Journal of Cranio-Maxillofacial Surgery最新文献

{"title":"Mandibular positioning using patient-specific guides and osteosynthesis implants in bimaxillary orthognathic surgery with maxilla-first approach. A 3D-analysis.","authors":"Mario Scheurer, Johannes Schulze, Thomas Lins, Tobias Daut, Robin Kasper, Frank Wilde, Alexander Schramm, Marcel Ebeling, Andreas Sakkas","doi":"10.1016/j.jcms.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.08.002","url":null,"abstract":"<p><p>The aim of this study was to evaluate the accuracy of a fully 3D planned digital workflow for bimaxillary osteotomies, utilizing patient-specific osteotomy and drill guides (PSDOG) and osteosynthesis implants (PSOI), within a maxilla-first approach. Emphasis was placed on the accuracy of guided mandibular positioning. This retrospective study included 30 patients undergoing bimaxillary orthognathic surgery [bimaxillary PSDOG/PSOI (Group 1; n = 11) versus maxillary PSDOG/PSOI (Group 2; n = 19)]. 3D CT datasets were used for accuracy assessment. Primary outcome parameter was the accuracy of the intraoperative mandibular transfer evaluated on cephalometric landmarks. Secondary outcome parameter was the 3D accuracy of mandibular positioning. Cephalometric analysis revealed significant vertical undercorrections and lateral deviations in the positioning of proximal mandibular segments (adj. p < 0.05). 3D analysis revealed a trend towards lower maximal deviations at the left ascending ramus in Group 1 (p = 0.058). Moderate positional accuracy was observed, with the largest vector deviations occurring in the latero-inferior-anterior direction. Iatrogenic injuries and bad splits were lower in Group 1 (p ≥ 0.52). Duration of surgery did not differ significantly between groups (p = 0.21). Fully guided and patient-specific orthognathic procedures enable precise and reproducible mandibular repositioning and may contribute to a reduction in intraoperative complication rates. However, control of the proximal segments, particularly condylar positioning, remains limited.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979229","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":"3D virtual surgical planning in patients with bilateral cleft lip and palate undergoing premaxilla osteotomy combined with secondary alveolar bone grafting: a retrospective accuracy analysis","authors":"L.S. Klunder ,&nbsp;B.B.J. Merema ,&nbsp;A.Z. Matthews-Brzozowski ,&nbsp;J. Jansma ,&nbsp;S.E.C. Pichardo ,&nbsp;J. Kraeima ,&nbsp;J.M. Alberga","doi":"10.1016/j.jcms.2025.07.013","DOIUrl":"10.1016/j.jcms.2025.07.013","url":null,"abstract":"<div><div>This retrospective study evaluates the surgical accuracy of 3D virtual planning and the use of computer-aided design/computer-aided manufacturing splints in premaxillary osteotomy combined with secondary alveolar bone grafting.</div><div>The study included all consecutive patients with bilateral cleft lip and palate undergoing a premaxillary osteotomy with secondary alveolar bone grafting treated by the Cleft Team North (the Netherlands) between 2016 and 2023. 3D virtual surgical planning was based on cone beam computed tomography scans and intraoral scans or plaster models. Surgical accuracy was assessed by comparing the planned and postoperative images of the premaxilla through three linear and three angular measurements. Eleven patients were included (mean age: 9.8 years). The mean Euclidean distance between the planned and postoperative outcomes was 1.57 ± 0.79 mm. Linear measurements showed mean differences of 0.74 ± 0.76 mm medio-laterally, 0.65 ± 0.53 mm caudo-cranially, and 0.89 ± 0.70 mm anteroposteriorly. Angular differences were 6.66 ± 5.12° for pitch, 5.09 ± 5.14° for yaw, and 4.61 ± 5.05° for roll. The intra-observer variability was 0.85 ± 0.58 mm and the intraclass correlation coefficient 0.99.</div><div>High surgical accuracy can be achieved using 3D virtual surgical planning and computer-aided design/computer-aided manufacturing splints in premaxillary osteotomy combined with secondary alveolar bone grafting.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1904-1910"},"PeriodicalIF":2.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979164","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":"Ameloblastoma: The association of BRAF V600E expression with clinicopathological characteristics and treatment outcomes in a case series","authors":"S. Crimi ,&nbsp;S. Battaglia ,&nbsp;R. Giudice ,&nbsp;V. Ronsivalle ,&nbsp;M. Cicciù ,&nbsp;A. Bianchi","doi":"10.1016/j.jcms.2025.08.010","DOIUrl":"10.1016/j.jcms.2025.08.010","url":null,"abstract":"<div><h3>Objectives</h3><div>Ameloblastoma is a benign tumor with clinical significance due to its high incidence as well as high recurrence rate after surgical enucleation. Notably BRAF V600E pathogenic mutations have been reported in high rate of ameloblastoma. The aim of this study was investigating the association of BRAF V600E expression with clinicopathological characteristics, treatment outcomes and recurrence rates.</div></div><div><h3>Material and methods</h3><div>We have analyzed 10 patients with ameloblastoma followed by a three-year evaluation, to understand the pathogenesis and molecular mechanism underlying the tumorigenic. All samples were tested for genomic DNA to identify Esone 15 mutations (codon 600) by PCR and perkiness on rotorgene Q and Pyromark Q24, by the Pathological Anatomy Department.</div></div><div><h3>Results</h3><div>Positive BRAF V600E mutation was detected in 4 of the 10 ameloblastoma cases. Three of the patients with BRAF V600E mutation had a recurrence within 3 years from the first surgery. The fourth patient with mutation showed no signs of relapse during followup. In only one BRAF- patient we showed recurrence of disease, 14 years after the last surgery. Another significant finding from the study is the correlation between the presence of the mutation and the initial size of the lesion.</div></div><div><h3>Conclusions</h3><div>Ameloblastoma with BRAF V600E mutation has been observed with a higher recurrence rate and an increased initial volume of the lesion. The results obtained demonstrate an increased aggressiveness and invasiveness of BRAF + ameloblastomas.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1911-1915"},"PeriodicalIF":2.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979238","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":"Three-dimensional tomographic assessment of the distances for access to superior joint space in the arthroscopy of temporomandibular joint","authors":"Fábio Ricardo Loureiro Sato ,&nbsp;Gustavo Tralli ,&nbsp;Marcelo Marotta Araujo ,&nbsp;Rodrigo Dias Nascimento ,&nbsp;Fernando Vagner Araldi ,&nbsp;Michelle Bianchi de Moraes","doi":"10.1016/j.jcms.2025.08.006","DOIUrl":"10.1016/j.jcms.2025.08.006","url":null,"abstract":"<div><div>In recent years, the refinement and dissemination of minimally invasive techniques for the surgical management of intra-articular pathologies have gained considerable relevance within the therapeutic arsenal, chiefly owing to the reduced morbidity associated with such interventions. Despite these advantages, arthroscopic procedures are not devoid of risks, particularly because the insertion of trocars and instruments into the joint is frequently performed in a blind manner, thereby increasing the likelihood of inadvertent iatrogenic events and technical complications. In view of these limitations, the present investigation sought to undertake a tridimensional morphometric analysis based on computed tomography in order to define precise anatomical parameters for intra-articular access routes during arthroscopic interventions. For this purpose, a total of 50 computed tomography (CT) scans were analyzed, with the goal of calculating three-dimensional insertion points for arthroscopic instrumentation. These values were subsequently compared with linear reference measurements previously established in the literature, as well as between gender and across individuals stratified by obesity status. The results demonstrated minimal variation in relation to the standard anatomical references reported in prior studies, with no statistically significant differences detected between male and female individuals. However, a significant disparity was identified between obese and non-obese subjects, particularly with respect to the soft tissue thickness overlying the access site. These findings underscore the necessity of individual arthroscopic entry point planning in obese patients to account for such anatomical differences, thereby reducing the risk of access-related complications and enhancing procedural safety.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1886-1891"},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979280","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":"Donor-site morbidity and aesthetic outcomes in patients undergoing head and neck reconstruction with anterolateral thigh or latissimus dorsi flaps: A systematic review and meta-analysis","authors":"Yuting Wang ,&nbsp;Chun Liang ,&nbsp;Quanquan Lin ,&nbsp;Lin Feng ,&nbsp;Libo Luo ,&nbsp;Haoran Jia ,&nbsp;Joseph Y. Zhang ,&nbsp;Maria J. Troulis ,&nbsp;Qing Xi ,&nbsp;Youbai Chen","doi":"10.1016/j.jcms.2025.08.012","DOIUrl":"10.1016/j.jcms.2025.08.012","url":null,"abstract":"<div><h3>Background</h3><div>Anterolateral thigh (ALT) and latissimus dorsi (LAT) flaps are workhorse flaps for head and neck reconstruction. However, evidence showing how donor-site morbidity (DSM) compares between these flaps is lacking. This systematic review and meta-analysis evaluates DSM and aesthetic outcomes with ALT and LAT flaps for head and neck reconstruction.</div></div><div><h3>Methods</h3><div>We reviewed articles identified in the PubMed, Web of Science, and Cochrane databases. Methodological quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality Scale. We performed a meta-analysis using fixed- and random-effects models to estimate the incidences of different DSM and dissatisfaction with the aesthetic outcome. These pooled incidences were compared between the ALT and LAT groups using Fisher exact test.</div></div><div><h3>Results</h3><div>We identified 82 studies including a total of 4436 patients who underwent reconstruction with an ALT flap (n = 3689) or LAT flap (n = 747). In the ALT flap group, the most prevalent DSM was paresthesia (21.2 %), followed by movement dysfunction (4.0 %), and poor wound healing (3.9 %). In the LAT group, the most prevalent DSM was hematoma (10.3 %), followed by movement dysfunction (10.1 %) and poor wound healing (8.6 %). The incidences of dissatisfaction with donor site appearance were 6.3 % in the ALT flap group and 2.4 % in the LAT flap group. Intergroup comparison of these DSM showed no statistically significant differences except a higher rate of donor site hematoma in the LAT flap (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The results of this meta-analysis suggest that LAT flaps have higher risk of hematoma/seroma and both flaps provide acceptable donor-site aesthetics. Additional well-designed prospective clinical studies are needed to enhance our understanding of DSM with large myocutaneous flaps in the setting of head and neck reconstruction.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1892-1903"},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979179","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":"Citation integrity in the age of AI: evaluating the risks of reference hallucination in maxillofacial literature","authors":"Anuj Jain ,&nbsp;Pranali Nimonkar ,&nbsp;Pratap Jadhav","doi":"10.1016/j.jcms.2025.08.004","DOIUrl":"10.1016/j.jcms.2025.08.004","url":null,"abstract":"<div><div>The increasing adoption of large language models (LLMs) such as ChatGPT in academic writing has introduced both opportunities and risks. While these tools enhance productivity and accessibility, their reliability in generating accurate references remains uncertain. This short communication highlights the growing concern of ‘reference hallucination’, where AI-generated citations appear legitimate but are fabricated or contain significant metadata errors. Across all scientific disciplines, including oral and maxillofacial surgery (OMFS), where evidence-based practice is foundational, such inaccuracies can undermine academic integrity and clinical trust. This article summarizes common reference-related errors reported in literature and calls for heightened editorial vigilance, AI-literacy training, and the integration of real-time bibliographic tools. Responsible use of AI in scholarly publishing is essential to preserving the quality and credibility of surgical literature.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1871-1872"},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884278","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":"Assessing three-dimensional soft tissue changes and the prediction of hard tissue changes after orthognathic surgery with a novel digital workflow","authors":"Jeremy Ho,&nbsp;Bingshuang Zou,&nbsp;HsingChi von Bergmann,&nbsp;Vincent Lee","doi":"10.1016/j.jcms.2025.08.013","DOIUrl":"10.1016/j.jcms.2025.08.013","url":null,"abstract":"<div><div>To investigate the application of three-dimensional hard and soft tissue virtual surgical planning in orthognathic surgery using a novel digital workflow, we prospectively included twenty-one consecutively treated patients from two private oral surgery practices. Soft tissue facial scans were acquired using the Artec Space Spider, and intra-oral scans were obtained at one month before (T0), and at two (T1) and six months (T2) post-surgery. Cone-beam computed tomography (CBCT) scans were collected at T0 and T1. Serial three-dimensional soft and hard tissue changes were assessed by superimposing the scans in Geomagic Control X. Achieved hard tissue changes were compared to pre-surgical predictions. Differences in soft and hard tissue changes between patients treated with fixed appliances versus Invisalign® were also analyzed. The Artec Space Spider proved to be a reliable component of a novel digital workflow for virtual surgical planning, demonstrating repeatability and reproducibility. Clinically significant soft tissue relapse was observed in both the maxillary and mandibular regions between T1 and T2. Predicted surgical movements for hard tissue landmarks showed high accuracy, and soft-to-hard tissue change ratios at T1 aligned with two-dimensional data reported in the literature. No significant differences in soft or hard tissue changes were found between fixed appliances and Invisalign®. These findings provide valuable insights for enhancing surgical planning and improving clinical outcomes for both clinicians and patients.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1878-1885"},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979206","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":"Virtual surgical planned subperiosteal implants. 3 years of follow up. Tips and tricks for a proper management","authors":"Paolo Cariati ,&nbsp;Fernando Pérez Salazar ,&nbsp;Lydia Fraile Ruíz ,&nbsp;Carlos Hugo Martínez Martínez ,&nbsp;Ildefonso Martinez Lara","doi":"10.1016/j.jcms.2025.08.008","DOIUrl":"10.1016/j.jcms.2025.08.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Severe maxillary atrophy presents significant challenges in oral rehabilitation, particularly for patients refusing conventional bone augmentation procedures. This study evaluates the 3-year clinical outcomes of digitally planned subperiosteal implants in 12 cases of extreme atrophy (Class V and VI of the Cawood and Howell Classification), analyzing survival rates, complication patterns, and providing evidence-based technical recommendations.</div></div><div><h3>Materials and methods</h3><div>A retrospective case series included patients with maxillary atrophy who declined conventional implants or bone grafting, opting instead for immediate loading under local anesthesia. Virtual planning (facial CT/intraoral scans) guided the fabrication of custom frameworks, fixed via self-tapping screws after osteotomy. Complications were analyzed using frequency-based methods.</div></div><div><h3>Results</h3><div>All 12 cases achieved immediate prosthetic loading (24 h post-surgery). Complications occurred in 4/12 of cases, including framework exposure (2 cases, managed conservatively), postoperative bleeding (1 anticoagulated patient), and one implant failure due to inadequate bone reshaping (successfully revised). The 3-year survival rate was 91.7 %.</div></div><div><h3>Conclusions</h3><div>Virtually planned subperiosteal implants offer a reliable alternative for severe atrophy when patients refuse general anesthesia or extended healing periods. Key recommendations include avoiding lateral incisions, using dual surgical guides, and pre-drilling pilot holes. While complications were observed in one-third of cases, they were typically manageable and did not compromise long-term function. Subperiosteal implants represent a viable option for immediate rehabilitation in carefully selected patients when combined with meticulous planning and execution.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1873-1877"},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979248","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":"Predicting the need for orthognathic surgery in cleft patients: A systematic review","authors":"Timothy Jie Han Sng ,&nbsp;Sophia Hui Jia Choo ,&nbsp;Adaia Valls-Ontañón ,&nbsp;Chai Kiat Chng ,&nbsp;Myra Nee Lin Wen Jui Elliot ,&nbsp;Raymond Chung-Weng Wong","doi":"10.1016/j.jcms.2025.07.025","DOIUrl":"10.1016/j.jcms.2025.07.025","url":null,"abstract":"<div><h3>Objectives</h3><div>A systematic review was performed to determine the predictive factors for orthognathic surgery in the cleft population.</div></div><div><h3>Materials &amp; methods</h3><div>A systematic search was made in Cochrane, Embase, Pubmed, Scopus, Web of Science and Google Scholar based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search terms focus on the variables or factors that are associated with or predictive for the later need for orthognathic surgery in patients with cleft lip &amp;/or palate (CLP). Clinical studies published from inception until July 2024 were included. Full text of potentially relevant studies were retrieved and independently examined by two reviewers.</div></div><div><h3>Results</h3><div>A total of 296 articles were identified. Eighteen studies were eligible for final inclusion. Out of the 1345 patients, unilateral CLP was the most common cleft subtype (64.0 %). All were retrospective in nature and the quality of most studies was moderate. Due to the heterogeneity of the studies, a meta-analysis could not be performed. Factors that were significantly associated with indication for future orthognathic surgery in cleft children were categorised into a) iatrogenic, b) intrinsic and c) cephalometric-based variables. Amongst all the factors in these 3 categories, a lower ANB angle was the most widely mentioned predictive factor for subsequent OGS in CLP patients. The age at which such prediction was derived, ranged from 5 to 11 years old.</div></div><div><h3>Conclusion</h3><div>Although further well-controlled studies are needed to better provide clinicians with predictive factors of the need for cleft orthognathic surgery, both intrinsic and iatrogenic factors have been shown to influence the overall maxillofacial growth in CLP patients.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1857-1870"},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884279","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":"Three-dimensional reconstruction based on computed tomography/magnetic resonance imaging multimodal image fusion for parotid gland tumor diagnosis and treatment","authors":"Liu Yue (刘玥),&nbsp;Yu Yao (于尧),&nbsp;Tang Zunan (唐祖南),&nbsp;Hu Leihao (胡耒豪),&nbsp;Zhang Wenbo (章文博),&nbsp;Peng Xin (彭歆)","doi":"10.1016/j.jcms.2025.08.001","DOIUrl":"10.1016/j.jcms.2025.08.001","url":null,"abstract":"<div><div>This research evaluated a novel computed tomography (CT)/magnetic resonance imaging (MRI) fusion-based three-dimensional (3D) reconstruction method for parotid gland tumor diagnosis and treatment. In 11 patients with primary parotid tumors adjacent to the facial nerve, contrast-enhanced CT and 3D multi-echo in steady acquisition MRI images were automatically fused, segmented, and reconstructed to visualize tumors and critical anatomical structures. Preoperative tumor localization and tumor–nerve relationship assessments matched intraoperative findings in 90.9 % of cases. The method outperformed facial nerve line identification in deep lobe tumor assessment. Mean deviation distances for total, nerve, vascular, and tumor markers were 3.14 ± 1.80, 3.51 ± 1.85, 2.40 ± 1.49, and 2.47 ± 2.04 mm, respectively. Of five cases with facial nerve invasion on 3D reconstruction, three received nerve sacrifice and anastomosis, whereas two with nerve continuity preservation received postoperative radiotherapy. This technique enables precise spatial mapping of parotid tumors, aiding surgical planning and facial nerve preservation.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1848-1856"},"PeriodicalIF":2.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859953","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}