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短暂性面瘫作为颊脂垫去除术的一种并发症。

Transient facial paresis as a complication of buccal fat removal.

作者信息

Franco Alexa, Frants Anna, von Sneidern Manuela, Eytan Danielle F

机构信息

NYU Langone Health Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA.

NYU Langone Health, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA.

出版信息

JPRAS Open. 2024 Sep 19;42:244-249. doi: 10.1016/j.jpra.2024.09.012. eCollection 2024 Dec.

DOI:10.1016/j.jpra.2024.09.012
PMID:39435017
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11491978/
Abstract

AIM

This case highlights the rarely reported complication of facial paresis following buccal fat pad removal and its management.

BACKGROUND

The buccal fat pad is a vital structure in facial aesthetics. In recent years, buccal fat pad removal for mid facial sculpting has gained popularity among patients owing in part to the rise of social media in plastic surgery. Although buccal fat pad removal is usually a safe procedure, potential complications can be quite severe, and can include infection, over-resection, asymmetry, hematoma, facial nerve or parotid duct injury and trismus.

CASE DESCRIPTION

Herein we describe a case of iatrogenic left facial paresis secondary to buccal fat removal, and discuss the importance of appropriate patient counseling, meticulous technique, and post-operative care in the event of a complication.

CONCLUSION

High dose corticosteroids and facial therapy can be effective in treating iatrogenic facial palsy secondary to buccal fat pad removal.

CLINICAL SIGNIFICANCE

Although buccal fat pad removal has become a common procedure for midface sculpting, the risks remain serious and patient counseling regarding possible complications, including transient facial palsy, is paramount. Meticulous technique as well as knowledge of the relationships between the buccal fat pad, the parotid duct, and the buccal branches of the facial nerve are vital in the prevention of facial paresis when removing buccal fat.

摘要

目的

本病例突出了颊脂垫切除术后罕见报道的面部轻瘫并发症及其处理。

背景

颊脂垫是面部美学中的一个重要结构。近年来,由于社交媒体在整形手术中的兴起,颊脂垫切除术用于中面部塑形在患者中越来越受欢迎。尽管颊脂垫切除术通常是一种安全的手术,但潜在并发症可能相当严重,包括感染、切除过度、不对称、血肿、面神经或腮腺导管损伤以及牙关紧闭。

病例描述

在此我们描述一例因颊脂切除继发医源性左侧面部轻瘫的病例,并讨论在出现并发症时进行适当患者咨询、细致技术操作和术后护理的重要性。

结论

高剂量皮质类固醇和面部治疗可有效治疗颊脂垫切除继发的医源性面瘫。

临床意义

尽管颊脂垫切除术已成为中面部塑形的常见手术,但风险仍然严重,关于可能并发症(包括短暂性面瘫)的患者咨询至关重要。在切除颊脂时,细致的技术操作以及对颊脂垫、腮腺导管和面神经颊支之间关系的了解对于预防面部轻瘫至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbd/11491978/cb6720e61261/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbd/11491978/0f47b6c16b2c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbd/11491978/5f22145dbab8/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbd/11491978/aaa6a1b5c483/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbd/11491978/cb6720e61261/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbd/11491978/0f47b6c16b2c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbd/11491978/5f22145dbab8/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbd/11491978/aaa6a1b5c483/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fbd/11491978/cb6720e61261/gr4.jpg

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本文引用的文献

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Buccal fat pad excision for cheek refinement: A systematic review.颊脂垫切除术用于改善颊部外观:系统评价。
Med Oral Patol Oral Cir Bucal. 2021 Jul 1;26(4):e474-e481. doi: 10.4317/medoral.24335.
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Physical Therapy for Iatrogenic Facial Paralysis: A Systematic Review.医源性面瘫的物理治疗:系统评价。
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Aesthet Surg J. 2019 May 16;39(6):585-592. doi: 10.1093/asj/sjy188.
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Buccal fat pad removal to improve facial aesthetics: an established technique?颊脂垫切除术改善面部美观:一种成熟的技术?
Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23(4):e478-e484. doi: 10.4317/medoral.22449.
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Interrelated buccal fat pad with facial buccal branches and parotid duct.与面颊支和腮腺导管相关的颊脂垫。
J Craniofac Surg. 2005 Jul;16(4):658-60. doi: 10.1097/01.scs.0000157019.35407.55.
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Anatomical structure of the buccal fat pad and its clinical adaptations.颊脂垫的解剖结构及其临床应用。
Plast Reconstr Surg. 2002 Jun;109(7):2509-18; discussion 2519-20. doi: 10.1097/00006534-200206000-00052.
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