Repair of a large surgical defect involving the lower lid, cheek, and temporal region.
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Cheek↗
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Results for “FACIAL NEOPLASMS”
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Reconstruction of a large surgical defect involving the lower eyelid and infraorbital cheek.
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Aged↗
A conservative surgical approach to the treatment of 'locally invasive' lentigo maligna melanoma of the face.
Lentigo maligna has the potential for malignant change, and is managed in many cases by wide local excision. However, there are clinical situations in which aggressive surgical management is inappropriate or unsuccessful. We present three such cases, in which a more conservative surgical approach was adopted and maintained over several decades.
Brain Neoplasms↗
[Microcystic adnexal carcinoma (malignant syringoma) of the nose: case report and review of the literature].
A case of Malignant Syringoma (syn. = Microcystic Adnexal Carcinoma, Sclerosing Swat Duct Carcinoma) of the nose in a 44 year old female patient is reported. The tumor had been misdiagnosed as a Rhinophyma some 20 years before and had thus been treated under cosmetic aspects. Besides the appearance, the patient did not suffer any complaints and was referred to the ENT-department of the Klinikum Hannover for cosmetic reasons. Histopathological examination after removal revealed a malignant syringoma, which, due to its extensive size and subepithelial growth pattern, made a complete ablation of the entire nose and the adjacent soft tissue of the face necessary. Pathohistologically cellular atypia, invasive growth pattern, perineural and perivascular infiltration was characteristic. Quantitative DNA anaylsis revealed a tumor with a diploid stem line and only few aneuploid cells. Malignant syringoma is a rare differential diagnosis of face skin tumors. The present case is discussed based on a review of the literature.
Adolescent↗
A double-muscle transfer using a divided rectus femoris muscle for facial-paralysis reconstruction.
There are two types of smiling: without exposure of the teeth (usual smile), and with their exposure (square smile). Performance of the former involves use of the major zygomatic muscle, while the latter is created by the major zygomatic and the depressor labii inferior muscles. The function of the depressor labii inferioris muscle cannot be ignored in facial paralysis reconstruction. A double-muscle transfer using a divided rectus femoris muscle for one-stage reconstruction of both the major zygomatic muscle and the depressor labii inferior muscle is described. The patient suffered facial paralysis caused by an extracranial schwannoma originating from the facial nerve. After the tumor was removed, divided rectus femoris muscle segments were transferred to reconstruct the major zygomatic muscle and the depressor labii inferior muscle. After the pedicle vessel of the muscles was anastomosed to the recipient facial vessel, the long motor nerve of the proximal divided muscle was cross-faced and coapted directly to the prepared contralateral buccal branch. The short motor nerve of the distal muscle segment was sutured to the ipsilateral masseteric nerve. The advantages of divided rectus femoris muscle transfers are that (1) independent muscle contraction can be reconstructed; (2) no tongue or trapezius muscle atrophy occurs because the masseteric nerve is used as the motor source of the labial depressor; (3) only one muscle is sacrificed for muscle grafts; and (4) it is a one-stage reconstruction.
Adult↗
[Organoid nevus syndrome (Schimmelpenning-Feuerstein-Mims syndrome): case report and literature].
The main symptom of the organoid nevus syndrome (Schimmelpenning-Feuerstein-Mims-Syndrom) is the nevus sebaceous, which is mostly linear and can be of variable expression. Malformations of the skeletal system and the eyes are usually associated, while malformations of the cardio-vascular system are less common. Neurological findings such as mental retardation and seizures are of clinical relevance. We describe a case and discuss this rare syndrome.
Dysplastic Nevus Syndrome↗
[Magnesium seeding in therapy of pediatric hemangioma of the temporal region, lower eyelid and orbit].
BACKGROUND: Magnesium seeding of haemangiomas is a form of treatment already successfully used in 1900. PATIENT: We report about a male infant with a haemangioma of the left temporal region, underlid and orbit. Maximum depth at the time of indication for magnesium seeding was 28 mm with an intraorbital extension of 7 mm. COURSE OF THERAPY: Magnesium seeding of the haemangioma first lead to a standstill and within 8 weeks to a significant remission. After this period, maximum depth was 6.7 mm without any intraorbital extension. CONCLUSION: Magnesium seeding is a hopeful and low-risked alternative in the therapy of infantile haemangiomas.
Eyelid Neoplasms↗
[Choroid effusion in an antiglaucoma operation in a child with Sturge-Weber syndrome].
The authors describe a case of expulsive choroidal effusion which occurred in the course of a fistulating operation in a child with Sturge-Weber syndrome. This is the youngest patient with this complication so far reported in the literature. The persistent postoperative choroidal and retinal detachments in this case led to a considerable diminution of visual acuity.
Angiomatosis↗
[Facio-cerebral lymphangioma in the Ullrich-Turner syndrome (author's transl)].
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Adult↗
[Nine years' experience of tumor cryotherapy in the cranial region (author's transl)].
The excellent results of more than nine years work in cryosurgery of 1540 cases of tumors of the head are discussed from an ophthalmological and dermatological viewpoint. The majority were basal cell carcinomas of the lids. In the five-year follow-up period 5.5% of basal cell carcinomas and squamous cell carcinomas turned out to be recidives. The paper discusses the techniques of cryosurgical treatment, data from temperature measurements and histological investigations and the possibility of qualitative evaluation of cryodestruction of tumors by means of low-frequency electrical impedance measurements.
Cryosurgery↗
[The special problems of lymphangioma perioculare and hemifaciale (author's transl)].
The authors describe two cases of the rare disease lymphangioma hemifaciale. Every ophthalmologist should know this disease in view of the complications such as hemorrhage or erysipelas. Treatment methods are discussed. Furthermore, lymphangioma must be taken into consideration in the differential diagnosis of ptosis, protrusio bulbi, protrusio conjunctivae and congenital hemifacial hypertrophy.
Child↗
[Torre-Muir syndrome. Sebaceous gland tumors indicate colon carcinoma and other internal malignant tumors].
The Torre-Muir syndrome belongs to a group of hereditory cancers and expresses itself in the occurrence of cutaneous gland tumors and (often multiple) carcinoma of the colon. The syndrome is probably a phenotypical manifestation of the "cancer family" syndrome, in which familial carcinoma of the colon also occurs. A case of Torre-Muir syndrome in a 43-year-old man is described. Because of the dermatological features, the colon carcinoma was diagnosed in time. Family investigations revealed another case of complete Torre-Muir syndrome, as well as a remarkable frequency of colon carcinoma in one family branch. Inheritance is autosomal dominant. The characteristic morphological features of the sebaceous gland neoplasias makes an early, often life-saving, diagnosis possible.
Adult↗
Ophthalmic issues in hemangiomas of infancy.
Hemangiomas are the most common benign tumor of infancy. Although most hemangiomas remain asymptomatic, certain hemangiomas can cause significant morbidity and require treatment. Periocular hemangiomas require close observation and early therapy for those lesions with potential for visual impairment. Hemangiomas typically cause visual morbidity by induction of amblyopia, strabismus, significant refractive error or optic nerve compromise. Diagnosis is typically straightforward but occasionally other entities may cause diagnostic confusion and radiologic evaluation can be helpful. This is particularly important if the hemangioma is one component of the PHACES syndrome. Therapeutic options which may be useful include steroids (oral, intralesional or topical), interferon alpha (usually reserved for life- or sight-threatening lesions due to serious potential side effects), laser, embolization and surgery. Ophthalmic treatment using patching, atropine, glasses and stabismus surgery may be necessary.
Amblyopia↗
Combined embolization and surgery for craniofacial angiomas--report of a complex case.
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Child↗
Orbital exenteration and reconstruction for massive basal cell and squamous cell carcinoma of cutaneous origin.
Eleven patients with basal cell or squamous cell carcinomas of skin origin requiring orbital exenteration over a ten-year period were reviewed. The patient population was characterized by old age, treatment delay, massive tumor size, and inadequate primary therapy. Following orbital exenteration, a 60% recurrence rate and 56% five-year survival were found. Combined craniofacial resection should be considered more frequently in hopes of improving prognosis. Split-thickness skin grafting was the mainstay of reconstruction, especially in elderly patients with smaller lesions. However, most of the operations were performed prior to the popularization of musculocutaneous flaps and free tissue transfers. Temporalis, forehead, and cheek flaps are dependable local alternatives when additional bulk or improved contour is desired. Latissimus dorsi and pectoralis major musculocutaneous flaps and microsurgical tissue transfer allow for coverage of defects of virtually unlimited size and may be superior in cases in which infectious or postradiation complications are anticipated.
Aged↗
Basal cell carcinoma of the cheek, malar region, and lower eyelid: the role of large cheek-neck flaps.
A retrospective study was performed analyzing 521 consecutive patients who had either lower eyelid, malar region, or cheek reconstruction performed from January 1960 through December 1985. Of the group, 285 patients had basal cell carcinoma (BCC) of the cheek and malar regions, and 236 had BCC of the lower eyelid. In this paper we reevaluate and illustrate the repair of different-sized lower eyelid, malar, and cheek defects at various locations by interpolated sliding skin flaps from the cheek and neck. Very satisfactory aesthetic results have been obtained and have been evaluated with follow-up observations and treatment discussed. In the reconstruction of soft-tissue defects in these areas, large cheek (or cheek and neck) flaps are preferred in 26 cases. This report shows three examples of the surgery.
Basal Cell Carcinoma↗
Use of the carbon dioxide laser in treating multiple cutaneous neurofibromas.
The CO2 laser is presented as a useful tool for the removal of large numbers of neurofibromas, the major source of cosmetic disfigurement in the patient with peripheral neurofibromatosis. Its advantages include high patient satisfaction with the rapid, staged removal of thousands of neurofibromas, with minimal morbidity and an enhanced appearance. The operative technique for each of the forms of neurofibroma, that is, pedunculated, sessile, and subcutaneous, is described. As with all procedures involving a change in appearance, it is essential that the patient be fully aware of the limitations of the procedure and the expected final result. This is easily accomplished in this procedure by the use of a "test treatment."
Adult↗
Temporalis muscle flap for craniofacial reconstruction after tumor resection.
Temporalis muscle flap provides a good solution for the reconstruction of craniofacial defects after tumor resection. Nine patients with complicated defects located at the upper two thirds of the face, anterior cranial base, or mastoid region are presented. Five patients had orbital exenteration, two with total maxillectomy and two with anterior craniofacial resection. Temporalis muscle flap provided profuse well-vascularized tissue for the obliteration of orbital exenteration and total maxillectomy cavities and coverage of surface defects. Cranial, oral, and nasal spaces were separated successfully in all patients. Temporalis muscle flap is a very reliable technique with low complication rates and few donor site problems. This safe and technically easy flap can be preferred for the reconstruction of craniofacial defects after ablative tumor surgery, especially in older and debilitated patients.
Aged↗