Journal of Craniofacial Surgery最新文献

{"title":"Traumatic Ear Amputations: An Analysis of Epidemiology and Treatment Course Based on the National Trauma Data Bank.","authors":"Puja M Jagasia, Sara C Chaker, Bachar Chaya, Barite Gutama, Ronald M Cornely, Salam A Kassis, Matthew Pontell, Patrick Assi","doi":"10.1097/SCS.0000000000011201","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011201","url":null,"abstract":"<p><p>Traumatic ear amputation (TEA) affects hundreds of Americans each year. However, there is little information regarding epidemiology, risk factors, and treatment for TEA, all of which enhance a surgeon's understanding of TEA and for treatment planning. This study included data from The National Trauma Data Bank (NTDB) collected from the year 2017 to 2021. The variables analyzed included demographics, pre-existing comorbidities, mechanism of TEA, concurrent injuries, inpatient complications, reattachment details, length of stay, and discharge disposition for each subgroup. Descriptive statistics were performed using a χ2 test for categorical variables and a rank-sum test for continuous variables. From 2017 to 2021, 1322 patients in the NTDB experienced TEA. Of those, 15% (198/1322) experienced complete TEA and 85% (1124/1322) had partial TEA. Most patients were white males, ages 25 to 34 years, affected by motor vehicle accidents, and there were no significant demographic differences between the partial and complete TEA cohorts. The most frequently reported preexisting condition was alcohol use disorder. Reattachment occurred in 13.6% (180/1322) of cases with no difference in reattachment rates between partial and complete TEA. Significantly more females and patients with private insurance underwent reattachment compared with those who did not undergo reattachment. The most commonly co-occurring injury was injury to head and neck and the most common complication was acute kidney injury. This study confirmed that TEA affects primarily young males, and showed that reattachment occurs at a low rate of 13.6% (180/1322), which may be due to co-occurring injuries, microsurgeon availability, and use of other reconstructive techniques.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700580","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":"Lateral Eyebrow Lifting and Eye-Opening Point Injection With Botulinum Neurotoxin: Anatomical Perspective.","authors":"Kyu-Ho Yi, Soo-Bin Kim, Hyun-Jin Park, Hee-Jin Kim","doi":"10.1097/SCS.0000000000011112","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011112","url":null,"abstract":"<p><strong>Background: </strong>The orbicularis oculi muscle plays a critical role in eye-opening and closure. Identifying precise injection sites for botulinum neurotoxin can improve both functional and esthetic outcomes, particularly for conditions like blepharospasm or ptosis.</p><p><strong>Materials and methods: </strong>Three fresh cadavers were dissected, separating soft tissues from bones to observe the muscle layers. A 29-year-old Korean female was administered a botulinum neurotoxin injection. Before the injection, ultrasound was used to identify the lateral superior part of the orbicularis oculi muscle. The injection point, at the edge of the superolateral orbital rim, received a 1-unit intradermal injection of letibotulinum neurotoxin. Changes in eye-opening were observed 4 weeks postinjection.</p><p><strong>Results: </strong>Dissection revealed intermingling of the frontalis and orbicularis oculi muscles, with the orbicularis oculi muscle exclusively present at the edge of the superolateral orbital rim. This point was targeted for the injection, resulting in improved eye-opening and eyebrow elevation. The patient reported a GAIS score of 2, indicating noticeable improvement.</p><p><strong>Discussion: </strong>Targeting the edge of the superolateral orbital rim for botulinum neurotoxin injections effectively reduces involuntary muscle contractions, facilitating easier eye-opening and eyebrow lifting. The anatomic specificity of this site minimizes risks to surrounding muscles. These findings suggest potential clinical applications for enhancing eyelid function and esthetic outcomes. Further research with larger samples and long-term studies is recommended to validate these results and explore additional benefits.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700533","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 Yonsei Point: A Precision Approach to Gummy Smile Correction With Botulinum Neurotoxin.","authors":"Jovian Wan, Song Eun Yoon, Hugues Cartier, Sebastien Garson, Kyu-Ho Yi","doi":"10.1097/SCS.0000000000011253","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011253","url":null,"abstract":"<p><strong>Background: </strong>A gummy smile, or excessive gingival display (EGD), is a condition characterized by the visibility of more than 3 mm of gingiva during smiling. It often stems from hyperactivity of the lip elevator muscles, a treatable etiology. Botulinum neurotoxin (BoNT) offers a minimally invasive option for addressing this issue. This study introduces the Yonsei Point, a novel injection site targeting the convergence of key muscles to achieve precise and natural correction of EGD.</p><p><strong>Objective: </strong>To evaluate the effectiveness and safety of the Yonsei Point as a standardized technique for BoNT injection in the treatment of gummy smiles caused by hyperactive lip elevator muscles.</p><p><strong>Methods: </strong>Patients presenting with EGD due to hyperactive lip elevator muscles were included in this study. Exclusion criteria encompassed skeletal-based EGD, altered passive eruption, and prior BoNT treatments. The Yonsei Point was identified using anatomic landmarks: a vertical line drawn from the alar base and a lateral point 1 cm from this line, intersecting a horizontal line 3 cm above the cheilion. BoNT-A was injected bilaterally at this site (2-3 units per side) using a 30-gauge needle placed intradermally or subdermally. Post-procedural instructions included avoiding massage and strenuous activity for 4 to 6 hours.</p><p><strong>Results: </strong>A 33-year-old female with a 5-mm gingival display underwent BoNT-A injections at the Yonsei Point, receiving 3 units per side. Within 1 week, gingival display reduced to 2 mm, achieving an aesthetically pleasing smile. No complications were reported, and effects lasted ~4 months. Similar outcomes were observed in other patients treated with this technique.</p><p><strong>Conclusions: </strong>The Yonsei Point represents a precise, effective, and minimally invasive method for correcting gummy smiles caused by hyperactive lip elevator muscles. Its anatomic specificity minimizes complications while ensuring natural results. Further research is warranted to validate its utility across diverse patient populations and refine the technique for broader clinical adoption.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700565","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":"Rare Diseases Affecting the Orofacial Area in Children and Adolescents: Utilization of Noninvasive AI-Based Planning of Therapeutic Approaches.","authors":"Tatjana Dostalova, Eliášová Hana, Markéta Havlovicová, Karolína Kočandrová, Milan Macek, Adam Nocar, Petra Hliňáková","doi":"10.1097/SCS.0000000000011236","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011236","url":null,"abstract":"<p><p>Patients with rare disease-related orofacial dysmorphic features receive more suitable long-term functional and aesthetic dental reconstruction, including implant insertions. Treatments utilizing 3D planning and implementation of AI in the process enable precise and generally noninvasive multidisciplinary therapy. This therapeutic strategy is more cost-effective and markedly improves patient adherence and, thus, the overall therapeutic outcomes. Moreover, the AI-based approach to 3D imaging processing represents a modern extension of complex therapy of rare disease-related orofacial abnormalities, which are highly heterogeneous and often patient-specific. In this regard, school-age children and adolescents could start living much fuller lives comparable to their healthy peers. The patient with the Ellis-van Creveld syndrome (EvC; MIM #225500, ORPHA:289) in the form of a case report demonstrates respective treatment strategies during their long-term therapy.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700470","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":"Assessing AI Accuracy in Generating CPT Codes From Surgical Operative Notes.","authors":"Emily L Isch, Judith Monzy, Bhavana Thota, Sydney Somers, D Mitchell Self, E J Caterson","doi":"10.1097/SCS.0000000000011258","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011258","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate and efficient medical coding is essential for proper reimbursement and health care management. Current Procedural Terminology (CPT) codes, derived from operative notes, standardize medical billing but are often prone to variability and errors due to the complexity of surgical procedures. With advancements in artificial intelligence (AI), tools like ChatGPT and other large language models (LLMs) are being explored for their potential to automate coding tasks. This study evaluates the ability of LLMs to generate accurate CPT codes for craniofacial surgical procedures based on operative notes.</p><p><strong>Methods: </strong>Operative notes for 10 craniofacial surgical cases were collected from a single surgeon at Nemours Children's Health. The notes were provided to AI tools (ChatGPT 4.0 and Gemini) to generate corresponding CPT codes. These AI-generated codes were compared against manually coded results by expert reviewers. Responses were evaluated for accuracy against manually generated CPT codes and classified as correct, partially correct, or incorrect.</p><p><strong>Results: </strong>ChatGPT and Gemini demonstrated similar performance in generating CPT codes, with no statistically significant differences in accuracy or correctness between the models (P > 0.999). Gemini produced a slightly higher proportion of correct responses (30% versus 20%), whereas ChatGPT had more partially correct responses (50% versus 40%).</p><p><strong>Conclusions: </strong>This study demonstrates that AI may be a clinically valuable resource for craniofacial CPT coding, reducing administrative burden and increasing coding accuracy. Findings from this research could inform the integration of AI into medical billing practices, promoting efficiency in surgical specialties. Future research will explore generalizability to other surgical domains and refinement of AI models for coding tasks.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700540","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 Face and Body Shape of the Idealized Pin-Up Girls During World War II.","authors":"Kun Hwang","doi":"10.1097/SCS.0000000000011257","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011257","url":null,"abstract":"<p><p>The objective of this study is to explore the representations of body and face in the pin-up girl imagery of nose art, as desired by World War II soldiers. Faces and body shapes of famous pin-up Hollywood stars were analyzed: Betty Grable, Rita Hayworth, Jane Russell, Marilyn Monroe, Veronica Lake, Lauren Bacall, Mae West, Jean Harlow, Lana Turner, Hedy Lamarr, Dorothy Lamour, Vivian Austin, and Bettie Page. The common traits of nose art pin-up girls were designed to project an idealized version of feminine beauty, emphasizing physical allure-particularly in terms of body lines and facial features-while maintaining a playful and suggestive demeanor. Their attractive faces, curvaceous figures, and flirtatious poses blended Hollywood glamour with fantasy, serving as a morale boost and a symbol of hope or longing for soldiers far from home. The average birth year of the abovementioned 13 classic Hollywood pin-up stars was 1917.15±8.48, and their death year was 1917.15±8.48. Their mean lifespan was 70.08±21.33 years. The mean heights and weights of these stars were 163.23±7.11 cm and 53.54±4.82 kg, respectively. Their mean BMI was 19.98±1.16 kg/m2. Their estimated mean bust, waist, and hip sizes were 35.69±1.38 cm, 23.85±0.80 cm, and 35.54±0.97 cm, respectively. Their estimated mean chest-waist ratio and waist-hip ratio were 1.50±0.07 and 0.67±0.02, respectively. By examining these, plastic surgeons might shift away from contemporary standards toward those of the \"Golden Age\" (1930s-1950s); characterized by voluptuous, hourglass figures emphasizing bust and hips. This approach could lead to surgical results \"glamour, romance, and excitement\" prevalent in popular culture.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700558","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":"A Study of 3D Printing Technology in the Fabrication and Clinical Application of Titanium Mesh Shaping Molds for Cranial Bone Repairs.","authors":"Cui Zhang, Zhengbo Yuan, Zefu Li","doi":"10.1097/SCS.0000000000011268","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011268","url":null,"abstract":"<p><strong>Objective: </strong>Explore a clinical-led approach that applies digital 3-dimensional (3D) reconstruction technology to titanium mesh design and production to achieve more cost-effective and personalized skull repair goals.</p><p><strong>Materials and methods: </strong>To develop a clinician-led titanium mesh fabrication method, which is achieved by digitally 3D reconstructing the patient's own medical imaging data and designing a personalized mold for cranial defects, physically constructing the mold using 3D printing technology, and ultimately shaping the titanium mesh according to the patient's personalized mold by an experienced clinician. A total of 60 cases of adult patients with cranial defects who met the inclusion criteria of this study and were seen in the Department of Neurosurgery from January 2022 to January 2024 were collected for retrospective analysis.</p><p><strong>Results: </strong>A total of 30 cases of cranial defect molds and personalized repair titanium mesh were made by 3D printing technology. All the molds and personalized repair titanium mesh were successfully produced, and all the titanium mesh matched with the molds, and the time consumed for the production of titanium mesh in group A was less than that in group B, with a statistically significant difference (P<0.001), and the cost of production of titanium mesh in group A was more economically advantageous than that in group B (P=0.002).</p><p><strong>Conclusion: </strong>The approach of titanium mesh designed and fabricated autonomously by clinicians in conjunction with 3D printing technology is less time-consuming, more economical, and highly personalized.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700460","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":"Individualized Therapy for Arteriovenous Malformations in Soft Tissues: A Single-Center Retrospective Study and Discussion of Treatment Strategy.","authors":"Qian Wang, Lei Cui, Ming-Li Zou, Yong Chen, Hai-Yan Zhong, Si-Ming Yuan","doi":"10.1097/SCS.0000000000011249","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011249","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Arteriovenous malformations (AVMs) in soft tissues are uncommon congenital vascular malformations, which are challenging to treat due to the high flow, risk of uncontrollable bleeding, and infiltrative growth. Surgical resection and interventional embolization are the main treatment for AVMs. The authors aim to summarize an individualized treatment strategy for treating AVMs in soft tissues to achieve the optimal outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The medical records of patients with soft tissue AVMs who were treated in our center from January of 2006 to December of 2023 were reviewed retrospectively. Treatment included surgical resection, interventional embolization, combinational therapy, bleomycin A5 injection, and copper wire retention. The treatment option for each patient was based on the Schobinger classification, the location, depth, and size of the lesion. The patients were followed up for 3 months to 5 years. The indications, precautions, complications, and outcomes of above treatment were analyzed, and the treatment strategy was hence summarized.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 68 patients were included in the study, including 37 male patients and 31 female patients with a mean age of 24.7 years (range: 3-62). Patients were followed up for 3 months to 5 years. Nine Schobinger stage I, 43 stage II, 14 stage III, and 2 stage IV case were included. Lesions consisted of 5 Yakes type I, 33 type II, 11 type III, and 16 type IV. Three patients could not be identified with Yakes classification due to lack of arteriographic data. Surgery alone was performed in 35 cases, including simple surgical resection with primary closure/local flap transfer (n=18), surgical resection with expanded flap reconstruction (n=7), and surgical resection followed by skin grafting (n=10). Interventional embolization alone was performed in 11 cases, including 7 cases through an intra-arterial approach and 4 cases through a direct puncture of the nidus. Ten cases underwent combinational treatment which consisted of a preoperative embolization and a subsequent surgery within 48 hours. Five cases underwent bleomycin A5 injection and 7 cases underwent copper wire retention therapy. Control (42, 61.8%) and improvement (13, 19.1%) was achieved in 68 patients (55, 80.9%). During the follow-up, 6 patients reported recurrence and received another surgery. Complications of surgical treatment included partial flap necrosis (n=5) and incision dehiscence (n=3) which healed after dress changing. No skin necrosis or ectopic embolism occurred after embolization. Sixty-six patients were very satisfied with the appearance and 2 patients were basically satisfied with the appearance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The individualized therapy considering Schobinger classification, site, depth, and size of AVMs can achieve satisfactory results. Surgery and embolization are still the mainstay treatment methods for arteriov","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700543","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":"Analysis of the Morphology of Female Characters of \"The Illustrated Night Parade of a Hundred Demons\" ().","authors":"Kun Hwang","doi":"10.1097/SCS.0000000000011256","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011256","url":null,"abstract":"<p><p>The aim of this study is to analyze the depiction of female characters in the book \"The Illustrated Night Parade of a Hundred Demons.\" Ten female characters were analyzed: Yamauba, Jorōgumo, Ubume, Takaonna, Kurozuka, Rokurokubi, Yuki-onna, Ikiryō, Yūrei, and Nure-onna. Morphology, origins, cultural significance, fates, and the correlations between morphology and redemption were analyzed. All 10 yokai are depicted as female figures, reflecting significant themes of femininity such as seduction, power, maternal instincts, and emotional turmoil. This portrayal underscores the cultural anxieties and fears associated with women in society. Among 10, 5 were characterized as beautiful, while the other 5 presented a more fearsome or ugly appearance. Among 10, 4 were sometimes redeemed, while 6 were not. This indicates a clear division between those who can achieve redemption through actions or love and those who continue to be perceived as fearsome or remain unresolved in their fates. Beauty is frequently linked to the notion of redemption, whereas fearsome or ambiguous entities tend to represent danger or uncertain outcomes. This dynamic highlights the cultural narratives surrounding femininity, morality, and societal perceptions in yokai folklore. Beauty is often portrayed as a conduit to positive outcomes, typically through expressions of love or nurturing qualities. Conversely, characters with more intimidating or eerie appearances are less likely to experience redemption. Their fearsome traits frequently mirror societal fears about powerful or deceptive women, thereby reinforcing their negative destinies. Therefore, plastic surgeons, by enhancing a patient's physical appearance, can be regarded as creators of virtue and value.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700462","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":"Total Approach to Postoperative Fistula After Head and Neck Reconstruction.","authors":"Satoshi Onoda, Ryohei Katsuragi, Kohta Kobayashi, Kahori Tsukura, Toshihiko Satake","doi":"10.1097/SCS.0000000000011260","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011260","url":null,"abstract":"<p><p>Head and neck reconstructive surgery is a complex and lengthy procedure that carries a high postoperative complication risk. At our institution, the authors have successfully minimized fistula formation incidence following immediate reconstructive surgery after tumor resection by accurately assessing the post-tumor resection status and taking appropriate measures. The authors describe the approach of our institution to prevent fistulas during reconstruction and our response when fistulas occur. Using our theory, the authors investigated the presence of wound infection and fistula formation in 30 consecutive patients who underwent reconstructive surgery after head and neck cancer resection, as well as those who underwent a successful flap transfer. The cases with different reconstruction sites by tumor resection were the tongue in 11, mandible in 11, maxilla in 3, hypopharynx to cervical esophagus in 3, buccal mucosa in 1, and skull base in 1. Postoperatively, partial necrosis and infection of the flap occurred in 1 patient, whereby a pectoralis major myocutaneous flap was used. Two patients had minor wound infections that resolved with conservative treatment. No obvious gastrointestinal fistulas were observed. Head and neck reconstruction involves various critical components, including precise major surgical procedure performance like flap harvesting, flap suturing, and microsurgery. Although this is a complex and difficult surgery, by referring to the information in this report, we can minimize complication occurrence, including postoperative fistula formation, and perform reconstructive surgery with high safety.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700575","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}