Jonathan M Sykes
University of California, Davis, Otolaryngology, Faculty Member
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The plasma cell granuloma of the upper aerodigestive tract is a benign lesion which consists of sheets of mature plasma cells that can be mistaken for a malignant tumor. The diagnosis of plasma cell granuloma can only be made after... more
The plasma cell granuloma of the upper aerodigestive tract is a benign lesion which consists of sheets of mature plasma cells that can be mistaken for a malignant tumor. The diagnosis of plasma cell granuloma can only be made after morphologic examination. In some cases, it may be difficult to determine whether the plasma cell infiltrate is reactive or neoplastic. Malignant lesions that can be mistaken for plasma cell granuloma include plasmacytoma, malignant melanoma, hematopoietic neoplasms, olfactory neuroblastoma, anaplastic carcinoma, and metastasis. The location of the tumor may be helpful in making diagnosis. Plasma cell granulomas most coinmonly manifest as solitary coin lesions in the lungs. I Plasma cell granulomas have also been reported in the stomach," renal pelvis,' kidney," spinal cord meninges,' gingiva," intracranial region/ and tonsil." We are the first to report a plasma cell granuloma of the paranasal sinuses, a location where plasmacytomas are frequently found.":"
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Background A global approach to facial rejuvenation involves multiple treatment modalities. Objectives The aim of this study was to evaluate the impact of multimodal facial aesthetic treatment on self-reported psychological and social... more
Background A global approach to facial rejuvenation involves multiple treatment modalities. Objectives The aim of this study was to evaluate the impact of multimodal facial aesthetic treatment on self-reported psychological and social outcomes. Methods HARMONY, a prospective, multicenter, 4-month study, enrolled patients aged 35 to 65 years to receive on-label treatment with a combination of hyaluronic fillers (VYC-20L, HYC-24L, and/or HYC-24L+), onabotulinumtoxinA, and bimatoprost. Fillers were injected on Day 1, with touch-ups performed on Day 14. OnabotulinumtoxinA was injected at Month 3 into glabellar lines and/or crow’s feet lines. Patients applied bimatoprost to eyelashes once daily for 17 weeks. Mean change from baseline on FACE-Q Psychological Well-being and Social Confidence Scales, FACE-Q Aging Appearance Appraisal Scale, and FACE-Q Age Appraisal Visual Analog Scale were assessed. Results Of 100 patients treated, 93 were evaluated at 4 months posttreatment. Significant im...
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BackgroundRecent advances in facial anatomy have increased our understanding of facial aging and where to best position facial soft tissue fillers.AimAim of this study was to investigate a novel injection protocol which makes use of... more
BackgroundRecent advances in facial anatomy have increased our understanding of facial aging and where to best position facial soft tissue fillers.AimAim of this study was to investigate a novel injection protocol which makes use of concepts like the line of ligaments or the surface ‐ volume coefficient.Materials and MethodsA total of 306 Caucasian patients (270 females, mean age 45.1 ± 11.4 years; 36 males, mean age 45.9 ± 11.6 years) were retrospectively investigated after the injection following a standardized protocol. This protocol comprised a total of six boluses and one retrograde fanning injections in the infraorbital area utilizing a 22G and a 25G blunt‐tip cannula, respectively. Medial midfacial distances were measured using skin surface landmarks and compared after the injection of the partial and the total algorithm.ResultsDistances between the dermal location of the lateral SOOF and the dermal location of the mandibular ligament increased by 0.17 ± 0.11 mm with P < ....
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Anatomical knowledge of the facial vasculature is crucial for successful plastic, reconstructive, and minimally invasive procedures of the face. Whereas the majority of previous investigations focused on facial arteries, the precise... more
Anatomical knowledge of the facial vasculature is crucial for successful plastic, reconstructive, and minimally invasive procedures of the face. Whereas the majority of previous investigations focused on facial arteries, the precise course, variability, and relationship with adjacent structures of the facial vein have been widely neglected. Seventy-two fresh frozen human cephalic cadavers (32 male and 40 female cadavers; mean age, 75.2 ± 10.9 years; mean body mass index, 24.2 ± 6.6 kg/m; 99 percent Caucasian ethnicity) were investigated by means of layer-by-layer anatomical dissection. In addition, 10 cephalic specimens were investigated using contrast agent-enhanced computed tomographic imaging. The facial vein displayed a constant course in relation to the adjacent anatomical structures. The vein was identified posterior to the facial artery, anterior to the parotid duct, and deep to the zygomaticus major muscle. The angular vein formed the lateral boundary of the deep medial chee...
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The plasma cell granuloma of the upper aerodigestive tract is a benign lesion which consists of sheets of mature plasma cells that can be mistaken for a malignant tumor. The diagnosis of plasma cell granuloma can only be made after... more
The plasma cell granuloma of the upper aerodigestive tract is a benign lesion which consists of sheets of mature plasma cells that can be mistaken for a malignant tumor. The diagnosis of plasma cell granuloma can only be made after morphologic examination. In some cases, it may be difficult to determine whether the plasma cell infiltrate is reactive or neoplastic. Malignant lesions that can be mistaken for plasma cell granuloma include plasmacytoma, malignant melanoma, hematopoietic neoplasms, olfactory neuroblastoma, anaplastic carcinoma, and metastasis. The location of the tumor may be helpful in making diagnosis. Plasma cell granulomas most coinmonly manifest as solitary coin lesions in the lungs. I Plasma cell granulomas have also been reported in the stomach," renal pelvis,' kidney," spinal cord meninges,' gingiva," intracranial region/ and tonsil." We are the first to report a plasma cell granuloma of the paranasal sinuses, a location where plasmacytomas are frequently found.":"
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The chin plays a very important role in overall facial appearance, and aesthetic procedures to augment the chin in patients with microgenia can improve overall facial balance. Many procedures exist to enhance the appearance of a small... more
The chin plays a very important role in overall facial appearance, and aesthetic procedures to augment the chin in patients with microgenia can improve overall facial balance. Many procedures exist to enhance the appearance of a small chin. Procedures include surgeries such as placement of an alloplast implant and bony osteotomy of the mentum (sliding genioplasty). The advantages and disadvantages of each surgical technique are well documented. Although surgical augmentation of the chin has been the gold standard of therapy, recent development of injectable filler products with lifting capacity has changed the way that many practitioners alter chin shape and size. Filler agents allow augmentation of the chin in horizontal (projection), vertical, and transverse dimensions. Injectable fillers are a simple, noninvasive procedure that causes minimal to no downtime, incurs minimal risks, and allows the practitioner to shape the chin in three dimensions. This procedure allows patients to enhance their chin size without requiring an operative visit. As more and varied filler products become FDA-approved, the versatility and application of these agents will increase.
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ABSTRACT
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Recent advances in nasal reconstruction are provided within the framework of traditional reconstructive principles. Recent advances build upon and challenge the established tenets and principles of nasal reconstruction. Advances focus on... more
Recent advances in nasal reconstruction are provided within the framework of traditional reconstructive principles. Recent advances build upon and challenge the established tenets and principles of nasal reconstruction. Advances focus on achieving perfection in restoration of form and function with the absolute minimum of donor site morbidity. Specifically, advances in tissue engineering show promise in recreating cartilaginous framework. This article summarizes the most recent developments in nasal reconstruction. The focus of recent advances in nasal reconstruction centers on minimizing morbidity while achieving an inconspicuous result.
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Intermediate and definitive cleft rhinoplasties are a challenging part of definitive cleft care. The anatomy of the cleft nose is severely affected by the structural deficits associated with congenital orofacial clefting. A comprehensive... more
Intermediate and definitive cleft rhinoplasties are a challenging part of definitive cleft care. The anatomy of the cleft nose is severely affected by the structural deficits associated with congenital orofacial clefting. A comprehensive understanding of the related anatomy is crucial for understanding how to improve the appearance and function in patients with secondary cleft nasal deformities. Timing of intermediate and definitive rhinoplasty should be carefully considered. A thorough understanding of advanced rhinoplasty techniques is an important part of providing adequate care for patients with these deformities.
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Deoxycholic acid (KybellaTM, Allergan Pharmaceuticals, Irvine, CA) is a novel injectable treatment used for the cosmetic reduction of redundant submental fat. By inducing adipose cell lysis, the soft tissue alteration induces subsequent... more
Deoxycholic acid (KybellaTM, Allergan Pharmaceuticals, Irvine, CA) is a novel injectable treatment used for the cosmetic reduction of redundant submental fat. By inducing adipose cell lysis, the soft tissue alteration induces subsequent contour change and sharpening of the cervicomental angle.The safety and efficacy have been well established in several prospective clinical trials and subsequent FDA approval for this purpose. This has provided an effective and less invasive alternative to surgical liposuction with virtually no recovery time and less overall discomfort. Given its success for use in this context, a logical step would be to extrapolate to other regions of the body where cosmetic deformity is caused by excessive adipose tissue. In the current article, the authors propose potential options for further use in various targeted areas where subcutaneous fat may be amenable to reduction with deoxycholic acid injection, understanding that such uses would be off-label and requi...
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In 2015, ATX-101 (deoxycholic acid injection; Kybella in the United States and Belkyra in Canada; Kythera Biopharmaceuticals, Inc., Westlake Village, CA [an affiliate of Allergan plc, Dublin, Ireland]) was approved as a first-in-class... more
In 2015, ATX-101 (deoxycholic acid injection; Kybella in the United States and Belkyra in Canada; Kythera Biopharmaceuticals, Inc., Westlake Village, CA [an affiliate of Allergan plc, Dublin, Ireland]) was approved as a first-in-class injectable drug for reduction of submental fat. Use of a pharmacologic/injectable therapy within the submental region requires a thorough understanding of cervicomental anatomy to ensure proper injection technique and safe administration. To this end, an anatomy laboratory was conducted to review key external landmarks and important internal anatomic structures that characterize the lower face and anterior neck. External landmarks that define the boundaries of the cervicomental and submental regions were identified including the inferior mandibular border, the anterior border of the sternocleidomastoid muscle, the antegonial notch, the submental crease, the thyroid notch, and the hyoid bone. Relevant internal anatomic structures, including preplatysmal...
Research Interests: Medicine, Anatomy, Humans, Female, Male, and 9 moreDissection, Clinical Sciences, Cadaver, Aged, Middle Aged, Adult, Neck, Dermatologic Surgery, and Chin
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Infantile hemangiomas are the most common benign, soft-tissue tumors of infancy, affecting between 5 and 10% of newborns, and up to 30% of premature infants. Morbidity may include disfigurement and scarring, difficulty in feeding,... more
Infantile hemangiomas are the most common benign, soft-tissue tumors of infancy, affecting between 5 and 10% of newborns, and up to 30% of premature infants. Morbidity may include disfigurement and scarring, difficulty in feeding, ulceration, vision loss, airway compromise, congestive heart failure, and death. Advances in understanding the pathogenesis of infantile hemangiomas have given rise to a number of promising treatments. This article reviews the current options for medical management of infantile hemangiomas. In the proliferative phase of infantile hemangiomas, vascular endothelial growth factor and basic fibroblast growth factor have shown increased expression, and vascular endothelial growth factor expression has been up-regulated by adrenergic stimulation. Moreover, the role of the renin-angiotensin system in the pathogenesis of infantile hemangiomas has been demonstrated. Numerous medical options have been under investigation. Since 2008, propanolol has become the first-line therapy, whereas other medical treatments are used less frequently or when propanolol is unsuccessful. Propranolol has been recently adopted as the first-line medical treatment for complicated infantile hemangiomas. Although emerging treatment options and modalities have shown promising results, there need to be high-quality multicenter randomized trials to support these preliminary data.
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Research Interests: Psychology and Medicine
Not Available Disclosures: Study supported by Allergan.
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An understanding of anatomy and pathophysiology of the cleft nasal deformity is crucial to its management, including selection of correct surgical techniques for repair. Timing of intermediate and definitive rhinoplasty should be... more
An understanding of anatomy and pathophysiology of the cleft nasal deformity is crucial to its management, including selection of correct surgical techniques for repair. Timing of intermediate and definitive rhinoplasty should be considered carefully, with definitive rhinoplasty occurring after management of facial skeletal deformities. At the time of definitive rhinoplasty, the septum, external and internal nasal valves, alar base malposition (and corresponding bony deficiency), and position and shape of the lower lateral cartilage and the columella all must be individually considered. Thorough knowledge of rhinoplasty techniques is crucial to address the cleft nasal deformity with optimal functional and aesthetic outcomes.
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There are limited data on the effect of otoplasty on health-related quality of life (HRQoL) in prominent ears. There are no data on the effect of otoplasty on Glasgow Benefit Inventory (GBI) of otoplasty using hybrid techniques in adult... more
There are limited data on the effect of otoplasty on health-related quality of life (HRQoL) in prominent ears. There are no data on the effect of otoplasty on Glasgow Benefit Inventory (GBI) of otoplasty using hybrid techniques in adult patients. This study involved 28 patients who underwent otoplasty using combined procedures. We chose the GBI because it is a sensitive tool for detecting changes in health status following an intervention. Patients older than 13 years received the GBI, being retrospective well-validated questionnaires for measuring the effect of otorhinolaryngologic interventions, and particularly plastic surgery procedures, on HRQoL. An individual questionnaire was created by the standard GBI. We combined posterior auricular skin excision, Mustarde suture technique, and conchomastoid suture techniques for maximizing the cosmetic improvements. According to the results of this study, good outcomes with patient satisfaction were achieved with this hybrid procedure. We...