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In the case of cranioplasty (CP) in patients with DC with resection of the temporalis muscle, CP with implants that include the opposite muscle may increase patient satisfaction without the risk of additional complications.We developed custom-made cleft palate (CP) models to teach V-Y pushback palatoplasty, with a focus on design and mucoperiosteal elevation.A model (23 cm wide, 30 cm long, and 13 cm high) was made using silicone (model 1; M1). On the palate of a skull model, 2 layers of colored rubber clay were applied to represent the superficial oral mucoperiosteum and deep nasal mucosa (model 2; M2). From the greater palatine foramen, threads of dental floss were inserted inside the clay, representing the greater palatine artery. In a workshop, a mouth gag was applied on M1, and participants designed 2-flap palatoplasty and 4-flap palatoplasty. On the palate of M2, incisions were made with a #15 blade. On M2, a mucoperiosteal flap (rubber clay over the hard palate) was elevated using a periosteal elevator, avoiding injury to the dental floss mimicking the greater palatine artery. Six participants were recruited for the workshop and were asked to rate their satisfaction with the outcome on a Likert scale.For CP design, participants answered that they had learned useful knowledge from this workshop, reflecting a significant improvement (4.0 ± 1.1 for incomplete CP, 4.2 ± 1.2 for complete CP). They became confident in this skill after the workshop (4.2 ± 0.8 for incomplete CP, 3.8 ± 0.8 for complete CP). For cleft mucoperiosteal flap elevation, they likewise learned useful knowledge (4.7 ± 0.5 for incomplete CP, 4.5 ± 0.5 for complete CP) and became confident in this skill (3.8 ± 0.8 for incomplete CP, 4.0 ± 0.6 for complete CP.)These models can be useful for V-Y pushback palatoplasty training for medical personnel.
Contour augmentation and mandibular angle modification surgery is becoming increasingly. The aim of this research is to compare technique and outcomes in augmentations done with standard implants or PEEK-based patient specific implants (PSI) in mandibular angle. Data from surgical planning, operative and post-operative of 6 months follow-up were revised for 21 patients who were submitted to facial surgery using a stock implant obtained from companies currently on the market or 3D implants created with CAD/CAM technology using PEEK 3D printing. Surgical time, intra-operative and post-operative complications were compared, analyzing the advantages and disadvantage of each technique. Statistical analyses using t-test and chi-squared were performed considering P value< 0.05 for statistical differences. Twelve patients were operated on with stock implants and nine patients with PSI. The surgical time was 15 minutes less for the 3D implant surgeries (P = 0.021) and intraoperatively only the stock implants needed modifications with wear and adaptation methods; post-operative infections were observed in both groups with no significant differences (P > 0.05). The 3D implants had greater levels of facial symmetry than the stock implants, although they did not present significant differences.Considering the limitations of this study, mandibular angle implants with a PEEK-based 3D CAD/CAM are efficient, stable and have a low complication rate; the CAD/CAM strategy is useful in facial surgery and can be integrated as a standard for surgical planning in facial makeover surgery.
 0.05). The 3D implants had greater levels of facial symmetry than the stock implants, although they did not present significant differences.Considering the limitations of this study, mandibular angle implants with a PEEK-based 3D CAD/CAM are efficient, stable and have a low complication rate; the CAD/CAM strategy is useful in facial surgery and can be integrated as a standard for surgical planning in facial makeover surgery.
Involutional ectropion is a disease in which the eyelids are everted outwards, and because the eyelids move away from the eyeballs, the ocular surface and conjunctiva are exposed causing inflammation, pain, photophobia, foreign body sensation, epiphora, and blurred vision. It is thought to be caused by horizontal and vertical laxity. Various surgical methods have reportedly been used to correct involutional ectropion. Shortening the lower eyelid retractor (LER) is an indispensable surgical operation for medial ectropion. When the LER is shortened, it is usually fixed to the lower edge of the tarsal plate. Herein we describe a new type of surgery that has now been performed on 6 eyes in 4 patients. The procedure involves separating the conjunctiva from the tarsal plate, inserting the LER between the conjunctiva and the tarsal plate, and then fixing it to the back of the tarsal plate. In all 6 eyes, the lower eyelid now contacts the eyeball, and morphological improvements were achieved. This new surgical methements were achieved. This new surgical method is a useful way to raise the tarsal plate.
Cranioplasty is a routine procedure in the practice in neurosurgery and craniofacial surgery. For the closure of the cranial defect, it may be difficult or impossible to split the bone sufficiently to obtain enough bone for complete closure of the defect in younger children. Thus, sometimes there is the need to use allografts, which may not be widely available in rural practice. We present 2 cases of cranioplasty with widely available and used polypropylene abdominal wall mesh. To add rigidity to the construct, the mesh was organized in a multilayered fashion. Postoperative follow-up showed good functional and cosmetic results.
Cranioplasty is a routine procedure in the practice in neurosurgery and craniofacial surgery. selleck products For the closure of the cranial defect, it may be difficult or impossible to split the bone sufficiently to obtain enough bone for complete closure of the defect in younger children. Thus, sometimes there is the need to use allografts, which may not be widely available in rural practice. We present 2 cases of cranioplasty with widely available and used polypropylene abdominal wall mesh. To add rigidity to the construct, the mesh was organized in a multilayered fashion. Postoperative follow-up showed good functional and cosmetic results.
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