Journal of Cranio-Maxillofacial Surgery最新文献

{"title":"Prevalence of complications of buccal fat removal: A systematic review and meta-analysis.","authors":"Maryana Calisto Albuquerque, Karen Ariely Rocha Arruda, Gesner Francisco Xavier Junior, Andrea Cristina da Silva Gama Cerqueira, Carla Massignan, Flaviana Soares Rocha","doi":"10.1016/j.jcms.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.jcms.2024.12.014","url":null,"abstract":"<p><p>Removal of the buccal fat pad can be considered safe as long as there is a detailed analysis of anatomical landmarks. The objective of this study was to estimate the prevalence of intra- and postoperative complications resulting from buccal fat pad removal through a systematic review. The search strategy involved observational and/or interventional studies in humans that included at least one case of buccal fat pad removal with a description of the surgery, postoperative progress, and complications. Methodological quality assessment was performed using the JBI checklist. Study heterogeneity was assessed using the I2 test. In total, 12 studies were included. Out of 308 patients who underwent buccal fat pad removal, 81 experienced some form of complication, with an overall prevalence of 25% (95% CI = 0.04-0.46). Complications found in the data collection included edema (38.40%), trismus (30.09%), pain (19.41%), asymmetry (11.65%), facial nerve paralysis (0.97%), infection (0.48%), hematoma (0.48%), and unilateral emphysema (0.48%). All complications occurred in the postoperative period. There was high heterogeneity among the studies. One in four patients undergoing buccal fat pad removal experiences some form of postoperative complication. Consequently, the procedure should be recommended with caution because there is evidence for safety concerns and a lack of predictability in the evaluated studies.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985470","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":"Evaluation of a context-aware chatbot using retrieval-augmented generation for answering clinical questions on medication-related osteonecrosis of the jaw.","authors":"David Steybe, Philipp Poxleitner, Suad Aljohani, Bente Brokstad Herlofson, Ourania Nicolatou-Galitis, Vinod Patel, Stefano Fedele, Tae-Geon Kwon, Vittorio Fusco, Sarina E C Pichardo, Katharina Theresa Obermeier, Sven Otto, Alexander Rau, Maximilian Frederik Russe","doi":"10.1016/j.jcms.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.jcms.2024.12.009","url":null,"abstract":"<p><p>The potential of large language models (LLMs) in medical applications is significant, and Retrieval-augmented generation (RAG) can address the weaknesses of these models in terms of data transparency and scientific accuracy by incorporating current scientific knowledge into responses. In this study, RAG and GPT-4 by OpenAI were applied to develop GuideGPT, a context aware chatbot integrated with a knowledge database from 449 scientific publications designed to provide answers on the prevention, diagnosis, and treatment of medication-related osteonecrosis of the jaw (MRONJ). A comparison was made with a generic LLM (\"PureGPT\") across 30 MRONJ-related questions. Ten international experts in MRONJ evaluated the responses based on content, language, scientific explanation, and agreement using 5-point Likert scales. Statistical analysis using the Mann-Whitney U test showed significantly better ratings for GuideGPT than PureGPT regarding content (p = 0.006), scientific explanation (p = 0.032), and agreement (p = 0.008), though not for language (p = 0.407). Thus, this study demonstrates RAG to be a promising tool to improve response quality and reliability of LLMs by incorporating domain-specific knowledge. This approach addresses the limitations of generic chatbots and can provide traceable and up-to-date responses essential for clinical practice.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973392","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":"\"Modified arthroscopic disc repositioning and suturing technique for the treatment of TMJ anterior disc displacement without reduction: A technical note\".","authors":"Haoran Dong, Jie Lei, Kaiyuan Fu, Yi Zhang, Yang He","doi":"10.1016/j.jcms.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.jcms.2024.12.012","url":null,"abstract":"<p><p>Anterior disc displacement without reduction (ADDwoR) is one of the most common types temporomandibular disorders (TMD), which is often characterized by joint pain, abnormal joint sounds, and limited mouth opening. Disc repositioning has been described as an effective method to reduce joint pain and improve range of motion. Yang's arthroscopic disc repositioning and suturing surgery has been reported to be the most stable technique with 95%-98% of success rate. However, the main challenges of this procedure are as follows: (1) it is relatively complex and requires a pair of customized grippers (lasso-type and hook-type); (2) it needs a self-designed surgical suture, which is hardened at the end of the suture. The aim of the study was to introduce the modification to the technique and report on the efficacy of the treatment. A total of 25 patients (36 joints) with anterior disc displacement without reduction were included. The visual analogue scale (VAS) scores (0-10) decreased to 0.48 ± 0.92 at 3 months postoperatively (P < 0.0001). Patients with limited mouth opening preoperatively detected a significant improvement in maximum inter-incisal opening (MIO) of 37.59 ± 4.33 mm (P < 0.0001). MRI showed the discs were repositioned in all 25 patients, giving a success rate of 100%. This study reports a modification to Yang's technique which enables extracorporeal suture threading, without excessive limitations on the suture materials, and allowing for the completion of all suturing procedures using one single instrument. Limitations should be noted such as the small sample size and short follow-up period, and further investigation will be carried out in the future.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958989","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":"Zygomatic implants for rehabilitation of patients with oncologic and congenital defects: A case series","authors":"Gerardo Pellegrino ,&nbsp;Achille Tarsitano ,&nbsp;Stefano Ratti ,&nbsp;Francesco Ceccariglia ,&nbsp;Manlio Gessaroli ,&nbsp;Carlo Barausse ,&nbsp;Subhi Tayeb ,&nbsp;Pietro Felice","doi":"10.1016/j.jcms.2024.10.003","DOIUrl":"10.1016/j.jcms.2024.10.003","url":null,"abstract":"<div><div>This case series aimed to assess the clinical outcomes of oncologic patients rehabilitated with a zygomatic implant-supported prosthesis. Ten oncologic patients who underwent upper jaw resections due to cancer were enrolled in the study. Zygomatic implants were utilized for rehabilitation according to specified inclusion criteria. Surgical and prosthetic procedures were standardized, and implant and prosthetic survival rates, along with complications, were evaluated. The study cohort comprised 10 patients with a mean age of 66.5 years. A total of 35 implants were placed, with a survival rate of 94.29% at the mean follow-up of 5.78 years. Biological complications affected 40% of patients, while prosthetic complications occurred in 40% of patients, necessitating modifications but with no outright failures. Zygomatic implants offer a viable solution for oncologic patient rehabilitation, particularly in cases where bone grafting is contraindicated or impractical. However, they present medium-to long-term complications that warrant careful consideration. Future research should focus on larger studies and meta-analyses to provide more robust evidence.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 1","pages":"Pages 24-29"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570391","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":"Effectiveness of oral posaconazole and surgical debridement of rhino maxillofacial mucormycosis","authors":"Satnam Singh Jolly,&nbsp;Vidya Rattan,&nbsp;Apoorva Singh","doi":"10.1016/j.jcms.2024.10.010","DOIUrl":"10.1016/j.jcms.2024.10.010","url":null,"abstract":"","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 1","pages":"Pages 75-80"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583663","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":"A generalizable procedure for Brown's class Ⅱ and Ⅲ defects reconstruction with deep circumflex iliac artery flap using computer-assisted technique","authors":"Chun-Bo Dou ,&nbsp;Xiao-Pei Gao ,&nbsp;Zi-Li Yu ,&nbsp;Jun Jia","doi":"10.1016/j.jcms.2024.10.009","DOIUrl":"10.1016/j.jcms.2024.10.009","url":null,"abstract":"<div><h3>Objective</h3><div>This study summarizes and analyzes the characteristics of deep circumflex iliac artery (DCIA) flap reconstruction for maxillary defects and proposes a generalized protocol under the guidance of computer-assisted technique to enhance surgical efficiency and success rate.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed 10 cases of maxillary defects reconstructed using DCIA flaps under the application of computer-assisted technique, collecting clinical data for statistical analysis.</div></div><div><h3>Results</h3><div>These cases included 2 cystic lesions, 2 mucinous tumors, 2 ameloblastomas, 1 mucoepidermoid carcinoma, 1 odontogenic fibroma, 1 bone defect following squamous cell carcinoma (SCC) surgery, and 1 ossifying fibroma. According to Brown's classification system, there were 7 Type IIb defects, 1 Type IId defect, 1 Type IIIb defect, and 1 Type IIId defect. The length of the iliac bone harvested ranged from 42 mm to 100 mm, and the width from 20 mm to 51 mm. In 7 patients, chimeric iliac myofascial flaps were used; in 2 patients, deep circumflex iliac artery perforator (DCIAP) flaps were utilized; and in 1 patient, a vascularized iliac crest was employed. The recipient vessels were the facial artery and vein in all cases. Intraoral anastomoses were performed in 4 cases, and submandibular anastomoses in 6 cases. The donor site was chosen from the ipsilateral ilium in 8 patients and from the contralateral ilium in 2 patients. The mean operative time was 8.74 hours. Postoperatively, 9 patients recovered well without any complications, while 1 patient experienced necrosis of the bone flap on the first day after surgery and underwent secondary reconstruction using a vascularized fibula flap. The average postoperative hospital stay was 8.6 days.</div></div><div><h3>Conclusion</h3><div>The combination of DCIA flaps with computer-assisted technique provides a reliable method for the reconstruction of maxillary defects and functional restoration. Establishing generalized procedures could facilitate its broader application.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 1","pages":"Pages 66-74"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632954","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":"Investigating determinants of surgical success in excising basal cell and cutaneous squamous cell carcinomas of the head and neck: A single-center retrospective analysis","authors":"Philipp Becker ,&nbsp;Sven Nahrstedt ,&nbsp;Andreas Pabst ,&nbsp;Gunnar Müller ,&nbsp;Anne-Kathrin Bär ,&nbsp;Peer W. Kämmerer ,&nbsp;Bilal Al-Nawas ,&nbsp;Richard Werkmeister","doi":"10.1016/j.jcms.2024.10.008","DOIUrl":"10.1016/j.jcms.2024.10.008","url":null,"abstract":"<div><div>This study aimed to identify factors influencing the completeness of primary and re-excision of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (SCC), and cutaneous carcinoma in situ (CIS) of the head and neck. A retrospective single-center analysis was conducted, encompassing 1513 instances of cutaneous tumors recorded between 2015 and 2022. This dataset comprised 1108 primary excisions and 405 re-excisions, all of which were histologically verified cases of BCC, SCC, and CIS located within the head and neck region. Correlation analyses were performed, considering variables such as patients' gender and age, tumor localization, preoperative suspicion or histological confirmation of skin tumor diagnosis, surgeons’ levels of training, and the utilization of magnifying glasses. The primary objective was to assess the impact of these factors on the completeness of both primary and re-excisions of skin tumors. The analysis revealed a significant correlation between the localization of BCC and the completeness of primary excision. Specifically, the nose and ear exhibited a significantly higher rate of incomplete excisions (R1), whereas the cheek demonstrated a substantial reduction in the R1 rate. The utilization of magnifying glasses exhibited a positive correlation with the completeness of primary BCC excision. However, no discernible influencing factors were identified for BCC re-excisions and the combined group of primarily and re-excised cutaneous squamous cell carcinoma (SCC) and carcinoma in situ (CIS). Tumor entity and localization emerged as crucial factors influencing the completeness of skin tumor excisions, with specific anatomical sites exhibiting varying rates of incomplete procedures. Notably, the use of magnifying glasses demonstrated a significant positive correlation with reduced rates of incomplete excisions, re-excisions, and subsequent procedures, suggesting its potential as a valuable tool in enhancing surgical precision and optimizing outcomes.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 1","pages":"Pages 57-65"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741310","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":"Nasal injuries in amateur male boxers before and after the 2013 rule change by the International Boxing Association removing the protective headgear","authors":"Abdurrahman Al-Awady ,&nbsp;Alexis Batiste ,&nbsp;Christopher Cheng ,&nbsp;Ryan Sicard ,&nbsp;Vikram Vasan ,&nbsp;Joshua Rosenberg ,&nbsp;Mingyang Gray","doi":"10.1016/j.jcms.2024.09.005","DOIUrl":"10.1016/j.jcms.2024.09.005","url":null,"abstract":"<div><div>Boxing is a popular combat sport in which participants frequently experience head trauma. The neurological impact of boxing has been widely discussed, but the impact on the bone and soft tissue of the head has been less investigated. For this study, a national emergency department database was used to investigate the impact of a 2013 rule change — removing the requirement for amateurs to wear head protection — on the frequency and type of facial injuries sustained by amateur boxers. Over the study period (2006–2021) there were 11 760 injuries, with 6261 occurring before the change and 5499 occurring after (<em>p</em> &lt; 0.001). The number of contusions, fractures, hematomas, and hemorrhages all significantly decreased after the rule change, while the number of lacerations did not. Additionally, the number of septal deviations increased from 16 to 97 (<em>p</em> &lt; 0.001). According to age-group-specific analysis, injuries decreased in both the 0–17 and 24–29 cohorts, but increased in the 18–23 group. The results suggest that the rule change may have had a protective effect on the risk of craniofacial trauma in amateur boxers, potentially due to increased risk-averse behavior by the boxers, who may feel less protected during sparring because of the lack of head protection.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 1","pages":"Pages 6-9"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570388","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(24)00355-X","DOIUrl":"10.1016/S1010-5182(24)00355-X","url":null,"abstract":"","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 1","pages":"Pages 81-82"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094559","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":"Anatomical study and clinical outcomes of endoscopic transoral surgery for benign salivary gland tumors in the parapharyngeal space","authors":"Xudong Yan,&nbsp;Shunke Li,&nbsp;Lin Wang,&nbsp;Ruifeng Tan,&nbsp;Longgang Yu,&nbsp;Shengnan Zhang,&nbsp;Yan Jiang","doi":"10.1016/j.jcms.2024.09.004","DOIUrl":"10.1016/j.jcms.2024.09.004","url":null,"abstract":"<div><div>The existing literature provides little insight into the efficacy of transoral endoscopy in exposing benign tumors originating from salivary glands in the parapharyngeal space at the parotid gland base and resecting part of the deep lobe with a safe margin. This study aims to investigate the efficacy of the endoscopic transoral approach for the visualization and resection of such tumors.</div><div>Through transoral endoscopic cadaveric dissections and surgical procedures, we examined the anatomical structures of the parapharyngeal space and the deep lobe of the parotid gland, identifying key anatomical landmarks. We conducted a retrospective analysis of 19 patients with benign salivary gland-derived tumors in the parapharyngeal space who underwent transoral endoscopic resection.</div><div>Intraoperative visualization of the tumor pedicle and the deep lobe of the parotid gland was successfully achieved in all cases, allowing for resection with safe margins. During a median follow-up period of 54.0 months, imaging revealed no signs of recurrence.</div><div>Endoscopic transoral approach provides effective visualization of the deep lobe of the parotid gland and the medial portion of the parotid bed from the parapharyngeal space. Benign tumors of salivary gland-derived in this area can be well exposed and safely resected with adequate margins.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 1","pages":"Pages 1-5"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}