• Title/Summary/Keyword: Craniofacial surgery

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Cell-Assisted Lipotransfer for the Treatment of Parry-Romberg Syndrome

  • Castro-Govea, Yanko;De La Garza-Pineda, Oscar;Lara-Arias, Jorge;Chacon-Martinez, Hernan;Mecott-Rivera, Gabriel;Salazar-Lozano, Abel;Valdes-Flores, Everardo
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.659-662
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    • 2012
  • Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive and self-limited deformation of the subcutaneous tissue volume on one side of the face that creates craniofacial asymmetry. We present the case of a patient with a five-year history of progressive right facial hemiatrophy, who underwent facial volumetric restoration using cell-assisted lipotransfer (CAL), which consists of an autologous fat graft enriched with adipose-derived stem cells (ASCs) extracted from the same patient. ASCs have the capacity to differentiate into adipocytes. They also promote angiogenesis, release angiogenic growth factors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissue atrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome. Currently, CAL has showed promising results in the long term by decreasing the rate of fat reabsorption. The permanence and stability of the graft in all the injected areas has showed that autologous fat grafts enriched with stem cells could be a promising technique for the correction of defects caused by this syndrome.

Treatment of Osteochondroma of the Mandibular Condyle with Inferior Adhesion of Meniscus: A Case Report (관절원판의 유착을 동반한 하악과두의 골연골종의 치료: 증례보고)

  • Seol, Dong-Ju;Choi, Byung-Joon;Kim, Yeo-Gab;Lee, Baek-Soo;Ohe, Joo-Young;Lim, Ji-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.189-194
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    • 2013
  • Osteochondroma is a benign neoplasm, osseous projection surrounded with cartilage, 35.8% of benign osseous tumor, 8.5% of whole osseous tumor and usually arises from the skeletal bone. Osteochondroma is a cartilaginous derivation and relatively uncommon in the craniofacial bone. Osteochondroma of the mandible has slow growth rates which mainly affect women around forty years of age and it can appear through the coronoid process and mandibular condyle, especially in the medial half. Clinical finding associated with osteochondroma of condyle are primarily a palpable, painless temporomandibular area mass with facial asymmetry, malocclusion and midline deviations. Sometimes pain and dysfunction like trismus often accompany the anatomic derangement. Other features include malocclusion with open-bite on the affected side and cross-bite on the contralateral side. In this study, a 45-years old female patient exhibits pain on the left temporo-mandibular joint area and malocclusion due to loss of the molar region with osteochondroma on the top left of her mandibular condyle head. The patient is able to recover gradually from the symptom through treatments on manipulation, stabilization splint, arthroscopic lavage and surgical excision, thus, this is reported as a clinical case.

A case report of Osteochondroma Occuring on the Right Zygoma body (우측 관골체부에 발생한 골연골종의 치험례)

  • Woo, Sang min;Kim, Jin Woo;Shin, Han Kyoung;Jung, Jae Hak;Kim, Young Hwan;Sun, Hook
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.237-241
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    • 2009
  • Purpose: An osteochondroma, also known as osteocartilaginous exostosis, is a common bone tumor, but rarely occurs in the facial bone, especially in the zygoma body. Because most of the craniofacial bones develop from intramembranous ossification, osteochondromas are relatively infrequent in mesenchymal bones of the head and neck. The osteochondroma of the facial bone is a slow growing, painless mass, causes facial asymmetry. In spine and other extremities, it rarely changes malignant, but untill now, there is no evidence of malignant change in facial bone. We herein describe a rare case of osteochondroma occuring on zygoma body with review of the literature. Method: A 50 - year - old male has painless, slowly growing mass on a right cheek for several years. For a diagnosis, CT and whole body bone scan were done and a diagnosis, osteochondroma was made. The tumor was removed with osteotome under general anesthesia. Result: Radiography showed a well - defined calcified mass attatched to the anterior aspect of the right zygoma body. And pathologic exam showed degenerative chondocyte and cancellous bone. As a result, these appearance is that of an osteochondroma. Conclusion: An osteochondroma is a common bone tumor, but rarely occurs in the facial bone. To the authors knowldege, this is the first case of osteochondroma occuring on zygoma in korea, body. For this case, we reviewed literature related to this topic.

Microvascular Reconstruction of the Cranial Base Defects (두개저 결손의 미세수술적 재건술)

  • Minn, Kyung-Won;Kim, In-Chul;Lee, Min-Goo
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.71-76
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    • 1999
  • Until recently, the cranial base tumors were deemed unresectable due to the inability to diagnose the extent of the involvement accurately and to approach and excise the tumor safely. With refinements in CT and NMR scanning and development of craniofacial techniques, reconstruction becomes absolutely crucial in allowing successful resection of these tumors. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amendable to local tissue closure. In such cases, the free tissue transfer was a useful alternative because it can provide large amount of well-vascularized tissues and reliable separation of intracranial space from bacterial flora of the upper airway. The microvascular free tissue transfer was used in 9 patients at our center to reconstruct the cranial base defects. Of these, 8 were free rectus muscle flaps, and 1 was free latissimua dorsi muscle flap. There were 1 case of partial flap loss and 1 case of postoperative wound infection. The large, complex defects were successfully reconstructed by one stage operation and the functional and aesthetic results were satisfactory with acceptable complication rates.

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Contribution of the Dura & the Pericranium in Absorption of Cranial Bone (두개골 흡수에 있어서 경막과 두개골막이 미치는 영향)

  • Bae, Ick Hyun;Chung, Seung Moon
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.744-752
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    • 2005
  • Many craniofacial and neurosurgical procedures rely on cranial bone as a bone graft. In the majority of instances, the bone heals and gives good results. But we found that if either the dura or the pericranium were missing adjacent to the cranial bone, bone absorption would be increased. We studied a single animal model, investigating the contribution of the dura and the pericranium in the process of cranial bone absorption. The animals were divided into four groups of each five animals depending on the differential blockade of the dura and/or the pericranium by silastic sheet. Bilateral $100-mm^2$, parietal bone flaps were harvested from mature rabbits. Animals were humanely killed after 12 weeks, and histomorphometric analysis was performed. The volume maintenance is as follows; Group I; 89.0%, Group II; 80.0%, Group III; 63.3%, Group IV; 52.4%. The weight maintenance; Group I; 87.1%, Group II; 79.4%, Group III; 61.6%, Group IV; 51.1%. The histological contribution of living bone; Group I; 92.9%, Group II; 85.6%, Group III; 71.1%, Group IV; 56.2%. Significantly increased bone absorption occurred in Group II, III, IV compared with Group I. Conclusions are: 1. Cranial bone absorption is effected by both the dura and the pericranium. 2. The dura is more important than the pericranium in preventing cranial bone absorption. 3. The dura to be the source of central cranial bone and the pericranium to be the source of peripheral cranial bone.

Plantar Keratosis Induced by Heterotopic Ossification under the Medial Sesamoid Bone: A Case Report (족무지 내측종자골 족저부에 발생한 이소성 골화증으로 인한 족저각화증: 증례 보고)

  • Kim, Seung Joo;Suh, Jin Soo;Kim, Ji Ye;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.3
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    • pp.120-123
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    • 2020
  • Heterotopic ossification is the formation of extra-skeletal bone in the muscle and soft tissues, and an osteoma is a benign bone-forming tumor composed of compact or mature trabecular bone limited almost exclusively to the craniofacial bones. This paper reports an extremely rare case of heterotopic ossification mimicking an osteoma that occurred independently at the plantar side of the medial sesamoid bone. The patient was a 46-year-old male with a three-month history of pain and a hard mass on the plantar aspect of the left forefoot sole. After excising the lesion, the patient's symptoms were relieved, and no pain or complications occurred. This paper discusses this exceedingly rare case of heterotopic ossification around the medial sesamoid bone with a review of the relevant literature.

Giant cell tumor of temporomandibular joint masquerading as temporomandibular joint pain dysfunction syndrome: a rare case report

  • Sam, Jo Ee;Rachmat, Rullyandrianto Pan Nuriman;Melano, Cri Saiful Jordan;Wahab, Nasser Abdul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.2
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    • pp.134-137
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    • 2017
  • Giant cell tumor (GCT) of the craniofacial bones has been reported but they are not common. This tumor occurs more often in women than in men and predominantly affects patients around the third to fifth decade of life. GCTs are generally benign but can be locally aggressive as well. We report a case of GCT involving the temporomandibular joint (TMJ), which was initially thought to be temporomandibular disorder (TMD). A 22-year-old female presented with swelling and pain over the right temporal region for 18 months associated with jaw locking and clicking sounds. On examination, her jaw deviated to the right during opening and there was a $2{\times}2$ cm swelling over the right temporal region. Despite routine treatment for TMD, the swelling increased in size. Computed tomography and magnetic resonance imaging of the brain and TMJ revealed an erosive tumor of the temporal bone involving the TMJ which was displacing the temporal lobe. Surgical excision was done and the tumor removed completely. Histopathological examination was consistent with a GCT. No clinical or radiological recurrence was detected 10 months post-surgery.

Bilateral Occipital Neuralgia in a Patient with Neurofibromatosis Type 1: A Case Report (신경 섬유종증 1형 환자의 양측 후두 신경통: 증례보고)

  • Kim, Ji-Young;Jeon, Sungmi;Kim, Sang Wha
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.77-80
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    • 2021
  • Plexiform neurofibromas (PNFs) represent an uncommon variant (30%) of neurofibromatosis type 1 (NF-1), in which neurofibromas arise from multiple nerves as bulging and deforming masses involving connective tissue and skin folds. We report the case of a 17-year-old man with known NF-1 presenting with bilateral occipital neuralgia that began in his late adolescence. His chief complaint was radiating pain in the occiput induced by protective helmet wear when riding alpine skiing. Craniofacial magnetic resonance imaging (MRI) confirmed the presence of fusiform masses arising from the bilateral greater occipital nerves. Histopathological examination of the biopsy samples showed PNFs. After surgical treatment, the patient's symptoms completely improved. Unlike cutaneous neurofibromas, PNFs have different clinical characteristics and have the risk of malignant mutations. Correct diagnosis and adequate surgical treatment are necessary for PNFs.

THE EFFECT OF HEPATOCYTE GROWTH FACTOR FOR REPAIR OF THE BONE DEFECT (간세포성장인자가 골결손부의 치유에 미치는 영향)

  • Shin, Sang-Hun;Kim, Chang-Ju;Kim, Cheol-Hun;Kim, Yong-Deok;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.380-390
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    • 2004
  • Bone healing plays an important role in orthognathic and craniofacial surgery. Bone tissue repair and regeneration are regulated by an array of growth and morphogenetic factors. Bone formation and remodeling require continuous generation of osteoprogenitor cells from bone marrow stromal cells, which generate and respond to a variety of growth factors with putative roles in hematopoiesis and mesenchymal differentiation. In this study, the efficacy of a single application of hepatocyte growth factor to promote bone regeneration in 5-mm experimental calvarial defects of adult male rats was assessed histologically and immunohistochemically. The result of the experimental site were compared with those of the contralateral contral side. None of the control and experimental bone defects demonstrated complete bone closure. Bone regeneration was found close th the margine and central part of the defects. At 1, 2 weeks, there were found much significant cellural mitotic activity and many inflammatory cells and osteoblasts on the experimental site than control site. At 4, 6 weeks, new bone apposition was founded in both site but, more apposition was seen at experimental site. At 8, 12 weeks, also, some differences was found that more apposition of new bone and collagen fiber was seen on experimental site. Our results have some possibility that HGF do a early positive role to repair the bone defect. More study will be needed.

Syngnathia: Review of literature and a case report (선천성 악골유합증)

  • Lee Jong-Ho;Kim Yong-Hun;Seo Byoung-Moo;Choi Jin-Young;Choung Pill-Hoon;Kim Myung-Jin
    • Korean Journal of Cleft Lip And Palate
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    • v.4 no.1
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    • pp.45-53
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    • 2001
  • Congenital craniofacial disorders represent approximately 20% of all birth defects, One of these disorders is syngnathia, Congenital fusion of the maxilla and mandible is rare and can present in a wide range of severity from single mucosal band(synechiae) to complete bony fusion(syngnathia), Syngnathia, congenital bony fusion of the mandible and maxilla, is even less common than synechiae, with only 25 cases reported in the literature, Most of them have presented as an incomplete, unilateral fusion, We report a case of unilateral bony fusion of the maxilla, mandible, and zygomatic arch, Details of operative management and follow-up data are presented with review of literature.

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