References: Hair growth and hair loss
Dermatol Surg. 1998 Mar;24(3):373-6; discussion 376-7.
Miniflap hair restoration.
Burres S.
Division of Otolaryngology/Head and Neck Surgery, University of California, Los Angeles, USA.
BACKGROUND: Flap reconstruction of the scalp has traditionally required multiple, delayed procedures, an extensive principle operation, and several minor revision surgeries to produce the optimal end result. The entire protocol had to be repeated for each subsequent flap. Flap reconstructions only covered a moderate portion of the bald scalp of the later-staged patient. This hair restoration process required considerable surgical skill on the part of the operator and tenacity on the part of the patient. OBJECTIVE: A system of short, nondelayed flaps was developed to shorten this comparatively long, multi-staged process and reduce the risk of flap compromise. METHODS: Initially, the patient underwent a two-step, scalp-lifting procedure to reduce the width of bald scalp to be spanned. At later sessions, anteriorly based flaps were outlined from the margin of the lifted scalp and rotated into the desired configuration. RESULTS: In 29 flaps rotated to date in 13 patients, flap viability was excellent and interflap scarring acceptable. Hair direction was readily adapted to the patients' desires. Case examples are presented. CONCLUSION: Staged scalp-lifting with miniflap reconstruction of the scalp is a preferred option for hair relocation in selected cases.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9537014&dopt=Abstract
Dermatol Surg. 1998 May;24(5):581-5.
Rhomboid minigrafts in hair restoration surgery.
Fan J, Wang J, Spraggs PD, Nordstrom RE.
Nordstrom Hospital for Plastic and Reconstructive Surgery, Helsinki, Finland.
BACKGROUND: The transplantation of large numbers of three- to five-hair minigrafts has superseded the use of traditional punch grafts in hair restoration surgery. The minigrafts are usually designed and cut in a square or rectangular shape for implantation into the recipient slits. Transplanting a large number of these grafts into the recipient slits can lead to a high frequency of complications, especially in cases in which there is a need for dense packing of grafts. The complications include excess graft compression resulting in extrusion or retraction into the slit. This in turn can lead to piggybacking or insertion of two grafts per slit with the resultant effect of cyst formation, cobblestoning, and hypertrophic scar formation. OBJECTIVE: To develop an optimal shape of minigrafts to match the recipient slits. METHODS: The authors have calculated the optimum geometric configuration for a minigraft in a linear slit and have developed the correct cutting instrument and preparation technique for its production. This rhomboid minigraft design maximizes the graft stability in the slit and therefore its survival, and also minimizes the risk of complications. RESULTS: The described technique shows that the transplanted rhomboid minigrafts remain well anchored in the recipient slits and results in an excellent clinical outcome. CONCLUSION: The rhomboid minigrafting technique (1.5 x 1.5 mm in size) seems to accommodate the grafts better into the recipient slits than the standard shape rectangular minigrafts. It thereby better facilitates the insertion of the grafts in the slits and reduces the frequency of graft extrusion as well as graft compression.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9598015&dopt=Abstract
ucl.ac.uk
The progression of recovery of the vestibular sensory epithelia of guinea pigs after gentamicin-induced hair cell injury was assessed quantitatively and qualitatively. Evaluations were made of the number of cells bearing hair bundles by using scanning electron microscopy (SEM) and of identifiable hair cells in thin sections. Both assessment procedures showed that an initial loss of hair cells in utricular maculae is followed by significant recovery in the number of hair cells present. SEM also showed recovery in saccules comparable to that in utricles. During the recovery, progressive maturation of hair bundles, which exhibited features similar to those seen during normal ontogenetic development of hair cells, could be identified. The pattern and extent of hair cell loss and subsequent reappearance revealed by SEM corresponded with that derived from analysis of thin sections. This suggests that repair of nonlethally damaged hair cells is unlikely but, rather, that new hair cells are produced. An apparent decrease in supporting cell numbers was observed coincident with the increase in hair cell numbers. This complements previous morphological observations, which have suggested new hair cells arise from direct, nonmitotic transdifferentiation of supporting cells. The quantitative analyses indicate that more than half of the hair cells that are lost are replaced, but the recovery process does not result in complete restoration of the epithelium. Eight months after the end of drug treatment, the number of hair cells present was still significantly less than normal, and several other abnormalities persisted. There was also no evidence of any hair cell recovery in the organ of Corti. Thus, there appear to be limitations on the capacity for spontaneous replacement of lost hair cells in the mammalian inner ear.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9671280&dopt=Abstract
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