Lipoenxertia autóloga no tratamento da atrofia hemifacial progressiva (síndrome de Parry-Romberg): relato de caso e revisão da literatura

Abstract

Parry-Romberg syndrome, also known as progressive hemifacial atrophy, is a rare disorder characterized by slow and progressive hemifacial atrophy. The treatment offered for the syndrome generally aims at improving aesthetics. Fat grafts, silicone injections or acrylic prosthesis are alternatives suggested for correction of facial atrophy. Currently, the recommended technique for correction of facial atrophy is cosmetic dermatologic surgery with autologous fat grafting. This study reports a case of Parry-Romberg syndrome and demonstrates that dermatologic surgery can relieve serious damage to the patient's anatomy, starting from the discussion of the therapeutic aspects of the syndrome with emphasis on autologous fat grafting. Keywords: Facial hemiatrophy; Lipodystrophy; Transplants; Homologous transplantation Resumo: A Síndrome de Parry-Romberg, também conhecida como atrofia hemifacial progressiva, é uma doença rara caracterizada por lenta e progressiva atrofia de hemiface. O tratamento ofertado para a sín-drome, geralmente, visa melhorar o aspecto estético. Os enxertos gordurosos, as injeções de silicone ou as próteses de acrílico são alternativas sugeridas para correção da atrofia facial. Atualmente, a técnica recomendada para correção da atrofia facial é cirurgia dermatológica cosmética com lipoenxertia autóloga. O objetivo deste estudo é relatar um caso de SPR e demonstrar que a cirurgia dermatológica pode aliviar danos sérios à anatomia do paciente, a partir da discussão dos aspectos terapêuticos da síndrome, com ênfase na lipoenxertia autóloga.

Síndrome de Romberg: uma série de casos

“…The clinical treatment of disease with immunosuppressant (methotrexate) or other medications, such as chloroquine and calcipotriol, is discussed by several authors; however, there is no scientific evidence for the use of this kind of medication 11 . Surgical treatment is delayed until stabilization of the di sease.…”

Autologous Fat Grafting as Adjuvant Treatment in Facial Reconstructive Surgery: Case Report

“…Lip transference has numerous advantages compared to procedures based on flaps, such as decreased morbidity at the site and operating time of the donor area, total surgical time, and complications. The feasibility of fat grafting as a combined method to correct large defects achieves a high degree of reconstructive precision [6,7].…”

Subdermal fat grafting for Parry-Romberg syndrome

“…They include dermis-fat grafts, omental free flaps and musculoskeletal free flaps, cartilage or bone, inclusion of tantalium, acrylic and solid or liquid silicone etc. [23] Recently, autologous fat transfer techniques such as liposuction and liposculpture techniques of Illouz, Fournier and Otteni have been employed to increase the soft-tissue mass. A widely employed technique was proposed by Coleman.…”

“…Recently cell-assisted lipotransfer that uses autologous adipose tissue transplant enriched with adipose-derived stem cells has been reported. [3] Irrespective of the treatment modality, the prognosis of the treatment is fair to good. Subdermal fat grafts have been noted to have better and longer stability.…”