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Highlights of Archives of Facial Plastic Surgery
September 2007

Highlights of Archives of Facial Plastic Surgery

Arch Facial Plast Surg. 2007;9(5):313. doi:10.1001/archfaci.9.5.313
Transglabellar Subcranial Approach for the Management of Nasal Masses With Intracranial Extension in Pediatric Patients

Congenital nasal masses are rare anomalies that may have an intracranial extension. All encephaloceles and some dermoids and gliomas have such an intracranial extension that can cause life-threatening infectious complications if left untreated. Accurate diagnosis and early management are required to reduce the potential for serious morbidity and mortality. Parul Goyal, MD, and colleagues present a case series of 5 patients who underwent resection of nasal dermoids with intracranial extension and encephaloceles via a transglabellar subcranial approach, which effectively combines excellent surgical exposure with low postoperative morbidity and a low potential for recurrence. All lesions were resected successfully with no recurrences during follow-up.


The Role of Nasal Feminization Rhinoplasty in Male-to-Female Gender Reassignment

Subtle differences in the facial skeleton play an important role in perceptions of female beauty and are important to patients undergoing gender reassignment. The nose is the central structure of the face, and there are key differences in male and female nasal cephalometrics. A change from a male nose to a more female nose helps these patients achieve their surgical goal. S. A. Reza Noureai, MBBChir, and colleagues studied a patient cohort over a 6-year period during which feminization of the nose via rhinoplasty was objectively measured. Outcomes in this study demonstrated that rhinoplasty is a reliable method of achieving feminine facial features in patients undergoing male-to-female gender reassignment without a perceived loss of nasal function.


Autogenous Nasal Tip Reconstruction of Complex Defects: A Structural Approach for Employing Rapid Prototyping

Total or subtotal reconstruction of the nose is one of the most difficult challenges in facial plastic and reconstructive surgery and requires re-creation of both a complex 3-dimensional (3D) external nose and a functional internal nasal lining with support. Traditionally, re-creation of the cosmetic external nose has been a difficult technical exercise aided by models made intraoperatively of aluminum foil, bone wax, and other materials to provide a template for the required nasal grafts. Patrick J. Byrne, MD, and Juan R. Garcia, MA, describe a new approach to this problem by using 3D laser scanning in combination with an anaplastologist (a highly trained artist who creates prosthetic noses) to develop an accurate template preoperatively. Photographs of 2 patients are presented to demonstrate the benefit of the technique. This new method has the potential to revolutionize the planning of nasal reconstruction and therefore to obtain a superior postoperative cosmetic result.


Effect of FK506 on Functional Recovery After Facial Nerve Injury in the Rat

Loss of facial nerve function after a facial nerve injury is a devastating injury that has profound cosmetic, functional, and psychological implications. The current management of long-term facial nerve injury relies on the inherent regenerative capabilities of the facial nerve supported by static and active surgical procedures to improve both function and cosmesis. A compound currently used for immunosuppression, FK506, has been identified as a potential neuroprotectant and neuroregenerator. Corey Yeh, MD, and colleagues have performed a randomized controlled trial to study the neuromodulating effects of FK506 in rat facial nerves by measuring the rat blink reflex return, vibrissial fibrillation loss, and return of vibrissial sweeping symmetry after facial nerve injury. To further characterize the recovery mechanism, recovery rate was also examined in animals receiving a monoclonal antibody to a known FK506 receptor, FK binding protein 52. They determined that this compound does improve facial nerve function recovery in the rat facial nerve model.


Portrait of My Daughters by Frank W. Benson (1862-1951).Article


This issue's Highlights were written by Tobias J. Pincock, MD.