Journal of Craniofacial Surgery最新文献

{"title":"Postoperative Orbital Morphology Observations Following Fronto-Orbital Advancement and Cranial Vault Remodeling in Patients With Unilateral Coronal Synostosis.","authors":"Songchunyuan Zhang, Cheng Fang, Dongyi Lan, Yueqing Wang, Chenbin Dong","doi":"10.1097/SCS.0000000000010493","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010493","url":null,"abstract":"<p><strong>Object: </strong>Observations of preoperative and postoperative orbital morphology following fronto-orbital advancement and cranial vault remodeling (FOA and CVR) in patients with unilateral coronal synostosis (UCS).</p><p><strong>Methods: </strong>This retrospective cohort included patients diagnosed with unilateral coronal synostosis and treated with fronto-orbital advancement and cranial vault remodeling at the Children's Hospital of Fudan University. The orbital height, orbital width, and orbital volume were obtained from head 3-dimensional computed tomography of preoperation and postoperation. The DICOM data of CT were then imported into mimics research version 21.0. The authors measured OH and OW according to the bony landmarks, then reset the parameters of the soft tissue window, and conducted a 3-dimensional reconstruction of the orbital soft tissue to get OV. The preoperative and postoperative measurements of the intact side were compared with the affected side, respectively. Statistical analysis was performed using SPSS version 25.0 (Ρ=0.05).</p><p><strong>Results: </strong>Twelve patients with UCS (5 male, 7 female) meeting criteria were included in the study. There were 4 patients with UCS on the left and 8 on the right. The average age at initial surgery was 19.50 months. Before the operation, the data of the intact side and the affected side were compared, respectively, and the difference was found to be significant in OH (Ρ=0.005) and OW (Ρ=0.005), while the OV (Ρ=0.106) was not statistically significant. After procedures of FOA and CVR, the data of the intact side and the affected side were compared, respectively, the significant difference was found in OV (Ρ=0.002), while not in OH (Ρ=0.060) or OW (Ρ=0.066).</p><p><strong>Conclusion: </strong>After undergoing the operation of FOA and CVR, the OH and OW of the ipsilateral and contralateral sides of patients with UCS were basically symmetrical, while the volume of the affected orbit was still relatively smaller.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154249","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":"Anatomic Subunit Cleft Lip Repair: New Repair Concept Based on Nostril Sill and Philtrum-White Roll Junction.","authors":"Praveen Ganesh Natarajan, Surya Rao Rao Venkata Mahipathy, Prasad Nalabothu","doi":"10.1097/SCS.0000000000010620","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010620","url":null,"abstract":"<p><p>A novel method for unilateral cleft lip repair based on lip anatomic subunits was presented in 2005 by David M. Fisher. It has about 25 landmarks with 2 arbitrary markings for the nostril. It is an important subunit when it comes to nose reconstruction. This article sheds light on the variance in nostril sill disposition among cleft lip patients. A novel marking technique based on differences in sills is presented. Furthermore, the unique anatomical structure of the philtrum-white roll junction is highlighted with a suggested modification to the subunit approximation leading to its reconstitution.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125864","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":"Application of Ultrasonic Bone Scalpel in Surgery for Masticatory Muscle Tendon-Aponeurosis Hyperplasia.","authors":"Sho Mitsugi, Manabu Habu, Izumi Yoshioka, Masaaki Sasaguri","doi":"10.1097/SCS.0000000000010557","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010557","url":null,"abstract":"<p><p>Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a disease that presents as a hard trismus due to hyperplasia of the masseter and temporalis aponeurosis. Standard surgical methods for MMTAH include masseter resection, temporalis aponeurosis, and coronoidectomy. The operation of resecting the tendon aponeurosis attached to the posterior surface of the coronoid process carries the risk of bleeding and nerve damage because it cannot be observed directly. Therefore, the authors introduce a safer method by using an ultrasonic bone scalpel for this procedure. The authors used an ultrasonic bone scalpel with a long neck blade to scrape the posterior side of the coronoid process from the bottom to the top. The authors have treated 4 cases using this technique, and in all cases, the surgical procedure was performed safely and easily. In conclusion, ultrasonic bone scalpels are effective in MMTAH surgery for removing the attachment of the stiffened temporalis muscle tendon and aponeurosis.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125865","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":"Lymphedema of the Head and Neck-Where Do We Stand and Where We Are Headed.","authors":"Ruby R Taylor, Sonia K Pandey, Taylor Smartz, Wei F Chen, Seth R Thaller","doi":"10.1097/SCS.0000000000010505","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010505","url":null,"abstract":"<p><p>Great advancements have been made in the management of lymphedema of the extremities with lymphatic surgery. However, lymphedema of other regions, including head and neck, has remained neglected. Recent discovery of lymphatic system in the brain and the communication between intracranial and paracranial lymphatic systems has drawn attention to the head and neck lymphatics. Lymphedema of the head and neck region can result from inherent abnormality of the lymphatic system (primary) or be caused by accidental or iatrogenic injury to lymphatics (secondary). The head and neck contain a large network of lymphatic tissue. They may be affected by direct tumor infiltration, surgical resection of tumors and surrounding cancer tissue, and/or radiotherapy. Proper screening and counseling of patients before facial aesthetic procedures may avoid managing the distress of lymphedema postprocedure. Progression of head and neck lymphedema (HNL) can lead to chronic inflammatory, fibrosclerotic, and fibrofatty deposition, resulting in permanent deformity and disability. Patients may experience functional impairment, including skin changes, pain, range of motion limitations, contracture, dysphagia, dysarthria, dyspnea, and trismus, all leading to reduced quality of life. Despite these known disabilities, HNL is underdiagnosed due to a lack of awareness about this entity and of tools available for measuring internal or external swelling. The authors' article comprehensively reviews the current diagnostic methods and management strategies and what lies ahead.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125886","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":"Atraumatic Release of Incarcerated Inferior Rectus Muscle in Trapdoor Fracture Can Lead to Better Functional Outcome.","authors":"Mohamed H Abdelazeem, Mohamed G Barhoma","doi":"10.1097/SCS.0000000000010569","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010569","url":null,"abstract":"<p><p>Deciding the proper surgical approach for repairing blowout fractures with entrapped soft tissue are among one of the most challenging decisions for maxillofacial surgeons. This is due to multiple factors including the type and site of fracture, time elapsed from trauma. Tranconjunctival, subciliary, and/or transantral endoscopic has been described before. The authors report here a case of a young adult, presenting with diplopia, pain, and enophthalmos after being exposed to a blunt trauma on the left side. Computed tomography (CT) scan confirmed diagnosis of left orbital floor fracture with trapped inferior rectus in a trapdoor manner. Although presentation was later than 48 hours from trauma, yet incorporating, minimally traumatic dual, transconjunctival-transantral endoscopic approach the inferior rectus muscle was preserved and regained full range of movement, after <3 months postoperatively.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125866","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":"Psychopathology in Infants, Toddlers, and Preschool Children with Nonsyndromic Clefts of the Lip and/or Palate: A Case-Control Study.","authors":"Semih Baghaki, Gul Karacetin, Elif Yerlikaya Oral, Ayse Beste Guzel Tuncer, Turkay Demir, Hulya Bingol Caglayan, Omer Uysal, Ozlem Ozdamar Mandi","doi":"10.1097/SCS.0000000000010559","DOIUrl":"10.1097/SCS.0000000000010559","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to assess psychopathology and maternal interactions in infants, toddlers, and preschool children with nonsyndromic clefts of the lip and/or palate (NSCLP) and association of psychopathology with cleft-related factors and maternal interactions.</p><p><strong>Design: </strong>Twenty-six children from 4 to 72 months of age with NSCLP, who were attending the Plastic, Reconstructive and Aesthetic Surgery Department were included as the case group. Fifty-two healthy children who were matched on age and sex with the case group were taken as controls. Children were assessed in aspects of psychiatric diagnosis, articulation, and development.</p><p><strong>Results: </strong>Speech and language disorders (SLD) ( P <0.001), disorders of affect (DA) ( P =0.005), feeding behavior disorder ( P =0.002), sleep-behavior disorder (SBD) ( P =0.038), and disordered mother-child relationship ( P <0.001) were more prevalent in children with NSCLP. Dental alignment ( P =0.024), number of operations ( P =0.006), and type of operations ( P =0.012) were associated with DA. The children in the case group, who had disordered relationship with their mothers had significantly more SLD ( P =0.036) and SBD ( P =0.039).</p><p><strong>Conclusions: </strong>Children with NSCLP are at risk of developing psychopathology, especially SLD and DA. Maternal interactions and the above cleft-related factors and may be the target of interventions to prevent and treat psychiatric disorders in these children.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125888","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":"Microtia and Social Media: How Can We Help Our Patients?","authors":"Muhammad Arslan, Chloe Cottone, Erinn Mangona, Andre Rafizadeh, Marium Mohsin, Jordan Frey","doi":"10.1097/SCS.0000000000010590","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010590","url":null,"abstract":"<p><p>In today's digital era, the intersection of social media and healthcare has emerged as a valuable tool for medical communication and education. However, the use of social media among microtia families has not been thoroughly explored in literature. The purpose of this study was to evaluate the presence of microtia surgeons on social media, the attitudes of microtia families towards physician social media use, and the motivations behind social media usage among microtia families. This study employed a cross-sectional survey methodology. Self-administered questionnaires were used to assess microtia families present in dedicated Instagram and Facebook groups, whereas the presence of microtia surgeons was assessed through responses from an official WhatsApp group. The findings reveal a significant disparity between the demand for microtia surgeons' social media presence and their actual engagement. Although 90.5% of microtia family respondents believed that microtia surgeons should have a presence on social media platforms, only 46.0% of microtia surgeons maintained an active presence. Of microtia families, 55% expressed that they used social media both to facilitate interactions with other families and explore treatment options. Microtia surgeons more often utilized Instagram and Twitter than microtia families. Of microtia families, 40.5% reported using a combination of social media platforms, most often Facebook. This study underscores the increasing reliance on social media for medical information. By increasing their social media presence, microtia surgeons can not only enhance patient education and satisfaction but also contribute to the broader landscape of medical communication and education in the digital age.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125887","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":"Strategy of Out-Fold Double Eyelid Corrected Into In-Fold: Low Position Design, Direction Control Suture, and Fat Transfer.","authors":"Chenyang Ji, Shanchen Liu, Fuli Min","doi":"10.1097/SCS.0000000000010576","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010576","url":null,"abstract":"<p><strong>Background: </strong>Double eyelid surgery is a common but delicate cosmetic procedure in Asia. Because of the precise requirements and technical reasons, patients who received blepharoplasty may not satisfied with their out-fold crease. Some patients are born with unsatisfied out-fold double eyelids. The medial creases of double eyelid were higher than should be.</p><p><strong>Objectives: </strong>In this study, the authors developed a strategy to correct out-fold crease of double eyelid to in-fold to satisfy patients' requirements.</p><p><strong>Methods: </strong>From January 2022 to May 2024, 102 patients (96 females and 6 males) were included in this retrospective analysis. Patients with out-fold double-eyelid inborn or obtained. The patients were divided into 3 groups: inborn out-fold double-eyelid, obtained double-eyelid with epicanthus, and obtained double-eyelid without epicanthus. The surgical strategy contained low position design, direction control suture, and fat transfer. Preoperative and postoperative images were collected, and patients' satisfaction and complications were evaluated.</p><p><strong>Results: </strong>In total, 102 consecutive patients were included in this study, with an average follow-up of 11.9 months. Eleven patients had inborn out-fold creases, and 83 patients had out-fold creases with epicanthus after primitive blepharoplasty, and 8 patients had out-fold creases without epicanthus after primitive blepharoplasty. Ninety-six (94.12%) patients were satisfied with their results. Complications included narrow double eyelid width (n =1, 0.98%), asymmetric creases (n=2, 1.96%), incompletely in-fold creases (n=3, 2.94%), and subtle fork in medial creases (n=4, 3.92%).</p><p><strong>Conclusions: </strong>The surgical strategy, which contained low-position design, direction control suture, and fat transfer, could correct out-fold creases of double-eyelid into in-fold effectively.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125901","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 Dynamic Expression of the SMAD Family in the Periosteum During Guided Bone Regeneration.","authors":"Bao-Fu Yu, Xiao-Qing Li, Xiao-Xue Chen, Chuan-Chang Dai, Jin-Guang He, Jiao Wei","doi":"10.1097/SCS.0000000000010498","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010498","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the dynamic expression of the SMAD family during guided bone regeneration for the reconstruction of cranio-maxillofacial bone defects.</p><p><strong>Methods: </strong>A swine model of guided bone regeneration was established with one side of the rib as the trauma group and the contralateral as control group. Periosteal and regenerative tissue specimens were harvested at 9 time points in the early, middle, and late phases, and were subjected to gene sequencing and tissue staining. Expression data of each SMAD family were extracted for further analysis, in which the correlation of the expression of the respective members within and between groups and at different time points was analyzed.</p><p><strong>Results: </strong>The expression of individual members of the SMAD family fluctuates greatly, especially during the first month. The SMAD3 and SMAD4 genes were the most highly expressed. The foldchange value of SMAD6 was the largest and remained above 1.5 throughout the process. The dynamic expression levels of SMAD2, SMAD4, SMAD5, SMAD6, and SMAD9 showed a significant positive correlation in both groups. The expression levels of each gene showed a positive correlation with other SMAD genes. Tissue staining showed that the overall contour of the regenerated bone tissue was basically formed within the first 1 month.</p><p><strong>Conclusion: </strong>The first month of guided bone regeneration is a critical period for bone regeneration and is an important period for the SMAD family to play a role. The SMAD6 may play an important role in the whole process of guided bone regeneration.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107836","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 the Efficacy of Large Language Models in CPT Coding for Craniofacial Surgery: A Comparative Analysis.","authors":"Emily L Isch, Advith Sarikonda, Abhijeet Sambangi, Angeleah Carreras, Adrija Sircar, D Mitchell Self, Theodore E Habarth-Morales, E J Caterson, Mario Aycart","doi":"10.1097/SCS.0000000000010575","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010575","url":null,"abstract":"<p><strong>Background: </strong>The advent of Large Language Models (LLMs) like ChatGPT has introduced significant advancements in various surgical disciplines. These developments have led to an increased interest in the utilization of LLMs for Current Procedural Terminology (CPT) coding in surgery. With CPT coding being a complex and time-consuming process, often exacerbated by the scarcity of professional coders, there is a pressing need for innovative solutions to enhance coding efficiency and accuracy.</p><p><strong>Methods: </strong>This observational study evaluated the effectiveness of 5 publicly available large language models-Perplexity.AI, Bard, BingAI, ChatGPT 3.5, and ChatGPT 4.0-in accurately identifying CPT codes for craniofacial procedures. A consistent query format was employed to test each model, ensuring the inclusion of detailed procedure components where necessary. The responses were classified as correct, partially correct, or incorrect based on their alignment with established CPT coding for the specified procedures.</p><p><strong>Results: </strong>The results indicate that while there is no overall significant association between the type of AI model and the correctness of CPT code identification, there are notable differences in performance for simple and complex CPT codes among the models. Specifically, ChatGPT 4.0 showed higher accuracy for complex codes, whereas Perplexity.AI and Bard were more consistent with simple codes.</p><p><strong>Discussion: </strong>The use of AI chatbots for CPT coding in craniofacial surgery presents a promising avenue for reducing the administrative burden and associated costs of manual coding. Despite the lower accuracy rates compared with specialized, trained algorithms, the accessibility and minimal training requirements of the AI chatbots make them attractive alternatives. The study also suggests that priming AI models with operative notes may enhance their accuracy, offering a resource-efficient strategy for improving CPT coding in clinical practice.</p><p><strong>Conclusions: </strong>This study highlights the feasibility and potential benefits of integrating LLMs into the CPT coding process for craniofacial surgery. The findings advocate for further refinement and training of AI models to improve their accuracy and practicality, suggesting a future where AI-assisted coding could become a standard component of surgical workflows, aligning with the ongoing digital transformation in health care.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107852","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}