A Case Report on Lateral Proboscis: A Rare Congenital Anomaly

Lateral proboscis is a rare congenital condition characterized by a cylindrical protuberance on the nasofrontal region accompanied by abnormal nasal development on the affected side. We aimed to describe the management of the lateral proboscis in staged repair. A 7-year-old girl came with a tube-like projection on the left medial canthal region and nasal agenesis on the ipsilateral side. She was diagnosed with lateral proboscis, left microphthalmia, lower eye lid coloboma, and asymmetry in the orbital region. The patient has undergone 3 major surgeries at our institution. The first surgery involved the deconstruction of the tube to form the left nasal body and nostril. The second operation involved trimming of the new nose form and the excision of the bony protrusion directly beneath the base of the pedicle through bifrontal craniotomy. The remaining bone defect was closed using a pericranial flap. The orbital floor was reconstructed using titanium mesh. The third operation involved nasal reconstruction using a costal cartilage graft to create a dorsal nasal and alar framework. The patient healed with no complications, had become less reserved and her grades improved significantly after the operation. Further appointments are being scheduled to evaluate growth distortion and the resulting facial asymmetry. Surgical correction will be planned thereafter to further reconstruct the facial features. Evaluation of patient is necessary to explore possible clinical outcomes and corresponding treatment options. Multidisciplinary management is highly recommended, involving plastic surgeons, neurosurgeons, ophthalmologists, pediatricians, and pediatric psychiatrists in order to improve patient's quality of life.

A Recurrent Inflammatory Myofibroblastic Tumor-like Lesion of the Splenic Capsule in a Kitten: Clinical, Microscopic and Ultrastructural Description

Objective: To describe the findings of an unusual splenic tumor in a kitten. Methods: A grossly multinodular mass arising from the splenic capsule of a 7-month-old male Havana kitten was echographically detected and surgically removed by splenectomy, then analyzed microscopically and ultrastructurally. Results: The mass showed features of an inflammatory myofibroblastic tumor. Treatment and Outcome: Two months after surgical excision, the mass recurred in the same intra-abdominal area but disappeared after 2 months of anti-inflammatory therapy. Follow-up at 18 months after surgery revealed resolution of the disease. Clinical Relevance: Inflammatory myofibroblastic tumor in cats have been rarely reported and are usually in the orbital region. In the present report, an unusual multinodular gross presentation, a recurrence over time, and a favorable clinical course, are described.

Análise termográfica da ação do jato de plasma no tratamento de rugas faciais

Individual's senescence process takes place slowly and continuously beyond generates several changes including skin aging, since the decline in cellular activities. Countless resources have been created over the years, with the goal of stopping and / or reversing the unsightly aspects of the skin caused by this process. Thus, plasma jet, a new therapeutic resource has been used in order to promote rejuvenation through the reduction of wrinkles and expression lines. Objective: To evaluate the pattern of thermal variation of the tissue treated with a plasma jet, using infrared thermography. Methodology: This was a series of clinical cases involving 5 female patients over the age of 40 who had facial wrinkles. Patients were previously evaluated and anesthetized. Then, plasma jet therapy was performed in the supra-orbital region. Patients were evaluated for thermal imaging before and after anesthesia and post-therapy. Result: It was found through thermographic analysis, a significant variation in the temperature coefficient of the skin where the anesthetic was applied and then the plasma jet (ΔT > 0.4 °C). Conclusion: The present study proved through the use of thermography that the plasma jet was able to generate an increase in local temperature. The authors suggest that such thermal variation may be the result of a process of vasodilation in the treated region.

FEATURES OF THE TOPOGRAPHIC ANATOMY OF THE LYMPHATIC CENTERS AND COLLECTORS DURING SURGICAL OPERATIONS IN THE HEAD AREA IN DOGS

The article presents the features of the topographic anatomy of the lymphatic centers and collectors of the head area in dogs. The interrelationships of the cellular and vascular parts of the lymphatic system, as well as the organs associated with them, are established. The features of the structure of the mandibular, medial retropharyngeal and facial lymph nodes are described. Statistics on their availability are provided. The study also presents a detailed lymph supply to the orbital region and its significance in the pathogenesis of ophthalmopathies. Anatomical and topographic maps developed by the authors are of practical importance for all surgical interventions in the head area.

Quantitative Anatomic Comparison of Microsurgical Transcranial, Endoscopic Endonasal, and Transorbital Approaches to the Spheno-Orbital Region

BACKGROUND The spheno-orbital region (SOR) is a complex anatomic area that can be accessed with different surgical approaches. OBJECTIVE To quantitatively compare, in a preclinical setting, microsurgical transcranial approaches (MTAs), endoscopic endonasal transpterygoid approach (EEA), and endoscopic transorbital approaches (ETOAs) to the SOR. METHODS These approaches were performed in 5 specimens: EEA, ETOAs (superior eyelid and inferolateral), anterolateral MTAs (supraorbital, minipterional, pterional, pterional-transzygomatic, and frontotemporal-orbitozygomatic), and lateral MTAs (subtemporal and subtemporal transzygomatic). All specimens underwent high-resolution computed tomography; an optic neuronavigation system with dedicated software was used to quantify working volume and exposed area for each approach. Mixed linear models with random intercepts were used for statistical analyses. RESULTS Anterolateral MTAs offer a direct route to the greater wings (GWs) and lesser wings (LWs); only they guarantee exposure of the anterior clinoid. Lateral MTAs provide access to a large area corresponding to the GW, up to the superior orbital fissure (SOF) anteriorly and the foramen rotundum medially. ETOAs also access the GW, close to the lateral portion of SOF, but with a different angle of view as compared to lateral MTAs. Access to deep and medial structures, such as the lamina papyracea and the medial SOF, is offered only by EEA, which exposes the LW and GW only to a limited extent. CONCLUSION This is the first study that offers a quantitative comparison of the most used approaches to SOR. A detailed knowledge of their advantages and limitations is paramount to choose the ideal one, or their combination, in the clinical setting.

Diagnostic and therapeutic approach to esthesioneuroblastoma: case report

Esthesioneuroblastoma is a rare neoplasm of the nervous system that appears in the paranasal cavities derived from the olfactory neuroepithelium, located in the cribriform region of the nasal fossa, and can invade the sinuses of the face, skull base and orbital region. Kadish classification is the most widely used to stage it according to its extension. The symptomatology is unspecific, and it may present progressive unilateral nasal obstruction, epistaxis, anosmia, headache, sinusitis, diplopia, and orbital proptosis. The diagnosis is based on the lesion biopsy, immunohistochemistry, and ultrastructural findings. Excision of the tumor is described as the treatment of choice that may be associated with radiotherapy and chemotherapy. This is a case report of an olfactory esthesioneuroblastoma in a patient admitted to the hospital complaining of orbital proptosis who, after a computed tomography of the skull, showed a suspicious lesion. After the biopsy and the anatomopathological study, a protocol with neoadjuvant chemotherapy was initiated, with the subsequent excision of the tumor. Despite the lack of other symptoms, an advanced stage of the neoplasm was identified, which reflects the importance of investigating less common complaints and thus facilitating the diagnosis and early treatment.

Adv-Makeup: A New Imperceptible and Transferable Attack on Face Recognition

Deep neural networks, particularly face recognition models, have been shown to be vulnerable to both digital and physical adversarial examples. However, existing adversarial examples against face recognition systems either lack transferability to black-box models, or fail to be implemented in practice. In this paper, we propose a unified adversarial face generation method - Adv-Makeup, which can realize imperceptible and transferable attack under the black-box setting. Adv-Makeup develops a task-driven makeup generation method with the blending module to synthesize imperceptible eye shadow over the orbital region on faces. And to achieve transferability, Adv-Makeup implements a fine-grained meta-learning based adversarial attack strategy to learn more vulnerable or sensitive features from various models. Compared to existing techniques, sufficient visualization results demonstrate that Adv-Makeup is capable to generate much more imperceptible attacks under both digital and physical scenarios. Meanwhile, extensive quantitative experiments show that Adv-Makeup can significantly improve the attack success rate under black-box setting, even attacking commercial systems.

A case of metastatic non-teratoid ocular medulloepithelioma in an adult horse

This case reports an eight-years-old horse that presented a unilateral tumor in the left ocular orbital region diagnosed on the basis of clinical signs, gross anatomopathological and histopathological investigations. The affected area was exenteration and submitted to histopathological evaluation and was diagnosed as a non-teratoid medulloepithelioma. This is a rare ocular neoplasm that usually affects young individuals – and was composed by neuroepithelium arranged in tubules and Flexner-Wintersteiner rosettes without presence of heteroplastic components. The animals died and was submitted to post-mortem evaluation, revealing presence of medulloepithelioma metastases at the internal region of the head, lymph nodes, lungs, and liver. This neoplasm usually presents a benign frame; however, the case herein described shows that it can be highly malignant and aggressive since it can cause extensive lesions and spread metastases to visceral organs.