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At least 19 recordsLinked to original sources
PubMed1992

Bilobed flap reconstruction of the temporal forehead.

The temporal forehead is a particularly challenging area for reconstruction. Temporal forehead skin lies in a broad flat plane that varies in thickness. The eyebrow, scalp hairline, and lateral canthus comprise its aesthetic boundaries and limit the available tissue for repair of defects. Characteristically, skin tumors of the temporal forehead have extensive subclinical spread and their removal leaves large defects. The goal of temporal forehead reconstruction is to recreate the aesthetic boundaries of the forehead and to regain symmetry with the contralateral side. The temporal forehead bilobed flap is a single-stage procedure that takes advantage of the best color match of adjacent tissue and often allows primary closure of the donor sites in relaxed skin tension lines with minimal distortion. Several cases are presented for illustration of the technique.

Aged↗
PubMed1991

A systematic aesthetic approach to primary closure of the donor site following transposition of vertical forehead flaps.

Twenty patients underwent transposition of a vertical forehead flap to correct defects of the middle third of the face. The treatment and results are reported and evaluated. Based of the width of the secondary forehead defect, the best technique of direct closure was determined. Simpler cases were resolved by careful application of the basic techniques of plastic surgery--undermining and scalp flap rotation. When a forehead defect larger than 4.5 cm was expected, previous forehead skin expansion seemed advisable. A primary, tension-free suture of the forehead defect was achieved in every case, thus significantly improving the aesthetic outcome of the operation.

Adult↗
PubMed1975

Modified nondelayed forehead flap.

The versatility and benefit of the forehead flap need not be lost when the external carotid artery system has been ligated. By basing the forehead flap laterally on the scalp, nourishment from the opposite external carotid artery gives the head and neck surgeon another advantage in reconstruction with nondelayed expedience. We report three cases of wide cheek ablative surgery, external carotid ligation, and utilization of the forehead flap. The occasions to use this modified nondelayed forehead flap are few, but it offers the same advantage without staging. It definitely can be used in any situation requiring a forehead flap when the external carotid artery system has been ligated.

Aged↗
PubMed1990

Management of the aging forehead.

Browlifting and forehead procedures are a critical element in the contemporary surgical management of the aging face. Esthetics of the upper third of the face will dictate brow position and its relationship to the supraorbital rim and eyes. Treatment of deformities of the upper third of the face can be varied according to the sex and age of the patient as well as contour of the hairline and forehead. The indications, advantages, disadvantages, and techniques of the coronal forehead, modified pretrichal forehead, midforehead, and direct browlifting procedures are discussed.

Aged↗
PubMed1992

The anatomic basis for the design of forehead flaps in nasal reconstruction.

The detailed arterial anatomy of the medial forehead region was evaluated using roentgenographic examinations of injected cadaver heads, anatomic dissections of injected cadaver heads, and Doppler examination of normal subjects. The supratrochlear artery was seen to be the dominant artery of the medial forehead (not the supraorbital). The supratrochlear artery exited the orbit 1.7 to 2.2 cm from the midline, passing superficial to the corrugator and deep to the orbicularis and frontalis muscles. The supratrochlear artery then passes just medial to the eyebrow and pierces the frontalis muscle, ascending the rest of the forehead in a subcutaneous plane 1.5 to 2.0 cm from the midline (paramedian position). The implications of this vascular anatomy on forehead flap design and execution for nasal reconstruction are discussed and clinical cases are presented.

Arteries↗
PubMed1992

Do forehead lifts lift or unfurl?

Forehead lifts are becoming increasingly more popular as an adjunct to facial rejuvenation. Considerable confusion exists as to how much the eyebrow should be elevated and how much scalp should be removed to achieve this goal. In an effort to evaluate this question, we have reviewed our recent forehead lift experience. These were done with forehead flap dissection down to glabella and supraorbital ridge, partial resection of corrugator supercilii, procerus, and frontalis muscles, and limited skin resection. We suggest that a natural-appearing, rejuvenating forehead lift should unfurl facial wrinkles without excessive eyebrow elevation. Technical maneuvers to obtain this goal are discussed.

Forehead↗
PubMed1991

Criteria for the forehead lift.

We have developed clinically useful measurements to assist the surgeon in deciding when to do the forehead lift and where to place the incision. Also, we have reviewed our experience over the past decade and discuss the four categories and applications of forehead lifts. We use three indications for forehead lift: ptosis, creases, and previous facelift (PCP). There are four basic surgical techniques applicable to the upper face: (1) direct browlift, (2) midforehead crease incision, (3) prehairline incision, and (4) posthairline incision. We determined more accurate guidelines from measurements taken on 50 volunteers, as well as patients seeking a facelift. The line of measurement in a vertical plane extends from the midpupil to the top of the eyebrow and up to the hairline. We have found that the normal distance from the midpupil to the upper edge of the eyebrow on average is 2.5 cm and that the distance from the upper edge of the eyebrow to the hairline is approximately 5 cm on average. If the distance from pupil to brow is less than 2.5 cm, then the patient may benefit from a forehead lift. If the distance from brow to hairline is less than 5 cm, then we use a posthairline incision in females. If this same distance is greater than 5 cm in females, we advise the prehairline incision. In male patients we strongly consider direct crease incision. The direct browlift is reserved for minimal ptosis, asymmetry, or patients who wish a minimal procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Inadequacy of the forehead reference montage for detecting abnormalities of the spinal N13 SEP in cervical cord lesions.

Cervical somatosensory evoked potentials (SEPs) recorded using forehead and anterior cervical reference montages were compared in 6 patients whose MRI showed a cervical syrinx. All patients presented with a segmental loss of pain and temperature sensation in upper limbs, but no clinical evidence of dorsal column system dysfunction. Cervical SEPs recorded using the forehead reference montage were normal in all cases, while the N13 potential recorded using an anterior cervical reference was reduced, or absent, in 11 median nerve SEPs out of 12. This discrepancy results from persisting scalp P13-P14 far-field potentials, which were picked up by the forehead, but not by the anterior cervical, reference. It is concluded that the forehead reference montage is inadequate for assessing selectively the spinal N13 potential and should be abandoned for cervical SEP recording.

Adult↗
PubMed1992

Subcutaneous approach to forehead, brow, and modified temple incision.

Placing the incision at the hairline or just posterior to the boundary of the hair, with subcutaneous elevation of the flaps, is a more effective way to correct the aging upper face, whether it be "crow's feet," excess forehead skin, or eyebrow ptosis. Furthermore, by placing the facial rhytidectomy incision at the sideburn boundary caudally and anteriorly, the sideburn can be preserved, regardless of the amount of skin removed. Patient selection and procedure have been described. Patients who are candidates for this type of surgery include those who have a long forehead, a short forehead, deep wrinkles, or thinner skin, as well as patients with deep frown lines and hyperactive corrugator muscles. The scars are generally minimal but can be camouflaged in one of many ways if they are visible. The most effective method is medical-grade tattooing. There are many advantages to the technique, the most important of which is control of forehead length and preservation of sensory and motor nerves. The results are far superior to most other available techniques in properly selected cases. In today's world of aesthetic surgery finesse, those who have expertise with a variety of approaches are more equipped to best serve the patients, and the techniques described here should be part of the aesthetic surgery armamentarium.

Female↗
PubMed1992

The subcutaneous forehead lift with an anterior hairline incision.

This review of patients after forehead rhytidectomy represents the longest published postoperative follow-up to date. Fifty patients who had undergone subcutaneous forehead rhytidectomy through an anterior hairline incision were assessed by chart review, detailed questionnaire, and physical examination. The mean follow-up was 7.5 years with a range of 1 to 17 years. Benefits of the technique described include maintenance of forehead size, a mechanically efficient lift, a direct attack on wrinkles, and a low incidence of hair loss. Patient assessment indicates that the benefits of the procedure are long lasting. The disadvantages include the added precision required in executing the incision, closure, and time-consuming dissection.

Aged↗
PubMed1992

Expanded midline forehead flap for coverage of nonnasal facial defects.

A 13-month-old infant with a giant hairy nevus of the superior portion of the right cheek, which measured 3.5 x 5.5 cm, was treated by excision and coverage using expanded midline forehead flap. This approach stands in contrast both to the standard technique of excision and full-thickness grafting for large facial defects as well as to the use of the midline forehead flap for nonnasal reconstruction. Although this approach did necessitate the placement of a midline forehead scar, the overall result was sufficiently superior to justify its use. The child has good, stable, soft coverage with no contour or landmark distortion. The child is presented in an 18-month follow-up with photographic documentation.

Cheek↗
PubMed1991

Pulse oximeter probes. A comparison between finger, nose, ear and forehead probes under conditions of poor perfusion.

The performances of 10 pulse oximeters using finger probes were compared with the same pulse oximeters using alternative probes (eight finger probes, two nose probes and a forehead probe) in poorly perfused patients. All readings were then compared with directly measured arterial blood oxygen saturations. The mean difference (bias, 'accuracy'), standard deviation (precision) and 'drop out' rate for each pulse oximeter combination was determined. An overall ranking of performance of each pulse oximeter was calculated using five criteria (accuracy, precision, number of readings within 3% of standard, percentage of readings given within 3% of standard, expected overread limit in 95% of cases). Nose and forehead probes performed poorly. Some ear probes performed well compared to some finger probes, but the overall performance of probes in other sites compared to finger probes was worse, (p = 0.05). Two of eight ear probes and no nose or forehead probes would be expected to be within 4% of the reference value in 95% of readings. The use of finger probes rather than probes in other sites is recommended in the patient with poor peripheral perfusion.

Adult↗
PubMed1977

Metabolism of testosterone by forehead skin of the roebuck (Capreolus capreolus).

Roebucks have a specialized region of skin on the forehead which contains sebaceous and apocrine glands that produce secretions used in territorial marking. These glands enlarge during the breeding season and regress after the rut as the testes regress. The metabolism of testosterone by this forehead skin in vitro was studied in two captive roebucks over the period of glandular enlargement and subsequent regression, and compared with that of dorsal skin. In May, June and July, both areas of skin actively metabolized testosterone and the metabolites detected were androstenedione, androstanedione, dihydrotestosterone, epiandrosterone, androsterone and 5alpha-androstanediols. There were no major differences in testosterone metabolism between the two body sites, although dorsal skin appeared to be more active in total metabolism than forehead skin. There was a peak in the extent of metabolism in June/July, with a subsequent gradual decline to December. The decline in metabolism occurred at a time when the associated glands were still enlarged, which suggests that the availability of androgen to the skin glands is determined not only by the amount of testosterone in the circulation, but also by a decrease in the metabolizing capacity of the tissue.

Androstenedione↗
PubMed1978

Distribution of androgen metabolizing enzymes in isolated tissues of human forehead and axillary skin.

The distribution of androgen metabolism in human skin was studied using tissues isolated either by direct dissection of axillary skin or by dissection of collagenase-digested forehead and axillary skin. All tissues (epidermis, sweat glands, sebaceous glands, hair follicles and dermis) were found to contain 17beta-, 3beta- and 3alpha-hydroxysteroid dehydrogenase (HSD) activities, 3beta-hydroxysteroid dehydrogenase-delta4--5 isomerase (delta5-3beta-HSD) activity and 5alpha-reductase activity. All tissues converted testosterone into 5alpha-dihydrotestosterone. In confirmation of previous histochemical studies, over 90% of the delta5-3beta-HSD of forehead skin was found in the sebaceous glands. In forehead skin, 40--66% of the 5alpha-reductase activity was in the sebaceous glands, while in axillary skin 50--70% was in the sweat glands, especially the apocrine glands. There was a more even distribution of 17beta-HSD activity in skin tissues than histochemical studies have indicated previously. Knowledge of the distribution of these enzymes has helped in the understanding of the function of androgen metabolism in skin.

Adult↗
PubMedDate not supplied

Occlusion effect: bone conduction speech audiometry using forehead and mastoid placement.

The occlusion effect (OE) was determined for bone conduction speech reception thresholds (SRTs) in 24 normally hearing subjects using forehead and mastoid placement. Results indicated that the OE was about 3 dB greater using forehead as opposed to mastoid placement. The intersubject variability of the OE is similar for the forehead and mastoid positions. The formula for effective masking for bone conduction speech should be equal to the minimum masking level for bone conduction speech plus the air-bone gap of the nontest ear plus 18 dB to account for the OE when using mastoid placement.

Acoustic Stimulation↗
PubMed1992

The coronal forehead lift--modifications and results.

The coronal forehead lift has produced excellent results in the rejuvenation of the upper face. The problem of brow and glabellar ptosis, as well as the problem of frontoglabellar rhytids, are directly addressed with this procedure while producing no visible scars. In addition, the pretrichial modification of it can be used without alteration in the hairline. The success and low morbidity of the coronal forehead lift has made it the procedure of choice for upper facial rejuvenation in females, and many male patients. A review of 41 coronal forehead lifts performed by the senior author is presented, with emphasis placed on the results and the refinements brought to the surgical technique. A discussion comparing this procedure to other brow lift procedures is also presented, outlining their respective advantages and disadvantages.

Adult↗
PubMedDate not supplied

Temporal artery-based forehead flap.

The historical development of the forehead flap is reviewed, and an operative experience using delayed and nondelayed techniques in 30 cases is described. The reliability of the forehead flap is evaluated with regard to patient morbidity and correction of deformity and dysfunction in such sites as the cheek, lip, corner of the mouth, floor of the mouth, tongue, pharyngeal wall, and tonsil. Analyses include length of hospital stay and complications, as well as the relationship of these factors to the methods employed in the reconstructive processes. The advantages and disadvantages of the various techniques are illustrated using individual cases.

Carcinoma, Squamous Cell↗