RESUMO
Avoiding complications of rhytidectomy requires meticulous technique, anatomic knowledge, and insight into perioperative risks. The surgeon must provide a swift diagnosis to resolve any potential complications. The surgeon's goal is to deliver the best results while minimizing procedural risks.
Assuntos
Complicações Pós-Operatórias , Ritidoplastia/efeitos adversos , Cicatriz/prevenção & controle , Traumatismos do Nervo Facial/prevenção & controle , Humanos , Necrose , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , Hemorragia Pós-Operatória/prevenção & controle , Medição de Risco , Infecção da Ferida Cirúrgica/prevenção & controleRESUMO
The crooked nasal pyramid and upper third of the nose can be straightened with various osteotomes. Appropriate solutions to maximize successful nasal straightening require a thorough knowledge of the anatomy, a comprehensive preoperative plan, and the appropriate osteotomy choice.
Assuntos
Deformidades Adquiridas Nasais/cirurgia , Nariz/anormalidades , Osteotomia/métodos , Rinoplastia/métodos , Humanos , Osso Nasal/patologia , Osso Nasal/cirurgia , Cartilagens Nasais/patologia , Cartilagens Nasais/cirurgia , Septo Nasal/patologia , Septo Nasal/cirurgia , Nariz/anatomia & histologia , Nariz/cirurgia , Osteotomia/classificação , Osteotomia/instrumentação , Planejamento de Assistência ao Paciente , Complicações Pós-Operatórias , Rinoplastia/instrumentaçãoRESUMO
OBJECTIVES/HYPOTHESIS: Ischemic necrosis of the tongue is a rare entity generally associated with vasculitis. Critically ill patients with shock might experience hypoperfusion of head and neck end organs including the tongue. STUDY DESIGN: Retrospective analysis of hospital charts. METHODS: Case histories and photographs of five patients who developed ischemic tongue necrosis in the context of cardiogenic shock. RESULTS: Five critically ill patients in our institution's cardiothoracic intensive care unit developed ischemic necrosis of the tongue. All five patients experienced protracted courses of profound cardiogenic shock requiring high-dose vasopressor support and urgent cardiac surgery. Three patients required intra-aortic balloon pumps. All patients had concomitant signs of poor end organ perfusion, including lower extremity ischemia and renal and hepatic failure. Ultimately, four of five patients died, with one patient surviving after sloughing of the entire oral tongue. CONCLUSIONS: Ischemic necrosis of the oral tongue is an uncommon but perhaps under-reported manifestation of end organ hypoperfusion in shock, likely signifying poor prognosis.
