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Netting Operation to Control Neurofibroma of the Face

Authors
 Byeong Yun Park  ;  Joon Pio Hong  ;  Won Jai Lee 
Citation
 PLASTIC AND RECONSTRUCTIVE SURGERY, Vol.109(4) : 1228-1236, 2002 
Journal Title
PLASTIC AND RECONSTRUCTIVE SURGERY
ISSN
 0032-1052 
Issue Date
2002
MeSH
Adolescent ; Adult ; Child ; Facial Expression ; Facial Neoplasms/surgery* ; Fascia ; Female ; Gravitation ; Humans ; Male ; Neurofibroma/surgery* ; Polytetrafluoroethylene ; Prostheses and Implants* ; Reconstructive Surgical Procedures/methods* ; Surgical Mesh*
Abstract
When neurofibroma involves the face, it can lead to a most disfiguring, destructive, and debilitating condition. Because of the unique aesthetic and functional properties of the face, the surgeon might hesitate to remove all of the involved soft tissues and facial nerves in a radical procedure. Involvement of the craniofacial skeleton makes the treatment more difficult and complex. The treatment usually consists of excising the symptomatic lesion, and often these lesions are incompletely corrected. Regrowth after partial excision is frequent and leads to recurrence of deformity. The force of gravity plays a major role in the appearance of deformity, leading to facial tissue drooping and bulging as the mass grows and gains weight. The aim of this operation was to contain the residual mass after excision within a tight net against the force of gravity, thus limiting and preventing drooping or bulging of the facial soft tissue while preserving muscles and nerves associated with facial expression. Polytetrafluoroethylene (Teflon) mesh, used as a net, was evaluated as a replacement material for subcutaneous tissue and a substitute for superficial fascia destroyed by tumor infiltration. The mesh was suspended in the superior-posterior direction, capturing the residual mass like a net capturing fish. From 1989 to 1999, a total of eight patients underwent the netting procedure after partial excision of neurofibroma of the face. The follow-up period was 3 to 10 years. The use of Teflon mesh proved to be compatible with the surrounding tissue, endurable at follow-up, and consistent with expectations. Follow-up computed tomographic scans revealed no further visible tumor growth, and the area was contained under the mesh net with satisfactory postoperative facial contour. The advantages of this procedure are the avoidance of radical excision of facial soft tissue, preservation of remnant facial expression, and prevention of progression of facial dysmorphism. (Plast. Reconstr. Surg. 109: 1228, 2002.)
Full Text
http://journals.lww.com/plasreconsurg/pages/articleviewer.aspx?year=2002&issue=04010&article=00002&type=abstract
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/143771
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