Journal of Craniofacial Surgery最新文献

{"title":"Therapeutic Strategies for Retention of Cranioplasty Titanium Mesh After Mesh Exposure.","authors":"Ming Zhou, Liang Li, Hua Sun, Ning Wang, Dan Wu","doi":"10.1097/SCS.0000000000011424","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011424","url":null,"abstract":"<p><strong>Objective: </strong>This study seeks to explore the efficacy of utilizing dermal skin pieces as a potential alternative to mesh removal in cases of titanium mesh exposure after cranioplasty, with the goal of preserving the benefits of the rigid prosthesis.</p><p><strong>Methods: </strong>This retrospective study analyzed patients who underwent treatment at the Department of Burns and Wound Repair Surgery of Zibo Central Hospital between January 2018 and November 2022 with the intention of preserving the titanium mesh. The treatment protocol involved initial wound bed management, including debridement of necrotic tissue and eradication of bacteria, followed by the augmentation of dermal thickness using a dermal pad to maintain the integrity of the titanium mesh.</p><p><strong>Results: </strong>Eight patients, consisting of 6 males and 2 females with a mean age of 47.5 ± 17.5 years (range, 30-65), were included in the study. The exposed area of the mesh varied from 0.3 × 1 to 2 × 3.0 cm, with the thinning scalp area around the exposed titanium mesh ranging from 1.6 × 1.8 to 2 × 2.5 cm. The hospital stay duration ranged from 21 to 40 days, with all 8 patients achieving primary wound healing. No signs of recurrence were observed during the 6 to 18 months of follow-up, and cranial CT scans showed no abnormalities.</p><p><strong>Conclusions: </strong>In conclusion, the utilization of dermal skin grafts to cover exposed titanium mesh after cranioplasty may facilitate the preservation of the titanium mesh.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248157","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":"Reverse Redraping Technique for Medial Epicanthal Fold Creation in Patients With No History of Epicanthoplasty.","authors":"Dongkyung Seo, Seung Hyun Sohng, Seung Wook Song","doi":"10.1097/SCS.0000000000011526","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011526","url":null,"abstract":"<p><p>The medial epicanthal fold plays a crucial role in the esthetics of the periorbital region, particularly in East Asian populations. While medial epicanthoplasty is commonly performed to modify or eliminate this fold, some patients without prior surgery may seek its creation for cosmetic enhancement. Although various techniques exist for reconstructing the epicanthal fold in revision cases, there is limited literature on fold creation in surgery-naïve patients. This study evaluates the application of the reverse redraping technique for primary medial epicanthal fold creation. Five patients underwent medial epicanthal fold creation using this technique, and their preoperative and postoperative interepicanthal distances (IEDs) and medial canthal contours were analyzed. The IED increased successfully in all patients, with a mean change from 32 mm preoperatively to 35.8 mm postoperatively. The technique effectively covered the exposed caruncle and softened the medial canthal angle, contributing to a more balanced and natural appearance. No major complications, such as ectropion, entropion, or functional disturbances, were observed. By preserving the natural anatomy and minimizing tissue disruption, the reverse redraping technique offers a predictable and effective method for medial epicanthal fold creation in surgery-naïve patients. This technique may provide a suitable option for those seeking subtle but controlled modifications to the medial canthal region. Further studies with larger sample sizes and longer follow-up periods are needed to confirm the long-term stability and esthetic benefits of this approach.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234217","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":"Case Report: A Complex Multidisciplinary Surgical Approach for a Pediatric Patient With Congenital Meningoencephalocele.","authors":"Zhifeng Li, Xiaojun Tang, Jidi Fu, Dongchao Pan, Tong Wang, Zhiyong Zhang","doi":"10.1097/SCS.0000000000011534","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011534","url":null,"abstract":"<p><p>Congenital meningoencephalocele is a rare condition where brain tissue and meninges protrude through a skull defect, often requiring complex surgical management. The authors report the case of a 14-year-old female with a frontoethmoidal meningoencephalocele, presenting with a progressively enlarging nasal mass since birth. Preoperative imaging revealed significant cranial base defects and brain herniation. A multidisciplinary team, including plastic surgery, neurosurgery, and otolaryngology, decided on a combined intracranial and extracranial approach. The surgery involved resection of the encephalocele, dura repair, and reconstruction of the cranial base using autologous bone grafts. Endoscopic techniques were used to create a drainage channel to manage the large bony cavity. Prophylactic cerebrospinal fluid (CSF) drainage was used to prevent CSF leakage. Postoperative recovery was uneventful, with no signs of infection or CSF leakage. Follow-up imaging showed proper cranial repair, and the patient had excellent functional and aesthetic outcomes. This case highlights the value of a multidisciplinary approach and advanced surgical techniques in managing rare and complex craniofacial anomalies.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234299","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":"Surgical Outcomes of Craniofacial Fibrous Dysplasia in the Pediatric Patient.","authors":"Jainaha Srikumar, Alexandre Meira Pazelli, Greg Griepentrog, Samir Mardini, Uldis Bite, Waleed Gibreel","doi":"10.1097/SCS.0000000000011483","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011483","url":null,"abstract":"<p><p>Surgical treatment and outcomes of fibrous dysplasia (FD) in pediatric patients are areas that have not been fully studied. The authors completed a retrospective review of 20 patients who had at least one surgery for craniofacial fibrous dysplasia before 18 years of age. Surgeries were categorized into 3 groups: bone contouring only; removal of the involved bone, contouring, and replacement of the contoured bone; or en bloc resection of the involved bone and reconstruction with an alloplastic material, bone allograft, or bone autograft obtained from non-involved sites. A total of 36 distinct surgical procedures were performed in 20 patients, with a mean number of 1.9 surgeries/patient (range 1-5). The maxilla was both the bone that was most commonly affected and most commonly operated on. The most common surgical indication was visible or palpable growth in 63.9% of cases. Bone contouring only was the initial surgery in 15 patients, of whom 9 patients (55.6%) had continued bone growth requiring subsequent surgeries. Removal, contouring, and replacement wasthe initial surgery in 1 patient, who required a secondary surgery. Four patients, all with monostotic calvarial disease, initially had an en bloc resection and reconstruction; none had recurrence. Patients with subsequent surgeries had a mean time to operation of 3.7 years (range 0.24-9.8). The recurrence rate and need for secondary surgical procedures were relatively high in patients who had bone contouring only. These patients tended to be patients with facial bone involvement more than calvarial involvement.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234219","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":"Management of Traumatic Anterior Skull Base Fractures and Cerebrospinal Fluid Fistulas.","authors":"Koray Keskin, Osman Bahadir, Uğur Yazar, Selçuk Arslan, Efnan A Fazli, Muhammed E Göktepe","doi":"10.1097/SCS.0000000000011546","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011546","url":null,"abstract":"<p><strong>Objectives: </strong>Blunt trauma and falls from heights are the primary causes of skull base fractures, which comprise ∼20% of all skull fractures. One-third of these fractures lead to a cerebrospinal fluid (CSF) fistula, typically managed conservatively and without surgery.</p><p><strong>Aims: </strong>The authors analyzed the factors affecting the formation and closure time of CSF fistulas.</p><p><strong>Methods: </strong>The authors followed up 31 patients with traumatic anterior skull base fractures (ASBF) between November 15, 2020 and October 10, 2023. The clinical characteristics, tomography data, and occurrence of CSF fistulas were documented in these patients.</p><p><strong>Results: </strong>Motor vehicle accidents were the primary cause of admission for most of the 31 patients with anterior skull base fractures (ASBF) (71%, n=26). Rhinorrhea was observed in 9 patients (29.0%). ASBF were most commonly seen in compartment I, representing the frontal sinus region, in 24 patients (77.4%), followed by compartment III, representing the sphenoid sinus region, in 22 patients (71.0%), and compartment II, representing the fovea ethmoidalis and cribriform plate region, in 21 patients (67.7%). Although conditions such as skull base fracture displacement and the presence of pneumocephalus were numerically higher in the patient group with rhinorrhea, they were not statistically significant. In addition, the contribution of acetazolamide use and high body mass index values ​​to the development of rhinorrhea in traumatic anterior skull base fractures was not statistically significant.</p><p><strong>Conclusion: </strong>Traumatic ASBF are complicated due to conditions such as CSF fistula, intracranial hemorrhage, and meningitis, and should be managed with a multidisciplinary approach. Traumatic anterior skull base fractures occur more frequently in compartment 1. Numerous factors may influence the formation and duration of posttraumatic CSF fistula, and these factors should be assessed in larger patient series.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234214","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 Evolution of Research on Orbital Floor Fractures: A Bibliometric Analysis.","authors":"Savannah C Braud, Tanya Boghosian, Yousif F Jubouri, Rawan ElAbd, Marwan Sheckley, Sinan K Jabori, Seth R Thaller","doi":"10.1097/SCS.0000000000011198","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011198","url":null,"abstract":"<p><strong>Objective: </strong>Orbital floor fractures present complex functional and aesthetic challenges for surgeons. A review of the most influential literature in this area can help clinicians gain a deeper understanding of current research trends and inform evidence-based treatment strategies.</p><p><strong>Methods: </strong>The Clarivate Web of Science database was used to identify the 50 most-cited articles on orbital fractures. A bibliometric analysis was conducted to assess publication metrics, including authorship, year of publication, level of evidence classification, and country of origin, as well as to identify emerging research topics.</p><p><strong>Results: </strong>The top 50 most-cited articles, published between 1957 and 2017, accumulated a total of 5618 citations. \"Clinical Recommendations for Repair of Isolated Orbital Floor Fractures-An Evidence-based Analysis\" by Burnstine received the highest number of citations (n = 294), followed by \"Nonsurgical Management of Blow-out Fractures of Orbital Floor\" (n = 211) by Putterman and colleagues, and \"Intervention Within Days for Some Orbital Floor Fractures: The White-eyed Blowout\" (n = 200) by Jordan and colleagues. Ellis authored the highest number of studies (n = 3), and the United States led in publication output (n = 23).</p><p><strong>Conclusion: </strong>Bibliometric analysis of influential research on orbital fractures helps clinicians navigate the extensive body of literature on the subject. Furthermore, understanding key research trends enables clinicians to refine their clinical practices and stay informed about evolving research trends.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234220","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":"Feminizing Rhinoplasty in Transfeminine Patients: Complications and Outcomes in 102 Patients.","authors":"Stephanie E Rothberg, Eric Bao, Nicholas Bastidas","doi":"10.1097/SCS.0000000000011515","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011515","url":null,"abstract":"<p><strong>Background: </strong>Transfeminine patients have anatomically male noses, although most surgeons perform rhinoplasties on female noses.</p><p><strong>Objectives: </strong>This study reports on the outcomes of feminizing rhinoplasty in 102 transfeminine patients and the reasons for revision.</p><p><strong>Methods: </strong>A retrospective review of patient characteristics was performed for 102 transfeminine patients who received feminizing rhinoplasty from January 2021 to February 2024. Multivariate regression was used to assess the relationship between the need for revision and patient characteristics.</p><p><strong>Results: </strong>Three patients (2.9%) experienced postoperative complications. One had postoperative hemorrhage requiring an ER visit and nasal packing, 1 had scar contracture at the alar base (after alar base resection), and 1 had chondritis requiring medrol and NSAIDs. Seventeen patients (16.7%) received revision surgery, citing 22 total reasons. Dorsal hump reduction (N=8, 36.4%) and tip revision (N=8, 36.4%) were the most common reasons, followed by a wide dorsum (N=3, 13.6%). Fourteen patients had a prior rhinoplasty or septoplasty, of which 14.3% (N=2) had revisions. Twenty-three percent of Caucasians (N=9), 50% of Asians (N=2), 22% of multiracial patients (N=6), and no African American and unspecified ethnicity patients underwent revision. Dorsal hump reduction was the most common revision reason for Caucasian and Asian patients, whereas multiracial patients equally cited dorsal hump reduction and poor tip rotation. No patient characteristics were significantly associated with revision.</p><p><strong>Conclusion: </strong>Revision surgery was not significantly associated with any patient characteristics. Patients most sought revision for dorsal hump reduction and tip revision. Surgeons and patients should discuss desired outcomes to minimize revision incidence.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234302","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":"Experimental Study on New Polymer Dressings to Accelerate the Epithelialization in Wound Healing.","authors":"Cafer Yildirim, Nuray Bayar Muluk, Mustafa Yazir, İskender Yilgör, Cemal Cingi","doi":"10.1097/SCS.0000000000011549","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011549","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, the authors applied polymers to an open wound and tried to determine their contribution to its closure or healing process.</p><p><strong>Methods: </strong>Eighteen adult male Wistar albino rats weighing between 190 and 220 g were used in the experiment. The animals were randomly divided into groups (n=6): group 1, group 2, and group 3. First experimental group (polymer 1, IY-04-109 ) (n=6), second experimental group (polymer 2, IY-04-225) (n=6), third control group (meloline) (n=6). Wounds with a diameter of 0.3cm were created in the dorsal region of the animals; the polymer patches provided were fixed to the wound from both sides with 2 simple sutures.</p><p><strong>Results: </strong>IY-04-109 and IY-04-225 are similar in composition and synthesis. They should both be biocompatible. Both are polydimethyl silicon-urea copolymers. The differences are that IY-04-109 used a PDMS with a molecular weight of 3200 g/mol, and urea was 13.9%. It was determined that polymer suturing upon the wound surface provided healing with healthy mucosa before scar tissue developed. Both groups, 1 and 2, were better than the control group. Polymer IY-04-225, used in group 2 animals, accelerated the epithelialization faster.</p><p><strong>Conclusion: </strong>In IY-04-225, a PDMS with a molecular weight of 11,000 g/mol was used. The amount of urea is 9.6%. There is more PDMS in IY-04-225, and the molecular weight of the PDMS is very high. This can lead to differences in polymer surface properties, which may explain why the second group is slightly better.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of \"Prehospital Tranexamic Acid and First 24-Hour Blood Product Transfusion in Patients With Isolated Traumatic Brain Injury\" By Newman Z.C., McKinley W.I., Nordgren R.K., et al. Journal of American College of Surgeons 2025.","authors":"Winston R Owens, Larry H Hollier","doi":"10.1097/SCS.0000000000011493","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011493","url":null,"abstract":"","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234218","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":"Factors Influencing the Decision-Making Process for Mandibular Fracture Internal Fixation: A Retrospective Study.","authors":"Xuebing Wang, Ruiliu Li, Shuo Chen, Bimeng Jie, Jingang An, Yi Zhang, Yang He","doi":"10.1097/SCS.0000000000011537","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011537","url":null,"abstract":"<p><p>This retrospective cohort study aimed to identify the critical factors influencing the selection of internal fixation for mandibular fractures. A total of 669 adult patients (with 72.05% male and the average age of 35.56 ± 12.36 y) who underwent open reduction and internal fixation (ORIF) at Peking University School and Hospital of Stomatology between January 2013 and April 2024 were analyzed. The study recorded demographic characteristics, clinical features and internal fixation modes. Bivariate and multivariate logistic regression analyses were used to evaluate associations between variables. Postoperative inflammatory complications (POICs) were also assessed. Fracture complexity (P<0.001, OR=0.075, 95% CI: 0.023-0.242) and mandibular angle fracture (P=0.008, OR=0.152, 95% CI: 0.038-0.606) were significantly associated with the selection of mandibular internal fixation. The rate of POICs was 5.82%. On the basis of 11 years of clinical cases and treatment experience at a single trauma center, this study indicates that fracture complexity and site are key factors influencing the selection of internal fixation mode. For mandibular fractures of higher complexity, especially those involving the angle, a more stable fixation mode should be prioritized.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234301","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}