Abstract：
Brow position, hairline shape, and forehead projection may confer cis-feminine identity, and facial feminization surgery (FFS) can improve gender dysphoria among transfeminine patients. Depending on the Ousterhout classification, burring, osteotomy, anterior frontal sinus setback, and augmentation, with subsequent fixation via metal or bioabsorbable plates, can address forehead projection. However, titanium mesh, often used in frontal sinus fracture repair, has not been described for forehead contouring in FFS. The purpose of this study was to study clinical outcomes associated with the use of titanium mesh for the stabilization of bone following anterior frontal sinus setback. A retrospective cohort study of trans-female and nonbinary patients undergoing primary FFS by our senior author between January 2021 and February 2023 was performed. Variables collected include demographics, Ousterhout classification, operative details, complications, and follow-up duration. Patients with prior FFS or facial trauma were excluded. Data were analyzed using SPSS, (IBM, Armonk, NY). Forty-three transfeminine patients were included for analysis. The cohort had an average age of 33.0±8.7 years and a median follow-up time of 3.0 months (IQR = 1.0-7.0). Among our cohort, 26 patients (60.5%) received titanium mesh and 17 patients (39.5%) underwent burring only for forehead contouring. There were no reported complications (ie, infection, hardware extrusion, or mucocele formation) or a need for forehead revisions among the entire cohort regardless of the frontal sinus reconstruction material utilized. Clinical outcomes were favorable among patients receiving titanium mesh anterior table fixation during FFS. Titanium mesh can be considered as an additional technique for frontal bossing reduction and anterior table fixation in FFS.
摘要：
眉形位置,发际线形状,前额突出可以赋予顺式女性身份，面部女性化手术（FFS）可以改善跨女性患者的性别焦虑。根据Ousterhout分类，去毛刺,截骨,前额窦后退,和增强，随后通过金属或生物可吸收板固定，可以解决额头投影。然而,钛网，常用于额窦骨折修复，在FFS中没有描述前额轮廓。这项研究的目的是研究与使用钛网稳定额前窦后退后骨骼相关的临床结果。我们的资深作者在2021年1月至2023年2月期间对接受原发性FFS的跨女性和非二元患者进行了回顾性队列研究。收集的变量包括人口统计，Ousterhout分类，操作细节,并发症,和后续持续时间。排除先前有FFS或面部创伤的患者。使用SPSS对数据进行分析，(IBM,Armonk,NY).纳入43例经女性患者进行分析。该队列的平均年龄为33.0±8.7岁，中位随访时间为3.0个月（IQR=1.0-7.0）。在我们的队列中，26例患者（60.5％）接受了钛网，17例患者（39.5％）仅用于额头轮廓。没有报告的并发症（即，感染,硬件挤压，或粘膜膨出形成）或无论使用额窦重建材料如何，整个队列都需要进行前额矫正。在FFS期间接受钛网前台固定的患者中，临床结果良好。钛网可以被认为是FFS中额叶凹陷减少和前台固定的附加技术。
