Journal of Craniofacial Surgery最新文献

This cross-sectional observational study aimed to establish facial linear and angular measurement values for Mozambique adults and to determine the morphologic differences between sexes and ages using stereophotogrammetry. One hundred and sixty-six Mozambique individuals categorized into 8 groups by age (20-65 y) and sex were assessed. Anthropometric points were marked on the face, and 3D images were captured. Linear and angular measurements were obtained and evaluated. Two-way ANOVA and Tukey's test were used to determine differences among groups and sexes, with significance set at P<0.05. Significant differences in linear and angular measurements were observed between the groups and sexes. Differences were evident in 13 of 15 linear measurements, with higher values observed in men than in women. Women showed higher angular measurements than men in 4 of 6 measurements. Sexual dimorphism was confirmed by significantly higher linear measurements in men and increased angular measurements in women. Morphologic changes with aging included decreased eye width and lip height, increased mouth width, and augmented nose measurements, particularly in men. In addition, the nasolabial angle widened with age, and women exhibited more pronounced facial convexity than men. This study aims to gain insights into the facial metrics of diverse populations and utilize these findings in clinical practice to enhance prosthetic flow and forensic training and develop a comprehensive population database.

Introduction: Alveolar cleft grafting plays a vital role in the treatment of individuals with cleft lip and palate. Vitamin D plays a crucial role in bone healing.

Methodology: The study involved 40 patients with cleft alveolus who were seeking alveolar cleft grafting (ACG). Participants were categorized into 2 groups-study and control-based on their vitamin D levels: those with levels below 20 were placed in the control group, while those with levels above 20 were assigned to the study group.

Results: Assessment of alveolar cleft grafting success rate was done by Bergland Scale assessment. The assessment using χ2 showed that the bone level in the study group was better than the control. However, the improvement was not statistically significant (P=0.2). Assessment of volumetric bone fill was done on the CBCT. The results were statistically checked by independent t-test and showed that the bone fill in the study group (224±78.4 mm3) was better than the control (176±135 mm3). However, the improvement was not statistically significant (P=0.17). Assessment of the incidence of fistula recurrence was done using the χ2 test. In the study group, the incidence of fistula was 5%, while in the control group, it was 30%. The incidence of success in reducing fistula recurrence was statistically significant (P=0.04).

Conclusion: Adjustment of vitamin D level may be a successful tool in predicting the success of the alveolar cleft grafting procedure, especially regarding the elimination of fistula recurrence.

A variety of autoimmune disorders that do not fit the criteria for specific connective tissue diseases are included in the category of undifferentiated connective tissue disease (UCTD). Facial lipoatrophy is an underreported presenting characteristic, despite the prevalence of cutaneous symptoms. The aim of this article is to demistrate the potential of early autologous fat grafting (AFG) in treating facial depressions caused by UCTD. A 29-year-old woman with UCTD presented with progressive bilateral cheek depressions and was managed with tacrolimus lately. Sheet-like depressions can be found during physical examination, which are more pronounced on the left cheek. The patient underwent AFG surgery to the affected areas. During the surgery, a total of 30 mL of fat was harvested from the lower abdomen, and 5.0 mL of pure fat was eventually gained and grafted to the bilateral cheek depressions. Satisfying aesthetic outcomes were achieved with smooth facial contours. Through the use of adipose-derived stem cells, early AFG in the active stage of UCTD can enhance face appearance while also possibly having local anti-inflammatory and antifibrotic benefits. It also has important implications for improving the look and slowing the progression of other autoimmune diseases that affect the face.

Objective: The accessory infraorbital foramen (AIOF) has been reported to have a prevalence of up to 47.6% in the global population. Cadaveric studies have observed that components of the infraorbital neurovascular bundle may emerge through the AIOF. The objective of this study was to determine the prevalence of the AIOF in the Mexican population.

Methods: A cross-sectional, observational, descriptive epidemiological study was conducted, analyzing skull computed tomography (CT) scans with three-dimensional reconstruction from 345 randomly selected Mexican patients performed between 2015 and 2022. The presence of the AIOF was assessed, including its area, location, laterality, and number. Descriptive statistical analysis was performed using IBM SPSS Statistics version 25.0.

Results: The presence of the AIOF was found in 17.8% (58 cases), with 11% in men and 6.8% in women. The majority of cases (73.9%) had a superomedial location. The AIOF was found bilaterally at 48.3%, on the left side at 41.4%, and on the right side at 10.3%. Of these, 96.6% were single, and 3.4% were double; no triple or quadruple AIOFs were observed. The average area of the AIOF was 2.9 mm².

Conclusions: Awareness of the presence of the AIOF is crucial for preventing inadvertent injuries to the infraorbital neurovascular bundle during procedures involving the infraorbital area, both medical and surgical, thereby reducing the risk of complications. The use of three-dimensional tomographic reconstruction offers more accurate and precise knowledge when planning these procedures.

Cemento-osseous dysplasia (COD) is a non-neoplastic condition, characterized by the replacement of normal cancellous bone with fibrous tissues containing woven bone and cementum in the tooth-bearing areas. This report presents the case of a 21-year-old male who developed COD following orthodontic treatment. A panoramic radiograph showed a periapical radiolucent lesion in the right mandibular canine area. Cone beam computed tomography revealed a mixed radiolucent and radiopaque lesion. Histologically, the lesion exhibited cementum-like calcifications and woven bone scattered within the hemorrhagic fibrous tissue. Ultimately, the lesion was diagnosed as cemento-osseous dysplasia, focal type. This case highlights the importance of careful monitoring of orthodontic forces to minimize risks and prevent unexpected complications during orthodontic treatment.

Objective: Remote site delayed extradural hematoma (RDEDH) is an uncommon but serious complication that can occur after decompressive craniectomy (DC) in patients with traumatic brain injury (TBI). This study aims to clarify the incidence, predictors, clinical and radiological characteristics, and outcomes of RDEDH to improve the authors' understanding and management of this complication.

Methods: This study identified 36 patients with TBI who developed RDEDH after DC. The incidence, predictors, clinical and radiological characteristics, and outcomes were analyzed retrospectively. Continuous variables were compared using the student t test, whereas categorical variables were assessed using the χ2 test. Variables with a P value of <0.05 in univariable analysis were included in the multivariable logistic regression analysis.

Results: The incidence of RDEDH after DC was 14.6%. Preoperative pupillary dilation [bilaterally; odds ratio (OR): 8.797; 95% CI: 1.969-39.297; P = 0.004], intraoperative acute brain swelling (OR: 33.696; 95% CI: 5.073-227.005; P < 0.001), and pupillary abnormalities after DC (OR: 8.141; 95% CI: 2.117-31.307; P = 0.002) were identified as independent risk factors for the development of RDEDH after DC. The average length of hospitalization in the RDEDH group was significantly longer than that in the non-RDEDH group (P = 0.018). The Glasgow Outcome Scale score at 6 months in the RDEDH group was significantly lower than that in the non-RDEDH group (P = 0.01). The incidence of poor prognosis in the RDEDH group (80.6%) was significantly higher than that in the non-RDEDH group (59.8%; P = 0.017).

Conclusion: Preoperative bilateral pupillary dilation, intraoperative brain swelling, and pupillary abnormalities after surgery were independent risk factors for the development of RDEDH after DC in patients with TBI. The occurrence of RDEDH in patients with TBI after DC did not significantly increase mortality, it was associated with a prolonged length of stay and an increased incidence of poor prognosis.

The middle cranial fossa exhibits an interesting typical and variant anatomy. Accessory foramina frequently or rarely exists and transmits emissary veins. The sinus computed tomography scan of a 63-year-old male patient was further examined for its unique morphology. An accessory foramen rotundum (FR) was identified on the left side, 2.67 mm laterally to the typical foramen. Posterolaterally to the typical FR (10.33 mm distance), the intracranial opening of a sphenopterygoid canal was detected. This canal had a length of 22.85 mm and opened extracranially through a pterygoid foramen on the lateral pterygoid plate. The right side of the patient was typical. The unusual coexistence of 2 rare skull base variants was recorded. The accessory FR and sphenopterygoid canal presence were described only in a few case reports in the current literature, while their coexistence has not been reported. Anatomists and clinicians should remember that rare variant foramina can transmit emissary veins, such as the ones presented in the current imaging case.

Background: This study aimed to evaluate the etiologic causes and prognostic factors affecting the final outcome of patients with open globe injury after penetrating keratoplasty.

Methods: This study included patients between November 2018 and June 2024. Age, sex, intraocular pressure (mm Hg), visual acuity (logMAR), indication for keratoplasty, time since keratoplasty, cause, location, and length of injury were noted. All patients were followed up for at least 3 months after surgery.

Results: There was a moderate positive correlation between visual acuity in the first month and the third month after trauma repair (r=0.562, P=0.036). Final visual acuity was 1.0 logMAR or worse in high injury length patients (6 clocks or more). Patients with vitreous loss had a final visual acuity of 0.9 logMAR or worse. Of the 5 patients who underwent PK for keratoconus, 4 (80%) had visual acuity of 1.2 logMAR or worse at the third month after trauma.

Conclusion: In conclusion, final visual acuity is poor in patients who underwent PK due to high injury length, vitreous loss, and keratoconus. In addition, final visual acuity is associated with visual acuity in the early postoperative period. Patients undergoing PK should be informed about globe injuries, risks of visual loss, and protective precautions. Patients should also be enlightened about wound healing and encouraged to prevent trauma.

Objective: To analyze the clinical characteristics and prognostic factors of eye injuries caused by angle grinders over 2 years.

Methods: Clinical data from 36 hospitalized patients (36 eyes) with eye injuries caused by angle grinders were collected. The causes of injury, types of trauma, and prognoses were analyzed.

Results: Among the 36 patients (36 eyes), 34 were male (34 eyes) and 2 were female (2 eyes), with ages ranging from 19 to 66 years. The time from injury to medical consultation was within 12 hours in 29 cases, between 12 and 24 hours in 6 cases, and over 24 hours in 1 case. Primary emergency globe repair surgery was performed within 8 hours of admission in 23 cases, while 29 cases required secondary surgical interventions. Preoperative visual acuity was recorded as no light perception to 0.05 in 13 cases, 0.05 to 0.1 in 10 cases, 0.1 to 0.3 in 9 cases, and >0.3 in 4 cases. Postoperative best-corrected visual acuity was <0.05 in 10 cases, 0.05 to 0.1 in 13 cases, 0.1 to 0.3 in 7 cases, and >0.3 in 6 cases.

Conclusion: Eye injuries caused by angle grinders are often complex, involving both ocular adnexa and globe injuries, with multiple sites of intraocular trauma. A high proportion of patients require secondary surgical interventions. Factors affecting visual outcomes include the location and type of injury, time to medical consultation, presence of infectious endophthalmitis, and intraocular foreign bodies.

Nasal augmentation using dermal fillers has become a popular nonsurgical esthetic procedure, particularly among Asian populations. This review explores the anatomical considerations, injection techniques, and safety measures essential for successful outcomes. The complex nasal anatomy, comprising 5 distinct soft tissue layers and intricate vascular networks, necessitates a thorough understanding to minimize risks of complications such as skin necrosis and visual impairment. The authors discuss the ideal nasal proportions and angles, emphasizing the importance of tailoring treatments to individual ethnic characteristics. The article outlines both needle-based and cannula-based injection techniques for the nasal dorsum, tip, and columella, highlighting the advantages and precautions for each approach. The dual-plane remodeling technique, utilizing firm and soft fillers, is presented as an advanced method for comprehensive nasal reshaping. Special attention is given to the columella injection technique, which addresses both esthetic and functional aspects of nasal tip projection. The discussion emphasizes the importance of choosing appropriate fillers, understanding vascular anatomy, and employing safe injection practices. As the field of non-surgical rhinoplasty evolves, continued refinement of techniques and ongoing research are crucial for enhancing safety and expanding the range of achievable outcomes in nasal augmentation with dermal fillers.