RESUMO
AIM: Our aim is focused on the field of action of plastic surgery in the cephalic malformation and on description of the surgical indications and techniques for their correction. MATERIAL OF STUDY: We looked at 27 patients from 2006 to 2012 with cephalic district deformities. All patients underwent surgical and rehabilitative treatments. RESULTS: After a median follow-up from one to five years, in most cases we reached both morphological and functional reconstruction, alone or in a surgical team together with other surgical disciplines. DISCUSSION: The correction of craniofacial malformations makes use of a surgical discipline particularly demanding, which must associate a basic surgical training with a learning techniques specific to the area and a knowledge of craniofacial malformation. CONCLUSIONS: The surgical treatment of craniofacial malformations can be seen only through a joint neurosurgical and plastic-maxillo-facial surgery, guided by knowledge of the malformation, under the close supervision of anesthetists and pediatricians. This surgery is not limited to remodel the morphology but has its bases on the recovery of the functions, maintained by rehabilitation treatment.
Assuntos
Anormalidades Craniofaciais/cirurgia , Procedimentos Neurocirúrgicos/métodos , Papel do Médico , Procedimentos de Cirurgia Plástica/métodos , Cirurgia Plástica , Malformações Arteriovenosas/reabilitação , Malformações Arteriovenosas/cirurgia , Anormalidades Craniofaciais/reabilitação , Disostose Craniofacial/reabilitação , Disostose Craniofacial/cirurgia , Seguimentos , Neoplasias de Cabeça e Pescoço/congênito , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Neurofibromatoses/reabilitação , Neurofibromatoses/cirurgia , Nevo/congênito , Nevo/cirurgia , Equipe de Assistência ao Paciente , Recuperação de Função Fisiológica , Estudos RetrospectivosRESUMO
Large facial defects involving the oral cavity can be difficult to restore prosthetically because of a lack of anatomic undercuts, limited means of retention, mobility of soft tissue margins, and the weight of the prosthesis. Use of skin adhesives may be precluded because of the presence of persistent moisture and saliva. The maxillofacial rehabilitation, including the design and fabrication of a 2-piece silicone prosthesis retained by the teeth, of a patient with a large facial defect as a result of treatment for an arteriovenous malformation is described. The pathogenesis and therapeutic alternatives for arteriovenous malformations is also discussed.
Assuntos
Malformações Arteriovenosas/reabilitação , Face/irrigação sanguínea , Implante de Prótese Maxilofacial , Prótese Maxilofacial , Adulto , Malformações Arteriovenosas/cirurgia , Humanos , Masculino , Fosfatos , Desenho de Prótese , Procedimentos de Cirurgia Plástica , Cimentos de Resina , SiliconesRESUMO
Este trabalho apresenta os resultados do tratamento de seis pacientes com malformaçäo arteriovenosa realizado pela radiocirurgia estereotáxica, com acelerador linear de 6 MeV de energia. Todos os pacientes foram previamente examinados por neurocirurgiöes e radiologistas intervencionistas, que contra-indicaram as formas tradicionais de tratamento pela ressecçäo cirúrgica ou pela embolizaçäo endovascular, baseados no tamanho e na localizaçäo do nidus. Exames radiológicos realizados de 12 a 26 meses após o tratamento revelaram resposta completa em cinco casos e parcial em apenas um, registrando-se uma taxa de resposta de 100 por cento. Näo foram constatados, até a última consulta, sinais ou sintomas de comprometimento do parênquima cerebral nem de nervos cranianos, provocados pela radiocirurgia estereotáxica. Näo foi constatado nenhum caso de ressangramento nem de óbito conseqüente ao tratamento radiocirúrgico.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Artérias Carótidas , Malformações Arteriovenosas/reabilitação , RadiocirurgiaRESUMO
Las malformaciones arterio-venosas pulmonares (MAVP) son una manifestación frecuente en la enfermedad de Rendu-Osler-Weber. La importancia de su diagnóstico y tratamiento radica en evitar complicaciones como la embolización paradójica, alteraciones en la ventilación y hemoptisis entre otras. En el presente artículo se comentará la experiencia de la embolización de fístulas arteriovenosas pulmonares en una familia con diagnóstico de enfermedad de Rendu-Osler-Weber.
Assuntos
Humanos , Malformações Arteriovenosas/fisiopatologia , Malformações Arteriovenosas/reabilitação , Malformações Arteriovenosas/terapia , Circulação Pulmonar , Pulmão/anatomia & histologia , Pulmão/anormalidadesRESUMO
The incidence of deep vein thrombosis (DVT) in the disabled pediatric population has rarely been studied. The purpose of our retrospective study was to define the incidence in patients younger than 18 years of age who were in a rehabilitation center. We reviewed the charts of 532 children admitted to the center from 1983 through 1987, and found a 2.2% overall incidence of DVT. The largest group of children under 18 of age with documented or suspected DVT was the group with spinal cord injuries (SCI). There were 87 SCI children, 67 of whom were between the ages of 15 and 18. Of the 67, 7 (10%) had DVT: 1 of the 20 SCI children under age 15 had DVT. There were single cases of DVT documented in children with: meningoencephalitis, arteriovenous malformation, closed head injuries, and Guillian-Barré syndrome. We studied the risk involved in treating DVT with heparin and formulated recommendations based on our findings.