Douglas K. Henstrom, MD, and colleagues present preliminary experience with platysmectomy in the treatment of neck synkinesis after facial nerve insult and recovery. They performed this procedure in 24 patients who chose this as a potential treatment for chronic, superficial torticollis-like neck symptoms due to synkinesis. They performed preoperative and postoperative Facial Clinimetric Evaluation scale (FaCE) measurements, measuring quality of life, and found that the overall quality of life statistically significantly improved in these patients. The authors describe the technique, detail the results, and explain why they feel this technique seems to be effective at managing the neck symptoms associated with chronic hypertonic platysmal activity.
Sirius Yoo, MD, and Sam P. Most, MD, measured the efficacy of the autospreader graft. This technique uses redundant dorsal upper lateral cartilage to function as a spreader graft by turning the cartilage into the usual spreader graft position. The authors used the Nasal Obstruction Symptoms Evaluations (NOSE) scale to evaluate 38 patients. They found that the patients who underwent surgery for purely aesthetic purposes did not have a change in their score. However, in the patients who underwent surgery for combined functional/aesthetic reasons, the NOSE score improved significantly. The authors conclude that this technique is effective in helping prevent postoperative obstruction and may actually improve the midvault in select patients.
Anthony P. Sclafani, MD, presents a study on the clinical safety and efficacy of the use of autologous platelet-rich fibrin matrix (PRFM) in facial plastic surgery. This is an autogenous wound-healing adjunct made from a patient's peripheral blood that may stimulate a mechanism similar to a wound response. Sclafani reviewed the medical charts of 50 patients with at least a 3-month follow-up period after treatment with PRFM for deep nasolabial folds and other volume-depleted areas. Patients had little swelling or bruising, and most patients were satisfied with the results of their treatment. The author describes the process and suggests that while the precise mechanism is still under investigation, this may be a well-tolerated and potentially effective treatment.
Khalid Ansari, MD, and colleagues present a retrospective review of a series of patients who underwent isolated mandible fractures treated with intraoperative intermaxillary fixation (IMF) bone screws. The authors examined whether anterior or posterior fractures do better or worse with this type of IMF. Their review of 53 patients showed that while the complication rate of the anterior fractures treated with IMF bone screws was 4.7% without any malocclusions, the complication rate of posterior fractures was 18.7%, most of which were the result of malunions/malocclusions. When comparing these results with the outcome of another author's large study of mandible fractures, the authors found a lower complication rate than that for use of arch bars for fixation of anterior fractures. Because of these results, they suggest that bone screws for fixation may work well for select anterior fractures.
The Brooding Woman by Paul Gauguin (1848-1903).
This issue's Highlights were written by Richard A. Zoumalan, MD.
Highlights of Archives of Facial Plastic Surgery. Arch Facial Plast Surg. 2011;13(4):229. doi:10.1001/archfacial.2011.45