Evaluation of the Blepharoplasty Patient.

The preoperative evaluation plays an important role in optimizing outcomes and minimizing morbidity for patients undergoing blepharoplasty. This article provides a detailed, systematic approach for the preoperative evaluation of patients undergoing upper and lower blepharoplasty. This article focuses on the critical steps of evaluating surgical blepharoplasty candidates to ensure optimal outcomes and high patient satisfaction, while minimizing risks and complications.

Lower Lid Blepharoplasty, Selecting Your Approach.

Successful lower blepharoplasties address patient-specific lower eyelid, canthal, and lid-cheek junction pathology. Various technical procedures have been described to address the lower eyelid lamellae and tarsoligamentous sling. The most appropriate procedure should be tailored for each patient in an algorithmic approach to ensure optimal esthetic outcomes and minimize risk.

Blepharoplasty: Difficult Cases.

Lower lid blepharoplasty surgery can be a challenging procedure for both the neophyte and the accomplished surgeon. It requires mastering complex periorbital anatomy and choosing the correct approach from a wide variety of patient presentations. This article spans the meticulous clinical evaluation, diagnostic approaches, and surgical techniques required to address challenging clinical scenarios of the lower eyelid, lid-cheek junction, and midface.

Applied Anatomy of the Lower Eyelid.

Lower eyelid function and appearance depend on the complex anatomic relationship between the soft tissue lamellae, supportive tarsoligamentous sling, and bone. Aging in the lower lid area may be caused by changes in the anterior lamella (skin and orbicularis oculi muscle), middle lamella (orbital septum and lower lid fat pads), posterior lamella (tarsus, lower eyelid retractors, and conjunctiva), tarsoligamentous sling (lateral retinaculum), or any combination of the previously described.

Amniotic Band Syndrome: Head-to-Toe Manifestations and Clinical Management Guidelines.

Learning Objectives: After studying this article, the participant should be able to: 1. Understand and describe the basic principles underlying the intrinsic versus extrinsic proposed mechanisms for the development of amniotic band syndrome (ABS). 2.

Orbital Foraminal Morphometrics in Nonsyndromic Unilateral Coronal Craniosynostosis.

Nonsyndromic unilateral coronal craniosynostosis (UCS) is a rare congenital disorder that results from premature fusion of either coronal suture. The result is growth restriction across the suture, between the ipsilateral frontal and parietal bones, leading to bony dysmorphogenesis affecting the calvarium, orbit, and skull base. Prior studies have reported associations between UCS and visual abnormalities.

Making the Case for Virtual Surgical Planning: Bilateral Sequential Fibula Flaps with Immediate Dental Implants for Maxillectomy.

Oncologic maxillectomy defects requiring bony reconstruction are among the most challenging head and neck cases because of the complex three-dimensional geometry of the midface. Virtual surgical planning technology is advantageous in these cases because it provides superior positional precision and accuracy compared with traditional techniques and facilitates prosthodontic rehabilitation. Maxillary cancer recurrence after an initial fibula flap reconstruction presents a unique challenge.

Maximizing the Virtual Surgical Planning Session for Orthognathic Surgery.

Virtual surgical planning (VSP) and computer-aided design/computer-aided manufacturing have become essential tools for planning orthognathic surgery. Despite widespread use, empirical gaps still exist in the literature regarding the logistics of the orthognathic planning session itself. More precisely, there is a need to explicate the VSP workflow on which specific parameters are needed for a translation into 3D software.

Dorsal Fixation of Coronal Hamate and Fifth Metacarpal Base Fractures: An Anatomic Evaluation of the Ulnar Nerve.

Purpose: Traumatic drill overshoot during dorsal fixation of coronal hamate and fifth metacarpal base fractures risks iatrogenic ulnar nerve injury. This study describes the anatomic relationships between exiting volar drill tips and ulnar nerve branches.

Methods: Dorsal drilling of hamate bones and fifth metacarpal bases was performed on cadavers.

Central slip and bilateral lateral band laceration with negative Elson's and modified Elson's tests.

Elson's test is the gold standard clinical exam for assessing central slip integrity, but the test and its modifications were historically applied to isolated central slip injuries with intact lateral bands (Elson, 1986; Schreuders et al., 2006). This case report presents an open zone III extensor injury to the right index finger with complete laceration of the central slip and bilateral lateral bands.

Six-year Burden of Care for Nonsyndromic Unilateral Cleft Lip and Palate Patients: A Comparison Between Cleft Centers and Noncleft Centers.

Objective: To determine differences in burden of care between nonsyndromic patients with unilateral cleft lip and palate undergoing treatment at American Cleft Palate-Craniofacial Association (ACPA)-accredited centers and nonaccredited centers in New York State.

Design: A retrospective review of the New York Statewide Planning and Research Cooperative System database from January 2001 to December 2014 was performed using ICD-9 and CPT coding.

Patients, Participants: This study included patients with unilateral cleft lip and palate who underwent both lip and palate repairs during their first  6 years of life.

Combined Treatment of High-Flow Scalp Arteriovenous Malformations.

Introduction: Appropriate treatment of scalp arteriovenous malformations (SAVMs) remains largely unclear given the rarity of reported cases. This single-institution case series presents consecutive patients with extracranial SAVMs and long-term follow up.The primary aim of this study was to review treatment decisions, evaluate clinical outcomes, and compare our experience to available literature in order to better understand SAVMs and improve future outcomes.

Major Complications After Textured Versus Non-textured Breast Implants in Direct-to-Implant Breast Reconstruction: A Propensity Score Analysis.

Background: While the risks and benefits of smooth versus textured implants for breast reconstruction and primary breast augmentation are thoroughly supported in the literature, few studies have examined the relationship between implant shell texture and complications following direct-to-implant (DTI) breast reconstruction.

Objectives: The present study examines the relationship between implant shell texture and complications in patients receiving DTI breast reconstruction.

Methods: Retrospective chart review of patients undergoing DTI breast reconstruction between 2011 and 2018 by a single surgeon was performed.

Low-level blast exposure disrupts gliovascular and neurovascular connections and induces a chronic vascular pathology in rat brain.

Much concern exists over the role of blast-induced traumatic brain injury (TBI) in the chronic cognitive and mental health problems that develop in veterans and active duty military personnel. The brain vasculature is particularly sensitive to blast injury. The aim of this study was to characterize the evolving molecular and histologic alterations in the neurovascular unit induced by three repetitive low-energy blast exposures (3 × 74.

Lack of chronic neuroinflammation in the absence of focal hemorrhage in a rat model of low-energy blast-induced TBI.

Blast-related traumatic brain injury (TBI) has been a common cause of injury in the recent conflicts in Iraq and Afghanistan. Blast waves can damage blood vessels, neurons, and glial cells within the brain. Acutely, depending on the blast energy, blast wave duration, and number of exposures, blast waves disrupt the blood-brain barrier, triggering microglial activation and neuroinflammation.

APOE and BDNF Val66Met polymorphisms combine to influence episodic memory function in older adults.

Genetic polymorphisms of apolipoprotein E (APOE) and brain-derived neurotrophic factor (BDNF) have shown inconsistent associations with healthy adult cognitive functions. Recent investigations have suggested that APOE polymorphisms do not contribute to non-pathological cognitive function and that any effect is likely due to prodromal Alzheimer's disease (AD). Similarly, although BDNF Val66Met polymorphisms affect hippocampal morphology and function, associations with learning and/or memory have not always been found.

Selective vulnerability of the cerebral vasculature to blast injury in a rat model of mild traumatic brain injury.

Background: Blast-related traumatic brain injury (TBI) is a common cause of injury in the military operations in Iraq and Afghanistan. How the primary blast wave affects the brain is not well understood. The aim of the present study was to examine whether blast exposure affects the cerebral vasculature in a rodent model.