1/4. MR of craniocerebral hemiatrophy.The magnetic resonance (MR) findings of three patients with cerebral hemiatrophy, the so-called Dyke-Davidoff-Masson syndrome, which is characterized by variable degrees of unilateral loss of cerebral volume and compensatory changes of the calvarium are presented. The condition was due to middle cerebral artery stroke in all patients. The pathologic alterations of cerebral tissue and the brainstem were reflected in detail on the MR studies. MR findings in addition to the primary vascular insult included prominence of the cortical sulci and perimesencephalic cistern in one subject with acquired infarction, but an absence of such generalized sulcal prominence in two cases of congenital infantile paralysis. Otherwise the secondary ipsilateral pathologic observations were quite similar in the patients with congenital and acquired ischemic disease and encompassed a unilaterally small cerebral hemisphere together with ipsilateral diploic calvarial expansion, elevation of the petrous bone and orbital roof, and hypoplasia/atrophy of the cerebral peduncle. Although computed tomography (CT) and MR are complimentary, it is felt that MR represents the imaging procedure of choice with respect to the assessment of the etiology and extent of cerebral parenchymal involvement in patients presenting with a clinical combination of congenital or early onset of seizures, hemiparesis/plegia, and/or craniofacial asymmetry.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
2/4. Parascapular free flap and fat grafts: combined surgical methods in morphological restoration of hemifacial progressive atrophy.BACKGROUND: Progressive hemifacial atrophy, widely referred to as Parry-Romberg syndrome or Romberg's disease, is a rare pathologic process characterized by an acquired, idiopathic, self-limited, unilateral atrophy of the face, variably involving skin, subcutaneous tissues, fat, muscle and, less frequently, the underlying bone structures. methods: Restoration of contour and symmetry is the main challenge in cases of Parry-Romberg syndrome; there are several different reconstructive techniques directed at augmentation of deficient soft-tissue volume. The present study describes the authors' own experience with deepithelialized free parascapular flap transfer combined with Coleman's lipoinjection in treatment of four severe cases affected by Parry-Romberg syndrome. RESULTS: The free microvascular parascapular flap, harvested and transferred for facial contour reconstruction, provided large volumes of tissue at the location of the greatest contour defect. It also has proven useful in restoring atrophic tissues trophism. To achieve the finest reconstructive result, Coleman's lipoinjection technique was used for a modification of the free parascapular flap contour, to restore adjacent atrophic areas, and to treat the remaining small or moderate defects. CONCLUSIONS: Free parascapular flap transfer combined with Coleman's lipoinjection, according to the authors' results, is the procedure of choice for facial contour restoration. Together, they can provide an excellent reconstructive solution directed at restoration of facial morphology, in terms of natural appearance and long-lasting results, with minimal donor-site morbidity.- - - - - - - - - - ranking = 2keywords = volume (Clic here for more details about this article) |
3/4. The volume limitation of the galeal temporalis flap in facial augmentation.Galeal temporalis flaps based on the superficial temporal vessels have been used for facial augmentation and can be extended to the contralateral side beyond the midline in order to achieve maximum volume. In five patients, the volumes of extended galeal flaps were measured intraoperatively using a water displacement method. The calculated volume varied between 28 and 38 cm3. Experience with this flap showed satisfactory results with no complications; therefore, it is concluded that the extended galeal temporalis flap may be a first choice in the correction of facial soft tissue deficits less than 40 cm3. Clinical cases are presented.- - - - - - - - - - ranking = 7keywords = volume (Clic here for more details about this article) |
4/4. Long-term follow-up of a patient with Romberg's disease reconstructed with free groin flaps.Sixteen years ago the result of an operation that was performed on a 5-year-old boy with Romberg's disease was described in this journal. Nineteen years have passed since the first operation, and the authors now report the long-term follow-up. The volume of the transferred free groin flaps was maintained. Although these flaps covered the patient's atrophic tissues as vascularized tissues, these flaps could not normalize the atrophy of the surrounding tissues, especially the bone. As for the orbital content, bony atrophy was more remarkable than the other tissues.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |