Facial plastic surgery and face recognition algorithms: Interaction and challenges. A scoping review and future directions.

INTRODUCTION: Face recognition (FR) technology can be used in wide range of applications such as identity authentication, access control, and surveillance. Interests and research activities in face recognition have increased significantly over the past twenty years. Plastic surgery procedures can significantly alter facial appearance, thereby posing a serious challenge even to the state-of-the-art face matching algorithms. The purpose of this work was to detail the interaction between facial plastic surgery and facial recognition software and discuss the new challenges of this interaction. MATERIAL AND METHODS: The authors critically reviewed the literature from January 2000 to September 2019, to identify articles reporting interactions between facial plastic surgery and facial recognition algorithms and discuss the new challenges of these interactions. Controlled vocabulary terms and keywords were used in the search strategy and two authors independently analyzed data. Factors included in the analysis were: Author, Journal, Year, Scope, Study design, Plastic surgery, Data (volume, origin and processing), Identification accuracy and Conclusion (interaction/challenge). RESULTS: Forty-three research articles underwent data extraction and 28 articles were included in quantitative synthesis. Of the 28 articles, the most common study designs were experimental evaluation (n=15, 53,5%), Evaluation Study studies (n=7, 25%) and Review studies (n=4, 14,3%). Fifty percent of the articles have been published in the last 4 years (14 articles, 50%). Most of the study scope was informatics (64,3%). Only 10 articles were published in medical journals. Rhytidectomy (face lift) is the most challenging procedure for the FR algorithms. Data volume varied from 4 to 2878 subjects. The proposed algorithms provide at least 15 to 99% better identification performance. Among these, only two papers discuss the new challenges of the interaction between facial plastic surgery and Face Recognition Algorithms. CONCLUSION: In the context of advances in artificial intelligence, Internet connectivity and data integration, the purpose of this review is, to look forward to analyze the new interactions of facial plastic surgery and facial recognition algorithms, and to suggest avenues for future research and clinical application of this technology. Furthermore, to evaluate if plastic surgeons are prepared to discuss this technology with their patients. Plastic surgeons should be prepared to answer questions from patients about the fundamentals of facial recognition technology, and the potential effects of plastic surgery on facial recognition technology performance. Continued efforts are needed to provide scientifically rigorous data of facial biometric identification after facial plastic surgery and to include these notions in the routine consultation or consent process for patients seeking aesthetic facial surgery.

Endoscopic resection of forehead osteomas: Technical notes.

INTRODUCTION: Forehead osteoma is an uncommon benign bone tumor that causes cosmetic disfigurement and occasional pain. Traditional excision directly over the lesion creates a visible scar on the forehead. PROCEDURE: We describe a method of endoscopic resection of the forehead osteoma, via incisions within the hairline. The access incision was hidden behind the frontal hairline and the dissection plane went in the subperiosteal layer. The injury of the nerve branch and vessel can be easily avoided and endorsed by manipulating the endoscope. CONCLUSION: Aesthetic considerations are important features in the craniomaxillofacial region. Especially for patients who are not willing to accept the risk of a prominent forehead scar. Endoscopic resection of forehead osteomas might be a useful tool in forehead osteoma resections. It might be an alternative tool in an Oral and Maxillofacial Surgeon's and in a Plastic Surgeon's repertoire.

Nose burns: 4-dimensional analysis.

The nose is the central organ of the face. It has two essential roles, aesthetic and breathing. It is often seriously damaged in the context of facial burns, causing grotesque facial disfigurement. As this disfigurement is visible on frontal and profile views, the patient suffers both socially and psychologically. The nose is a three-dimensional organ. Reconstruction is therefore more difficult and needs to be more precise than in other parts of the face. Maintaining symmetry, contour and function are essential for successful nasal reconstruction. Multiple factors determine the optimal method of reconstruction, including the size of the defect, its depth and its site. Satisfactory social life is recovered only after multiple surgical procedures and long-term rehabilitation and physiotherapy.

[Treatment of recurrent temporomandibular dislocation by displacement of the zygomatic arch: a modification of Gosserez and Dautrey's technique]. / Traitement de la luxation temporo-mandibulaire récidivante par abaissement de l'arcade zygomatique: modification de la technique de Gosserez et Dautrey.

INTRODUCTION: Many methods have been reported for the surgical treatment of recurrent anterior temporomandibular dislocation. Most of these techniques are designed to limit the forward migration of the condylar head. The great number of surgical techniques experimented illustrates the difficulty to find a satisfactory method for the treatment of these recurrent dislocations. TECHNICAL NOTE: We present a modification of Gosserez and Dautrey's surgical technique for the treatment of recurrent anterior temporomandibular joint dislocation. DISCUSSION: The surgical technique is described and its indications are discussed.

[Tongue base schwannoma in a child]. / Schwannome de la base de la langue chez l'enfant.

INTRODUCTION: A schwannoma is a benign slow growing tumor originating from the peripheral nerve sheath. Its tongue base location is extremely rare, especially in very young patients. CASE REPORT: A 15-year-old female patient was admitted in emergency for moderate hematemesis. The clinical examination revealed swelling of the tongue base, causing the bleeding. This lesion had appeared when she was 3years of age and no treatment was done. A complete surgical excision was performed and the histopathological examination allowed diagnosing a tongue base schwannoma. The postoperative outcome was uneventful, and no recurrence was detected 6months after surgery. DISCUSSION: The particularities of this report are the patient's very young age and the tumor's tongue base location. The prognosis is usually good after complete excision, if there is only one tumor. Type 2 neurofibromatosis should be excluded, given the risk of malignant degeneration.

[Comparative study of C-reactive protein and procalcitonin in the severity diagnosis of pyelonephritis in children]. / Étude comparative de la protéine C-réactive et de la procalcitonine dans le diagnostic de sévérité des pyélonéphrites aiguës de l'enfant.

OBJECTIVE: The aim of this study is to compare two biologic parameters; C-reactive protein (CRP) and procalcitonin (PCT) in the detection of acute renal lesions assessed by DMSA scintigraphy in the urinary tract infection in child. DESIGN: In a prospective study, serum PCT, CRP and leukocyte counts were measured for children admitted, between January and December 2010, with a first episode of febrile urinary tract infection. RESULTS: Seventy-five children were enrolled in the study. Thirty-three patients had renal lesions (group A) and 42 had a normal DMSA scintigraphy (group B). The mean PCT level was significantly higher in group A than in group B (8.81 ng/mL versus 1.7 ng/mL, P=0.01). In this study, using receiver operating characteristic (ROC) curve, we identified that the optimal cut-off value with ideal sensitivity and specificity for PCT in detection of renal lesions was 0.76 ng/mL and for CRP, it was 70 mg/L. The sensitivity, the negative predictive value and the indice of Youden of the cut-off value of PCT were significantly higher than CRP (82% versus 70%; 84% versus 70% and 0.58 versus 0.25). CONCLUSIONS: This study confirmed that the serum PCT level was more sensitive and specific than the CRP in the detection of renal lesions in the first urinary tract infection in child.

Cervical unicentric Castleman's disease in children.

INTRODUCTION: Unicentric Castleman's disease (CD) is a rare benign lymphoproliferative disorder. A cervical location has rarely been reported in the pediatric literature. CASE REPORT: A 13-year-old boy presented with a mass in the right neck region of 3 months' evolution. Clinical examination revealed a smooth mobile 5 cm node deep in the sternocleidomastoid muscle. The diagnosis of hyaline vascular type CD was confirmed by complete surgical excision and histopathologic examination. Postoperative course was simple, without recurrence over 1 year's follow-up. DISCUSSION AND CONCLUSION: Cervically located CD often shows few symptoms, and is rarely suggested by a cervical mass found in children. Definitive diagnosis is histopathological. The hyaline vascular type of unicentric CD has a good prognosis after complete resection of the lesion.

[Hepatopulmonary syndrome: a complication of type 1 Gaucher disease]. / Syndrome hépatopulmonaire: une complication de la maladie de Gaucher de type 1.

Gaucher's disease is a not exceptional lysosomial disease in Tunisia. Type 1 is by far the most common one. Pulmonary involvement is considered to be rare in type 1 Gaucher's disease. Pulmonary hypertension, infiltration of the lungs with Gaucher cells, and severe hypoxemia due to intrapulmonary arterial-venous shunts, have been described in case reports and small case series. We reported the case of hepatopulmonary syndrome in a 14-year-old boy with type 1 Gaucher disease. The diagnosis of Gaucher disease was established, at 2 years age, by enzyme assay of leucocyte ß-glucosidase. The patient presented dyspnoea, digital clubbing and cyanosis of the lips. The arterial blood gas found severe hypoxaemia with PaO(2) at 56.9 mmHg. The diagnosis of hepatopulmonary syndrome, in our patient, was confirmed by demonstration of the intrapulmonary shunting using contrast-enhanced echocardiography and the technetium-99m-labeled macroaggregated albumin. The patient was treated by symptomatic measure, long term oxygen therapy because the insufficiency of the enzyme replacement therapy. Screening for hypoxemia in children with liver disease should be considered.

[Weight variation after reduction mammary surgery: retrospective study of 100 cases]. / Profil pondéral après chirurgie mammaire de réduction: étude rétrospective à propos de 100 cas.

INTRODUCTION: Patients desiring breast reduction are often in overweight, and describe interferences with their daily life and minor psychological problems. We undertook this study to establish the pre- and postoperative weight pattern by age and histological breast type. PATIENTS AND METHODS: A retrospective review was performed on 100 consecutive patients who underwent bilateral reduction mammaplasty for macromastia (>300g per breast) in 2007. The patients were categorized by age in two groups: group 1 (G1) comprising the 50 younger patients (mean age: 35.5 years) and group 2 (G2) comprising the 50 older (mean age: 47.2 years). We obtained data points including: preoperative and postoperative weight pattern according to age and histological subtypes, calculation of body mass index (BMI), data from surgery including amount of resection, postoperative course and complications. RESULTS: Patients consulting for breast reduction are moderately overweight (mean BMI: 28.22 confounded all ages). Preoperative weight loss is low despite systematic surgeon request (<0.5 % on average waiting time of 6.45 months). The postoperative weight loss is higher in young patients with glandular form of HTM (respectively -4.76 kg for glandulofibrous type and -3kg for fibrous, which corresponds to a loss of 6.5 and 4.1 % of their body weight). The impact of surgery on the patient's psychological condition is better in young patients. CONCLUSION: This study demonstrated that postoperative weight loss after breast reduction are significant only in young patients with a constitutional type of macromastia (glandular or mixed forms). We believe that in addition to the functional improvement associated with surgery, these young patients lose weight they initially take to harmonize their silhouette.

[Facial infantile aggressive fibromatosis: a frequent localization of an exceptional tumor!]. / La fibromatose agressive faciale chez l'enfant: une localisation fréquente d'une tumeur exceptionnelle !

INTRODUCTION: Although fibromatosis is considered as benign tumor, it can have significant morbidity, particularly when it occurs in the head and neck. Their propensity for infiltrative local growth with encroachment on vital structures and their tendency to recur make fibromatoses of the head and neck extremely challenging lesions. CASE REPORT: We report the case of a 10-year-old boy with desmoid fibromatosis of the upper lip. For this patient, the medical treatment has been decided to avoid a mutilating surgery. He had a good result with chemotherapy using methotrexate and vinblastine. DISCUSSION: According to the literature, surgery is the most common treatment of fibromatosis in the head and neck region. However, particularly in children, alternative modes of therapy must be considered because of the high recurrence rate and to avoid mutilating operations. Chemotherapy using methotrexate and vinblastine may be a reasonable choice.

[Surgical treatment of sequelae of deep breast burns: a 25-year experience]. / Traitement chirurgical des séquelles de brûlures profondes du sein : 25ans d'expérience.

INTRODUCTION: Deep chest burns in prepubescent girl prevent the development of the mammary gland, because scar contracture becomes an inextensible envelope. In adults, scar contracture can deform the breast shape. The aim of this work is to define the interest of tissue expansion in breast reconstruction of prepubescent's and adult's post-burns scars. PATIENTS AND METHODS: We conducted a 25-year retrospective study including patients treated surgically for deep thoracomammary burns. We studied following parameters: surgical techniques step by step, average time between each intervention, and morphologic and aesthetic results achieved. RESULTS: Twenty-eight patients have been operated between 1983 and 2008. Each patient has been operated on average 4.5 times (two to 12 times) during 6.3 years on average (1-19 years). Adult patients have showed a higher number of response (5.5 on average) than prepubescent girls (2.4 on average). Number of skin expansion has been 1.2 (0 to three) per patient. Sixty-two expanders have been placed (one to eight), 390cm(3) volume on average (180-1200). Delay of skin expansion has been about 7 months (4-10). Twenty-five breast implants have been raised on average 11 months (6-17) after debridement. Three changes of breast implant have occurred on average 5.3 years after insertion (3-8). Reconstruction of the areolonipple complex and controlateral symetrisation were conducted generally in the same time, 1 year after the last intervention. All patients will receive the possible additional volume (breast implant). Alternatives in breast volume reconstruction are lipomodelling and musculocutaneous expanded flaps. They are also discussed. Breast reconstruction in post-burns scars give clever cosmetic and morphologic despite of breast shape imperfections and apparent scars persistence satisfied cosmetic and morphologic results. These results, analyzed over a period of 25 years, show a qualitative change and decreased postoperative complications. DISCUSSION: Locoregional tissue expansion provide very clever results. In pre-pubescent grils, skin expanded flaps allow a near-normal mammary gland development. In adult women, they make the envelope that will receive the possible additional volume (breast implant). Alternatives in breast volume reconstruction are lipomodelling and musculo-cutaneous expanded flaps. They are also discussed. Breast reconstruction in post-burns scars give clever cosmetic and morphologic despite of breast shape imperfections and apparent scars persistence.

[Fat grafting in facial burns sequelae]. / La lipostructure dans les séquelles de brûlures faciales.

INTRODUCTION: Fat graft is now part of the armamentarium in face plastic surgery. It is successfully used in burn scars. The aim of our study is the discussion of the value of this technique in optimizing cosmetic result of burns face sequelae. PATIENTS AND METHOD: Fifteen adult patients (10 females and five males) with scars resulting from severe burns 2 to 9 years previously were selected. The patients were treated by injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman's technique. Two to three injections were administered at the dermohypodermal junction. Ages, sexes, aetiology of burn, facial burn sequelae, recipient sites, quantity of fat injected, aesthetic results are discussed. RESULTS: Patient age ranged from 21 to 55 years (average: 38). The mean follow-up of the study was 66 months (23-118). Patients received 7.5 (5-11) facial restorative surgeries before fat graft. Patients underwent two sessions of fat transfer, 33cc average per session. We did not report any complications. The clinical appearance, discussed by three surgeons and subjective patient feelings, after a 6-month follow-up period, suggests considerable improvement in the mimic features, skin texture, and thickness. The result is good in 86% of cases and acceptable in the other cases. DISCUSSION: Burns sequelae offer local conditions which justify special cannula can cross fibrosis and explaining the value of multiplying the sessions. Indications for lipostructure include four distinct nosological situations, sometimes combined. Lipostructure can restore a missing relief, filling a localized depression, reshape a lack of face volume or smooth a scarring skin. CONCLUSION: Fat graft seems to complete and improve the results of the standard surgical approach in burned face.

A c.3216_3217delGA mutation in AGL gene in Tunisian patients with a glycogen storage disease type III: evidence of a founder effect.

Glycogen storage disease type III (GSD III) is an autosomal recessive disorder characterized by excessive accumulation of abnormal glycogen in the liver and muscles and caused by deficiency in the glycogen debranching enzyme, the amylo-1,6-glucosidase (AGL). In this study, we report the clinical, biochemical and genotyping features of five unrelated GSD III patients coming from the same region in Tunisia. The concentration of erythrocyte glycogen and AGL activity were measured by colorimetric and fluorimetric methods, respectively. Four CA/TG microsatellite markers flanking the AGL gene in chromosome 1 were amplified with fluoresceinated primers. The full coding exons and their relevant exon-intron boundaries of the AGL gene were directly sequenced for the patients and their parents. All patients showed a striking increase of erythrocytes glycogen content. No AGL activity was detected in peripheral leukocytes. Sequencing of the AGL gene identified a c.3216_3217delGA (p.Glu1072AspfsX36) mutation in the five patients which leads to a premature termination, abolishing the AGL activity. Haplotype analysis showed that the mutation was associated with a common homozygote haplotype. Our results suggested the existence of a founder effect responsible for GSD III in this region of Tunisia.

Asymptomatic carriage of Leishmania in family members of patients with visceral leishmaniasis in Central Tunisia.

INTRODUCTION: In Tunisia, asymptomatic carriage of Leishmania is poorly documented. OBJECTIVE: The aim of the present study was to estimate the frequency of asymptomatic infection among the family members of patients with patent visceral leishmaniasis by using the Western blotting kit based on 14 and 16kDa bands. MATERIAL AND METHODS: We tested 94 sera collected from 24 patients with patent visceral leishmaniasis and 70 from their families' members. RESULTS: The rate of seropositivity was 100% in the group of patients and 54.3% in the group of families' members. The analysis of the Western blotting patterns showed that the 33kDa, 24kDa and to a lesser extent the 22kDa band were very indicative of patent visceral leishmaniasis in contrast to asymptomatic infection where these bands were very rarely detected. CONCLUSION: The results reported herein showed the high frequency of asymptomatic carriers of Leishmania among the families' members of visceral leishmaniasis cases and the usefulness of the Western blotting as a screening technique and in distinguishing between patent visceral leishmaniasis and the asymptomatic carriage of Leishmania.

Digestive malacoplakia in children: case report.

Malacoplakia is a form of chronic granulomatous inflammatory reaction that rarely affects the pediatric age group. The gastrointestinal system is the second most common site for the occurrence of malacoplakia. We report the case of a 9-year-old girl who was hospitalized for abdominal pain, chronic diarrhea, and rectal hemorrhage. The endoscopic examinations and histopathology confirmed the diagnosis of intestinal malacoplakia. We successfully treated her with oral levofloxacin. This disease does not have any specific clinical or biological signs, and the diagnosis is exclusively based on histology.

[Eagle syndrome: a rare and atypical pain!]. / Le syndrome d'Eagle: une douleur mal connue et mal reconnue!

The styloid process projects down and forward from the inferior surface of the petrous bone. It arises from the second branchial arch. Its average length ranges from 22 to 33 mm. The styloid process hypertrophy, or Eagle syndrome, may be a source of cervicofacial pain and is very difficult to diagnose. The pathogenesis of this abnormality is unknown. Traumatic origin is usually admitted even if recent embryological data suggest a genetic origin with interindividual variations. The diagnosis is made on several elements: exacerbated cervical pain on neck hyperextension and sudden head movements, typical pain caused by palpation of the tonsillar fossa, diagnostic test with xylocain, and radiological investigation. Treatment is surgery and exeresis of the styloid process via a transoral or cervical approach.