Facial infiltrating lipomatosis(FIL)is a congenital asymmetrical deformity of the maxillofacial region that can significantly affect a patient’s facial appearance and function.With the development of sequencing techn...Facial infiltrating lipomatosis(FIL)is a congenital asymmetrical deformity of the maxillofacial region that can significantly affect a patient’s facial appearance and function.With the development of sequencing technologies,PIK3CA mutations are considered among the potential etiologies of FIL.The management and treatment of FIL involves plastic surgery;more recently,an improved understanding of its pathogenesis has given rise to new treatment options,including targeted therapy.Here we report the clinical data of two patients diagnosed with FIL and present current curative concepts.展开更多
Facial skeletal contouring surgery such as reduction malarplasty and reduction angleplasty is popular in Asian countries. With rapid economic development, an increasing number of patients receive facial skeletal conto...Facial skeletal contouring surgery such as reduction malarplasty and reduction angleplasty is popular in Asian countries. With rapid economic development, an increasing number of patients receive facial skeletal contouring surgery combined with other facial aesthetic sur geries. From January 2014 to December 2016, a total of 37 patients underwent Facial skeletal contouring surgery combined with facial esthetic surgeries in our department. The modified L-shape reduction malarplasty and reduction mandibular angleplasty were performed using reciprocating saws. The combined facial esthetic surgeries are 4 cases of double eyelid blepharoplasty, 6 cases of augmentation rhinoplasty, 2 cases of autologous fat transplantation and 1 case of augmentation genioplasty. 36 patients were satisfied with the final facial contour and appearance. No severe complications were seen in our series. Facial skeletal contouring surgeries can drastically and permanently change the patient's facial contour. Plastic surgeons should be acquainted with the metabolic aesthetic trends and be familiar with all the surgical techniques. The selection of an appropriate procedure or combined procedures for individual patients should be made according to the cultural background, patient's chief complain, anatomic variations and possible operative sequ elae.展开更多
Cleft surgery requires an expert team performing ongoing treatment in order to achieve optimal outcomes. The senior author's(KES) experiences of more than 2000 patients with cleft lip and palate treated by a surgi...Cleft surgery requires an expert team performing ongoing treatment in order to achieve optimal outcomes. The senior author's(KES) experiences of more than 2000 patients with cleft lip and palate treated by a surgical-orthodontic protocol were introduced. The paper here will concentrate on not only correcting the occlusion as others have described,but also on what one surgeon can do to achieve optimal aesthetic balance, harmony and beauty. The results of orthognathic surgery in respect to function, stability, cosmesis, and complications are also audited.展开更多
Objective: To identify the facial nerve trunk (FNT) very easily. quickly and accurately considering the styloid process as the robust anatomically consistent landmark during parotid surgery. Patients and Methods: This...Objective: To identify the facial nerve trunk (FNT) very easily. quickly and accurately considering the styloid process as the robust anatomically consistent landmark during parotid surgery. Patients and Methods: This prospective study was conducted between January 2010 to December 2022 at a Tertiary care hospital. It included 130 patients: 84 (65%) males and 46 (35%) females with a mean age of 43.52 ± 15.63 years. Patients presented with pleomorphic adenoma (90), chronic sialectasis (05), parotid cyst (03), parotid sinus (01), mucoepidermoid carcinoma (28), adenoid cystic carcinoma (02) and squamous cell carcinoma (01) were subjected to superficial parotidectomy and total parotidectomy. The outcome was evaluated regarding the clinical success of facial nerve function that considered the location of the styloid process in the triangle technique for identification of the FNT during parotid surgery. Results: All 130 patients underwent superficial and total parotidectomy. The facial nerve trunk was successfully identified as the location of the styloid process in the triangle technique in all the patients with no intra-operative complications. Operative time ranged from 50 to 180 minutes with a mean time 90.70 ± 15.68 minutes. Dysfunction of the angle of the mouth due to the deficit of the marginal mandibular nerve (MMN) was noted in 5 patients (3.8%), 02 had difficulty in eye closure (1.5%). No patient reported surgical site infection, skin flap necrosis and hematoma in this series. Conclusion: Styloid process is the prominent robust landmark in the triangle technique for the identification of facial nerve trunk with relative ease, safety and accuracy in the parotid surgical procedure. This can be a very useful method to locate the FNT and minimize facial nerve injury during parotid surgery.展开更多
We present a rare and unusual complication of cervico-facial soft tissue emphysema with pneumo-mediastinum which occurred in a 30-year-old female Jordanian patient in our hospital in October 2010 in Abu Dhabi followin...We present a rare and unusual complication of cervico-facial soft tissue emphysema with pneumo-mediastinum which occurred in a 30-year-old female Jordanian patient in our hospital in October 2010 in Abu Dhabi following FESS. CT scan evaluation of aero-digestive tract in the immediate post-operative period was done to ascertain the cause pertaining to any surgical trauma or anaesthesia related complications. Such a case previously unreported has been included in this study. A simple close monitoring after establishing the cause is usually sufficient in management of such related or unrelated complications during FESS which in our case was likely to be anaesthesia related. Published data of such a complication assists in building up a good and effective medical audit based on ethical practice. This paper stresses the importance of immediate CT scan of aero-digestive tract in evaluating the cause.展开更多
Objective To study influence of distal portion compression of facial nerve in hemifacial spasm surgery. Methods 120 hemifacial spasm patients were undergone lateral spread response monitoring during microvascular deco...Objective To study influence of distal portion compression of facial nerve in hemifacial spasm surgery. Methods 120 hemifacial spasm patients were undergone lateral spread response monitoring during microvascular decompression surgery. 39 patients’LSR remained after decompression of the root exit zone of the facial nerve.展开更多
Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents.The global incidence of children...Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents.The global incidence of children born with congenital anomalies has been reported to be 3%-6%with more than 90%of these occurring in low-and middle-income group countries.The exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several reasons.These children are operated under several surgical disciplines,viz,paediatric-,plastic reconstructive,neuro-,cardiothoracic-,orthopaedic surgery etc.These conditions may be life-threatening,e.g.,trachea-oesophageal fistula,critical pulmonary stenosis,etc.and require immediate surgical intervention.Some,e.g.,hydrocephalus,may need intervention as soon as the patient is fit for surgery.Some,e.g.,patent ductus arteriosus need‘wait and watch’policy up to a certain age in the hope of spontaneous recovery.Another extremely important category is that of patients where the operative intervention is done based on their age.Almost all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery(many as multiple stages of correction)at appropriate ages.There are advantages and disadvantages of intervention at different ages.In this article,we present a review of optimal timings,along with reasoning,for surgery of many of the common congenital anomalies which are treated by plastic surgeons.Obstetricians,paediatricians and general practitioners/family physicians,who most often are the first ones to come across such children,must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late.展开更多
基金supported by the Major and Key Cultivation Projects of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong university School of Medicine (grant no. JYZP005)Project of Biobank from Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine (grant no. YBKA202209)Rare Disease Registration Platform of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine (grant no. JYHJB02)
文摘Facial infiltrating lipomatosis(FIL)is a congenital asymmetrical deformity of the maxillofacial region that can significantly affect a patient’s facial appearance and function.With the development of sequencing technologies,PIK3CA mutations are considered among the potential etiologies of FIL.The management and treatment of FIL involves plastic surgery;more recently,an improved understanding of its pathogenesis has given rise to new treatment options,including targeted therapy.Here we report the clinical data of two patients diagnosed with FIL and present current curative concepts.
文摘Facial skeletal contouring surgery such as reduction malarplasty and reduction angleplasty is popular in Asian countries. With rapid economic development, an increasing number of patients receive facial skeletal contouring surgery combined with other facial aesthetic sur geries. From January 2014 to December 2016, a total of 37 patients underwent Facial skeletal contouring surgery combined with facial esthetic surgeries in our department. The modified L-shape reduction malarplasty and reduction mandibular angleplasty were performed using reciprocating saws. The combined facial esthetic surgeries are 4 cases of double eyelid blepharoplasty, 6 cases of augmentation rhinoplasty, 2 cases of autologous fat transplantation and 1 case of augmentation genioplasty. 36 patients were satisfied with the final facial contour and appearance. No severe complications were seen in our series. Facial skeletal contouring surgeries can drastically and permanently change the patient's facial contour. Plastic surgeons should be acquainted with the metabolic aesthetic trends and be familiar with all the surgical techniques. The selection of an appropriate procedure or combined procedures for individual patients should be made according to the cultural background, patient's chief complain, anatomic variations and possible operative sequ elae.
文摘Cleft surgery requires an expert team performing ongoing treatment in order to achieve optimal outcomes. The senior author's(KES) experiences of more than 2000 patients with cleft lip and palate treated by a surgical-orthodontic protocol were introduced. The paper here will concentrate on not only correcting the occlusion as others have described,but also on what one surgeon can do to achieve optimal aesthetic balance, harmony and beauty. The results of orthognathic surgery in respect to function, stability, cosmesis, and complications are also audited.
文摘Objective: To identify the facial nerve trunk (FNT) very easily. quickly and accurately considering the styloid process as the robust anatomically consistent landmark during parotid surgery. Patients and Methods: This prospective study was conducted between January 2010 to December 2022 at a Tertiary care hospital. It included 130 patients: 84 (65%) males and 46 (35%) females with a mean age of 43.52 ± 15.63 years. Patients presented with pleomorphic adenoma (90), chronic sialectasis (05), parotid cyst (03), parotid sinus (01), mucoepidermoid carcinoma (28), adenoid cystic carcinoma (02) and squamous cell carcinoma (01) were subjected to superficial parotidectomy and total parotidectomy. The outcome was evaluated regarding the clinical success of facial nerve function that considered the location of the styloid process in the triangle technique for identification of the FNT during parotid surgery. Results: All 130 patients underwent superficial and total parotidectomy. The facial nerve trunk was successfully identified as the location of the styloid process in the triangle technique in all the patients with no intra-operative complications. Operative time ranged from 50 to 180 minutes with a mean time 90.70 ± 15.68 minutes. Dysfunction of the angle of the mouth due to the deficit of the marginal mandibular nerve (MMN) was noted in 5 patients (3.8%), 02 had difficulty in eye closure (1.5%). No patient reported surgical site infection, skin flap necrosis and hematoma in this series. Conclusion: Styloid process is the prominent robust landmark in the triangle technique for the identification of facial nerve trunk with relative ease, safety and accuracy in the parotid surgical procedure. This can be a very useful method to locate the FNT and minimize facial nerve injury during parotid surgery.
文摘We present a rare and unusual complication of cervico-facial soft tissue emphysema with pneumo-mediastinum which occurred in a 30-year-old female Jordanian patient in our hospital in October 2010 in Abu Dhabi following FESS. CT scan evaluation of aero-digestive tract in the immediate post-operative period was done to ascertain the cause pertaining to any surgical trauma or anaesthesia related complications. Such a case previously unreported has been included in this study. A simple close monitoring after establishing the cause is usually sufficient in management of such related or unrelated complications during FESS which in our case was likely to be anaesthesia related. Published data of such a complication assists in building up a good and effective medical audit based on ethical practice. This paper stresses the importance of immediate CT scan of aero-digestive tract in evaluating the cause.
文摘Objective To study influence of distal portion compression of facial nerve in hemifacial spasm surgery. Methods 120 hemifacial spasm patients were undergone lateral spread response monitoring during microvascular decompression surgery. 39 patients’LSR remained after decompression of the root exit zone of the facial nerve.
文摘Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents.The global incidence of children born with congenital anomalies has been reported to be 3%-6%with more than 90%of these occurring in low-and middle-income group countries.The exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several reasons.These children are operated under several surgical disciplines,viz,paediatric-,plastic reconstructive,neuro-,cardiothoracic-,orthopaedic surgery etc.These conditions may be life-threatening,e.g.,trachea-oesophageal fistula,critical pulmonary stenosis,etc.and require immediate surgical intervention.Some,e.g.,hydrocephalus,may need intervention as soon as the patient is fit for surgery.Some,e.g.,patent ductus arteriosus need‘wait and watch’policy up to a certain age in the hope of spontaneous recovery.Another extremely important category is that of patients where the operative intervention is done based on their age.Almost all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery(many as multiple stages of correction)at appropriate ages.There are advantages and disadvantages of intervention at different ages.In this article,we present a review of optimal timings,along with reasoning,for surgery of many of the common congenital anomalies which are treated by plastic surgeons.Obstetricians,paediatricians and general practitioners/family physicians,who most often are the first ones to come across such children,must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late.
