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3.
Plast Reconstr Surg ; 145(3): 764-773, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32097322

RESUMEN

BACKGROUND: Psychosocial distress in children with craniofacial anomalies is multifactorial. A known cause of childhood psychosocial distress is parental limited English proficiency; however, its role as a psychosocial stressor in the craniofacial anomaly population remains unknown. The current study aimed to understand the potential influence of parental English proficiency in children with craniofacial anomalies. METHODS: Two hundred ninety-six children were prospectively evaluated at the University of California, Los Angels and the Orthopaedic Institute for Children using the Pediatric Patient-Reported Outcomes Measurement Information System to assess anger, anxiety, depression, and peer relationships. Children were grouped by parental English proficiency based on the requirement or lack thereof for interpreting services during clinic appointments. Independent t tests, analyses of variance, and linear regressions were performed to compare groups and identify predictors for psychosocial functioning. RESULTS: Although comparison children did not exhibit any differences in psychosocial scores with respect to parental English proficiency, craniofacial anomaly children with parents who have limited English proficiency demonstrated higher anger, anxiety, depression, and lower peer relationships compared with those with parents who are English proficient. Linear regression analyses demonstrated that limited English proficiency in parents was a significant predictor for anger (p = 0.005), anxiety (p = 0.002), depression (p < 0.001), and poor peer relationships (p < 0.001) in children with craniofacial anomalies. CONCLUSIONS: Parental English proficiency is associated with increased psychosocial distress in children with craniofacial anomalies. Future efforts toward identification of and assistance for parents with limited English proficiency to address barriers to care may improve psychosocial function in children with craniofacial anomalies. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.


Asunto(s)
Anomalías Craneofaciales/psicología , Dominio Limitado del Inglés , Padres , Estrés Psicológico/diagnóstico , Adolescente , Ira , Ansiedad/diagnóstico , Ansiedad/psicología , Niño , Depresión/diagnóstico , Depresión/psicología , Femenino , Hispanoamericanos/psicología , Humanos , Relaciones Interpersonales , Masculino , Medición de Resultados Informados por el Paciente , Grupo Paritario , Estudios Prospectivos , Autoinforme , Estrés Psicológico/psicología
6.
Plast Reconstr Surg ; 145(1): 175-183, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31881620

RESUMEN

BACKGROUND: Understanding and optimizing psychosocial functioning in children with craniofacial anomalies are essential components of their reconstructive care. This work compared parental perceptions to pediatric self-reported psychosocial functioning in children with craniofacial anomalies. METHODS: Two hundred twenty-one children with craniofacial anomalies (aged 8 to 17 years) and their parents were prospectively evaluated at two institutions using the parent-proxy and pediatric Patient-Reported Outcomes Measurement Information System to assess anger, anxiety, depression, and peer relationships. Children were stratified into three age groups: group A, 8 to 10 years; group B, 11 to 13 years; and group C, 14 to 17 years. Pearson correlations, analyses of variance with post hoc comparisons under the Tukey criterion, and paired samples t tests were performed. RESULTS: When stratified by age, no correlations between parent and child reports were found in anxiety for group A and anger, anxiety, and peer relationships for group C. Whereas group A reported the worst psychosocial functioning, group C parents perceived their children to have the worst psychosocial functioning. Group A parents perceived lower depression and better peer relationships, whereas group C parents perceived higher anxiety and depression compared to self-reports. CONCLUSIONS: Parents perceived an inverse relationship between age and psychosocial functioning compared to self-reports by children with craniofacial anomalies. These discrepancies in the current work highlight the importance of child self-report and suggest incorporating longitudinal patient-reported and parent-proxy-reported outcomes measures for psychosocial functioning as part of standard clinical care for patients with craniofacial anomalies.


Asunto(s)
Adaptación Psicológica , Anomalías Craneofaciales/psicología , Padres/psicología , Medición de Resultados Informados por el Paciente , Adolescente , Factores de Edad , Ira , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/psicología , Niño , Anomalías Craneofaciales/complicaciones , Depresión/diagnóstico , Depresión/etiología , Depresión/psicología , Femenino , Humanos , Relaciones Interpersonales , Masculino , Estudios Prospectivos , Psicometría , Calidad de Vida , Autoinforme/estadística & datos numéricos
7.
Ann Plast Surg ; 84(1): 117-122, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31633539

RESUMEN

BACKGROUND: The fibula free flap (FFF) remains the criterion standard for complex mandibular reconstruction. Surgeons have incorporated virtual surgical planning (VSP) into the reconstructive algorithm with the assertion that VSP increases operative efficiency and may improve clinical outcomes. To date, no large-scale studies have analyzed these claims. This study examines the literature and tests the hypothesis that VSP improves operative efficiency, clinical outcomes, and accuracy when compared with traditional techniques. METHODS: A systematic review was performed to identify articles utilizing VSP and traditional techniques for FFF-based mandibular reconstruction. Two reviewers independently assessed all articles for methodological quality using a validated instrument (weighted Cohen κ for interrater reliability = 0.70). Outcomes included operative time, length of stay, complications, and accuracy. Meta-analytic comparisons were performed using data from comparative studies using a random-effects model and differences of means analysis for outcomes measured on identical scales. RESULTS: One hundred thirty-one articles were identified, and 25 met the inclusion criteria: 12 were VSP only, whereas 13 were comparative. There were 241 VSP patients and 214 traditional patients available for meta-analysis. Patients undergoing reconstruction with VSP had a significant reduction in operative time by 44.64 minutes (95% confidence interval [CI], -74.69 to -14.58 minutes; P < 0.01) and demonstrated a mean trend toward shorter hospital admission (mean difference, -1.24 days; 95% CI, -4.00 to 1.52 days; P = 0.38). There was no statistical difference between cohorts for major (odds ratio, 1.03; 95% CI, 0.46-2.31; P = 0.95) or minor complications (odds ratio, 0.97; 95% CI, 0.54-1.71; P = 0.90). Insufficient data were available for cost analysis and accuracy. CONCLUSIONS: Virtual surgical planning-guided mandibular reconstruction with FFF is associated with significantly decreased operative time and a mean trend toward shorter hospital admission. While multiple studies reported a high degree of accuracy, no standard measurement was available for meta-analysis.

10.
Plast Reconstr Surg ; 143(3): 572e-580e, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30601327

RESUMEN

BACKGROUND: The intermediate cleft tip rhinoplasty is performed in childhood to address residual tip asymmetries during the most critical period of psychosocial development. The authors describe and evaluate long-term outcomes of that approach for the unilateral cleft lip and palate patient based on the concept of individual restoration of each abnormal anatomical component. METHODS: Photomorphometric analyses of unilateral cleft lip and palate patients (n = 50) who underwent intermediate cleft tip rhinoplasty using the component restoration technique were evaluated preoperatively (time 0) and postoperatively at less than 1 year (time 1), 1 to 3 years (time 2), and more than 3 years (time 3) and compared to age-matched unilateral cleft lip and palate control patients. Nasal relationships (alar symmetry, nasal tip protrusion-to-alar base width ratio, and height-to-width dimensions for the cleft and noncleft nostrils) were compared over time using a linear mixed-effect model. RESULTS: At time 0, both groups demonstrated similar nasal relationships, with the exception of a wider cleft-side nostril in relationship to height in the rhinoplasty group. The component restoration technique improved all four nasal relationships at all postoperative time points compared with time 0 in a statistically significant manner, whereas control patients did not demonstrate significant changes at the corresponding ages. Long-term differences at time 3 revealed a trend toward improved alar symmetry and cleft-side and non-cleft-side nostril dimensions, and a significant improvement in the nasal tip protrusion-to-alar base width ratio in intermediate cleft tip rhinoplasty-treated versus control patients (p = 0.002). CONCLUSION: The component restoration technique for the unilateral intermediate cleft tip rhinoplasty improves nasal relationships toward normal immediately and in a sustained manner for at least 3 years. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Asunto(s)
Labio Leporino/complicaciones , Fisura del Paladar/complicaciones , Cartílagos Nasales/anomalías , Enfermedades Nasales/cirugía , Rinoplastia/métodos , Niño , Preescolar , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Femenino , Humanos , Masculino , Cartílagos Nasales/diagnóstico por imagen , Cartílagos Nasales/cirugía , Enfermedades Nasales/diagnóstico por imagen , Enfermedades Nasales/etiología , Enfermedades Nasales/psicología , Fotograbar , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
11.
J Vasc Surg ; 68(6S): 222S-233S.e1, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30126780

RESUMEN

OBJECTIVE: The tumor suppressor protein p53 regulates angiogenesis and is a key regulatory mediator of cellular apoptosis, proliferation, and growth. p53 expression is induced in response to ischemia; however, its role in regulating ischemia-induced angiogenesis and arteriogenesis remains undefined. The objective of this study was to define the role of p53 in regulating ischemia-induced angiogenesis and arteriogenesis and to identify mechanisms by which this regulation occurs in vivo. METHODS: Surgically induced hindlimb ischemia or mesenteric artery ligation was performed in wild-type (p53+/+) and p53 knockout (p53-/-) mice. Limb perfusion and revascularization were assessed by laser Doppler perfusion imaging, capillary density, and collateral artery development. Mesenteric collateral artery flow and development were determined by arterial flow measurement and by histologic analysis, respectively. An in vitro aortic ring assay was performed on p53+/+ and p53-/- aortic tissue to evaluate endothelial function. The p53 inhibitor and activator pifithrin-α and quinacrine, respectively, were used to modulate p53 activity in vivo after ischemia. RESULTS: Absence of p53 in mice resulted in increased limb perfusion (P < .05), capillary density (P < .05), and collateral artery development (P < .05) after induction of hindlimb ischemia. In the nonischemic mesenteric artery ligation model of arteriogenesis, p53 expression was induced in collateral arteries and increased arterial blood flow in mice lacking p53 (P < .05). Lack of p53 decreased apoptosis in ischemic hindlimb tissue (P < .05) and increased proangiogenic factors hypoxia-inducible factor 1α and vascular endothelial growth factor (VEGF). Endothelial cell outgrowth in vitro increased in the absence of p53 (P < .05). Pharmacologic augmentation of p53 expression after ischemia impaired perfusion and collateral artery formation and decreased VEGF levels (P < .05). Conversely, inhibition of p53 with pifithrin-α augmented limb perfusion (P < .05) and collateral artery formation (P < .05) and increased protein levels of hypoxia-inducible factor 1α and VEGF. Pharmacologic augmentation and inhibition of p53 had no significant effect in mice lacking p53. CONCLUSIONS: p53 negatively regulates ischemia-induced angiogenesis and arteriogenesis. Inhibition of p53 increases ischemia-induced arteriogenesis and limb perfusion and thus represents a potential therapeutic strategy for arterial occlusive disease.


Asunto(s)
Músculo Esquelético/irrigación sanguínea , Neovascularización Fisiológica , Daño por Reperfusión/metabolismo , Proteína p53 Supresora de Tumor/metabolismo , Inductores de la Angiogénesis/farmacología , Inhibidores de la Angiogénesis/farmacología , Animales , Benzotiazoles/farmacología , Velocidad del Flujo Sanguíneo , Circulación Colateral , Modelos Animales de Enfermedad , Células Endoteliales/metabolismo , Miembro Posterior , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Ratones de la Cepa 129 , Ratones Endogámicos C57BL , Ratones Noqueados , Neovascularización Fisiológica/efectos de los fármacos , Quinacrina/farmacología , Flujo Sanguíneo Regional , Daño por Reperfusión/patología , Daño por Reperfusión/fisiopatología , Daño por Reperfusión/prevención & control , Transducción de Señal , Técnicas de Cultivo de Tejidos , Tolueno/análogos & derivados , Tolueno/farmacología , Proteína p53 Supresora de Tumor/agonistas , Proteína p53 Supresora de Tumor/antagonistas & inhibidores , Proteína p53 Supresora de Tumor/genética , Factor A de Crecimiento Endotelial Vascular/metabolismo
12.
Ann Plast Surg ; 81(4): 475-481, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30059386

RESUMEN

BACKGROUND: A key educational component of the integrated plastic and reconstructive surgery (PRS) training model is the prerequisite, or core, experiences. The aim of this study is to assess the integrated PRS residents' experience with this early part of training. METHODS: A 20-question survey was developed and piloted before deployment to integrated PRS training programs from 4 United States Census regions. Respondents were asked to characterize their prerequisite clinical and operative experiences. Results were analyzed using pairwise correlation statistics and logistic regression modeling following Bonferroni correction for multiple hypothesis testing. RESULTS: One hundred ninety six residents (22 programs) participated in the study (response rate, 65.3%). The majority of residents were satisfied with their prerequisite experiences. Most did not take the American Board of Surgery In-Training Examination, which was perceived as noncontributory to PRS training. The majority of residents preferred to have fewer prerequisite experiences. Operative hours per week were predictive of resident satisfaction with the clinical and operative prerequisite experiences (both P < 0.001). Perception of general surgery program director investment in PRS education was also predictive of resident satisfaction with clinical and operative experiences (P = 0.05 and P < 0.001, respectively). CONCLUSIONS: The present study demonstrates that PRS residents are satisfied with the quality of prerequisite training but prefer less overall. Reevaluation of the benefits of the American Board of Surgery In-Training Examination and individual essential rotations for resident education would be welcomed. Furthermore, this study identifies the residents' clinical and operative experience and perceived general surgery program director involvement as important determinants of integrated resident satisfaction with prerequisite training.


Asunto(s)
Educación de Postgrado en Medicina , Internado y Residencia , Satisfacción Personal , Cirugía Plástica/educación , Adulto , Competencia Clínica , Humanos , Encuestas y Cuestionarios , Estados Unidos , Carga de Trabajo/estadística & datos numéricos
13.
Ann Plast Surg ; 80(5): 581-586, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29389706

RESUMEN

The challenges of cleft reconstruction have been present for centuries. However, understanding of the cleft nasal tip and the evolution of techniques decidedly began in the 20th century and refinement continues into the present day. Although a multitude of technical descriptions and case series have been published, a compendium of seminal techniques, which have shaped modern thought, has not been compiled in the literature. In this review, we discuss the anatomical disturbances in the cleft nasal tip anomaly, the timing and strategy of tip correction, and the major classic techniques for management of the cleft nasal tip. In addition, we have categorized the classic techniques into concepts that they embody.


Asunto(s)
Labio Leporino/cirugía , Nariz/anomalías , Nariz/cirugía , Rinoplastia/métodos , Humanos
14.
Plast Reconstr Surg ; 140(4): 776-784, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28953730

RESUMEN

BACKGROUND: Age is a frequent consideration for surgical timing in pediatric craniofacial surgery for optimal psychosocial development. However, systematic evaluations of the effects of age in children under active treatment have not been thoroughly evaluated. METHODS: Ninety-nine patients (age, 8 to 17 years; 46.5 percent male) from the University of California, Los Angeles, Craniofacial Clinic were prospectively evaluated using the Pediatric Patient-Reported Outcomes Measurement Information System to assess anger, anxiety, depression, and quality of peer relationships. Patients were stratified into three age groups by years: group A, 8 to 10 years, n = 30; group B, 11 to 13 years, n = 41; and group C, 14 to 17 years, n = 28. Analyses of variance and logistic regression analyses were performed. RESULTS: Significant differences in anxiety (F2,96 = 5.1; p = 0.008), depression (F2,96 = 9.7; p < 0.001), peer relationships (F2,96 = 3.5; p = 0.03), and anger (F2,96 = 4.9; p = 0.009) were found among the age groups. Group A demonstrated the highest anxiety, highest depression, and lowest peer relationship scores overall. Although there were no differences in anger between groups A and C, group B had the lowest anger scores. Children with poor scores of higher severity, defined as greater than 1 SD worse than the national mean, were compared. Group A contributed the highest percentages of more severely affected children in all categories. A logistic regression analysis demonstrated that group A was a statistically significant predictor for scores of higher severity in both anxiety (OR, 3.8; 95 percent CI, 1.3 to 11.5; p = 0.02) and peer relationships (OR, 3.4; 95 percent CI, 1.3 to 9.3; p = 0.02). CONCLUSIONS: Children between 8 and 10 years of age with craniofacial anomalies constitute a high-risk subset for psychosocial dysfunction. The authors' work suggests that tight surveillance with family and school awareness may be necessary for this age group. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.


Asunto(s)
Adaptación Psicológica , Anomalías Craneofaciales/psicología , Depresión/epidemiología , Psicometría/métodos , Calidad de Vida , Adolescente , Factores de Edad , Niño , Anomalías Craneofaciales/complicaciones , Depresión/diagnóstico , Depresión/etiología , Femenino , Humanos , Los Angeles/epidemiología , Masculino , Estudios Prospectivos , Índice de Severidad de la Enfermedad
15.
Dev Biol ; 415(2): 242-250, 2016 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-27034231

RESUMEN

Fibroblast growth factor receptor 2 (FGFR2) signaling is critical for proper craniofacial development. A gain-of-function mutation in the 2c splice variant of the receptor's gene is associated with Crouzon syndrome, which is characterized by craniosynostosis, the premature fusion of one or more of the cranial vault sutures, leading to craniofacial maldevelopment. Insight into the molecular mechanism of craniosynostosis has identified the ERK-MAPK signaling cascade as a critical regulator of suture patency. The aim of this study is to investigate the role of FGFR2c-induced ERK-MAPK activation in the regulation of coronal suture development. Loss-of-function and gain-of-function Fgfr2c mutant mice have overlapping phenotypes, including coronal synostosis and craniofacial dysmorphia. In vivo analysis of coronal sutures in loss-of-function and gain-of-function models demonstrated fundamentally different pathogenesis underlying coronal suture synostosis. Calvarial osteoblasts from gain-of-function mice demonstrated enhanced osteoblastic function and maturation with concomitant increase in ERK-MAPK activation. In vitro inhibition with the ERK protein inhibitor U0126 mitigated ERK protein activation levels with a concomitant reduction in alkaline phosphatase activity. This study identifies FGFR2c-mediated ERK-MAPK signaling as a key mediator of craniofacial growth and coronal suture development. Furthermore, our results solve the apparent paradox between loss-of-function and gain-of-function FGFR2c mutants with respect to coronal suture synostosis.


Asunto(s)
Suturas Craneales/embriología , Disostosis Craneofacial/embriología , Sistema de Señalización de MAP Quinasas/fisiología , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/fisiología , Fosfatasa Alcalina/biosíntesis , Fosfatasa Alcalina/genética , Animales , Butadienos/farmacología , Células Cultivadas , Suturas Craneales/anomalías , Activación Enzimática/efectos de los fármacos , Ratones , Ratones Noqueados , Mutación , Nitrilos/farmacología , Osteoblastos/metabolismo , Osteoblastos/patología , Osteoclastos/metabolismo , Osteogénesis/fisiología , Fenotipo , Isoformas de Proteínas/antagonistas & inhibidores , Isoformas de Proteínas/fisiología , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/antagonistas & inhibidores , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/deficiencia , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/genética , Sinostosis/genética , Sinostosis/patología
16.
Plast Reconstr Surg ; 137(3): 603e-616e, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26910704

RESUMEN

UNLABELLED: Three-dimensional analysis and planning is a powerful tool in plastic and reconstructive surgery, enabling improved diagnosis, patient education and communication, and intraoperative transfer to achieve the best possible results. Three-dimensional planning can increase efficiency and accuracy, and entails five core components: (1) analysis, (2) planning, (3) virtual surgery, (4) three-dimensional printing, and (5) comparison of planned to actual results. The purpose of this article is to provide an overview of three-dimensional virtual planning and to provide a framework for applying these systems to clinical practice. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.


Asunto(s)
Diseño Asistido por Computadora , Planificación de Atención al Paciente , Impresión Tridimensional , Procedimientos Quirúrgicos Reconstructivos/métodos , Cirugía Asistida por Computador/métodos , Cirugía Plástica/métodos , Adulto , Niño , Estética , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Prótesis e Implantes , Diseño de Prótesis , Implantación de Prótesis , Resultado del Tratamiento , Interfaz Usuario-Computador
18.
Plast Reconstr Surg ; 135(5): 1449-53, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25919258

RESUMEN

UNLABELLED: The goal of primary cleft lip repair is to unify the lip elements and achieve a nearly normal appearance. Many techniques can confer satisfactory results; however, scarring and contour irregularities may persist. Lipofilling can modulate scar formation and enable soft-tissue augmentation. The authors hypothesize that fat grafting during immediate cleft lip repair may be of benefit. Patients who underwent primary cleft lip repair with and without immediate fat grafting were compared. Postoperative photographs were analyzed by three blinded reviewers. Cronbach statistics and a two-tailed t-test were used. Scar analysis revealed statistically significant (p < 0.05) improvement in scar appearance and contour of the fat-grafted cleft lip repair. Immediate fat grafting may be a promising strategy to improve lip appearance, contour, and scarring during primary cleft lip repair. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Asunto(s)
Labio Leporino/cirugía , Procedimientos Quirúrgicos Orales/métodos , Procedimientos Quirúrgicos Reconstructivos/métodos , Colgajos Quirúrgicos , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Estudios Retrospectivos , Resultado del Tratamiento
19.
Craniomaxillofac Trauma Reconstr ; 7(4): 323-6, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25383157

RESUMEN

Reconstruction of the temporomandibular joint (TMJ) region is challenging. The conventional direct preauricular incision permits only limited access to the TMJ and surrounding structures, therefore risking injury to the facial nerve during retraction. The ideal approach allows sufficient exposure, preservation of underlying neurovascular structures, and achieves an optimal aesthetic outcome. We describe a preauricular posttragal incision with a superficial musculoaponeurotic system flap to allow wide exposure of the zygomatic arch, TMJ, condyle, and coronoid process. We postulate that this approach improves access, lessens the amount of retraction required, and creates a more inconspicuous scar.

20.
Yale J Biol Med ; 87(3): 349-57, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25191150

RESUMEN

INTRODUCTION: Dermoid cysts are common, benign, embryologically derived soft tissue cysts that can arise at a variety of craniofacial sites. It is not known whether specific histological variations exist between the different craniofacial sites. This study aims to establish whether inter-site histologic differences exist between periorbital, nasal, scalp, and postauricular dermoid cysts and analyze these in context of their distinct embryological origin and varied clinical presentation. METHODS: A retrospective review of craniofacial dermoid cysts was performed. Using light microscopy with hematoxylin and eosin staining, histological appearance was directly compared between craniofacial sites. RESULTS: All (n = 16) cysts contained keratinizing, stratified squamous epithelial lining, intraluminal keratin, and hair. Sebaceous glands were commonly present (n = 13). Eccrine (sweat) glands were less common (n = 3). Structures of mesodermal origin were seen in three periorbital cysts. Only the six ruptured cysts showed evidence of inflammation. CONCLUSIONS: Histological properties of dermoid cysts are conserved between craniofacial sites (periorbital, nasal, scalp, and postauricular). This reflects the consistency of ectodermal inclusion during early embryological development, which is independent of specific craniofacial site or surrounding anatomical structures.


Asunto(s)
Quiste Dermoide/patología , Cara/patología , Cráneo/patología , Preescolar , Demografía , Quiste Dermoide/cirugía , Cara/cirugía , Femenino , Humanos , Lactante , Cuidados Intraoperatorios , Masculino , Cráneo/cirugía
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