title: Postoperative pressure-induced alopecia after segmental osteotomy at the upper and lower frontal edentulous areas for distraction osteogenesis.
abstract: BACKGROUND
  Postoperative alopecia is a relatively rare event, and therefore both patients and surgeons are puzzled once it develops even though it is said to improve spontaneously with time in most cases. We report a parieto-occipital pressure-induced alopecia firstly developed in a patient who had undergone repeated surgery for 10 years after a traffic accident.
  
  
  METHODS
  A 29-year-old male underwent segmental osteotomy at the upper and lower frontal edentulous areas for distraction osteogenesis. Throughout the operation, he was in the supine position with the hair covered with a paper cap and the head on a plastic vinyl chloride-covered soft foam horseshoe-shaped urethane sponge placed on the horseshoe-shaped headrest. About 2 weeks after the surgery, two patches of parieto-occipital alopecia were observed at the barber's. It cured gradually during the follow-up visits.
  
  
  CONCLUSIONS
  The pathophysiology of the condition is thought to be mostly pressure-induced ischemia of hair follicles, and then we have to try not to make the situation. Scalp massages and the head repositioning during the surgery should be one of the means of prevention.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Division of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Kita-ku, Sapporo, Hokkaido, Japan. matsushi@den.hokudai.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Matsushita
authors.forename: Nobuo
authors.initials: N
authors.lastname: Inoue
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ooi
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Totsuka
mesh_terms: D000328:Adult; D000505:Alopecia / Q000209:etiology*; D005500:Follow-Up Studies; D006197:Hair / Q000254:growth & development; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000379:methods*; D010027:Osteotomy / Q000379:methods*; D056888:Patient Positioning / Q000295:instrumentation; D011183:Postoperative Complications; D011312:Pressure / Q000009:adverse effects; D016683:Supine Position; D058636:Surgical Drapes
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