Massive facial

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At the time the case was submitted for publication Michael P Hartung had no recorded disclosures. Patient was born with a very dark birth mark in the temporal region. With respect to the very large facial mass, it involves the right orbit, face, and right cranial convexity resulting in thickened area of enhancement, and develops an exophytic component protruding along the rightward and lateral aspect of the face. There is a covering of the right globe which has dystrophic calcifications and abnormal shape indicating phthisis bulbi. There is some buckling and irregularity of the right optic nerve.

Massive facial

Metrics details. A case of massive facial edema and airway obstruction secondary to an acute sialadenitis is described that occurred a few hours after a neurosurgical procedure performed in the prone position. Literature on this topic is reviewed. A year-old Caucasian woman underwent a right parieto-occipital craniotomy to remove a meningioma. The procedure was performed in the prone position and lasted for 7 hours. One hour after the end of surgery, left submandibular gland swelling was clearly visible and in a few hours, she developed massive facial edema. Imaging computed tomography and magnetic resonance showed inflammatory swelling of the submandibular and parotid glands and of the periglandular tissues, undilated excretory ducts, and complete obliteration of the pharynx lumen pharyngeal mucosa adhered to the endotracheal tube. Analgesics, corticosteroids, and antibiotics were administered. Edema regressed from the 4th postoperative day and the endotracheal tube could be removed on the 7th postoperative day. The patient was discharged from the surgical intensive care unit on the 14th postoperative day and from hospital on the 28th postoperative day. This is the first case report in which acute postoperative sialadenitis caused complete upper airway obstruction: only the presence of a tracheal tube avoided the need for an emergency tracheostomy. Since edema evolves insidiously, we recommend caution when removing the endotracheal tube in patients who are acutely developing postoperative sialadenitis. Acute postoperative sialadenitis, commonly known as 'anesthesia mumps', is occasionally observed after general anesthesia [ 1 ]-[ 4 ]. Parotid or submandibular swelling develops during surgery or, more often, a few hours later and usually resolves in a few days with no sequelae. The etiology has not been fully explained, but possible causes include trauma, infection, hypersensitivity reactions, and obstruction of the glandular excretory ducts by position, calculi, or thickened secretion.

Abstract Introduction A case of massive facial edema and airway obstruction secondary to an acute sialadenitis is described that occurred a few hours after a neurosurgical massive facial performed in the prone position, massive facial. J Am Coll Surg ;

Neurofibromas that involve more than a quarter of the face are called massive facial neurofibromas. His mouth was visible, although mouth opening and neck movements were limited. General anesthesia after awake fiberoptic intubation was planned due to potentially difficult intubation and apparently impossible mask ventilation. Awake fiberoptic intubation attempts, however, had to be abandoned because the patient was unable to tolerate it and developed a panic attack. Preoxygenation was performed in the supine position.

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Massive facial

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Tsai et al. Insertion of a supraglottic device is the key to ensure effective ventilation and serves as a conduit for fiberoptic intubation. Singal et al. A drain may be placed prior to closure of the skin flaps as necessary. Preoxygenation was performed in the supine position. A preoperative MRI will demonstrate the extent of tumor invasion and proximity to subcutaneous structures and can be valuable for resection planning [10,20,22]. Reprints and permissions. After discharge, regular follow up is recommended due to the risk of recurrence and malignant transformation, as well as scar and skin ptosis observation. These patients must have emotional, institutional, and financial support. Skin Ther. The Journal of dermatologic surgery and oncology. As will be described in this paper, modern approaches aim to overcome the pitfalls of delayed management by decreasing wound contracture and scarring before they can further distort the complexities of the facial anatomy. Close Modal.

Read just about any skincare blog - or talk to any aesthetician. They recommend regular facials as an essential component of great skincare.

Aesthetic reconstruction of the postburn neck contracture with a preexpanded anterolateral thigh free flap. Studies show that neurofibromas compromise the quality of the surrounding normal skin and increase tissue expansion complications. To that end, facial transplantation has evolved as a last-resort option to reconstruct defects from massive facial trauma failing free flap repair. Induction started with incremental intravenous administration of fentanyl and propofol to ensure spontaneous breathing. Krastinova-Lolov D, Hamza F. Treatment of patients with giant tumors in the course of Recklinghausen disease - own experience. Instruction for Authors. Plast Reconstr Surg ;; discussion Anesthesiology May , Vol. Importantly, if surgical planning includes preoperative embolization and a free flap, the surgeon and interventional radiologist must discuss preservation of recipient anastomosing vessels. Although tenants of acute trauma management continue to prioritize airway management and cardiopulmonary support, improved functional outcomes are achievable with an emphasis on early definitive free tissue transfer.