ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Sinus pericranii is an anomalous extracranial vascular malformation that is in continuity with the intracranial dural venous sinuses. Five case reports, three congenital and two traumatic, are described. Clinical management, including evaluation, diagnosis, and treatment, is discussed. Awareness of this entity by plastic surgeons will allow for earlier diagnosis and appropriate surgical management, resulting in decreased risk of complications.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Dynamic Orthotic Cranioplasty (DOC) was developed to treat craniofacial deformities associated with positional plagiocephaly. This investigation describes the treatment of more than 750 patients with the DOC Band since 1988. All patients undergoing DOC treatment were fit with a custom fabricated orthosis made from a plaster impression taken from the infant's head. When the orthosis was applied, the corrective pressure was directed to hold growth at the calvarial prominences and redirect symmetrical growth. A detailed medical history was obtained and anthropometric measurements were taken at start, exit, 12, 18, and 24 months follow-up. This information was recorded in a database created in Microsoft Excel. Mean length of treatment was 4.3 months with an average entrance age of 6.9 months. Analysis of anthropometric data showed significant reduction in mean cranial vault, skull base, and facial asymmetries. Correction of the more difficult skull base was documented with computed tomography. Our anthropometric and clinical observations document complete or near complete correction of asymmetry for a wide variety of head shapes. Based on the results of this investigation, we are able to support the earlier claims of our pilot study, which concluded that DOC is effective in the treatment of positional plagiocephaly.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Fifty-five patients with unilateral cleft lip nasal deformities were operated on from March 1992 to June 1996. Thirty-one patients were male and 24 were female. Three patients were 2 to 5 years of age, 7 patients were 6 to 10 years old, 12 patients were 11 to 15 years old, 13 were 16 to 20 years old, and 20 were greater than 21 years of age. The average follow-up period was 16 months. Combined operative procedures, depending on the severity of the cleft lip nasal deformity, were the following: (1) a reverse-U incision and Z-plasty for a mild vestibular web, (2) a reverse-U incision and V-Y plasty for a moderate vestibular web, (3) open rhinoplasty incision combined with a reverse-U incision and V-Y plasty for severe flattening or buckling of the cleft lower lateral cartilage, (4) lower lateral cartilage suspension or repositioning with or without an onlay cartilage graft, (5) alar base advancement, (6) bone graft on the piriform aperture, (7) septoplasty and corrective rhinoplasty, and (8) columella lengthening with an auricular composite graft. A nasal splint was applied for 3 to 6 months in every patient to maintain the corrected nostril contour. Most patients were satisfied with their surgical results. We suggest that to achieve a good contour of the nose, bony and cartilaginous deformities should be corrected simultaneously with correction of the soft tissue.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The cause of craniosynostosis continues to elude researchers. Although several studies have looked at the ultrastructure of normal suture closure, no previous studies have examined the microarchitecture of the synostotic suture. Our goal was to assess the scanning electron microscope (SEM) as a viable and useful tool in examining craniosynostosis. Our hypothesis is that the SEM is a powerful analytical tool that can evaluate nonsynostotic, partial synostotic, and complete synostotic cranial sutures. We analyzed the cranial suture of 3 human infants with nonsyndromic sagittal craniosynostosis. The specimens were separated into three groups, which included regions of partial and complete synostosis and a region of open suture. Histological examination provided cellular and tissue data about craniosynostosis, whereas the SEM provided detailed information regarding the trabecular microarchitecture of the synostosed suture. The SEM produced quality images of complete and partially synostotic sutures and open sutures. At low magnification, the SEM characterized the general bony microarchitecture of cranial sutures in a manner different from, but complementary to, standard histological sections. At higher magnification, the SEM allowed us a look at the cellular population of craniosynostotic sutures in a way that surpasses standard light microscopy. The SEM is an excellent tool for the study of craniosynostosis and has proved invaluable in our ability to evaluate the microarchitecture and cellular population of the fusing suture. We believe we have proven our hypothesis by demonstrating the SEM to be a powerful analytical tool that can evaluate nonsynostotic, partial synostotic, and complete synostotic cranial sutures.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Despite the widespread use of rigid fixation techniques in craniofacial surgery, there is a paucity of studies in the literature that serve to better define the reasons for the subsequent removal of plates and screws. The current study appears to be the first to attempt to assess these issues among a broad range of craniofacial surgery patients. Fifty-five patients who underwent hardware removal following craniofacial surgery at the University of Michigan Medical Center between 1989 and 1995 were retrospectively studied via an in-depth chart review. Common reasons for hardware removal included palpable/prominent hardware in 19 patients (34.5%), loosening of plates and screws in 14 patients (25.5%), pain in 14 patients (25.5%), infection in 13 patients (23.6%), wound dehiscence/exposure of hardware in 11 patients (20%), and removal at the time of secondary procedures in 5 patients (9.1%). It is hoped that this study will serve as a tool to define more completely the risk of needing subsequent hardware removal among craniofacial surgery patients treated with rigid internal fixation.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The giant-cell central reparative granuloma, unlike other giant-cell neoplasias, is mainly found in maxillary bones, particularly in the mandible. We report a patient study of giant-cell central reparative granuloma in the mandible extending from dental elements 34 to 44. The patient underwent excision of a neoplasm and reconstruction of the mandible via an autologous bone graft of the iliac crest. To restore fully, functionally, and aesthetically the masticatory apparatus after verification of graft stability, four osseointegrated implants were fixed, and an “overdenture” prosthesis was then applied, thus finally solving the problem.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID