Journal of Craniofacial Surgery最新文献

{"title":"Augmented Reality and 3D Printing as an Aid to Surgical Planning in Modern Microtia Reconstruction.","authors":"Diego A Gomez, Kiana Hashemi, Ishpriya Sharma, Alexander Demeris, Mario A Aycart, Pushpak Patel, Brian C Kellogg, Joseph R Dusseldorp, Angelo A Leto Barone","doi":"10.1097/SCS.0000000000012082","DOIUrl":"https://doi.org/10.1097/SCS.0000000000012082","url":null,"abstract":"<p><p>Since Tanzer's seminal work introducing costal cartilage for ear reconstruction, subsequent advances by Brent, Nagata, and Firmin have refined surgical techniques and aesthetic outcomes. However, fundamental aspects of the procedure-such as planning incisions, achieving accurate ear positioning, and guiding chest wall incisions for rib harvest-have seen limited innovation. The current standard practice of using projection paper or transparent templates to replicate the contralateral ear position remains imprecise. Similarly, autologous cartilage harvest can be particularly challenging in patients with higher BMI, due to difficulty in accurate rib palpation and visualization. Misplaced chest wall incisions can result in suboptimal rib harvest, longer operative times, and increased morbidity. In this study, we introduce patient-specific, three-dimensional (3D) printed masks, termed hEARo masks, as a novel and user-friendly tool for ear framework positioning. Furthermore, we present the integration of augmented reality (AR) technology to enhance preoperative planning and intraoperative guidance during microtia repair, enabling more precise incision placement for rib harvest. The combined use of 3D printing and AR facilitates complex ear reconstruction, offering increased surgical precision, reduced operative time, and potentially improved patient outcomes. These innovations represent a significant advancement in the personalization and accuracy of auricular reconstruction.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development and Validation of CranioFix: An Augmented-Reality Biomodel for Craniomaxillofacial Education.","authors":"Sultan Al-Shaqsi, Tara L Teshima, Glenn Edwards, Oleh Antonyshyn","doi":"10.1097/SCS.0000000000012060","DOIUrl":"https://doi.org/10.1097/SCS.0000000000012060","url":null,"abstract":"<p><strong>Objective: </strong>To describe the development, implementation, and validation of CranioFix, an augmented-reality (AR)-enhanced educational toolkit for the training of craniomaxillofacial trauma management, specifically orbit-zygomatic complex (OZC) fractures.</p><p><strong>Background: </strong>Surgical training in craniomaxillofacial trauma presents significant challenges due to the complexity of the anatomy, limited exposure to trauma cases, and the need for hands-on technical skill acquisition. Augmented-reality simulation technologies offer a promising solution to these limitations.</p><p><strong>Methods: </strong>CranioFix was developed as a hybrid AR and physical simulation model consisting of a 3D-printed skull with realistic tissue overlays, integrated surgical instruments, and a smartphone-based AR application. The app provides guided surgical instruction, anatomic overlays, and self-assessment tools. A validation study involving 15 surgeons and surgical trainees was conducted in a war-zone mission setting.</p><p><strong>Results: </strong>Participants reported significant improvement in confidence levels for OZC trauma management (mean precourse 3.2/10 versus postcourse 6.3/10). The educational content received high ratings for usefulness (9.1/10), interactivity (8.3/10), and overall design (8.2/10). All participants endorsed CranioFix as a valuable training tool and recommended its expansion to other craniofacial procedures.</p><p><strong>Conclusion: </strong>CranioFix is an effective, portable, and scalable AR-based simulation platform that enhances surgical training in craniomaxillofacial trauma. It is particularly valuable in resource-constrained or disrupted settings and has the potential for wide application in global surgical education.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glomus Tumor in the Neck Region Misdignosed Initially as Metastatic Lymphadenopathy.","authors":"Zixi Tian, Zijian Pan, Yike Li, Ming Xuan, Zhuang Zhang, Chunjie Li, Zhiyong Guo, Jian Pan","doi":"10.1097/SCS.0000000000012083","DOIUrl":"https://doi.org/10.1097/SCS.0000000000012083","url":null,"abstract":"<p><p>Glomus tumor is a rare benign neoplasm derived from glomus cells of arteriovenous anastomoses, typically occurring in the distal extremities. Its occurrence in the head and neck region is exceedingly rare and shows overlapped clinical features with other cervical diseases, such as metastatic malignant tumors in the neck, cervical schwannomas, and chronic lymphadenitis. Herein, we report a 37-year-old male with a painless cervical mass. Initial imaging assessments with contrast-enhanced CT and PET-CT raised suspicion of metastatic nasopharyngeal cancer. However, after undergoing 2 biopsies of the nasopharynx, nasopharyngeal malignancy was ruled out. The neck lesion was finally diagnosed as a cervical glomus tumor through excisional biopsy and histopathologic examination. The patient underwent regular follow-up postoperatively, without detecting significant abnormalities.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Temporomandibular Joint Involvement in a Rare Case of Malignant Otitis Externa.","authors":"Süleyman Celleoğlu, Demet Yazici","doi":"10.1097/SCS.0000000000012058","DOIUrl":"https://doi.org/10.1097/SCS.0000000000012058","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant otitis externa (MOE) is a potentially life-threatening infection of the external auditory canal that predominantly affects elderly, diabetic, or immunocompromised patients. Although the temporomandibular joint (TMJ) is anatomically close to the external auditory canal, its involvement is rare.</p><p><strong>Case presentation: </strong>The authors present a 69-year-old male with uncontrolled diabetes mellitus and stage 3 chronic kidney disease who was admitted to ENT clinic with persistent ear pain and otorrhea unresponsive to prior treatments. Ear swab cultures revealed Pseudomonas aeruginosa. Despite prolonged intravenous antibiotic therapy and hyperbaric oxygen treatment, the patient experienced recurrence 3 times and imaging revealed osteomyelitis of the TMJ. The patient improved after a further course of intravenous meropenem and hyperbaric oxygen therapy over 2 months.</p><p><strong>Conclusion: </strong>MOE is a challenging, recurrent infection requiring early diagnosis and a multidisciplinary approach. Although TMJ involvement is rare, it should be considered in patients presenting with trismus and preauricular swelling. Imaging modalities, ear swab cultures with antibiogram-guided antibiotic therapy, and hyperbaric oxygen treatment may improve therapeutic outcomes.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Reconstruction of Postoncologic Maxillary Defect Using a 3D-Printed PEEK Implant: A Focus on Esthetic and Functional Outcomes.","authors":"Wenhao Cheng, Bing Jiang, Na Bai, Jian Sun, Yanshan Liu","doi":"10.1097/SCS.0000000000012074","DOIUrl":"https://doi.org/10.1097/SCS.0000000000012074","url":null,"abstract":"<p><p>Radiotherapy and chemotherapy can lead to local skin adhesion, fibrosis, poor vascular activity, and weakened tissue recovery capacity. Accurately reconstructing the maxilla after radiotherapy and chemotherapy has become a focal issue for oral and maxillofacial surgeons. This article presents a case of a patient with a maxillary defect resulting from comprehensive sequential treatment of malignant sinonasal tumors. Utilizing 3D printing technology, virtual surgical planning, and individualized PEEK implants, the authors achieved precise repair of the maxillary defect. When the patient is a young female, it is necessary to consider both aesthetics and functionality. In this case, a personalized 3D-printed PEEK implant was used to repair a severe maxillary defect. The surgery was completed in a short time, with concealed scars in the surgical area, satisfactory appearance, and improvement in diplopia.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Muscle Relaxants on the Postoperative Sore Throat Associated With LMA Protector Mask: A Prospective Randomized, Double-Blind Clinical Study.","authors":"Siyi Xiong, Mingxiao Chai, Peiqi Xu, Xiaoqian Shi, Chenxi Gao, Jiayun Zhang, Shujie Liu, Jinghui Shi","doi":"10.1097/SCS.0000000000012043","DOIUrl":"https://doi.org/10.1097/SCS.0000000000012043","url":null,"abstract":"<p><strong>Objectives: </strong>To observe the performance of the LMA Protector mask during short anesthesia procedures in gynecology with or without muscle relaxants.</p><p><strong>Methods: </strong>A total of 100 patients (aged 18-65 years old, BMI <35 kg/m2) with American Society of Anesthesiologists (ASA) physical status I to III, scheduled to undergo elective gynecologic surgery, with an expected operative time <1 hour, were randomly divided into 2 groups, that is, the muscle relaxant group and the control group. The patients were given 0.06 mg/kg cisatracurium or the same amount of normal saline. The primary outcome was postoperative sore throat, and the secondary outcomes were the postoperative adverse effects, recovery time, oropharyngeal leak pressure (OLP), and the ease score of placements.</p><p><strong>Results: </strong>There were no significant differences in postoperative sore throat, the amount of blood stained on the laryngeal mask, and other postoperative adverse effects in both groups. The OLP of LMA Protector in the muscle relaxant group was 32 cm H2O, which was significantly higher than the 28 cm H2O in the control group (P=0.0017). The ease of mask placement score was significantly lower in the muscle relaxant group at 2 (0-4) than in the control group at 3 (0-6) (P=0.042). The eye-opening time, laryngeal mask removal time, and leaving time in the muscle relaxant group were significantly longer than in the control group (all P<0.001).</p><p><strong>Conclusions: </strong>The use of muscle relaxants does not affect postoperative sore throat associated with the LMA Protector mask, but facilitates the placement and also helped to improve OLP, thus improving mask tightness and enhancing the safety of the laryngeal mask.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of \"Educational Strategies for Clinical Supervision of Artificial Intelligence Use\" by Abdulnour R, Gin B, Boscardin C. The New England Journal of Medicine 2025;393:786-97.","authors":"Sam P Griffin, Larry H Hollier","doi":"10.1097/SCS.0000000000012076","DOIUrl":"https://doi.org/10.1097/SCS.0000000000012076","url":null,"abstract":"","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Surgery for Multiple Facial Basal Cell Carcinoma Excision: Modified Hughes Procedure and Rieger Nasal Flap.","authors":"Emirhan Ozkul, Ahmed Hakan Cokkeser, Mehmet Serhat Mangan, Cigdem Tepe Karaca, Sema Zer Toros","doi":"10.1097/SCS.0000000000012086","DOIUrl":"10.1097/SCS.0000000000012086","url":null,"abstract":"<p><p>An 84-year-old female patient initially presented to the general ophthalmology outpatient clinic with a complaint of a mass on the left lower eyelid. At that time, only the eyelid lesion was noted. Upon referral to the oculoplastic unit, an expert oculoplastic surgeon identified, in addition, multiple lesions on the left nasal alar rim. The patient was subsequently referred to the Department of Otorhinolaryngology. Incisional biopsies confirmed basal cell carcinoma in both sites. Under general anesthesia, the ophthalmology and otorhinolaryngology teams performed simultaneous resections and reconstructions in a single operative session. The lower eyelid tumor was excised with tumor-free margins confirmed by frozen section and reconstructed with a Hughes flap. The nasal alar rim lesion was excised with safe margins and repaired with a Rieger flap. Histopathology confirmed nodular and adenoid BCC in both specimens, with all margins clear. The postoperative course was uneventful, and no recurrence was observed during the follow-up. This case highlights 3 key points: ophthalmologists should extend their examination beyond the periocular region to include the entire face; simultaneous multidisciplinary surgery can eliminate the need for additional anesthesia, procedures, and costs; and, to our knowledge, this is the first reported case of synchronous lower eyelid and nasal alar BCCs managed with concurrent Hughes and Rieger flap reconstructions.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Efficacy of Tear Trough Depression Reconstruction Using an Intraoral Cannula-Guided Puncture for Orbital Septum Fat Flap With the FACE-Q Scale.","authors":"Cuimei Wang, Chong Wu, Hongwei Liang","doi":"10.1097/SCS.0000000000012070","DOIUrl":"https://doi.org/10.1097/SCS.0000000000012070","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Previous corrections of infraorbital and tear trough depression often utilized particulate fat or artificial material fillers, or used orbital septum fat flaps fixed via subcutaneous/epicutaneous knotting through facial puncture, which carried risks of displacement, contour irregularity, and traction. This study aims to investigate a novel surgical technique for correcting infraorbital depression using a cannula-guided intraoral approach to fix a repositioned orbital septum fat flap, assess its therapeutic efficacy and feasibility, and employ the FACE-Q scale for objective evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Twenty-nine patients undergoing lower blepharoplasty were enrolled, with a mean age of 48.6 ± 4.5 years. Paired t tests were used to compare FACE-Q scale scores (Eye Appearance Satisfaction, Psychosocial Function, and Self-confidence domains) preoperatively and at 6 months postoperatively. Cohen's d was calculated to assess effect sizes (d &gt; 0.8 indicating a large effect). Multiple linear regression analyzed the impact of preoperative infraorbital depression severity (Hirmand classification grades 1-3) and skin laxity severity (mild/moderate/severe) on the magnitude of postoperative score improvement (Δ). Principal component analysis (PCA) explored the underlying dimensional structure of score changes. Statistical significance was set at P &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohort included 26 females (89.7%) and 3 males (10.3%). At 6 months postoperatively, all FACE-Q domain scores showed significant improvement compared with preoperative values (all P &lt; 0.001): Eye Appearance Satisfaction improved the most (Δ = 34.40 ± 4.36, Cohen's d = 5.93), followed by Psychosocial Function (Δ = 25.73 ± 3.59, d = 4.85) and Self-confidence (Δ = 23.27 ± 3.78, d = 4.12). Effect sizes far exceeded the 0.8 threshold, indicating highly clinically meaningful improvements. No serious adverse events occurred postoperatively. Multiple linear regression revealed that a higher infraorbital hollowness grade (β = 3.2, P = 0.006) and severe skin laxity (β = 4.1, P = 0.016) were independent positive predictors of improvement in eye satisfaction, with the model explaining 32% of the variance (F = 4.21, P = 0.003). Principal component analysis further revealed that 69% of the variance in score changes was explained by a single principal component (Δ Eye Satisfaction loading 0.94, Δ Psychological Function loading 0.86, Δ Social Function loading 0.85), indicating highly synergistic improvements across dimensions without significant subgroup differentiation patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The technique of guided fixation of the orbital septum fat flap via an intraoral approach effectively corrects tear trough depression, allows for dynamic adjustment, avoids subcutaneous nodules and lower eyelid traction, and represents a safe and feasible autologous tissue correction method worthy of clinical promotion. The FACE-Q ","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Differentially Expressed Genes That Are Associated With Autophagy in Microtia.","authors":"Jingyang Zhou, Runmeng Cui, Lin Lin","doi":"10.1097/SCS.0000000000012079","DOIUrl":"https://doi.org/10.1097/SCS.0000000000012079","url":null,"abstract":"<p><p>The microtia is a congenital disease that might be simultaneously influenced by internal genetic level disorder and external hazardous substances. Since autophagy is an essential cell response to adverse conditions, its dysregulation has been found to be closely linked to a number of illnesses. In comparison, the role of genes that are related to autophagy in the pathogenesis of microtia is relatively rarely discussed. In the meanwhile, the study aims to determine the degree of expression and subsequent molecular pathways of autophagy-related genes and demonstrate the possible role autophagy may play in the pathophysiology of microtia. The method of computational bioinformatics analysis offers fresh perspectives and original motivations for further research in linked fields.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}