{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T07:49:19Z","timestamp":1717746559786},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>In 1997 the authors presented the case of a 3-year-old girl who underwent complete resection of a huge tumor via a new technique using a dismasking flap. Since that report, 14 patients have undergone surgery using this technique. There have been few reports on long-term follow-up after a craniofacial surgical approach and reconstruction of a huge tissue defect. The authors report details of this procedure based on these cases, including long-term follow-up in the original case.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The dismasking flap is a cranioorbitofacial degloving method that uses a circumpalpebral approach with or without piriform margin incisions and presents a wide surgical field under direct vision. Fourteen patients have undergone surgery using the dismasking flap technique. These patients had multiple craniofacial bone fractures (3 cases) and malignant or premalignant craniofacial tumors (11 cases). Patients ranged in age from 3 to 62 years old. The longest follow-up period was 15 years. The results of these cases are reported regarding changes in the facial bones and soft tissues with growth, the various pathologies involved, and complications.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Complications using this approach were lagophthalmos with ectropion of the lower eyelid, disturbance of the superior orbital nerve, disturbance of the inferior orbital nerve, maxillary hypoplasia, and blepharoptosis. In all affected patients these complications were almost always temporary. In 2 of the 14 cases, a repair operation for lagophthalmos was necessary, while others showed spontaneous improvement approximately 6 months to a year after the procedure. In the case with the longest follow-up duration, the patient's nose is asymmetrical, especially the alar portion, due to hypoplasia of the grafted bone and\/or the fixation with titanium miniplates.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This flap is very useful for en bloc resection of huge skull base tumors, multiple craniofacial bone fractures, and as a lateral approach to a deep portion of the middle cranial base. Careful attention is necessary, however, because one may encounter unexpected complications if one does not ensure adequate protection of the perioperative flap. Meticulous postoperative management is also essential.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.1.peds10271","type":"journal-article","created":{"date-parts":[[2011,4,1]],"date-time":"2011-04-01T15:18:48Z","timestamp":1301671128000},"page":"345-350","source":"Crossref","is-referenced-by-count":3,"title":["Retrospective assessment of the dismasking flap procedure as a craniofacial approach"],"prefix":"10.3171","volume":"7","author":[{"given":"Takuya","family":"Fujimoto","sequence":"first","affiliation":[{"name":"Departments of Plastic and Reconstructive Surgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Imai","sequence":"additional","affiliation":[{"name":"Departments of Plastic and Reconstructive Surgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Departments of Plastic and Reconstructive Surgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaharu","family":"Hatano","sequence":"additional","affiliation":[{"name":"Departments of Plastic and Reconstructive Surgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motoki","family":"Tamai","sequence":"additional","affiliation":[{"name":"Departments of Plastic and Reconstructive Surgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Nakano","sequence":"additional","affiliation":[{"name":"Otolaryngology, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery, Osaka City General Hospital; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Ohata","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate Medicine, Osaka City University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0070345","series-title":"Neurosurgery","first-page":"1398","article-title":"Analytical evaluation of complex anterior approaches to the cranial base: an anatomic study","volume":"43","author":"Ammirati","year":"1998"},{"key":"b2-0070345","series-title":"J Neurosurg Sci","first-page":"1","article-title":"Transnasal endoscopic management of frontal sinus mucopyocele with orbital and frontal lobe displacement as minimally invasive surgery","volume":"54","author":"Bozza","year":"2010"},{"key":"b3-0070345","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1227\/01.NEU.0000368395.82329.C4","article-title":"Endoscopic endonasal transethmoidal transcribriform transfovea ethmoidalis approach to the anterior cranial fossa and skull base","volume":"66","author":"Greenfield","year":"2010"},{"key":"b4-0070345","series-title":"Jpn J Head Neck Cancer","doi-asserted-by":"publisher","first-page":"597","DOI":"10.5981\/jjhnc1974.28.597","article-title":"[Approach of the craniofacial region using a dismasking flap.]","volume":"28","author":"Imai","year":"2002"},{"key":"b5-0070345","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"625","DOI":"10.3171\/jns.1997.87.4.0625","article-title":"Osteoblastoma of the nasal cavity invading the anterior skull base in a young child. Case report","volume":"87","author":"Imai","year":"1997"},{"key":"b6-0070345","series-title":"Auris Nasus Larynx","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.anl.2009.07.005","article-title":"Nasal downward swing approach coupled with the facial dismasking flap","volume":"37","author":"Kishimoto","year":"2010"},{"key":"b7-0070345","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1097\/MLG.0b013e31806dd040","article-title":"Facial dismasking flap for removal of tumors in the craniofacial region","volume":"117","author":"Koda","year":"2007"},{"key":"b8-0070345","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1227\/01.NEU.0000088802.58956.5A","article-title":"Zones of approach for craniofacial resection: minimizing facial incisions for resection of anterior cranial base and paranasal sinus tumors","volume":"53","author":"Liu","year":"2003"},{"key":"b9-0070345","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1016\/j.otohns.2009.11.027","article-title":"Maxillary removal and reinsertion: a favorable approach for extensive anterior cranial base tumors","volume":"142","author":"Ozer","year":"2010"},{"key":"b10-0070345","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1055\/s-0030-1247504","article-title":"The supraorbital craniotomy for access to the skull base and intraaxial lesions: a technique in evolution","volume":"53","author":"Raza","year":"2010"},{"key":"b11-0070345","series-title":"Ann Plast Surg","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1097\/00000637-199011000-00005","article-title":"The effect of rigid internal fixation on cranial growth","volume":"25","author":"Resnick","year":"1990"},{"key":"b12-0070345","series-title":"Bull Osaka Med Coll","first-page":"1","article-title":"Extended coronal flap\u2014\u201cdismasking flap\u201d for craniofacial and skull base surgery","volume":"39","author":"Tajima","year":"1993"},{"key":"b13-0070345","series-title":"Eur J Plast Surg","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1007\/s002380050235","article-title":"Recovery of forehead sensation after extended coronal flap or \u201cdismasking flap","volume":"23","author":"Ueda","year":"2000"},{"key":"b14-0070345","series-title":"J Craniomaxillofac Surg","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/S1010-5182(99)80030-4","article-title":"The resorbable miniplate system Lactosorb in a growing cranio-osteoplasty animal model","volume":"27","author":"Wiltfang","year":"1999"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/7\/4\/article-p345.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/7\/4\/article-p345.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/7\/4\/article-p345.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T15:28:09Z","timestamp":1681572489000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/7\/4\/article-p345.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2011,4]]},"references-count":14,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2011.1.peds10271","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,4]]}}}