Rhytidectomy

2019 ◽  
pp. 207-218
Author(s):  
Malcolm D. Paul
Keyword(s):  
Facial Nerve ◽  
Clinical Examination ◽  
Skin Tension ◽  
Aging Face ◽  
Superficial Musculoaponeurotic System ◽  
Supporting Layer ◽  
Surgical Options ◽  
Selection Of

Current concepts in rejuvenating the aging face and neck have evolved from simple undermining of the skin resulting in skin tension-based closure to various techniques that utilize the superficial musculoaponeurotic system (SMAS) as a supporting layer with no tension on the skin. The evolution of techniques regarding the manipulation of the SMAS began with an understanding of the anatomy of the facial nerve and sub-SMAS anatomy. Both volume-based and vector-based corrections are required. The selection of the appropriate technique is based on the clinical examination and the surgical options that the surgeon possesses. A safely performed procedure that provides impressive rejuvenation of the aging face and neck is always the goal.

Surgical Options for the Aging Face Explored

2009 ◽  
Vol 40 (8) ◽  
pp. 22
Author(s):  
KERRI WACHTER
Keyword(s):  
Aging Face ◽  
Surgical Options

Surgical Anatomy for Extended Facelift Techniques

2020 ◽  
Vol 36 (03) ◽  
pp. 309-316
Author(s):  
Ozcan Cakmak ◽  
Ismet Emrah Emre
Keyword(s):  
Facial Nerve ◽  
Soft Tissues ◽  
Extended Techniques ◽  
Surgical Anatomy ◽  
Superficial Musculoaponeurotic System ◽  
Increased Risk ◽  
The Face ◽  
Facial Soft Tissues ◽  
Relationship Of ◽  
The Relationship

AbstractPreservation of the facial nerve is crucial in any type of facial procedure. This is even more important when performing plastic surgery on the face. An intricate knowledge of the course of the facial nerve is a requisite prior to performing facelifts, regardless of the technique used. The complex relationship of the ligaments and the facial nerve may put the nerve at an increased risk of damage, especially if its anatomy is not fully understood. There are several danger zones during dissection where the nerve is more likely to be injured. These include the areas where the nerve branches become more superficial in the dissection plane, and where they traverse between the retaining ligaments of the face. Addressing these ligaments is crucial, as they prevent the transmission of traction during facelifts. Without sufficient release, a satisfying pull on the soft tissues may be limited. Traditional superficial musculoaponeurotic system techniques such as plication or imbrication do not include surgical release of these attachments. Extended facelift techniques include additional dissection to release the retaining ligaments to obtain a more balanced and healthier look. However, these techniques are often the subject of much debate due to the extended dissection that carries a higher risk of nerve complications. In this article we aim to present the relationship of both the nerve and ligaments with an emphasis on the exact location of these structures, both in regard to one another and to their locations within the facial soft tissues, to perform extended techniques safely.

scholarly journals Selection of non-invasive load procedure in diagnosis of ischemic heart disease (review)

2018 ◽  
pp. 62-70 ◽  
Author(s):  
V. P. Lupanov
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Clinical Examination ◽  
Ischemic Heart ◽  
Non Invasive ◽  
Careful Clinical Examination ◽  
Very High ◽  
Selection Of ◽  
High Pretest Probability

The diagnosis of stable ischemic heart disease begins with a careful clinical examination of the patient and non-invasive testing to identify the disease. Patients with very low and very high pretest probability should not undergo various non-invasive tests. Various non-invasive tests are available to assess the presence of coronary heart disease in patients with an intermediate probability of ischemic heart disease (15–65%). The combination of anatomical with functional non-invasive tests helps improve diagnostic capabili of the disease.

EquineReview

UK-Vet Equine ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 32-32
Author(s):  
Rachel Agass
Keyword(s):  
Facial Nerve ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Selection Of

Introduction: The topics of facial nerve paralysis, synovitis following blackthorn injury, sepsis of the calcaneal bursae, and the extent to which xylazine and acepromazine affect the assessment of forelimb lameness are discussed in this month's selection of recent papers for equine practitioners.

The Effect of Extended SMAS Face-lift on Earlobe Ptosis and Pseudoptosis

2021 ◽  
pp. 074880682110390
Author(s):  
Allison Altman ◽  
Zachary Sin ◽  
Erik Dan Tran ◽  
Jeanie Nguyen ◽  
Arian Mowlavi
Keyword(s):  
Protective Effect ◽  
Senior Author ◽  
Face Lift ◽  
Skin Tension ◽  
Neck Lift ◽  
Clinical Observations ◽  
Superficial Musculoaponeurotic System ◽  
Cheek Flap ◽  
Fine Tune ◽  
Caudal Segment

In this study, we explore the changes in the earlobe segments following an extended superficial musculoaponeurotic system (SMAS) face-lift and neck lift. We proposed to delineate the effect of the cheek and neck skin tension vectors on the earlobe based on the amount of excised skin length. A retrospective study identified patients who underwent extended SMAS rhytidectomy performed by the senior author (A.M.) at the Cosmetic Plastic Surgery Institute (CPSI) from 2017 to 2020. A total of 34 North American Caucasians, who had preoperative and postoperative photographs available for comparison, were evaluated. Preoperative and postoperative cephalic (the distance from the intertragal notch to the otobasion inferius, abbreviated as I to O) and caudal earlobe segment (the distance from the otobasion inferius to the subaurale, abbreviated as O to S) heights were collected. The change from the postoperative to preoperative measurements was calculated. The effects of the degree of cheek skin (superior ear [SE]) and neck skin (mastoid peak [MP]) excision lengths were then determined by comparing the change in I to O and O to S. The postoperative attached cephalic segment (15.94 ± 1.02 mm) increased significantly compared with the preoperative attached cephalic segment (12.99 ± 1.03 mm). The postoperative free caudal segment (3.62 ± 0.81 mm) decreased significantly compared with the preoperative free caudal segment (5.44 ± 0.95 mm). The SE median was found to be 3.0 cm and the MP median was found to be 3.5 cm. I to O increased by 3.85 mm for SE ≤3.0 cm compared with only 1.57 mm for SE >3.0 cm. O to S decreased by 2.79 mm for SE ≤3.0 cm compared with only decrease of 0.14 mm for SE >3.0 cm. I to O increased by only 1.67 mm for MP < 3.5 cm. O to S decreased less dramatically by 0.55 mm for MP ≤3.5 cm compared with decrease of 2.39 mm for MP >3.5 cm. These data demonstrate that more aggressive SE >3.0 cm cheek excision lengths resulted in a protective effect on decreasing the free caudal segment of the earlobe. More aggressive excisions of the cheek demonstrate a protective effect on preserving the free earlobe caudal segment, whereas more aggressive neck skin excisions result in higher propensity for loss of the free earlobe caudal segment. In our study, we demonstrate findings observed with clinical observations that a face-lift and neck lift will result in increase in the attached cephalic earlobe segment height (I to O) and a decrease in caudal free earlobe segment height (O to S). These findings may assist plastic surgeons when trying to fine-tune the earlobe aesthetics during face-lift and neck lift. If the patient has a small free hanging earlobe, the more aggressive pull on the cheek flap will result in less reduction in the earlobe hang.

ASYMMETRIC CRYING FACIES: A CLINICAL ODDITY

2021 ◽  
pp. 7-8
Author(s):  
Dilesh Kohat ◽  
Vishwanath Patil ◽  
Kusum Mahajan
Keyword(s):  
Facial Nerve ◽  
Clinical Examination ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Facial Asymmetry ◽  
Associated Anomalies ◽  
Benign Condition ◽  
Rare Congenital Disorder ◽  
The Face ◽  
Clinical Description

Background – Congenital hypoplasia of depressor angularis oris muscle (CHDAOM), which is often confused with unilateral facial nerve palsy, is a rare congenital disorder presenting with asymmetric crying facies in a newborn. Accurate diagnosis of this condition is imperative in order to ensure further screening to rule out associated anomalies and appropriate management. We report a late preterm male Clinical description – neonate who was noticed to have facial asymmetry selectively during episodes of crying. During quiet or sleeping state, the face was symmetrical. Clinical examination did not reveal any other facial abnormality or any evidence of facial nerve palsy. Associated anomalies were Management – ruled out by thorough evaluation. In view of isolated CHDAOM, parents were explained regarding benign course of the condition. The neonate was discharged after an uneventful hospital stay. This case report emphasizes the importance of a Conclusion – detailed clinical examination in the diagnosis of CHDOAM. CHDOAM, if occurring in isolation, is a benign condition and does not require any intervention. Parental counselling is the cornerstone of management. However, the diagnosis of CHDAOM should raise suspicion for other associated congenital anomalies and warrants a thorough evaluation.

Novel Techniques for Trigeminal Neuralgia Including Trigeminal Neurostimulators

2018 ◽  
pp. 118-138
Author(s):  
Arvin R. Wali ◽  
Christian Lopez ◽  
Peter Abraham ◽  
Michael G. Brandel ◽  
David R. Santiago-Dieppa ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Facial Nerve ◽  
Patient Selection ◽  
Microvascular Decompression ◽  
Published Data ◽  
Gasserian Ganglion ◽  
Therapeutic Modalities ◽  
Trigeminal Nerve Stimulation ◽  
Surgical Options ◽  
Novel Therapeutic

Several innovative surgical options for the management of trigeminal neuralgia have emerged over the past 40 years. In addition to microvascular decompression, other techniques have been introduced for the treatment of trigeminal neuralgia and facial nerve pain. This chapter describes the following novel therapeutic modalities: endoscopic microvascular decompression, radiosurgery, radiofrequency, thermocoagulation, glycerol rhizotomoy, balloon compression, Gasserian ganglion stimulation, and subcutaneous trigeminal nerve stimulation. For each of these techniques, this chapter provides a description of the procedure, criteria for patient selection, and discusses published data regarding patient outcomes.

scholarly journals Individualizing hyperosmolar therapy for management of intracranial hypertension

2018 ◽  
Vol 4 (2) ◽  
pp. 54-56
Author(s):  
Gentle Sunder Shrestha
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Hypertonic Saline ◽  
Significant Heterogeneity ◽  
Raised Intracranial Pressure ◽  
Threshold Method ◽  
Treatment Threshold ◽  
Hyperosmolar Therapy ◽  
Surgical Options ◽  
Selection Of

Intracranial hypertension is a major cause of morbidity and mortality in patients with brain injury. If not appropriately treated, it can precipitate brain ischemia, brain herniation and death. Hyperosmolar therapy remains the main armamentarium for management of raised intracranial pressure, especially in patients with diffuse lesions and where surgical options are not applicable. Substantial amount of studies have tried to explore the superiority of hypertonic saline or mannitol over the other. Due to significant heterogeneity in the pathophysiology of patients, variation in treatment threshold, method of drug administration and drug concentration, substantial evidence is lacking to support one agent over other. Hypertonic saline may be more effective than mannitol for lowering raised intracranial pressure. Well designed novel trials need to try to find the answer. Clinical, pathophysiological and biochemical data should be incorporated at bedside while individualizing selection of hyperosmolar therapy, with the aim to improve outcome and minimize harm.Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, Page: 54-56 

Surgery for Moyamoya Disease in Children

2019 ◽  
Vol 34 (9) ◽  
pp. 517-529 ◽  
Author(s):  
Ramana Appireddy ◽  
Manish Ranjan ◽  
Bryce A. Durafourt ◽  
Jay Riva-Cambrin ◽  
Walter J. Hader ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Hemorrhagic Stroke ◽  
Pediatric Population ◽  
Surgical Revascularization ◽  
Surgical Options ◽  
Revascularization Procedures ◽  
Cerebrovascular Occlusive Disease ◽  
The Brain ◽  
Internal Carotid Arteries ◽  
Selection Of

Moyamoya disease is a chronic progressive cerebrovascular occlusive disease of the terminal portion of the internal carotid arteries associated with an acquired abnormal vascular network at the base of the brain, often leading to ischemic or hemorrhagic stroke. Moyamoya disease is a relatively common cause of pediatric stroke with a specific racial and well-identified clinical and imaging phenotype. Moyamoya disease is more prevalent in East Asian countries compared with other geographic regions with a higher incidence of familial cases and clinically more aggressive form. Moyamoya disease is one of the few causes of stroke that is amenable to effective surgical revascularization treatment. There are various surgical options available for revascularization, including the direct, indirect, or combined bypass techniques, each with variable responses. However, due to the heterogeneity of the diseases, different clinical course, geographical variables associated with the disease, and availability of a wide variety of surgical revascularization procedures, optimal selection of a surgical candidate and the surgical technique becomes challenging, particularly in the pediatric population. This brief review presents pertinent literature of clinical options for the diagnosis and surgical treatment of moyamoya disease in children.

scholarly journals Chiari Malformation-I with Syringomyelia: A Non-specific Presentation and Surgical Consideration

2016 ◽  
Vol 13 (2) ◽  
pp. 105-108
Author(s):  
Jemesh S Maharjan ◽  
Pranaya Shrestha ◽  
Avinash Chandra ◽  
Pravesh Rajbhandari ◽  
Samir Acharya ◽  
...  
Keyword(s):  
Case Report ◽  
Chiari Malformation ◽  
Foramen Magnum ◽  
Clinical Findings ◽  
Tonsillar Herniation ◽  
Diverse Range ◽  
Broad Perspective ◽  
Surgical Options ◽  
Chiari I ◽  
Selection Of

Chiari Malformation-I is a congenital disorder characterized by the anatomical defect of the base of skull with tonsillar herniation (≥5 mm) below the foramen magnum, which is detected on MRI. It has a diverse range of symptoms with non-specific presentation leading to the chances of misdiagnosis and untimely recognition of the disorder. Syringomyelia is the most common result of Chiari-I. The selection of surgical or non-surgical management depends upon the patient symptoms and the presence of absence of Syringomyelia. The objective of this case report is to give a broad perspective on Chiari Malformation-I from the symptoms and clinical findings obtained in a patient with Syringomyelia associated with Chiari Malformation-I and to discuss about the different surgical options as well as the psychological support required for the management of the condition.Nepal Journal of Neuroscience. Vol. 13, No. 2, 2016, Page: 105-108 

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