FACE Pub Date : 2024-05-11 DOI: 10.1177/27325016241252953

Gwendolyn E. Daly, Peter Ferrin, J. Carboy, Lori K. Howell, Nathan R Selden, Erik M. Wolfswinkel

{"title":"Concurrent Craniosynostosis and Positional Plagiocephaly: A Scoping Review","authors":"Gwendolyn E. Daly, Peter Ferrin, J. Carboy, Lori K. Howell, Nathan R Selden, Erik M. Wolfswinkel","doi":"10.1177/27325016241252953","DOIUrl":"https://doi.org/10.1177/27325016241252953","url":null,"abstract":"Craniosynostosis and positional plagiocephaly (PP) both lead to deformities of the infant skull. In some cases, patients may present with concurrent craniosynostosis and PP. The forces exerted on the skull by both conditions can complicate and delay correct diagnosis and require adjustments to surgical planning. The purpose of this scoping review was to identify and analyze the existing peer-reviewed literature covering the diagnosis and treatment of concurrent craniosynostosis and PP. In accordance with PRISMA guidelines, PubMed, MEDLINE, and EMBASE were searched for articles discussing concurrent diagnoses of craniosynostosis and PP. Out of 633 articles discovered, 7 met inclusion criteria and discussed a cumulative total of 10 patients. The average age of referral to a craniofacial team was 17 ± 22.2 months. The most common reason for referral was craniofacial asymmetry (90%, n = 9). 40% presented with unilateral coronal synostosis (n = 4), 40% with lambdoid synostosis (n = 4), 10% with sagittal synostosis (n = 1), and 10% with metopic synostosis (n = 1). The most commonly reported clinical features were occipital flattening (90%, n = 9), ear displacement (80%, n = 8), and frontal bossing (30%, n = 3). Delayed or incorrect initial diagnosis was noted in 70% (n = 7) of patients. CT scan was the most commonly employed diagnostic tool, utilized in 100% of patients. 70% of patients (n = 7) underwent surgery at an average age of 6.75 ± 3 months. Two studies, accounting for 2 patients reported, noted altering their surgical technique to account for PP in addition to the synostotic suture. Coincident craniosynostosis and PP can pose a complicated diagnostic and therapeutic challenge. An in-depth understanding of the most reliable physical exam findings associated with each type of craniosynostosis combined with PP will facilitate accurate diagnosis. Consideration of the concurrent forces on the skull created by craniosynostosis and PP aid in the design of a tailored surgical plan.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"123 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140987408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Mandibular Brown Tumor: A Pediatric Case Report and Summary of Adolescence Cases 下颌骨棕色瘤：儿科病例报告和青少年病例摘要

FACE Pub Date : 2024-05-11 DOI: 10.1177/27325016241253276

Gabriella E. Glassman, Joseph K. Williams, Colin M. Brady

{"title":"A Mandibular Brown Tumor: A Pediatric Case Report and Summary of Adolescence Cases","authors":"Gabriella E. Glassman, Joseph K. Williams, Colin M. Brady","doi":"10.1177/27325016241253276","DOIUrl":"https://doi.org/10.1177/27325016241253276","url":null,"abstract":"Mandibular brown tumors are often radiographically and histologically indistinguishable from cherubism, aneurysmal bone cyst, giant cell granuloma, and odontogenic fibroma. Laboratory findings of hyperparathyroidism (HPT) aid in directing therapy. We present a case of a 14-year-old male with a brown tumor of the mandible associated with secondary HPT due to vitamin D deficiency. Core biopsy exhibited a proliferation of plump spindle cells and osteoclast-like giant cells within variably fibrous stroma. Parathyroid hormone (PTH) levels were elevated to 288 pg/mL (normal 8.5-77.1 pg/mL) and vitamin D was low at a level of 6.9 ng/mL (normal > 20.0 ng/mL). Six months after the introduction of weekly vitamin D supplementation, PTH and vitamin D levels improved but remained abnormal with PTH of 86.8 pg/mL and vitamin D of 9.3 ng/mL. Alongside an improvement in laboratory indices, the tumor character stabilized and became less clinically friable; however, the burden remained unchanged. At 9 months, the patient underwent surgical debulking of the tumor with local soft tissue coverage. A review of pediatric literature was performed, among which 16 patients were identified. Most children who developed brown tumors were found to have secondary HPT and ultimately 44% underwent some degree of surgical debridement of the mass.","PeriodicalId":508736,"journal":{"name":"FACE","volume":" 1024","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140989462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pericranial Flap Reconstruction in Pediatric Patients Undergoing Neuromodulatory Surgery: Impact on Wound Healing 接受神经调节手术的小儿患者的颅周皮瓣重建：对伤口愈合的影响

FACE Pub Date : 2024-04-14 DOI: 10.1177/27325016241246784

Lawrence O. Lin, Annie Orr, Gregory D. Pearson, Jonathan Pindrik, Ammar Shaikhouni, Alyssa Fogolin, I. Khansa

{"title":"Pericranial Flap Reconstruction in Pediatric Patients Undergoing Neuromodulatory Surgery: Impact on Wound Healing","authors":"Lawrence O. Lin, Annie Orr, Gregory D. Pearson, Jonathan Pindrik, Ammar Shaikhouni, Alyssa Fogolin, I. Khansa","doi":"10.1177/27325016241246784","DOIUrl":"https://doi.org/10.1177/27325016241246784","url":null,"abstract":"Pediatric patients with medically-intractable epilepsy may require modulation of seizure foci to reduce frequency and severity of seizures. These neuromodulatory procedures, which include responsive neurostimulator (RNS) and deep brain stimulator (DBS), involve the implantation of high-profile and long-term cranial hardware, placing patients at risk of wound healing complications, hardware exposure and infection. A multidisciplinary neurosurgical and plastic surgical approach utilizing pericranial flap coverage of hardware may decrease wound healing complications in these cases. This study compares the wound-healing outcomes in patients undergoing RNS/DBS insertion with and without pericranial flap coverage. A retrospective chart review was conducted of all patients who underwent RNS and DBS insertion with or without pericranial flap coverage at a level 1 pediatric medical center between 2014 and 2022. Wound healing outcomes at 60 days were evaluated. Data were compared using Fisher’s exact test. Twenty-seven patients underwent 29 neuromodulatory epilepsy procedures (14 DBS, 15 RNS). Twenty of the procedures included a pericranial flap to cover hardware. Median length of stay was 2.0 days for both cohorts. Two subjects without pericranial flap reconstruction had a wound healing complication (22.2%), compared to none of the procedures that included a pericranial flap ( P = .09). In pediatric patients undergoing insertion of responsive neurostimulators and deep brain stimulators for medically-intractable epilepsy, a multidisciplinary neurosurgery and plastic surgery approach utilizing pericranial flap reconstruction may reduce the risk of postoperative wound complications.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"76 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unveiling a Misdiagnosed Midline Cervical Cleft: A Case Report and Review of the Literature 揭开被误诊的中线颈裂的面纱：病例报告与文献综述

FACE Pub Date : 2024-04-08 DOI: 10.1177/27325016241246223

Nikki Rezania, Elizabeth S. O’Neill, Kelly A. Harmon, Sydney H. Arnold, Christina Tragos

{"title":"Unveiling a Misdiagnosed Midline Cervical Cleft: A Case Report and Review of the Literature","authors":"Nikki Rezania, Elizabeth S. O’Neill, Kelly A. Harmon, Sydney H. Arnold, Christina Tragos","doi":"10.1177/27325016241246223","DOIUrl":"https://doi.org/10.1177/27325016241246223","url":null,"abstract":"Congenital midline cervical cleft (CMCC) is a rare congenital abnormality of the ventral neck that is often misdiagnosed. We present a case of a 12-year-old male with a history of incomplete CMCC excision and limited neck extension. We highlight the need for increased awareness of this anomaly and propose a clinical algorithm for clinicians when faced with this rare congenital condition. CMCC typically presents at birth and involves a defect along the midline of the neck, characterized by a nipple-like protrusion of the skin and a fibrous cord with an underlying sinus. Micrognathia and mandibular growth restriction are anticipated consequences of CMCC, requiring early intervention. Current treatment guidelines recommend surgical excision prior to age two using a Z-plasty technique. This report emphasizes the rarity and diagnostic challenges of CMCC. It underscores the significance of accurate identification and appropriate surgical planning in a timely manner. Based on the authors’ experience with this case and a review of the literature, we propose a clinical algorithm aimed to enhance CMCC diagnosis and management.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"35 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140728427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Humility in the Operating Room: The Essential Virtue of the Evidence-Based Surgeon 手术室中的谦逊：循证外科医生的基本美德

FACE Pub Date : 2024-04-03 DOI: 10.1177/27325016241244530

Robin J. Evans, Kristen E. Hughes

引用次数: 0

Maxillary and Midface Advancement With Rigid External Distraction: A Review and Technical Recommendations for Optimized Halo Placement 刚性外牵引下的上颌和中面部前移：优化光晕安置的综述和技术建议

FACE Pub Date : 2024-04-03 DOI: 10.1177/27325016241241962

Okensama M. La-Anyane, Nikki Rezania, Kelly A. Harmon, Christina Tragos, John W. Polley, Alvaro A. Figueroa

{"title":"Maxillary and Midface Advancement With Rigid External Distraction: A Review and Technical Recommendations for Optimized Halo Placement","authors":"Okensama M. La-Anyane, Nikki Rezania, Kelly A. Harmon, Christina Tragos, John W. Polley, Alvaro A. Figueroa","doi":"10.1177/27325016241241962","DOIUrl":"https://doi.org/10.1177/27325016241241962","url":null,"abstract":"Background: The use of a rigid external distraction (RED) is recognized as a viable treatment option for patients with severe maxillary and midface hypoplasia. However, there is limited research on the technical placement of the RED device and its impact on patient outcomes. This systematic review examined variations in RED placement as reported in published clinical photos from journal articles, discusses its potential connection to distraction outcomes, and provides suggestions for proper placement of the device. Material and Methods: Articles in which RED was utilized and included clinical photos of patients wearing the RED device were systematically reviewed using PRISMA guidelines. Data extraction and RED placement photo assessment were performed, including subjective analysis of the images and objective angular measurement of device placement. Results: Despite the reporting of satisfactory outcomes in 83% of the reviewed articles, 64% of the photos depicted variations to the recommended halo frame placement. Of these photos, the halo frame was angled inferiorly in 73.8% and 45.16% of those studies depicting inferiorly angled halos reported adverse events. The vertical bar placement was angled posteriorly in 45% of the articles, and 44.4% of these articles reported complications. Conclusion: Photos from the literature show a high variability in RED device placement, with varying outcomes and complication rates. When placed optimally, with consideration to technical placement details such as cranial pin placement and distraction vector angles, the RED system should allow predictable maxillary and midface advancements with minimal complications.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140747945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Modification of Noordhoff Flap for Tubercle Reconstruction in Unilateral Cleft Lip Repair 在单侧唇裂修复术中改良 Noordhoff 皮瓣以重建唇结节

FACE Pub Date : 2024-04-01 DOI: 10.1177/27325016241245049

Joel M. Prince, Erin Poole, Christian El Amm

引用次数: 0

The CHIP Score: A Valuable Method for Determining Risk of Surgical Intervention for Hemangioma Patients CHIP 评分：确定血管瘤患者手术干预风险的有效方法

FACE Pub Date : 2024-03-28 DOI: 10.1177/27325016241242372

Pearl Shah, Amanda Royek, Anand R. Kumar

{"title":"The CHIP Score: A Valuable Method for Determining Risk of Surgical Intervention for Hemangioma Patients","authors":"Pearl Shah, Amanda Royek, Anand R. Kumar","doi":"10.1177/27325016241242372","DOIUrl":"https://doi.org/10.1177/27325016241242372","url":null,"abstract":"Infantile hemangiomas (IHs) are the most common benign tumor of infancy. These tumors may have wide-ranging effects on functional and cosmetic outcomes for patients. With variations in recommendations for surgery among providers, it can be difficult to counsel patients and their families on potential surgical treatment. Through the development of the Case Western Hemangioma Intervention Predictor (CHIP) score, this study aims to improve the consistency of counseling regarding surgery and timing of surgical referral. This was a retrospective review of all patients (179) treated for IHs at a single tertiary care center over 17 years. Patients were divided equally into 2 cohorts. Descriptive statistics and correlation plots were performed on the first cohort to evaluate which disease factors (including size, location, and complications) and patient factors significantly correlated with the decision to pursue surgical treatment (surgical risk). These factors were used to form a CHIP score, which was then validated through logistic regression with length of medical management as a covariate against the second cohort of patients. After controlling for length of medical management to treat IH, lack of medical management, functional impairment, and ulceration were found to be significantly correlated with the risk of surgical intervention ( P < .05). When validated against the second half of our cohort, a CHIP score of 3 (of a maximum score of 3) was found to have a specificity of 92% and a sensitivity of 81% in predicting risk of surgical intervention. IHs can have clinical characteristics that may be predictors of complexity and surgical intervention. The CHIP score can assist in educating patients and families on surgery as a treatment option and guiding appropriate referrals.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"68 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140371570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Schwannoma of Facial Region: A Pathology Often Missed in the Initial Diagnostic Hypothesis: A Case Report 面部区域的许旺瘤：一种在最初诊断假设中经常被忽略的病理学：病例报告

FACE Pub Date : 2024-03-27 DOI: 10.1177/27325016241242006

Md Kalim Ansari, Akash Ganguly, Tabishur Rahman, Mohd Aswad Khan, G. N, Abhiparna Kundu

引用次数: 0

Infantile Myofibroma of the Frontal Bone: A Case Report 婴儿额骨肌纤维瘤：病例报告

FACE Pub Date : 2024-03-27 DOI: 10.1177/27325016241241782

K. A. Alawi, Ruqaya Al Abri, S. A. Shaqsi, Jehad Al Habsi, Ahmed Al Azri, Taimoor Al Balushi

引用次数: 0

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