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1.
J Craniofac Surg ; 31(2): e133-e135, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31934976

RESUMO

Recently, several adjunctive procedures have gained traction to aid cleft surgeons in repairing especially challenging palatal clefts. Buccal fat flaps and buccal myomucosal flaps have demonstrated particular utility in reinforcing thin palatal flaps or tissue deficits. Although their use has not been widely accepted, they may be particularly helpful in the setting of significant scarring or vascular compromise. Here the authors describe the case of an intraoperative salvage using bilateral buccal fat flaps and a right buccal myomucosal flap after transection of the right Greater Palatine artery (GPA) during palatoplasty on a 14-month old female with Pierre Robin Sequence and a wide Veau II cleft palate. For this operative salvage, bilateral buccal fat flaps were used to reinforce the hard-soft palate junction and a 4 cm × 2 cm flap of the right-sided buccal mucosa and buccinator muscle was inset along the majority of the right-sided soft and posterior hard palate. At 2 years follow-up, the patient had no significant complications and was doing well with healthy-appearing palatal tissue and age-appropriate speech.


Assuntos
Artérias/cirurgia , Fissura Palatina/cirurgia , Síndrome de Pierre Robin/cirurgia , Terapia de Salvação , Artérias/diagnóstico por imagem , Bochecha/cirurgia , Fissura Palatina/complicações , Fissura Palatina/diagnóstico por imagem , Músculos Faciais/cirurgia , Feminino , Humanos , Lactente , Cuidados Intraoperatórios , Mucosa Bucal/irrigação sanguínea , Mucosa Bucal/cirurgia , Palato Duro/irrigação sanguínea , Palato Duro/cirurgia , Síndrome de Pierre Robin/complicações , Síndrome de Pierre Robin/diagnóstico por imagem , Procedimentos Cirúrgicos Reconstrutivos , Retalhos Cirúrgicos/cirurgia
3.
J Craniofac Surg ; 31(1): e78-e79, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31634310

RESUMO

Hyaluronic acid is among the most commonly used cosmetic fillers. Although considered biocompatible and safe, it may rarely cause a wide range of complications. The authors report a case of migration of hyaluronic acid concomitant with granulomatous inflammatory response that mimicked a buccal tumor. A 52-year-old female presented with a solid painless mass of the right buccal area. The patient denied any history of trauma and cosmetic procedures of the affected area. Skin and mucosal membrane were intact and the lesion was firm and well fixed in the deep plane. Due to worrisome clinical presentation and the patient's history of breast cancer, the lesion was excised radically. Histopathological examination revealed multiple granulomas surrounding amorphous lakes of hyaluronic acid. During repeated, thorough anamnesis the patient admitted having underwent lip augmentation and nasolabial fold correction with HA two years before, after which the filler must have migrated posteriorly. Physicians need to be aware of various complications associated with cosmetic fillers as they may mimic severe clinical conditions.


Assuntos
Bochecha/diagnóstico por imagem , Ácido Hialurônico/análise , Neoplasias Cutâneas/química , Neoplasias Cutâneas/diagnóstico por imagem , Pele/química , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Sulco Nasogeniano
4.
Anat Histol Embryol ; 49(1): 38-50, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31502343

RESUMO

Cheek pouches have evolved from the oral cavity in rodents and act as temporary food storage repositories. There are two types of opening, internal and external. Details about the complex cutaneous muscles controlling the pouches have still not been fully elucidated. To understand the shared and derived traits of the muscles surrounding the cheek pouch and their innervation, we carried out an evolutionary morphological study using two desert kangaroo rats (Dipodomys deserti) and three plains pocket gophers (Geomys bursarius) from each of the two families equipped with external cheek pouches, and four Syrian hamsters (Mesocricetus auratus) with internal cheek pouches. The most conspicuous derived trait of the muscles between the external and internal cheek pouches, the sphincter sacculi, surrounds almost all of the edge of the outer entrance of the pouch. It is present in both species with external pouches, but not in hamsters, which have internal pouches. Our neurological findings demonstrate that most pouch muscles are innervated by both the facial and the cervical nerves, regardless of the pouch type. In these dually innervated muscles, the ventromedial part of the muscles tends to be innervated dominantly or uniquely by the cervical nerves, which usually enter from the superficial or lateral aspect. As a trait shared with the cervical nerves innervating the propatagial muscles in aerodynamic mammals such as bats and flying squirrels, and panniculus carnosus in most mammals, our neurological evidence suggests that the cervical nerve has the potential to innervate derived cutaneous muscles in the cervicofacial region.


Assuntos
Bochecha/anatomia & histologia , Nervos Cranianos/anatomia & histologia , Músculos Faciais/anatomia & histologia , Mesocricetus/anatomia & histologia , Roedores/anatomia & histologia , Animais , Evolução Biológica , Nervo Facial/anatomia & histologia
5.
Plast Reconstr Surg ; 145(1): 99-102, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31881610

RESUMO

Facial nerve injury is one of the most feared complications in surgical rejuvenation of the aging face. Understanding the three-dimensional architecture of the facial soft tissue, the fascial planes that exist within this architectural arrangement, and the danger zones where the facial nerve is situated superficial and adjacent to the planes of dissection commonly used in face-lift techniques, are the keys to safety in preventing motor branch injury. The two-dimensional branching patterns of the marginal and cervical branches of the facial nerve are variable, making it difficult to ascertain exact nerve location when dissecting within the cheek and neck. On a three-dimensional basis, the position and depth of the marginal and cervical branches are constant and predictable. Understanding the three-dimensional anatomy in terms of planes of dissection, and the danger zones where these nerve branches are vulnerable to injury, provides protection against iatrogenic injury when performing surgical rejuvenation of the aging face. These video vignettes provide an overview of the fascial anatomy of the cheek in relation to the facial nerve branches and delineate the regions of the face in which nerve branches are most likely to be injured. Methods to prevent injury are discussed. Furthermore, the vignette defines these danger zones and delineates methods to protect the nerve branches.


Assuntos
Bochecha/anatomia & histologia , Traumatismos do Nervo Facial/prevenção & controle , Nervo Facial/anatomia & histologia , Dissecação/métodos , Fáscia/anatomia & histologia , Humanos , Ritidoplastia/métodos
6.
Ann Anat ; 227: 151418, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31626903

RESUMO

The present study aims to provide anatomical evidence for clinical application of the medial sural artery perforator (MSAP) flap. The current study investigated the vascular anatomy of the flap, evaluated the postoperative appearance and function of the donor and recipient sites, and investigate the clinical value in reconstruction of oral cavity. Six lower limbs of Chinese adult cadavers were microsurgically dissected. The locations and courses of the medial sural artery perforators were identified and recorded, which provided an anatomical basis for clinical application. Then, 16 clinical cases employing this flap were evaluated, ranging from 3×4cm to 6×8cm, and were employed for defects in the oral cavity region. Sixteen clinical cases with intraoral soft tissue defects, which included four clinical cases with inner cheek defects, were successfully followed up for 10-47 months (24 months on average). The donor site function, contour of recipient site and oral function recovery were evaluated as acceptable or better in cases with intraoral soft tissue defect, which were further verifying the value of clinical application of MSAP in repairing oral cavity defects. Moreover, two typical clinical cases were described in detail. To conclude, the MSAP flap is a favorable choice for small- to medium-size defects based on minor donor site morbidity, satisfactory oral function recovery, perforator stability and adaptation of the pedicle for anastomosis in the oral cavity region.


Assuntos
Boca/cirurgia , Idoso , Artérias , Cadáver , Bochecha/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/cirurgia , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/irrigação sanguínea , Artéria Poplítea/anatomia & histologia , Estudos Prospectivos , Retalhos Cirúrgicos/irrigação sanguínea , Inquéritos e Questionários , Língua/cirurgia , Neoplasias da Língua/cirurgia
7.
Pan Afr Med J ; 34: 69, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31819785

RESUMO

Oroantral communication (OAC) or fistula (OAF) is an open pathological communication between the oral cavity and maxillary sinus which mostly occurs as a result of extraction of upper molars and premolars, iatrogenic complications or from dental infections, osteomyelitis, radiation therapy or trauma. Several alternative techniques modalities have been described throughout the years for the management of OAC and OAF which show both advantages and limitations. The most employed surgical flaps are of three types: advanced buccal flap, palatal flap and buccal fat pad flap. The authors present two clinical cases: oroantral communication and oroantral fistula, both were treated by using buccal advancement flap.


Assuntos
Fístula Bucoantral/cirurgia , Retalhos Cirúrgicos , Bochecha , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fístula Bucoantral/patologia , Adulto Jovem
11.
Plast Reconstr Surg ; 144(5): 1070-1078, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31688754

RESUMO

The facial fat compartments were described over a decade ago, but their clinical relevance to both deflation and techniques in facial rejuvenation is underappreciated. Although much of the literature following their description has focused on further anatomical elucidation of compartment anatomy, clinical relevance has focused on volumetric compartment augmentation. From the authors' perspective, understanding compartmentalization of facial fat provides an anatomical roadmap of the facial subcutaneous plane and a patient-specific guide for the degree of skin flap dissection in facial rejuvenation. The compartmentalization of facial fat also explains the regional development of cheek deflation in aging. An individualized treatment plan to restore facial shape can be achieved with deep compartment volume augmentation and repositioning of superficial facial fat using the superficial musculoaponeurotic system.


Assuntos
Tecido Adiposo/transplante , Ritidoplastia/métodos , Gordura Subcutânea/cirurgia , Sistema Musculoaponeurótico Superficial/cirurgia , Cadáver , Bochecha/cirurgia , Dissecação , Feminino , Humanos , Masculino , Rejuvenescimento , Gordura Subcutânea/anatomia & histologia
13.
Br J Nutr ; 122(s1): S68-S79, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31638497

RESUMO

Variants in the human genes of fatty acid (FA) desaturase 1 (FADS1), 2 (FADS2) and 3 (FADS3) are associated with PUFA blood levels. We explored if maternal prenatal supplementation and children's genetic variation in seventeen SNP of the FADS1, FADS2 and FADS3 gene cluster influence twenty-one of the most relevant cheek cells' derived FA in glycerophospholipids (GPL-FA). The study was conducted in 147 Spanish and German mother-children pairs participating in the Nutraceuticals for a Healthier Life (NUHEAL) study at 8, 9 and 9·5 years. Linear and mixed model longitudinal regression analyses were performed. Maternal fish-oil (FO) or FO+5-methyltetrahydrofolate (5-MTHF) supplementation during pregnancy was associated with a significant decrease of arachidonic acid (AA) concentrations in cheek cell GPL in the offspring, from 8 to 9·5 years; furthermore, maternal FO+5-MTHF supplementation was associated with higher n-6 docosapentaenoic acid concentrations in their children at age 8 years. FADS1 rs174556 polymorphism and different FADS2 genotypes were associated with higher concentrations of linoleic and α-linolenic acids in children; moreover, some FADS2 genotypes determined lower AA concentrations in children's cheek cells. It is suggested an interaction between type of prenatal supplementation and the offspring genetic background driving GPL-FA levels at school age. Prenatal FO supplementation, and/or with 5-MTHF, seems to stimulate n-3 and n-6 FA desaturation in the offspring, increasing long-chain PUFA concentrations at school age, but depending on children's FADS1 and FADS2 genotypes. These findings suggest potential early nutrition programming of FA metabolic pathways, but interacting with children's FADS polymorphisms.


Assuntos
Ácidos Graxos Dessaturases/genética , Ácidos Graxos/análise , Glicerofosfolipídeos/química , Mucosa Bucal/química , Ácido Araquidônico/análise , Bochecha , Criança , Suplementos Nutricionais , Feminino , Óleos de Peixe/administração & dosagem , Genótipo , Alemanha , Humanos , Masculino , Mucosa Bucal/citologia , Família Multigênica/genética , Polimorfismo de Nucleotídeo Único/genética , Gravidez , Cuidado Pré-Natal/métodos , Espanha , Tetra-Hidrofolatos/administração & dosagem
14.
J Craniofac Surg ; 30(8): 2632-2634, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31592846

RESUMO

The aim of this study was to compare Hamra's and Mendelson's models of midface lift.The terms "Hamra ST" and "Mendelson BC" were used to search PubMed, yielding 35 and 48 papers, respectively. Of the 83 abstracts, 55 were excluded and 28 full papers discussing midface lift were reviewed. Among those 28 papers, 13 were excluded because they did not have sufficient content. Among the 15 full texts, 5 mined papers were added. Thereafter, 20 papers were analyzed.Hamra's description of his surgical technique changed twice. In 1990 (The Deep-Plane Rhytidectomy), he wrote that he performed Skoog-type subsuperficial muscular aponeurotic system (SMAS) dissection to the nasolabial fold. In 1992 (Composite Rhytidectomy), however, he cited a paper insisting that the SMAS does not exist in the cheek area. He wrote that his deep-plane rhytidectomy was not a sub-SMAS procedure, stating that he dissected the cheek fat that is attached to the zygomaticus major, then repositioned the skin. This was a substantially different explanation of the dissection plane. In 1997, he stated that instead of dividing the orbicularis oculi muscle from the zygomaticus major and minor, he elevated them together in a flap. Thus, his method returned to the sub-SMAS plane. Mendelson introduced the concepts of the prezygomatic space, orbicularis-retaining ligament, and zygomatic-retaining ligament, and proposed an anatomical model.If the authors explain Hamra's zygorbicular dissection using Mendelson's model, the dissection starts just beneath the roof of the prezygomatic space, traverses the floor, and then releases the zygomatic ligament (lower boundary of the space). The authors should consider the necessity and riskiness of this release.


Assuntos
Bochecha/cirurgia , Músculos Faciais/cirurgia , Aponeurose/cirurgia , Dissecação , Pálpebras/cirurgia , Humanos , Ligamentos/cirurgia , Sulco Nasogeniano/cirurgia , Ritidoplastia/métodos , Retalhos Cirúrgicos/cirurgia
16.
J Craniofac Surg ; 30(8): 2618-2620, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31567770

RESUMO

Oronasal fistula (ONF) is the most common complication after palatoplasty in patients with cleft lip and palate (CLP). When left untreated, it may negatively affect the quality of life, leading to development of other comorbidities. This study reports for the first time, the use of a portion of a hyperplasic tissue associated with pedicled buccal fat pad flap to repair a large anterior ONF in a 60-year-old man. The hyperplasic tissue may have developed due to the combination of a loose fitting upper denture and long-term use of dihydropyridine calcium channel blocker (amlodipine besylate). There is controversy in the literature about use of pedicled buccal fat pad flap in the anterior region. However, in this study, we report successful repair of a large anterior ONF using a portion of a fibroepithelial hyperplasic tissue associated with pedicled buccal fat pad flap.


Assuntos
Bochecha/cirurgia , Doenças Nasais/cirurgia , Fístula Bucal/cirurgia , Tecido Adiposo/transplante , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Procedimentos Cirúrgicos Reconstrutivos , Retalhos Cirúrgicos
17.
J Pak Med Assoc ; 69(9): 1403, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31511737

RESUMO

Fluorine-18 Fluorodeoxyglucose positron emission tomography computed tomography (18FDG PET-CT) is routinely used for post treatment monitoring of oral cavity cancers. In addition to physiological uptake of 18FDG, apposition of anatomical structures poses a big challenge in accurate localization of pathology in oral cavity that is further complicated by surgery and/or radiotherapy related distortion. Case of recurrent Squamous Cell Carcinoma (SCC) of tongue is being presentedin a patient who underwent 18FDG PET-CT for post treatment monitoring. Simple 'Puffed Cheek' maneuver helped in accurately localizing tumour recurrence site within the retro-molar trigone.


Assuntos
Recidiva Local de Neoplasia/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias da Língua/diagnóstico por imagem , Bochecha , Feminino , Fluordesoxiglucose F18 , Humanos , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico por imagem , Compostos Radiofarmacêuticos , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Neoplasias da Língua/terapia
18.
J Dermatol Sci ; 96(1): 42-49, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31522824

RESUMO

BACKGROUND: The progression of human skin aging has a strong genetic basis. However, recent studies have mainly focused on Caucasian populations and we have thus performed a genetic association study on skin aging signs in Han Chinese population. OBJECTIVE: To investigate genetic risk factors in skin aging in Han Chinese female, we performed a genome-wide association study. METHODS: We collected genotype data from 1534 Han Chinese female from Taizhou cohort and evaluated 15 skin aging phenotypes by using the validated skin aging SCINEXA™ score. Genetic associations were tested by linear and logistic regression analyses and adjusted for potential confounders. RESULTS: Six genomic regions significantly associated with a risk for skin aging were revealed : 6q24.2 (rs3804540, P=4.6×10-9, additive model) with size of pigmented spots on forehead, 10q26.13 (rs4962295, P=1.9 ×10-8, additive model) with wrinkles under eyes, 15q21.1 (rs28392847, P=1.6×10-8, additive model) with crow's feet, 2p25.1 (rs191497052, P=5.5×10-9, dominant model) with telangiectasia, 13q34 (rs3825460, P=3.7×10-8, dominant model) with size of pigmented spots on cheeks and 16p13.11(rs76053540, P=5.0×10-9, dominant model) with nasolabialfold. The signal on 15q21.1 was replicated in the meta-analysis with two independent Caucasian cohorts (P=8.6×10-10). We have also successfully replicated in our cohort an association between SNP rs1048943 of gene CYP1A1 (P=7.1 × 10-4) and pigmented spots on cheeks previously described in Caucasian cohort. CONCLUSIONS: Our study has identified new genetic risk factors for signs of skin aging in the Han Chinese. This study suggests there are differences in genetic susceptibility to skin aging between Caucasians and the Han Chinese.


Assuntos
Grupo com Ancestrais do Continente Asiático/genética , Envelhecimento da Pele/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Bochecha , Estudos de Coortes , Citocromo P-450 CYP1A1/genética , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Estudo de Associação Genômica Ampla , Humanos , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Pigmentação da Pele/genética
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