The Journal of craniofacial surgery
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The authors studied the anatomic importance of the endoscopic prelacrimal recess approach (PLRA) to the pterygopalatine fossa (PPF) and infratemporal fossa (ITF). ⋯ Use of the PLRA to the PPF and ITF offers a clear visual field, wide range of exposure, as well as preservation of the integrity of nasal structures.
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To investigate clinical characteristics of postcranioplasty seizures (PCS) first observed after cranioplasty after decompressive craniectomy (DC) to treat traumatic brain injury and to define factors that increase PCS risk. ⋯ Understanding risk factors for PCS will benefit the management of cranioplasty patients.
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Case Reports
Pneumocephalus-Induced Oculomotor Nerve Palsy After Atlanto-Occipital Decompression With Dural Plasty.
Pneumocephalus after posterior fossa craniotomy is very common. However, cranial nerve dysfunction secondary to pneumocephalus is a very rare phenomenon. ⋯ Cranial nerve dysfunction caused by pneumocephalus after craniotomy is rare and easily misdiagnosed. Timely head computed tomography or magnetic resonance imaging examination can exclude other causes and reveal the anatomic sites of pneumocephalus. Conservative treatment is available in most patients while sometimes it is necessary to drain the air.
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The scars of face and scalp caused by burning often show as 1 large facial-scalp scar. The deltopectoral flap was recognized as one of the first choices for the facial scar reconstruction. However, this flap cannot cross the level of zygomatic arch traditionally when it was transferred with pedicle. ⋯ There were complications including expander exposure in 3 patients, stretch marks in 5 patients, flap tip necrosis in 2 patients, and mild postoperative hypertrophic scars in 3 patients. In conclusion, the expanded pedicled deltopectoral flap can enlarge the reconstructive territory in face successfully with the technique improvements. The combination of the expanded pedicled deltopectoral flap and scalp flap is a reliable and excellent reconstructive option for large postburn facial-scalp scars.
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With the development of endoscopic technique, Caldwell-Luc approach has more wide applications and becomes a common method of pterygopalatine fossa (PPF) surgery. Few data can be used in this approach to avoid injuring the vessels and nerves within this area. In this study, the authors used computed tomography to get the coordinates of inferior orbital fissure, foramen rotundum, sphenopalatine foramen, internal opening of pterygoid canal, the strangulation of PPF, and the greater palatine foramen with canine fossa as the origin. ⋯ After calculating the relative distances and angles between these points and canine fossa, the authors get the proportions of the upper part of PPF, and the pterygopalatine canal to PPF, respectively. The authors finally got the safety surgical range. The results are meaningful to safety in surgery and complication avoidance, which can be great references in clinical applications.