Browsing by Author "Tapia Contreras, Pedro"
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Publication Advantages of the upper eyelid approach with lateral canthotomy in the resolution of complex fronto-orbito-zygomatic fractures: bibliographic review of conventional approaches and a case report(2025) Tapia Contreras, Pedro; Díaz, Fernanda; Zeballos, Jessica; Díaz, Sofía; Jollán, Florencia; Ossandón-Zúñiga, BenjamínThis study presents a modified upper eyelid approach incorporating a lateral canthotomy to improve surgical access in complex fronto-orbital fractures. A 69-year-old male patient with no comorbidities was admitted to the regional hospital of Rancagua with a left fronto-orbital-zygomatic fracture. Surgery was performed under general anesthesia using an upper eyelid incision combined with a lateral canthotomy to enhance exposure of the fracture site. Reduction and osteosynthesis of the lateral orbital wall and part of the frontal bone were successfully achieved without complications. The modified approach provided wide and direct access to the affected areas, particularly beneficial in cases with comminuted fractures requiring the placement of multiple osteosynthesis elements. The lateral canthotomy significantly expanded the surgical field, facilitating accurate reconstruction. Additionally, the eyelid incision, placed along the natural palpebral crease, offered excellent aesthetic results with a nearly imperceptible scar. This technique proves to be a valuable option for the management of complex fronto-orbital injuries, combining effective exposure with favorable cosmetic outcomes. It is especially useful in extended fractures where optimal visualization is critical for successful repair. The upper eyelid approach with lateral canthotomy thus stands out as a reliable and aesthetically conscious alternative for orbital fracture surgery.Publication Therapeutic Alternatives of Buccal Mucosa Grafting in Extraoral Reconstructions: a Case of Fournier's Gangrene(2025) Tapia Contreras, Pedro; Sarzosa Enrriquez, Marcelo; Matus-Miranda, Gustavo; Pizzi Lazo, Pablo; Díaz-Abarza, Sofía; Jollán, FlorenciaBuccal mucosal grafts are versatile in medical practice, documented minimally despite potential in otolaryngology, ophthalmology, dermatology, plastic surgery and urology. They offer advantages such as being hairless, easily obtained, and infection-resistant, with a thin, highly vascularized epithelial layer aiding absorption and reducing contracture risk. Complications from oral donor sites, like pain and sensory changes, are known, relevant in conditions such as Fournier's gangrene, necessitating urgent surgical intervention and often reconstruction. We present a case report of a 45-year-old male with Fournier's gangrene treated jointly by urology and maxillofacial surgery. Buccal mucosal grafts were harvested from the inner cheek mucosa for simultaneous urethral reconstruction. The procedure preserved the parotid duct, obtaining a graft comprising mucosal, submucosal, and glandular tissues, applied to the urethral defect with bovine dermis coverage. Postoperative recovery was uneventful, with successful catheter removal in 2 weeks and complete donor site healing in 6 months. Buccal mucosal grafts prove effective in complex reconstruction, offering structural integrity and minimal morbidity. Despite challenges like graft contraction and limited tissue availability in severe cases, buccal mucosal grafts are favored for reliability and patient satisfaction in reconstructive needs, notably urethral reconstruction. The evidence shows a high success rate in most of the uses of buccal mucosal grafts, so it is recommended as an effective and safe graft for extraoral reconstructions, particularly urethral reconstruction, where the Maxillofacial Surgeon is part of the interdisciplinary team. Awareness of potential complications and procedural limitations ensures optimal outcomes and patient care.