Rombergʼs Disease Associated with Hornerʼs Syndrome: Contour Restoration by a Free Anterolateral Thigh Perforator Flap and Ancillary Procedures

Esthetic Restoration in Progressive Hemifacial Atrophy (Romberg Disease)

“…67,68 The group of microsurgical reconstruction boasts the biggest number of patients (380 individuals) with a low mean age (24.7 y) and the lowest complication rate (8.4%) and reoperative rate (0.7%). [39][40][41][42][43][44][45] This consideration is consistent with the experience of Upton and coworkers 70 who reported microvascular transfer of scapular and parascapular flaps in 30 patients, 5 of whom had Romberg disease. On the basis of this, patients having PHA should preferably be treated using microsurgery, and we would like to mollify this conclusion with further considerations.…”

“…[1][2][3][4][5][6][7][8] Free Microsurgical Transfer to Volume Restoration Thirty-nine articles were included in this second group and were published from 1974 to 2011. 12,21,25,26,[30][31][32]45 Volume correction was achieved with a single free flap harvested from the trunk in 17 cases, 9,10,12,14,17,19,21,22,27,29,36,37,39,42,44,47 with a single free flap from the limbs in 8 cases, 26,[33][34][35]40,43,45,46 and with a single free flap from the abdomen in 3 cases. The mean age of correction was 24.7 years (range, 5-59 y) 9-11,13-20,22-24,27-29,33.44,46,47 and was not available in 8 articles.…”

“…13,15,38 The total number of patients who benefited from a single flap reconstruction was 154. Complications were reported in 21 articles 9,11,[13][14][15][16]20,22,27,28,30,31,34,[38][39][40][41][43][44][45]47 and included hematoma, 11,14,16,27,28,31,41,43 infection, 9,16,30 partial flap loss, 14,20,30,38 bulkiness, 15,16,39,40,45 atrophy, 34,41 dehiscence, 31 seroma, and 43 transient facial palsy. 25 In all cases, free flaps were harvested from the trunk and limbs.…”

“…The mean follow-up (41 mo) is close to that of patients who have undergone soft tissue restoration using structural fat grafting (43 mo). They did not report flap atrophy and noticed that, in patients who gained 3 Groin flap 11,12,14,16,17,20,22,24,25,29,31,32 12 Deep inferior epigastric perforators flap 11 1 Scapular and parascapular 17,[23][24][25]27,[30][31][32]36,37,47 11 Latissimus dorsi flap 21,24,25,31,39,41 6 Omental flap 13,15,20,23,38 5 Dorsalis pedis flap 16 1 Circumflex iliac flap 16,42 2 Gracilis flap 23 1 Radial forearm flap 25,26,30 3 Serratus flap 28,44 2 Lateral arm flap 28 1 Anterolateral thigh flap [33][34][35]40,41,43,45,46 8 The Journal of Craniofacial Surgery • Volume 25, Number 3, May 2014 Fat Grafting Versus Local/Free Flaps weight, the flap volume increased but the free tissue transfer did not alter the natural history of the disease process. First, the structural fat grafting technique has been introduced to the clinical practice more recently with respect to the microsurgical correction of soft tissue volume deficiency, which in part explains the larger number of patients treated with free tissue transfer.…”

Nummular Headache: 2 Cases With Good Beta Blocker Responses and a Narrative Review

“…Headache is one of the most frequently reported neurological symptoms . Some cases of PRS have also been reported with accompanying autonomic symptoms . Therefore, PRS and NH with focal trophic changes might have an overlapping pathogenesis in consideration of the similar clinical manifestations, including headache, cutaneous atrophy innervated by the trigeminal nerve, and accompanying autonomic symptoms.…”