punched in the left eye and presented with a minor headache, swelling around the left orbit, a small cut on the cheek and slightly reduced left eye abduction. After radiological evaluation, a penetrating head injury was diagnosed. Under general anesthesia, through a lateral eyelid incision a 10.5 cm long paint brush, which had penetrated from the left orbit to the right thalamus, was removed. No post-operative infection was seen at six months follow-up. This brief report serves to highlight that penetrating brain injury can occur without neurological deficit and that a minimally invasive surgical approach was successful in avoiding any complications.

Salvage of partial facial soft tissue avulsions with medicinal leeches.

BACKGROUND: Medicinal leeches have been demonstrated to be extremely useful and safe in the salvage of venous outflow compromised tissue, particularly in digit replants and various forms of flaps. OBJECTIVE: To demonstrate the utility of medicinal leeches in the salvage of venous outflow-compromised traumatic soft tissue avulsions in key facial structures. METHODS: A retrospective review of 4 cases involving the external ear, nose, lip, and scalp in which apparent venous outflow compromise was present. Medicinal leeches were applied acutely in each of these 4 cases, salvaging each of the partially avulsed soft tissue segments. RESULTS: Complete or near complete salvage of each soft tissue segment after using medicinal leeches. CONCLUSIONS: Although it is unusual for a partial soft tissue avulsion of the face to require medicinal leech therapy, situations may occur in which there is adequate arterial inflow but inadequate venous outflow. In such cases, medicinal leeches may play a very important role in salvaging the soft tissue segment. This is particularly important in vital structures such as the ear, nose, lip, and eyelid in which acute or secondary reconstruction is complex. EBM RATING: C.

[Treatment of atypical post-traumatic and postoperative facial neuralgias by chronic stimulation. Apropos of 2 cases, with review of the literature]. / Traitement des névralgies faciales atypiques post-traumatiques et postopératoires par stimulation chronique. A propos de deux cas, avec revue de la littérature.

This article describes the case of two patients suffering from deafferentation pain after surgery or traumatic lesions in the area of the peripheric trigeminal branches on the Gasserian ganglion. Chronic electrical stimulation by an electrode implanted in the Gasserian ganglion led to a good permanent result in both cases, within a follow-up period of one year and one year and a half, respectively. The pre-operative test was carried out percutaneously via the foramen ovale, the definitive implantation by surgery with subtemporal access. This method can only be used when at least part of the ganglion cells of the Gasserian ganglion are intact. According to identical observations by other authors, it is mostly adequate for surgical and traumatic trigeminal lesions, whereas for pain due to herpes zoster, the stimulation of specific thalamus nuclei is a much better method.