Surgical Planning for Composite Tissue Allotransplantation of the Face Using 320-Detector Row Computed Tomography

2010 ◽  
Vol 34 (5) ◽  
pp. 766-769 ◽  
Author(s):  
Shigeyoshi Soga ◽  
Hale Ersoy ◽  
Dimitrios Mitsouras ◽  
Kurt Schultz ◽  
Amanda G. Whitmore ◽  
...  
2010 ◽  
Vol 59 (4) ◽  
Author(s):  
Maria Luisa Di Pietro ◽  
Barbara Corsano

L’allotrapianto di tessuto composito (CTA) nella forma di faccia viene proposto nel caso di gravi alterazioni della funzionalità e dell’estetica del volto e consente di sostituire tessuto facciale danneggiato e/o non-esistente con tessuto facciale sano, ben vascolarizzato, da donatore. Sebbene ancora in fase sperimentale, simile procedura – effettuata allo stato attuale nove volte in Francia, Cina, Stati Uniti e Spagna – pare mostrare risultati promettenti. Tuttavia, accanto alle difficoltà che come ogni procedura trapiantologica essa presenta dal punto di vista clinico, occorre considerare le problematiche economiche, organizzative e soprattutto etiche. ---------- Composite tissue allotransplantation (CTA) of the face is used for serious changes of the facial functionality and beauty and allows to replace facial tissue damaged or nonexistent by facial tissue sound, well vascularized, from donor. Although it is still at the experimental stage, this procedure – nine times realized in France, China, United States and Spain – seems to be promising. Neverthless, in addition to clinic issues, economic, organizational and above all ethical questions should be considered.


2007 ◽  
Vol 15 (3) ◽  
pp. 145-152 ◽  
Author(s):  
Sabrina Cugno ◽  
Sheila Sprague ◽  
Eric Duku ◽  
Achilleas Thoma

Background Facial composite tissue allotransplantation is a potential reconstructive option for severe facial disfigurement. The purpose of the present investigation was to use decision analysis modelling to ascertain the expected quality-adjusted life years (QALYs) gained with face transplantation (versus remaining in a disfigured state) in an effort to assist surgeons with the decision of whether to adopt this procedure. Study Design The probabilities of potential complications associated with facial allotransplantation were identified by a comprehensive review of kidney and hand transplant literature. A decision analysis tree illustrating possible health states for face allotransplantation was then constructed. Utilities were obtained from 30 participants, using the standard gamble and time trade-off measures. The utilities were then translated into QALYs, and the expected QALYs gained with transplantation were computed. Results Severe facial deformity was associated with an average of 7.34 QALYs. Allotransplantation of the face imparted an expected gain in QALYs of between 16.2 and 27.3 years. Conclusions The current debate within the medical community surrounding facial composite tissue allotransplantation has centred on the issue of inducing a state of immunocompromise in a physically healthy individual for a non-life-saving procedure. However, the latter must be weighed against the potential social and psychological benefits that transplantation would confer. As demonstrated by a gain of 26.9 QALYs, participants' valuation of quality of life is notably greater for face transplantation with its side effects of immunosuppression than for a state of uncompromised physical health with severe facial disfigurement.


The Lancet ◽  
2008 ◽  
Vol 372 (9639) ◽  
pp. 639-645 ◽  
Author(s):  
Laurent Lantieri ◽  
Jean-Paul Meningaud ◽  
Philippe Grimbert ◽  
Frank Bellivier ◽  
Jean-Pascal Lefaucheur ◽  
...  

Author(s):  
M Mazhar Celikoyar ◽  
Michael F Perez ◽  
M Ilhan Akbas ◽  
Oguzhan Topsakal

Abstract Background Facial features and measurements are utilized to analyze patients’ faces for various reasons, including surgical planning, scientific communications, patient-surgeon communications, and post-surgery evaluations. Objectives There are numerous descriptions regarding these features and measurements scattered throughout the literature and we did not encounter a current compilation of these parameters in the medical literature. Methods A narrative literature review of the published medical literature for facial measurements used for facial analysis in rhinoplasty was done through the electronic databases MEDLINE/PubMed and Google Scholar, along with a citation search. Results A total of 61 facial features were identified. 45 points (25 bilateral, 20 unilateral), five lines (three bilateral, two unilateral), eight planes, and three areas. A total of 122 measurements were identified: 48 distances (6 bilateral, 42 unilateral), 57 angles (13 bilateral, 44 unilateral), and 17 ratios. Supplemental Figures were created to depict all features and measurements using either a frontal, lateral or basal view of the face. Conclusions This paper provides the most comprehensive and current compilation of facial measurements to date. We believe this compilation will guide further developments (methodologies and software tools) for analyzing nasal structures and assessing the objective outcomes of facial surgeries, in particular rhinoplasty. Moreover, it will improve the communication as a reference for facial measurements of facial surface anthropometry, in particular rhinoplasty.


2002 ◽  
Vol 73 (5) ◽  
pp. 832-835 ◽  
Author(s):  
John H. Barker ◽  
Cedric G. Francois ◽  
Johannes M. Frank ◽  
Claudio Maldonado

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