Journal of Cranio-Maxillofacial Surgery最新文献

{"title":"Postoperative assessment of forehead contouring in facial feminization surgery.","authors":"Sead Abazi, Till Schatzmann, Michel Beyer, Lukas Seifert, Neha Sharma, Shankeeth Vinayahalingam, Alexander Lunger, Dirk J Schaefer, Florian M Thieringer","doi":"10.1016/j.jcms.2025.08.014","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.08.014","url":null,"abstract":"<p><p>Facial feminization surgery (FFS) is essential for transgender women seeking alignment between facial appearance and gender identity. Frontal bone and sinus reshaping is a key component of FFS to achieve a more traditionally feminine contour. This retrospective study evaluates the effectiveness of frontal debossing by comparing pre- and postoperative volumetric and morphometric data. Sixteen patients who underwent frontal debossing at the University Hospital Basel between 2020 and 2024 were included. Preoperative and postoperative CT or CBCT scans were used to assess volume changes in the frontal bone, frontal sinus, and bilateral supraorbital rims. Additionally, changes in the nasofrontal angle were measured. Significant volume reductions were observed in all analyzed structures: left supraorbital rim (mean reduction 792.28 mm³), right supraorbital rim (726.19 mm³), frontal bone (2930.81 mm³), frontal sinus (2508.84 mm³), and combined frontal structures (3251.83 mm³). The nasofrontal angle increased by an average of 21.71°, indicating a substantial improvement in upper facial contour. These results support the clinical value of frontal debossing as an effective and safe component of FFS, providing quantifiable improvements in facial morphology and symmetry. This study further underscores the importance of individualized planning and objective outcome assessment in gender-affirming craniofacial surgery.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporomandibular joint osseous characteristics in skeletal short and long facial types with and without temporomandibular disorders: A three-dimensional comparative study.","authors":"Abeer A Almashraqi, Amira A Aboalnaga, Maged S Alhammadi, Ahmed A Thawaba, Mona M Salah Fayed","doi":"10.1016/j.jcms.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.09.005","url":null,"abstract":"<p><p>This study sought to compare the three-dimensional osseous characteristics of the temporomandibular joint in patients with skeletal short and long facial patterns with temporomandibular disorders (TMDs) presenting clinically as disc displacement with/without reduction (DDR/DDWR) and those without TMDs (non-TMD). One-hundred sixty adult patients were divided into two groups. Group 1 (n = 79) consisted of patients with DDR/DDWR, and Group 2 (n = 86) consisted of non-TMD patients. Each group was divided into skeletal short and long facial patterns following the mandibular plane inclination (MP/SN). Three-dimensional analysis was done using Cone-Beam Computed Tomography images to compare measurements of the glenoid fossa, mandibular condyles, and joint spaces between the two groups. The MP/SN showed insignificant differences between the DDR/DDWR and non-TMD groups in both patterns. Short facial patients showed significant variance in condyle length and width, while long facial patients demonstrated major differences in condyle height. Differences in condyle inclinations were observed in horizontal planes for short facial patients and in vertical and anteroposterior planes for long facial patients. Joint spaces also varied significantly in anterior, posterior, and medial spaces for long facial patients. The DDR/DDWR group with a long facial skeletal pattern exhibited significant variations in condyle dimensions, orientations, and positions, showing more anterior and inferior condylar placements, as well as differences in joint spaces. In contrast, these variations were not significant in patients with a short facial skeletal pattern.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstructing complexity: Indications for simultaneous and chimeric free flaps in extensive maxillofacial defects.","authors":"Jakob Fenske, Philipp Lampert, Henri Kreiker, Claudius Steffen, Steffen Koerdt, Christian Doll, Norbert Neckel, Max Heiland, Carsten Rendenbach, Kilian Kreutzer","doi":"10.1016/j.jcms.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.09.003","url":null,"abstract":"<p><p>Reconstructing complex head and neck defects using multiple simultaneous or chimeric microvascular free flaps is rare, with no established guidelines on indications. This study evaluates the indications, flap combinations, outcomes, and complications associated with these techniques in maxillofacial reconstruction. A retrospective analysis was conducted on patients who underwent either two simultaneous free flaps or chimeric free flaps for head and neck defects between February 2018 and December 2024. Flap success rates and complication rates were assessed. Twenty-two patients received simultaneous free flaps, with a flap-level success rate of 91 % and a complication rate of 55 %. The most common combination was a fibula free flap with an anterolateral thigh flap. Thirty-six patients underwent chimeric flap reconstruction, achieving a success rate of 94 % and a complication rate of 39 %. Indications for these reconstructions fell into three broad categories: extensive composite defects, complex extraoral defects requiring additional bone reconstruction, and defects involving compromised tissues due to prior radiotherapy or multiple surgeries. Chimeric flaps are a viable option for addressing complex defects in more vulnerable patients, while simultaneous free flaps are feasible for selected cases. Despite acceptable success rates, the elevated complication risks associated with simultaneous flaps necessitate vigilant postoperative monitoring.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic surgery: The convergence of digital innovations in head and neck surgery.","authors":"Yue Liu, Xue Zhao, Chengbi Xu, Dan Yu, Xueshibojie Liu","doi":"10.1016/j.jcms.2025.08.018","DOIUrl":"10.1016/j.jcms.2025.08.018","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the application value, technical advantages, clinical efficacy, educational impact, and challenges in promotion of the Da Vinci robotic surgical system (Transoral Robotic Surgery, TORS) in complex head and neck surgeries, providing a reference for the advancement of precise and intelligent surgery in this field.</p><p><strong>Methods: </strong>The technical principles and evolution of the Da Vinci system were analyzed. Its clinical application data in laryngeal, oropharyngeal, obstructive sleep apnea (OSA), nasal cavity, and thyroid surgeries were reviewed. The supporting role of digital technologies (AI, 3D visualization, VR, 3D printing) was assessed. Challenges related to cost and training requirements were summarized.</p><p><strong>Results: </strong>Leveraging advantages such as instrument flexibility, high-definition 3D visualization, tremor filtration, and precise manipulation, the Da Vinci system significantly enhanced outcomes in head and neck surgery: precise resection of laryngeal cancer reduced operative risks; efficient treatment of early-stage oropharyngeal squamous cell carcinoma (OPSCC) was achieved with fewer complications; favorable long-term survival rates were observed for OPSCC; OSA symptoms were effectively improved; and it demonstrated both minimally invasive benefits and therapeutic efficacy in recurrent nasal cavity cancers and thyroid surgeries. Digital technologies enhanced surgical precision and medical training efficiency. However, high unit costs and stringent training requirements limit its adoption in small and medium-sized hospitals.</p><p><strong>Conclusion: </strong>The Da Vinci system, integrated with digital technologies, significantly improves the safety, precision, and patient prognosis in head and neck surgery, while elevating medical education standards. High costs and intensive training needs are issues for why it is not widely used. Future tasks should emphasize cost-cutting to enhance patient care access and improve quality across the medical spectrum.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary bilateral cleft lip repair: An orbicularis oris muscle reorientation technique for philtrum reconstruction.","authors":"Ying Xie, Ye-Xin Yue, Yu-Chuan Fu, Xiao-Le Wang, Jian Li","doi":"10.1016/j.jcms.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.09.006","url":null,"abstract":"<p><p>Traditional surgical approaches typically involve end-to-end suturing of the orbicularis oris muscle during cleft lip repair. However, this method often leads to a flattened lip and requires subsequent secondary revision surgery. This retrospective single-arm study aims to evaluate the efficacy and aesthetic improvement of an orbicularis oris muscle reorientation technique for philtrum reconstruction in correcting secondary bilateral cleft lip nasolabial deformities. From October 2020 to January 2024, 34 patients with secondary bilateral cleft lip nasolabial deformities were included, with ages ranging from 16 to 36 years. The orbicularis oris muscle reorientation technique was employed to address nasolabial deformities. In the 34 patients, the nasolabial morphology was significantly improved postoperatively, with successful reconstruction of the vermilion tubercle (Ls-Sto) and the philtrum structure. The Ls-Sto thickness increased from an average preoperative of 7.02 ± 2.63 mm to 11.33 ± 3.04 mm. The extremely large columellar base (CobR-CobL) was reduced by 24.5 %, and the Cupid's peak distance (ChpR-ChpL) was reduced by 18 %. The convexity of the philtral ridge and the concavity of the philtral dimple were significantly enhanced. This study demonstrates that the orbicularis oris muscle reorientation technique is an effective approach for correcting secondary bilateral cleft lip nasolabial deformities. It successfully constructs a three-dimensional philtral ridge and achieves significant morphological improvement with stable outcomes observed during the 7-month follow-up period.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy of subsequent microvascular free flaps in head and neck reconstructive surgery.","authors":"Friedrich Mrosk, Emilia Schott, Victoria Vertic, Maximilian Richte, Jan Oliver Voß, Christian Doll, Carsten Rendenbach, Norbert Neckel, Kilian Kreutzer, Max Heiland, Steffen Koerdt","doi":"10.1016/j.jcms.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.09.004","url":null,"abstract":"<p><p>Microvascular free flap reconstruction is a standard technique in head and neck surgery with high success rates. Nevertheless, complications like early flap loss, locoregional recurrence of head and neck cancer and osteoradionecrosis may require further flap procedures. This study aims to assess outcomes and challenges associated with subsequent free flap procedures. In this retrospective cohort study, all patients who received subsequent free flaps between January 2013 and December 2022 were assessed and examined by explorative descriptive analysis. Furthermore, one exemplary case is presented. Overall, 69 patients with 150 free flaps were included, with up to 4 subsequently performed flaps. Reasons for subsequent flaps included early failure, local cancer recurrence, osteoradionecrosis and wound healing disorders. After early failures, subsequent flaps were successful in 97 % of this cohort. The more flaps were performed, the more likely the contralateral neck was used for vascular anastomosis and the more likely vein grafts were used. Subsequent free flap procedures are safe and viable options in head and neck reconstruction, even in cases of previous flap failure. Even if previous surgeries, already harvested flaps and radiation therapy might complicate the choice of reconstruction, this should not be a deterrent to achieve consistent rehabilitation of the patient.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EACMFS Prizes & Awards","authors":"","doi":"10.1016/S1010-5182(25)00284-7","DOIUrl":"10.1016/S1010-5182(25)00284-7","url":null,"abstract":"","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1916-1917"},"PeriodicalIF":2.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fitting accuracy of preformed osteosynthesis plates for zygomaticomaxillary complex fractures.","authors":"I I Raghoebar, R Schreurs, S A L Y Youssef, R Helmers, J de Lange, L Dubois","doi":"10.1016/j.jcms.2025.07.014","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.07.014","url":null,"abstract":"<p><strong>Background: </strong>Preformed osteosynthesis plates are a novel treatment option for the fixation of zygomaticomaxillary complex (ZMC) fractures. A preformed plate may improve the reduction accuracy, as an accurate fit and sufficient fixation possibilities are provided.</p><p><strong>Purpose: </strong>This study aimed to evaluate the virtual fitting accuracy of preformed anatomical osteosynthesis zygoma plates and to assess whether their shape and size are adequate for ZMC fracture treatment.</p><p><strong>Methods: </strong>The fitting accuracy of three preformed osteosynthesis plates (KLS Martin: zygoma small, zygoma large, and zygoma-paranasal) was evaluated in 100 patients with unilateral ZMC fractures. Using a semi-automatic method, the plates were virtually positioned in their optimal fitting position on the mirrored 3D model of the unaffected side. Overall virtual adequacy was assessed by calculating the plate-to-bone distance and evaluating the fixation possibilities.</p><p><strong>Results: </strong>The median (IQR) plate-to-bone distances were 0.22 [0.16-0.28] mm (zygoma small), 0.25 [0.20-0.34] mm (zygoma large) and 0.51 [0.41-0.75] mm (zygoma-paranasal), demonstrating a significant improvement in fitting accuracy as the plate size decreased (p < 0.001). The median (IQR) number of available fixation points differed significantly: 6 [5-7] (zygoma small), 7 [6-8] (zygoma large), and 14 [12.25-16] (zygoma-paranasal) (p < 0.001). The zygoma small, zygoma large, and zygoma-paranasal plates were deemed adequate in 97 %, 98 %, and 93 % of the fractures, respectively.</p><p><strong>Conclusions: </strong>Preformed anatomical osteosynthesis plates for ZMC reconstruction demonstrate an accurate fit, sufficient fixation possibilities, and overall virtual adequacy. These plates are designed to have a high level of anatomical congruence with the zygomatic bone, offering potential advantages in fracture reduction. However, successful clinical implementation requires careful attention to virtual surgical planning, and consideration of the plate rigidity and compulsive fit.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of COVID-19 on complications and long-term outcomes in maxillofacial trauma: A retrospective multicentre analysis.","authors":"Ladislav Czako, Mária Janickova, Branislav Borza, Kristian Simko, Sarah Kalmanova, Rastislav Juricek, Marek Sovis, Klaudia Uvegesova, Anna Kobyliakova, Peter Kizek","doi":"10.1016/j.jcms.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.08.019","url":null,"abstract":"<p><p>The COVID-19 pandemic significantly impacted global healthcare, including patterns of maxillofacial trauma. This multicentre retrospective study analysed 3954 patients treated from January 2018 to December 2023 at hospitals in Bratislava, Martin, and Kosice, covering three periods: pre-COVID, during COVID, and post-COVID. Data included patient demographics, trauma causes, treatment methods, and complication rates. While short-term complication rates remained consistent across the periods, statistical analysis showed a strong association between fracture type and complications (p < 0.001). Mandibular, alveolar process, and naso-orbito-ethmoidal (NOE) fractures had the highest short-term complication rates (9.8 %, 11.8 %, and 16.4 %, respectively). Long-term outcomes were significantly affected by fracture type and injury cause, with blow-in fractures resulting in persistent issues in 50 % of cases. The COVID-19 period showed slightly fewer short-term complications, but worse long-term outcomes, likely due to delayed care and limited follow-up. Post-COVID outcomes improved compared to pre-COVID levels. The findings underscore the importance of resilient and adaptable healthcare systems in managing trauma effectively during public health crises, offering key lessons for future protocols in trauma care. © The Author(s) 2025.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sagittal split ramus osteotomy-enhanced mandibular distraction osteogenesis: A biomechanically superior approach for three-dimensional reconstruction in severe micrognathia.","authors":"Xiang Li, Tianyu Zhao, Zhuoga Baima, Kan Li, Siyong Gao, Huanzhong Ji, Wei Sun, Xiang Gao, Guangsen Zheng, Guiqing Liao","doi":"10.1016/j.jcms.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.08.005","url":null,"abstract":"<p><strong>Background: </strong>Mandibular distraction osteogenesis (MDO) remains essential for severe micrognathia correction. The clinical adoption of conventional osteotomy techniques has been constrained by complications including non-union, inferior alveolar nerve injury, and dental germ damage, compounded by suboptimal occlusal relationships and compromised facial aesthetics. Critical considerations in MDO execution encompass neural structure preservation, osteotomy gap integrity, and achieving three-dimensional skeletal augmentation to enhance both functional stability and craniofacial proportions.</p><p><strong>Methods: </strong>Between January 2020 and September 2024, ten patients with severe micrognathia underwent MDO via sagittal split ramus osteotomy (SSRO) or vertical transversal osteotomy (VTO). A subset of patients subsequently underwent staged orthognathic procedures to optimize facial balance.</p><p><strong>Results: </strong>SSRO-based MDO (SSRO-DO) demonstrated superior clinical outcomes relative to VTO-DO, evidenced by 3-fold greater osteotomy surface area (p < 0.01) and thus 33 % superior central ossification area ratio (COAR) (p = 0.02). Postoperative enhance was confirmed with SSRO, achieving significant transverse expansion of mandibular body (p = 0.02). SSRO-DO group demonstrated significant improvement in sagittal advancement of mandibular body as well as facial contour against VTO-DO group.</p><p><strong>Conclusions: </strong>SSRO-DO demonstrates potential advantages over current VTO-DO. This technique facilitates primary deformity correction and preserves anatomical foundations for subsequent orthognathic refinement. Further studies and long-term follow-up are needed.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}