Journal of Craniofacial Surgery最新文献

{"title":"Are Submental Flap Reconstructions From Oncological and Reconstructive Perspective Safe? Evaluation and Review of Ipsilateral and Contralateral Submental Flap Reconstructions.","authors":"Richard Pink, Petr Heinz, Srinivasa R Chandra, Michal Mozola, Jaroslav Michalek, Jana Zapletalova, Zdenek Dvorak","doi":"10.1097/SCS.0000000000011240","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011240","url":null,"abstract":"<p><p>This study compared the risk of nodal metastasis progression in the submandibular area when using submental flap contralateral (SFC) or submental flap ipsilateral (SFI) relative to the tumor side. Thirty patients underwent treatment for squamous cell carcinoma of the oral cavity. Submental flap ipsilateral and SFC were used in 14 and 16 patients, respectively. After unilateral supraomohyoid neck dissection (levels I-III), the SFC group showed a significantly higher total number of positive lymph nodes removed (P = 0.014). In addition, the number of positive lymph nodes in the IB region was significantly higher in the SFC group compared with the SFI group (P = 0.001). Tumour relapse was the same in both groups (SFI: n = 4/SFC: n = 4). The authors' results suggest that SFC can be adequately used to reconstruct oral cavity defects because, after rerouting, the rotation arc reaches the upper incisors and covers the arc of SFI rotation in the oral cavity. Moreover, with SFC, a complete neck block dissection and more radical tumor resection can be achieved without limitations.</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":"143752995","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":"Bony Bridge Evaluation Following Alveolar Bone Grafting by Hounsfield Unit Visualization.","authors":"Sayuri Uehara, Tomoko Sugiyama-Tamura, Yasuyuki Fujii, Hayato Hamada, Chiaki Niho, Tadahide Noguchi, Yoshiyuki Mori, Daichi Chikazu","doi":"10.1097/SCS.0000000000011307","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011307","url":null,"abstract":"<p><p>Although alveolar bone grafting (ABG) is the standard treatment for cleft lip and palate with alveolar clefts, no studies have visually demonstrated the qualitative changes in grafted bones over time. In this study, the authors attempted to depict the changes in ossification of the grafted bone over time using color mapping based on differences in Hounsfield units (HUs). Alveolar bone grafting was performed in 7 cases. Computed tomography data procured ∼1 month before ABG, 1 day after surgery, and 6 months after surgery were extracted using Mimics (version 26.0)-a medical image analysis software. The difference in the HU values was visualized through color mapping in the axial, coronal, and sagittal planes, and changes in the HU values of the grafted bone over time and structure were observed. The HU values were high in all areas immediately after surgery; however, 6 months after surgery, cortical bone-like structures with high HU values were observed around the grafted bone, regardless of the presence of dynamic teeth changes. Moreover, the HU values were evidently high in areas where tooth movement was observed. Changes in the HU values over time can contribute to quantitative suggestions regarding the filling volume and filling pressure in ABG techniques and aid in determining the optimal orthodontic force most conducive to tooth movement during orthodontic treatment. Hence, this technique is expected to be valuable for both research and clinical practice.</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":"143752321","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 Management of Severe Bilateral Carotid Artery Stenosis With Combined Carotid Endarterectomy and Stenting: Implications for Craniofacial and Cerebrovascular Health.","authors":"Shuo Sun, Ya-Tong Wang, Xiao-Song Shan, He Yang, Yu Zhao, Chun-Hui Li, Xiao-Guang Tong","doi":"10.1097/SCS.0000000000011303","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011303","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the clinical outcomes of a combined surgical approach involving carotid endarterectomy (CEA) and carotid artery stenting (CAS) for the management of patients with severe bilateral carotid atherosclerotic stenosis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 19 patients diagnosed with severe bilateral carotid artery stenosis who were hospitalized between June 2019 and January 2022. The efficacy of the combined CEA and CAS approach was analyzed.</p><p><strong>Results: </strong>Postoperative imaging confirmed complete resolution of stenosis, restored lumen patency, and substantial improvement in intracranial hypoperfusion across 38 stenotic sites in the 19 patients. No serious complications were observed during the perioperative period. At the 3-month follow-up, none of the patients experienced cerebrovascular events, and symptoms of preoperative cerebral ischemia revealed varying degrees of improvement. The modified Rankin Scale (mRS) score was ≤2 in all patients, with a mean score of 1.52±0.18. Over a follow-up period extending up to 48 months, no recurrence of stroke or severe complications was reported.</p><p><strong>Conclusion: </strong>The choice of surgical intervention for patients with severe bilateral carotid artery stenosis should be tailored to the clinical profile of each patient. The combined approach of CEA and CAS integrates the advantages of both techniques, reduces the risk of postoperative complications, and enhances the range of therapeutic options available for this population.</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":"143752899","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 Abnormal Characteristics of Alveolar Sounds in Postoperative Palatoplasty Patients and Rehabilitation Methods.","authors":"Qing Zhang, Susu Zhang, Duolikun Wupuer, Hui Xu, Tianyi Zhou, Fei Wang, Zhiheng Xu, Jun Li, Haiyan Zhou","doi":"10.1097/SCS.0000000000011349","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011349","url":null,"abstract":"<p><p>The aim of this study was to analyze and compare the error types of alveolar sounds /s/, /ts'/, and /ts/ (ie, fricative and affricate sounds) in different ethnic groups (Han, Uyghur, Kazakh) after palatoplasty. The goal was to provide a basis for clinical assessment and effective intervention. A total of 68 patients who had undergone palatoplasty in our hospital's maxillofacial surgery department were retrospectively selected; all presented with alveolar sound abnormalities. These patients were divided into 3 age groups: 3.5 to 6 years, 7 to 13 years, and 14 years and above. Among them were 39 Han, 18 Uyghur, and 11 Kazakh patients. All had a good velopharyngeal function, normal speech organs, and occlusion, and no hearing or cognitive impairments (ie, no cognition disorders). Assessment employed the Chinese Standard Mandarin speech intelligibility scale, an alveolar sound (/s/, /ts'/, /ts/) clarity scale, the PRAAT speech workstation, and a soundproof booth equipped with a professional noise-shielding sound card and microphone. Three experienced speech therapists independently evaluated error rates and error types for each alveolar sound (/s/, /ts'/, /ts/) by different ethnic groups and ages, and they also recorded intervention duration. Error articulation patterns included omission (deletion), weakening, and various compensatory articulations. The highest error rate was found in /ts/, predominantly omission (67.65%, 46/68). Next, /s/ showed mainly omission and lateralization errors, whereas /ts'/ was primarily characterized by weakening. There was no significant difference (P>0.05) in the incidence of alveolar sound articulation errors among different ethnic groups. Spectrogram analysis objectively confirmed whether the error type involved omission, weakening, or substitution. During treatment, three types of visual biofeedback were used as intervention methods, achieving favorable therapeutic outcomes. All patients were treated for 4 to 6 weeks, resulting in complete recovery in 63 cases and improvement in 5 cases; 0 cases showed no improvement. Among postoperative palatoplasty patients with good velopharyngeal function, alveolar affricates (/ts/) show the highest error rates in both Han and ethnic minority patients. Providing targeted foundational training before inducing the target sound and utilizing three visual biofeedback interventions in rotation yields optimal results. The third biofeedback approach showed particularly high acceptance among patients, making it especially suitable for remote therapy.</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":"143753019","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 Giant Secondary Orbital Melanoma.","authors":"Suhui Zhu, Rongjin Deng, Banghui Lai, Kaiming Gu, Xiaohu Chen, Yan Dai","doi":"10.1097/SCS.0000000000011243","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011243","url":null,"abstract":"<p><p>Secondary orbital melanomas are a kind of malignant pigmented tumors that can come from a variety of sources. The most common initial tumor is choroidal melanoma, which typically spreads to the orbit through the scleral channel, although it can also migrate through the optic nerve in rare cases. Its pathologic kind primarily consists of highly invasive and metastatic epithelial cells. According to recent research, surgery is the primary treatment. The most often recommended course of action is enucleation of orbital contents while maintaining eyelid integrity, typically paired with chemotherapy and radiation therapy. The authors report a rare case of massive orbital melanoma after primary choroidal melanoma in this article.</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":"143753011","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":"Craniofacial Langerhans Cell Histiocytosis Successfully Treated Through Intralesional Injection of Triamcinolone Acetonide: A Retrospective Study.","authors":"Jiahao Li, Hasnaa Alaoui, Huanzi Lu, Dikan Wang, Yujie Liang","doi":"10.1097/SCS.0000000000011300","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011300","url":null,"abstract":"<p><p>Treatment options for single-system Langerhans cell histiocytosis (LCH) range from observation to chemotherapy. Among these options, corticosteroid injection is appealing due to the feasibility, preservation of structure and function as well as the low complication rate. Therefore, this study aimed to investigate the effectiveness of intralesional injection of triamcinolone acetonide (TA) for the treatment of craniofacial LCH and present a typical case. 11 patients diagnosed with LCH of the jaws who received intralesional injection of TA at Hospital of Stomatology, Sun Yat-sen University from April 2014 to May 2021 were involved. Clinicopathologic data were collected and analyzed. The 11 subjects included 7 males and 4 females (mean age 14.6±16.9 y). Most lesions were located in the mandible (n=9, 81.8%). The effective rate of intralesional injection of TA was 90.9%. The average initial dosage and average accumulative dosage were 33.2±21.0 and 99.5±88.7 mg, respectively. The mean time needed for complete ossification of the lesion was 12.5±8.2 months. The mean follow-up time was 20±13.4 months. Although the effective rate was similar between children and adults (100% versus 75%, P=0.364), the initial dosage, accumulative dosage, number of injections, and time needed for complete ossification of the lesion were all lower in children (P<0.05). In conclusion, intralesional injection of TA is a suitable treatment option for craniofacial LCH, especially in children. Studies that incorporate a larger patient cohort should be conducted to verify the current findings.</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":"143752479","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 Effect on Stability Using Max VPC Screw Versus Lag Screw in the Treatment of Mandibular Symphysis Fractures (A Pilot Study).","authors":"Sherif Hamed, Mohamed G Beheiri, Mohamed Khashaba","doi":"10.1097/SCS.0000000000011211","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011211","url":null,"abstract":"<p><p>This study was conducted to assess the hardware installation time, stability of occlusion, and interfragmentary stability following osteosynthesis using MAX VPC screw. A total of 10 patients with symphyseal fractures were included in this study; they were divided into 2 groups of 5; the patients were assessed by Multislice CT scans. The study group received treatment with 2 MAX VPC screws, and the control group received treatment with 2 lag screws. The outcomes that were studied were hardware installation time, stability of occlusion, interfragmentary stability, and pain. The study was conducted on 10 patients, all cases went uneventful, the only significant difference was found in the hardware installation time favoring the study group. In all the other parameters (stability of occlusion, interfragmentary stability, and pain) no statistical difference was recorded. Treatment of symphyseal mandibular fractures with MAX VPC headless compression screws is a valid treatment modality that is comparable to other treatment modalities and presented a faster method of treatment.</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":"143752908","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":"Craniofacial Injuries in Mixed Martial Arts: An Analysis of Incidence, Risk Factors, and Prevention Strategies.","authors":"Ekansh Parekh, Thor S Stead, Jasra Elahi, Latha Ganti","doi":"10.1097/SCS.0000000000011330","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011330","url":null,"abstract":"<p><strong>Objective: </strong>The rising popularity of martial arts has unfortunately led to a surge in injuries, particularly in the head and neck. Craniofacial injuries, a common occurrence in mixed martial arts (MMA), necessitate a closer look. By studying these injuries, the authors can identify gaps in diagnosis and treatment, and more importantly, the authors can take steps to prevent future injuries. This includes advocating for increased safety measures and risk reduction through the Consumer Product Safety Commission.</p><p><strong>Methods: </strong>The National Electronic Injury Surveillance System database was analyzed from 2014 to 2023 to collect data on head and neck injuries related to martial arts equipment within the last 10 years. This data set conveys patient information, such as sex, race, weight, age, diagnosis, treatment date, body part, disposition, and injury location, that occurred while competing in MMA.</p><p><strong>Results: </strong>Over the most recent 10 years, an estimated 54,787 cases of craniofacial injury due to MMA were reported to the emergency department, with a majority taking place in 2022 (6880 cases/12.6% of all cases). Men were 3.69 times more likely to get injured than women. The 10-year age group with the most injuries was 20 to 29 (18,182 cases/34.3%), but the age with the most cases was 15 years old (2349 cases/6.7%). The most common location of craniofacial injury was the head (22,214 cases/39.3%), and the most common diagnosis was internal injury (11,034 cases/19.5% of all cases). The overwhelming majority of cases had no hospitalization (52,023 cases/95.0% of all cases).</p><p><strong>Conclusions: </strong>This study underscores the significant occurrence of craniofacial injuries in the context of MMA over the past decade. It provides novel insights into preventative strategies, epidemiology, and disposition of these injuries. The results reveal a spectrum of damage, from low to high severity, and a predilection for adolescent and young adult males. This study advocates for stricter regulations, better protective gear, and increased awareness of safety standards to ensure the well-being of MMA athletes. Future research should focus on post-injury recovery and long-term outcomes to further mitigate risks and enhance the safety of this demanding sport.</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":"143752262","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":"Evaluating Auricular Conchal Cartilage Grafts in the Surgical Management of Pediatric Orbital Floor Fractures.","authors":"Mustafa Akyurek, Buruc Barkin Battal, Gunes Hafiz","doi":"10.1097/SCS.0000000000011310","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011310","url":null,"abstract":"<p><p>Pediatric orbital floor fractures present unique challenges due to ongoing craniofacial growth and the need for reconstructive materials that provide stability while minimizing long-term complications. This retrospective study evaluates the outcomes of auricular conchal cartilage grafts in the surgical management of pediatric blowout fractures. Pediatric patients aged 7 to 16 years who underwent orbital floor reconstruction with conchal cartilage grafts between October 2013 and September 2023 were analyzed. Clinical data, computed tomography findings, surgical details, and postoperative outcomes were reviewed. Among 31 patients diagnosed with blowout fractures, 8 underwent surgical repair using conchal cartilage grafts. The mean age of surgically treated patients was 11.8 years, with an approximate orbital defect size of 2.8 cm². The mean follow-up period was 25 months. No postoperative infections or donor site deformities were observed. In long-term follow-up, 1 patient exhibited both diplopia on inferolateral gaze and enophthalmos. The use of auricular conchal cartilage provided a structurally compatible, low-morbidity alternative to traditional graft materials. Its inherent concave shape and ease of harvest make it a viable option for pediatric orbital floor reconstruction. The findings of this study support the use of conchal cartilage as a reliable autologous graft for orbital floor repair in pediatric patients; however, further studies with larger patient cohorts and comparative analyses are required to better define its long-term outcomes and optimal indications.</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":"143752664","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 New Device for Nasal Morphology Correction in Patients With Incomplete Cleft Lip.","authors":"Shinji Kobayashi, Madoka Sugiyama","doi":"10.1097/SCS.0000000000011320","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011320","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to introduce and evaluate a new nasal correction device designed to improve nasal morphology in infants with incomplete cleft lip before surgery.</p><p><strong>Methods: </strong>This case series included 2 patients with incomplete cleft lip and alveolar cleft (1 boy and 1 girl), aged 45 and 50 days at the time of device application. The device consists of a titanium body with a stainless steel spring exerting a force of ~2.3 N. The device was customized with resin to fit the nasal mucosa and was used to lift the drooping nostril margin. Patients were monitored monthly until surgery, with nasal morphology assessed using a noncontact scanner at 3 time points. Five nasal morphology measurements were taken using the Artec EVA scanner and VX elements software.</p><p><strong>Results: </strong>No erosions or ulcers of the skin and mucous membranes around the nose were observed in either patient. Over time, the height of the affected nostril increased, eventually matching the height of the unaffected side.</p><p><strong>Conclusions: </strong>The new nasal correction device is effective in improving nasal morphology in infants with incomplete cleft lip before surgery. It offers a simple structure that can be easily handled by nonmedical personnel and is best applied as early as possible to maximize its effectiveness. The device shows potential for maintaining postsurgical nostrils and has possible applications in cosmetic medicine. Long-term outcomes should be monitored over time.</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":"143753016","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}