Archives of Craniofacial Surgery最新文献

{"title":"Outcomes of the modified neurovascular cheek flap compared with nasolabial flap in lower lip reconstruction: a retrospective cohort analysis.","authors":"Premsak Sakarinpanichakul","doi":"10.7181/acfs.2025.0086","DOIUrl":"10.7181/acfs.2025.0086","url":null,"abstract":"<p><strong>Background: </strong>Lower lip reconstruction following cancer resection commonly employs the nasolabial flap (NLF) or modified neurovascular cheek flap (MNCF). Both techniques inadequately restore the orbicularis oris sphincter, theoretically predisposing patients to oral incompetence and drooling. However, direct comparative data on functional outcomes remain limited. To compare the incidence of postoperative drooling and wound complications between NLF and MNCF reconstruction for lower lip defects.</p><p><strong>Methods: </strong>This retrospective cohort study included 125 patients with lower lip squamous cell carcinoma who underwent reconstruction with either NLF (n= 47) or MNCF (n= 78) between August 2012 and August 2025 at a single tertiary center. The primary outcome was drooling at the 3-month follow-up. Secondary outcomes included overall wound complications within 30 days. Multivariate logistic regression was performed to adjust for confounders.</p><p><strong>Results: </strong>Baseline characteristics were comparable except for defect size, which was significantly larger in the MNCF group (75.0% vs. 60.0%; p= 0.007), and flap laterality, with bilateral procedures more common in the MNCF group (56.4% vs. 12.8%; p< 0.001). The overall drooling rate was 14.4%, with no significant difference between groups in univariate analysis (MNCF 11.5% vs. NLF 19.1%; p= 0.240). However, after adjusting for confounders, including flap laterality, the MNCF demonstrated a significantly lower risk of drooling (adjusted odds ratio [OR], 0.18; 95% confidence interval [CI], 0.04-0.82; p= 0.026). The MNCF group also showed significantly lower complication rates (1.3% vs. 14.9%, p= 0.003; adjusted OR, 0.06; 95% CI, 0.01-0.76; p= 0.030).</p><p><strong>Conclusion: </strong>The MNCF is associated with significantly lower rates of drooling and wound complications than the NLF, despite reconstructing larger defects. After controlling for flap laterality, the MNCF demonstrates superior functional outcomes, establishing it as the preferred technique for extensive lower lip reconstruction when surgical expertise is available.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":" ","pages":"135-145"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788947","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":"Evaluation of the accuracy of a custom-made plate in maxillary repositioning.","authors":"Wafaa A Mohamed, Susan A Hassan, Fatma I Mohamed, Ahmed A Barakat, Hatem H Alahmady, Mahmoud M Fata, Ahmed A Mohamed","doi":"10.7181/acfs.2025.0040","DOIUrl":"10.7181/acfs.2025.0040","url":null,"abstract":"<p><strong>Background: </strong>Orthognathic surgery has become increasingly accurate with the integration of computerized technologies. This study aimed to evaluate the accuracy of custom-made plates in transferring the three-dimensional virtual plan to intraoperative maxillary repositioning.</p><p><strong>Methods: </strong>This study included 10 patients. A digital surgical simulation technique was used for preoperative planning. The surgical components-osteotomy/plates, locating guides, and customized titanium plates-were fabricated using computer-aided design and manufacturing techniques, replacing the need for a surgical splint. Postoperative outcomes were assessed using unaltered anatomical landmarks from the preoperative virtual plan. Absolute discrepancies in translational and rotational movements between the planned and actual postoperative positions were measured through superimposition analysis. This evaluation assessed the precision of custom-made plates in transferring the virtual surgical plan, identifying deviations in the cephalocaudal, mediolateral, and anteroposterior directions that could influence functional and esthetic outcomes.</p><p><strong>Results: </strong>No statistically significant differences were observed for any landmarks across the axial, coronal, and sagittal planes. The greatest variability was noted at the posterior nasal spine landmark in the axial plane (1.7 mm), compared with the coronal (0.9 mm) and sagittal (0.5 mm) planes.</p><p><strong>Conclusion: </strong>Customized titanium plates effectively transferred the virtual surgical plan for maxillary repositioning without the need for an occlusal splint. However, potential posterior interference should be considered during surgical execution.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 3","pages":"120-128"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392342","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":"Risk factors for residual diplopia in orbital trauma: a retrospective analysis of 109 patients.","authors":"Emrah K Yasar, Canberk M Gurbuz, Ceyhun Uzun, Oguzhan Eroglu, Berkay Y Çınar, Berke Kahraman, Murat S Alagoz","doi":"10.7181/acfs.2025.0085","DOIUrl":"10.7181/acfs.2025.0085","url":null,"abstract":"<p><strong>Background: </strong>Orbital floor fractures are among the most common maxillofacial injuries and represent the predominant type of isolated orbital fractures. Residual diplopia is a common complication in these patients, and its management is quite challenging. The present study aimed to investigate predisposing factors for late residual diplopia following surgical repair of orbital floor fractures.</p><p><strong>Methods: </strong>Patients presenting with maxillofacial trauma between 2019 and 2024 were retrospectively analyzed. Individuals diagnosed with orbital floor fractures were included. Data regarding concomitant wall involvement, preoperative diplopia, mechanism of trauma, time interval between trauma and surgery, defect size, and postoperative enophthalmos were obtained from patient records. Patients with a follow-up period of less than 3 months were excluded from the study. These variables were statistically compared to assess their relationship with persistent postoperative diplopia.</p><p><strong>Results: </strong>A total of 109 patients with orbital floor fractures were evaluated. Post-traumatic diplopia was observed in 15.6% of cases. The presence of residual enophthalmos was significantly associated with residual diplopia (p< 0.001): 56.3% of patients with enophthalmos exhibited diplopia compared to 8.6% without. \"Floor+rim\" fractures demonstrated a higher incidence of diplopia (20.9%) than other wall combinations (p= 0.054). The interval between trauma and surgery was not correlated with diplopia (p= 0.425), whereas increasing defect size was significantly associated (p= 0.039). Although diplopia was more frequent in assault (19.4%) and collision (28.6%) cases, the difference was not statistically significant (p= 0.578).</p><p><strong>Conclusion: </strong>Persistent postoperative diplopia remains a challenging complication after orbital fracture repair. The strong association between residual enophthalmos and diplopia underscores the need for meticulous intraoperative reconstruction and close postoperative follow-up to optimize functional and aesthetic outcomes.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":" ","pages":"129-134"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788934","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":"Double free flap reconstruction using the piggyback technique for multifocal scalp radiation necrosis: a case report.","authors":"Joon Hyuk Lee, Tae Gon Kim","doi":"10.7181/acfs.2025.0104","DOIUrl":"10.7181/acfs.2025.0104","url":null,"abstract":"<p><p>Scalp angiosarcoma is a rare, aggressive malignancy with poor prognosis, particularly when multifocal. We report a 62-year-old woman with multifocal scalp angiosarcoma, a 3.5× 3.5 cm ulcerated vertex lesion within an approximately 10× 10 cm clinically abnormal vertex field and three 1× 1 cm temporal satellite lesions (two in the right temporal region and one in the left temporal region). Initial wide excision with frozen biopsy-guided margins and reconstruction using a rotation flap and split-thickness skin grafts was followed by adjuvant radiotherapy. At 7 months after completion of radiotherapy, radiation-induced necrosis with bone exposure developed in the frontal and occipital regions, with multiple biopsies negative for recurrence. Double free flap reconstruction (radial forearm free flap and adipofascial anterolateral thigh flap using a piggyback anastomosis) was performed 11 months after radiotherapy using a single recipient vessel pair. Venous congestion on postoperative day 1 was successfully revised with vein graft interposition, resulting in complete flap survival. The patient was disease-free with stable flap coverage at the latest follow-up, more than 2.5 years after radiotherapy. This case demonstrates that double free flap reconstruction using a piggyback technique can be a safe and effective reconstructive option for extensive irradiated scalp defects in multifocal angiosarcoma.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 3","pages":"151-155"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392339","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":"Zygomatic bone deformation caused by a periorbital epidermoid cyst in a child: a case report and literature review.","authors":"Jun Mo Kim, Woo Young Choi, Ji Seon Cheon, Jeong Yeol Yang","doi":"10.7181/acfs.2025.0069","DOIUrl":"10.7181/acfs.2025.0069","url":null,"abstract":"<p><p>Epidermoid and dermoid cysts are common congenital lesions of the pediatric periorbital region arising from ectodermal inclusion during embryologic development. Although these lesions originate in the soft tissue, chronic pressure from long-standing masses may induce cortical depression or remodeling of adjacent craniofacial bones, particularly in young children with malleable skeletal structures. We report a case of a 26-month-old girl presenting with a small periorbital epidermoid cyst associated with pressure-induced depression of the zygomatic surface. Radiologic evaluation revealed a well-circumscribed cystic lesion abutting the frontal process of the zygoma with smooth cortical indentation and no features suggestive of aggressive osseous pathology. Complete excision was performed through a lateral brow approach with preservation of the periosteum. Histopathologic examination confirmed an epidermoid cyst. Postoperative follow-up demonstrated progressive spontaneous restoration of the zygomatic contour without the need for bone grafting or alloplastic materials, reflecting the osteogenic potential of the pediatric periosteum. This case emphasizes the importance of distinguishing secondary pressure-related bone remodeling from true intraosseous lesions in the pediatric craniofacial region and highlights the capacity for natural osseous recovery following removal of the compressive source. A brief review of relevant embryologic and radiologic considerations is also provided.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 3","pages":"146-150"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392340","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":"Scalp salvage with acellular dermal matrix assistance for recurrent exposure of deep brain stimulation hardware: a case report.","authors":"Min Ho Lee, Da Yoon Kwon, Junho Lee, Sung-No Jung, Bommie Florence Seo","doi":"10.7181/acfs.2026.0086","DOIUrl":"10.7181/acfs.2026.0086","url":null,"abstract":"<p><p>Recurrent scalp compromise following deep brain stimulation (DBS) implantation remains a challenging reconstructive problem, particularly in patients with chronic infection and repeated revision procedures. We present an acellular dermal matrix (ADM)-assisted salvage strategy using rotational scalp flap coverage with adjunctive calvarial recession for preservation of exposed DBS hardware. After debridement and subperiosteal flap elevation, ADM was applied over the exposed hardware as a biologic reinforcement layer prior to tension-free closure. Adjunctive calvarial recession was performed to reduce hardware prominence. Postoperative computed tomography demonstrated decreased hardware projection, and stable wound healing without recurrent dehiscence or infection was maintained during follow-up. This combined approach may represent an effective salvage option for recurrent DBS scalp compromise while preserving functional neuromodulation hardware.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 3","pages":"156-161"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392415","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":"Syndromic craniosynostosis: current concepts in intracranial hypertension, cranial base pathology, and surgical management.","authors":"So Young Lim","doi":"10.7181/acfs.2026.0080","DOIUrl":"10.7181/acfs.2026.0080","url":null,"abstract":"<p><p>Syndromic craniosynostosis is characterized by premature fusion of multiple cranial sutures accompanied by progressive craniofacial dysostosis and neurological complications. Although reduction of intracranial volume (ICV) was historically regarded as the principal mechanism underlying elevated intracranial pressure (ICP), contemporary evidence suggests that intracranial hypertension in syndromic craniosynostosis is multifactorial. Abnormal cerebrospinal fluid circulation, venous hypertension, upper airway obstruction, and premature cranial base fusion appear to contribute substantially to disease progression. A narrative review was performed using previously published clinical studies, radiologic investigations, and institutional experience regarding syndromic craniosynostosis, with emphasis on Crouzon syndrome, cranial base suture fusion, increased ICP, hydrocephalus, and surgical outcomes. Recent radiologic investigations demonstrated that cranial base sutures and synchondroses exhibit characteristic physiologic closure patterns during childhood. In syndromic craniosynostosis, particularly Crouzon syndrome, premature cranial base fusion correlates with recurrent increased ICP and repeated cranial vault remodeling procedures. Elevated ICP cannot be explained solely by reduced ICV because many patients maintain relatively normal ICV through compensatory cranial growth. Clinical manifestations of intracranial hypertension are often nonspecific, whereas papilledema and radiologic changes remain useful surveillance markers. Contemporary surgical management includes fronto-orbital advancement, cranial vault remodeling, distraction osteogenesis, endoscopic strip craniectomy, and long-term multidisciplinary monitoring. Syndromic craniosynostosis represents a progressive disorder involving not only major calvarial sutures but also cranial base structures. Premature cranial base fusion may serve as an important prognostic factor for recurrent intracranial hypertension and disease severity. Improved understanding of cranial base pathology may facilitate individualized treatment strategies and improve long-term neurological outcomes.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 3","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392372","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":"Platelet-rich fibrin in the management of mandibular fractures.","authors":"Premsak Sakarinpanichakul, Watchara Burapholkul","doi":"10.7181/acfs.2025.0079","DOIUrl":"10.7181/acfs.2025.0079","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich fibrin (PRF) is an autologous biomaterial that promotes tissue regeneration through sustained release of growth factors. Its role in accelerating bone healing in mandibular fractures, however, remains incompletely defined. This study evaluated the effect of PRF on bone regeneration following open reduction and internal fixation (ORIF) of bilateral mandibular fractures.</p><p><strong>Methods: </strong>A prospective split-mouth clinical trial was conducted at a single center between December 2023 and September 2025. Twenty patients with bilateral mandibular fractures were enrolled; each patient received PRF on one fracture side and conventional ORIF on the contralateral side. Bone density was quantified using Hounsfield units (HU) from preoperative and postoperative computed tomography scans at 2 weeks, 1 month, and 3 months. Statistical analysis employed a two-way repeated-measures analysis of variance with post hoc comparisons.</p><p><strong>Results: </strong>Eighteen patients completed the 3-month follow-up and were included in the final analysis. Bone density increased significantly over time in both sides (p< 0.001), with a significant side by time interaction (p< 0.001). At 3 months, PRF-treated sites demonstrated higher HU values (700.0± 152.1) than controls (567.8± 135.7), yielding a mean difference of 132.2 HU (p< 0.001, Cohen's d= 0.94). No early intergroup differences or postoperative complications were observed.</p><p><strong>Conclusion: </strong>Adjunctive use of PRF significantly enhanced bone density at 3 months without increasing complications. PRF appears to promote late-stage bone mineralization; however, larger multicenter studies with longer follow-up are required before recommending routine clinical implementation.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 2","pages":"55-64"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846131","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":"Synchronous presentation of cutaneous CD30-positive large T-cell lymphoma and glomangioma of the upper lip: a case report.","authors":"Jignesh Rajguru, Kunal Patankar, Ramakrishna Shenoi, Rajiv Desai, Kalyani Puntambekar, Shreeyash Khadse","doi":"10.7181/acfs.2025.0059","DOIUrl":"10.7181/acfs.2025.0059","url":null,"abstract":"<p><p>We report a rare case of synchronous presentation of cutaneous CD30 (cluster of differentiation 30)-positive anaplastic large T-cell lymphoma and glomangioma involving the labial mucosa of the upper lip, highlighting its diagnostic challenges and clinical significance. A 61-yearold woman presented with a mildly tender mucosal lump measuring approximately 7× 4× 2 mm on the inner aspect of the upper lip, without ulceration, discoloration, or other distinctive clinical features. An excisional biopsy was performed under local anesthesia. Histopathological examination revealed a high-grade lymphoproliferative lesion composed of pleomorphic large, atypical cells, consistent with anaplastic large cell lymphoma. Notably, the lymphomatous lesion was located over a well-circumscribed glomangioma characterized by dilated vascular channels. This case underscores the importance of maintaining a high index of suspicion and performing thorough histopathological and immunohistochemical evaluation of all excised lesions, even when clinical features suggest a benign process. The rarity of this synchronous presentation underscores the need for heightened diagnostic vigilance and contributes valuable insight to the existing literature on unusual tumor associations in the oral and maxillofacial region.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 2","pages":"94-99"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846087","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":"Single-field reconstruction of congenital longitudinal cleft earlobes using large Z-plasty and dermofat grafting.","authors":"Youngjin Kim, Jun Park, Sang Yoon Kang, Jin Sik Burm","doi":"10.7181/acfs.2025.0114","DOIUrl":"10.7181/acfs.2025.0114","url":null,"abstract":"<p><p>Congenital longitudinal cleft earlobes (CLCEs) present a ginkgo leaf-shaped malformation with combined skin and soft-tissue deficiency along the inferior margin. No previous method has addressed both deficiencies while preserving earlobe length and contour. We introduce a simple, single-field procedure that combines a large, single Z-plasty for complete skin preservation with dermofat grafting for volumetric restoration. A Z-plasty was designed on the cleft-side skin, with the central limb placed along the cleft valley and the opposing limbs aligned with the anterior and posterior ridges of both lobules. After elevating both triangular flaps and fully releasing the contracted fibrotic tissue at the cleft base, a compact, dense dermofat graft harvested from the ipsilateral mastoid area was inserted into the inferior marginal defect and anchored to prevent superior migration. The Z-plasty flaps were then transposed and closed without skin sacrifice. Postoperatively, the superior portion of the earlobe was compressed to prevent graft displacement. At 16-32 months of follow-up, all reconstructed earlobes maintained stable volume and natural contour without horizontal or vertical shortening. This combined technique provides a reliable, tissue-preserving, and cosmetically favorable option for correcting CLCEs, effectively resolving both skin and soft-tissue deficiencies within a single operative field.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":"27 2","pages":"108-111"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846055","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}