Deep Pyriform Space: Anatomical Clarifications and Clinical Implications.

Abstract:

BACKGROUND:The purpose of this study was to define the anatomical boundaries, transformation in the aging face, and clinical implications of the Ristow space. The authors propose a title of deep pyriform space for anatomical continuity. METHODS:The deep pyriform space was dissected in 12 hemifacial fresh cadaver dissections. Specimens were divided into three separate groups. For group 1, dimensions were measured and plaster molds were fashioned to evaluate shape and contour. For group 2, the space was injected percutaneously with dyed hyaluronic acid to examine proximity relationships to adjacent structures. For group 3, the space was pneumatized to evaluate its cephalic extension. RESULTS:The average dimensions of the deep pyriform space are 1.1 × 0.9 cm. It is bounded medially by the depressor septi nasi and cradled laterally and superficially in a "half-moon" shape by the deep medial cheek fat and lip elevators. The angular artery courses on the roof of the space within a septum between the space and deep medial cheek fat. Pneumatization of the space traverses cephalic to the level of the tear trough ligament in a plane deep to the premaxillary space. CONCLUSIONS:The deep pyriform space is a midface cavity cradled by the pyriform aperture and deep medial cheek compartment. Bony recession of the maxilla with age predisposes this space for use as a potential area of deep volumization to support overlying cheek fat and draping lip elevators. The position of the angular artery in the roof of the space allows safe injection on the bone without concern for vascular injury.

journal_name

Plast Reconstr Surg

authors

Surek CK,Vargo J,Lamb J

doi

10.1097/PRS.0000000000002262

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

59-64

issue

1

eissn

0032-1052

issn

1529-4242

pii

00006534-201607000-00011

journal_volume

138

pub_type

杂志文章
  • Systematic Review of the Impact of Acellular Dermal Matrix on Aesthetics and Patient Satisfaction in Tissue Expander-to-Implant Breast Reconstructions.

    abstract:BACKGROUND:Acellular dermal matrix is used in most postmastectomy implant-based breast reconstructions in the United States. It is believed to be safe, despite a slightly increased complication rate. Although never established in a unifying study, the primary advantage of acellular dermal matrix is believed to be an en...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,meta分析

    doi:10.1097/PRS.0000000000006212

    authors: DeLong MR,Tandon VJ,Farajzadeh M,Berlin NL,MacEachern MP,Rudkin GH,Da Lio AL,Cederna PS

    更新日期:2019-12-01 00:00:00

  • Evaluation of a novel technique for wound closure using a barbed suture.

    abstract:BACKGROUND:Suture knots present several disadvantages in wound closure, because they are tedious to tie and place ischemic demands on tissue. Bulky knots may be a nidus for infection, and they may extrude through skin weeks after surgery. Needle manipulations during knot-tying predispose the surgeon to glove perforatio...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/01.prs.0000209971.08264.b0

    authors: Murtha AP,Kaplan AL,Paglia MJ,Mills BB,Feldstein ML,Ruff GL

    更新日期:2006-05-01 00:00:00

  • Immediate reconstruction of full-thickness burn of an ear with an undelayed myocutaneous flap. Case report.

    abstract::We report a case in which an undelayed cervical myocutaneous flap was used early to cover the denuded cartilage of a burned ear. The ear was saved, and a good result was obtained. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197810000-00030

    authors: McGrath MH,Ariyan S

    更新日期:1978-10-01 00:00:00

  • Nasal trauma and the deviated nose.

    abstract::As the most prominent facial feature, the nose carries an increased risk of traumatic injury. Nasal fracture is the most common bone injury of the adult face and frequently results from motor vehicle accidents, sports-related injuries, and altercations. Although often initially considered minor, nasal fracture may eve...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/01.prs.0000260722.91183.50

    authors: Higuera S,Lee EI,Cole P,Hollier LH Jr,Stal S

    更新日期:2007-12-01 00:00:00

  • Spherical contracture of fibrous capsules around breast implants. Prevention and treatment.

    abstract::A follow-up of 82 patients who had had augumentation mammaplasties is reported. Though the number of patients having had each form of ancillary treatment is small, we believe that intraoperative instillation of triamcinolone and postoperative "expansion exercises" are of value in decreasing the incidence of capsular c...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197611000-00004

    authors: Vinnik CA

    更新日期:1976-11-01 00:00:00

  • Enhancing the take of injected adipose tissue by a simple method for concentrating fat cells.

    abstract::Injection of aspirated fat for the correction of tissue defects is a common procedure in plastic surgery. The reported rates of fat cell survival vary greatly in the medical literature, and different techniques of harvesting, processing, and reinjecting the fat cells are claimed to be responsible for these differences...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Ramon Y,Shoshani O,Peled IJ,Gilhar A,Carmi N,Fodor L,Risin Y,Ullmann Y

    更新日期:2005-01-01 00:00:00

  • Electrical burns causing a urinary bladder fistula. Case report.

    abstract::We present a patient with electrical burns which resulted in loss of the right upper arm and a urinary bladder fistula. A jump flap was used to cover the repaired bladder, and also to cover the stump of the amputated right arm. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197803000-00026

    authors: Chari PS,Bapna BC,Balakrishnan C

    更新日期:1978-03-01 00:00:00

  • The sit-up position for breast reconstruction.

    abstract::For breast reconstruction, we have found that breast symmetry can be created optimally when the patient is brought to a totally upright position with the trunk vertical and perpendicular to the floor. The size of the opposite breast can better be appreciated. Nipple and areola position can be determined accurately eve...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198601000-00010

    authors: Smoot EC,Ross D,Silverberg B,Ruttle M,Newman LM

    更新日期:1986-01-01 00:00:00

  • Effects of single-dose steroid usage on edema, ecchymosis, and intraoperative bleeding in rhinoplasty.

    abstract::To examine the effects of single-dose dexamethasone use on edema, ecchymosis, and intraoperative bleeding in rhinoplasty, a double-blind, randomized trial with placebo control was planned. A total of 55 consecutive patients were included in the study. The dexamethasone (10 mg) was given intravenously just before surge...

    journal_title:Plastic and reconstructive surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00006534-199912000-00041

    authors: Kara CO,Gökalan I

    更新日期:1999-12-01 00:00:00

  • Expansion of the socket and orbit for congenital clinical anophthalmia.

    abstract:BACKGROUND:Congenital clinical anophthalmia requires fitting an artificial eye, achieving a pleasing aspect of the palpebral apparatus, and stimulating growth of the orbit, as well as of the entire midface. METHODS:Out of 25 patients with clinical anophthalmia, 22 were treated according to a new protocol (first descri...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000181653.38200.eb

    authors: Gundlach KK,Guthoff RF,Hingst VH,Schittkowski MP,Bier UC

    更新日期:2005-10-01 00:00:00

  • Beyond working hours: part I. Genesis and current difficulties.

    abstract::The roots of the working hours mandate and controversy are outlined, the effect on resident education is described, and the service versus education equation is defined. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3182450c27

    authors: Luce EA

    更新日期:2012-04-01 00:00:00

  • Guiding local perforator flaps with preoperative imaging: revealing perforator anatomy to improve flap design.

    abstract:BACKGROUND:Perforator flap nomenclature continues to evolve, with many classification schemes reported. Each of them focuses on the fascial penetration pattern of perforators, which has no impact on flap perfusion. With the advent of advanced imaging technologies, the subcutaneous course of perforators can be highlight...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31824ecaff

    authors: Rozen WM,Paddle AM,Chubb D,Wilson J,Grinsell D,Ashton MW

    更新日期:2012-07-01 00:00:00

  • Evolution in minimal-incision palatoplasty: surgical technique and outcomes in 67 consecutive cases.

    abstract:BACKGROUND:Conventional palatoplasty relies on extensive mucosal incisions and isolation of flaps on the palatine vessels to facilitate midline closure and velar reconstruction. This introduces substantial scarring, which has adverse effects on vascularity and growth. The authors have developed a minimally invasive pal...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000280

    authors: Pan BS,Rapp SJ,Vu A,Uribe-Rivera A,Billmire DA,Gordon CB

    更新日期:2014-07-01 00:00:00

  • Diced cartilage grafts in rhinoplasty surgery.

    abstract::The use of diced cartilage grafts in rhinoplasty surgery was recently revived by Erol with the publication of his technique for "Turkish delight" grafts (i.e., diced cartilage grafts wrapped in Surgicel). The present study details the authors' experience with 50 consecutive diced cartilage grafts used in three configu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000122544.87086.b9

    authors: Daniel RK,Calvert JW

    更新日期:2004-06-01 00:00:00

  • A guide to organizing a multicenter clinical trial.

    abstract::Multicenter clinical trials are important research tools. Planning a multicenter clinical trial is a long and arduous task that requires substantial preparation time. In this guide, the authors discuss the steps used to plan a multicenter clinical trial. A preplanning phase, which involves formulating and refining a r...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0b013e3181df64fa

    authors: Chung KC,Song JW,WRIST Study Group.

    更新日期:2010-08-01 00:00:00

  • Intravenous Hyaluronidase with Urokinase as Treatment for Rabbit Retinal Artery Hyaluronic Acid Embolism.

    abstract:BACKGROUND:Although various salvage methods have been proposed to treat intraretinal artery hyaluronic acid embolism, their applications are still limited by various factors. The authors investigated the effectiveness of intravenous hyaluronidase with urokinase for resolving retinal artery hyaluronic acid embolism. ME...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000002803

    authors: Chiang C,Zhou S,Chen C,Ho DS,Zhang H,Liu K

    更新日期:2016-12-01 00:00:00

  • Sagittal craniosynostosis outcome assessment for two methods and timings of intervention.

    abstract::A retrospective quantitative analysis of 40 infants who underwent surgery for sagittal craniosynostosis was conducted to determine whether any difference in outcome, with respect to cranial index (cranial width/cranial length x 100), could be associated with either the age at surgery or the extent of the operation. Ch...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199905060-00004

    authors: Panchal J,Marsh JL,Park TS,Kaufman B,Pilgram T,Huang SH

    更新日期:1999-05-01 00:00:00

  • Syndactylic toe transfer for fingertip reconstruction.

    abstract::In the case of multiple fingertip reconstruction requiring toe transfer, double toes can be elevated in the syndactylic fashion with a single vascular pedicle for transfer, followed by separation a few weeks later. The biggest advantage of this procedure is that the problem of limitation of recipient arteries for mult...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Hirasé Y,Kojima T,Takeishi M,Konno M

    更新日期:1995-03-01 00:00:00

  • The impact of acellular dermal matrix on tissue expander/implant loss in breast reconstruction: an analysis of the tracking outcomes and operations in plastic surgery database.

    abstract:BACKGROUND:Use of acellular dermal matrix in breast reconstruction has been associated with increased complications. However, existing studies are generally small, from single centers, and underpowered to control for confounding using regression techniques. Here, the Tracking Outcomes and Operations in Plastic Surgery ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318290f917

    authors: Pannucci CJ,Antony AK,Wilkins EG

    更新日期:2013-07-01 00:00:00

  • Lumbar Flap versus the Gold Standard: Comparison to the DIEP Flap.

    abstract:BACKGROUND:The lumbar artery perforator flap is an excellent free flap for breast reconstruction whenever the deep inferior epigastric perforator (DIEP) flap is not an option. The main indication is a lack of abdominal bulk, often seen in young BRCA-positive women seeking prophylactic amputation and immediate reconstru...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006681

    authors: Opsomer D,Vyncke T,Depypere B,Stillaert F,Blondeel P,Van Landuyt K

    更新日期:2020-04-01 00:00:00

  • The "babysitter" procedure: minihypoglossal to facial nerve transfer and cross-facial nerve grafting.

    abstract:BACKGROUND:In 1984, Terzis introduced the "babysitter" procedure, a new concept in facial reanimation. It involves two stages, with coaptation of ipsilateral 40 percent hypoglossal to facial nerve on the affected side, performed concomitantly with cross-facial nerve grafting and secondary microcoaptations 8 to 15 month...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31819ba4bb

    authors: Terzis JK,Tzafetta K

    更新日期:2009-03-01 00:00:00

  • Reconstruction of oncologic tibial defects in children using vascularized fibula flaps.

    abstract:BACKGROUND:Tibial resection in children presents a unique reconstructive challenge because of technical demands, future growth potential, and repetitive loading of the lower extremity. Positioned in a tibial defect, the free fibula undergoes primary bone healing while maintaining intrinsic resistance to infection and t...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318230e463

    authors: Schwarz GS,Disa JJ,Mehrara BJ,Healey JH,Cordeiro PG

    更新日期:2012-01-01 00:00:00

  • Comparative analysis of 18-month outcomes and costs of breast reconstruction flap procedures.

    abstract:BACKGROUND:Data from large-scale studies of breast reconstruction surgery outcomes and downstream costs are lacking. The authors assessed outcomes, patient return rates, and costs across a large, geographically diverse patient population undergoing autologous breast reconstruction. METHODS:Insurance claims for patient...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000064

    authors: Israeli R,Funk S,Reaven NL

    更新日期:2014-03-01 00:00:00

  • High-Throughput Screening of Full-Face Clinically Relevant Arterial Variations Using Three-Dimensional Postmortem Computed Tomography.

    abstract:BACKGROUND:Vascular complications resulting from intravascular filler injection and embolism are major safety concerns for facial filler injection. It is essential to systematically screen full-face arterial variations and help design evidence-based safe filler injection protocols. METHODS:The carotid arteries of 22 c...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000004834

    authors: Zhu GZ,Zhao WR,Luo CE,Cai B,Kong XX,Zhan WF,Sun ZS,Luo SK

    更新日期:2018-11-01 00:00:00

  • Remote Ischemic Conditioning Improves Blood Flow and Oxygen Saturation in Pedicled and Free Surgical Flaps.

    abstract:BACKGROUND:Surgical flaps have become safe and reliable reconstructive tools, but total flap loss rates as high as 25 percent and partial flap loss rates as high as 36 percent have been reported due to insufficient perfusion. Therefore, a reliable, noninvasive, and effective way to improve the microcirculation of surgi...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000002664

    authors: Kolbenschlag J,Sogorski A,Kapalschinski N,Harati K,Lehnhardt M,Daigeler A,Hirsch T,Goertz O

    更新日期:2016-11-01 00:00:00

  • Ocular advancement in monobloc distraction.

    abstract:BACKGROUND:Monobloc distraction has been demonstrated to be an efficacious, safe, and stable method of providing functional and aesthetic improvement in children with syndromic craniosynostosis. Although the movement of bony structures following monobloc distraction has been quantitatively assessed before, objective an...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181a07625

    authors: O'Connor EJF,Marucci DD,Jeelani NO,Witherow H,Richards R,Dunaway DJ,Hayward RD

    更新日期:2009-05-01 00:00:00

  • Anatomic basis and clinical implications for nasal tip support in open versus closed rhinoplasty.

    abstract::Successful rhinoplasty depends on nasal tip support and its influence on nasal tip projection. The factors involved in nasal tip support are numerous; however, the role of the anterior septum versus the lower lateral cartilages has been debated in the literature. The purpose of this study was to quantitate, using fres...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199901000-00040

    authors: Adams WP Jr,Rohrich RJ,Hollier LH,Minoli J,Thornton LK,Gyimesi I

    更新日期:1999-01-01 00:00:00

  • Photoacoustic Tomography Shows the Branching Pattern of Anterolateral Thigh Perforators In Vivo.

    abstract::The distal branching pattern of perforators is associated with thin anterolateral thigh flap failure. The purpose of this study was to investigate the feasibility of using photoacoustic tomography as a diagnostic imaging modality to identify anterolateral thigh perforators and their branching patterns in the subcutane...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000004328

    authors: Tsuge I,Saito S,Sekiguchi H,Yoshikawa A,Matsumoto Y,Toi M,Suzuki S

    更新日期:2018-05-01 00:00:00

  • Thin anterolateral thigh perforator flap using a modified perforator microdissection technique and its clinical application for foot resurfacing.

    abstract:BACKGROUND:A thin skin flap is often required for optimal resurfacing of particular areas of the body. An anterolateral thigh perforator flap can be thinned to an extent to which it is vascularized by the subdermal plexus only. This study presents a novel flap thinning technique and its application for resurfacing the ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000200615.77678.f1

    authors: Yang WG,Chiang YC,Wei FC,Feng GM,Chen KT

    更新日期:2006-03-01 00:00:00

  • Surgical correction of postburn flexion contractures of the fingers in children.

    abstract::One-hundred forty-eight operative procedures for flexion contractures of the finger(s) following burn injury in children have been studied in detail with follow-up from 6 months to 8 years. Intramedullary K-wires, used for 53 procedures where a graft was done, were associated with a significantly worse long-term resul...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198108000-00016

    authors: Alexander JW,MacMillan BG,Martel L,Krummel R

    更新日期:1981-08-01 00:00:00