Archives of Craniofacial Surgery最新文献

{"title":"Atypical fibroxanthoma of the cheek in an elderly patient: a case report and literature review.","authors":"Sae Hwi Ki, Gun Hee Lee, Do Hyuk Chung","doi":"10.7181/acfs.2026.0019","DOIUrl":"10.7181/acfs.2026.0019","url":null,"abstract":"<p><p>Atypical fibroxanthoma (AFX) is a rare fibroblastic cutaneous malignancy that predominantly arises in sun-exposed regions of the head and neck in elderly individuals. Accurate diagnosis of AFX remains challenging because of its rarity and histopathologic overlap with other spindle- cell tumors, especially when the initial biopsy findings are inconclusive. The authors encountered a 90-year-old woman who presented with a rapidly growing, ulcerative nodule on the left cheek. An initial biopsy performed at a local dermatology clinic showed spindle cell proliferation without a definitive diagnosis. A subsequent punch biopsy confirmed AFX. The patient showed no evidence of metastasis or lymphadenopathy in the preoperative examination. The tumor was treated with a wide local excision using a 1 cm safety margin, followed by a reconstruction with a full-thickness skin graft. At 1-year follow-up, the patient showed no evidence of local recurrence or metastasis, and the aesthetic outcome was satisfactory. This case highlights the diagnostic difficulty of AFX, particularly in elderly patients with nonspecific biopsy findings. Careful histopathologic evaluation, appropriate surgical management, and long-term follow-up are essential for optimal outcomes. Reporting well-documented cases like the present one may help improve the diagnostic accuracy and clinical management of this uncommon malignancy.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"196-200"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882653","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":"Reply: Comment on \"Transnasal balloon-assisted posterior ridge restoration for inferior orbital wall fractures\".","authors":"Sungyeon Kim, Hong Bae Jeon, Hyonsurk Kim, Dong Hee Kang","doi":"10.7181/acfs.2026.0097","DOIUrl":"10.7181/acfs.2026.0097","url":null,"abstract":"","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"215-217"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882756","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":"Clinical feasibility of wireless handheld ultrasound in closed reduction of nasal bone fractures: a comparative study with high-end probes.","authors":"Ji Min Kim, Sung Gyun Jung, Young Joong Hwang, Chang Hoon Jeong","doi":"10.7181/acfs.2026.0037","DOIUrl":"10.7181/acfs.2026.0037","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound-guided closed reduction allows for real-time visualization of fracture segments, overcoming the limitations of blind palpation. However, standard probes vary in resolution and adaptability. This study aimed to evaluate the clinical feasibility and efficiency of a wireless handheld ultrasound device (V-scan) by comparing it with high-end linear and hockey stick probes through a retrospective analysis.</p><p><strong>Methods: </strong>This retrospective comparative study reviewed the medical records of 160 patients with nasal bone fractures treated between January 2024 and January 2026. Closed reductions were performed by four experienced plastic surgeons. Patients were categorized into three groups based on the ultrasound probe used: Group H (hockey stick, 8-18 MHz), Group L (linear, 3-12 MHz), and Group V (V-scan Air, 3-12 MHz). We compared radiologic reduction accuracy (residual depression and deviation), intraoperative image visibility, surgical convenience, and operative time.</p><p><strong>Results: </strong>Baseline fracture characteristics were comparable among the groups, although age differed significantly (p= 0.036). Regarding radiologic outcomes, there were no significant differences in postoperative residual depression depth (p= 0.294) or deviation angle (p= 0.139) among the groups. Even in complex fractures, reduction accuracy was comparable (p= 0.198). Qualitatively, Group H achieved the highest image visibility score (4.79, p< 0.001). However, Group V demonstrated the highest surgical convenience (4.73) and shortest operative times (20.7 minutes) (p< 0.001).</p><p><strong>Conclusion: </strong>The wireless handheld ultrasound device demonstrated clinical outcomes comparable to high-end probes. While the hockey stick probe offers superior image clarity, the V-scan provides adequate visualization with superior workflow efficiency, making it a viable tool for nasal fracture management.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"189-195"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882576","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":"Correction of nostril contour with a recoil graft inserted through a lateral approach.","authors":"Benyamin Rahmaty, Hossein Sadeghi","doi":"10.7181/acfs.2026.0014","DOIUrl":"10.7181/acfs.2026.0014","url":null,"abstract":"<p><p>An essential step in rhinoplasty is correcting the shape of the nostrils by addressing both function and appearance. Traditional methods like alar base reduction, alar rim grafts, nostril sill augmentation, and composite grafts have specific indications and benefits. We introduce a new approach with several potential advantages. It employs a lateral rim graft inserted through a lateral incision for precise placement close to the skin. This technique enhances the nostril's contour without creating an unnatural or bulky appearance by considering the effects of two vectors. The method supplies structural support to the nostril rim while maintaining its natural curve, preventing collapse, and preserving both aesthetic and functional integrity. The recoil rim graft not only improves the nostril contour but also offers biomechanical and functional advantages by retracting the alae of the nose superior-laterally.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"210-212"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882581","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":"Parosteal lipoma of the mandible: a case report of an asymptomatic, non-ossifying variant.","authors":"Ji Min Kim, Sung Gyun Jung, Young Joong Hwang","doi":"10.7181/acfs.2026.0024","DOIUrl":"10.7181/acfs.2026.0024","url":null,"abstract":"<p><p>Parosteal lipoma is a rare benign neoplasm arising in intimate association with the periosteum. Involvement of the mandible is exceptionally rare. We present the case of a 75-year-old man presenting with a 1-year history of a painless, fixed mass on the left chin. Unlike previous reports of mandibular parosteal lipomas which often feature ossification or neurologic symptoms, this patient was asymptomatic, and imaging revealed a non-ossifying, homogeneous fat-density mass. The tumor was completely excised via an extraoral approach. Surgically, the mass was firmly adherent to the periosteum, requiring meticulous dissection at the subperiosteal level to ensure complete removal. Histopathology confirmed a simple lipoma. This case highlights a critical diagnostic and surgical lesson for plastic surgeons: a fixed mandibular mass, even if asymptomatic and radiologically benign, suggests potential periosteal adherence. Therefore, surgical planning must prioritize deep, periosteal-level dissection rather than simple enucleation to prevent recurrence.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"206-209"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882711","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":"Non-syndromic craniosynostosis: contemporary concepts in biology, diagnosis, and distraction-based operative strategy.","authors":"Wooyeol Baek","doi":"10.7181/acfs.2026.0127","DOIUrl":"10.7181/acfs.2026.0127","url":null,"abstract":"<p><p>Non-syndromic craniosynostosis is the most common clinical form of craniosynostosis, but the mature phenotype cannot be accounted for by a purely local model of premature suture fusion. The deformity is the product of interactions among calvarial growth, cranial base geometry, dural and mesenchymal signaling, orbital development, and regional soft-tissue adaptation. This narrative review examines current evidence on epidemiology, developmental biology, diagnosis, imaging, operative timing, and surgical management, with emphasis on systematic reviews, multicenter and population-based data, comparative cohorts, and larger independent series. Contemporary options-conventional cranial vault remodeling, fronto-orbital advancement and remodeling, endoscope-assisted suturectomy with postoperative orthotic therapy, spring-assisted techniques, and distraction osteogenesis-each occupy a legitimate place in selected age groups and phenotypes. This review gives particular attention to distraction because of its potential for individualized, three-dimensional correction: it is the approach in which vector, magnitude, and regional expansion can be adjusted while new bone forms and the surrounding soft-tissue envelope adapts, which is precisely what a three-dimensional deformity demands. Current comparative evidence does not establish superiority for every subtype, but the biologic rationale and available clinical results justify a broader role for distraction in contemporary reconstruction. Osteotomy design and vector geometry should follow the dominant phenotype: transverse expansion when biparietal restriction predominates in sagittal synostosis; multivector correction when orbital, skull-base, or posterior vault distortion is established; and a higher operative threshold in metopic synostosis, where true fronto-orbital narrowing-not suture fusion alone-should drive the decision. Outcomes should be judged by deformity-specific three-dimensional balance, functional safety, treatment burden, and long-term stability, and not by a single cranial index.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"163-172"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882677","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":"Comment on \"Transnasal balloon-assisted posterior ridge restoration for inferior orbital wall fractures\".","authors":"Muhammed Said Aydin, Gökay Özler, Şükrü Kasap, Mustafa Nişanci","doi":"10.7181/acfs.2026.0073","DOIUrl":"10.7181/acfs.2026.0073","url":null,"abstract":"","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"213-214"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882647","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":"Which intraoral parameters are prognostic factors for speech outcomes in incomplete cleft palate?","authors":"Ju Heon An, Hyung Joon Seo, Chi Hyun Lee, Go Woon Park, Yong Chan Bae","doi":"10.7181/acfs.2025.0057","DOIUrl":"10.7181/acfs.2025.0057","url":null,"abstract":"<p><strong>Background: </strong>The goal of cleft palate surgery is to improve speech articulation; however, factors predicting postoperative speech outcome remain unclear. This study aimed to identify anatomical parameters associated with speech outcome in patients with incomplete cleft palate.</p><p><strong>Methods: </strong>Ninety-eight patients with incomplete cleft palate who underwent palatoplasty and completed long-term follow-up of more than 4 years were included. All surgeries were performed by a single senior surgeon, and eight intraoral parameters were consistently measured intraoperatively. Speech outcomes were evaluated at 4 years of age using the Pittsburgh Weighted Speech Scale (PWSS) and the Simple Speech Screening Protocol (SSSP). Pearson correlation analysis, Kruskal-Wallis test, and multivariable linear regression analyses were performed to assess associations between anatomical parameters and speech outcomes.</p><p><strong>Results: </strong>Most parameters showed no significant correlation with PWSS or SSSP. However, a greater preoperative straight palatal length and a greater postoperative curved palatal length were significantly associated with lower PWSS scores (p< 0.05). In multivariable analysis, postoperative curved palatal length remained independently associated with PWSS, and palatal width also showed a significant association, with wider palate associated with poorer speech outcome (p< 0.05).</p><p><strong>Conclusion: </strong>Most intraoral anatomical parameters were not independently associated with speech outcome, suggesting that factors beyond simple anatomical measurements-particularly those related to restoring appropriate velopharyngeal function, such as reconstruction of the levator veli palatini muscle-may play a more important role. Nevertheless, preoperative straight palatal length, postoperative curved palatal length, and palatal width demonstrated meaningful associations with speech outcome. Therefore, these parameters should be considered when planning palatoplasty to optimize postoperative speech outcome.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"173-179"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882690","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":"Germanium-doped calcium phosphate ceramics in combination with mesenchymal stem cells derived from the neural crest, obtained from rabbit vibrissae: an experimental model of rabbit jaw regeneration.","authors":"Anna Zhmurko, Roman Palyvoda, Natalia Ulyanchich, Valeryi Chemerovskyi, Tetyana Todosiuk, Alona Zlatska","doi":"10.7181/acfs.2026.0026","DOIUrl":"10.7181/acfs.2026.0026","url":null,"abstract":"<p><strong>Background: </strong>Jaw bone regeneration remains a clinical challenge in maxillofacial surgery. Bioactive ceramics and neural crest-derived multipotent mesenchymal stem cells (NC-MSCs) show regenerative potential, but their combined effect in repairing jaw defects has not been fully investigated. To our knowledge, no previous studies have evaluated germanium-doped biphasic calcium phosphate ceramics combined with NC-MSCs from vibrissae in a critical-size mandibular defect model. This study aimed to evaluate biphasic calcium phosphate ceramics doped with 1% germanium (BCPdGe 1%) alone versus BCPdGe 1% combined with NC-MSCs on rabbit mandibular defect regeneration and NC-MSC viability from rabbit vibrissae.</p><p><strong>Methods: </strong>NC-MSC properties on modified ceramics were assessed in vitro using microscopic, cytochemical, and colorimetric analyses. Nine ceramic samples with different Ge and SiO2 concentrations and NC-MSCs from rabbit vibrissae were tested. The BCPdGe 1% group without stem cells was previously evaluated in the same rabbit mandibular defect model and used as a reference control following ethical 3R principles. In vivo, 30 rabbits with critical-size mandibular defects (7 mm) were assigned to BCPdGe 1% (n= 15) or BCPdGe 1%+NC-MSCs (n= 15). Bone regeneration was analyzed histologically, and data were processed in EZR (p< 0.05).</p><p><strong>Results: </strong>NC-MSCs showed the highest viability with samples no. 3 (pure hydroxyapatite doped with 1.5% germanium), no. 5 (BCPdGe 1%), and no. 7 (biphasic calcium phosphate ceramics doped with SiO2). In vivo, BCPdGe 1% alone achieved significantly better bone regeneration than BCPdGe 1% combined with NC-MSCs.</p><p><strong>Conclusion: </strong>Implanted NC-MSCs are highly sensitive to local biological conditions and mechanical stress, highlighting the need for further research on stem cell sources and cultivation methods.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"180-188"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882672","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":"Primary Merkel cell carcinoma of the submandibular region without cutaneous lesion: a case report.","authors":"Hye Mi Lee, Ryang Woo Lee, Hyeon Hee Lee, Young Cheon Na","doi":"10.7181/acfs.2026.0016","DOIUrl":"10.7181/acfs.2026.0016","url":null,"abstract":"<p><p>Merkel cell carcinoma (MCC) is a rare but highly aggressive cutaneous neuroendocrine malignancy that typically arises in sun-exposed skin and may secondarily invade deeper soft tissues. Primary MCC arising from non-cutaneous structures is exceedingly uncommon. We describe an unusual case of a large MCC presenting as a submandibular mass without any clinically or radiologically identifiable overlying skin lesion. This report highlights the need to include MCC in the differential diagnosis of rapidly enlarging submandibular masses lacking an apparent cutaneous origin.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 4","pages":"201-205"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882746","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}