title: Surgical treatment of head and neck port-wine stains by means of a staged zonal approach.
abstract: BACKGROUND
  The majority of patients with capillary malformations (port-wine stains) develop soft-tissue and bony hypertrophy leading to gross facial asymmetry and functional deficits in vision, breathing, speech, and feeding. The authors describe and illustrate a surgical approach for the treatment of these malformations with restoration of facial symmetry and contour based on facial subunits.
  
  
  METHODS
  The authors conducted a retrospective case series of patients from 2004 to 2011 presenting for primary evaluation and treatment to a tertiary referral center specializing in vascular anomalies. The medical records and photographs of patients with facial capillary malformations and soft-tissue hypertrophy were reviewed.
  
  
  RESULTS
  Of the 160 patients who presented with the diagnosis of facial capillary malformation/port-wine stain, 96 (60 percent) had soft-tissue hypertrophy in one or more dermatomes resulting in facial asymmetry. Only 4.4 percent of patients had solely V1 involvement, 38.8 percent had V2 involvement, and 15.6 percent had V3 involvement. The technique and incisions used for each facial zone are described in detail. In all cases, incisions were placed along existing boundaries of facial subunits. Serial pulsed-dye laser treatments were also performed.
  
  
  CONCLUSIONS
  Sixty percent of patients with facial capillary malformation experience soft-tissue hypertrophy with or without bony remodeling, and surgical correction is required. The authors describe a staged surgical treatment for these patients based on a subunit and zonal approach to the face.
  
  
  METHODS
  Therapeutic, IV.
authors: New York, N.Y.; and Daegu, Republic of Korea From the Department of Otolaryngology, New York University School of Medicine; the Vascular Birthmark Institute of New York, Lenox Hill and Manhattan Eye, Ear, and Throat Hospitals; and the Department of Plastic and Reconstructive Surgery, Kyungpook National University Hospital.
authors: Eric W
authors: EW
authors: Cerrati
authors: Teresa M
authors: TM
authors: O
authors: David
authors: D
authors: Binetter
authors: Hoyun
authors: H
authors: Chung
authors: Milton
authors: M
authors: Waner
mesh_terms: D015331:Cohort Studies; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005145:Face / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D009333:Neck / Q000503:physiopathology / Q000601:surgery; D019339:Port-Wine Stain / Q000175:diagnosis* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome