Rhytidectqmy

Baker, Thomas J.; Gordon, Howard L.; Mosienko, Peter

doi:10.1097/00006534-197701000-00004

Cited by 71 publications

(2 citation statements)

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“…The great auricular nerve has long been implicated in neuroma pain secondary to injury during rhytidectomy. 29,[35][36][37][38][39] This pain has been likened to migraine pain. 35,40 In 1978, Lewin and Tsur noted that patients who have experienced transection of the great auricular nerve during rhytidectomy may complain of "migraine-like headaches" related to neuroma pain or nerve regeneration.…”

Section: Discussionmentioning

confidence: 99%

The Great Auricular Nerve Trigger Site: Anatomy, Compression Point Topography, and Treatment Options for Headache Pain

Schoenbrunner¹,

Konschake²,

Zwierzina³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Background: Peripheral nerve decompression surgery can effectively address headache pain caused by compression of peripheral nerves of the head and neck. Despite decompression of known trigger sites, there are a subset of patients with trigger sites centered over the postauricular area coursing. The authors hypothesize that these patients experience primary or residual pain caused by compression of the great auricular nerve. Methods: Anatomical dissections were carried out on 16 formalin-fixed cadaveric heads. Possible points of compression along fascia, muscle, and parotid gland were identified. Ultrasound technology was used to confirm these anatomical findings in a living volunteer. Results: The authors' findings demonstrate that the possible points of compression for the great auricular nerve are at Erb's point (point 1), at the anterior border of the sternocleidomastoid muscle in the dense connective tissue before entry into the parotid gland (point 2), and within its intraparotid course (point 3). The mean topographic measurements were as follows: Erb's point to the mastoid process at 7.32 cm/7.35 (right/left), Erb's point to the angle of the mandible at 6.04 cm/5.89 cm (right/left), and the posterior aspect of the sternocleidomastoid muscle to the mastoid process at 3.88 cm/4.43 cm (right/left). All three possible points of compression could be identified using ultrasound. Conclusions: This study identified three possible points of compression of the great auricular nerve that could be decompressed with peripheral nerve decompression surgery: Erb's point (point 1), at the anterior border of the sternocleidomastoid muscle (point 2), and within its intraparotid course (point 3). (Plast.

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Section: Discussionmentioning

confidence: 99%

The Great Auricular Nerve Trigger Site: Anatomy, Compression Point Topography, and Treatment Options for Headache Pain

Schoenbrunner¹,

Konschake²,

Zwierzina³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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confidence: 99%

Perioperative Approach to Reducing Hematoma during Rhytidectomy: What Does the Evidence Show?

Cason

Avashia

Shammas

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Hematoma remains the most common complication in rhytidectomy, with reported rates as high as 15.6 percent. 1,2 Postoperative hematomas can threaten tissue viability, increase the risk for infection, require a return to the operating room, and compromise the final aesthetic result. The risk factors for developing a postoperative hematoma have been well defined to include male sex, perioperative hypertension, and aspirin use. [3][4][5] In addition, a thorough preoperative evaluation should identify any coagulopathies, medications, or herbal supplements that may predispose the patient to bleeding complications. 4,6

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Hematoma Rates in Drainless Deep-Plane Face-lift Surgery With and Without the Use of Fibrin Glue

Zoumalan

Rizk

2008

Archives of Facial Plastic Surgery

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To determine the rate of hematoma formation in drainless deep-plane rhytidectomy and compare it with the rate using the same technique with the use of fibrin glue. Methods: This is a retrospective review of 605 patients (78 male and 527 female) who, over a 6-year period, underwent deep-plane face-lift surgery (n = 544) or lateral superficial musculoaponeurotic system (SMAS)ectomy (n=61) by the senior author (S.S.R.) without the use of surgical drains. One hundred forty-six consecutive patients underwent rhytidectomy without fibrin tissue glue, and the following 459 consecutive patients were sprayed with fibrin glue under the flap prior to flap closure. Pressure dressings were used on all patients for 24 hours. Results: None of the patients in either group had major or expanding hematomas requiring operative intervention. In the group of patients treated without fibrin glue (n = 146), there were 5 minor, nonexpanding hematomas, all managed by needle aspiration. This is a minor hematoma rate of 3.4%. In the fibrin glue group (n = 459), there were 2 hematomas, for a rate of 0.4%. Using a Fisher exact test, we found a statistically significant decrease in the hematoma rate from 3.4% to 0.4% (P=.01). Male patients had a higher hematoma rate than female patients, and only men had significantly fewer hematomas when fibrin glue was applied (P=.01). All 7 hematomas were recognized in the first 24 hours after surgery. Of the 7 patients with hematomas, 2 (29%) had emesis in the recovery room despite medication. Conclusions: The use of fibrin glue demonstrates a significant decrease in the rate of hematoma formation. Fibrin glue may benefit male more than female patients. If meticulous hemostasis and pressure dressings are used, drains are not necessary. The prevention and prompt treatment of postoperative nausea may also help prevent hematoma formation.

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Rhytidectqmy

Cited by 71 publications

References 0 publications

The Great Auricular Nerve Trigger Site: Anatomy, Compression Point Topography, and Treatment Options for Headache Pain

The Great Auricular Nerve Trigger Site: Anatomy, Compression Point Topography, and Treatment Options for Headache Pain

Perioperative Approach to Reducing Hematoma during Rhytidectomy: What Does the Evidence Show?

Hematoma Rates in Drainless Deep-Plane Face-lift Surgery With and Without the Use of Fibrin Glue

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