Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2010
The anatomy of the greater occipital nerve: Part II. Compression point topography.
Advances in the understanding of migraine trigger points have pointed to entrapment of peripheral nerves in the head and neck as a cause of this debilitating condition. An anatomical study was undertaken to develop a greater understanding of the potential entrapment sites along the course of this nerve. ⋯ There are six compression points along the greater occipital nerve. These can be located using the data from this study, serving as a guide for surgeons interested in treating patients with migraine headaches originating in these areas. Long-term relief from migraine headaches has been demonstrated clinically by using both noninvasive and surgical decompression of these points.
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Plast. Reconstr. Surg. · Nov 2010
Local anesthetics have a major impact on viability of preadipocytes and their differentiation into adipocytes.
Autologous fat transplantation is a well-established technique in surgery. Moreover, the use of preadipocytes in soft-tissue engineering is currently being intensely investigated. Current efforts focus on identifying maneuvers that may minimize resorption and provide predictable late results. The aim of this study was to investigate the influence of different local anesthetics frequently used in clinical practice on the viability of preadipocytes and their ability to differentiate into adipocytes. ⋯ The authors' results show that there is a marked influence of local anesthetics not only on the quantity but also on the quality of viable preadipocytes as determined by their ability to differentiate into mature adipocytes. Therefore, these results should be considered in the context of autologous fat transfer and soft-tissue engineering.
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Plast. Reconstr. Surg. · Nov 2010
The prevalence of cervical spine injury, head injury, or both with isolated and multiple craniomaxillofacial fractures.
Several studies have reported the relationship among craniomaxillofacial fractures, cervical spine injuries, and head injuries with varying results. Life-threatening injuries to the head and cervical spine with devastating consequences cannot be missed by reconstructive surgeons during evaluation of facial trauma. The purpose of this study was to establish the prevalence of cervical spine injuries and/or head injuries with isolated and multiple craniomaxillofacial fractures at trauma centers across the United States. ⋯ This article represents the most accurate description of the prevalence of cervical spine and/or head injury with craniomaxillofacial fracture at trauma centers in the United States.
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Plast. Reconstr. Surg. · Oct 2010
Institutional review board-based recommendations for medical institutions pursuing protocol approval for facial transplantation.
Preliminary outcomes from the previous nine face transplants performed since 2005 have been encouraging and have therefore led to a rise in the number of medical centers interested in establishing face transplant programs worldwide. However, until now, very little literature has been published providing surgeons the necessary insight on how to (1) prepare a protocol for institutional review board approval and (2) establish a face transplant program. ⋯ Every surgical department hoping to establish a face transplant program must realize that this endeavor requires both tremendous financial and long-term commitments by its medical institution. These transplants should be performed only within university-based medical centers capable of orchestrating a specialized, talented, multidisciplinary team. More importantly, facial composite tissue allotransplantation possesses an unmatched level of complexity and therefore requires most centers to prepare a carefully detailed protocol using these institutional review board-based guidelines.