Journal of Craniofacial Surgery最新文献

Surgery is performed for craniosynostosis to enlarge intracranial volume and improve cranial morphology. Endoscope-assisted suturectomy is one of the effective treatments. Compared with other techniques, it is reported to be low invasive and enables improvement of cranial volume and morphology at an early age. At the National Center for Child Health and Development (Tokyo, Japan), endoscope-assisted suturectomy is performed for all patients with craniosynostosis under the age of 3 months. Bone defects are sometimes observed several years after endoscope-assisted suturectomy. In syndromic bilateral coronal craniosynostosis patients in whom fused coronal sutures are removed, bone defects often remain in the temporal region. These may cause difficulty in setting the osteotomy line and placing distraction device for later monobloc advancement. In the present study, syndromic bilateral coronal craniosynostosis patients who underwent endoscope-assisted suturectomy between 2017 and 2022 at our hospital were retrospectively reviewed to investigate residual bone defects after the operation. As monobloc advancement, tongue-in-groove technique and placing internal distractors were assumed, and cranial bone defects between the ages of 3 and 5 years were evaluated in 3D by using image processing software. Five patients were included, and in 2 patients, the bone defects in the temporal regions were deemed large enough to interfere with making the bandeau or restrict the use of internal distractors for monobloc advancement. When performing suturectomy for syndromic craniosynostosis patients with midfacial concavity, careful surgical strategies that take into account future monobloc advancement should be considered.

I read "The Pilgrim's Progress," by John Bunyan, and this book echoes the journey I have taken from medical school to the present. Christian's journey symbolizes the spiritual path of a believer in the pursuit of salvation. This narrative serves as an allegory for the Christian life, highlighting themes such as faith, redemption, and perseverance through trials. It includes twelve key stage. Comparing the life of a surgeon, from medical student to master surgeon approaching retirement, to Christian's journey in "The Pilgrim's Progress" makes for a fascinating allegory. Both paths involve growth, challenges, and perseverance toward a final goal: (1) Medical Student (City of Destruction), (2) Basic Training (Slough of Despond), (3) Residency (Wicket Gate and Hill of Difficulty), (4) Becoming a Junior Surgeon (Interpreter's House), (5) First Independent Operations (The Cross and the Burden Lifted), (6) Early Career (Palace Beautiful), (7) Facing Major Challenges (Valley of Humiliation and Shadow of Death), (8) Mid-Career Success and Worldly Temptations (Vanity Fair), (9) Crisis of Confidence (Doubting Castle and Giant Despair), (10) Mastery and Maturity (Delectable Mountains), (11) Facing Retirement (Enchanted Ground), and (12) Retirement and Legacy (Celestial City). In this allegory, the life of a surgeon mirrors Christian's spiritual journey-a path marked by challenges, doubts, triumphs, and ultimately, the fulfillment of a calling. Both are in pursuit of a final "rest" in their respective fields, whether it be spiritual salvation or the surgeon's sense of a lasting contribution to humanity. The journey of the surgeon is similar to that of the pilgrim.

We present a minimally invasive technique for deep brain hematoma evacuation that combines 3-dimensional visualization through 3DSlicer and laser-guided navigation, providing a practical and cost-effective alternative to traditional navigation in resource-limited settings.

Objective: To investigate the immune reconstitution after total parathyroidectomy and forearm transplantation in chronic renal failure.

Method: Forty-three patients, accompanied with chronic renal failure and secondary hyperparathyroidism (SHPT) that hospitalized during January 2019 to 2021 and underwent total thyroidectomy and forearm transplantation were enrolled as observation group. Forty hemodialysis patients with chronic renal failure but without SHPT were selected as the hemodialysis group. In addition, fifty volunteers who underwent physical examination within the same period were chosen as a control group. The parathyroid hormone (iPTH), blood phosphorus, blood calcium, th22, Treg cells, and inflammatory factors were detected in the three groups.

Results: The preoperative iPHT, serum phosphorus, and calcium levels in the observation group were higher than those in the control group and hemodialysis group (P<0.05), and the index values of the observation group at each time point after surgery were remarkably lower than those in pre-surgery (P<0.05). The preoperative Th22 and Th22/Treg in the observation group were higher, and Treg was lower than those in the control group and hemodialysis group (P<0.05); The levels of Th22 and Th22/Treg in the observation group at each time point in post-operation were lower than those in pre-operation (P<0.05), whereas Treg cells in observation group at each time point postoperatively were higher than those prior-operation (P<0.05). The preoperative serum TNF-α, IL-6, TGF-β, and IL-22 in the observation group were notably higher than those in the control group and hemodialysis group (P<0.05); And TNF-α, IL-6, TGF-β, and IL-22 in observation group at each time point in post-operation were lower than those in pre-surgery(P<0.05).

Conclusion: For chronic renal failure patients complicated with SHPT, total parathyroidectomy and forearm transplantation can effectively improve their clinical symptoms, reduce the inflammatory state of the body, and beneficial for immune reconstruction.

Objective: The authors present a case of a patient with a large branchial cleft cyst on the right side of the neck and face that rapidly increased after eating Angelica-stewed chicken.

Methods: An older adult patient was admitted to West China Hospital on February 28, 2021, with a large branchial cleft cyst. Resection of the right cervical cystic tumor and partial resection of the parotid gland were performed.

Results: After complete surgical resection of the cyst, the patient was followed up for 3 years without any recurrence in the surgical area.

Conclusions: Angelica is a type of traditional Chinese medicine, which has the effect of promoting blood circulation to remove meridian obstruction. However, it is difficult to determine whether this case that occurred after eating Angelica-stewed chicken coincides with the sudden growth of cysts and related pathological changes.

Nasoethmoidal dermoid cysts are rare congenital ectodermal malformations. Unlike other dermoid cysts, those located in the midline can exhibit intracranial extension. Clinically, they may manifest with sebaceous discharge through a fistulous orifice and other morphologic alterations, occasionally presenting with complications at the onset. The authors present a clinical case of a nasoethmoidal dermoid cyst with an intracranial extension, treated with combined interdisciplinary surgical intervention. An adequate imaging evaluation before the surgical planning and complete lesion resection are crucial, considering their high recurrence rates.

This paper describes the development and implementation of a mobile craniofacial surgical unit designed to address complex posttraumatic craniofacial deformities in both civilian and military casualties resulting from Russia's invasion of Ukraine. Restricted air space, limited possibilities for transportation of personnel and equipment, frequent interruption of power and water supply, and constant threat of injury to patients and medical personnel from missile and drone strikes, precludes reliable and safe delivery of tertiary care. The Canada Ukraine Surgical Aid Program (CUSAP) addressed these challenges by establishing a mobile craniofacial surgery unit, operating just outside of the war zone. The following report characterizes the civilian and military casualties, highlights the barriers to the provision of adequate tertiary care locally, and provides a detailed description of the measures that were taken to organize the mobile unit. The effectiveness of this program is documented, and specific challenges are illustrated through case examples. We believe this model serves as a template for delivering surgical aid to victims of any global disaster where care cannot be provided locally.

Objective: To identify the size and angle of the sphenoid ridge (SR) in fetuses.

Methods: Skull bases of 32 fetuses (11 males / 21 females) aged 17 to 32 weeks of gestations were included the study. The angle of SR (SRA), length of LW (SRL), and also LW widths at the midline (SRW-ML), at the midpoint (SRW-MP), and at the lateral point (SRW-L) were measured.

Results: SRL, SRA, SRW-ML, SRW-MP, and SRW-L were measured as 22.98±4.62 mm, 150.69±8.05 degrees, 6.57±1.46 mm, 4.68±1.07 mm, and 2.68±0.71 mm, respectively. No significant difference was observed between the measurements in terms of sex and sides. Apart from SRA, the parameters were greater in the third-trimester fetuses than the second-trimester fetuses. SRA was similar in both trimester fetuses. SRA did not alter with advancing gestational weeks, but the other increased. In fetuses, only one configuration regarding SRA types was observed. Type A was observed in all fetuses. Linear function was calculated as y=1.411 + 0.902×age for SRL, y=-0.137 + 0.281×age for SRW-ML, and y=1.024 + 0.069×age for SRW-L.

Conclusion: Our study provides beneficial data for neurosurgeons and anatomists to understand the development of SR in the prenatal period. The authors' regression equations for determining the growth dynamics of the ridge may be used to estimate SR parameters.

Lymph node metastasis (LNM) is a significant prognostic factor in head and neck cancer (HNC) patients. To obtain a better understanding of the worldwide prevalence and current research status, the authors conducted a comprehensive bibliometric analysis of literature published from 2000 to 2022. The contributions of institutions, journals, countries or regions, cited literature, keywords, and authors in global publications were concisely summarized using the COOC and VosViewer software tools. The data were extracted from the expansive Web of Science database. A total of 5478 papers were collected for analysis, and the number of publications has exhibited exponential growth over the last 22 years. The United States emerged as the most productive country, closely followed by China. Noteworthy institutions for their high productivity include the Sloan-Kettering Cancer Center, Sun Yat-Sen University, and the University of Texas MD Anderson Cancer Center. The Head & Neck and Oral Oncology journals lead in terms of publication volume. The main areas of research in this field were prognostication, radiotherapy, survival rates, sentinel lymph node biopsy, and the human papillomavirus. In addition, the analysis of author collaboration networks yielded valuable insights into the collaborative relationships within this research domain. Our research has identified the primary characteristics of highly impactful studies on LNM in HNC, providing significant insights into the advancements made in this area of research.