Surgical treatment of head and neck XXXX by means of a staged zonal approach.

@entity1 @entity455 @entity1184 @entity600 @entity3809 @entity7439
BACKGROUND: The majority of @entity1 with @entity600 ( @entity3809 ) develop soft-tissue and bony @entity1184 leading to gross @entity7439 in vision, breathing, speech, and feeding. The authors describe and illustrate a surgical approach for the treatment of these @entity600 with restoration of facial symmetry and contour based on facial subunits. METHODS: The authors conducted a retrospective case series of @entity1 from 2004 to 2011 presenting for primary evaluation and treatment to a tertiary referral center specializing in @entity455 . The medical records and photographs of @entity1 with @entity600 and soft-tissue @entity1184 were reviewed. RESULTS: Of the 160 @entity1 who presented with the diagnosis of facial @entity600 /port-wine stain, 96 (60 percent) had soft-tissue @entity1184 in one or more dermatomes resulting in @entity7439 . Only 4.4 percent of @entity1 had solely V1 involvement, 38.8 percent had V2 involvement, and 15.6 percent had V3 involvement. The technique and incisions used for each facial zone are described in detail. In all cases, incisions were placed along existing boundaries of facial subunits. Serial pulsed-dye laser treatments were also performed. CONCLUSIONS: Sixty percent of @entity1 with facial @entity600 experience soft-tissue @entity1184 with or without bony remodeling, and surgical correction is required. The authors describe a staged surgical treatment for these @entity1 based on a subunit and zonal approach to the face. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
