Journal of Craniofacial Surgery最新文献

{"title":"Utilization of Cone Beam CT for the Measurement of Peri-Implant Bone Graft Density Following Lateral Sinus Augmentation.","authors":"Ali H Abbas Alhussaini, Thair A Hassan, Salah Abdalmehdi Ismael","doi":"10.1097/SCS.0000000000013383","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013383","url":null,"abstract":"<p><strong>Background: </strong>Bone remodeling after tooth extraction and maxillary sinus pneumatization often creates a clinical challenge for dental implant placement in the posterior maxilla.</p><p><strong>Aim: </strong>To evaluate the changes in graft density after 1-stage lateral sinus augmentation utilizing deproteinized bovine bone alone or mixed with platelet-rich fibrin.</p><p><strong>Materials and methods: </strong>Twenty-five patients, ages ranged from 25 to 72 years, met the eligibility criteria. A total of 34 lateral sinus augmentation procedures were performed utilizing bone graft and 50 simultaneously installed dental implants. The lateral sinus augmentation cases were allocated randomly into 3 groups: group A, utilizing solely deproteinized bovine bone. Group B, using deproteinized bovine bone mixed with leukocyte and platelet-rich fibrin. Group C, using deproteinized bovine bone mixed with advanced platelet-rich fibrin. The graft density was measured at baseline (T1) and after 24 weeks (T2). Cone beam computerized tomography was obtained for the measurement of changes in graft density for all groups.</p><p><strong>Results: </strong>There was an increase in mean peri-implant graft density from T1 to T2 for each study group; however, it did not reach the statistical significance difference level (P˃0.05). Furthermore, there was no statistically significant increase in graft density for both study groups B and C versus group A after 24 weeks.</p><p><strong>Conclusions: </strong>The study groups B and C did not significantly improve the graft density in comparison to group A at T2. The use of cone beam computerized tomography is valuable for the measurement of graft density after maxillary sinus augmentation.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224186","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":"Sports-Related Craniofacial Trauma and Traumatic Brain Injury: A Global Research Landscape.","authors":"Mona Satishkumar, Ananya Uddanti, Latha Ganti","doi":"10.1097/SCS.0000000000013527","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013527","url":null,"abstract":"<p><p>Sports-related craniofacial injury and traumatic brain injury (TBI) research has expanded considerably over the past 2 decades, yet no bibliometric analysis has characterized the structure, geographic distribution, or thematic evolution of this literature. This study aimed to map publication trends, collaboration networks, and emerging research themes in sports-related craniofacial injury and TBI. A search of the Web of Science Core Collection identified 515 publications related to sports-related craniofacial injury and TBI. Coauthorship networks at the author, country, and institutional levels, as well as author-keyword co-occurrence networks, were constructed and visualized using VOSviewer. Publication output increased substantially after 2016 and peaked at 48 publications in 2021. The most represented research categories were surgery, sport sciences, and dentistry/oral surgery/medicine. Pennsylvania Commonwealth System of Higher Education, the University of Miami, and the University of Pittsburgh were the leading institutions by publication count, while the Journal of Craniofacial Surgery, Dental Traumatology, and the British Journal of Sports Medicine were the most frequent publication venues. Research in this area has grown substantially since the mid-2000s and increasingly emphasizes epidemiology, prevention, and long-term outcomes. Research output remains geographically concentrated in the United States and Australia, while India, Brazil, and Italy appear as more recent contributors to the collaborative network. These findings identify current strengths and gaps in the literature and may help guide future research priorities and funding allocation.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224203","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":"Palatal Process Pneumatization in Miniscrew-Assisted Rapid Palatal Expansion Planning.","authors":"Tuğçe Taşkındere Abbasoğlu","doi":"10.1097/SCS.0000000000013495","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013495","url":null,"abstract":"","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224208","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":"Predictors of Interfacility Transfer in Head and Neck Trauma: A National Trauma Data Bank Study.","authors":"William C Moss, Prem C Patel, Dylan Z Erwin, Travis R Newberry, Alvaro G Moreira","doi":"10.1097/SCS.0000000000013484","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013484","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic head and neck (H/N) injuries frequently present to level III/IV trauma centers, yet many require care available only at higher-level facilities. This study aims to characterize transfer patterns in H/N trauma patients initially treated at level III/IV centers.</p><p><strong>Methods: </strong>The National Trauma Data Bank was queried for adults with H/N trauma initially presenting to level III/IV trauma centers between 2007 and 2015. Univariate analysis compared cohort characteristics, while multivariate logistic regression identified independent predictors of transfer.</p><p><strong>Results: </strong>In total, 18,454 patients met inclusion criteria, of whom 5923 (32.1%) were transferred. Cut/piercing and striking injuries were associated with greater transfer odds (aOR: 1.328, 1.653), while motor vehicle trauma was associated with decreased odds (aOR: 0.845, 95% CI: 0.763-0.937). Transfer was associated with jaw dislocation (aOR: 1.871, 95% CI: 1.228-2.852) and H/N burns (aOR: 8.832, 95% CI: 7.131-10.940). Mandibular (aOR: 2.53, 95% CI: 2.19-2.93), skull base (aOR: 1.379, 95% CI 1.229-1.547), and malar/maxillary fractures (aOR: 1.314, 95% CI: 1.163-1.486) increased transfer odds, while nasal bone fracture decreased odds (aOR: 0.817, 95% CI: 0.741-0.901). Isolated H/N injury increased transfer odds (aOR: 1.379, 95% CI: 1.247-1.526). Transferred cohorts most commonly underwent diagnostic imaging and simple bedside procedures prior to transfer.</p><p><strong>Conclusion: </strong>Interfacility transfer is driven primarily by injury patterns rather than physiologic instability, likely reflecting anticipated need for subspecialty surgical intervention. Understanding injury-specific transfer predictors may optimize trauma systems and resource utilization while ensuring timely specialized care.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224213","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":"Patient Characteristics and Anesthetic Factors Affecting Hospital Length of Stay in Orthognathic Surgery.","authors":"Thomas Ren, Anahita Nimbalkar, Yurui Zhang, Emma Yan, Yeonjae A Lee, Taeyoung Park, Katherine J Zhu, Edgar Soto, Richard J Redett, Pasha Shakoori, Teresa Lee, Robin Yang","doi":"10.1097/SCS.0000000000013514","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013514","url":null,"abstract":"<p><strong>Background: </strong>As orthognathic surgery increasingly shifts toward ambulatory pathways, identifying patients at risk for extended length of stay (eLOS) remains clinically important. This study evaluated preoperative patient characteristics and anesthetic factors associated with eLOS after orthognathic surgery.</p><p><strong>Methods: </strong>A retrospective cohort study was performed of patients who underwent Le Fort I osteotomy at a single tertiary academic center between 2019 and 2025. Demographic, airway-related, anesthetic, and operative variables were extracted from the electronic medical record. The primary outcome was eLOS, defined as hospitalization of 2 or more days. Patients were compared by length-of-stay cohort, and multivariable logistic regression was used to identify independent predictors.</p><p><strong>Results: </strong>The study included 170 patients, of whom 47 experienced eLOS. On unadjusted analysis, patients with eLOS had higher rates of obstructive sleep apnea (OSA), difficult airway history, elevated Mallampati class, ASA class III status, and longer anesthesia and operative durations. Higher ASA classification was associated with OSA, difficult airway history, elevated Mallampati scores, longer induction time, and increased use of indirect visualization during intubation. On multivariable regression, ASA class III independently predicted eLOS (adjusted odds ratio, 8.49; 95% CI: 2.09-40.0; P=0.004), as did longer operative duration (adjusted odds ratio, 1.50 per hour; 95% CI: 1.13-1.97; P=0.006).</p><p><strong>Conclusions: </strong>ASA class III and longer operative duration independently predict eLOS after orthognathic surgery. ASA classification may serve as a practical preoperative surrogate for airway-related perioperative risk and help guide individualized postoperative monitoring.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224167","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":"Cost Analysis of Maxillofacial Trauma Treatment in Three Major Ministry of Health Malaysia Hospitals.","authors":"Xiao Feng Ling, Mei Mei Tew, Zainal Abidin Marzuki, Khairul Zaman Adnan, Ravindran Murugesan, Nurlidiah Md Ghazali, Nurhalim Ahmad, Daryl Chan, Syakiroh Mohd Nazri, Shalini Jagadisen, Nur Amalina Zaimi, Nor Zam Azihan Mohd Hassan","doi":"10.1097/SCS.0000000000013520","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013520","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Maxillofacial trauma imposes a considerable burden on healthcare systems. The Facial Injury Severity Scale (FISS) may help to estimate treatment complexity and healthcare resource requirements. However, evidence regarding its relationship with treatment costs and resource utilization in Malaysian public hospitals remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the relationship between FISS scores, treatment costs, and healthcare resource utilization among maxillofacial trauma patients treated in Ministry of Health Malaysia (MOH) hospitals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A retrospective multicenter cohort study included 132 adult patients who underwent open reduction and internal fixation (ORIF) for maxillofacial fractures between January and December 2022 in 3 MOH hospitals. FISS scores were characterized as low (1-5), moderate (6-10), and high (&gt;10) severity groups. Healthcare resource utilization was assessed using operating theatre (OT) duration, length of stay (LOS), and treatment cost. Treatment costs were estimated from the healthcare provider's perspective using a combination of activity-based and top-down costing approaches. Unadjusted differences across FISS groups were evaluated, and multivariable-adjusted general linear models were used to examine associations between FISS severity groups and each outcome after adjustment for age, gender, Glasgow Coma Scale (GCS), study site, and injury-to-OT time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Increasing FISS severity was associated with significantly longer OT duration (118 versus 135 versus 162 min; P&lt;0.001), prolonged LOS (4 d versus 4 d versus 9 d; P=0.048), and higher treatment costs (RM 6564.47 versus RM 8065.28 versus RM 9830.90; P=0.003). After adjustment for age, gender, GCS, study site, and injury-to-OT time, significant differences across FISS categories remained for OT duration (P=0.001) and treatment cost (P=0.001), whereas the association with LOS was no longer statistically significant (P=0.201). Adjusted mean OT duration increased from 145.42 minutes in the low-FISS group to 220.94 minutes in the high-FISS group, while adjusted mean treatment cost increased from RM 7158.23 to RM 9552.91. The mean treatment cost per patient was RM 7592.43 ± 2364.14 (USD 1807.72 ± 562.89). Plating and screw costs (28.97%) and personnel costs (20.44%) were the largest contributors to treatment expenditure, while the operating theatre accounted for 60.18% of the total cost.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Higher FISS scores were associated with greater healthcare resource utilization and treatment costs among maxillofacial trauma patients treated in MOH hospitals. After adjustment for relevant and institutional factors, higher FISS severity remained significantly associated with longer operative duration and higher treatment cost, whereas the association with LOS was attenuated. These findings support the potential use of FISS as a practica","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224237","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":"Predicting Plastic Surgery Residency Match Tier From Publication Metrics: A Machine Learning Analysis.","authors":"Pratik Vangal, Amogh Shetty, Sahil Sharma, Matthew Q Dao, Ishan Patel, Dev Dwivedi, Sheuli Chowdhury, Peter W Henderson, Stephanie M C Bray","doi":"10.1097/SCS.0000000000013525","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013525","url":null,"abstract":"<p><p>In recent years, matched plastic surgery applicants have shown a marked increase in research output, yet it remains unclear whether these academic metrics can predict the tier of the residency program into which an applicant matches. This study utilized machine learning (ML) to evaluate whether a comprehensive set of preresidency publication measures could jointly predict the matched program tier. In this retrospective, cross-sectional analysis, data were aggregated from scientific databases including PubMed and Scopus for 914 applicants who matched into ACGME-accredited integrated plastic surgery residency positions during the 2019 to 2024 National Resident Matching Program cycles. Five ML classifiers (logistic regression, decision tree, k-nearest neighbors, Gaussian naïve Bayes, and multilayer perceptron) were trained to predict program tiers under reputation-based and research-based Doximity ranking schemes. Variables included publication volume (total, first-author, and PRS-journal-specific), subspecialty categorization, and institutional variables. Performance was assessed using accuracy and F1-score (a balanced measure of precision and recall) in binary and tertiary classification settings. Performance was above chance but limited across all schemes. For binary reputation tasks, the best model achieved 61.0% accuracy and 71.4% F1-score. Under the research scheme, performance peaked at 57.5% accuracy and 66.0% F1. For tertiary classification, the best reputation result was 45% accuracy and 44% F1, and the best research result was 43% accuracy and 43% F1. No algorithm consistently outperformed the others. Preresidency publication metrics alone weakly predict the matched residency program tier, and factors beyond research output likely play a more decisive role in residency placement.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224198","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":"What is the Utility of Whole Body Imaging for Screening Patients With Craniofacial Fibrous Dysplasia?","authors":"Nathan Ramachandran, Jared Cornejo, Louis Paul D Berlinguette, Laura A Drubach, David L Best","doi":"10.1097/SCS.0000000000013488","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013488","url":null,"abstract":"<p><p>Whole body imaging is commonly performed in patients with fibrous dysplasia (FD) to screen for additional lesions. However, the frequency of newly-detected lesions in patients presenting with isolated craniofacial FD is unclear. The purpose of this study was to evaluate the frequency of newly-detected FD lesions on whole body imaging in patients with craniofacial FD and no known extracraniofacial lesions or symptoms. This was a retrospective observational cohort study at a tertiary children's hospital in an urban setting. The study population consisted of patients with craniofacial FD who underwent whole body imaging with technetium-99m (Tc-99m) bone scintigraphy or fluorine-18 sodium fluoride positron emission tomography/computed tomography (F-18 NaF PET/CT). Patients with previously identified extracraniofacial lesions, symptoms, or McCune-Albright syndrome were excluded. The primary outcome was the frequency of newly-detected extracraniofacial FD lesions. Fifteen subjects were included (80% female). Mean age at FD diagnosis was 9.6±4.3 years, and mean age at imaging was 10.4±4.2 years. Tc-99m bone scintigraphy was the most common imaging modality (86.7%). Newly-detected extracraniofacial FD lesions were observed in 1 of 15 subjects (6.7%). Two additional subjects (13.3%) had incidental skeletal findings related to recent traumatic injuries. In patients presumed to have isolated craniofacial FD, whole body imaging identified a low frequency of extracraniofacial skeletal lesions. These findings suggest that routine screening may be considered selectively based on clinical history and physical examination. Further investigation is required to develop evidence-based screening guidelines.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224240","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":"Pulp Treatment Outcomes and Influencing Factors in Traumatized Teeth Associated With Maxillofacial Injury.","authors":"Jingxue Gou, Xiaoyan Zhao, Dandan Wen, Sheng Zhang, Qingwei Meng, Jiarui Liu, Teng Ma","doi":"10.1097/SCS.0000000000013404","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013404","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate tooth-bearing alveolar segment salvage after maxillofacial trauma and identify surgical-pathway determinants of late infective-inflammatory segment failure that can be addressed during acute facial fracture care.</p><p><strong>Methods: </strong>A tooth-unit cohort nested within 246 patients treated from January 2021 to March 2026 for maxillofacial injury was analyzed from the perspective of facial trauma triage, tooth-bearing alveolar segment stabilization, and postoperative surveillance. Candidate determinants included delay to definitive segment stabilization, mature root apex, alveolar fracture, open tooth wound or pulp exposure, wound contamination, Injury Severity Score, and tooth displacement. The primary outcome was 12-month tooth-bearing alveolar segment salvage, defined as retained occlusal tooth units without late pulp-derived infection, inflammatory resorption, or persistent apical disease. Multivariable logistic regression used patient-clustered robust standard errors.</p><p><strong>Results: </strong>The analysis included 599 traumatized permanent teeth. Tooth-bearing alveolar segment salvage at 12 months was 42.1%, occlusal tooth-unit retention was 79.3%, and late infective-inflammatory segment failure occurred in 54.1%. Definitive stabilization within 24 hours was associated with higher salvage than later intervention (52.6% vs. 34.6%). The strongest adjusted determinants of failure were delayed stabilization, mature root apex, concomitant alveolar fracture, and open tooth wound or pulp exposure; model discrimination was acceptable (AUC=0.68).</p><p><strong>Conclusions: </strong>In maxillofacial trauma care, late failure of tooth-bearing alveolar segments was linked to modifiable surgical-pathway factors and injury biology. Systematic segment assessment, early stabilization, contamination control, and risk-coded follow-up should be integrated into facial fracture protocols to preserve occlusal units and reduce delayed infectious or reconstructive complications.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224159","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":"Facial Injury Severity Scale and Frontal-Segment Involvement as Risk Stratification Markers in Panfacial Fractures: A Single-Center Retrospective Study.","authors":"Burçin Acuner, Oğuzhan Durmuş, Zamin Rasulov, Enes Cem Erol, Ahmet Eksal Kargı","doi":"10.1097/SCS.0000000000013524","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013524","url":null,"abstract":"<p><p>Panfacial fractures are high-energy injuries. We evaluated whether the Facial Injury Severity Scale (FISS) and frontal-segment involvement are associated with early surgical complications, length of stay, intensive care unit (ICU) admission, and craniocerebral injury. Thirty-four panfacial fracture patients treated between January 2016 and May 2026 were analyzed retrospectively at a single center. Fractures were classified with the Erdmann-Follmar four-segment model (≥3 of 4 segments); FISS used the Duke modified system. Because several tables were sparse, associations were estimated by Firth penalized logistic regression with profile penalized-likelihood confidence intervals (CIs), unadjusted and FISS-adjusted. Twenty-seven men and 7 women were included (mean age 37.2±18.6); the frontal-upper midface-lower midface pattern was commonest (38.2%), and median FISS was 13.5 (IQR 9-21). Concomitant injury occurred in 73.5% (craniocerebral 44.1%), early complications in 50.0%, and ICU admission in 52.9%. Frontal-segment involvement was associated with craniocerebral injury [odds ratio (OR) 7.14, 95% CI 1.31-74.4; P=0.021] and intracranial pathology (OR 17.59, 95% CI 1.88-2356.2; P=0.008); both were unchanged after adjustment for FISS, which showed no independent association with either. Conversely, FISS was independently associated with early surgical complications (OR 1.13 per point, 95% CI 1.01-1.27; P=0.028), whereas frontal involvement was not. The FISS ≥ 11 threshold was not validated. The 2 markers appear to index different axes of injury, but in 34 patients, CIs are wide, subgroup analyses are underpowered, and the composite craniocerebral association is partly definitional; these findings are hypothesis-generating and require multicenter validation.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224233","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}