Defects in mid-facial development, including cleft lip/palate, account for a large number of human birth defects annually. In many cases, aberrant gene expression results in either a reduction in the number of neural crest cells (NCCs) that reach the frontonasal region and form much of the facial skeleton or subsequent failure of NCC patterning and differentiation into bone and cartilage. While...

BACKGROUND We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions. METHODS Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intra...

BACKGROUND/AIM Midface fractures are commonly present and difficult to diagnose in trauma patients. The objective of this study was to determine clinically accessible indicators of midface fracture. MATERIAL AND METHODS A case-control study design was used to determine clinical indicators of midface fracture. Population source was a level I trauma center registry for years 2007-2009. Cases ha...

Compared with other locations on the face, skin cancer of the midface has a higher risk of recurrence owing, in part, to the mode of spread and the high frequency of subclinical extension. Skin cancers occurring in the region of the melolabial crease, nasal columella and medial canthus should be resected by Mohs surgery. Because tumors of the midface are sometimes recalcitrant, there are times ...

BACKGROUND Pfeiffer syndrome (PS; OMIM #101600) is an autosomal dominant disorder characterized by craniosynostosis, midface hypoplasia, broad thumbs, brachydactyly, broad great toes, and variable syndactyly. CASE We report a case of PS (type 3) with tracheal and visceral involvement and sacrococcygeal eversion. The patient shows facial dysmorphism with macrocephaly, dolichocephaly, and trigo...

Ballistic facial wounds present daunting reconstructive challenges to the most experienced of surgeons. The early Waltzing method tissue transfer, perfected by Sir Gillies, was superseded free flaps and transplantation as methods for reconstruction. In low resource setting, however, Waltz may be only suitable option. This case study describes use reconstruction at Port Spain General Hospital in...

Elevation of the skin along with its deep fascia vascular network is a recent facility for flap design. The longitudinal trapezius fasciocutaneous flap was first introduced in 1996; at that time it did not receive much attention, although it has many significant benefits compared with other available procedures. Sixteen trapezius fasciocutaneous flaps were elevated in 15 patients for reconstruc...

OBJECTIVE To describe a surgical technique for total palatomaxillary and orbital reconstruction using a fibula osteocutaneous free flap in a layered fashion. METHODS Case series from a tertiary care facial plastic and reconstructive surgical practice including patients with postextirpative Brown 3a and 3b orbitopalatomaxillary defects undergoing immediate microvascular reconstruction. Applica...