Forehead ; surgery ; Humans ; Nose ; surgery ; Rhinoplasty ; Surgical Flaps

Knowledge of the location of the maxillo-facial foramina is essential for regional nerve blocks and endoscopic surgical procedures to avoid nerve injury passing through these foramina. The purposes of this study were to determine the locations of the supraorbital foramen (SOF) and the infraorbital foramen (IOF) related to medial canthus (MC), and to analyze the morphology of these foramina. Thirty-two embalmed cadavers (64 sides, mean age: 64.1 years) and 33 dry skulls (66 sides) were used. The distances from the SOF, IOF, and MC to facial midline were directly measured on the cadavers using digital Vernier caliper. The vertical and horizontal distances of the SOF and IOF relative to the medial canthus were indirectly measured on the digital photographs using image analyzer software. The vertical and horizontal diameters of the IOF, and its location in relation to maxillary tooth were evaluated on the dry skull. Statistical analysis was performed using one-way ANOVA with declaration of significant difference when P<0.05. The mean distances of SOF, MC, and IOF to the facial midline were 24.13 mm, 15.00 mm, and 29.11 mm, respectively. The SOF was located 18.99 mm superior and 9.05 mm lateral to the medial canthus. The distance between the medial canthus and the SOF was 22.67 mm, and the vertical angle (Angle 1) between these structures was 24.36degrees superolaterally. The IOF was located 26.69 mm inferior and 13.53 mm lateral to the medial canthus. The distance between the medial canthus and IOF was 30.82 mm and the vertical angle (Angle 2) between these structures was 26.59degrees inferolaterally. In the this study, spraorbital notch (SON) was found more frequently than the SOF. The mean vertical and horizontal diameters of IOF were 3.36 mm, 3.45 mm, respectively. IOF was most commonly found in the same vertical plane with the second upper premolar. In conclusion, these results are important for performing local anesthetic, facial plastic surgery, and other invasive procedures in the forehead and periorbital region to prevent injury of neurovascular bundles passing through these foramina.
Cadaver ; Endoscopy ; Forehead ; Nerve Block ; Skull ; Surgery, Plastic ; Tooth

Defects resulting from Mohs micrographic surgery may immediately be reconstructed with primary repair, flaps or grafts, or the wound may be allowed to heal by secondary intention. We experienced 3 cases of secondary intention healing using occlusive dressing and purse-string suture, and wounds were healed with excellent cosmetic and functional results. Therefore, we conclude that secondary intention healing of forehead and temple wounds is a safe and effective method of wound management after Mohs micrographic surgery.
Forehead* ; Intention* ; Mohs Surgery ; Occlusive Dressings ; Sutures ; Transplants ; Wounds and Injuries

BACKGROUND: Repairing large nasal defects in the nose gives us technical challenge. Despite the commonly available surgical techniques, paramedian forehead flap (PFF), an arterial flap, should be considered in repairing some of the large nasal defects. OBJECTIVE: The aim of this study was to evaluate the effectiveness and cosmetic consequences of PFF for the reconstruction of large nasal defects after skin cancer excision. METHODS: Between 2008 and 2011, 8 patients were treated with PFF for reconstruction of large nasal defects after Mohs surgery or wide excision. We reviewed surgical techniques, complications, and final results. Post-operative results were assessed with serial clinical photographs, physicians' objective records and patients' subjective records. RESULTS: The size of surgical defects was ranged from 2.0 to 3.0 cm in their greatest diameter, involving at least 2 cosmetic subunits after tumor excision. Frequent involved sites were nasal tip and nasal dorsum. There were no significant complications, except transient bleeding and oozing. The cosmetic outcomes were considered as good or excellent in most of patients. CONCLUSION: PFF is regarded as the recommended technique for the repair of large nasal defects, involving several cosmetic subunits, providing excellent cosmetic results with few complications.
Cosmetics ; Forehead ; Hemorrhage ; Humans ; Mohs Surgery ; Nose ; Skin ; Skin Neoplasms

BACKGROUND: Repairing large nasal defects in the nose gives us technical challenge. Despite the commonly available surgical techniques, paramedian forehead flap (PFF), an arterial flap, should be considered in repairing some of the large nasal defects. OBJECTIVE: The aim of this study was to evaluate the effectiveness and cosmetic consequences of PFF for the reconstruction of large nasal defects after skin cancer excision. METHODS: Between 2008 and 2011, 8 patients were treated with PFF for reconstruction of large nasal defects after Mohs surgery or wide excision. We reviewed surgical techniques, complications, and final results. Post-operative results were assessed with serial clinical photographs, physicians' objective records and patients' subjective records. RESULTS: The size of surgical defects was ranged from 2.0 to 3.0 cm in their greatest diameter, involving at least 2 cosmetic subunits after tumor excision. Frequent involved sites were nasal tip and nasal dorsum. There were no significant complications, except transient bleeding and oozing. The cosmetic outcomes were considered as good or excellent in most of patients. CONCLUSION: PFF is regarded as the recommended technique for the repair of large nasal defects, involving several cosmetic subunits, providing excellent cosmetic results with few complications.
Cosmetics ; Forehead ; Hemorrhage ; Humans ; Mohs Surgery ; Nose ; Skin ; Skin Neoplasms

Forehead deep wrinkles make man's face ugly. Especially, in case that a young people has short forehead, one or two forehead deep wrinkles is likely go give a aggressive impression to people. Traditional forehead lift basically not only perfrom the selective excision of frontalis muscle which cause forehead wrinkles, but extend the width of forehead by practical lift through scalp excision. Recently, various filling materials such as collagen have been developing, and laser resurfacing and endoscopic plastic surgery has gradually been generalized, so the frequency of the traditional forehead lift which needs the extensive operation through coronal incision is gradually diminished. But collagen injection is repeatedly taken every regular times and it has a weak point that the width of forehead cannot be regulated. Laser resurfacing can't solve the problem of deep wrinkles. The purpose of endoscopic brow lift which has been generalized currently is mainly brow lift, and so this method is not good for deep wrinkles because it can't modualte frontalis muscle which cause forehead transverse wrinkles. Recently it has been reported that Alloderm composed of dermal collagen from cadavar skin is universally used in covering as well as filling up soft tissue defect and its usability is also successful. Authors recently correct three young persons who have forehead deep wrinkles by combination of endoscopic forehead lift and subcutaneous Alloderm implantation under the wrinkles for 2 years. At first, we extended the width of forehead and smoothed the depth of wrinkles by endoscopic brow lift. After having endoscopic operation, we inserted Alloderm in subcutaneous pocket and performed suspension suture outside. The average increase of forehead width is 5 mm and all patients had corrected transverse wrinkles remarkably. During the 9 months, wrinkles didn't recur and implanted Alloderm also didn't absorbed. As a better method, authors reported that combining endoscopic brow lift with Alloderm implantation for the correction of short forehead and deep wrinkles could be used in place of traditional forehead lift.
Collagen ; Forehead* ; Humans ; Scalp ; Skin ; Surgery, Plastic ; Sutures

Forehead ; surgery ; Humans ; Nose ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

OBJECTIVETo sum up three types of plastic procedures for frontal plagiocephaly Based on the principle of floating forehead, the plagiocephaly (unilateral coronal synostosis).

METHODSwas corrected and orbito-frontal reconstruction was performed by orbito-frontal advancement, 'or temporoparietal osteotomy, or fronto-parietal osteotomy. The absorbable plates and microscrews composed of From January 2008 to polylactide polymers, were used to immobilize calvarial segments.

RESULTSDecember 2010, 9 cases of plagiocephaly were treated with satisfactory result and no severe complication. The patients were followed up for 1-2 years with no recurrence of suture fusion and deformity. The brain development was not restricted. The absorbable plates were applied to avoid the metal fixation moving into The three types of plastic procedures, orbito-frontal advancement, or the cranial bone.

CONCLUSIONStemporo-parietal osteotomy, or fronto-parietal osteotomy, can correct the plagiocephaly with satisfactory orbito-frontal appearance. Long-term follow-up is needed to observe the long-term effect of the orbito-frontal reconstructive operation on mental and calvarial development as well as visual function.

Absorbable Implants ; Bone Plates ; Craniosynostoses ; surgery ; Forehead ; Humans ; Osteotomy ; methods ; Plagiocephaly ; surgery ; Reconstructive Surgical Procedures ; methods

OBJECTIVE: To investigate the causes, clinical manifestation and treatment principles of frontal sinus tract after the frontal approach craniotomy. METHOD: The clinic data of 13 patients with frontal skin sinus tract after the frontal approach craniotomy were retrospectively analyzed. All of them were described in the clinical record to have undergone frontal sinus mucosa pushing down or shaving and bone wax filling in the frontal sinus during the surgery, of whom 3 cases had history of frontal abscess incision drainage. All patients were performed endoscopic frontal sinus surgery and forehead skin sinus tract excision and suture. RESULT: All of the patients successfully recovered after one-stage operation, and the frontal skin sinus tract was healed. CONCLUSION The frontal approach craniotomy with postoperative frontal sinus tract was related with the improper use of bone wax tamponade and sealing of frontal sinus. The treatment principles were to remove bone wax, remove inflammatory granulation tissue around the sinus tract, and to open frontal sinus and promote frontal sinus drainage.
Craniotomy ; methods ; Drainage ; Endoscopy ; Forehead ; Frontal Sinus ; surgery ; Granulation Tissue ; surgery ; Humans ; Palmitates ; Retrospective Studies ; Waxes

Aged ; Forehead/surgery* ; Humans ; Male ; Nose/surgery* ; Nose Neoplasms/surgery* ; Retrospective Studies ; Rhinoplasty ; Skin Neoplasms/surgery* ; Surgical Flaps