Pub Date : 2025-01-01Epub Date: 2024-10-17DOI: 10.1097/SCS.0000000000010795
Xin-Ran Guo, Zi-Xiu Liu, Jun Jia, Zi-Li Yu
Lipomas are benign soft tissue tumors composed of mature adipocytes, commonly found in subcutaneous tissues. Despite their prevalence in various body regions, they are relatively rare in the oral and maxillofacial regions. This study retrospectively analyzed the clinical and imaging characteristics, as well as the treatment outcomes of 57 patients diagnosed with lipoma. Among these, 42 cases (73.7%) were located in the oral-maxillofacial and head-neck regions, predominantly in areas with relatively abundant adipose tissue, including the facial/cheek area, parotid region, submental/submandibular area, and neck. In addition, this study presents a rare case of tongue lipoma in a 57-year-old male, highlighting the clinical features, diagnostic challenges, and treatment approach. The patient presented with a painless mass on the left side of the tongue that had gradually increased in size over 5 months. Physical examination revealed a firm, well-defined, moderately mobile mass measuring ~3.0×1.5 m. Imaging, including enhanced magnetic resonance imaging, suggested a diagnosis of lipoma, leading to surgical excision. The excised mass was yellowish, encapsulated, and soft. Intraoperative frozen section biopsy confirmed it as a fat-derived tumor consistent with a lipoma, and postoperative pathological examination further identified it as a spindle cell/pleomorphic lipoma. The patient experienced a smooth recovery without complications, with normal tongue function restored. This case underscores the significance of including lipoma in the differential diagnosis of tongue masses and demonstrates the efficacy of surgical excision in managing such rare tumor.
{"title":"Diagnostic and Therapeutic Approach to Rare Tongue Lipoma.","authors":"Xin-Ran Guo, Zi-Xiu Liu, Jun Jia, Zi-Li Yu","doi":"10.1097/SCS.0000000000010795","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010795","url":null,"abstract":"<p><p>Lipomas are benign soft tissue tumors composed of mature adipocytes, commonly found in subcutaneous tissues. Despite their prevalence in various body regions, they are relatively rare in the oral and maxillofacial regions. This study retrospectively analyzed the clinical and imaging characteristics, as well as the treatment outcomes of 57 patients diagnosed with lipoma. Among these, 42 cases (73.7%) were located in the oral-maxillofacial and head-neck regions, predominantly in areas with relatively abundant adipose tissue, including the facial/cheek area, parotid region, submental/submandibular area, and neck. In addition, this study presents a rare case of tongue lipoma in a 57-year-old male, highlighting the clinical features, diagnostic challenges, and treatment approach. The patient presented with a painless mass on the left side of the tongue that had gradually increased in size over 5 months. Physical examination revealed a firm, well-defined, moderately mobile mass measuring ~3.0×1.5 m. Imaging, including enhanced magnetic resonance imaging, suggested a diagnosis of lipoma, leading to surgical excision. The excised mass was yellowish, encapsulated, and soft. Intraoperative frozen section biopsy confirmed it as a fat-derived tumor consistent with a lipoma, and postoperative pathological examination further identified it as a spindle cell/pleomorphic lipoma. The patient experienced a smooth recovery without complications, with normal tongue function restored. This case underscores the significance of including lipoma in the differential diagnosis of tongue masses and demonstrates the efficacy of surgical excision in managing such rare tumor.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":"36 1","pages":"e83-e86"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-10-03DOI: 10.1097/SCS.0000000000010734
Hee Young Choi, Seung Ahn Yang, Jung Hyo Ahn
A 56-year-old woman was referred to the authors' hospital after the removal of the lower eyelid fat through a transconjunctival approach using a carbon dioxide laser. The patient was noted to have vertical diplopia in the primary position, with worsening diplopia on downgaze. Detachment of the right inferior rectus (IR) muscle from its insertion point was observed during exploratory surgery. The thermally damaged IR muscle fibers were attached to a location posterior to the original insertion point. At 6 months postoperatively, 8 prism diopters of right hypertropia in the primary position and a -3 degrees limitation on downgaze were still present. The patient underwent the vertical transposition of the lateral and medial rectus muscles to the IR muscle. After strabismus surgery, orthotropia was observed with no vertical diplopia in the primary gaze, but ocular motility limitation on the downgaze has permanently remained.
{"title":"Inferior Rectus Muscle Thermal Injury Following Transconjunctival Blepharoplasty Using Carbon Dioxide Laser.","authors":"Hee Young Choi, Seung Ahn Yang, Jung Hyo Ahn","doi":"10.1097/SCS.0000000000010734","DOIUrl":"10.1097/SCS.0000000000010734","url":null,"abstract":"<p><p>A 56-year-old woman was referred to the authors' hospital after the removal of the lower eyelid fat through a transconjunctival approach using a carbon dioxide laser. The patient was noted to have vertical diplopia in the primary position, with worsening diplopia on downgaze. Detachment of the right inferior rectus (IR) muscle from its insertion point was observed during exploratory surgery. The thermally damaged IR muscle fibers were attached to a location posterior to the original insertion point. At 6 months postoperatively, 8 prism diopters of right hypertropia in the primary position and a -3 degrees limitation on downgaze were still present. The patient underwent the vertical transposition of the lateral and medial rectus muscles to the IR muscle. After strabismus surgery, orthotropia was observed with no vertical diplopia in the primary gaze, but ocular motility limitation on the downgaze has permanently remained.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e43-e45"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-10-28DOI: 10.1097/SCS.0000000000010747
Stefania Requejo, Henry García Guevara, Maria Daniela Viamonte, Marcos Cicciu, Maria Dianella Jensen, Sergio Olate, Salvatore Crimi
Facial trauma is mostly associated with traffic accidents, fights, and sports accidents. The mandible, midface, and temporomandibular joint are usually the region's most frequently affected. Coronoid process fractures are rare, representing ∼2% of facial fractures in the literature, usually being the result of direct trauma to the zygomatic region. Due to the anatomical relationship of the coronoid process, it may be associated with other facial fractures, such as fractures of the zygomatic bone. Zygomatic-coronoid ankylosis is a rare clinical entity with variable etiology. It is most commonly associated with trauma (13%-100%), local or systemic infection (0%-53%), or systemic diseases, such as ankylosing spondylitis, rheumatoid arthritis, or psoriasis. The aim of this research is to evaluate the different treatments for ankylosis from the coronoid process to the zygoma after trauma, allowing to determine the treatment to obtain the best results. A systematic review was carried out following PRISMA "preferred reports for systematic reviews and meta-analyses" search matrix, based on a PICO question; was used PubMed, Embase, Sciencedirect, Cochrane, Google Scholar, and manual search in high-impact journals between 1946 and 2023 publications in English or Spanish, including randomized and nonrandomized clinical trials, prospective and retrospective cohort studies, case-control studies, series, and case reports. A total of 1993 articles were obtained from the 4 databases. After corroborating duplicate articles, 847 articles were excluded. Another 1112 articles were excluded in the title evaluation, and an additional 1093 after the abstract review; a total of 19 articles eligible for full-text evaluation were established and 1 article was added as a result of the manual search. After the full-text review, it was decided to include 16 articles in the study that met the objectives of the systematic review. After evaluating the different treatments described in the literature, the authors can determine that coronoidectomy through an intraoral approach is the most appropriate treatment for zygomatic coronoid ankylosis, accompanied by postoperative physiotherapy to achieve greater oral opening without recurrences.
{"title":"Treatment of Posttraumatic Zygomatic Coronoid Ankylosis. Systematic Review.","authors":"Stefania Requejo, Henry García Guevara, Maria Daniela Viamonte, Marcos Cicciu, Maria Dianella Jensen, Sergio Olate, Salvatore Crimi","doi":"10.1097/SCS.0000000000010747","DOIUrl":"10.1097/SCS.0000000000010747","url":null,"abstract":"<p><p>Facial trauma is mostly associated with traffic accidents, fights, and sports accidents. The mandible, midface, and temporomandibular joint are usually the region's most frequently affected. Coronoid process fractures are rare, representing ∼2% of facial fractures in the literature, usually being the result of direct trauma to the zygomatic region. Due to the anatomical relationship of the coronoid process, it may be associated with other facial fractures, such as fractures of the zygomatic bone. Zygomatic-coronoid ankylosis is a rare clinical entity with variable etiology. It is most commonly associated with trauma (13%-100%), local or systemic infection (0%-53%), or systemic diseases, such as ankylosing spondylitis, rheumatoid arthritis, or psoriasis. The aim of this research is to evaluate the different treatments for ankylosis from the coronoid process to the zygoma after trauma, allowing to determine the treatment to obtain the best results. A systematic review was carried out following PRISMA \"preferred reports for systematic reviews and meta-analyses\" search matrix, based on a PICO question; was used PubMed, Embase, Sciencedirect, Cochrane, Google Scholar, and manual search in high-impact journals between 1946 and 2023 publications in English or Spanish, including randomized and nonrandomized clinical trials, prospective and retrospective cohort studies, case-control studies, series, and case reports. A total of 1993 articles were obtained from the 4 databases. After corroborating duplicate articles, 847 articles were excluded. Another 1112 articles were excluded in the title evaluation, and an additional 1093 after the abstract review; a total of 19 articles eligible for full-text evaluation were established and 1 article was added as a result of the manual search. After the full-text review, it was decided to include 16 articles in the study that met the objectives of the systematic review. After evaluating the different treatments described in the literature, the authors can determine that coronoidectomy through an intraoral approach is the most appropriate treatment for zygomatic coronoid ankylosis, accompanied by postoperative physiotherapy to achieve greater oral opening without recurrences.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e49-e53"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Influence of Bone Defects After Endoscope-Assisted Suturectomy on Monobloc Advancement in Syndromic Bilateral Coronal Craniosynostosis Patients.","authors":"Masafumi Kamata, Makoto Hikosaka, Tsuyoshi Kaneko, Hideki Ogiwara, Kenichi Usami","doi":"10.1097/SCS.0000000000010803","DOIUrl":"10.1097/SCS.0000000000010803","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"149-152"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-09-16DOI: 10.1097/SCS.0000000000010585
Fengjuan Yan, Chunxiao Pang
Objective: To summarize the clinical experience of ipsilateral cerebellar hemorrhage after superficial temporal artery-middle cerebral artery bypass surgery.
Methods: The clinical data of 2 patients with cerebellar hemorrhage after superficial temporal artery-middle cerebral artery bypass grafting were retrospectively collected, including 1 case with left cerebellar hemorrhage after left cerebral artery bypass grafting and 1 case with right cerebellar hemorrhage after right cerebral artery bypass grafting. The perioperative blood pressure, laboratory, and imaging data were analyzed.
Results: All patients had a history of hypertension, and their perioperative blood pressure was stable. Low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were normal before the operation. Cerebral magnetic resonance imaging showed cerebral atherosclerosis and multiple ischemic cerebral infarcts. At 24 hours after surgery, the patients' continuous epidural low drainage was 260 mL and 160 mL, respectively. The amount of cerebellar bleeding was small, and no new sequelae were left after conservative treatment with drugs.
Conclusion: Cerebellar hemorrhage after superficial temporal artery-middle cerebral artery bypass grafting is related to perioperative blood pressure fluctuation, hemodynamic changes, hemorrhagic transformation of ischemic lesions, and excessive cerebrospinal fluid drainage. Maintaining stable blood pressure during the perioperative period and avoiding excessive and rapid loss of cerebrospinal fluid after operation can reduce the occurrence of this complication.
{"title":"Two Patients With Ipsilateral Cerebellar Hemorrhage After Superficial Temporal Artery-Middle Cerebral Artery Bypass Grafting.","authors":"Fengjuan Yan, Chunxiao Pang","doi":"10.1097/SCS.0000000000010585","DOIUrl":"10.1097/SCS.0000000000010585","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the clinical experience of ipsilateral cerebellar hemorrhage after superficial temporal artery-middle cerebral artery bypass surgery.</p><p><strong>Methods: </strong>The clinical data of 2 patients with cerebellar hemorrhage after superficial temporal artery-middle cerebral artery bypass grafting were retrospectively collected, including 1 case with left cerebellar hemorrhage after left cerebral artery bypass grafting and 1 case with right cerebellar hemorrhage after right cerebral artery bypass grafting. The perioperative blood pressure, laboratory, and imaging data were analyzed.</p><p><strong>Results: </strong>All patients had a history of hypertension, and their perioperative blood pressure was stable. Low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were normal before the operation. Cerebral magnetic resonance imaging showed cerebral atherosclerosis and multiple ischemic cerebral infarcts. At 24 hours after surgery, the patients' continuous epidural low drainage was 260 mL and 160 mL, respectively. The amount of cerebellar bleeding was small, and no new sequelae were left after conservative treatment with drugs.</p><p><strong>Conclusion: </strong>Cerebellar hemorrhage after superficial temporal artery-middle cerebral artery bypass grafting is related to perioperative blood pressure fluctuation, hemodynamic changes, hemorrhagic transformation of ischemic lesions, and excessive cerebrospinal fluid drainage. Maintaining stable blood pressure during the perioperative period and avoiding excessive and rapid loss of cerebrospinal fluid after operation can reduce the occurrence of this complication.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e5-e8"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The zygomaticomaxillary complex is integral to facial aesthetics and is frequently involved in facial fractures. These injuries often necessitate surgical intervention, with open reduction and internal fixation being the standard treatment. This article presents a novel philosophy for managing zygomatic fractures, emphasizing the "Scarless Surgery" technique. The authors' approach prioritizes minimal osteosynthesis material and fixation points while utilizing the least visible surgical access. For isolated zygomatic arch fractures, an intraoral technique is preferred, whereas the frontozygomatic suture is approached through an upper eyelid crease for optimal aesthetic outcomes. The zygomaticomaxillary buttress is accessed through a vestibular mucosal incision and the infraorbital rim benefits from a transconjunctival approach. The findings suggest that fewer fixation points can still yield satisfactory stability and cosmetic results, aligning with literature supporting the efficacy of 1 and 2-point fixations. This modern technique not only minimizes visible scarring but also conforms to the contemporary push for minimally invasive surgical methods. The authors' experience and the existing literature support the efficacy of this approach, reinforcing its viability as a standard practice in the surgical management of facial trauma.
{"title":"Aesthetic Approaches to Zygomatic Fracture Management: Achieving Optimal Outcomes With Minimal Scarring.","authors":"Gianmarco Saponaro, Alessandro Moro, Mattia Todaro, Giulio Gasparini, Federico Perquoti, Giuliano Ascani, Giuseppe D'Amato","doi":"10.1097/SCS.0000000000010694","DOIUrl":"10.1097/SCS.0000000000010694","url":null,"abstract":"<p><p>The zygomaticomaxillary complex is integral to facial aesthetics and is frequently involved in facial fractures. These injuries often necessitate surgical intervention, with open reduction and internal fixation being the standard treatment. This article presents a novel philosophy for managing zygomatic fractures, emphasizing the \"Scarless Surgery\" technique. The authors' approach prioritizes minimal osteosynthesis material and fixation points while utilizing the least visible surgical access. For isolated zygomatic arch fractures, an intraoral technique is preferred, whereas the frontozygomatic suture is approached through an upper eyelid crease for optimal aesthetic outcomes. The zygomaticomaxillary buttress is accessed through a vestibular mucosal incision and the infraorbital rim benefits from a transconjunctival approach. The findings suggest that fewer fixation points can still yield satisfactory stability and cosmetic results, aligning with literature supporting the efficacy of 1 and 2-point fixations. This modern technique not only minimizes visible scarring but also conforms to the contemporary push for minimally invasive surgical methods. The authors' experience and the existing literature support the efficacy of this approach, reinforcing its viability as a standard practice in the surgical management of facial trauma.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"279-281"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-09-30DOI: 10.1097/SCS.0000000000010708
Yuchen Sun, Xiaoqing Wang, Huijuan Wang
Multiple primary cavernous hemangiomas of the skull are exceedingly rare, with surgery often being the treatment of choice. The complexity of radiologic diagnosis means that the identification of these hemangiomas still largely depends on pathologic analysis. This article outlines the diagnostic and therapeutic journey of a 52-year-old female patient afflicted with multiple primary cavernous hemangiomas of the skull. Although the occurrence of multiple cavernous hemangiomas in this patient may seem fortuitous, the authors aim to contribute to understanding the pathogenesis of such conditions through this case report.
{"title":"Multiple Primary Cavernous Hemangiomas of the Skull.","authors":"Yuchen Sun, Xiaoqing Wang, Huijuan Wang","doi":"10.1097/SCS.0000000000010708","DOIUrl":"10.1097/SCS.0000000000010708","url":null,"abstract":"<p><p>Multiple primary cavernous hemangiomas of the skull are exceedingly rare, with surgery often being the treatment of choice. The complexity of radiologic diagnosis means that the identification of these hemangiomas still largely depends on pathologic analysis. This article outlines the diagnostic and therapeutic journey of a 52-year-old female patient afflicted with multiple primary cavernous hemangiomas of the skull. Although the occurrence of multiple cavernous hemangiomas in this patient may seem fortuitous, the authors aim to contribute to understanding the pathogenesis of such conditions through this case report.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e39-e41"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-10-07DOI: 10.1097/SCS.0000000000010719
Rachita Sood, Jill R Froimson, Russell R Reid
Ballistic facial trauma can cause complex fractures and overlying soft tissue damage, with a zone of injury that extends beyond the bullet tract. Early skeletal fixation is indicated, and previous large case series describe the use of debrided bone fragments as 'spare part' grafts. This series presents the indications and techniques for simultaneous coronoid bone grafting in 2 patients who sustained a gunshot wound to the right midface and required coronoidectomy. The coronoid process was used as (1) an interposition graft in the lateral buttress of the right maxilla for stability, and (2) an onlay graft on the right inferior orbital rim for contour. Both patients did not have graft infection, extrusion, or malposition at the 1-month clinic follow-up. The coronoid process of the mandible is a viable, safe spare-part option, despite the possible location of the coronoid process within the zone of injury in the reconstruction of complex ballistic facial trauma.
{"title":"Simultaneous Coronoid Bone Grafting in Ballistic Facial Trauma Patients Undergoing Coronoidectomy.","authors":"Rachita Sood, Jill R Froimson, Russell R Reid","doi":"10.1097/SCS.0000000000010719","DOIUrl":"10.1097/SCS.0000000000010719","url":null,"abstract":"<p><p>Ballistic facial trauma can cause complex fractures and overlying soft tissue damage, with a zone of injury that extends beyond the bullet tract. Early skeletal fixation is indicated, and previous large case series describe the use of debrided bone fragments as 'spare part' grafts. This series presents the indications and techniques for simultaneous coronoid bone grafting in 2 patients who sustained a gunshot wound to the right midface and required coronoidectomy. The coronoid process was used as (1) an interposition graft in the lateral buttress of the right maxilla for stability, and (2) an onlay graft on the right inferior orbital rim for contour. Both patients did not have graft infection, extrusion, or malposition at the 1-month clinic follow-up. The coronoid process of the mandible is a viable, safe spare-part option, despite the possible location of the coronoid process within the zone of injury in the reconstruction of complex ballistic facial trauma.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e41-e43"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Non-cleft craniofacial anomalies significantly impact patients' lives and health care systems. This study addresses the gap in the literature concerning these anomalies. Conducted at 4 major hospitals across Thailand, the research aims to provide an overview and understand the experiences of caregivers. The authors conducted a cross-sectional descriptive study in a 3-year period involving 224 primary caregivers of young patients with non-cleft craniofacial anomalies (demographics, medical history, psychosocial aspects). The authors found the highest prevalence of anomalies in the Northern (26.8%) region and the lowest in the Western (3.1%) region. Craniosynostosis and clefts were the predominant anomalies (67.0%), with a surprising lack of family history (7%). Diagnoses were frequently established at regional hospitals (42.0%). Notably, the average outpatient visit was 18.22. A substantial portion of patients required multiple hospital stays: 65.6% with 1 to 5 stays and 9.8% with more than 5 stays. Despite frequent visits, 29% had not received necessary surgery. Of caregivers, 78% had a family income in the middle range (5000-50,000 Thai baht/mo), yet a significant proportion (59.4%) perceived their income as adequate. Their education was bachelor's and higher in only 27.2%. Although stress was common (62.1%), most caregivers (79.0%) did not consider it a burden. The study highlights the challenges faced by both patients and caregivers. It reveals a need for improved access to specialized care, more specialists, dedicated centers, and support networks. A more robust classification system is also essential. To optimize care, a comprehensive and region-specific health care approach is crucial.
{"title":"Current Situation of Non-cleft Craniofacial Anomalies in Thailand: A Multicenter Study.","authors":"Nond Rojvachiranonda, Bussara Chaithat, Nantaga Sawasdipanich, Artiteeya Dangsomboon, Krit Khwanngern, Watcharaporn Sitthikamtiub, Kamolchanok Kammabut, Pattama Punyavong, Suteera Pradabwong, Vichai Chichareon, Orawan Chansanti, Niti Tawaranurak","doi":"10.1097/SCS.0000000000010754","DOIUrl":"10.1097/SCS.0000000000010754","url":null,"abstract":"<p><p>Non-cleft craniofacial anomalies significantly impact patients' lives and health care systems. This study addresses the gap in the literature concerning these anomalies. Conducted at 4 major hospitals across Thailand, the research aims to provide an overview and understand the experiences of caregivers. The authors conducted a cross-sectional descriptive study in a 3-year period involving 224 primary caregivers of young patients with non-cleft craniofacial anomalies (demographics, medical history, psychosocial aspects). The authors found the highest prevalence of anomalies in the Northern (26.8%) region and the lowest in the Western (3.1%) region. Craniosynostosis and clefts were the predominant anomalies (67.0%), with a surprising lack of family history (7%). Diagnoses were frequently established at regional hospitals (42.0%). Notably, the average outpatient visit was 18.22. A substantial portion of patients required multiple hospital stays: 65.6% with 1 to 5 stays and 9.8% with more than 5 stays. Despite frequent visits, 29% had not received necessary surgery. Of caregivers, 78% had a family income in the middle range (5000-50,000 Thai baht/mo), yet a significant proportion (59.4%) perceived their income as adequate. Their education was bachelor's and higher in only 27.2%. Although stress was common (62.1%), most caregivers (79.0%) did not consider it a burden. The study highlights the challenges faced by both patients and caregivers. It reveals a need for improved access to specialized care, more specialists, dedicated centers, and support networks. A more robust classification system is also essential. To optimize care, a comprehensive and region-specific health care approach is crucial.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"119-122"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-10-22DOI: 10.1097/SCS.0000000000010779
Aikebaier Wumanerjiang, Tayierjiang Julaiti, Li Wang, Yan-Long Han
Background: At present, conventional operations are weak for pain relief and restoring the carpal joint function in the treatment of avascular necrosis of the lunate bone.
Case report: Mirror image 3-dimensional (3D)-printing technology has rarely been reported for the treatment of lunate bone necrosis, The use of mirror 3D-printed lunar bone replacement and bone cement technology in the treatment of stage IIIb lunar bone necrosis has been rarely reported in previous literature. Personalized customized 3D-printed prostheses have become an effective solution for solving many complex cases, and the flexible application of bone cement technology can also achieve satisfactory clinical results. The authors report 3 patients who underwent mirror printing of lunar bone prostheses based on healthy side lunar bone computed tomography data, 3D printing of lunar bone prostheses replacement through small incisions, and intraoperative selection of alternative bone cement technology based on actual conditions.
Conclusion: Mirror image 3D printing relieved the pain and resulted in satisfactory functional recovery for stage IIIb lunate bone necrosis.
{"title":"Application of Mirror Image 3D-Printing Technology Bone Cement in Treatment of Stage IIIb Necrosis of the Lunate Bone.","authors":"Aikebaier Wumanerjiang, Tayierjiang Julaiti, Li Wang, Yan-Long Han","doi":"10.1097/SCS.0000000000010779","DOIUrl":"10.1097/SCS.0000000000010779","url":null,"abstract":"<p><strong>Background: </strong>At present, conventional operations are weak for pain relief and restoring the carpal joint function in the treatment of avascular necrosis of the lunate bone.</p><p><strong>Case report: </strong>Mirror image 3-dimensional (3D)-printing technology has rarely been reported for the treatment of lunate bone necrosis, The use of mirror 3D-printed lunar bone replacement and bone cement technology in the treatment of stage IIIb lunar bone necrosis has been rarely reported in previous literature. Personalized customized 3D-printed prostheses have become an effective solution for solving many complex cases, and the flexible application of bone cement technology can also achieve satisfactory clinical results. The authors report 3 patients who underwent mirror printing of lunar bone prostheses based on healthy side lunar bone computed tomography data, 3D printing of lunar bone prostheses replacement through small incisions, and intraoperative selection of alternative bone cement technology based on actual conditions.</p><p><strong>Conclusion: </strong>Mirror image 3D printing relieved the pain and resulted in satisfactory functional recovery for stage IIIb lunate bone necrosis.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e61-e66"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}