Journal of Craniofacial Surgery最新文献

{"title":"The Efficacy and Disadvantages of Endovascular Therapy for Deep-Seated Cerebral Arteriovenous Malformations: A Long-Term Follow-Up Study.","authors":"Zhen-Long Ji, Si-Shi Xiang, Jing-Wei Li, Jin Xu, Jia-Xing Yu, Jia-Wei Qi, Gui-Lin Li, Hong-Qi Zhang","doi":"10.1097/SCS.0000000000011486","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011486","url":null,"abstract":"<p><p>Arteriovenous malformations (AVMs) in the basal ganglia, the thalamus, and the insular lobe of the brain are rare and difficult-to-treat diseases that require integrated multimodal management. This study aimed to determine the safety and disadvantages of embolization as an independent therapy for deep-seated AVMs. The authors reviewed 76 patients from a single center with cerebral deep-seated AVMs from 2010 to 2020. Clinical hemorrhage refers to the initial clinical presentation with bleeding, the first occurrence of bleeding, and delayed postoperative hemorrhage refers to subsequent bleeding following the initial hemorrhage. After interventional therapy, 8 patients experienced delayed postoperative hemorrhage during the total follow-up of 94,631 person-years, with an annual postoperative hemorrhage rate of 3.1%. Compared with the overall clinical hemorrhage rate before treatment (15.9%/person-year), 11 patients experienced clinical hemorrhage during 25,238 person-years, indicating a significantly decreased risk of clinical hemorrhage after treatment. A total of 28.9% (22/76) of patients achieved angiographic obliteration. Multivariate analysis showed that pretreatment limb weakness and a high Spetzler-Martin grade predicted poor clinical outcomes (P = 0.043 and 0.005). Fewer feeding arteries predicted AVMs' obliteration (P = 0.048). Endovascular procedure-related complications, mortality, and morbidity were, respectively, reported in 7.9% (6/76), 1.3% (1/76), and 14.8% (8/54) of patients. Endovascular embolization significantly lowered the risk of clinical deterioration and delayed hemorrhage, indicating it to be a safe and effective therapy for deep-seated AVMs. Lesions with a simple angioarchitecture were more likely to be completely obliterated.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078376","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 Matters to Patients With Nonsyndromic Craniosynostosis and Their Parents: A Qualitative Study Informing the Development of a Patient-Reported Outcome Measures Set.","authors":"Pauline A E Tio, Coralie J Wijnhoven, Elin Weissbach, Jacoba Kats, Jolanda M E Okkerse, Irene M J Mathijssen, Karolijn Dulfer","doi":"10.1097/SCS.0000000000011491","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011491","url":null,"abstract":"<p><p>The primary objective of this study was to identify important concepts that hold significance for both patients with nonsyndromic craniosynostosis and their parents regarding their craniosynostosis care. The findings from this study will guide the development of patient-reported outcome measures (PROM) sets tailored to specific craniosynostosis subtypes and age groups, which will be implemented in our treatment protocol. A qualitative methodology was used, and data were obtained through focus groups. A purposive sample of patients and parents of patients with nonsyndromic craniosynostosis was collected at Sophia Children's Hospital Erasmus Medical Center. The focus groups were recorded, transcribed verbatim, and analyzed using thematic content analysis. Important domains in the preoperative and postoperative period were identified. In total, 34 participants were included in this study, of which 24 parents and 10 patients were divided over 12 focus groups. Based on our qualitative data, 4 top-level domains were considered to be of importance in patients with nonsyndromic craniosynostosis and their parents, including: emotional and social, cognitive, physical, and disease-specific functioning. Each top-level domain consisted of subdomains. Findings from this qualitative study reveal domains important to patients with nonsyndromic craniosynostosis and their parents with regard to their outcomes in craniosynostosis care. The comprehensive framework derived from this study serves as a guideline for developing a craniosynostosis-specific PROM set of relevance to our population.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078392","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":"Efficacy of the Modified Frontalis Muscle Flap Technique in Severe Eyelid Ptosis in a Craniofacial Surgery Reference Center.","authors":"Héctor O Malagón Hidalgo, Fernán A Ayala Ugalde, Carlos Escobar Rivera, Miguel A Cálix García, Stéphane P Guerrero Zambrano","doi":"10.1097/SCS.0000000000011474","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011474","url":null,"abstract":"<p><strong>Introduction: </strong>Upper eyelid ptosis is described as an abnormal drooping of the upper eyelid >1 to 2 mm from the corneal scleral margin. There are multiple techniques for the treatment of eyelid ptosis, the following article focuses on those patients with poor upper lid levator function. The authors present a series of cases with severe ptosis using the pulley technique, which allows us to change the vector in a more tangential direction, which is reflected in the following advantages; it provides stronger posterior support, more physiological excursion, horizontal traction, prevents eyelash ptosis, and gives a better aesthetic result.</p><p><strong>Methods: </strong>Retrospective study where data were collected from January 2014 to September 2024. The inclusion criteria were patients who presented with congenital, traumatic, and involutional bilateral ptosis.</p><p><strong>Results: </strong>Were obtained a total of 25 cases of blepharoptosis. The mean age of the cohort was 34.2 years and 68% were male. The primary etiology of ptosis was congenital, 80% of patients had severe ptosis. All patients classified as severe in the study presented with deficient preoperative elevator function (<6 mm). Specifically, 75% of patients achieved good function (10-15 mm).</p><p><strong>Conclusion: </strong>This is an effective technique that allows changing the vector in a more tangential direction, which is reflected in the following advantages: it provides greater posterior support, greater physiological excursion, horizontal traction, prevents eyelash ptosis, and gives a better aesthetic result.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078419","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":"Combining Computed Tomography Angiography and Computed Tomography Perfusion for Evaluating Patients With Middle Cerebral Artery Stenosis and Acute Cerebral Infarction.","authors":"Ze-Ying Wang, Hua Bao, Qin-Bao Zhang","doi":"10.1097/SCS.0000000000011502","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011502","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the correlation between MCA stenosis severity and CTP parameter changes in ACI patients.</p><p><strong>Materials and methods: </strong>Sixty unilateral MCA stenosis-induced ACI patients (6 h-7 d post-onset) underwent CTA+CTP. Patients were stratified by stenosis degree: mild (<50%), moderate (50%-69%), severe (≥70%). CTP parameters were compared across groups. Patients with 50% to 100% stenosis were further analyzed by collateral circulation status (scores 2-3: good; 0-1: poor). Differences in CTP parameters and 90-day mRS were evaluated.</p><p><strong>Results: </strong>(1) Good collateral circulation (scores 2-3) was associated with higher CBF/CBV, prolonged TTP/MTT, and lower NIHSS/90-day mRS compared with poor circulation (scores 0-1). (2) Mild stenosis showed increased CBF/CBV in unaffected hemisphere. Moderate stenosis demonstrated reduced CBV and prolonged TTP/MTT in affected hemisphere. Severe stenosis exhibited increased CBF/CBV in unaffected hemisphere.</p><p><strong>Conclusion: </strong>(1) CBV and CBF reduction positively correlated with stenosis severity. (2) Adequate collateral circulation was associated with reduced early neurological damage and disability.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078413","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":"Contraindicated? Not So Fast-The Buccal Fat Pad Flap in Down Syndrome.","authors":"Jimmy Xu, Thomas McConnell, Mathew Thomas","doi":"10.1097/SCS.0000000000011500","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011500","url":null,"abstract":"","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078418","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":"Symptomatic Glomuvenous Malformation of the Anterior Chest: Clinical Presentation, Surgical Management, and Genetic Considerations.","authors":"Emily L Isch, Meryem Guler, D Mitchell Self, Edward J Caterson","doi":"10.1097/SCS.0000000000011504","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011504","url":null,"abstract":"<p><strong>Introduction: </strong>Glomuvenous malformations (GVMs), historically referred to as \"glomangiomas,\" are rare venous malformations characterized by the presence of smooth muscle-like glomus cells around vein-like channels. A subset of these lesions arises due to heterozygous mutations in the glomulin (GLMN) gene. This case report describes the clinical presentation, surgical excision, and histopathologic evaluation of a glomuvenous malformation, highlighting the key role of genetic testing and the importance of differentiating GVMs from other vascular anomalies.</p><p><strong>Methods: </strong>A 2-year-old male was found to have multiple small, flat, blue-gray lesions of the skin during his well-child visit. The patient underwent imaging studies to characterize the lesion's extent and vascularity, followed by complete surgical excision. Blood and biopsy samples from the procedure were sent to another institution for genetic testing.</p><p><strong>Results: </strong>Genetic analysis of samples were positive for germline and somatic mutations of the GLMN gene at nucleotide positions c.157_161 and c.661, creating truncated glomulin proteins through premature stop codons. These genetic variants are consistent with a diagnosis of GVM. Postoperative follow-up demonstrated no evidence of recurrence.</p><p><strong>Conclusions: </strong>Glomuvenous malformations are clinically distinct from other venous malformations due to their histology, mutational etiology (GLMN), and characteristic appearance. Proper recognition of GVMs is critical to guide management, avoid unnecessary investigations, and offer genetic counseling for families. Complete surgical excision remains curative for symptomatic, localized lesions.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078374","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 Role of Artificial Intelligence With Deep Convolutional Neural Network in Screening Melanoma: A Systematic Review and Meta-Analyses of Quasi-Experimental Diagnostic Studies.","authors":"Stella Maureen Miracle, Louis Rianto, Kelvin Kelvin, Kevin Tandarto, Felix Setiadi, Angela Angela, Thiara Maharani Brunner, Hari Darmawan, Henry Tanojo, Rosalyn Kupwiwat, Inneke Jane Hidajat, Rungsima Wanitphakdeedecha, Kyu-Ho Yi","doi":"10.1097/SCS.0000000000011498","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011498","url":null,"abstract":"<p><strong>Introduction: </strong>Detecting melanoma as one of the most common skin cancer with using artificial intelligence (AI), such as deep convolutional neural network (DCNN) have the potency to increase the accuracy of the diagnosis. The aim of this study is to analyze the sensitivity, specificity, precision, and F1-score of DCNN in screening melanoma.</p><p><strong>Methodology: </strong>The authors followed the PRISMA 2020 guidelines to retrieve literature in the following databases: PubMed, EBSCOhost, Emerald, Wiley, and ScienceDirect. The study's inclusion criteria were human quasi-experimental investigated DCNN in screening melanoma. The analysis was conducted using RevMan 5.4 and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) to ensure the quality of the studies.</p><p><strong>Results: </strong>Fifty-six of 2386 articles published in 2003 to 2023 were included and 24 studies were statistically analyzed. Various type of DCNN was used [artificial neural network (n=4); pigment network (n=4); atypical pigment network (n=1); ResNet (=8); AlexNet (n=3); visual geometry group (n=7); inception (n=4); custom DCNN (n=4)]. The mean and median of total sample size in meta-analysis with melanoma subjects were (18,791; 2,157) with (573; 261), respectively. Overall, QUADAS-2 showed low risk of bias. Diagnostic performance was observed with pooled sensitivity (0.881), pooled specificity (0.897), and pooled AUC (0.894). The precision and F1-score were ranging from 58% to 98.83% and 0.45 to 0.98. The forest plot and summary receiver operating characteristics curve (SROC) of each multiple in multiple analysis showed satisfactory results.</p><p><strong>Conclusions: </strong>DCNN showed significant result to screen melanoma in patients. It has the potential to help clinician in giving early screening.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078391","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":"Inverted Horseshoe Osteotomy for Vertical Chin Reduction and Masculinization Procedure With Individual Mandibular Angles Implants.","authors":"Rafal Pokrowiecki","doi":"10.1097/SCS.0000000000011482","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011482","url":null,"abstract":"<p><p>Sliding genioplasty is an established surgical technique used in orthognathic and facial plastic surgery. It enables the correction of multiple bone discrepancies, such as pro- or retrogenia, as well as asymmetries. Chin narrowing procedures are beneficial in gender-affirming surgery for male-to-female patients, as they provide a more triangular shape to the lower face, which is considered more feminine. However, <10% of transgender patients undergo female-to-male transition where the lower face needs to be more squared, with prominent angles and a strong chin. Moreover, cisgender males are increasingly opting for facial aesthetic surgery to enhance their masculine appearance. This study presents the protocol for lower face masculinization with a modified chin osteotomy that may be used in conjunction with custom mandibular angle implants.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078368","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":"Nerve Decompression in Occipital Neuralgia: A Systematic Review and Meta-analysis.","authors":"Antoinette T Nguyen, Rena A Li, Robert D Galiano, Marco F Ellis","doi":"10.1097/SCS.0000000000011490","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011490","url":null,"abstract":"<p><p>Occipital neuralgia (ON) is a debilitating craniofacial pain disorder often refractory to conservative treatments. Nerve decompression surgery has emerged as a promising intervention, yet the long-term efficacy and optimal patient selection remain unclear. This systematic review and meta-analysis evaluate the effectiveness of occipital nerve decompression in reducing pain frequency, intensity, and duration in patients with ON. A systematic search of PubMed, Embase, and Scopus was conducted following PRISMA guidelines. Studies evaluating greater occipital nerve (GON) or lesser occipital nerve (LON) decompression for ON were included. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the Joanna Briggs Institute (JBI) checklist for case series and observational studies. A random-effects meta-analysis estimated pooled effects on pain reduction, and heterogeneity was analyzed using I² statistics. Twelve studies comprising 838 patients were included. Meta-analysis demonstrated a significant reduction in pain frequency by 20.30 days/month (95% CI: 16.53-24.08, P<0.0001) following nerve decompression. Subgroup analysis revealed superior outcomes for post-traumatic ON, while chronic migraine-related ON showed more variability. Technique modifications, such as midline versus separate incisions for LON decompression, influenced reoperation rates (4.4% versus 15.2%, P<0.05). Heterogeneity was high (I²=97.21%), likely due to surgical variability and patient selection differences. Nerve decompression significantly reduces ON-related pain, though patient selection and surgical technique optimization remain crucial. Standardized protocols and prospective trials are needed to refine clinical guidelines.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078372","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":"Racial, Ethnic, and Socioeconomic Trends in Microtia and Anotia Care.","authors":"Puja Jagasia, Noah Alter, Sara Chaker, Andrea Hiller, Benjamin Savitz, Ronald Cornely, Izabela Galdyn, Matthew Pontell","doi":"10.1097/SCS.0000000000011495","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011495","url":null,"abstract":"<p><p>This study aims to investigate the effects of ethnic, racial, and socioeconomic differences on outcomes for patients undergoing surgical management for microtia or anotia in the United States. Using the Pediatric Health Information System (PHIS) database, 2928 patients presenting for primary microtia or anotia reconstruction between 2017 and 2023 were analyzed. The majority of patients were non-White (55.2%, 1617/2928), with a significant proportion identifying as Hispanic/Latino (48.5%, 1421/2928). Non-White patients were more likely to present at a later age for surgery (10.8 versus 9.4 y; P=0.036), reside in urban areas (90.4% versus 82.2%, P<0.01), and live in households with incomes below the national median (71.7% versus 69.1%; P=0.13). Similarly, Hispanic/Latino patients presented at an older age (10.7 versus 9.0 y; P<0.01), were more frequently located in urban areas (90.6% versus 82.6%; P<0.01), and more likely to live in households with incomes below the national median (79.2% versus 61.8%; P<0.01). In the United States, the majority of patients presenting for primary reconstruction of microtia or anotia are non-White and Hispanic/Latino. This suggests an increased prevalence in these populations. Non-White and Hispanic/Latino patients are more likely to live in households with incomes below the national median and are more likely to present at a later age for primary reconstructive procedures. Multidisciplinary care teams should prioritize the development and implementation of targeted outreach programs to improve timely access to care for at-risk populations.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078373","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}