Anatomical Fat Grafting for Reconstruction of Frontotemporal Contour Deformities After Neurosurgical and Craniofacial Surgical Interventions: A Symmetry Outcome Study.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Jul 2019
Historique:
received: 26 01 2019
revised: 03 04 2019
accepted: 04 04 2019
pubmed: 14 4 2019
medline: 15 1 2020
entrez: 14 4 2019
Statut: ppublish

Résumé

Fat grafting has been described as an option to repair frontotemporal contour deformities (volumetric deficiency of bone and/or soft tissues) after neurosurgical/craniofacial surgical interventions. However, technical surgical descriptions have varied, with reports describing the bolus fat injection or the classical multilayer injection, but with no detailed descriptions concerning how and where the fat should be grafted. The purpose of this study was to assess the frontotemporal symmetry outcomes after a single fat-grafting procedure for postoperative frontotemporal contour deformity reconstructions using the anatomical fat-grafting approach. A prospective analysis was conducted of consecutive patients (n = 106) who underwent anatomical fat grafting (Coleman's structural fat grafting technique using anatomical facial subunit and fat compartment principles) to reconstruct frontotemporal contour deformities after neurosurgical/craniofacial surgical interventions. A subjective assessment by a panel of external surgical professionals and laypersons was obtained to grade the frontotemporal symmetry. Objective ultrasound symmetry assessment was blindly performed preoperatively and at 3- and 12-month follow-up. There were significant (all P  <  0.05) postoperative subjective and objective frontotemporal symmetry enhancements (preoperative < postoperative) after anatomical fat grafting, with no differences (all P > 0.05) between the 3- and 12-month postoperative comparisons. Thirty-seven percent of patients required an additional fat grafting session for residual asymmetry after 12 months of follow-up. Patients with frontotemporal contour deformities presented improved subjective and objective frontotemporal symmetry after an anatomical fat grafting session.

Sections du résumé

BACKGROUND BACKGROUND
Fat grafting has been described as an option to repair frontotemporal contour deformities (volumetric deficiency of bone and/or soft tissues) after neurosurgical/craniofacial surgical interventions. However, technical surgical descriptions have varied, with reports describing the bolus fat injection or the classical multilayer injection, but with no detailed descriptions concerning how and where the fat should be grafted. The purpose of this study was to assess the frontotemporal symmetry outcomes after a single fat-grafting procedure for postoperative frontotemporal contour deformity reconstructions using the anatomical fat-grafting approach.
METHODS METHODS
A prospective analysis was conducted of consecutive patients (n = 106) who underwent anatomical fat grafting (Coleman's structural fat grafting technique using anatomical facial subunit and fat compartment principles) to reconstruct frontotemporal contour deformities after neurosurgical/craniofacial surgical interventions. A subjective assessment by a panel of external surgical professionals and laypersons was obtained to grade the frontotemporal symmetry. Objective ultrasound symmetry assessment was blindly performed preoperatively and at 3- and 12-month follow-up.
RESULTS RESULTS
There were significant (all P  <  0.05) postoperative subjective and objective frontotemporal symmetry enhancements (preoperative < postoperative) after anatomical fat grafting, with no differences (all P > 0.05) between the 3- and 12-month postoperative comparisons. Thirty-seven percent of patients required an additional fat grafting session for residual asymmetry after 12 months of follow-up.
CONCLUSIONS CONCLUSIONS
Patients with frontotemporal contour deformities presented improved subjective and objective frontotemporal symmetry after an anatomical fat grafting session.

Identifiants

pubmed: 30980984
pii: S1878-8750(19)31036-8
doi: 10.1016/j.wneu.2019.04.044
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1064-e1082

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Rafael Denadai (R)

Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paul, Brazil. Electronic address: denadai.rafael@hotmail.com.

Cesar Augusto Raposo-Amaral (CA)

Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paul, Brazil.

Celso Luiz Buzzo (CL)

Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paul, Brazil.

Enrico Ghizoni (E)

Division of Neurosurgery, Department of Neurology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.

Fernando Cendes (F)

BRAINN (Brazilian Institute of Neuroscience and Neurotechnology, Research, Innovation and Dissemination Centers), Neuroimaging Laboratory, Department of Neurology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.

Cassio Eduardo Raposo-Amaral (CE)

Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paul, Brazil.

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Classifications MeSH