Head & Face Medicine最新文献

{"title":"Application of 3D-Printed nasal models in lacrimal surgery training.","authors":"Haowen Li, Dongmei Li, Hua Sun","doi":"10.1186/s13005-025-00579-6","DOIUrl":"10.1186/s13005-025-00579-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the feasibility and efficacy of 3D-printed nasal models for training in nasal endoscopic examination and artificial lacrimal duct intubation, while also evaluating trainees' learning experience and skill improvement.</p><p><strong>Methods: </strong>A nasal model replicating anatomical structures was constructed using stereolithography (SLA) 3D printing based on adult nasal CT data. Twenty-four ophthalmologists subsequently underwent training involving simulated nasal endoscopic procedures and artificial lacrimal duct intubation on these models. Pre- and post-training practical assessments included the anatomical identification rate, nasal endoscopic operation time, and the success rate of artificial lacrimal duct intubation. A 5-point Likert scale questionnaire was used to measure participants' learning outcomes and satisfaction.</p><p><strong>Results: </strong>3D-printed model accurately replicated nasal anatomical details, encompassing the nasal cavity, nasopharyngeal structures, and precise nasolacrimal duct opening localization. Following training, participants demonstrated significantly improved anatomical identification rates (p < 0.0001) and substantially reduced endoscopic operation times (p < 0.001), further achieving a 95.8% (23/24) qualification rate for lacrimal duct implantation positioning. Notably, questionnaire feedback indicated that 91.7% of trainees agreed the model enhanced anatomical understanding; 87.5% affirmed its haptic feedback approximated real surgery; 95.8% reported increased surgical confidence; and 91.7% endorsed its use for pre-operative training.</p><p><strong>Conclusions: </strong>3D-printed nasal model offers a high-fidelity, reusable platform for nasal endoscopy and lacrimal surgery training, effectively advancing trainees' operative skills and confidence-thus demonstrating significant potential for clinical dissemination.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":"14"},"PeriodicalIF":2.4,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12882591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of different immunohistopathological patterns and Ki67 proliferation index for Merkel cell carcinoma.","authors":"Katharina Theresa Obermeier, Wenko Smolka, Maximilian Kollmuss, Sabina Noreen Wuersching, Ina Dewenter, Philipp Poxleiter, Sven Otto, Yoana Malenova, Florian Fegg, Paris Liokatis","doi":"10.1186/s13005-025-00578-7","DOIUrl":"10.1186/s13005-025-00578-7","url":null,"abstract":"<p><p>Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin tumor, which preferentially appears in the head and neck area. Overall 5-year survival is about 66–70% in patients with non-metastasized tumors and reduces to 42% in cases with regional metastases, and down to 18% in case of distant metastases. The Ki67- index is one of the most important biological markers in neuroendocrine tumors and is recently known as a prognostic marker in pancreatic neuroendocrine neoplasms. This study aims to evaluate the prognostic role of Ki67 in Merkel cell carcinoma. A cut-off value for Ki67 index was calculated using Youden’s index. Overall, 16 patients were included in this retrospective study. The best matching cutoff value for our data was calculated at 77.5%. Ki67 turned out to be > 85% in patients with local recurrence of MCC and > 90% with lymph node metastases. A Ki67-index of 77.5% stratified the patients in our cohort most efficiently. A safety margin higher than 1 cm should be aimed.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":"10"},"PeriodicalIF":3.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orofacial manifestations in mucopolysaccharidoses: a comprehensive clinical and radiographic evaluation of 35 pediatric cases.","authors":"Dilşah Çoğulu, Sema Kalkan Uçar, Ebru Canda, Elif Kantar Atila, Ali Rıza Alpöz, Mahmut Çoker","doi":"10.1186/s13005-025-00563-0","DOIUrl":"10.1186/s13005-025-00563-0","url":null,"abstract":"<p><strong>Objective: </strong>Mucopolysaccharidoses (MPS) represent a heterogeneous group of rare, inherited lysosomal storage disorders characterized by the accumulation of glycosaminoglycans in various tissues, including the orofacial region. This study aims to investigate the orofacial features and radiographic manifestations in a cohort of pediatric patients diagnosed with MPS.</p><p><strong>Materials and methods: </strong>Thirty-five patients (18 males, 17 females) diagnosed with different subtypes of MPS underwent comprehensive oral and radiographic examinations. The presence and frequency of clinical and radiographic findings were documented. Radiographic analysis was feasible in 26 patients, with 9 excluded due to severe intellectual disability. The decayed, missing, and filled teeth (DMFT/dft); decayed, missing, and filled surfaces (DMFS/dfs) indices were recorded according to WHO criteria. The dental plaque scores were determined according to Silness & Löe plaque index. Data was analysed using SPSS 25.0, with descriptive statistics summarizing variables and Fisher's Exact test applied for subgroup comparisons by MPS subtype; significance was set at p < 0.05.</p><p><strong>Results: </strong>The most frequent orofacial findings included tongue thrusting (80%, n = 28/35), limited mouth opening (71%, n = 25/35), macroglossia (71%, n = 25/35), and anterior open bite (54%, n = 19/35). Radiographic analysis revealed a thin mandibular cortex in 38% (n = 10/26) of cases, impacted teeth in 27% (n = 7/26), and a short mandibular ramus in 23% (n = 6/26). This is the first reported case of a talon cusp, a rare dental anomaly occurring in a patient with MPS-IV, highlighting a previously unrecognized association in the literature. The distribution of MPS types was: MPS-I (n = 3), MPS-II (n = 6), MPS-III (n = 8), MPS-IV (n = 10), MPS-VI (n = 7), and MPS-VII (n = 1).</p><p><strong>Conclusions: </strong>Orofacial manifestations are frequently observed in patients with MPS and may serve as early indicators of the disorder, particularly within dental settings. Recognition of these features is essential, as they underscore the need for multidisciplinary care and routine dental evaluations to mitigate potential complications and enhance overall quality of life.</p><p><strong>Clinical relevance: </strong>Orofacial abnormalities are common in children with MPS and may provide early clues to the diagnosis. This study emphasizes the importance of dental evaluations in identifying these signs, including the first reported case of a talon cusp in a patient with MPS. Early recognition by dental professionals can support timely diagnosis, guide appropriate referrals, and improve patient outcomes through coordinated, multidisciplinary care.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"90"},"PeriodicalIF":2.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable machine learning with multimodal hearing data for diagnosing endolymphatic hydrops.","authors":"Xu Liu, Qin Sun, Suming Shi, Wenqian Gao, Wuqing Wang","doi":"10.1186/s13005-025-00580-z","DOIUrl":"10.1186/s13005-025-00580-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the diagnostic value of electrocochleography (ECochG) for identifying endolymphatic hydrops (EH) and to investigate whether integrating multimodal auditory data from ECochG and pure-tone audiometry (PTA) into machine learning models could improve diagnostic accuracy and clinical interpretability.</p><p><strong>Methods: </strong>A prospective cohort of 78 patients (156 ears) with a strong clinical suspicion of EH was evaluated between March and June 2024. ECochG and PTA examinations were performed, and extracted parameters were used to develop and validate multiple machine learning models. Diagnostic performance was compared using the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and overall accuracy.</p><p><strong>Results: </strong>After excluding six ears with unrecordable ECochG data, 150 ears were analyzed. Models based solely on ECochG-derived features demonstrated limited diagnostic performance (maximum AUC = 0.61). When multimodal hearing data were incorporated, model performance improved substantially. The Light Gradient Boosting Machine (LightGBM) model achieved an AUC of 0.92 and an accuracy of 0.73 for predicting the anatomical distribution of EH.</p><p><strong>Conclusions: </strong>Integrating multimodal auditory data into interpretable machine learning models can markedly improve the diagnostic accuracy of endolymphatic hydrops, providing an objective framework to support early clinical diagnosis and management. However, this study is limited by a small sample size and has not yet been validated across multiple centers.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":"13"},"PeriodicalIF":2.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic significance and value of vestibular function testing combined with MRI in Meniere's disease.","authors":"Yao Lu, Fei Gao, Yiming Zhu, Jiangyan Wang, Shujuan Li, Bo Gao, Xiaoye Pan, Xudong Wei","doi":"10.1186/s13005-025-00568-9","DOIUrl":"10.1186/s13005-025-00568-9","url":null,"abstract":"<p><p>OBJECTIVE: This study aims to evaluate the diagnostic efficacy of electrocochleography (EcochG), vestibular evoked myogenic potentials (VEMPs), magnetic resonance imaging (MRI), and their combination in diagnosing Meniere’s disease (MD) by comparing these methods against established diagnostic standards. Using MRI as a reference for assessing the degree of endolymphatic hydrops (EH), this study analyzes the correlation between EH and each diagnostic method and assesses the ability of these methods to predict EH severity. METHODS: A retrospective analysis was performed on 50 patients diagnosed with unilateral definite Meniere’s disease (DMD), which included functional vestibular examinations and MRI. All patients underwent testing for EcochG and VEMPs. The amplitudes of the summating potential (SP) and the cochlear nerve action potential (AP) were measured during the EcochG assessment. The VEMPs comprised cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP), with bilateral amplitude ratios recorded. Abnormal findings were defined as a summating potential to action potential (SP/AP) ratio of ≥ 40% and/or a bilateral amplitude ratio greater than 1.61. This study also assessed the diagnostic accuracy of EcochG, VEMPs, MRI, and combined examinations for diagnosing unilateral DMD, along with their association with EH. RESULTS: A total of 50 patients (100 ears) were examined using relevant diagnostic methods. The positivity rate of EcochG was significantly lower than that of the other diagnostic methods (P < 0.05). Taking into account sensitivity, specificity, and AUC values comprehensively, the combined accuracy of EcochG, VEMPs, and MRI was significantly higher than that of the other diagnostic methods (P < 0.05). Additionally, we found that EcochG was negatively correlated with EH, whereas cVEMP was positively correlated with EH. CONCLUSION: Although the combination of EcochG, VEMPs, and MRI demonstrates a lower positivity rate but higher specificity compared to other diagnostic test batteries, its overall diagnostic accuracy for diagnosing MD remains superior. Therefore, this combination holds significant diagnostic value in the evaluation of MD. </p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"89"},"PeriodicalIF":3.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative landing zones for one-piece, rigidly fixated patient-specific subperiosteal implants in dental rehabilitation of severe maxillary and midfacial defects.","authors":"Nils-Claudius Gellrich, Philippe Korn, Philipp Jehn, Fritjof Lentge, Michael-Tobias Neuhaus, Björn Rahlf","doi":"10.1186/s13005-025-00549-y","DOIUrl":"10.1186/s13005-025-00549-y","url":null,"abstract":"<p><strong>Purpose of the study: </strong>This study demonstrates and investigates the feasibility of a novel approach for dental rehabilitation in complex maxillary and midfacial defects, often resulting in severe pseudo-class III relationships. It explores the use of patient-specific subperiosteal implants (IPS Implants^® Preprosthetic) with innovative design variations that anchor to the skull base from below and laterally, extending beyond traditional implants to provide enhanced stability in cases of significant bone loss.</p><p><strong>Methods: </strong>Patients with significant maxillary and midfacial bone loss due to postablative defects were included in our case series, with or without irradiation. From 100 patients, 13 required design modifications based on FEM analysis, involving implant anchorage to the lateral skull base and/or pterygoid process. Eight patients received single-sided lateral skull base extensions; one posttraumatic case required bilateral extensions. In five of 13 cases, additional extensions to the pterygoid process were implemented. One case needed both bilateral skull base and pterygoid extensions, while two had bilateral pterygoid and a single-sided skull base extension. Outcomes assessed included primary stability, prosthodontic restoration, complications, and soft tissue management.</p><p><strong>Results: </strong>No implant failures occurred during follow-up, with functional stability established immediately post-insertion. Prosthodontic restoration succeeded in all cases, with no stability loss or periimplantitis. Mucositis was noted around posterior posts in some instances, and one bar required trimming due to soft tissue changes, without affecting implant function. One implant had to be removed, due to chronic pain.</p><p><strong>Conclusions: </strong>Patient-specific IPS Implants^® Preprosthetic with design extensions provide a biologically suitable solution for stable dental rehabilitation in severe maxillary and midfacial structure loss, without biomechanical limitations. Achieving rigid fixation distant from the soft tissue transition is crucial for success.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":"7"},"PeriodicalIF":2.4,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12822269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the effect of impacted third molar position and orientation on bad split fractures in sagittal split ramus osteotomy using finite element analysis.","authors":"İrfan Üstündağ, Erkan Mecu, Yunus Çetiner, Mehmet Sait Şimşek","doi":"10.1186/s13005-025-00574-x","DOIUrl":"10.1186/s13005-025-00574-x","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the impact of different angular orientations and buccolingual positions of impacted third molars on the incidence of bad splits during sagittal split ramus osteotomy using finite element analysis.</p><p><strong>Materials and methods: </strong>A total of 12 mandibular models were constructed, each representing a unique combination of third molar orientations (vertical, distoangular, horizontal, mesioangular) and positions (buccal, lingual, central). A force of 20 N was applied from the osteotomy line toward the proximal and distal segments to simulate the working principle of the Smith Spreader instrument.</p><p><strong>Results: </strong>The maximum principal stress followed the order: vertical > distoangular > horizontal > mesioangular. In terms of positional stress distribution, the buccal position generated the highest stress, followed by lingual and central positions. Similar trends were observed across all stress criteria evaluated.</p><p><strong>Conclusion: </strong>The orientation and position of impacted third molars have a direct effect on the risk of bad splits during SSRO. Mesioangular and centrally positioned teeth were associated with lower stress levels, indicating lower risk, while vertically oriented and buccally or lingually positioned molars showed significantly higher stress concentrations. Thus, extraction of high-risk impacted third molars prior to surgery is recommended to reduce the likelihood of complications.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":"11"},"PeriodicalIF":2.4,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of otorhinolaryngologists in the treatment of hereditary hemorrhagic telangiectasia.","authors":"René Lehner, Robin Lochbaum, Thomas K Hoffmann, Jens Greve","doi":"10.1186/s13005-025-00567-w","DOIUrl":"10.1186/s13005-025-00567-w","url":null,"abstract":"<p><p>PURPOSE: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease which affects the entire vascular system. Symptoms vary from mild complaints to severe complications and are highly individual. Therapy is strictly symptomatic and creates an interdisciplinary challenge with relevant involvement of otorhinolaryngologists (ORL). The aim of this study is to evaluate this involvement. METHODS: A retrospective analysis between 01/2006 and 12/2023 at Ulm University Medical Center was conducted. Two collectives were defined, the first one representing all patients who have been treated in any department for HHT, in order to draw a comparison between the departments. The second focused specifically on patients treated in the ORL department, providing a detailed analysis that includes emergency visits, hospital admissions, interventions and blood transfusions. RESULTS: In the 1st collective 252 patients were identified generating 1092 cases. 43.3% of the patients were primarily treated at the ORL department, 24.0% at the dermatology department and 13.1% in internal medicine. The ORL patients generated significantly more cases as other specialties (p = 0.0001). The 2nd collective consisted of 105 patients. Men were more likely to be hospitalized (p = 0.0001) and to receive blood transfusions (p = 0.0045). There were no other gender specific differences. Symptoms and the need for medical help were independent of the season. A vast variety of visits, admissions and interventions could be shown. CONCLUSION: ORL specialists play a critical role in the management of HHT patients. The study shows the year-round necessity for specialized care. Sex-related differences should be taken into account. Besides multidisciplinary therapy strategies further prospective research is essential. </p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"87"},"PeriodicalIF":3.0,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12702161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Passivity, torque stability, and fracture resistance in screw-retained and dual-retained metal-ceramic implant-supported restorations: an in vitro study, part II.","authors":"Safoura Ghodsi, Sareh Habibzadeh, Marzieh Alikhasi, Seyed Ali Mosaddad, Hosein Mohebbi","doi":"10.1186/s13005-025-00575-w","DOIUrl":"10.1186/s13005-025-00575-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the passivity, screw torque stability, and fracture resistance between dual- and screw-retained implant restorations, before and after thermomechanical loading.</p><p><strong>Methods: </strong>Twenty metal-ceramic restorations were divided into two groups (n = 10 each). Group 1 (G1) featured dual-retained restorations on prefabricated titanium abutments, while Group 2 (G2) had screw-retained restorations on UCLA chromium-cobalt cast-to abutments. Passivity, adjustment ease, and torque loss were compared, along with fracture resistance and mode, post-fabrication and after thermomechanical loading (500 thermal and 500,000 mechanical loading cycles). Independent t-tests and Mann-Whitney U tests were used to compare passivity characteristics and fracture resistance, while torque losses were analyzed using a generalized estimating equations (GEE) model with LSD post-hoc test (α = 0.05).</p><p><strong>Results: </strong>G1 required significantly less adjustment time and frequency (P < .001) and exhibited a lower torque angle (higher passivity) (P = .001) compared to G2. In G1, the screw torque loss (%) measured 24.02 ± 3.01 before and 36.51 ± 4.28 after loading compared to the initial torque and 16.17 ± 3.67 after loading compared to the detorque value. In G2, these values were 24.76 ± 3.45, 39.9 ± 2.55, and 20.1 ± 3.96, respectively. While the rate of torque loss did not differ significantly before loading, it was significantly higher in G2 after loading (P < .05). Fracture resistance was significantly higher in G1 (P < .05). Both groups exhibited a mixed type of failure mode.</p><p><strong>Conclusions: </strong>Dual-retained metal-ceramic restorations outperformed screw-retained counterparts, demonstrating improved passivity, lower screw torque loss percentages, and higher fracture resistance.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":" ","pages":"6"},"PeriodicalIF":2.4,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12822276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative CT evaluation of repositioning accuracy in zygomaticomaxillary complex fractures: 1-point versus multiple-point fixation.","authors":"Andreas Sakkas, Johannes Schulze, Mario Scheurer, Majeed Rana, Robin Kasper, Marcel Ebeling, Alexander Schramm, Frank Wilde, Marc Knitz","doi":"10.1186/s13005-025-00558-x","DOIUrl":"10.1186/s13005-025-00558-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The increasing interest in minimally invasive procedures, which carries minimal risk for wound complications and scarring while also providing predictable outcomes, has brought attention to the concept of 1-point fixation in treating zygomaticomaxillary (ZMC) fractures. The primary aim of this study was to compare the intraoperative accuracy of repositioning following osteosynthesis with 1-point fixation versus multiple-point fixation in unilateral fractures of the ZMC complex. The secondary aim was to evaluate associations between trauma- and procedure-specific factors and the surgical outcomes of both fixation methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective cohort single-centre study, patients who underwent surgical treatment for unilateral ZMC fractures using either 1-point or multiple-point fixation over a 7-year period were included. Forty-two patients were treated with 1-point fixation through an intraoral Keen's approach (group 1), while 20 patients were treated with multiple-point fixation through intraoral and extraoral approach (group 2). Demographic, clinical, radiological, and treatment data were analyzed. The degree of repositioning including protrusion difference of the zygoma (height, width, diagonal), malar difference using an asymmetry index, and difference in the intraorbital volume were measured comparing preoperative and intraoperative CT imaging. Multivariable analyses were conducted to compare the surgical outcomes in both groups and identify associations between the trauma- and procedure-specific variables and the intraoperative accuracy of fracture repositioning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 62 patients with 62 unilateral ZMC fractures were included in the analysis. Violence was the most common mechanism of injury (n = 16; 25.8%). Forty-two patients underwent treatment with 1-point fixation, while 20 patients received multiple-point fixation. The intraoperative malar width difference and malar diagonal difference were significantly higher in group 1 (p = 0.003 / p = 0.036). No difference was detected in the intraorbital volume between the two fixation groups intraoperatively. Univariate analysis revealed that an interval between trauma-surgery of 3-7 days was significantly associated a better repositioning result in terms of intraorbital volume difference after multiple-point fixation (p = 0.03).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study shows that multiple-point fixation achieves superior accuracy in restoring zygomatic geometry, especially malar projection and transverse symmetry, while both techniques adequately restore intraorbital volume. Single-point fixation remains a viable, less invasive option for non-comminuted ZMC fractures when guided by intraoperative 3D imaging. The lack of revision surgeries in either group supports a tailored, fracture-specific strategy that balances precision with minimal invasiveness, consistent with trends toward individuali","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"83"},"PeriodicalIF":3.0,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12702150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}