Journal of Cranio-Maxillofacial Surgery最新文献

{"title":"\"Injectable platelet-rich fibrin for modelling of mandibular lower border defects in bilateral sagittal split osteotomy\"","authors":"Lana Micko ,&nbsp;Ingus Skadins ,&nbsp;Girts Salms ,&nbsp;Arita Dubnika ,&nbsp;Karina Egle ,&nbsp;Oskars Radzins ,&nbsp;Matteo D'Este ,&nbsp;Sophie Verrier ,&nbsp;Aleksejs Dons ,&nbsp;Maksims Zolovs ,&nbsp;Ilze Salma","doi":"10.1016/j.jcms.2025.07.018","DOIUrl":"10.1016/j.jcms.2025.07.018","url":null,"abstract":"<div><div>Despite the remarkable progress in virtual surgical planning in the last few decades, which has made orthognathic surgery results more precise and predictable, there remains an unforeseeable risk of developing mandibular lower border defects after bilateral sagittal split osteotomy (BSSO). These defects can cause visible and palpable irregularities of the lower border of the mandible, thereby worsening the surgical result. The study aimed to evaluate the benefit of injectable platelet-rich fibrin (i-PRF) for contour defect modelling in orthognathic surgery in comparison to conventional orthognathic surgery. i-PRF was used to fill the osteotomy gap in BSSO aiming to stimulate bone tissue formation and reduce the risk of mandibular lower border defect formation. Additionally, the correlation between the concentration of the most important growth factors and interleukins in i-PRF and clinical outcomes of different patients was investigated. Also, the antibacterial activity of i-PRF was tested. Cone-beam computed tomography analysis demonstrated a statistically significant increase of bone volume in the BSSO vertical osteotomy gap when i-PRF was applied during surgery. The findings of the study support the use of an autologous biomaterial for BSSO, utilizing a simple preparation technique and application, while also contributing to a deeper understanding of i-PRF content and properties. Study protocol published in ISRCTN10296235 registry <span><span>https://doi.org/10.1186/ISRCTN10296235</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1769-1779"},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769374","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 complex dynamics of maxillofacial trauma in blast and fragmentation injuries: Current understanding and gaps in scientific evidence","authors":"Ricardo Grillo ,&nbsp;Leandro Bottura ,&nbsp;Bernardo Correia Lima ,&nbsp;Natacha Kalline de Oliveira ,&nbsp;Fernando Melhem-Elias ,&nbsp;Maria Cristina Zindel Deboni","doi":"10.1016/j.jcms.2025.07.017","DOIUrl":"10.1016/j.jcms.2025.07.017","url":null,"abstract":"<div><div>Recent epidemiological data demonstrate a significant rise in blast-induced maxillofacial trauma incidences in both military and civilian settings. This study aimed to comprehensively analyze maxillofacial trauma caused by heavy weaponry, examining blast dynamics, ballistic forces, and fragmentation effects.</div><div>A comprehensive literature review was conducted using PubMed, SciSpace, and Google Scholar, incorporating studies on blast injuries, ballistic trauma, and war-related maxillofacial damage. Keywords included \"maxillofacial injuries\", \"blast injuries\", \"ballistic trauma\", \"high-energy trauma\", \"heavy weapon injuries\", \"shock waves\", \"fragmentation injuries\", \"missile wounds\", \"grenade injuries\", \"shrapnel injuries\", and \"war-related maxillofacial trauma\". Inclusion criteria covered case reports, retrospective analyses, reviews, and clinical trials, while non-human and irrelevant studies were excluded. Data extraction and synthesis were performed to categorize injury mechanisms and surgical challenges.</div><div>The findings revealed distinct injury patterns, including comminuted fractures, barotrauma-induced sinus ruptures, and thermal-chemical burns. Blast waves preferentially damaged thin bony structures, while high-velocity shrapnel caused widespread soft-tissue disruption. Surgical management is complicated by contamination, delayed necrosis, and polytrauma, necessitating multidisciplinary approaches. Emerging solutions, such as 3D-printed implants and damage-control surgery, show promise but require further validation.</div><div>Heavy weaponry induces complex maxillofacial trauma that demands tailored, multidisciplinary care. Our review highlights critical gaps in existing protocols and underscores the need for advanced biomaterials, staged reconstruction, and battlefield-adapted surgical strategies. Future research should focus on predictive modeling and standardized guidelines to optimize outcomes in blast-related injuries.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1762-1768"},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769381","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":"Association between the timing of secondary alveolar bone grafting and maxillary permanent central incisor development in unilateral cleft lip and palate","authors":"Akihiro Saka ,&nbsp;Chiaki Nishizawa ,&nbsp;Yutaka Matsushita ,&nbsp;Toshimi Michigami ,&nbsp;Susumu Tanaka ,&nbsp;Emiko Tanaka Isomura ,&nbsp;Mikihiko Kogo ,&nbsp;Kazuaki Miyagawa","doi":"10.1016/j.jcms.2025.07.021","DOIUrl":"10.1016/j.jcms.2025.07.021","url":null,"abstract":"<div><div>Secondary alveolar bone grafting (SABG) supports the eruption of impacted permanent teeth and the establishment of a proper dental arch in patients with cleft lip and palate (CLP) or cleft lip and alveolus (CLA). However, the optimal timing for SABG remains controversial. This retrospective study aimed to evaluate the developmental changes of the maxillary permanent central incisor (MPCI) following SABG in patients with unilateral CLP (UCLP), using cone-beam computed tomography (CBCT). CBCT scans were collected from 49 patients (aged 4–10 years) with UCLP before and 12 months after SABG. The positional change and axial angulation of the MPCI within the alveolar cleft were quantitatively assessed. The greatest change in displacement and angulation changes of the MPCI were observed in patients who underwent SABG between 4 and 7 years of age, regardless of postoperative orthodontic intervention. The early SABG (aged 4–7 years) group showed greater axial angulation changes compared to the late group (aged 8–10 years). These findings suggest that early SABG may facilitate bone bridge formation, thereby supporting the physiological development of the MPCI on the cleft side. CBCT evaluation may be a useful tool for guiding clinical research and optimizing surgical timing in patients with UCLP.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1795-1803"},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776959","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":"Repairing composite mandibular defects with the chimeric deep circumflex iliac artery perforator flap","authors":"Qiu-Sheng Xu ,&nbsp;Zhou-Yang Wu ,&nbsp;Bi-Zhu Luo ,&nbsp;Xu-Hui Zhang ,&nbsp;Yi-Fang Zhao ,&nbsp;Yan-Ping Hu ,&nbsp;Zi-Li Yu ,&nbsp;Jun Jia","doi":"10.1016/j.jcms.2025.07.022","DOIUrl":"10.1016/j.jcms.2025.07.022","url":null,"abstract":"<div><div>Mandibular defects caused by congenital anomalies, oncologic resections, trauma, or infections impair essential functions such as mastication, speech, and facial aesthetics, necessitating reconstruction to restore both biomechanical integrity and quality of life. While fibula osteocutaneous flaps remain the gold standard for complex defects due to their versatility, the deep circumflex iliac artery (DCIA) bone flap—historically limited by inconsistent vascular anatomy and technical harvesting challenges—provides anatomical advantages but lacks reliable soft tissue utility. The chimeric DCIA perforator flap (DCIAPF) addresses these limitations by utilizing terminal DCIA skin perforators to create thin, well-vascularized skin paddles independent of muscular branches, thereby reducing bulk and donor-site morbidity. Building on prior anatomical studies that confirmed consistent perforator patterns and vascular reliability, this retrospective analysis evaluated 24 consecutive patients undergoing DCIAPF reconstruction for composite mandibular defects at the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University (August 2022–May 2024). All cases achieved successful restoration of mandibular dimensions (bone segments: 35.64–120.60 mm) and soft tissue repair (skin paddles: 5 × 3 cm–10 × 5 cm), with 100 % flap survival. Postoperative imaging demonstrated optimal bone integration, and donor sites healed primarily without grafts, showing minimal complications (one minor skin revision; one transient gait issue). The DCIAPF uniquely combines precise 3D mandibular reconstruction, adaptable soft tissue coverage, and concealed donor scars, supported by its robust vascular architecture. These outcomes position it as a functionally and aesthetically viable alternative to fibula-based techniques for complex composite defects.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1804-1811"},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769378","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":"Effect of neoadjuvant chemotherapy on the clinical outcomes and immune microenvironment in oral squamous cell carcinoma","authors":"Zhu You ,&nbsp;Tianqi Zhang ,&nbsp;Mingyang Liu ,&nbsp;Jie Wen ,&nbsp;Yihua Wu ,&nbsp;Shizhou Zhang","doi":"10.1016/j.jcms.2025.07.019","DOIUrl":"10.1016/j.jcms.2025.07.019","url":null,"abstract":"<div><div>Neoadjuvant chemotherapy (NAC) is increasingly significant in oral squamous cell carcinoma (OSCC), but its effect on the immunological profile of OSCC is not well defined. This study aims to evaluate NAC's impact on OSCC patients and to characterize immune checkpoints and tumor-associated immune cells in tumor specimens before and after NAC. We compared the effects of NAC (16 cases) and surgery alone (18 cases) in OSCC treatment. Immunological markers were analyzed in tumor samples from 12 OSCC patients (6 with NAC, 6 without) using multiplex immunofluorescence. Two antibody panels were used to quantify markers, including POXPE3, CD4, CD8, CD68, PD-1, PD-L1, CTLA-4, CD66b, CD16, CD19, Caspase-3, and GSDMD. No significant difference in overall survival was observed between the NAC and control groups. NAC did not harm patients and led to downstaging in 8 individuals. CD8+PDL1+ expression increased significantly in NAC-treated cases (P &lt; 0.05). Higher densities of PD1+, PDL1+, CTLA4+, and Caspase+ were found in NAC-OSCC. The density of CD8+PD1+, CD8+PDL1+, and CD68 + PDL1+ cells in the tumor was increased in NAC-treated cases. The densities of CD68⁺, CD16⁺, CD19⁺, CD66b+, and GSDMD + cells were lower in NAC-OSCC. NAC enhances clinical outcomes, reducing clinical stage and enabling more aggressive surgery, without causing harm. Increased CD8+PDL1+ cells in NAC-treated OSCC suggest that NAC may enhance immune response pathways, underscoring the need for further research into combining chemotherapy with immunotherapy in OSCC.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1780-1786"},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769376","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":"Surgical design and outcomes evaluation of two-jaw correction for short face syndrome with square jaw: A retrospective study","authors":"Zihang Zhou ,&nbsp;Hamza Younis ,&nbsp;Han Ge,&nbsp;Xiaoshuang Sun,&nbsp;Bin Ye,&nbsp;Jihua Li","doi":"10.1016/j.jcms.2025.07.020","DOIUrl":"10.1016/j.jcms.2025.07.020","url":null,"abstract":"<div><div>Short face syndrome with square jaw presents with vertical facial deficiency and prominent mandibular angles, compromising facial proportions and aesthetics. This retrospective study evaluated a surgical strategy combining two-jaw orthognathic surgery and mandibular angle ostectomy, with autologous maxillary bone grafting using resected mandibular angles. Twenty patients diagnosed with short face syndrome and square jaw underwent simultaneous maxillary advancement, inferior repositioning, mandibular “V-line” osteotomy, and inlay maxillary grafting. Spiral CT scans were obtained preoperatively (T0), 1 month postoperatively (T1), and 1 year postoperatively (T2). Changes in facial height and angles were assessed using repeated measures ANOVA and Bonferroni-corrected pairwise comparisons. Statistically significant improvements were observed across all parameters from T0 to T1, with minimal relapse between T1 and T2. At T2, total facial height increased by 6.05 ± 0.38 mm (P &lt; 0.001), and mandibular angle by 13.19 ± 1.11° (P &lt; 0.001), while occlusal and mandibular plane angles also improved significantly. No major complications occurred, and patient satisfaction was high. This approach effectively restored vertical proportions and facial harmony, while maintaining long-term stability. The use of autologous grafts from the mandibular angle provides a reliable, integrated solution for managing bone gaps without secondary donor sites.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1787-1794"},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769379","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 accuracy of dual energy CT on evaluation of bone invasion caused by oral squamous cell carcinoma – a comparison to MRI","authors":"Veronique C.M.L. Timmer ,&nbsp;Genevieve A.J.C. Crombag ,&nbsp;Sander M.J. van Kuijk ,&nbsp;Lauretta A.A. Vaassen ,&nbsp;Peter A.W.H. Kessler ,&nbsp;Alida A. Postma","doi":"10.1016/j.jcms.2025.07.005","DOIUrl":"10.1016/j.jcms.2025.07.005","url":null,"abstract":"<div><div>Bone marrow edema (BME) is a key sign of bone invasion by malignancies, alongside cortical involvement. Dual-energy CT virtual non-calcium (VNCa) reconstructions can visualize BME in the head and neck, but its role in evaluating bone invasion by oral squamous cell carcinoma (OSCC) remains underexplored. This study aimed to evaluate the accuracy of Dual energy CT (DECT) and additional virtual non-calcium (VNCa) reconstructions in detecting OSCC- related bone invasion in comparison to MRI using histology as reference standard. This retrospective study included 59 consecutive participants (mean age 68 years ± 12, 33 male) with primary OSCC who underwent both contrast-enhanced DECT and MRI. DECT weighted average (DECT WA) and DECT VNCa reconstructions were assessed for bone invasion based on the presence of cortical erosion, cortical disruption and cortical erosion combined with BME. DECT WA(erosion) showed a sensitivity and specificity of 95 % and 86 % comparable to MRI (92 % and 86 % respectively). Addition of VNCa-reconstructions to DECT WA did not improve sensitivity or specificity (84 % and 86 % respectively). Overall, accuracy of DECT is excellent and comparable to MRI for detecting bone invasion caused by OSCC. However, additional diagnostic benefits of VNCa reconstructions could not be shown in this study.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1731-1737"},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769380","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":"Efficiency and outcomes in microvascular anastomosis: A meta-analysis of mechanical versus manual techniques","authors":"Chaim Ohayon ,&nbsp;Niv Gross ,&nbsp;Tal Capucha ,&nbsp;Shaqed Carasso ,&nbsp;Yotam Shkedy ,&nbsp;Adi Rachmiel ,&nbsp;Omri Emodi","doi":"10.1016/j.jcms.2025.07.015","DOIUrl":"10.1016/j.jcms.2025.07.015","url":null,"abstract":"<div><div>Microvascular anastomosis plays a critical role in free flap transfers, aiming to reduce ischemia time, minimize vessel trauma, and optimize ease of use. This meta-analysis compares coupler devices and hand-sewn techniques for venous anastomosis across all types of free flaps, with a subgroup analysis focused on head and neck reconstruction. A comprehensive literature search following PRISMA guidelines was conducted across multiple databases up to November 6, 2024. Eighteen retrospective comparative studies met the inclusion criteria from an initial pool of 3184 articles. The overall flap loss rate was 1.53 % for coupler devices and 2.32 % for hand-sewn techniques. Thrombosis occurred in 2.91 % of coupler cases versus 3.17 % for hand-sewn. Anastomosis time was notably shorter with coupler devices (7.5 min) compared to hand-sewn methods (32.2 min). In head and neck reconstruction, the coupler group showed even more favorable outcomes: flap loss was 0.66 % versus 3.08 %, thrombosis rates were 1.7 % versus 3.88 %, and anastomosis times were 7.5 versus 17 min. These findings suggest that coupler devices are a safe and time-efficient alternative to traditional hand-sewn techniques in free flap surgery, particularly in head and neck reconstruction.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1720-1730"},"PeriodicalIF":2.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719068","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":"Mandibular condyle dislocation into the middle cranial fossa: First report of CAS-guided surgical management","authors":"Vittorio Chiantini ,&nbsp;Simone Benedetti ,&nbsp;Andrea Frosolini ,&nbsp;Flavia Cascino ,&nbsp;Guido Gabriele ,&nbsp;Vittoria Fantozzi ,&nbsp;Salvatore Chibbaro ,&nbsp;Luisa Bini ,&nbsp;Alfonso Cerase ,&nbsp;Paolo Galluzzi ,&nbsp;Paolo Gennaro ,&nbsp;Olindo Massarelli","doi":"10.1016/j.jcms.2025.07.004","DOIUrl":"10.1016/j.jcms.2025.07.004","url":null,"abstract":"<div><div>Traumatic mandibular condylar fractures are the most common mandibular fractures in maxillofacial surgery. Approximately 42 % of facial skeletal fractures involve the mandible, and of these, 34 % involve the mandibular condyle. Normally, due to its anatomical structure, the mandibular condyle fractures upon impact and dislocates anteriorly and/or medially. This mechanism preserves the integrity of the cranial base. In rare cases, a fracture of the glenoid fossa and an intrusion of the condylar head at the level of the middle cranial fossa occurs. This represents a serious complication, in which ensuring patient survival is the primary goal of the treatment, possibly followed by the restoration of joint functionality and the prevention of ankylosis. We present the first documented application of computer-assisted surgery (CAS) aided by in-house 3D printing for the management of this condition, enabling precise preoperative planning, enhanced patient counseling, and successful surgical outcomes. Stable occlusion and mandibular mobility were achieved and preserved after 3 months, with the support of re-adapted prostheses used for intermaxillary fixation and functional rehabilitation. This novel approach underscores the potential of CAS and 3D printing to revolutionize the preoperative and surgical approach of rare and complex cranio-maxillofacial cases.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1711-1719"},"PeriodicalIF":2.1,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719069","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":"Costal cartilage graft harvesting for auricular reconstruction: donor-site morbidity assessment","authors":"Laura Tognin ,&nbsp;Jacopo Benerecetti ,&nbsp;Michela Bergonzani ,&nbsp;Francesca Zito ,&nbsp;Giovanni Lilloni ,&nbsp;Andrea Varazzani ,&nbsp;Marilena Anghinoni","doi":"10.1016/j.jcms.2025.07.008","DOIUrl":"10.1016/j.jcms.2025.07.008","url":null,"abstract":"<div><div>Auricular reconstruction is a challenging procedure, and the use of autologous costal cartilage represents the gold standard for the treatment of congenital microtia. Since adolescents are a significant demographic for congenital reconstruction, age-related psychosocial factors must be considered. The aim of this study was to evaluate postoperative patient perception of donor-site morbidity following costal cartilage graft harvesting and its impact on social and physical activities.</div><div>We included patients treated at the University Hospital of Parma (Italy) between 2010 and 2020. Data collected included: scar evaluation, asymmetry of the thoracic profile, sport participation before and after surgery, physical limitation, donor-site long-term discomfort, postoperative pain.</div><div>A total of 100 patients were enrolled in the study (58 males and 42 females; mean age: 13.58 years), reporting good long-term aesthetic results at the thoracic site, with female patients showing slightly better outcomes. The majority (82 %) participated in sports before surgery, and 70 % continued the same activities afterward. Minimal chest deformity or thorax asymmetry was reported by 30 patients (30 %).</div><div>The study confirms that postoperative donor-site morbidity following costal cartilage graft harvesting is low. Sporting activities do not appear to be significantly affected by ear reconstruction procedures, supporting social and psychological development in growing patients.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 10","pages":"Pages 1691-1695"},"PeriodicalIF":2.1,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700354","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}