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Biomedical subjects

F Iñigo

Publications and source records attributed to F Iñigo.

13 recordsLinked to original sources

Restoration of facial contour in Romberg's disease and hemifacial microsomia: experience with 118 cases.

The experience with free flaps and conventional reconstructive procedures for 118 patients with Rombergapos;s disease and hemifacial microsomia over a 10-year period is presented. The groin free flap was used most frequently for patients with Rombergapos;s disease, whereas the scapular free flap was used for patients with hemifacial microsomia. The rectus abdominis or the latissimus dorsi free flap was chosen only when additional volume was required. To achieve better contour, secondary procedures, such as defatting the flap, pedicled temporal fascial flaps, cartilage and bone grafts, orthognathic surgery, and bone distraction were performed in severe cases. For patients with Rombergapos;s disease, excellent results were achieved in 35% (n = 28) of mild cases, in 72% (n = 27) out of 38 moderately and in 41% (n = 5) out of 12 severely affected patients. In hemifacial microsomia group (n = 40) excellent results were obtained in 66% of cases.

Adult↗

Free flaps for head and neck reconstruction in non-oncological patients: experience of 200 cases.

Two hundred free flaps for reconstructing the head and neck regions in 192 patients with non-oncological pathology were studied. Pathological entities included Romberg's disease, hemifacial microsomia, acquired facial palsy, trauma, and burn sequelae. Indications for selecting a specific free flap for reconstructing each case, details of anastomoses, reexploration, flap success, operative time, length of hospitalization, and complications were studied. The long-term results of cosmetic and function were also obtained. Patient age ranged from 6 to 40 years. The most common diagnosis was Romberg's disease 39% (n = 75), followed by hemifacial microsomia 20% (n = 40). The free flap most frequently used was the scapular 32% (n = 64), followed by the groin free flap 21% (n = 42). A total of 190 flaps (95%) were successful, whereas only 10 (5%) were lost. The mean operative time was 5:30 h and the average hospital stay was only 6 days. There were no major complications and no deaths in the study group. The patients were followed for at least 1 year in all cases. It is concluded that free flaps are safe and reliable procedures for reconstructing complex head and neck non-oncological defects.

Adolescent↗

Frontotemporal fasciocutaneous island flap for facial aesthetic subunit reconstruction.

The frontotemporal fasciocutaneous island flap is a useful source of tissue for correcting aesthetic units of the face. The quality of the tissue may be enhanced, and a successful color and texture match may be achieved. This flap is based on the temporal vessel system and its own fascia. Its provides excellent venous drainage and its pedicle length and arc of rotation may be increased. The donor scar is hidden under the hair-bearing area. The frontotemporal fasciocutaneous island flap was used in patients with inferior eyelid defects, for cheek reconstruction, for providing coverage of superior and inferior lip defects, for restoring the normal anatomy of columellar defects, and for reestablishing the contour of menton defects. The frontotemporal fasciocutaneous island flap was employed successfully in 9 patients at the Hospital Gea Gonzalez. The wide treatment possibilities for the reconstruction of aesthetic units in the face with the frontotemporal fasciocutaneous island flap are illustrated.

Adolescent↗

Three different techniques for mandibular reconstruction after hemimandibulectomy.

Mandibular reconstruction is a condition in which both bone defect and function must be restored. A wide range of approaches--from grafts to distant bone flaps--have been used for correcting bony defects. However, adequate mastication has been restored in only a few cases. In this article the results of three different techniques for mandibular reconstruction after hemimandibulectomy were studied. Sixteen patients underwent a second mandibular reconstruction after hemimandibulectomy and were monitored at least 1 year. Three different techniques were used: (1) full-thickness galeoparietal bone flap (eight patients), (2) free iliac crest graft (three patients), and (3) free fibular grafts (five patients). Occlusion on the nonoperated side and the possibility and function of osseointegrated denture in the vascularized bone transfer were evaluated. The full-thickness galeoparietal flap and free iliac crest bone flap appeared to be good options. However, only acceptable or poor occlusion could be achieved on the normal side. The fibular free flap demonstrated good results and good occlusion. Nonetheless, dental implantation was difficult because a prosthesis for reaching the normal height of the mandible was necessary.

Adolescent↗

Congenital facial palsy and crossed facial nerve grafts: age and outcome.

Crossed facial nerve grafts for treating unilateral permanent facial palsy in association with hemifacial microsomia were studied in 18 patients, ages ranging from 2 months to 10 years. Patients were divided into groups according to the age at the time of indication of surgery. It is concluded that crossed nerve grafting for facial palsy associated with hemifacial microsomia appears to be an adequate procedure especially when the surgery is indicated soon after birth.

Child↗

Surgical treatment of lagophthalmos in facial palsy: ear cartilage graft for elongating the levator palpebrae muscle.

Ocular exposure, conjunctival irritation and corneal keratitis are disturbing consequences of facial paralysis with lagophthalmos. Many techniques have been described for correcting this condition. A new method for decreasing the palpebral fissure is presented. An ear cartilage graft is interposed between the tarsal plate and the levator palpebrae superioris muscle. 12 patients with paralysis of the orbicularis oculi muscle, as assessed by electromyography, were treated with this technique. The palpebral fissure was decreased by 2-3 mm in all cases. 11 patients showed significant improvement of their eye symptoms. One patient, in whom the palpebral fissure could not be closed sufficiently to protect the eye, required additional lengthening by 4 mm of the cartilage graft and a lateral tarsorrhaphy.

Adult↗

Recovery of congenital facial palsy in patients with hemifacial microsomia subjected to sural to facial nerve grafts is enhanced by electric field stimulation.

The effect of electric field stimulation for promoting axonal growth between sural to facial nerve grafts in cases of congenital permanent facial palsy associated with hemifacial microsomia was studied. For this purpose, a total of 17 patients with unilateral congenital permanent facial palsy associated with hemifacial microsomia were studied pre- and post-operatively. A sural to facial nerve graft was performed in all cases and long term postoperative electric field stimulation was randomly applied to half of the patients. Although improvement occurred in both groups, the results indicated that clinical and electrophysiological recovery was significantly better in patients receiving post-operative electric field stimulation. The results, therefore, suggest that electric stimulation of the grafted area induces improvements of facial palsy over and above those observed in the non-stimulated patients.

Axons↗

Recovery of facial palsy after crossed facial nerve grafts.

Crossed facial nerve grafts for treating congenital or acquired permanent facial palsy were studied in 23 patients, ages ranging from 2 months to 38 years. Patients were divided into groups according to time after onset of paralysis. It is concluded that although crossed facial nerve grafts offered the possibility of reinnervation after facial palsy, the degree of recovery was critically dependent upon the time after onset of the facial palsy before the reinnervation procedure.

Adolescent↗

Aesthetic treatment of Romberg's disease: experience with 35 cases.

Our experience with dermis-fat free flaps and conventional reconstructive procedures for 35 patients with Romberg's disease over a 7-year period is presented. The groin flap was used for increasing volume in 33 cases, the scapular flap in 3 cases, and 2 were treated with the latissimus dorsi free flap. To achieve better contour, secondary procedures such as defatting of the flap, pedicled temporal fascial flaps, cartilage and bone grafts, orthognathic surgery, and other conventional aesthetic procedures were performed in 32 patients. Excellent results were achieved in 9 mildly deformed patients, in 12 out of 16 moderately, and in 3 out of 10 severely affected patients. Four moderate and 5 severe cases were classified as good results. Poor results were achieved in 2 severe cases.

Adolescent↗

Early postnatal treatment of congenital facial palsy in patients with hemifacial microsomia.

Facial palsy associated with hemifacial microsomia results in a devastating deformity. To date, no attempts on early treatment of the associated facial palsy have been reported. A therapeutic approach may be to provide reinnervation to the affected muscles through a crossed facial nerve graft. The purpose of this paper is to present 8 cases of hemifacial microsomia with associated facial palsy. All these patients were treated before 1 year of age with cross-sural-to-facial nerve grafts. After a 1 year follow-up, clinical and electrodiagnostic results indicate axonal continuity through the graft and evidence of reinnervation activity in all patients. Crossed facial nerve grafting appears to be an adequate procedure in patients with hemifacial microsomia with associated facial palsy.

Action Potentials↗

Secondary coverage of the hand using a dorsalis pedis plus first web space free flap.

Traditionally, severe degloving injuries of the hand have been treated with random abdominal or pedicled groin flaps, which offer good cutaneous coverage but do not provide sensibility. The authors present the results of the application of an extended dorsalis pedis plus first web space of the foot flap to resurface the hands of five male patients who had been treated originally with random abdominal or pedicled groin flaps. The reported flap has the advantage of providing the patient with up to three different nerve territories, aiding in a better functional use of the hand.

Adolescent↗