Journal of Craniofacial Surgery最新文献

{"title":"Preconditioning Strategies for Skin Flap Survival: Clinical Observations and Experimental Insights.","authors":"Wen-Tsao Ho","doi":"10.1097/SCS.0000000000011353","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011353","url":null,"abstract":"","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764063","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":"Gender-typing of Isolated Horizontal Facial Thirds Before and After Facial Feminization Surgery.","authors":"Jose F Palacios, Kenneth Pessino, Nicole Schiraldi, Elisa K Atamian, Nissim Hazkour, Nicholas Bastidas","doi":"10.1097/SCS.0000000000011319","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011319","url":null,"abstract":"<p><strong>Objective: </strong>Evaluation of facial feminization surgery (FFS) outcomes in the published literature has taken a panfacial perspective. However, horizontal facial thirds analysis may elucidate current deficiencies in facial feminization. In this study, the authors surveyed the general public to determine how FFS influences gender typing of the upper, middle, and lower thirds of the face.</p><p><strong>Methods: </strong>Standardized frontal and lateral images of isolated horizontal facial thirds from 1 cis-man control, 1 cis-woman control, and 8 consecutive patients before and after FFS were prepared (n = 108 images). Reviewers were asked to determine whether segment images were of a man or woman, indicate their response confidence on a scale from 0 to 10, and specify whether a particular feature influenced their answer.</p><p><strong>Results: </strong>A total of 4182 image ratings were collected from 48 survey respondents. For all 3 segments, there was a significant increase in female gender typing after FFS (P < 0.001). Male gender typing of the upper segment was significantly higher than the middle and bottom segments regardless of FFS status (P < 0.001). Confidence in female gender typing increased significantly for only the middle (P = 0.045) and bottom (P = 0.041) segments after FFS. Male gender typing of the upper segment after FFS was mostly due to the hairline (49%) or forehead (23%).</p><p><strong>Conclusions: </strong>Facial feminization surgery increases female gender typing of isolated horizontal facial thirds. However, general public surveys attribute less effective feminization of the upper third to persistent masculine hairlines. Adjuncts such as hair transplantation may further decrease male gender typing after FFS.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764136","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":"Successful Treatment of Intracranial Infection Caused by Chryseobacterium Indologenes Following Aneurysm Clipping.","authors":"Yanrui Cai, Jiamin Liu, Di Tian, Yuting Wang","doi":"10.1097/SCS.0000000000011352","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011352","url":null,"abstract":"<p><p>Chryseobacteriumindologenes (C. indologenes) is a rare but emerging pathogen causing central nervous system (CNS) infections. It poses significant treatment challenges due to its antibiotic resistance. This case report describes the successful management of an intracranial infection caused by C. indologenes after aneurysm clipping, using a multidrug regimen. A retrospective analysis of the clinical course was performed, revealing that the patient responded well to intravenous Trimethoprim-Sulfamethoxazole (TMP/SMZ), oral Sulfamethoxazole (SMZ), and minocycline, resulting in complete resolution of the infection. The microbial characteristics of the infection and the subsequent treatment strategy were reviewed. Infections caused by C. indologenes present significant treatment challenges due to antibiotic resistance. A combination of intravenous TMP/SMZ, oral SMZ, and minocycline can be an effective therapeutic approach for managing such infections.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764070","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 Retrospective Analysis of 8457 Glossectomy Cases Over 15 Years-The Boon and Bane of Radical Neck Dissection.","authors":"Leonard Knoedler, Helena Baecher, Michael Alfertshofer, Samuel Knoedler, Thomas Schaschinger, Benedikt Geldner, Ali-Farid Safi, Alexandre G Lellouch, Max Heiland, Kilian Kreutzer, Martin Kauke-Navarro, Steffen Koerdt","doi":"10.1097/SCS.0000000000011327","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011327","url":null,"abstract":"<p><strong>Background: </strong>Glossectomy is a commonly performed procedure in head and neck oncology, primarily for the treatment of squamous cell carcinoma of the tongue. Radical neck dissection (RND) is still being combined with glossectomy to manage lymph node metastases, yet its impact on postoperative outcomes in glossectomy patients remains largely underexplored.</p><p><strong>Methods: </strong>This study utilized data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to analyze 30-day postoperative outcomes in 8457 patients who underwent partial or extended glossectomy, with or without concurrent RND, between 2008 and 2022.</p><p><strong>Results: </strong>No significant differences in 30-day postoperative complications were found between partial and extended glossectomy groups (P=0.571). However, extended glossectomy with concurrent RND was associated with longer operative times (P<0.001), increased length of hospital stay (P=0.045), and higher complication rates (P=0.008). In partial glossectomy patients, concurrent RND was linked to higher 30-day mortality (P=0.022). Multivariable analysis identified smoking status, obesity, and inpatient setting as significant risk factors for postoperative complications across all subgroups.</p><p><strong>Conclusion: </strong>While the extent of glossectomy did not influence immediate postoperative outcomes, concurrent RND significantly increased complication risks in extended glossectomy patients. These findings emphasize the importance of individualized risk assessment and tailored surgical planning to enhance patient outcomes in glossectomy procedures.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764134","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":"Herpes Zoster Occurring After Injection of Botulinum Toxin and Hyaluronic Acid.","authors":"Yutong Liang, Guyu Tan, Xueshang Su, Jun Zhuang, Ziming Zhang, Ronghao Ouyang, Jintian Hu","doi":"10.1097/SCS.0000000000011239","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011239","url":null,"abstract":"<p><p>Botulinum toxin, as a common facial wrinkle removal product, can be used for facial rejuvenation or improvement of skin texture, which is a commonly used cosmetic injectable product. However, botulinum toxin may lead to decreased immune function, causing a series of subsequent complications. This case report describes a 32-year-old female patient who developed herpes zoster after receiving injections of semaglutide, botulinum toxin, and hyaluronic acid. Viral infection and decreased immune function are common triggers of herpes zoster. After injection of botulinum toxin, the local immune response may be affected, which may activate the latent varicella-zoster virus or lead to decreased immune function that causes herpes zoster.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764141","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":"Mandibular Lengthening by Distraction for Airway Obstruction in Treacher-Collins Syndrome: The 30-Year Results.","authors":"George D Dounas, Lachlan D M Farmer, Hyok J Kwon, Mark H Moore","doi":"10.1097/SCS.0000000000011255","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011255","url":null,"abstract":"<p><p>Treacher-Collins syndrome is a rare facial clefting disorder, the management of which remains among the most challenging for craniofacial teams. Herein, we report the long-term outcome of early mandibular lengthening by distraction osteogenesis for established airway obstruction in Treacher-Collins syndrome. This case, which was the first literature report in this clinical scenario1, has subsequently been reviewed at skeletal maturity2 and can now be addressed more than 30 years later.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764147","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":"Zygoma Fractures: When Should You Repair the Orbital Floor?","authors":"Jesse E Menville, Nidhi Shinde, Matthew J Lee, Luke Soliman, Albert S Woo","doi":"10.1097/SCS.0000000000011298","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011298","url":null,"abstract":"<p><strong>Background and purpose: </strong>The zygomaticomaxillary complex (ZMC) is one of the most commonly fractured areas of the midface. As the zygoma is an inherent component of the orbit, any fracture of the ZMC naturally involves the orbital floor. Previous research has focused on the surgical outcomes and complications of zygomatic fractures, but few have explored indications for orbital floor exploration alongside zygoma reduction. This study evaluates whether specific clinical and radiographic parameters predict the need for orbital floor reconstruction.</p><p><strong>Methods: </strong>A retrospective review was conducted of all patients with zygoma fractures managed by the plastic surgery service from 2015 to 2023. All patients underwent orbital floor exploration at the time of ZMC reconstruction, with implants placed when determined necessary. Computed tomography imaging was assessed for the presence of co-occurring fracture elements: zygomatic displacement at the infraorbital rim, zygomaticomaxillary buttress, zygomaticofrontal suture, and zygomaticotemporal suture; and orbital floor displacement in the anterior-posterior, inferior-superior, and transverse directions. Logistic regression models were used to assess the adjusted effects of age and sex on implant placement.</p><p><strong>Results and conclusion: </strong>Seventy-nine zygomatic fracture cases met the study criteria, with 43 receiving an implant after orbital floor exploration. For every 1 mm increase in zygomatic displacement in the anterior-posterior direction, patients had 1.30 times higher odds of receiving an orbital implant (P=0.015). Rectus rounding and orbital floor defect volume were similarly among the strongest indications for orbital floor implant placement (P<0.001).</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764149","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":"Evolution of Craniosynostosis Care at a Single Institution Over an 11-Year Period.","authors":"John B Phillips, Clay B Thames, Clarice A Swift, Haven Howell, Rebekah B Hazlewood, Katherine E Baker, Gidarell C Bryant, Alexander E Velazquez, Anna G Boydstun, Colton Fernstrum, Michael S Lebhar, John M Sullivan, Emily E Hecox, Laura S Humphries, Ian C Hoppe","doi":"10.1097/SCS.0000000000011272","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011272","url":null,"abstract":"<p><strong>Background: </strong>Surgical correction of craniosynostosis is continuously evolving. There has been a shift from total vault procedures towards minimally invasive techniques, reflecting advances in the understanding of the condition and surgical technique. This study aims to document the evolution and outcomes of craniosynostosis care over an 11-year period at one academic institution.</p><p><strong>Methods: </strong>Institutional review board approval was received. Patient demographics, operative details, and postoperative courses were collected for patients receiving surgical cranial vault correction for craniosynostosis at the authors' institution. Retrospective analysis was conducted with primary outcomes including intensive care unit (ICU) length of stay, estimated blood loss, and blood replacement volumes. χ2 tests and independent t tests determined significance (0.05).</p><p><strong>Results: </strong>One hundred sixty-eight patients met the inclusion criteria. Total vault remodeling procedures, the most common procedure from 2012 to 2017, significantly decreased in 2018 to 2023. An increase in spring-assisted cranioplasties occurred in 2018 to 2023. Frontal orbital advancement remained a popular choice throughout the examined period. Spring cranioplasties and respective protocols correlated with shorter procedure times (P=0.003), reduced ICU length of stay (P=0.004), and lower morphine equivalents given per admission (P=0.002) compared with traditional techniques.</p><p><strong>Conclusions: </strong>Craniosynostosis care has evolved considerably over the last decade. In the present study, the use of spring-assisted cranioplasty yielded benefits in reducing ICU stay and lowering morphine equivalents given. This study provides insights into how surgical care for craniosynostosis is adapting to new evidence-based studies and technologies, emphasizing the importance of continuous review and adaptation of treatment protocols.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752804","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":"Understanding the Psychological Impact of Medical Care Experiences on Adults With Craniofacial Conditions: A Pilot Survey of Traumatic Stress Symptoms and Resilience.","authors":"Madeline G McClinchie, Hailey Umbaugh, Carrie L Heike, Nicola M Stock, Alexis L Johns, Kristin Billaud Feragen, Amelia F Drake, Cassandra Aspinall, Canice E Crerand","doi":"10.1097/SCS.0000000000011299","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011299","url":null,"abstract":"<p><p>Craniofacial conditions often require extensive medical care and surgeries throughout childhood and adolescence. However, there is limited research investigating the psychological effects of craniofacial care, including risks for medical traumatic stress. This cross-sectional study investigated the medical care experiences of adults with craniofacial conditions, including the frequency of potentially traumatic medical events, post-traumatic stress disorder (PTSD) symptoms, and resilience. Participants (N=34; mean age 35.2 ± 12.2 y; 71% female) were recruited at 3 US pediatric hospitals and craniofacial support organizations. Participants completed the PTSD Checklist (PCL-5), Connor-Davidson Resilience Scale, the Craniofacial Experiences Questionnaire, and open-ended questions about their medical care experiences. Most participants reported experiencing potentially traumatic medical experiences, such as prolonged and/or painful dental (79%) and medical treatments (73%) and hospitalization in the intensive care unit (70%). On the PCL-5, 21% met the criteria for PTSD, which is similar to other medical populations and higher than the 6% rate of PTSD in the general US population. Participants reported both stressors and positive aspects related to living with a craniofacial condition; however, resilience scores were lower relative to a US community sample. Qualitative analysis of open-ended responses identified themes including interactions with providers, medical treatment experiences, and psychosocial impacts. Adults with craniofacial conditions appear to be vulnerable to post-traumatic stress symptoms related to their medical care experiences, and report reduced resilience relative to community samples. Implications for clinical care and research include the integration of trauma-informed care approaches and strategies to support coping and resilience across the lifespan.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752911","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":"Psychological Screening Indicates That 1 in 4 Children With Cleft Lip and Palate Require Psychological Support.","authors":"Marizela Kljajić, Johnna Schölin Sahlsten, Sara Rizell, Hans Mark","doi":"10.1097/SCS.0000000000011315","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011315","url":null,"abstract":"<p><p>Children with cleft lip and/or palate (CL/P) often experience developmental issues, including language delay, learning difficulties, and attention issues. The aim of the study was to assess potential difficulties in children with CL/P and to determine the necessity of ongoing psychological support. Eighty-two children treated for CL/P, 29 5-year-olds and 53 10-year-olds, participated together with their parents in the study. The Strengths and Difficulties Questionnaire (SDQ) was used to assess difficulties and strengths. Proxy reports were used for the 5-year-olds, while self-reports and proxy reports were utilized for the 10-year-olds. Patients who were identified as requiring further support were offered psychological interventions. Parents of 5-year-olds and 10-year-olds with CL/P estimated significantly more difficulties compared with parents of children in the normal population. Thirty-nine percent of the parents estimated that their child had minor, moderate or severe difficulties. However, 10-year-olds with CL/P didn't perceive any difference in difficulties compared with preadolescents in the normal population. The 10-year-olds estimated significantly less emotional difficulties than children in the normal population. Nevertheless, 41% of the 10-year-olds reported that they overall had difficulties, either minor or severe, in one or more areas. There were significantly moderate correlations between parental and child reports on SDQ. According to the results of the standardized psychological screenings, 25.6% of children with CL/P required additional psychological support. One in 4 children with CL/P needs psychological support. Standardized psychological interview-based follow-ups for patients with CL/P can contribute to more information regarding the patient's needs rather than only using a questionnaire.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752877","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}