Gang Chai, MD, PhD, and colleagues use computed tomography (CT) to evaluate morphological dynamic changes of masseter muscle after mandibular angle sagittal split osteotomy (MASO). MASO aims to change a square face to a slender, more feminine face. Although this procedure has a known effect on masseter bulk, the authors aim to determine how the muscle changes and to quantify the degree of change over time to better predict long-term outcome. Using 3-dimensional reconstructions of CT scans, they found a progressive decrease in masseter volume over 18 months. They also found that the highest loss of volume is in the inferior aspect of the muscle.
John S. Rhee, MD, MPH, and colleagues use computational fluiddynamics (CFD) and virtual surgery (VS) to assess functional outcomes of nasal surgery. They generated 3-dimensional models of the nasal airway using presurgical and postsurgical computed tomographic images, which they then digitally altered to generate different changes in the nasal anatomy. When comparing these models with presurgical images, they found that the postsurgical CFD analysis on all VS models predicted similar reduction in overall nasal resistance, as well as more balanced airflow distribution between sides. However, inferior turbinate reduction alone produced little positive change. This may be a helpful tool to enable surgeons to predict how much a patient may benefit from nasal surgery.
Benjamin Powell, MD, and colleagues present a retrospective review of 21 patients who underwent midforehead brow-lift for brow ptosis with follow-up of at least 6 months. They used 4 independent evaluators to compare preoperative and postoperative photographs for brow symmetry, elevation, incision scar, and overall appearance. The evaluators were plastic surgeons and laypeople. They found that the midforehead brow-lift offered excellent aesthetic results in all patients, without any of the patients receiving the lowest score of “poor” results. They also present a review of the literature.
Rahul Seth, MD, and colleagues present a detailed characterization of the anterolateral thigh microvascular free tissue flap, which has become a frequently used free flap for head and neck reconstruction. While this has been studied in Asian populations, there is a lack of comprehensive analysis of anthropomorphic parameters of this flap in the Western population. They assessed computerized tomography angiograms of 196 lower extremities for volumetric characteristics and vascular anatomical variations. They found a degree of predictability in both the vasculature and thickness, and the details of their study can be helpful to the reconstructive surgeon.
Escapando de la Crítica (Escaping Criticism) by Pere Borrell del Caso (1835-1910).
This issue's Highlights were written by Richard A. Zoumalan, MD.
Highlights of Archives of Facial Plastic Surgery. Arch Facial Plast Surg. 2011;13(5):299. doi:10.1001/archfacial.2011.59