Poster 14: Internal midfacelift: the foundation for facial rejuvenation

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nasopharyngeal airway obstructions included: 1) widecolumella creating narrow nostrils, 2) constricture ofluminal valves, 3) deviated nasal septum, 4) hypertro-phic turbinates, 5) hypertrophic adenoids, 6) hypertro-phic uvula, and 7) hypertrophic tonsils. Diagnosis wasperformed combining clinical and radiological evalua-tion. Descriptive statistics were used to evaluate thedata.

Results: Fifty-two percent of the patients were diag-nosed with at least one of the most common nasopha-ryngeal airway obstructions and required additional sur-gical procedures to correct these specific obstructions.From the 52% of the patients, the most common obstruc-tion found was the hypertrophic turbinates prevalentalone or combined with others in 87% of the patientswith airway obstructions. The second most common inprevalence was the deviated nasal septum occurring in64% of these patients by itself or combined. Wide colu-mella base and obstructive luminal valves accounted for5% of the cases. Hypertrophic adenoids, tonsils, anduvula occurred alone or combined in 7% of the patientswith obstructions. There were no additional surgical orpostsurgical complications encountered when perform-ing the correction of these airway obstructions concom-itant with Le Fort I osteotomy to correct dentofacialdeformities.

Conclusions: The results of this study showed thatnasopharyngeal airway obstructions occurred in morethan half of the dentofacial deformities patients. Carefuldiagnosis should be performed in order to improve thefunctional results of the corrective orthognathic surgery.With the use of proper techniques, the oral and maxil-lofacial surgeon can combine the correction of theseairway obstructions with the conventional orthognathicsurgery procedures without any additional complica-tions or risks.

References

Morales-Ryan CA, Wolford LM: Hypertrophic turbinates: Prevalence,surgical indications and outcome in the orthognathic surgery patients.J Oral Maxillofac Surg 59:35, 2001 (suppl 1)

Wolford LM, Mehra P: Modified uvulopalatopharyngoplasty: Thelateral inversion flap technique. J Oral Maxillofac Surg 59:1242, 2001

POSTER 14Internal Midfacelift: The Foundation forFacial RejuvenationStephen W. Watson, DDS, MD, 3302 Gaston Ave,Dallas, TX 75246 (Morales-Ryan CA; Sinn DP)

There are 2 essential aspects or components to con-sider when treatment planning or performing any typeof facial rejuvenation operation. These are 1) attempt towork from the inside out and 2) attempt to reposition oradd to before performing any type of “take away” pro-

cedure. The purpose of this study is to evaluate theaesthetic effect performing the internal midfacelift(which is always combined with an endoscopic foreheadlift) concomitant with our conventional rhytidectomy asa facial rejuvenation comprehensive therapy.

Methods: This prospective study included 15 female pa-tients that underwent the internal midfacelift (IML) con-comitant with our conventional rhytidectomy approach. Asecond group of patients that underwent rhytidectomyalone were used as controls to compare the results. Clinicaland photographic evaluations with VAS (visual analogscale) by surgeons and nursing staff were performed at 3time intervals: presurgery (T1), at surgery (T2), and post-surgical follow-up (T3). Evaluation criteria included 1) softtissue projection in the malar and submalar area (increase,no change or decrease); 2) natural or unnatural appear-ance; and 3) overall outcome between IML and non-IMLpatients. We use t test for the statistical analysis.

Results: We found statistically significant higher VASscores for the IML group in all 3 parameters comparedwith the non-IML group of patients. These results weresimilar between surgeons and nursing staff. The IMLgroup showed significantly increased soft tissue projec-tion, while the non-IML group showed no change or adecrease in projection. The overall outcome was highlyrated for the IML group as compared to the non-IMLgroup.

Conclusions: The results of this study showed that bycombining the internal midfacelift with our conventionalrhytidoplasty, the aesthetic outcome is a more natural,longer lasting facelift than with a subcutaneous lift alone,showing a significant soft tissue projection in the malarand submalar area. It also eliminates the need forsubSMAS dissection and hence decreases the chances forfacial nerve damage.

References

Ozdemir R, Kilinc H, Unlu RE, et al: Anatomicohistologic study of theretaining ligaments of the face and use in face lift: Retaining ligamentcorrection and SMAS plication. Plast Reconstr Surg 110:1134, 2002discussion, 1148

Stone TL, Watson SW, Throckmorton GS, et al: A comparative studyof scalp tension with and without intraoral subperiosteal release of themidface in laser-assisted endoscopy.

POSTER 15Gene Expression of Oral CancerExamined by cDNA MicroarraysIn-Kyo Chung, Pusan National University, School ofDentistry, Department of OMS, Korea (Shin SH;Kim CH; Heo J)

Purpose: cDNA microarray provided a powerful alter-native with an unprecedented view scope in monitoringgene expression levels and led to discoveries of regula-

Scientific Poster Session

88 AAOMS • 2003

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