Maxillofacial Plastic and Reconstructive Surgery最新文献

{"title":"Ultra-low-dose cone-beam CT for cleft and craniofacial deformity surgery: radiation reduction and clinical applicability.","authors":"Pilvi Mäntynen, Juha Koivisto, Junnu Leikola, Touko Kaasalainen, Noemi Sipos, Arja Heliövaara, Jani Horelli, Jan Wolff, Niilo Lusila, Juho Suojanen","doi":"10.1186/s40902-026-00505-z","DOIUrl":"10.1186/s40902-026-00505-z","url":null,"abstract":"<p><p>BACKGROUND: Patients with cleft lip and palate and other craniofacial deformities often require repeated imaging during growth, making radiation reduction a priority. Cone-beam computed tomography (CBCT) offers lower radiation exposure than conventional CT, and ultra-low-dose (ULD) protocols may further reduce dose while maintaining clinical usability for surgical planning. OBJECTIVE: This retrospective cohort study evaluated whether ULD CBCT provides comparable clinical usability to standard-dose CBCT for virtual surgical planning (VSP) and patient-specific implant (PSI) design in children and young adults undergoing orthognathic surgery for pediatric-onset craniofacial conditions. METHODS: Forty consecutive patients with pediatric-onset craniofacial anomalies (23 unilateral cleft lip and palate, 10 bilateral cleft lip and palate, and 7 other craniofacial deformities) who underwent PSI-based orthognathic surgery were included. The primary predictor was the CBCT protocol (standard-dose FACE vs. ULD JAW), selected in routine clinical practice according to institutional imaging protocols and case-specific assessment by the interpreting radiologist; no predefined allocation criteria were applied. Primary outcomes were intraoperative cutting guide fit and PSI fit, defined as stable anatomical seating without visible gap or rocking and no need for intraoperative modification. The secondary outcome was occlusal outcome (as planned/compromise/reoperated). Radiation exposure during the orthognathic surgical phase was quantified using dose–area product (DAP) and effective dose. Baseline comparability between protocol groups was explored using bivariate analyses and logistic regression. RESULTS: The ULD protocol resulted in a significantly lower effective dose (40.3 µSv) compared with the standard-dose protocol (89.0 µSv, p < 0.001). No significant differences were observed in cutting guide fit (p = 0.450) or PSI fit (p = 0.238). In logistic regression analysis, age was associated with protocol allocation (p = 0.014), whereas sex, diagnosis, and procedure type were not. Thirty-seven of 40 PSIs were clinically acceptable intraoperatively. Both CBCT protocols were clinically adequate for PSI-based orthognathic planning. CONCLUSION: ULD CBCT provides sufficient image quality and intraoperative usability for VSP in cleft and dentofacial deformity surgery while significantly reducing radiation exposure. These findings support adherence to the ALARA principle in patients requiring repeated imaging. </p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monocyte chemoattractant protein-1 from a conditioned medium of bone marrow-derived mesenchymal stem cells promotes bone regeneration by enhancing macrophage phenotype polarization.","authors":"Kosuke Hashizume, Wataru Katagiri, Ryoko Takeuchi, Daisuke Suda, Tadaharu Kobayashi","doi":"10.1186/s40902-026-00503-1","DOIUrl":"10.1186/s40902-026-00503-1","url":null,"abstract":"<p><strong>Background: </strong>We have reported that the cytokines and chemokines contained in conditioned medium of human mesenchymal stem cells (MSC-CM), which were derived from bone marrow, promote bone regeneration. We recently reported macrophage phenotype polarization towards the anti-inflammatory M2 phenotype induced by MSC-CM and its potential to establish regenerative condition and assist subsequent bone regeneration. However, the specific factors in the MSC-CM responsible for this process remain unclear. Monocyte chemoattractant protein (MCP) -1, present in MSC-CM, promotes cell migration and activation of the monocyte-macrophage lineage; therefore, we hypothesized that MCP-1 is one of the key factors in MSC-CM-induced macrophage phenotype polarization. The effect of MCP-1 on MSC-CM-induced macrophage phenotype polarization and subsequent bone regeneration was investigated in this study.</p><p><strong>Methods: </strong>MCP-1 was depleted from MSC-CM (depMSC-CM) and used in subsequent experiments. Rat bone marrow macrophages were incubated in MSC-CM or depMSC-CM and expression of macrophage markers was examined in vitro. In addition, the effect of MSC-CM and depMSC-CM on bone regeneration and macrophage phenotype polarization were evaluated using rat calvaria defect model in vivo.</p><p><strong>Results: </strong>MSC-CM enhanced M2 macrophage marker expression in rat bone marrow macrophages compared to those treated with depMSC-CM in vitro. In addition, MSC-CM increased the number of M2 macrophage marker-positive cells in bone defects and enhanced subsequent bone regeneration in a rat calvaria bone defect model.</p><p><strong>Conclusions: </strong>MCP-1 seemed to be a one of the most contributing factors in MSC-CM-induced macrophage phenotypic polarization and subsequent bone regeneration.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of impacted mandibular third molar surgery performed with piezosurgery and conventional systems on postoperative sequelae and quality of life: a randomized controlled trial.","authors":"Izzet Acikan, Aykut Can Balkanlioglu","doi":"10.1186/s40902-026-00502-2","DOIUrl":"10.1186/s40902-026-00502-2","url":null,"abstract":"<p><p>BACKGROUND: Although piezosurgery has become a common technique in maxillofacial procedures—including third molar extractions—its advantages over conventional rotary instruments regarding postoperative recovery are still debated. Therefore, this randomized clinical trial aimed to evaluate and compare postoperative complications following the removal of impacted mandibular third molars using either piezosurgery or conventional rotary instruments. METHODS: This randomized controlled clinical trial included a total of 50 participants who were randomly allocated into two groups: the piezosurgery group and the conventional surgery group. Postoperative outcomes were assessed in patients who underwent surgical extraction of impacted mandibular third molars using one of these two methods. Pain levels were recorded daily using a Visual Analog Scale (VAS), whereas swelling, mouth opening, and oral health–related quality of life were evaluated before surgery and again on postoperative days two and seven. RESULTS: The piezosurgery technique resulted in a faster reduction of postoperative swelling on the second day; however, by the seventh day, no statistically significant differences were found between the two surgical techniques with respect to postoperative swelling. Similarly, there were no significant variations between the piezosurgery and conventional methods in terms of postoperative pain, mouth opening, or oral health–related quality of life throughout the observation period. CONCLUSION: Piezosurgery appears to offer a potential advantage; however, apart from reducing swelling, it does not demonstrate any significant superiority in terms of mouth opening, pain, or quality of life. Further standardized, large-scale randomized controlled studies are needed to obtain stronger evidence regarding the efficacy of both techniques. </p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"48 1","pages":"3"},"PeriodicalIF":3.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative discomfort following inverted periosteal pedicle graft versus subepithelial connective tissue graft for treating gingival recession RT1 & RT2: a randomized clinical trial.","authors":"Marwa Elsayed, Mona Salaheldin Darhous, Ayat Gamal-AbdelNaser, Ahmed Reda Abdel Rahman","doi":"10.1186/s40902-025-00499-0","DOIUrl":"10.1186/s40902-025-00499-0","url":null,"abstract":"<p><p>BACKGROUND: Despite being the most predictable root coverage technique, coronally advanced flap with subepithelial connective tissue graft (CAF + SCTG) necessitates graft harvesting from a second surgical site; increasing patient’s post-operative discomfort. Besides, due to the promising regenerative capacity of the periosteum and omitting the need for a second surgical site, periosteal pedicle graft (PPG) is tested as an alternative technique. Eighteen RT1 and RT2 gingival recession defects were randomly assigned to receive either CAF + SCTG or inverted PPG (iPPG). Postoperative discomfort, recession depth, and patient’s satisfaction were assessed within 6-months of follow-up. RESULTS: Patients in the iPPG group reported postoperative discomfort (VAS) of (2.28 ± 0.83) compared to (3.11 ± 1.17) in SCTG group; with no statistically significant difference. Clinically, the mean recession depth was significantly decreased from baseline in iPPG group (from 3.78 ± 0.67 to 0.56 ± 0.53) and in SCTG group (from 3.89 ± 0.78 to 0.33 ± 0.5). Lastly, iPPG showed significantly higher level of patients’ satisfaction compared to SCTG. CONCLUSIONS: iPPG can be a promising alternative to SCTG for root coverage with significantly increased patient’s satisfaction after six months and comparable clinical root coverage parameters. </p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"48 1","pages":"1"},"PeriodicalIF":3.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors for functional recovery after lingual nerve reconstruction using an artificial nerve conduit.","authors":"Shigeyuki Fujita, Shigeru Suzuki, Osamu Sakaguchi, Itaru Tojyo","doi":"10.1186/s40902-026-00500-4","DOIUrl":"10.1186/s40902-026-00500-4","url":null,"abstract":"<p><strong>Background: </strong>Lingual nerve injury following dental procedures, such as lower third molar extractions, can cause significant sensory deficits. For patients with persistent severe symptoms, surgical reconstruction using a nerve conduit is often considered. However, the degree of recovery varies, and the optimal timing of intervention and the significance of the nerve gap distance remain subjects of clinical debate.</p><p><strong>Objectives: </strong>Using the Medical Research Council Scale (MRCS) as a standardized measure of sensory function, this study aims to determine the independent effects of the timing of surgery, nerve gap length, and other potential prognostic factors on nerve functional recovery, specifically defining success as MRCS S3+ or higher.</p><p><strong>Methods: </strong>This study retrospectively analyzed a cohort of 49 patients who underwent lingual nerve repair surgery. The success of nerve recovery was evaluated using two established criteria: the standard Functional Sensory Recovery (FSR), MRCS S3 or higher, and the strict MRCS S3+ or higher criteria based on American Society of Plastic Surgeons (ASPS) criteria. The MRCS S3+ or higher criteria was designated as the primary outcome for all multivariate analyses. The time to surgery variable was logarithmically transformed, Log (Time to Surgery, months), to account for the highly skewed distribution. Statistical analysis used univariate and multivariate logistic regression to assess the association between each predictor and postoperative MRCS score. A secondary analysis examined predictors for allodynia resolution.</p><p><strong>Results: </strong>The logarithmically transformed time to surgery, Log (Time to Surgery, months), was the sole statistically significant independent predictor for achieving MRCS S3+ (Odds Ratio OR = 0.236, 95% CI: 0.063-0.887, P = 0.032). This indicates that earlier intervention significantly increases the odds of functional recovery. Nerve gap length was not a significant predictor (OR = 0.941, P = 0.518). Furthermore, no variable was found to be a significant predictor for allodynia resolution (P > 0.05).</p><p><strong>Conclusion: </strong>Earlier surgical intervention, quantified by Log (Time to Surgery), is an independent and critical factor for achieving MRCS S3+ functional sensory recovery after lingual nerve repair. The distance of the nerve gap did not show an independent predictive effect on the final sensory outcome.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":"2"},"PeriodicalIF":2.8,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Methods in Orthognathic Surgery Studies.","authors":"Mehrdad Farrokhi, Mohammad Amin Nochian","doi":"10.1186/s40902-025-00496-3","DOIUrl":"10.1186/s40902-025-00496-3","url":null,"abstract":"<p><p>This letter provides a methodological comment on the recent study by Kim et al., which evaluated soft tissue canting at preoperative, postoperative, and post-debonding stages in the same group of patients. The correspondence highlights that these measurements represent dependent observations and therefore require appropriate repeated-measures statistical methods. It emphasizes that one-way analysis of variance is designed for independent groups and is not suitable for longitudinal data. The aim of this letter is to encourage accurate statistical practice in studies involving repeated measurements in orthognathic and orthodontic research.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"44"},"PeriodicalIF":3.5,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12753596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision of patient specific screw holes locating surgical guide and pre-bent plates osteosynthesis versus classical workflow in management of class III mandibular fracture.","authors":"Abdallah Gaber, Hussein Hatem, Mona El, Mohammed Omara","doi":"10.1186/s40902-025-00495-4","DOIUrl":"10.1186/s40902-025-00495-4","url":null,"abstract":"<p><strong>Background: </strong>Several treatment modalities have been reported in the management of mandibular fractures using an alternative computer-guided approach through the utilization of different designs of guiding devices. However, these computer-guided methods do not always guarantee accurate anatomical bone reduction. This study aimed to assess the reduction precision of the computer-guided mandibular fracture and internal fixation using screw holes locating surgical guide, as presented earlier in the orthognathic surgery field in various studies to be applied in the field of mandibular traumatology, comparing it with the conventional approach.</p><p><strong>Methods: </strong>Twenty-six patients with Brown Class III mandibular fracture, defined by a single fracture line involving the body, parasymphysis or symphysis regions, were randomly assigned to two groups for open reduction and internal fixation. The study group underwent reduction and fixation using patient-specific screw-hole locating guide and pre-bent titanium miniplates, whereas the control group received conventional reduction and fixation with intraoperatively adapted titanium miniplates. Virtual reduction of the fractured mandible was performed in all cases of both groups utilizing CT scan and mimics software. Then, the actual postoperative mandibular model was superimposed over the virtually operated mandibular model based on predefined reference points and plans to obtain dental and bony linear measurements. The recorded measures were statistically analysed.</p><p><strong>Results: </strong>The actual postoperative mandibular model in the computer-guided group showed minimal deviation from the virtual mandibular model. While the deviation of the actual post operative model in the conventional group from the virtual model was higher, the difference in deviation between the two groups was statistically significant. The mean bony deviation was 0.09 ± 0.29 mm in the computer-guided group, versus 0.70 ± 0.33 mm in the control group p < 0.001. The mean dental deviation was 0.05 ± 0.16 mm in the computer-guided group versus 0.56 ± 0.32 mm in the control group p < 0.001.The mean operative time of the computer-guided group(1.49 ± 0.19)(hours) was significantly shorter than the mean operative time of control group (1.82 ± 0.37)(hours) which is statistically significant p < 0.001.</p><p><strong>Conclusions: </strong>The use of screw-hole locating guide and pre-bent plates enhanced surgical accuracy and efficiency. It also highlighted how patient-specific design can reduce dependence on surgeon experience and standardized outcomes in complex mandibular fractures.</p><p><strong>Trial registration: </strong>The study is registered at ClinicalTrials.gov Protocol Registration and Results System Receipt, ID: NCT05444829.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":"43"},"PeriodicalIF":2.8,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12722589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtually planned and CAD/CAM-guided secondary reconstruction of the mandibular condyle after malunion: from \"unpredictable\" to precise? -accuracy and outcomes.","authors":"Paris Georgios Liokatis, Carl Peter Cornelius, Jens Tobias Hartung, Ina Dewenter, Wenko Smolka, Florian Andreas Probst, Philipp Poxleitner, Sven Otto, Katharina Theresa Obermeier, Yoana Malenova","doi":"10.1186/s40902-025-00497-2","DOIUrl":"10.1186/s40902-025-00497-2","url":null,"abstract":"<p><p>BACKGROUND: In patients with malunited condylar fractures of the mandible surgical intervention is preferred when malocclusion and compromised masticatory function occur. This study evaluated the accuracy and clinical utility of virtual surgical planning (VSP) and CAD/CAM fabricated patient-specific implants (PSIs) for the secondary correction of post-traumatic mandibular condyle deformities. METHODS: Accuracy of condylar segment repositioning was quantified by comparing the virtually planned joint surface with the actual postoperative same surface of the condylar head using Mimics and 3-Matic software (Materialise, Leuven, Belgium). Deviation was calculated by two methods: the Part Comparison Analysis (PCA) function of the analysis software and by measuring distances between four corresponding reference points on the planned and final segments. RESULTS: The mean deviation between planned and final joint surfaces was 2.27 mm (range 4.69) with the PCA method and 2.56 mm (range: 8.99) with the reference-point method. No significant difference was observed between high and low condylar osteotomies. Accuracy was greatest along the lateromedial axis (1.83 mm; range: 6.98 mm) and lowest in the craniocaudal axis (3.30 mm; range: 6.75 mm). A good postoperative mandibular mobility was assessed in most cases with an average active mouth opening of 37 mm and no permanent sensory impairment was reported. CONCLUSION: Virtual surgical planning combined with CAD/CAM PSIs provides a reliable option for secondary reduction and fixation of condylar fragments, achieving high positional accuracy, good postoperative mandibular mobility, and a low rate of major complications. </p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"42"},"PeriodicalIF":3.5,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12701210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional imaging of the facial arteries: an overview of ocular vascular anatomy.","authors":"Liya Jiang, Yuejie Zhou, Fei Chen, Xueshang Su, Ningbei Yin, Jintian Hu","doi":"10.1186/s40902-025-00492-7","DOIUrl":"10.1186/s40902-025-00492-7","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the use of facial soft tissue fillers via cosmetic injections has steadily increased, along with the incidence of adverse events caused by injection vascular occlusion. We aimed to three-dimensionally visualize the anastomosis between facial soft tissue and the vascular system to enhance the safety and effectiveness of facial injections. A cadaver model was used to visualize facial anatomy. A red gelatin-lead oxide contrast agent was perfused to visualize the blood vessels, while 3.75% iodine-potassium iodide was used to stain the soft tissues. Micro-computed tomography scanning was then performed to capture detailed imaging results.</p><p><strong>Results: </strong>We successfully visualized both facial soft tissues and blood vessels simultaneously, including the two-dimensional distribution of vascular tissues and the three-dimensional hierarchical structure of the soft tissue. This allowed accurate assessment of the vascular flow and interconnections in the facial region.</p><p><strong>Conclusions: </strong>This study provides a detailed three-dimensional representation of the facial vascular anatomy, particularly in the periocular area. By clarifying facial vascular anastomoses, this technique offers a valuable reference for promoting safer and more effective filler injections and reducing the risk of injection-related complications. Providing an interactive, high-resolution vascular dataset of a specific developmental stage. Promoting safe and effective injection of fillers provides a more reliable reference for reducing complications caused by injections.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"41"},"PeriodicalIF":2.8,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12644337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and outcomes of facial nerve injury following rhytidectomy: a systematic review.","authors":"Niloufar Arianpour, Kazem Khiabani, Hosein Aberoumand, Amirhosein Pourhoseini","doi":"10.1186/s40902-025-00494-5","DOIUrl":"10.1186/s40902-025-00494-5","url":null,"abstract":"<p><strong>Background and aim: </strong>Facial nerve injury is a critical complication of rhytidectomy, affecting patient outcomes and satisfaction. Despite its importance, standardized management strategies remain limited. This systematic review evaluates current evidence on the management, outcomes, and prevention of facial nerve injuries in rhytidectomy, with stratification by injury severity to enhance clinical applicability.</p><p><strong>Methods: </strong>In this study, PubMed, Embase, and the Cochrane Library were searched from inception to July 2025, identifying 20 studies that met the inclusion criteria. The quality of the studies was assessed using AMSTAR 2 and the Newcastle-Ottawa Scale. Additionally, the review was conducted in accordance with the PRISMA guidelines to ensure transparency and accuracy in reporting the results.</p><p><strong>Results: </strong>The incidence of facial nerve injury ranged from 0.5% to 5%, with 70% of patients achieving full recovery within six months through conservative treatments (corticosteroids, physiotherapy). Management and outcomes varied by injury severity: neuropraxia (80-90% of cases) typically resolved conservatively, while axonotmesis or neurotmesis required surgical interventions (e.g., nerve repair) or adjunct therapies (e.g., botulinum toxin). Preventive measures, such as meticulous surgical techniques and awareness of facial danger zones, were effective. Intraoperative nerve monitoring showed potential but needs further validation.</p><p><strong>Conclusions: </strong>Conservative management suffices for most cases, particularly neuropraxia, yet 10% of patients experience persistent deficits, underscoring the need for severity-stratified approaches. Prospective multicenter registries with standardized outcome measures, individual patient data meta-analyses, and Bayesian hierarchical modeling are essential to address evidence gaps and enhance clinical practice.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":"40"},"PeriodicalIF":2.8,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12644352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}