Additional Information
Book Details
Abstract
Completely revised to meet the demands of today’s trainee and practicing plastic surgeon, Craniofacial, Head and Neck Surgery Pediatric Plastic Surgery, Volume 3 of Plastic Surgery, 4th Edition, features new full-color clinical photos, dynamic videos, and authoritative coverage of hot topics in the field. Editor-narrated PowerPoint presentations offer a step-by-step audio-visual walkthrough of techniques and procedures in plastic surgery.
- Offers evidence-based advice from a diverse collection of experts to help you apply the very latest advances in craniofacial, head and neck, and pediatric plastic surgery and ensure optimal outcomes.
- Provides updated coverage of: Aesthetic reconstruction of the nose; Orbito-maxillary reconstruction; Cheek and lip reconstruction; Facial paralysis; Facial transplant; and Surgical management of migraine headaches.
- Highlights the latest information on Computerised surgical planning in orthognathic surgery; Computerised surgical planning in craniofacial, head and neck surgery; and Rotation advancement.
- Includes brand-new color clinical photos, videos, and lectures.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Plastic Surgery | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Video Contents | xii | ||
| Lecture Video Contents | xvii | ||
| Preface to the Fourth Edition | xxi | ||
| List of Editors | xxii | ||
| List of Contributors | xxiii | ||
| Acknowledgments | xl | ||
| Dedication | xli | ||
| 1 Head, neck, and craniofacial surgery | 1 | ||
| 1 Anatomy of the head and neck | 2 | ||
| Synopsis | 2 | ||
| The fascial planes of the head and neck and the facial nerve | 2 | ||
| The fascia in the face | 4 | ||
| The fascia in the temporal region | 5 | ||
| The fascia in the neck | 6 | ||
| Retaining ligaments and adhesions of the face | 7 | ||
| The prezygomatic space | 9 | ||
| The malar fat pad and the subcutaneous fat compartments of the face | 9 | ||
| The buccal fat pad | 9 | ||
| The facial nerve | 10 | ||
| Frontal (temporal) branch | 11 | ||
| Zygomatic and buccal branches | 12 | ||
| Marginal mandibular | 12 | ||
| Cervical branch | 13 | ||
| Connection with sensory nerves | 13 | ||
| The scalp | 13 | ||
| The musculature | 13 | ||
| Frontalis, galeal fat pad, and the glide plane | 13 | ||
| Corrugators | 14 | ||
| Procerus | 15 | ||
| Depressor supercilii | 15 | ||
| Midfacial muscles | 15 | ||
| Muscles of mastication | 15 | ||
| The temporalis muscle | 15 | ||
| The masseter muscle | 15 | ||
| The medial pterygoid muscle | 15 | ||
| The lateral pterygoid muscle | 15 | ||
| Actions of muscle of mastication | 15 | ||
| The pterygomasseteric sling | 16 | ||
| The aesthetic importance of the masseter and the temporalis muscle | 16 | ||
| The sensory innervation | 16 | ||
| Anatomy of the ear | 18 | ||
| Anatomy of the eyelids | 18 | ||
| Anatomy of the nose | 20 | ||
| Access the complete reference list online at http://www.expertconsult.com | 20 | ||
| References | 21.e1 | ||
| I Craniofacial Trauma | 22 | ||
| 2 Facial trauma | 22 | ||
| Synopsis | 22 | ||
| Introduction | 22 | ||
| Historical perspective | 22.e1 | ||
| Basic science | 22 | ||
| Global considerations | 22 | ||
| Diagnosis and patient presentation | 23 | ||
| Evaluation for immediate life-threatening injuries | 23 | ||
| Systematic evaluation of the head and neck | 23 | ||
| Eye examination | 23 | ||
| Ear examination | 24 | ||
| Nose examination | 24 | ||
| Cheek examination | 24 | ||
| Oral cavity and mouth | 24 | ||
| Neck examination | 24 | ||
| Diagnostic studies | 24 | ||
| Plain films | 24 | ||
| CT | 25 | ||
| Consultation with other providers | 25 | ||
| Ophthalmology | 25 | ||
| Dental/OMFS | 25 | ||
| Treatment and surgical techniques | 25 | ||
| Anesthesia for treatment | 25 | ||
| Topical | 25 | ||
| Local infiltration | 25 | ||
| Facial field block | 25 | ||
| Forehead, anterior scalp to vertex, upper eyelids, glabella (supraorbital, supratrochlear, infratrochlear nerves) | 25 | ||
| Lateral nose, upper lip, upper teeth, lower eyelid, most of medial cheek (infraorbital nerve) | 25 | ||
| Lower lip and chin (mental nerve) | 25 | ||
| Posterior auricle, angle of the jaw, anterior neck (cervical plexus: great auricular, transverse cervical) | 26 | ||
| Ear (auriculotemporal nerve, great auricular nerve, lesser occipital nerve, and auditory branch of the vagus (Arnold’s) nerve) | 27 | ||
| General treatment considerations | 27 | ||
| Irrigation and debridement | 27 | ||
| Abrasions | 28 | ||
| Traumatic tattoo | 28 | ||
| Simple lacerations | 29 | ||
| Complex lacerations | 29 | ||
| Avulsions | 29 | ||
| Secondary intention healing | 31 | ||
| Treatment of specific areas | 31 | ||
| Scalp | 31 | ||
| Eyebrows | 33 | ||
| Local flap | 33 | ||
| Local graft | 36 | ||
| Eyelids | 36 | ||
| Ears | 37 | ||
| Anatomy | 37 | ||
| Hematoma | 38 | ||
| Lacerations | 39 | ||
| Auditory canal stenosis | 40 | ||
| Partial amputation with a wide pedicle | 40 | ||
| Complete amputation of all or part of the ear with the amputated part available | 40 | ||
| Nose | 41 | ||
| Abrasions | 41 | ||
| Lacerations | 41 | ||
| Lining | 41 | ||
| Framework | 41 | ||
| Skin covering | 42 | ||
| Avulsions | 42 | ||
| Amputation | 42 | ||
| Cheek | 43 | ||
| Repair of parotid duct | 43 | ||
| Facial nerve injury | 43 | ||
| Mouth and oral cavity | 43 | ||
| The oral cavity | 44 | ||
| Oral mucosa repair | 44 | ||
| The lips | 44 | ||
| Neck | 44 | ||
| Conclusion | 46 | ||
| Access the complete reference list online at http://www.expertconsult.com | 46 | ||
| References | 46.e1 | ||
| 3 Facial injuries | 47 | ||
| Synopsis | 47 | ||
| Introduction | 47 | ||
| Historical perspective | 47.e1 | ||
| Initial assessment | 47 | ||
| Clinical examination of the face | 47 | ||
| Computerized tomographic scans | 49 | ||
| Timing of treatment | 49 | ||
| Upper facial fractures | 49 | ||
| Frontal bone and sinus injury patterns | 49 | ||
| Clinical examination | 49 | ||
| Nasofrontal outflow tract | 49 | ||
| Radiography | 50 | ||
| Surgical treatment | 50 | ||
| Complications | 50 | ||
| Orbital fractures | 50 | ||
| Surgical anatomy of the orbit | 50 | ||
| Orbital physical examination | 51 | ||
| Radiographic evidence of fracture | 51 | ||
| Indications for surgical treatment | 51 | ||
| Blow-out fractures of the floor of the orbit | 52 | ||
| Medial orbital wall fractures | 52 | ||
| Blow-out fractures in younger individuals | 52 | ||
| Surgical treatment | 53 | ||
| The timing of surgical intervention | 53 | ||
| Operative technique for orbital fractures | 53 | ||
| Endoscopic approaches for orbital floor fractures | 53 | ||
| Cutaneous exposures | 53 | ||
| Surgical technique | 53 | ||
| The forced duction test | 53 | ||
| Restoration of continuity of the orbital floor | 54 | ||
| Bone grafts for orbital floor reconstruction | 54 | ||
| Inorganic implants | 54 | ||
| Postoperative care | 54 | ||
| Complications of orbital fractures | 54 | ||
| Diplopia | 54 | ||
| Enophthalmos | 55 | ||
| Retrobulbar hematoma | 55 | ||
| Ocular (globe) injuries and blindness | 55 | ||
| Implant migration, late hemorrhage around implants, and implant fixation | 55 | ||
| Ptosis of the upper lid | 55 | ||
| Scleral show, ectropion, and entropion – vertical shortening of the lower eyelid | 55 | ||
| Infraorbital nerve anesthesia | 55 | ||
| The “superior orbital fissure” syndrome and the “orbital apex” syndrome | 55 | ||
| Midfacial fractures | 56 | ||
| Nasal fractures | 56 | ||
| Types and locations of nasal fractures | 56 | ||
| Fractures and dislocations of the nasal septum | 56 | ||
| The treatment of nasal fractures | 57 | ||
| Open reduction and the use of supporting k wires | 57 | ||
| Treatment of fractures and dislocations of the septum | 57 | ||
| Complications of nasal fractures | 58 | ||
| Nasoethmoidal orbital fractures | 59 | ||
| Surgical pathology | 59 | ||
| Interorbital space | 59 | ||
| Traumatic telecanthus and hypertelorism | 59 | ||
| Clinical examination | 59 | ||
| Radiographs | 60 | ||
| Classification of nasoethmoidal orbital fractures | 60 | ||
| Treatment of nasoethmoidal orbital fractures | 60 | ||
| The importance of the “central fragment” in nasoethmoidal orbital fractures | 61 | ||
| Canthal reattachment | 62 | ||
| Lacrimal system injury | 62 | ||
| Complications of nasoethmoidal orbital fractures | 62 | ||
| Fractures of the zygoma | 62 | ||
| Physical diagnosis and surgical pathology of zygoma fractures | 62 | ||
| Anterior approaches | 63 | ||
| “Minimalist” approaches for fractures without zygomaticofrontal suture diastasis | 63 | ||
| Fractures with zygomaticofrontal (Z-F) suture diastasis | 63 | ||
| Coronal incisions (posterior approach) | 64 | ||
| Treatment of fractures of the zygoma | 64 | ||
| Closed reduction | 64 | ||
| Buttress articulations and alignment for complete open reduction | 64 | ||
| Methods of reduction | 64 | ||
| Reduction through the maxillary sinus | 64 | ||
| Temporal approach | 64 | ||
| Fixation required to achieve stability | 65 | ||
| Surgical techniques for fixation following reduction | 65 | ||
| Delayed treatment of fractures of the zygoma | 65 | ||
| Complications of zygomatic fractures | 65 | ||
| Bleeding and maxillary sinusitis | 65 | ||
| Late complications | 65 | ||
| Orbital complications | 65 | ||
| Numbness | 65 | ||
| Oral–antral fistula | 66 | ||
| Plate complications | 66 | ||
| Midface buttresses | 66 | ||
| Clinical examination | 66 | ||
| Inspection | 66 | ||
| Palpation | 66 | ||
| Digital manipulation | 67 | ||
| Malocclusion of the teeth | 67 | ||
| Cerebral spinal rhinorrhea or otorrhea | 67 | ||
| Radiological examination | 67 | ||
| Treatment of maxillary fractures | 67 | ||
| Alveolar fractures | 67 | ||
| Le Fort classification of facial fractures | 67 | ||
| Goals of Le Fort fracture treatment | 67 | ||
| Transverse (Guerin) fractures or Le Fort I level fractures | 67 | ||
| Pyramidal fractures or Le Fort II level fractures | 67 | ||
| Craniofacial dysjunction or Le Fort III fractures | 68 | ||
| Surgical technique | 68 | ||
| Le Fort I level fractures | 68 | ||
| Le Fort II level fractures | 69 | ||
| Le Fort III fractures | 69 | ||
| Postoperative care of maxillary fractures | 69 | ||
| Complications of maxillary fractures | 69 | ||
| Airway | 69 | ||
| Bleeding | 69 | ||
| Infection | 70 | ||
| Cerebrospinal fluid rhinorrhea | 70 | ||
| Blindness | 70 | ||
| Late complications | 70 | ||
| Nonunion and bone grafting | 70 | ||
| Malunion | 70 | ||
| Malocclusion | 70 | ||
| Nasolacrimal duct injury | 70 | ||
| Lower facial fractures | 70 | ||
| Mandible fractures | 70 | ||
| Dental wiring and fixation techniques | 71 | ||
| Arch bars | 71 | ||
| IMF screws | 71 | ||
| Classification | 71 | ||
| Clinical examination and diagnosis | 71 | ||
| Direction and angulation of the fracture line | 71 | ||
| Indications for ORIF of mandibular fractures | 72 | ||
| Treatment of class I fractures | 72 | ||
| General principles of reduction and fixation | 72 | ||
| Treatment of class II fractures | 72 | ||
| Comminuted fractures | 73 | ||
| Class III fractures | 73 | ||
| Extraoral approach to open reduction | 73 | ||
| Intraoral approach to open reduction | 74 | ||
| Selection of internal fixation devices for mandibular fractures: how much fixation is enough | 74 | ||
| Champy or miniplate system | 74 | ||
| Lag screw technique | 75 | ||
| Third molars in mandibular angle fractures | 75 | ||
| Antibiotic use | 75 | ||
| Treatment principles of mandibular fractures | 75 | ||
| Complications after fracture treatment | 76 | ||
| Malocclusion | 76 | ||
| Hardware infection and screw migration | 76 | ||
| Increased facial width and rotation of the mandible | 76 | ||
| Non-union | 76 | ||
| Osteomyelitis | 76 | ||
| Condylar and subcondylar fractures | 76 | ||
| Edentulous mandible fractures | 76 | ||
| Panfacial injuries | 77 | ||
| Treatment of panfacial fractures | 77 | ||
| Order of the procedure | 78 | ||
| Complications of panfacial fractures | 78 | ||
| Postoperative care | 79 | ||
| Gunshot wounds of the face | 79 | ||
| Low velocity gunshot wounds | 79 | ||
| Intermediate and high velocity ballistic injuries to the face | 79 | ||
| Access the complete reference list online at http://www.expertconsult.com | 80 | ||
| References | 81.e1 | ||
| II Head and Neck Reconstruction | 82 | ||
| 4 Surgical treatment of migraine headaches | 82 | ||
| Synopsis | 82 | ||
| Introduction | 82 | ||
| Basic science/disease process | 82 | ||
| Historical perspective | 84.e1 | ||
| Diagnosis and patient presentation | 84 | ||
| Preoperative history and examination | 84 | ||
| Patient selection | 84 | ||
| Trigger sites | 84 | ||
| The role of botulinum toxin injection | 84 | ||
| Surgical technique | 86 | ||
| Deactivation of frontal trigger site | 86 | ||
| Transpalpebral approach | 86 | ||
| Complications | 86 | ||
| Endoscopic approach | 86 | ||
| Complications | 87 | ||
| Deactivation of temporal triggers | 87 | ||
| 2 Pediatrics | 485 | ||
| I Clefts | 486 | ||
| 20 Embryology of the craniofacial complex | 486 | ||
| Synopsis | 486 | ||
| Introduction | 486 | ||
| The craniofacial complex | 486 | ||
| Distinguishing head from tail | 487 | ||
| Patterning the craniofacial complex | 487 | ||
| Genesis of the cranial neural crest | 487 | ||
| Exodus of the neural crest | 488 | ||
| Differentiation of the cranial neural crest | 489 | ||
| Organization of the pharyngeal arches | 490 | ||
| Disorders of arch development | 491 | ||
| Building the face | 492 | ||
| Facial fusions and clefting defects | 493 | ||
| Palatogenesis | 493 | ||
| The neurocranial base | 494 | ||
| Cranial vault and sutures | 494 | ||
| Conclusions | 495 | ||
| Access the complete reference list online at http://www.expertconsult.com | 496 | ||
| References | 496.e1 | ||
| 21.1 Overview of the unilateral cleft lip and nose deformity | 497 | ||
| Synopsis | 497 | ||
| Introduction | 497 | ||
| Historical perspective | 497.e1 | ||
| Embryology | 497 | ||
| Epidemiology | 498 | ||
| Anatomy | 499 | ||
| Presurgical infant orthopedics | 499 | ||
| Taping | 499 | ||
| Lip–nose adhesion | 499 | ||
| Latham device | 499 | ||
| Naso-alveolar molding | 500 | ||
| Surgical techniques | 500 | ||
| The Randall–Tennison repair | 500 | ||
| The rotation-advancement repair | 500 | ||
| Extended Mohler repair | 500 | ||
| Fisher anatomic subunit repair | 500 | ||
| Postoperative considerations | 500 | ||
| Complications | 501 | ||
| Access the complete reference list online at http://www.expertconsult.com | 501 | ||
| References | 501.e1 | ||
| 21.2 Rotation advancement cheiloplasty | 502 | ||
| Synopsis | 502 | ||
| Introduction | 502 | ||
| Preoperative plan | 502 | ||
| Multidisciplinary care | 502 | ||
| First visit | 502 | ||
| Nasoalveolar molding/nasal molding | 502 | ||
| Modified Grayson’s technique | 503 | ||
| Liou’s technique (Modified Figueroa technique) | 503 | ||
| Nasoalveolar molding with a spring device | 503 | ||
| Nasal molding with silicone nasal conformer | 503 | ||
| Operative techniques | 503 | ||
| Treatment plan for lip repair in Chang Gung Craniofacial Center | 503 | ||
| Rotation advancement cheiloplasty for complete clefts (Videos 21.2.1 and 21.2.2 ) | 503 | ||
| Markings | 503 | ||
| Cupid’s bow, vermilion, commissure, columellar base, and alar base | 503 | ||
| Base of philtral column on the cleft side | 503 | ||
| Proposed point of medial nasal sill | 504 | ||
| Measurements | 504 | ||
| Peaking of Cupid’s bow | 505 | ||
| Lateral lip height and length | 505 | ||
| White skin roll | 506 | ||
| Vermilion width | 506 | ||
| Incision lines | 507 | ||
| Incisions on the non-cleft side | 507 | ||
| Mohler incision | 507 | ||
| Simple rotation incision | 507 | ||
| Adequate rotation | 508 | ||
| Muscle dissection on the rotation flap | 509 | ||
| C-flap and footplate of medial crura | 509 | ||
| Septal dissection | 509 | ||
| Incisions on the cleft side lateral lip element | 509 | ||
| White skin roll flap and L-flap | 509 | ||
| Inferior turbinate (T) flap | 509 | ||
| Incision and dissection | 509 | ||
| Removal of fat pad under the vestibulum | 510 | ||
| Creation of the orbicularis marginalis flap | 510 | ||
| Nasal floor reconstruction and alar base repositioning | 510 | ||
| Muscle reconstruction | 513 | ||
| Philtral column reconstruction | 514 | ||
| Insertion of the WSR flap | 514 | ||
| Incisions for the triangular vermilion flap | 514 | ||
| Closure of the free border of the lip | 514 | ||
| Incisions on nasal floor | 514 | ||
| Final skin closure on lip | 515 | ||
| Adjustments during the final stage | 515 | ||
| Long vertical length of cleft side lip | 515 | ||
| Short vertical length of cleft side lip | 515 | ||
| Long horizontal length of cleft side lip | 516 | ||
| Short horizontal length of cleft side lip | 516 | ||
| Long vertical height of non-cleft side lip | 516 | ||
| Free border of the lateral lip | 517 | ||
| Semi-open rhinoplasty | 518 | ||
| Incision | 518 | ||
| Release of fibrofatty tissue from LLCs | 518 | ||
| Repositioning of LLCs | 518 | ||
| Trimming the excessive skin | 518 | ||
| Alar base position | 518 | ||
| Creation of the alar–facial groove | 518 | ||
| Rotation advancement cheiloplasty for incomplete clefts | 518 | ||
| Markings and incisions | 519 | ||
| Nasal floor incision | 519 | ||
| Dissection of muscle and elevation of OM flap | 520 | ||
| Nasal floor reconstruction | 520 | ||
| Muscle reconstruction | 520 | ||
| Nasal correction | 520 | ||
| Excessive free border | 520 | ||
| Complete cleft of primary palate | 521 | ||
| Microform cleft lip | 523 | ||
| Postoperative care | 524 | ||
| Postoperative maintenance of nasal shape | 526 | ||
| Outcomes, prognosis, and complications | 526 | ||
| Long-term results of lip morphology | 526 | ||
| Long-term result of nasal morphology | 526 | ||
| Satisfaction of patients | 526 | ||
| Complications | 527 | ||
| Summary | 527 | ||
| Access the complete reference list online at http://www.expertconsult.com | 527 | ||
| References | 527.e1 | ||
| 21.3 Extended Mohler repair | 528 | ||
| Synopsis | 528 | ||
| Introduction | 528 | ||
| Treatment philosophy | 529 | ||
| Nasoalveolar molding | 529 | ||
| Gingivoperiosteoplasty | 529 | ||
| Tension-free reconstruction | 529 | ||
| No lip adhesion | 529 | ||
| Primary nasal repair | 530 | ||
| Nasal floor closure | 530 | ||
| Evolution of technique | 530 | ||
| Markings | 531 | ||
| Technical aspects of surgery | 533 | ||
| Downward rotation of Cupid’s bow | 533 | ||
| Preparation of the medial lip element | 533 | ||
| L-flap dissection | 534 | ||
| Lateral lip element dissection | 534 | ||
| Intranasal mucosa reconstruction | 534 | ||
| Oral mucosa reconstruction | 535 | ||
| Primary rhinoplasty Part I | 535 | ||
| Alar base repositioning | 536 | ||
| Orbicularis oris repair | 536 | ||
| Upper lip skin and vermillion repair | 536 | ||
| Primary rhinoplasty Part II | 537 | ||
| Postoperative care | 537 | ||
| Results | 538 | ||
| Access the complete reference list online at http://www.expertconsult.com | 539 | ||
| References | 539.e1 | ||
| 21.4 Unilateral cleft lip repair, anatomic subunit approximation technique | 540 | ||
| Synopsis | 540 | ||
| Preoperative assessment | 540 | ||
| Pre-surgical orthopedics | 540 | ||
| Surgical plan: anatomical subunit approximation technique | 540 | ||
| Primary nasal correction | 544 | ||
| Operative technique | 544 | ||
| Postoperative care | 545 | ||
| Access the complete reference list online at http://www.expertconsult.com | 545 | ||
| References | 545.e1 | ||
| 22 Repair of bilateral cleft lip | 546 | ||
| Synopsis | 546 | ||
| Introduction | 546 | ||
| Principles | 546 | ||
| Third and fourth dimensions | 547 | ||
| Historical perspective | 547.e1 | ||
| The premaxilla | 547.e1 | ||
| Labial closure | 547.e1 | ||
| Muscular closure | 547.e1 | ||
| Nasal inattention | 547.e1 | ||
| Secondary nasal correction | 547.e1 | ||
| Primary repair of the bilateral cleft lip nasal deformity | 547.e2 | ||
| Presentation | 547 | ||
| Preoperative dentofacial orthopedics | 548 | ||
| Operative techniques | 549 | ||
| Bilateral cleft, complete cleft lip, and palate | 549 | ||
| Markings | 549 | ||
| Labial dissection | 550 | ||
| Alveolar closure | 550 | ||
| Labial closure | 551 | ||
| Nasal dissection and positioning the lower lateral cartilages | 551 | ||
| Final touches | 552 | ||
| Postoperative care | 553 | ||
| Technical modifications for bilateral variations | 554 | ||
| Late presentation of bilateral complete cleft lip/palate | 554 | ||
| Binderoid bilateral complete cleft lip/palate | 554 | ||
| Bilateral complete cleft lip and intact secondary palate | 554 | ||
| Bilateral incomplete cleft lip | 555 | ||
| Asymmetrical bilateral (complete/incomplete) cleft lip | 555 | ||
| Outcomes | 558 | ||
| Photography | 559 | ||
| Revision rate | 559 | ||
| Direct anthropometry | 561 | ||
| Indirect anthropometry | 561 | ||
| Photogrammetry | 561 | ||
| Stereophotogrammetry | 563 | ||
| Conclusion | 564 | ||
| Access the complete reference list online at http://www.expertconsult.com | 564 | ||
| References | 564.e1 | ||
| 23 Cleft palate | 565 | ||
| Synopsis | 565 | ||
| Historical perspective | 565.e1 | ||
| Basic science | 565 | ||
| Embryology | 565 | ||
| Anatomy of the velar muscles | 565 | ||
| Ear pathology | 565 | ||
| Patient presentation | 566 | ||
| Cleft palate with cleft lip and alveolus | 566 | ||
| Clefts of the secondary palate | 567 | ||
| Submucous cleft palate | 567 | ||
| Pierre Robin sequence | 567 | ||
| Syndromes | 570 | ||
| 22q chromosomal deletion | 570 | ||
| Growth | 570 | ||
| Feeding and swallowing | 570 | ||
| Speech | 571 | ||
| Timing of palate repair | 572 | ||
| Speech | 572 | ||
| Maxillary growth | 573 | ||
| Treatment/surgical technique | 573 | ||
| Technical considerations | 573 | ||
| Hard versus soft palate closure | 573 | ||
| von Langenbeck | 573 | ||
| V-Y pushback (Veau–Wardill–Kilner) | 573 | ||
| Two-flap palatoplasty | 575 | ||
| Vomer flaps | 575 | ||
| Intravelar veloplasty | 575 | ||
| Double opposing Z-plasty (Furlow) | 577 | ||
| Two-stage palate repair | 578 | ||
| Postoperative care | 579 | ||
| Outcomes of cleft palate repair | 579 | ||
| Fistula | 579 | ||
| Speech outcomes/velopharyngeal insufficiency | 579 | ||
| Maxillary growth | 579 | ||
| Conclusion | 580 | ||
| Access the complete reference list online at http://www.expertconsult.com | 580 | ||
| References | 580.e1 | ||
| 24 Alveolar clefts | 581 | ||
| Synopsis | 581 | ||
| Introduction | 581 | ||
| Historical perspective | 581.e1 | ||
| Basic science/disease process | 581 | ||
| Anatomy of the alveolar cleft | 581 | ||
| Dental development | 581 | ||
| Diagnosis/patient presentation | 582 | ||
| Gingivoperiosteoplasty | 582 | ||
| Primary bone grafting | 582 | ||
| Secondary bone grafting | 582 | ||
| Bone morphogenetic protein-2 | 584 | ||
| Late bone grafting | 584 | ||
| Alveolar distraction | 584 | ||
| Treatment/surgical technique | 585 | ||
| Gingivoperiosteoplasty | 585 | ||
| Primary bone grafting | 586 | ||
| Secondary bone grafting | 586 | ||
| Horizontal TDO of a tooth-bearing alveolar segment | 588 | ||
| Vertical alveolar TDO | 588 | ||
| Outcomes, prognosis, and complications | 588 | ||
| Gingivoperiosteoplasty | 588 | ||
| Primary bone grafting | 590 | ||
| Secondary bone grafting | 590 | ||
| Bone morphogenetic protein-2 | 591 | ||
| Late bone grafting | 591 | ||
| Graft site augmentation | 591 | ||
| Access the complete reference list online at http://www.expertconsult.com | 591 | ||
| References | 592.e1 | ||
| 25 Orthodontics in cleft lip and palate management | 593 | ||
| Synopsis | 593 | ||
| Introduction | 593 | ||
| Infancy | 594 | ||
| Unilateral cleft lip | 594 | ||
| Bilateral cleft lip | 594 | ||
| Primary dentition | 595 | ||
| Posterior crossbite | 595 | ||
| Anterior crossbite | 595 | ||
| Transitional dentition | 595 | ||
| Orthodontic tooth movement to regenerate a homologous lyophilized bone graft combined with platelet rich plasma to reconstruct the alveolar cleft: “Chinchilla–Asensio Approach” | 597 | ||
| Orthodontic protocol – pre-graft | 598 | ||
| Pre-graft orthopedics and orthodontics | 598 | ||
| Surgical protocol | 598 | ||
| Orthodontic protocol – post-graft | 599 | ||
| Outcomes and benefits | 599 | ||
| Other considerations | 600 | ||
| Permanent dentition | 602 | ||
| Orthognathic surgery and distraction procedures for the cleft patient | 606 | ||
| Growth and orthodontic treatment | 614 | ||
| Conclusion | 615 | ||
| Access the complete reference list online at http://www.expertconsult.com | 618 | ||
| References | 618.e1 | ||
| 26 Velopharyngeal dysfunction | 619 | ||
| Synopsis | 619 | ||
| Introduction | 619 | ||
| Anatomy and physiology of the velopharynx | 619 | ||
| Anatomy | 619 | ||
| Physiology | 621 | ||
| Basic science/disease process of velopharyngeal dysfunction | 621 | ||
| Velopharyngeal insufficiency | 621 | ||
| Velopharyngeal incompetence | 623 | ||
| Velopharyngeal mislearning | 624 | ||
| Combined types | 624 | ||
| Diagnosis/patient presentation | 624 | ||
| Patient history and physical exam | 624 | ||
| Perceptual speech evaluation | 624 | ||
| Indirect measures of velopharyngeal closure for speech | 626 | ||
| Imaging | 627 | ||
| Static radiographs | 627 | ||
| Multiview videofluoroscopy (Videos 26.1 and 26.2 ) | 627 | ||
| Nasopharyngoscopy | 627 | ||
| Treatment/surgical techniques | 628 | ||
| Preoperative evaluation | 628 | ||
| Furlow double-opposing Z-palatoplasty (Fig. 26.10) | 629 | ||
| Posterior pharyngeal flap (Fig. 26.11) | 630 | ||
| Sphincter pharyngoplasty (Fig. 26.12) | 632 | ||
| Posterior pharyngeal wall augmentation | 633 | ||
| Surgical management in the 22q11.2 deletion syndrome | 634 | ||
| Non-surgical treatment options | 634 | ||
| Prosthetic treatment | 634 | ||
| Behavioral speech therapy approaches | 635 | ||
| Access the complete reference list online at http://www.expertconsult.com | 635 | ||
| References | 636.e1 | ||
| 27 Secondary deformities of the cleft lip, palate, and nose | 637 | ||
| Synopsis | 637 | ||
| Introduction | 637 | ||
| Examination and evaluation | 637 | ||
| Unilateral cleft lip | 637 | ||
| Vermilion/Mucosa | 638 | ||
| Vermilion notching | 638 | ||
| Mucosal excess | 638 | ||
| Skin | 639 | ||
| Short lip | 639 | ||
| Long lip | 639 | ||
| White roll discontinuity | 640 | ||
| Poor scarring | 640 | ||
| Muscle | 642 | ||
| Dehiscence | 642 | ||
| Bilateral cleft lip | 642 | ||
| Vermilion/Mucosa | 642 | ||
| Vermilion deficiency – whistle deformity | 642 | ||
| Vermilion excess | 642 | ||
| Mucosal excess | 643 | ||
| Skin | 644 | ||
| Poor scarring | 644 | ||
| Skin deficiency | 645 | ||
| Skin excess | 645 | ||
| Muscle | 645 | ||
| Dehiscence | 645 | ||
| Cleft palate | 645 | ||
| Velopharyngeal insufficiency | 645 | ||
| Workup and algorithm | 646 | ||
| Fistula closure | 646 | ||
| Furlow palatoplasty | 648 | ||
| Posterior pharyngeal flap | 650 | ||
| Sphincter pharyngoplasty | 651 | ||
| Posterior pharyngeal wall augmentation | 651 | ||
| Cleft nasal deformity | 652 | ||
| Intermediate rhinoplasty | 653 | ||
| Secondary cleft rhinoplasty – unilateral | 653 | ||
| Incision | 654 | ||
| The septum | 654 | ||
| The nasal tip | 654 | ||
| Nasal vestibule | 654 | ||
| Nasal dorsum | 654 | ||
| Nasal alae | 655 | ||
| Bilateral cleft nasal deformity | 655 | ||
| Conclusion | 657 | ||
| Access the complete reference list online at http://www.expertconsult.com | 658 | ||
| References | 659.e1 | ||
| 28 Cleft and craniofacial orthognathic surgery | 660 | ||
| Synopsis | 660 | ||
| Introduction | 660 | ||
| Historical perspective | 660.e1 | ||
| Basic science | 660 | ||
| Growth and development | 660 | ||
| Diagnosis/patient preparation | 661 | ||
| Preoperative evaluation | 661 | ||
| The cleft and craniofacial team | 661 | ||
| The history and physical examination | 661 | ||
| Patient selection | 662 | ||
| Cephalometric and dental evaluation | 662 | ||
| Model surgery | 663 | ||
| Isolated mandibular surgery | 663 | ||
| Isolated maxillary and two-jaw surgery | 663 | ||
| 3D CT modeling | 663 | ||
| Developing a treatment plan | 663 | ||
| Treatment/surgical technique | 664 | ||
| General principles and pertinent anatomy | 664 | ||
| Le Fort I osteotomy | 665 | ||
| Surgically assisted rapid palatal expansion | 666 | ||
| Bilateral sagittal split osteotomy (BSSO) | 666 | ||
| Intraoral vertical ramus osteotomy | 667 | ||
| Two-jaw surgery | 667 | ||
| Genioplasty | 667 | ||
| Cleft surgery | 667 | ||
| Distraction osteogenesis | 670 | ||
| Basic approaches to commonly encountered problems | 670 | ||
| Skeletal class II malocclusion | 670 | ||
| Skeletal class III malocclusion | 671 | ||
| Maxillary constriction | 671 | ||
| Apertognathia | 671 | ||
| Vertical maxillary excess | 671 | ||
| Short lower face | 671 | ||
| Postoperative care | 671 | ||
| Outcomes, prognosis, and complications | 671 | ||
| Secondary procedures | 677 | ||
| References | 677 | ||
| II Craniofacial | 678 | ||
| 29 Pediatric facial fractures | 678 | ||
| Synopsis | 678 | ||
| Introduction | 678 | ||
| Historical perspective | 678.e1 | ||
| General principles | 678 | ||
| Epidemiology | 678 | ||
| Associated injuries | 679 | ||
| Growth, development, and fracture patterns | 679 | ||
| Diagnosis and presentation | 681 | ||
| Treatment | 682 | ||
| Outcomes, prognosis, and complications | 682 | ||
| Growth outcomes | 683 | ||
| Secondary procedures | 684 | ||
| Cranial base and skull fractures | 685 | ||
| Diagnosis and presentation | 685 | ||
| Treatment | 686 | ||
| Outcomes, prognosis, and complications | 688 | ||
| Orbital fractures | 688 | ||
| Diagnosis and presentation | 688 | ||
| Treatment | 689 | ||
| Outcomes, prognosis, and complications | 690 | ||
| Nasal and naso-orbito-ethmoid fractures | 690 | ||
| Diagnosis and presentation | 690 | ||
| Treatment | 691 | ||
| Outcomes, prognosis, and complications | 691 | ||
| Maxillary, zygomaticomaxillary complex and midface fractures | 692 | ||
| Diagnosis and presentation | 692 | ||
| Treatment | 692 | ||
| Outcomes, prognosis, and complications | 693 | ||
| Mandible fractures | 693 | ||
| Diagnosis and presentation | 693 | ||
| Treatment | 693 | ||
| Nondisplaced fractures | 693 | ||
| Condylar fractures | 693 | ||
| Displaced fractures | 694 | ||
| Outcomes, prognosis, and complications | 695 | ||
| Conclusions | 695 | ||
| Access the complete reference list online at http://www.expertconsult.com | 695 | ||
| References | 695.e1 | ||
| 30 Orbital hypertelorism | 696 | ||
| Synopsis | 696 | ||
| Introduction | 696 | ||
| Historical perspective | 696.e1 | ||
| Basic science and disease process | 696 | ||
| Diagnosis of hypertelorism and patient presentation in facial clefts | 697 | ||
| Median facial clefts | 697 | ||
| Tessier classification of facial clefts | 697 | ||
| Diagnosis of hypertelorism and patient presentation in faciocraniosynostosis | 698 | ||
| Crouzon’s syndrome | 698 | ||
| Pfeiffer’s syndrome | 698 | ||
| Apert’s syndrome (acrocephalosyndactyly) | 699 | ||
| Craniofrontonasal dysplasia | 699 | ||
| Patient selection | 699 | ||
| Orbital shift or bipartition? | 699 | ||
| Treatment/surgical technique | 699 | ||
| Surgical principles in facial clefts | 699 | ||
| Surgical techniques in facial clefts | 700 | ||
| Principles | 700 | ||
| Infrafrontal correction of hypertelorism | 700 | ||
| Box-shift osteotomies (symmetrical orbital hypertelorism) | 702 | ||
| Frontal craniectomy | 702 | ||
| Osteotomies of the orbit | 703 | ||
| Bipartition with intracranial approach (large symmetrical hypertelorism with arched palate) | 703 | ||
| Asymmetrical cases | 703 | ||
| Timing and indications for surgery in faciocraniosynostosis | 704 | ||
| Orbits | 704 | ||
| Face | 704 | ||
| Surgical technique of hypertelorism correction in faciocraniosynostosis | 705 | ||
| Hypertelorism correction by bipartition in combination with Le Fort III osteotomy (Figs. 30.9 and 30.10) | 705 | ||
| Coronal approach | 705 | ||
| Subcranial osteotomies | 705 | ||
| Osteosynthesis and grafts | 705 | ||
| Postoperative care | 705 | ||
| Outcomes, prognosis, and complications | 706 | ||
| Secondary procedures | 708 | ||
| Refinements in hypertelorism correction (in clefts or craniosynostotic patients) | 709 | ||
| Canthus correction | 709 | ||
| Scalp and eyebrows | 709 | ||
| Nose | 709 | ||
| Eyelids and orbits | 709 | ||
| Oculomotor disorders | 709 | ||
| Recurrences of hypertelorism | 709 | ||
| Craniofacial surgery is teamwork | 710 | ||
| Access the complete reference list online at http://www.expertconsult.com | 710 | ||
| References | 710.e1 | ||
| 31 Craniofacial clefts | 711 | ||
| Synopsis | 711 | ||
| Introduction | 711 | ||
| Classifications of craniofacial clefts | 711 | ||
| I: Median craniofacial hypoplasia (tissue deficiency and/or agenesis) | 712 | ||
| A. Holoprosencephalic spectrum (alobar brain) | 712 | ||
| B. Median cerebrofacial hypoplasia (lobar brain) | 712 | ||
| C. Median facial hypoplasia | 712 | ||
| D. Microforms of median facial hypoplasia | 712 | ||
| II: Median craniofacial dysraphia | 713 | ||
| A. True median cleft | 713 | ||
| B. Anterior encephaloceles | 713 | ||
| III: Median craniofacial hyperplasia (tissue excess or duplication) | 713 | ||
| Epidemiology and etiologic factors | 714 | ||
| Embryologic craniofacial development | 714 | ||
| Failure of fusion | 715 | ||
| Neuromeric theory | 716 | ||
| Patient selection | 716 | ||
| Distinctive features of Tessier craniofacial clefts | 716 | ||
| Number 0 cleft | 716 | ||
| Median craniofacial hypoplasia (deficiency of midline structures) | 717 | ||
| Soft-tissue deficiencies | 718 | ||
| Skeletal deficiencies | 718 | ||
| Median craniofacial dysraphia (normal tissue volume but clefted) | 718 | ||
| Index | 961 | ||
| A | 961 | ||
| B | 963 | ||
| C | 964 | ||
| D | 970 | ||
| E | 971 | ||
| F | 972 | ||
| G | 976 | ||
| H | 976 | ||
| I | 978 | ||
| J | 978 | ||
| K | 978 | ||
| L | 978 | ||
| M | 979 | ||
| N | 981 | ||
| O | 983 | ||
| P | 984 | ||
| R | 987 | ||
| S | 988 | ||
| T | 990 | ||
| U | 992 | ||
| V | 993 | ||
| W | 994 | ||
| Z | 994 | ||
| Inside Back Cover | ibc1 |