Forehead
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Rekonštrukcia čela a čelovej dutiny sa robila pri úrazoch, zápaloch a nádoroch v tejto oblasti. Sledovaný súbor tvorí 19 pacientov liečených v rokoch 1996 až 2001 pre úraz čela (12), nádor (6) a zápal (1) v čelovej dutine. Na rekonštrukciu kostenej steny dutiny sa použili titanové minidlahy (6krát), kostný štep z lopaty panvovej kosti (3krát), chrupka z rebra (1krát), alebo sa kostné úlomky fixovali silonovým stehom (6krát). Pre obliteráciu čelovej dutiny sme sa rozhodli len v prípade ak sa rekonštrukcia nedala urobiť (4krát). V prípade frontobazálneho poranenia s poškodením zadnej steny a mozgových obalov je potrebná spolupráca s neurochirurgom. Revízia vývodu čelovej dutiny je nevyhnutnou súčasťou operácie.
Reconstruction of the forehead and frontal cavity is necessary in case of injury, tumour and chronic inflammation in this region. From 1996 to 2001 19 patients were operated on for frontal fracture (12) tumour (6) and frontal sinusitis (1). The postoperative bone defect was reconstructed in all cases. Several approaches were used. In the case of injury with torn skin the operative field was reached through the wound. Eyebrow incision was used in 7 cases, eyebrow incision with skin incision in nasal root in 5 cases, and coronal incision with scalp stripping was used in 5 cases where wide frontal exposure was desired. Impression fracture of the frontal bone was managed either by elevation and fixation of bony fragments using permanent suture material or metal splints. Initially a bony graft from the iliac crest, or rib cartilage was used for reconstruction of a large bony defect, now metal titanium minisplints and mesh are used instead. In three cases the anterior frontal wall was destroyed by big osteoma and there was no healthy bone suitable for reconstruction. On patient suffered from hyperostosis, which had to be removed. Aesthetic results were very good in all but one patient and a second operation because of sinusitis was required in two patients. In patients with frontobasal fractures with liquorrhea and a damaged posterior wall cooperation with a neurosurgeon is neccessary. Peroperative revision of the frontonasal duct is recommended.
Background: The growing popularity of aesthetic procedures on the face raises the question of their safety. The forehead region is crucial aesthetically, but due to its abundant vascularization, it is also one of the most dangerous areas for dermatologic procedures, especially in the glabella area. The purpose of this article is to review the literature on the arterial vascularization of the forehead to identify potential high-risk zones for aesthetic dermatology procedures. Methods: A database search (PubMed, Web of Science, Scopus, and Embase) was conducted, and the titles and abstracts of all identified studies were screened, followed by full-text evaluation. Results: We identified 714 articles during the database search, and 25 articles were included in the review. The included studies used cadaveric dissection and computed tomography applied to cadavers as well as Doppler ultrasonography on volunteers to evaluate the forehead arteries (supratrochlear (STrA), supraorbital (SOA), central (CA), paracentral artery (PCA), and frontal branch of superficial temporal artery(FBSTA)). A total of 1714 cases involving the forehead arteries were analyzed. The included arteries were observed over a relatively large area, and their locations varied. The CA and PCA in cadaver studies were observed in an area of 0.2 to 10.8 mm and 0.8 to 16.2 mm, respectively, on the entire path from the glabellar point to the frontal prominence point. The distances from the midline in cadaveric studies at various measurement points ranged from 0.6 to 28.0 mm for the superficial branch of the STrA and 13.6 to 40.7 mm for the deep branch of STrA. In case of SOA, the distance from the midline ranged from 23 to 32 mm. Measurements from the midline in Doppler studies ranged from 0 to 23 mm for STrA and from 10 to 50 mm for the SOA. In studies using computed tomography, STrA was observed at a distance of 11 to 21 mm and the SOA at a distance of 21 to 32 mm, both lateral to the midline. Conclusions: Medical professionals should be aware of zones where frontal arteries are more likely to be encountered. The glabella region appears to be one of the most dangerous areas for dermatologic procedures. It is believed that the supratrochlear, supraorbital, and the paracentral arteries may cause ophthalmic complications due to occlusion of the ophthalmic artery, while this risk for the frontal branch of the superficial temporal artery seems to be low but cannot be completely excluded.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
In this article we would like to present, to our best knowledge, the very first published replantation of a forehead/part of a forehead as a single unit. The patient is a 57-year-old male smoker who sustained an avulsion forehead injury after a dog bite. Replantation was performed using microanastomosis of the supratrochlear vessels with restoration of good blood circulation after the procedure. Unfortunately, 5 days after the surgery, ischemia of the flap occurred followed by successful acute revision surgery. Nevertheless, the day after the ischemia reoccurred due to the time that passed, circumstances and unfavorable conditions affecting the sutured vessels, no further revision surgery was indicated. Observation continued and eventual wound necrosis after demarcation was left to be treated with skin grafting or per secundam intentionem. Only partial necrosis of the flap occurred, approximately 50%, which was subsequently treated with a full-thickness skin graft with very good results leading to the satisfaction of the patient.
- MeSH
- anastomóza chirurgická metody škodlivé účinky MeSH
- čelo chirurgie zranění MeSH
- cévy zranění MeSH
- ischemie etiologie terapie MeSH
- kouření škodlivé účinky MeSH
- kousnutí a bodnutí chirurgie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikrochirurgie metody MeSH
- nekróza etiologie terapie MeSH
- recidiva MeSH
- replantace * metody MeSH
- skalpační poranění * chirurgie etiologie komplikace patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Infrared thermography (IRT) is a non-invasive method for surface temperature measuring. The use of the contactless IRT method is comfortable for the patient, fast and hygienic. However, this method does not provide information about the core body temperature because the temperature is measured indirectly from the surface of the human body. There are several places on a human body from which surface temperature is commonly measured; the methods of measurement and application of the device is inconsistent. The aim of this article is to show the difference between the temperature measured on the forehead and on the inner corner of the eye in healthy persons, with reference to the recommendations of ISO standard. This is mainly due to the fact that compliance with the ISO standard is not always met, as shown by the personal experience of the authors. The body surface temperature was measured by use infrared camera WIC 640 under control of calibrated model of a black body. The data from 59 different volunteer subjects show statistically significant difference in measured temperature from both selected positions. The obtained median temperature values were 35.04 °C from forehead area and 35.85 °C from canthus of eyes. The observed difference was more than three-quarters of a degree Celsius for the median value. The maximum observed temperature difference within the observed group was almost 1.94 °C. The present study defines surface temperature from canthus of eye and undoubtedly shows how important it is to comply with the standards and recommendations of professional thermology societies.
- MeSH
- analýza dat MeSH
- čelo * MeSH
- lidé MeSH
- slzné ústrojí * anatomie a histologie MeSH
- tělesná teplota MeSH
- termografie * klasifikace metody MeSH
- výzkumný projekt MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
BACKGROUND: Cutaneous lymphomas co-expressing CD56 and CD30 are very rare. They share a clinicopathological overlap with natural killer- (NK)/T-cell lymphomas and anaplastic large-cell lymphomas (ALCLs), two entities with widely disparate clinical behavior. METHODS: We present a case of an immunocompetent 57-year-old Caucasian woman with a rapidly growing, angiodestructive and neuroinvasive primary cutaneous ALCL (PCALCL). The neoplastic population of large anaplastic CD30+ and CD56+ T cells was masked by a massive admixture of histiocytes and neutrophils. The partially ulcerated and pus-secreting tumor involved the forehead and scalp and was assessed as clinical stage IAE. RESULTS: After chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone), the patient achieved a complete remission. Additionally, high-dose chemotherapy with autologous peripheral blood stem-cell transplantation was administered as a consolidation of complete remission, in which she has remained for 6 years. CONCLUSIONS: This is the first CD30+ and CD56+ primary skin lymphoma to be reported on the head. The presented case carries a remarkable combination of clinicopathological features of PCALCL and NK-/T-cell lymphoma.
- MeSH
- antigen CD56 analýza MeSH
- antigen Ki-1 analýza MeSH
- čelo MeSH
- difúzní velkobuněčný B-lymfom farmakoterapie imunologie patologie MeSH
- financování organizované MeSH
- histiocyty cytologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory hlavy a krku farmakoterapie imunologie krevní zásobení patologie MeSH
- nádory kůže farmakoterapie imunologie krevní zásobení patologie MeSH
- neutrofily cytologie MeSH
- skalp inervace krevní zásobení patologie účinky léků MeSH
- transplantace kmenových buněk MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
Kožní karcinomy nosu jsou obvykle léčeny excizí vedoucí ke vzniku defektu, který je třeba vyřešit. Chirurg má řadu rekonstrukčních možností. Paramediální čelní lalok je jednou z běžně užívaných technik. V této studii popisujeme oboustranný lalokový posun z tváře na nos jako alternativu paramediálního čelního laloku u pacientů s výraznou nazolabiální rýhou a dostatečně volnou kůží tváří, u kterých je potřeba uzavřít defekt na hřebeni a stranách nosu po kontrolované excizi. Touto metodou bylo léčeno celkem 12 pacientů, výsledek byl hodnocen po dvou týdnech a po šesti měsících. S odstupem šesti měsíců po operaci bylo subjektivní hodnocení pacienty a objektivní hodnocení chirurgy v kategorii „velmi spokojen“ nebo „spokojen“. Oboustranný lalokový posun z tváře na nos je účinnou technikou ve škále rekonstrukčních postupů, které má chirurg k dispozici.
Skin cancer on the nose is commonly treated with surgical excision resulting in defects that require closure. The surgeon is faced with many reconstructive options. The paramedian forehead flap is one commonly used technique. In this study we describe the bilateral cheek-to-nose advancement flap as an alternative to the paramedian forehead flap in patients with strong nasolabial folds and prominent cheek tissue laxity, who require closure of MOHS surgery defects on the nasal dorsum and sidewall. Twelve patients were treated with the latter flap and evaluated after 2 weeks and 6 months. The patientsʼ subjective and the surgeonsʼ objective evaluation after 6 months were either completely satisfied or satisfied. The bilateral cheek-to-nose advancement flap is a reliable tool in the interventional portfolio of the reconstructive surgeon.
