Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Forehead reconstruction with a custom-made three-dimensional titanium implant in a Parry-Romberg syndrome patient

  • Kim, Jae Yoon (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Jung, Bok Ki (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Young Suk (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Roh, Tai Suk (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Yun, In Sik (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • Received : 2017.12.18
  • Accepted : 2018.04.27
  • Published : 2018.06.25
Download PDF
⟨ Previous Next ⟩

Abstract

Parry-Romberg syndrome is a rare neurocutaneous syndrome characterized by progressive shrinkage and degeneration of the tissues usually on only one side of the face. It is usually difficult to restore the facial contour due to skin tightness. In this case report, we report a forehead reconstruction with custom-made three-dimensional (3D) titanium implant of a Parry-Romberg syndrome patient who was treated with multiple fat grafts but had limited effect. A 36-year-old man presented with hemifacial atrophy. The disease progressed from 5 to 16 years old. The patient had alopecia on frontal scalp and received a surgery using tissue expander. The alopecia lesion was covered by expanded scalp flap done 22 years ago. Also, he was treated with fat grafts on depressed forehead 17 years ago. However, it did not work sufficiently, and there was noted depressed forehead. We planned to make 3D titanium implant to cover the depressed area (from the superior orbital rim to the vertex). During the operation, we confirmed that the custom-made 3D implant accurately fit for the depressed area without any dead spaces. Previously depressed forehead and glabella were elevated, and the forehead contour was improved cosmetically. A custom-made 3D titanium implant is widely used for skull reconstruction and bring good results. In our case, the depressed forehead of a Parry-Romberg syndrome patient was improved by a 3D titanium implant.

Keywords

References

  1. Sharma M, Bharatha A, Antonyshyn OM, Aviv RI, Symons SP. Case 178: Parry-Romberg syndrome. Radiology 2012;262:721-5. https://doi.org/10.1148/radiol.11092104
  2. Rangare AL, Babu SG, Thomas PS, Shetty SR. Parry-romberg syndrome: a rare case report. J Oral Maxillofac Res 2011;2:e5.
  3. Hu J, Yin L, Tang X, Gui L, Zhang Z. Combined skeletal and soft tissue reconstruction for severe Parry-Romberg syndrome. J Craniofac Surg 2011;22:937-41. https://doi.org/10.1097/SCS.0b013e31820fe27d
  4. Rigotti G, Cristofoli C, Marchi A, Bruti M, Pignatti M. Treatment of Romberg's disease with parascapular free flap and polyethylene porous implants. Facial Plast Surg 1999;15:317-25. https://doi.org/10.1055/s-2008-1064333
  5. Vaienti L, Soresina M, Menozzi A. Parascapular free flap and fat grafts: combined surgical methods in morphological restoration of hemifacial progressive atrophy. Plast Reconstr Surg 2005;116:699-711. https://doi.org/10.1097/01.prs.0000177449.12366.48
  6. Teng L, Jin X, Wu G, Zhang Z, Ji Y, Xu J, et al. Correction of hemifacial atrophy using free anterolateral thigh adipofascial flap. J Plast Reconstr Aesthet Surg 2010;63:1110-6. https://doi.org/10.1016/j.bjps.2009.06.009
  7. Wang X, Qiao Q, Liu Z, Zhao R, Zhang H, Yang Y, et al. Free anterolateral thigh adipofascial flap for hemifacial atrophy. Ann Plast Surg 2005;55:617-22. https://doi.org/10.1097/01.sap.0000189659.76694.e2
  8. Asai S, Kamei Y, Nishibori K, Katoh T, Torii S. Reconstruction of Romberg disease defects by omental flap. Ann Plast Surg 2006;57:154-8. https://doi.org/10.1097/01.sap.0000216243.91162.c2
  9. Wallace JG, Schneider WJ, Brown RG, Nahai FM. Reconstruction of hemifacial atrophy with a free flap of omentum. Br J Plast Surg 1979;32:15-8. https://doi.org/10.1016/0007-1226(79)90053-5
  10. Suominen EA, Niemi TS, Koskivuo IO, Bruck NM, Saaristo AM. Free latissimus dorsi perforator flap for reconstruction of hemifacial atrophy: case report. Microsurgery 2007;27:369-71. https://doi.org/10.1002/micr.20373
  11. Guerrerosantos J, Guerrerosantos F, Orozco J. Classification and treatment of facial tissue atrophy in Parry-Romberg disease. Aesthetic Plast Surg 2007;31:424-34. https://doi.org/10.1007/s00266-006-0215-4
  12. Ducic Y. Titanium mesh and hydroxyapatite cement cranioplasty: a report of 20 cases. J Oral Maxillofac Surg 2002;60:272-6. https://doi.org/10.1053/joms.2002.30575
  13. Moreira-Gonzalez A, Jackson IT, Miyawaki T, Barakat K, DiNick V. Clinical outcome in cranioplasty: critical review in long-term follow-up. J Craniofac Surg 2003;14:144-53. https://doi.org/10.1097/00001665-200303000-00003
  14. Blake GB, MacFarlane MR, Hinton JW. Titanium in reconstructive surgery of the skull and face. Br J Plast Surg 1990;43:528-35. https://doi.org/10.1016/0007-1226(90)90115-G
  15. Neligan PC. Plastic surgery. London: Elsevier Saunders; 2013.
  16. Winder J, Cooke RS, Gray J, Fannin T, Fegan T. Medical rapid proto- typing and 3D CT in the manufacture of custom made cranial titanium plates. J Med Eng Technol 1999;23:26-8. https://doi.org/10.1080/030919099294401

Cited by

  1. Aesthetic treatment of frontal sinus fractures and their complications vol.61, pp.12, 2018, https://doi.org/10.5124/jkma.2018.61.12.732
  2. Clinical case of Parry-Romberg syndrome vol.9, pp.1, 2018, https://doi.org/10.17650/2222-8721-2019-9-1-75-82
  3. Clinical case of Parry-Romberg syndrome vol.9, pp.1, 2018, https://doi.org/10.17650/2222-8721-2019-9-1-75-82
  4. Reconstruction of the Occipital and Parietal Congenital Defect with 3D Custom-Made Titanium Prosthesis: A Case Report with Four and a Half Years of Follow-Up and a Brief Review of Literature vol.2021, pp.None, 2021, https://doi.org/10.1155/2021/7027701