Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 350
Filtrar
1.
J Laryngol Otol ; 136(2): 146-153, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34588007

RESUMO

OBJECTIVE: To assess benefits of surgical intervention at an early age and focus on surgical techniques using exclusively autologous cartilage grafts. METHODS: Five children aged 8-15 years, treated between March 2016 and 2020, underwent augmentation rhinoplasty using autologous cartilage, with post-operative follow up ranging from 1.5 to 2 years. Photographs and Rhinoplasty Outcome Evaluation questionnaire scores were examined. RESULTS: Augmentation was achieved without complications. No restricted skin or mucosal pockets were encountered. Patients showed improved confidence and perspective with regard to self-image, and were less socially self-conscious. There was significant improvement in all Rhinoplasty Outcome Evaluation questionnaire scores. CONCLUSION: Early surgery allows augmentation with easier release of skin and mucosal pockets, and without the tension otherwise encountered if primary augmentation is performed at a later age. It offers a chance to improve confidence and self-perception in a growing child conscious about their appearance, which may make them socially withdrawn. Autologous cartilage gives better results than bone grafts, and is comparable with silicone but without its complications.


Assuntos
Cartilagem/transplante , Anormalidades Maxilofaciais/cirurgia , Rinoplastia/métodos , Adolescente , Criança , Intervenção Médica Precoce , Feminino , Humanos , Masculino , Transplante Autólogo
2.
J Craniofac Surg ; 32(3): 1037-1041, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34779597

RESUMO

ABSTRACT: Maxillonasal dysplasia or Binder syndrome is an uncommon condition. It is a congenital disease characterized by undergrowth of the central face and may include elements of the nose and upper jaw. The hallmark of the deformity is a retruded mid-face and an extremely flat nose. The timing and the surgical approaches for management of such deformity are still controversial. In this paper, we are going to present our experience in management of Binder syndrome in children. Seven children ranging in age from 6 to 13 years with classic features of Binder syndrome were operated upon in this study. The surgical approach was done at an early age and included 3 main components; nasal dorsum augmentation by costal cartilage graft, maxillary augmentation by rib grafts and columellar reconstruction by VY-plasty and strut grafts. Patients were followed for up to 6 years. Excellent results were obtained in all patients with this surgical procedure. Half of our patients required more than 1 surgery but none of them required any secondary orthognathic surgery. Therefore, we recommend that children with Binder syndrome should be managed at an early age at least for correction of their nasal deformities. Maxillary augmentation can also be done simultaneously or delayed for a second stage. During the second stage, further nasal augmentation can be accomplished. Definitive orthognathic surgeries have to be postponed to adolescence. This strategy can dramatically improve the patient aesthetic and alleviate the psychological upset without much disturbance of the facial growth.


Assuntos
Implantes Dentários , Anormalidades Maxilofaciais , Adolescente , Criança , Estética Dentária , Humanos , Anormalidades Maxilofaciais/cirurgia , Septo Nasal
4.
Eur J Ophthalmol ; 31(2): NP12-NP14, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31771345

RESUMO

Bilateral Tessier cleft types 3 and 4 are rare and commonly involve the lacrimal drainage system owing to their anatomical location. Such clefts commonly present with associated ocular anomalies and include colobomatous eyelids, hypertelorism, microphthalmia, punctal or canalicular agenesis, and nasolacrimal duct obstruction or exstrophy. The current report presents an 18-month-old baby with bilateral Tessier cleft 3 with a unilateral anophthalmos, symmetrical eyelid colobomas, and lacrimal drainage anomalies. The lacrimal anomalies noted include small lacrimal sac with inferior canaliculus on the right side and upper and lower punctal and canalicular agenesis on the left side. Computed tomographic dacryocystography demonstrated unilateral lacrimal sac and bilateral maldevelopment of the bony nasolacrimal duct.


Assuntos
Anoftalmia/complicações , Fenda Labial/complicações , Coloboma/complicações , Pálpebras/anormalidades , Doenças do Aparelho Lacrimal/congênito , Anormalidades Maxilofaciais/complicações , Ducto Nasolacrimal/anormalidades , Anoftalmia/diagnóstico por imagem , Anoftalmia/cirurgia , Fenda Labial/cirurgia , Coloboma/diagnóstico por imagem , Coloboma/cirurgia , Dacriocistorinostomia , Pálpebras/diagnóstico por imagem , Pálpebras/cirurgia , Humanos , Lactente , Doenças do Aparelho Lacrimal/diagnóstico por imagem , Doenças do Aparelho Lacrimal/cirurgia , Masculino , Anormalidades Maxilofaciais/cirurgia , Ducto Nasolacrimal/diagnóstico por imagem , Ducto Nasolacrimal/cirurgia , Tomografia Computadorizada por Raios X
5.
J Craniofac Surg ; 32(1): e5-e8, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32694479

RESUMO

ABSTRACT: Binder Syndrome occurs in less than 1 per 10,000 live births. Mean features of the syndrome include arhinoid face, abnormal position of the nasal bones, intermaxillary hypoplasia with associated malocclusion, reduced or absent anterior nasal spine, atrophy of the nasal mucosa and absence of the frontal sinus. Treatment of these facial deformities is obviously surgical. In the present work, the authors describe, step by step, their technique in secondary rhinoplasty in a 36-years-old patient affected by Binder Syndrome. In this case, the authors used autologous cartilage graft and heterologous bone graft.Satisfying results are achieved in 12 months of follow-up: graft resorption is acceptable, position of the graft is stable, the authors have no signs of infection and the patient is satisfied with the aesthetical and functional results. The authors believe that the first option, in complex nose's reconstruction, is the use of autologous grafts but, the use of cartilage heterologous bone graft should be taken in account, in the future, as a secondary option in Binder Syndrome and in malformed patients.


Assuntos
Anormalidades Maxilofaciais , Rinoplastia , Adulto , Humanos , Anormalidades Maxilofaciais/cirurgia , Nariz/cirurgia , Estudos Retrospectivos
6.
J Plast Reconstr Aesthet Surg ; 74(1): 223-243, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32978114

RESUMO

Nasomaxillary hypoplasia is a rare congenital malformation involving the middle third of the face. The present paper describes a novel technique for restoring the nasal projection in a patient with nasomaxillary hypoplasia, analyses its advantages and limitations, and discusses its potential applicability in other similar contexts. After orthognathic surgery, lateral osteotomies of the nasal bones were performed integrally with a piezoelectric device using a long cutting saw tip through the intraoral approach. The nasal bones were then projected by interpositioning two triangular-shaped collagenated cancellous bone graft blocks on each side in the osteotomies between the nasal and the frontal processes of the maxillary bones. Cone-beam computed tomography (CBCT) data was used to perform a morphometric analysis at one and 12 months of follow-up through image superimposition, which revealed a stable increased projection of the nasal dorsum and an anterior nasal spine (ANS) of 5.18 mm and 5.52 mm, respectively. The results of this case suggest that the technique affords satisfactory nasal dorsum augmentation while avoiding the use of permanent foreign materials, with minimal morbidity, no unsightly and visible scars, great patient satisfaction, and adequate stability at 12 months of follow-up.


Assuntos
Anormalidades Maxilofaciais/cirurgia , Nariz/anormalidades , Nariz/cirurgia , Rinoplastia/métodos , Osso Esponjoso/transplante , Colágeno/uso terapêutico , Feminino , Humanos , Procedimentos Cirúrgicos Ortognáticos , Adulto Jovem
8.
J Craniofac Surg ; 31(6): e602-e603, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32649539

RESUMO

Dental transplantation is an alternative for rehabilitation with a high success rate. This article presents a clinical case of autogenous dental transplantation in a 17-year-old male patient undergoing treatment for Class III dento-facial deformity. After 32 months followup, low-cost rehabilitation was possible, and without prejudice to ortho-surgical treatment.


Assuntos
Transplante Ósseo , Anormalidades Maxilofaciais/cirurgia , Adolescente , Humanos , Masculino , Transplante Autólogo
9.
J Dent Res ; 99(2): 125-132, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31675262

RESUMO

Orofacial congenital defects such as cleft lip and/or palate are associated with impaired muscle regeneration and fibrosis after surgery. Also, other orofacial reconstructions or trauma may end up in defective muscle regeneration and fibrosis. The aim of this review is to discuss current knowledge on the development and regeneration of orofacial muscles in comparison to trunk and limb muscles. The orofacial muscles include the tongue muscles and the branchiomeric muscles in the lower face. Their main functions are chewing, swallowing, and speech. All orofacial muscles originate from the mesoderm of the pharyngeal arches under the control of cranial neural crest cells. Research in vertebrate models indicates that the molecular regulation of orofacial muscle development is different from that of trunk and limb muscles. In addition, the regenerative ability of orofacial muscles is lower, and they develop more fibrosis than other skeletal muscles. Therefore, specific approaches need to be developed to stimulate orofacial muscle regeneration. Regeneration may be stimulated by growth factors such fibroblast growth factors and hepatocyte growth factor, while fibrosis may be reduced by targeting the transforming growth factor ß1 (TGFß1)/myofibroblast axis. New approaches that combine these 2 aspects will improve the surgical treatment of orofacial muscle defects.


Assuntos
Desenvolvimento Muscular , Músculo Esquelético , Crista Neural , Regeneração , Desenvolvimento Embrionário , Fibrose , Humanos , Anormalidades Maxilofaciais/cirurgia , Mesoderma , Músculo Esquelético/crescimento & desenvolvimento
10.
Georgian Med News ; (294): 62-68, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687951

RESUMO

Recently, there has been a tendency for the growth of dentognathic deformities of various origins, accompanied by phonetic abnormalities. Aim - to increase the effectiveness of orthodontic treatment of dentognathic deformities, accompanied by phonetic disorders, by developing and justifying a set of diagnostic and therapeutic measures based on a multidisciplinary approach. The influence of the state of ENT organs on the formation of dentognathic deformities and phonetic disturbances is studied in 155 children. A clinical dental examination and orthodontic treatment is performed in 82 patients aged 6-12 years. Individual corrective speech therapy work has been carried out to overcome the defects of the phonological side of speech. A certain pathological "chain" of cause-effect relationships of dentognathic deformities with phonetic disorders and diseases of the ENT organs became the basis for a multidisciplinary approach to solving the problems identified. The qualitative and quantitative dependence of sound deterioration on the type of orthognathic deformities is established. A complex of diagnostic and therapeutic measures for patients with dental deformities accompanied by phonetic disorders, consisting of motivational, diagnostic and therapeutic blocks, has been developed and introduced into practice. The proposed complex of diagnostic and treatment measures made it possible to increase the efficiency of orthodontic treatment of children with dentognathic deformities with disturbances of sound pronunciation depending on the type of bite by means of a multidisciplinary approach involving an otolaryngologist, speech therapist, children's therapist and surgeon, which was confirmed in 86.6% of patients by the improvement of electromyography, anthropometric measurements of scanned models of jaws, cephalometry; the analysis of cone-beam computed tomography data showed a significant increase in the upper respiratory tract volume by 53.8±4.2%.


Assuntos
Anormalidades Maxilofaciais/diagnóstico , Anormalidades Maxilofaciais/cirurgia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Fonética , Prognatismo/cirurgia , Distúrbios da Fala/cirurgia , Cefalometria , Criança , Humanos , Imageamento Tridimensional , Prognatismo/diagnóstico por imagem , Reprodutibilidade dos Testes , Distúrbios da Fala/diagnóstico , Resultado do Tratamento
11.
Neurochirurgie ; 65(5): 295-301, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31562883

RESUMO

Treatment of craniosynostosis is complex and has greatly progressed in recent decades. From the early stages in the 1950s to today's most recent techniques, surgeons have faced the challenge of overcoming the deformities often caused by such invasive, complex surgeries. In the most recent years, new techniques have been developed that address surgical sequelae, including those of surgery performed in childhood. After a general introduction on craniosynostosis, the present paper describes the various types of deformity that may result from complex surgery and offers an overview of the various tools available to surgeons. An explanation of each indication and procedure is given.


Assuntos
Craniossinostoses/cirurgia , Anormalidades Maxilofaciais/cirurgia , Osteotomia/métodos , /métodos , Transplante Ósseo , Criança , Pré-Escolar , Progressão da Doença , Humanos , Lactente , Osteotomia/tendências , Crânio/cirurgia
12.
J Craniofac Surg ; 30(5): e460-e462, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299814

RESUMO

Postburn maxillofacial deformities, although rare, are a significant cause of morbidity. Since contracture scars have a potential role in deforming the maxillofacial skeleton, the focus of treatment should be on growing patients, where scar contractures can drastically influence growth and morphology of the maxillofacial units. There are certain aspects of severe facial burns and deformities, especially of the jaws, that deserve sincere attention to overcome aesthetic and functional disabilities such as inability to masticate and incompetent lips. The purpose of this article, therefore, is to discuss these injuries, the mechanism of development of deformities of the jaws and associated structures and their management for better aesthetic, functional, and psychological health of patient. An interpretive clinical report is presented.


Assuntos
Queimaduras/cirurgia , Traumatismos Faciais/cirurgia , Anormalidades Maxilofaciais/cirurgia , Modalidades de Fisioterapia , Adulto , Queimaduras/complicações , Cicatriz/cirurgia , Contratura/cirurgia , Traumatismos Faciais/complicações , Humanos , Masculino , Mastigação , Anormalidades Maxilofaciais/etiologia , Anormalidades Maxilofaciais/terapia , Cirurgia Plástica
13.
Rev. esp. cir. oral maxilofac ; 41(1): 3-7, ene.-mar. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182840

RESUMO

Objetivos: La cirugía ortognática ha experimentado un desarrollo significativo en las últimas décadas que la ha convertido en una técnica segura, pero no está exenta de presentar complicaciones. El objetivo del estudio es evaluar las complicaciones perioperatorias y postquirúrgicas inmediatas (durante el ingreso del paciente) asociadas a la cirugía ortognática en pacientes intervenidos de deformidades dentofaciales en nuestro hospital, analizando las características epidemiológicas de los pacientes y las posibles asociaciones entre el sexo, la edad, el tipo de osteotomía realizada y las complicaciones más frecuentes. Material y métodos: Realizamos un estudio descriptivo retrospectivo que comprende 284 intervenciones de cirugía ortognática realizadas consecutivamente entre el 1 de enero del 2000 y el 31 de diciembre del 2016 en el Hospital Povisa de Vigo. Resultados: La media de edad de los pacientes intervenidos fue de 28,72 años. El 64,4 % eran mujeres. La deformidad dentofacial más frecuentemente tratada fue la maloclusión clase III de Angle, y la osteotomía con mayor incidencia fue la osteotomía tipo Le Fort I del maxilar superior. La mayoría de los pacientes fueron clasificados como ASA I. El tiempo operatorio promedio fue de 174 minutos y el tiempo medio de hospitalización fue de 3,26 días. Las náuseas o vómitos en el postoperatorio inmediato (NVPO) fue la complicación más frecuentemente registrada. Se encontraron correlaciones estadísticamente significativas entre el tipo de osteotomía realizada y la hemorragia, las NVPO, la ansiedad, la necesidad de transfusión sanguínea y el dolor postoperatorio. Conclusión: El bajo índice de complicaciones encontradas en el presente estudio sugiere que la cirugía ortognática es un procedimiento quirúrgico seguro


Objectives: Orthognathic surgery has undergone a significant development in recent years becoming a safe surgical technique. However, different complications can occur after orthognathic surgery. The purpose of this study is to analyze the possible complications found during surgery and immediately after orthognatic surgery, at our institution. Material and methods: A retrospective descriptive study comprising 284 consecutive orthognathic surgical procedures performed between January 1, 2000 and December 31, 2016 at Povisa Hospital, Vigo, Spain, were studied. Results: Mean age of the treated patients was 28.72 years. 64.4 % were women. The most frequent dentofacial deformity diagnosed was Angle class III malocclusion and the most frequent performed osteotomy was Le Fort I maxillary osteotomy. The majority of patients were classified as ASA I. Mean operative time was 174 minutes and mean hospitalization time was 3.26 days. Postoperative nausea or vomiting (PONV) was the most frequent complication found. Statistically significant correlations were found between the type of osteotomy performed and postoperative bleeding, PONV, anxiety, need of blood transfusion and postoperative pain. Conclusions: The low rate of complications found in the present study suggests that orthognathic surgery is a safe surgical procedure


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Ortognáticos/tendências , Anormalidades Maxilofaciais/cirurgia , Dor Pós-Operatória/epidemiologia , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Estudos Retrospectivos , Complicações Pós-Operatórias/epidemiologia , Complicações Intraoperatórias/epidemiologia , Reconstrução Mandibular/estatística & dados numéricos , Resultado do Tratamento
15.
Surgeon ; 17(6): 340-345, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30661952

RESUMO

AIMS: The aim of this study was to assess patient satisfaction with a clinical psychology service, integrated within an inter-disciplinary orthognathic planning clinic. METHOD: A self-report, custom-designed questionnaire was sent to patients who had completed orthognathic treatment within the last three years. Of the 60 patients approached, 49 responded. RESULTS: The great majority of patients agreed that there was a need for a psychological assessment and that its purpose was adequately explained. Most patients were happy with the information given during their appointment and found the experience helpful. A number of patients felt that additional appointments would have been helpful shortly before, and after, surgery. CONCLUSIONS: The group of orthognathic patients studied found the pre-treatment psychology assessment, provided for them through the combined clinic, to be very acceptable and beneficial. Some suggested that further appointments, throughout the treatment journey, as well as supportive literature, might also have been helpful.


Assuntos
Assistência Ambulatorial/organização & administração , Anormalidades Maxilofaciais/psicologia , Serviços de Saúde Mental/organização & administração , Cirurgia Ortognática , Humanos , Anormalidades Maxilofaciais/cirurgia , Equipe de Assistência ao Paciente/organização & administração , Satisfação do Paciente , Estudos Retrospectivos , Inquéritos e Questionários , Reino Unido
16.
Surg Innov ; 26(1): 5-20, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30270757

RESUMO

Orthognathic surgery belongs to the scope of maxillofacial surgery. It treats dentofacial deformities consisting in discrepancy between the facial bones (upper and lower jaws). Such impairment affects chewing, talking, and breathing and can ultimately result in the loss of teeth. Orthognathic surgery restores facial harmony and dental occlusion through bone cutting, repositioning, and fixation. However, in routine practice, we face the limitations of conventional tools and the lack of intraoperative assistance. These limitations occur at every step of the surgical workflow: preoperative planning, simulation, and intraoperative navigation. The aim of this research was to provide novel tools to improve simulation and navigation. We first developed a semiautomated segmentation pipeline allowing accurate and time-efficient patient-specific 3D modeling from computed tomography scans mandatory to achieve surgical planning. This step allowed an improvement of processing time by a factor of 6 compared with interactive segmentation, with a 1.5-mm distance error. Next, we developed a software to simulate the postoperative outcome on facial soft tissues. Volume meshes were processed from segmented DICOM images, and the Bullet open source mechanical engine was used together with a mass-spring model to reach a postoperative simulation accuracy <1 mm. Our toolset was completed by the development of a real-time navigation system using minimally invasive electromagnetic sensors. This navigation system featured a novel user-friendly interface based on augmented virtuality that improved surgical accuracy and operative time especially for trainee surgeons, therefore demonstrating its educational benefits. The resulting software suite could enhance operative accuracy and surgeon education for improved patient care.


Assuntos
Simulação por Computador , Imageamento Tridimensional , Procedimentos Cirúrgicos Ortognáticos/métodos , Modelagem Computacional Específica para o Paciente , Software , Cirurgia Assistida por Computador/métodos , França , Hospitais Universitários , Humanos , Anormalidades Maxilofaciais/diagnóstico por imagem , Anormalidades Maxilofaciais/cirurgia , Cirurgia Ortognática/normas , Cirurgia Ortognática/tendências , Procedimentos Cirúrgicos Ortognáticos/instrumentação , Sensibilidade e Especificidade
17.
Rev. Fac. Odontol. (B.Aires) ; 34(77): 21-28, 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1103901

RESUMO

Las anomalías dentoesqueletales se presentan en el 2-3% de la población. Las mismas afectan el complejo maxilomandibular como también la relación entre las arcadas dentarias. Estas alteraciones producen problemas fonéticos, deglutorios, respiratorios y estéticos. Existe una tendencia en corregir las alteraciones dentarias sin tratar las discrepancias esqueletales, dificultando la corrección quirúrgica, si esta fuera necesaria. Actualmente, la cirugía ortognática ha tenido mayor aceptación como el tratamiento ideal para pacientes con estas anomalías. Se presentará una revisión de la literatura sobre las características que esta alteración presenta, junto a la resolución de casos clínicos (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Osteotomia de Le Fort , Anormalidades Maxilofaciais/cirurgia , Cirurgia Ortognática , Má Oclusão Classe II de Angle/cirurgia , Má Oclusão Classe III de Angle/cirurgia , Argentina , Faculdades de Odontologia , Avanço Mandibular , Mordida Aberta/cirurgia
18.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 32(12): 1567-1571, 2018 12 15.
Artigo em Chinês | MEDLINE | ID: mdl-30569685

RESUMO

Objective: To evaluate the reliability and effectiveness of a deep circumflex iliac artery based iliac-internal oblique musculofascial chimeric flap (DCIA-IIOF) in reconstruction of complex oromandibular defect. Methods: Between January 2010 and December 2015, DCIA-IIOFs were used to repair complex oromandibular defects in 11 patients. There were 8 males and 3 females, with an age of 27-75 years (median, 56 years). Original disease was lower gingival squamous cell carcinoma in 7 cases (T 3N 1M 0 in 2 cases, T 3N 2M 0 in 1 case, T 4N 0M 0 in 2 cases, and T 4N 2M 0 in 2 cases), osteoradionecrosis after radiotherapy for nasopharyngeal carcinoma in 2 cases, central mandibular squamous cell carcinoma in 1 case (T 4N 0M 0), and mandibular malignant fibrous histiocytoma in 1 case. The length of mandibular bone defects ranged from 7 to 10 cm (mean, 8 cm), and the area of the mucosal defects ranged from 5 cm×3 cm to 7 cm×4 cm. Preoperative ultrasonic identification of the DCIA and its ascending branch was routinely performed. The DCIA-IIOF was harvested by using an anterograde dissection technique, of which the iliac island was used for segmental mandibular defect repair and the musculofascial island for soft tissue and mucosal defect repair. Results: All 11 cases were followed up 15-75 months (median, 37 months). All flaps survived after operation, without necrosis of both iliac island and oblique internal musculofascial island. One patient had a mild submandibular infection which healed after wound drainage and intravenous antibiotics. At 1 month after operation, the color and texture of the musculofascial island were similar to oral mucosa without contracture, and the occluding relation was good for all patients. At 6 months after operation, the mouth opening hardly improved in 2 patients who had osteoradionecrosis; 1 patient who underwent postoperative radiotherapy had restriction of mouth opening; the remaining 8 patients had normal month opening and normal diet. Three patients died of cancer recurrence, 2 patients died of other diseases (encephalorrhagia in 1 case and myocardial infarction in 1 case), and the others survived without recurrence during follow-up. No patient developed abdominal hernia during follow-up. Conclusion: DCIA-IIOF is a reliable flap in reconstruction of complex oromandibular defects. The occluding relation after operation is good and the mucosal lining is soft. This technique provides an effective option for moderate complex oromandibular defects repair.


Assuntos
Artéria Ilíaca , Anormalidades Maxilofaciais , Retalhos Cirúrgicos , Adulto , Idoso , Feminino , Humanos , Artéria Ilíaca/transplante , Masculino , Anormalidades Maxilofaciais/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Reprodutibilidade dos Testes
19.
J Craniofac Surg ; 29(8): e797-e803, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30277955

RESUMO

BACKGROUND: The Le Fort I maxillary osteotomy is a versatile and simple procedure, which has gained popularity nowadays, to correct a wide range of malocclusion and maxillofacial deformities. This procedure is often associated with significant but rare postoperative complications. The aim of this study was to evaluate the types and frequencies of intra- and perioperative complications related to Le Fort I osteotomies in noncleft Iranian patients. MATERIALS AND METHODS: In this prospective study, all the healthy systemic patients, (ASA I, II) with the age range of 18 to 30 years from both genders, who had the skeletal class II or III deformities and required only isolated 1-piece maxillary Le Fort I osteotomy, were included in this study. These patients had no craniofacial cleft history and were candidates for orthognathic surgery in Maxillofacial Surgery Department of Qaem Hospital of Mashhad (Iran), 2015 to 2017. All of the operations were carried out or supervised by a single surgeon and anesthesiologist using the same protocol. The patients were monitored for occurrence of intra- or postoperative complications till 6 months. The t-test, Chi-squared test, and Fisher exact test were performed for data analysis using SPSS version 16 (SPSS Inc, Chicago, IL). RESULTS: In the present study, a total of 114 consecutive patients with the average age of 22 ±â€Š5 years from October 2015 to November 2017 were recruited. About 77 (67.54%) patients were presented skeletal class III deformity and 37 (32.46%) were class II. The most prevalent maxillary movement after Le Fort I osteotomy was identified to be isolated maxillary advancement in 51 (44.75%) patients. Only 10 (8.77%) of all 114 patients confronted surgical complications. Hemorrhagic complication (arterial bleeding from descending palatine artery and epistaxis) and anatomic complications (septal deviation and bad fracture) would be the most prevalent complications with the frequency of 5.25% and 3.5% in total. Maxillary setback with impaction presented the highest rate (36.4%) of complications compared to other maxillary movement types. On balance, there was a significant association between Le Fort I surgery complications and maxillary movement types in our research (P = 0.002). CONCLUSION: The rate of intra- and postoperative complications following Le Fort I osteotomy for healthy noncleft adults in our center was low. Therefore, it can be concluded that this technique is safe and reliable. The maxillofacial surgeon should pay more attention for prevention or even management of the risk of intra- and perioperative complications in patients with anatomic irregularities (previous craniofacial cleft or trauma history) and those who required maxillary setback concomitant with impaction movements.


Assuntos
Complicações Intraoperatórias/etiologia , Osteotomia Maxilar/efeitos adversos , Osteotomia de Le Fort/efeitos adversos , Complicações Pós-Operatórias/etiologia , Adolescente , Adulto , Epistaxe/etiologia , Feminino , Humanos , Irã (Geográfico) , Masculino , Maxila/cirurgia , Osteotomia Maxilar/métodos , Anormalidades Maxilofaciais/cirurgia , Septo Nasal , Deformidades Adquiridas Nasais/etiologia , Osteotomia de Le Fort/métodos , Estudos Prospectivos , Adulto Jovem
20.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 32(8): 1056-1060, 2018 08 15.
Artigo em Chinês | MEDLINE | ID: mdl-30238735

RESUMO

Objective: To investigate the technical points and effectiveness of autogenous costal cartilage transplantation in repair of Binder's syndrome. Methods: Between June 2012 and June 2017, 8 cases of Binder's syndrome were admitted. There were 3 males and 5 females, aged 16-31 years (mean, 22 years). All patients were conformed to the typical manifestations of Binder's syndrome. The autogenous costal cartilage was harvested and carved into the nasal dorsum graft, nasal column graft, and nasal basement graft. Before and after operation, standard pictures of the anterior view, lateral view, and base view were taken to measure facial related parameters of nasal dorsum length, nasal columella-lobule ratio, nasofrontal angle, nasal columella-upper lip angle, nasal tip projection rate, and nasion projection. Then the effectiveness of this surgical procedure for Binder's syndrome was evaluated. Results: All incisions healed by first intention without acute infections. All patients were followed up 6-36 months, with an average of 18 months. The foreign body sensation in upper lip and scar hyperplasia in thoracic incision occurred in 1 case, respectively. The nasal morphology improved significantly and the coordinated relationships of the nose with the upper lip and face were restored postoperatively. Postoperative parameter measurements were taken in 6 cases. The nasal dorsum length, nasal columella-lobule ratio, nasofrontal angle, nasal columella-upper lip angle, nasal tip projection rate, and nasion projection at preoperation were significantly improved when compared with the values at 6 months after operation ( P<0.05). The difference in nasal dorsum length, nasal tip projection rate, and nasion projection between actual values at 6 months after operation and normal values was no significant ( P<0.05). There was significant difference in nasal columella-lobule ratio between actual value at 6 months after operation and normal value ( P>0.05). Conclusion: Autogenous costal cartilage transplantation in repair of Binder's syndrome can obviously improve patients' appearance of the external nose and middle face, and obtain the persistent effectiveness.


Assuntos
Cartilagem Costal , Anormalidades Maxilofaciais , Adolescente , Adulto , Cartilagem Costal/transplante , Face , Feminino , Humanos , Masculino , Anormalidades Maxilofaciais/cirurgia , Septo Nasal/cirurgia , Nariz/cirurgia , Rinoplastia , Síndrome , Transplante Autólogo , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...