Journal of Craniofacial Surgery最新文献

{"title":"Human Auricles Are Not Symmetrical: A Comparative Study Using Landmark-Based and Surface-Based Software.","authors":"Yangyang Lin, Johannes G G Dobbe, Nadia Lachkar, Theo H Smit, Corstiaan C Breugem, Geert J Streekstra","doi":"10.1097/SCS.0000000000011480","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011480","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the outcome of ear reconstruction, the contralateral auricle is often used as a reference. Literature has shown that auricles are symmetric on a group level, but it is unknown if this is also true on an individual level. In this paper, the authors quantify bilateral symmetry of the auricle and hypothesize that quantifying bilateral differences on an individual level requires a technique that is more precise than conventional manual measurement methods.</p><p><strong>Methods: </strong>CT sinus scans of 42 healthy volunteers were used to determine the bilateral symmetry of the auricle using conventional manual measurement techniques and a high-precision computer-assisted surface-based technique with a high precision of measurement. Bilateral symmetry was evaluated for the following geometric auricle parameters: length, width, protrusion distance, auriculocephalic angle, inclination angle, posteroanterior and superoinferior position difference. Bilateral differences exceeding the reliability threshold, based on the precision of measurement for the manual and automated approaches, were considered true differences.</p><p><strong>Results: </strong>In both the manual and automated measurements, the authors found no statistically significant differences in bilateral auricle parameters at the group level when evaluating a group of L versus R ears. At the individual level, however, the automated algorithm established bilateral differences in auricle parameters in 74% to 100% of the cases, whereas manual measurements could only detect bilateral differences in 7% to 64% of the cases.</p><p><strong>Conclusions: </strong>The high-precision surface-based technique shows that human auricles are generally not symmetric on the individual level. Future research is needed to investigate which discrepancies are acceptable from a technical point of view and which left-right differences are considered acceptable from a cosmetic and reconstructive point of view.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109805","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":"Billing Practices in Pediatric Fronto-Orbital Advancement Surgeries: Review of a National Billing Database.","authors":"Diego A Gomez, Anna D Lee, Elliot L H Le, Christodoulos Kaoutzanis, Skyler K Palmer, Jason W Yu, Brooke French, David W Mathes, Phuong D Nguyen, David Y Khechoyan","doi":"10.1097/SCS.0000000000011368","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011368","url":null,"abstract":"<p><strong>Background: </strong>Fronto-orbital advancement (FOA) for craniosynostosis is the standard treatment for patients with anterior cranial vault differences. Despite its widespread use, national billing practices for FOA have not been described. This study analyzes billing codes from a national multicenter claims database to evaluate variations in billing for FOA, aiming to inform standardization efforts.</p><p><strong>Methods: </strong>We performed a retrospective study using PearlDiver, a national deidentified aggregate claims database covering over 100 million patients in the United States. Patients aged 0 to 16 years who had undergone FOA between 2007 and 2015 were included. CPT codes used to characterize various craniosynostosis and cranioplasty techniques, such as muscle flap, craniectomy for single or multiple suture craniosynostosis, bone flap, craniectomy, and other fronto-orbital contouring and bone graft interventions were included. Descriptive statistics were conducted using PearlDiver and Microsoft Excel.</p><p><strong>Results: </strong>A total of 2026 patients met the inclusion criteria. In addition to billing for the index FOA procedure (CPT 21175), other codes billed in order of decreasing frequency were extensive craniectomy for multiple cranial suture craniosynostosis requiring multiple osteotomies and bone autografts (44.6%), craniectomy with bifrontal bone flap (37.1%), and muscle advancement flap to the orbital bandeau (7.3%). Less frequently billed codes included extensive craniectomy for multisuture craniosynostosis not requiring bone grafts (4.5%), and forehead reconstruction with autografts (3.95%) or allografts (1.28%).</p><p><strong>Conclusions: </strong>Our study characterizes current national trends in fronto-orbital advancement billing practices. Our findings emphasize the need for standardization to ensure equitable compensation that reflects the complexity of FOA procedures.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111017","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":"Early-Onset Facial Weakness: Evaluation and Surgical Treatment of Facioscapulohumeral Muscular Disease.","authors":"Diego A Gomez, Anna D Lee, Jacob B Hammond, Skyler K Palmer, Brooke French, Jason W Yu, Phuong D Nguyen, David W Mathes, David Y Khechoyan","doi":"10.1097/SCS.0000000000011379","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011379","url":null,"abstract":"<p><p>Facioscapulohumeral muscular dystrophy (FSHD) is the third most common inherited muscular dystrophy, following Duchenne and Becker muscular dystrophy. Early-onset FSHD presents unique challenges, particularly in the context of managing early-acquired facial weakness, which significantly impacts functional and psychosocial well-being. Despite its clinical significance, the surgical outcomes of facial reanimation in this population have not been reported, and a standardized treatment protocol is lacking. This review seeks to address this gap by proposing a standardized diagnostic and management pathway for pediatric patients with early-onset FSHD presenting with facial paralysis. Our multidisciplinary diagnostic protocol includes comprehensive genetic testing, magnetic resonance imaging, and electromyography, with assessments conducted by a collaborative team comprising Pediatricians, Neurologists, Geneticists, and Ophthalmologists. We discuss surgical strategies for facial reanimation, emphasizing their critical role in preserving psychosocial health and quality of life. By consolidating current knowledge and proposing a structured approach, this review aims to serve as a reference for clinicians and surgeons, guiding improved diagnosis, management, and outcomes in early-onset FSHD.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111018","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":"Neuroendoscopy-Assisted Modified Anterior Approach for Contralateral Cervical 7 Nerve Transfer: A Cadaveric Study.","authors":"Sen Jiang, Zhengcun Yan, Xiaodong Wang, Can Tang, Xingdong Wang, Hengzhu Zhang","doi":"10.1097/SCS.0000000000011412","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011412","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate a safer and more minimally invasive method for transferring the contralateral C7 nerve in the treatment of central spastic paralysis of the upper limb, while also providing anatomic data to support this approach.</p><p><strong>Methods: </strong>Eight anatomic specimens from the head and neck were utilized: 4 dry specimens were used to measure anatomic data, whereas the other 4 fresh specimens were used to simulate the transposition of the contralateral C7 nerve for observing bilateral nerve anastomosis. Relevant anatomic landmarks and their surrounding relationships were examined using a neuroendoscope, and anatomic data were subsequently measured and analyzed.</p><p><strong>Results: </strong>The modified anterior vertebral approach, assisted by a neuroendoscope, can expose both the affected and contralateral C7 nerve roots, vertebral arteries, and the middle trunk of the brachial plexus on the contralateral side. It can also facilitate the completion of bilateral C7 nerve transfer within the affected side's longus colli muscle tunnel, with tension-free suturing achieved without the need for nerve bridging. Measurement results from dry specimens: The angle between the C7 nerve and the spine was 63.6±3.8 degrees, the horizontal distance from the vertebral artery to the midline of the spine was 2.44±0.54 cm, and the horizontal distance from the C7 horizontal vertebral artery to the midline of the spine, as measured by imaging, was 2.46±0.14 cm. The difference between the 2 measurements was not statistically significant (P>0.05). The measured nerve displacement in fresh specimens was 4.62±0.37 cm, and the length of the C7 nerve was 7.87±0.55 cm.</p><p><strong>Conclusion: </strong>The experiments confirmed that the neuroendoscopy-assisted modified anterior vertebral approach is a simple, effective, and safe method for contralateral C7 nerve transfer. This approach involves a short nerve transfer distance and does not necessitate nerve transplantation. It may serve as a safe and effective surgical method for treating central upper limb spastic paralysis. The anatomic parameters obtained in this study will aid in the implementation of this procedure.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101902","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":"Middle Cerebral Artery Duplication Linked to Bilateral Duplication of the Superior Cerebellar Arteries.","authors":"George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, George Tsakotos, Maria Piagkou","doi":"10.1097/SCS.0000000000011508","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011508","url":null,"abstract":"<p><p>Morphologic variations of the cerebral arterial circle are often recorded through imaging and cadaveric studies; however, the combinations of such variants remain rare. The current imaging report emphasizes a unique case identified through magnetic resonance angiography (MRA) of a 56-year-old male, revealing the coexistence of a (unilateral) duplication of the right middle cerebral artery (dMCA) with a (bilateral) duplication of the right and left superior cerebellar arteries (dSCA). The right dMCA (1.5 mm) originated directly from the right internal carotid artery, accompanying the typical right MCA (2.5 mm). In addition, the right and left SCA arose in duplicate patterns, with morphologic variations in origin relative to the posterior cerebral arteries. These findings contribute to the limited reports of concurrent arterial duplications within the cerebral arterial circle. Recognition of such rare variations is crucial for accurate diagnosis and surgical planning, especially in procedures involving aneurysm treatment or stroke intervention. Advanced imaging modalities like MRA and CTA remain essential in identifying these anomalies and guiding clinical decision-making.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093873","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":"Prediction of Alveolar Cleft Reconstruction Outcomes: From the Perspective of Systemic Inflammatory Status and Local Structural Characteristics.","authors":"Zhilu Zhang, Wenjun Di, Yu Wang, Tao Song, Ningbei Yin, Yongqian Wang","doi":"10.1097/SCS.0000000000011452","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011452","url":null,"abstract":"<p><strong>Introduction: </strong>To promote alveolar cleft reconstruction outcomes, it is crucial to identify the factors that may influence postoperative bone formation. Both local structural characteristics and systemic inflammatory status are closely related to bone formation, requiring comprehensive investigation. This study aimed to investigate the impact of these potential influencing factors on the bone formation percentage (BFP) of alveolar bone grafting.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted on patients who underwent alveolar bone grafting by the same surgeon between 2017 and 2023. Demographic data, preoperative blood test results, and various local structural characteristics were investigated as independent variables. The BFP was considered as a dependent variable. Correlation and multiple linear regression analyses were performed to determine the key factors influencing BFP. The ROC curve analysis was utilized to evaluate the predictive efficacy.</p><p><strong>Results: </strong>Fifty-five patients met the inclusion criteria. The mean BFP was 39.75%±19.68%. The initial bone bridge was an independent positive influencing factor of BFP, whereas the preoperative lymphocyte percentage (L%) was negative. According to ROC curve analysis, a value of L% equal to 34.9% was the optimal cutoff point for whether the BFP was >39.75%. Other parameters were nonsignificantly correlated with BFP.</p><p><strong>Conclusion: </strong>The presence of the bone bridge and a lower value of L% may indicate a better postoperative bone formation outcome. These findings can help surgeons identify patients who are more likely to achieve favorable bone grafting results based on readily available CT images and preoperative blood tests.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093874","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":"Comparative Proteomic Analysis of Engineered Cartilage on Biochemistry In Vitro and In Vivo.","authors":"Jinping Ding, Bo Chen, Wenjiang Qian","doi":"10.1097/SCS.0000000000011034","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011034","url":null,"abstract":"<p><p>To regenerate a functional engineered cartilage in vitro with favorable mechanical property remains a bottleneck problem. The mechanical properties are known mainly determined by the unique extracellular matrix structure. Because of the limited detection methods, this study applied proteomics analysis to fully elucidate protein profiles that related to the mechanical property between in vitro and in vivo engineered cartilages. Passage 1 chondrocytes were used for in vitro cartilage engineering for 4 weeks. Then the constructs were kept in culture in vitro or implanted subcutaneously into nude mice for another 6 weeks. The engineered neo-cartilages were subjected to proteomic analysis, histologic examination, quantitation of glycosaminoglycan, Young Modulus, and transmission electron microscope observation. As expected, the engineered cartilages in vivo exhibited a more mature tissue characterized by a firmer tissue texture and densely deposited matrices than the in vitro group. Proteomic analysis showed that total 387 proteins were identified from both groups with 75 and 95 proteins uniquely presented in in vivo and in vitro groups, respectively. The differentially expressed proteins could generally be classified into the categories of extracellular matrix, structural molecules, cellular process, physiological process, cell and binding proteins. Proteomic analysis of selected molecules had partially revealed the proteins associated with the mechanical properties of the engineered cartilages. This study revealed a certain of important proteins associated with the mechanical properties in the maturation of engineered cartilages using mass spectrometry along with shotgun strategy.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101900","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":"Forgivable Beauty of Helen Through the Lens of a Plastic Surgeon.","authors":"Kun Hwang","doi":"10.1097/SCS.0000000000011509","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011509","url":null,"abstract":"","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101901","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":"Unveiling the Phenotypic Spectrum of Miller Syndrome: A Systematic Review.","authors":"Victor L van Roey, Saranda Ombashi, Idilay Kaymaz, Marieke F van Dooren, Anne Goverde, Eppo B Wolvius, Irene M J Mathijssen, Sarah L Versnel","doi":"10.1097/SCS.0000000000011501","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011501","url":null,"abstract":"<p><p>Miller syndrome is an extremely rare condition in the group of facial dysostosis syndromes. These syndromes have great phenotypic overlap and variability, even within families. To facilitate the differentiation of Miller syndrome from related facial dysostosis syndromes, such as Treacher Collins and Nager syndrome, this study aims to provide an overview of the phenotypic spectrum of the syndrome. A systematic literature search of Embase, MEDLINE/PubMed, Web of Science, and CINAHL was conducted until November 2024. Case reports and case series of patients with a clinical or genetic diagnosis of Miller syndrome in all languages were included. The quality of the included reports was assessed using the Joanna Briggs Institute critical appraisal tool and the Fichas de Lectura Critica 3.0 web application. In total, 44 cases of Miller syndrome were found, with only 18.2% having genetic confirmation. Craniofacial anomalies were prominent, including midface hypoplasia (72.7%) and micrognathia (75.0%), orofacial clefts (77.3%), eyelid anomalies (70.5%), and external ear anomalies (63.6%). Limb anomalies were present in all cases, primarily involving the hands (95.5%), forearms (52.3%), and feet (90.9%). Anomalies in other extracraniofacial tracts were also reported. Despite limitations, including limited genetic confirmation and reliance on literature, this study provides valuable insights into the phenotypic spectrum of Miller syndrome. Efforts for genetic confirmation, international collaboration, and comprehensive reporting are essential to advance research and care for rare conditions like Miller syndrome. Therefore, a detailed checklist for phenotypic evaluation in Miller syndrome cases is provided in this study.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093875","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":"Innovative 3D-Printed Surgical Guide for Radiation-Free Middle Meningeal Artery Coagulation in Chronic Subdural Hematoma: A Technical Note.","authors":"Qin Wang, Bao He, Xi-Feng Fei, Lei Shi, Zhixiang Sun, Jiang Zhu","doi":"10.1097/SCS.0000000000011497","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011497","url":null,"abstract":"<p><p>This technical note describes a novel x-ray fluoroscopy-free or embolization method for middle meningeal artery (MMA) coagulation in chronic subdural hematoma (CSH) using 3D-printed surgical guides. This approach enables precise MMA targeting, reduces radiation exposure, and offers a cost-effective alternative to conventional embolization techniques, demonstrating improved accuracy in managing CSH.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093872","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}