Journal of Oral and Maxillofacial Surgery最新文献

{"title":"What Happens After the Free Flap? Evaluation of Aesthetic and Functional Elective Revisions","authors":"Ashleigh Weyh MPH, DMD, MD ,&nbsp;Timothy W. Neal DDS, MD ,&nbsp;Roderick Y. Kim DDS, MD, MBA ,&nbsp;Nicholas Callahan MPH, DMD, MD ,&nbsp;Rui Fernandes DMD, MD ,&nbsp;Stacey Nedrud DMD, MD","doi":"10.1016/j.joms.2024.10.015","DOIUrl":"10.1016/j.joms.2024.10.015","url":null,"abstract":"<div><h3>Background</h3><div>Microvascular free flap reconstruction of a defect, as a single-stage procedure, does not always achieve the desired functional and esthetic result. Revisions may be necessary to achieve ideal contour, symmetry, and suspension of soft tissues, or to support dental rehabilitation.</div></div><div><h3>Purpose</h3><div>The study purpose was to estimate the incidence and identify factors associated with elective free flap revisions.</div></div><div><h3>Study Design, Setting, Sample</h3><div>A retrospective cohort study of subjects who underwent free flap reconstruction was conducted to characterize the rate of elective free flap revision surgery. The study included subjects aged &gt;18 years, who underwent head and neck microvascular free flap surgery for any etiology, and both primary and secondary reconstructions, between 2014 and 2021. Subjects were excluded if they had incomplete records.</div></div><div><h3>Predictor Variable</h3><div>The predictor variable was composed of a set of variables, grouped into the following categories: subject demographic data, medical history, disease etiology, anatomical site, and postoperative complications.</div></div><div><h3>Main Outcome Variable</h3><div>The outcome variable was time to elective revision surgery measured as months from the date of the initial operation to date of elective revision surgery. Elective revision surgery was defined as a procedure to enhance esthetics or function, which directly modifies the original surgical site, not including procedures to correct a complication, treat the original disease process, or emergencies.</div></div><div><h3>Covariates</h3><div>Not applicable.</div></div><div><h3>Analyses</h3><div>Kaplan-Meier method was used to analyze the data, with <em>P</em> value &lt; .05. Risk factors for elective revisions were analyzed with Cox hazard ratio.</div></div><div><h3>Results</h3><div>The sample was composed of 377 subjects who underwent free flap surgery, with a mean age of 55.9 ± 15.9 years. Of these, 67% were male and 33% female, and 62 had an elective revision surgery (16.4%), with median follow-up period of 17 months (interquartile range 9 to 28). In the Cox regression model, only type of free flap was associated with an elective revision (<em>P</em> &lt; .05), where radial forearm had the lowest association with elective revision, and fasciocutaneous, latissimus dorsi, and scapula flaps had the highest.</div></div><div><h3>Conclusion and Relevance</h3><div>Achieving basic wound coverage with free flaps can be a challenge; however, surgeons should prepare patients for the potential need for functional and esthetic revisions after free flap surgery to improve patient quality of life.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages 231-239"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volumetric Analysis of Orbital Volume Discrepancy as a Marker of Change in Globe Position After Three-Point Fixation of Zygomatic Complex Fractures","authors":"Gharam Mefleh Alharbi BDS ,&nbsp;Khalid Zabin Alotaibi SBOMFS ,&nbsp;Ghada Amin Khalifa PhD","doi":"10.1016/j.joms.2024.11.015","DOIUrl":"10.1016/j.joms.2024.11.015","url":null,"abstract":"<div><h3>Background</h3><div>Many researchers have proposed incorporating orbital volume (OV) discrepancies between the affected and unaffected orbits into routine diagnostic processes as an indicator for early surgical repair of zygomatic complex fractures (ZMCFxs) to avoid postoperative ocular complications.</div></div><div><h3>Purpose</h3><div>The study aimed to determine the correlation between the preoperative OV discrepancy and postoperative globe position.</div></div><div><h3>Study Design, Setting, Sample</h3><div>A retrospective cohort study was performed on patients with unilateral ZMCFxs associated with orbital floor fractures, treated at Al-Zahraa Hospital, Al-Azhar University, from January 2020 to July 2023. Patients with comminuted ZMCFxs, medial or superior orbital wall fractures, or corrective surgeries were excluded.</div></div><div><h3>Predictor Variable</h3><div>The predictor variable was the preoperative OV discrepancy between the affected and unaffected orbits.</div></div><div><h3>Outcome Variables</h3><div>The outcome variables were the 3-month postoperative globe position, which was classified as normal, enophthalmos, or exophthalmos, and the orbital repair quality, that was categorized as well-corrected, under-corrected, or over-corrected.</div></div><div><h3>Covariates</h3><div>They included age, sex, ethnicity, side, etiology, type of orbital floor fractures, timing, and indication for surgery.</div></div><div><h3>Statistical Analysis</h3><div>χ², Pearson's correlation, and linear regression analyses were used; the statistical significance was set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The study included 111 patients, with an average age of 30.3 ± 6.6 years and male predominance. The preoperative OV discrepancy between both orbits was 5.1± 1 cc³, associated with enophthalmos in the patients. Postoperatively, the OV discrepancy became 0.9 ± 0.7 cc³, but the globe position was heterogenic. Thirty-seven patients (33.3%) had normal globe position. Sixty-three (56.8%) subjects had enophthalmos. Eleven (9.9%) individuals had exophthalmos. The preoperative OV discrepancy and postoperative globe position had a significant weak positive linear correlation. For every one-cubic-centimeter change in OV, the globe moved 0.1 mm (<em>P</em> &lt; .05). The majority of the patients had under-corrected orbits, followed by over-corrected and well-corrected orbits. Every category of globe position was recorded with every category of orbital repair, and the findings showed no correlation between globe position and orbital repair quality (<em>P</em> = .08).</div></div><div><h3>Conclusion</h3><div>Preoperative OV discrepancies between both orbits should not be employed as the sole predictor of globe position because a one-cubic-centimeter change in OV affects globe position by only 0.1 mm.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages 188-198"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Patient Care, Words Matter","authors":"Leonard B. Kaban DMD, MD ,&nbsp;Bonnie L. Padwa DMD, MD ,&nbsp;Jeffrey C. Posnick DMD, MD","doi":"10.1016/j.joms.2024.10.022","DOIUrl":"10.1016/j.joms.2024.10.022","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages 132-133"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Paging Activity Among Oral and Maxillofacial Surgery Residents: Implications for Patient Care","authors":"Anthony J. Burgois DMD ,&nbsp;Christopher M. Edwards MD ,&nbsp;Thomas Austin MD, MS ,&nbsp;Shelly Abramowicz DMD, MPH","doi":"10.1016/j.joms.2024.10.013","DOIUrl":"10.1016/j.joms.2024.10.013","url":null,"abstract":"<div><h3>Background</h3><div>One-way alphanumeric pagers remain a primary communication method for health care providers, despite the rise of app-based communication systems. Frequent nonurgent pages can disrupt workflows and potentially impact patient care, particularly in high-demand specialties like oral and maxillofacial surgery (OMS).</div></div><div><h3>Purpose</h3><div>The purpose of this study was to examine the association between paging patterns and time of day among OMS residents.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective cohort study analyzed paging data from the Emory Healthcare OMS service in 2021 and 2022. Pages included were those received by primary OMS residents responsible for inpatient care, consultations, and emergency department evaluations. Exclusions were pages related to outpatient matters and those sent to backup or senior-level residents.</div></div><div><h3>Predictor Variable</h3><div>The primary predictor variable was paging rate, defined as the number of pages received per hour. This measure captures the intensity of paging activity during specific periods.</div></div><div><h3>Main Outcome Variable</h3><div>The primary outcome variable was time of day, categorized into peak and off-peak hours. Peak hours were statistically determined through data analysis and were defined as 07:00-20:00 on weekdays and 09:00-14:00 on weekends. Off-peak hours included all other time periods. Secondary outcomes included the comparison of paging rates on weekdays versus weekends to identify potential variations in paging activity.</div></div><div><h3>Covariates</h3><div>There are no covariates.</div></div><div><h3>Analysis</h3><div>An independent <em>t</em> test was used to compare paging rates between peak and off-peak hours and between weekdays and weekends. Two-sided <em>P</em> values &lt; .5 were considered statistically significant.</div></div><div><h3>Results</h3><div>There were 7,224 pages. Of them, 4,626 pages met the inclusion criteria. In 2021, there was an average of 18.8 pages per day (range: 0 to 56; standard deviation: 10.2). In 2022, there were 19.2 pages per day (range: 3 to 52; standard deviation: 8.7). Weekdays had more pages (20.8 pages/day) than weekends (14.3 pages/day; <em>P</em> &lt; .001). During weekday peak hours, there were 1.3 pages/hour compared to 0.4 pages/hour during off peak hours (<em>P</em> &lt; .001). During weekend peak hours, there were 0.9 pages/hour compared to 0.5 pages/hour during off-peak hours (<em>P</em> value &lt; .001). Weekdays between 0700 and 0800 had the highest average number of pages (1.53 pages/hour).</div></div><div><h3>Conclusion and Relevance</h3><div>This study identified patterns in paging rates, with significantly higher paging activity during peak hours and on weekdays. Awareness of these patterns may inform the development of protocols to minimize nonurgent interruptions during critical times, such as during patient handoffs.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages 256-260"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Differentiates Between Benign and Malignant Parotid Tumors With Contrast-Enhanced Ultrasound Features","authors":"Jie Shan MD ,&nbsp;Yifei Yang MD ,&nbsp;Hualian Liu PhD ,&nbsp;Zhaoyao Sun PhD ,&nbsp;Mingming Chen MD ,&nbsp;Zhichao Zhu MD","doi":"10.1016/j.joms.2024.10.018","DOIUrl":"10.1016/j.joms.2024.10.018","url":null,"abstract":"<div><h3>Background</h3><div>Contrast-enhanced ultrasound (CEUS) is frequently used to distinguish benign parotid tumors (BPTs) from malignant parotid tumors (MPTs). Introducing machine learning may enable clinicians to preoperatively diagnose parotid tumors precisely.</div></div><div><h3>Purpose</h3><div>We aimed to estimate the diagnostic capability of machine learning in differentiating BPTs from MPTs.</div></div><div><h3>Study Design, Setting, and Sample</h3><div>A retrospective cohort study was conducted at the Third Affiliated Hospital of Soochow University. Patients who underwent parotidectomy and CEUS for untreated parotid tumors were included. Patients with recurrent tumors, inadequate specimens, or chemoradiotherapy were excluded.</div></div><div><h3>Predictor Variable</h3><div>Predictor variable was preoperative diagnosis coded as BPTs and MPTs based on the support vector machine (SVM) algorithms, laboratory, and CEUS variables.</div></div><div><h3>Main Outcome Variable(s)</h3><div>Outcome variable was pathological diagnosis coded as BPTs and MPTs.</div></div><div><h3>Covariates</h3><div>Covariate was demographics.</div></div><div><h3>Analyses</h3><div>A senior surgeon labeled patients' tumors as BPTs or MPTs, creating a clinical diagnosis. Patients were randomly divided into training (70%) and testing (30%) sets. After developing the SVM models using the training set, we evaluated their diagnostic performance on the testing set with the area under the receiver-operating characteristic curve (AUC), accuracy, positive predictive value, negative predictive value, sensitivity, and specificity. Delong's test was used to compare the AUC of SVM models, laboratory, and CEUS variables.</div></div><div><h3>Results</h3><div>The sample included 48 patients, and the testing set comprised 12 (25%) BPTs and 3 (6.25%) MPTs. Three CEUS variables (width, arrival time, and time to peak) and 3 laboratory variables (lymphocyte count, D-dimer, prognostic nutritional index) were identified through recursive feature elimination. Tested on the testing set, the SVM models with linear, polynomial, and radial kernels showed identical performance (AUC = 0.972, accuracy = 93.3%, positive predictive value = 75%, negative predictive value = 100%, sensitivity = 100%, specificity = 91.7%). They had larger AUC than SVM with sigmoid kernel (<em>P</em> = .18), width (<em>P</em> = .03), lymphocyte count (<em>P</em> = .02), D-dimer (<em>P</em> &lt; .01), prognostic nutritional index (<em>P</em> = .03), arrival time (<em>P</em> = .02), time to peak (<em>P</em> = .04), CEUS diagnosis (<em>P</em> &lt; .01), and clinical diagnosis (<em>P</em> &lt; .01).</div></div><div><h3>Conclusion and Relevance</h3><div>The SVM algorithm differentiated BPTs from MPTs better than laboratory and CEUS variables.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages 208-221"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway Management in Microvascular Reconstruction of the Oral Cavity: Is Immediate Extubation Possible?","authors":"John M. Le DDS, MD ,&nbsp;Jordan Gigliotti DMD, MD, CM ,&nbsp;Lior Aljadeff DDS, MD ,&nbsp;Yedeh P. Ying DMD, MD ,&nbsp;Jay Ponto DDS, MD ,&nbsp;Anthony B. Morlandt DDS, MD","doi":"10.1016/j.joms.2024.10.014","DOIUrl":"10.1016/j.joms.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>A tracheostomy is routinely performed following free tissue transfer (FTT) for oral cavity reconstruction; however, its avoidance whenever possible is advocated to enhance patient recovery and reduce hospital length of stay (LOS).</div></div><div><h3>Purpose</h3><div>This study aims to measure and compare clinically relevant outcomes for patients who have endotracheal intubation versus tracheostomy for FTT for oral cavity reconstruction.</div></div><div><h3>Study Design, Setting, Sample</h3><div>A retrospective cohort study was conducted to evaluate subjects undergoing FTT of the oral cavity for benign and malignant pathology at the University of Alabama at Birmingham from 2014 to 2021. Subjects with unresectable tumors or defects that were not primarily located in the oral cavity were excluded.</div></div><div><h3>Independent Variable</h3><div>The independent variable was perioperative airway management and was divided into 2 groups: <em>1)</em> endotracheal intubation or <em>2)</em> tracheostomy.</div></div><div><h3>Main Outcome Variable(s)</h3><div>The main outcome measure was defined as a postoperative airway-related complication and required escalation of care to an intensive care unit. LOS and surgical complications were also analyzed.</div></div><div><h3>Covariates</h3><div>The covariates were classified as demographic, medical, pathologic, and operative.</div></div><div><h3>Analyses</h3><div>Bivariate and multivariate statistical analyses were conducted to compare the outcomes between subjects who were immediately extubated and tracheotomized. Subject demographics and operative parameters were also analyzed.</div></div><div><h3>Results</h3><div>A total of 560 subjects met the inclusion criteria, with 122 subjects in the immediate extubation group and 438 subjects in the tracheostomy group. The mean age was 59.7 ± 16.3 years in the immediate extubation group and 59.3 ± 13.8 years in the tracheostomy group (<em>P</em> = .8). The proportion of males was 57.4% in the immediate extubation group and 60% in the tracheostomy group (<em>P</em> = .6). No postoperative airway-related complications occurred in the endotracheal intubation group. After controlling for confounding factors, tobacco use was associated with airway-related complications (odds ratio [OR]: 2.66; 95% confidence interval: 1.1-6.3; <em>P</em> = .03). LOS was shorter in the endotracheal intubation versus tracheostomy group (6.8 vs 9 days, <em>P</em> &lt; .01).</div></div><div><h3>Conclusion and Relevance</h3><div>In subjects who underwent FTT for oral cavity reconstruction, postoperative airway-related complications were associated with a tracheostomy and tobacco use status.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages 222-230"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Cleft and Craniofacial Surgery Experience in Oral and Maxillofacial Surgery Residency Training Programs","authors":"Ashley Manlove DMD, MD ,&nbsp;Christopher Edwards MD ,&nbsp;Thomas M. Austin MD, MS ,&nbsp;Leonard B. Kaban DMD, MD ,&nbsp;Shelly Abramowicz DMD, MPH","doi":"10.1016/j.joms.2024.10.012","DOIUrl":"10.1016/j.joms.2024.10.012","url":null,"abstract":"<div><h3>Background</h3><div>The impact of cleft and craniomaxillofacial (CCMF) surgeons on oral and maxillofacial surgery (OMS) resident training is not well known.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to measure the association between resident exposure to OMS faculty with CCMF surgery training, clinical experience, and scholarly activity.</div></div><div><h3>Study Design, Setting, Sample</h3><div>An anonymous survey of OMS residency directors in the United States, distributed electronically by the American Association of Oral and Maxillofacial Surgeons, was used to conduct a cross-sectional study. Survey consisted of 3 following sections: <em>1)</em> CCMF surgery faculty and program-related information, <em>2)</em> CCMF surgery curriculum in residency programs, and <em>3)</em> academic productivity related to CCMF surgery.</div></div><div><h3>Predictor Variable</h3><div>Primary predictor variable was CCMF surgery exposure: presence or absence of an OMS faculty with CCMF surgery fellowship or equivalent.</div></div><div><h3>Main Outcome Variable</h3><div>Primary outcome variables were: <em>1)</em> number of CCMF surgery cases with OMS resident involvement, <em>2)</em> number of OMS residents who pursued CCMF surgery fellowship, and <em>3)</em> CCMF-related academic productivity of faculty and residents by abstract or publication.</div></div><div><h3>Covariates</h3><div>Covariates include clinical experience of OMS residents in CCMF surgery cases and CCMF surgery-related academic productivity.</div></div><div><h3>Analyses</h3><div>Descriptive statistics and continuous/ordinal variables were summarized. Fisher exact and Wilcoxon Rank Sum tests were completed. 2-sided <em>P</em> values of &lt;.05 were considered statistically significant.</div></div><div><h3>Results</h3><div>There were 81 completed surveys (91% response rate; excluded military programs). Almost half of OMS training programs have at least one attending surgeon who completed a CCMF surgery fellowship (n = 36/81, 44.4%). OMS departments with a CCMF surgery-trained faculty performed more operations on patients with congenital craniofacial differences (<em>P</em> value &lt;.001) and were more likely to publish at least one manuscript related to CCMF surgery in the last 5 years (<em>P</em> value = .029).</div></div><div><h3>Conclusion and Relevance</h3><div>Nearly half of OMS training programs have at least one attending surgeon who completed a CCMF surgery fellowship or equivalent. CCMF surgery faculty may increase opportunities for OMS resident involvement in caring for patients with congenital craniofacial differences. There is academic productivity in programs with CCMF surgeons. This should improve as the cohort of CCMF trained oral and maxillofacial surgeons increases.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages 177-187"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AAOMS Author Disclosure forms","authors":"","doi":"10.1016/S0278-2391(24)00998-4","DOIUrl":"10.1016/S0278-2391(24)00998-4","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages A9-A11"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Hope: Patient-Specific Bone-Anchored Subperiosteal Implants: Perspective of 3 US Institutions on This Resurrected Treatment Modality","authors":"Dane C. McMillan DDS, MD, MS ,&nbsp;Kale B. McMillan DDS, MD, MS ,&nbsp;Christopher F. Viozzi MD, DDS ,&nbsp;Paul Shivers MD, DMD ,&nbsp;Nils-Claudius Gellrich MD, DMD ,&nbsp;David B. Powers MD, DMD","doi":"10.1016/j.joms.2024.10.005","DOIUrl":"10.1016/j.joms.2024.10.005","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages 134-137"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of and Risk Factors for Hearing Impairment in Craniofacial Microsomia","authors":"Danique van Dop BSc ,&nbsp;Cornelia J.J.M. Caron MD, DMD, PhD ,&nbsp;Lisa Nussbaum MA, MBA ,&nbsp;Cory M. Resnick MD, DMD","doi":"10.1016/j.joms.2024.10.011","DOIUrl":"10.1016/j.joms.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>While ear anomalies and hearing impairment are common in patients with craniofacial microsomia (CFM), their prevalence, characteristics, and relationship to speech-language development remain unclear.</div></div><div><h3>Purpose</h3><div>This study analyzed the prevalence and risk factors for hearing impairment in patients with CFM.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective cohort study included patients with unilateral or bilateral CFM from a single center between January 1980 and July 2023 who had evidence of a hearing assessment at &lt;18 years. Exclusion criteria were inconclusive CFM diagnosis by clinical examination and/or radiographs or incomplete medical records.</div></div><div><h3>Predictor Variable</h3><div>The predictor variables included presence or absence of cleft lip and/or palate, laterality of CFM, and external ear and mandibular anomaly scores measured using the Orbit, Mandible, Ear, Nerve, and Soft Tissue and Pruzansky-Kaban classifications.</div></div><div><h3>Main Outcome Variables</h3><div>Primary outcome variable was hearing impairment, measured through air and bone conduction audiometry and categorized by type, severity, and side. Secondary outcome variable was speech-language delay, evaluated through assessments of expressive and receptive language skills, vocabulary, speech intelligibility, general articulation, and phonological speech.</div></div><div><h3>Covariates</h3><div>The covariates included sex and age at first hearing assessment.</div></div><div><h3>Analyses</h3><div>Logistic regression models were used to analyze the effect of predictors on outcomes. <em>P</em> value &lt;.05 was considered significant.</div></div><div><h3>Results</h3><div>The sample included 213 patients (61.5% male). Hearing assessments were performed at a mean age of 4.6 ± 4.8 years. Hearing impairment was found in 183 (85.9%) and was predominantly conductive (n = 130, 91.5%). Of subjects with hearing impairment, 158 (86.3%) had external ear anomalies (<em>P</em> &lt; .001). In patients with unilateral CFM, 38 (21.8%) had bilateral hearing loss and 9 (5.2%) had contralateral-only hearing loss. Both M3 and E3 scores were associated with the presence and severity of hearing loss (<em>P</em> = .01 and <em>P</em> &lt; .001, respectively). There was no significant association between hearing impairment and speech-language development (<em>P</em> &gt; .05).</div></div><div><h3>Conclusion and Relevance</h3><div>Although the severity of mandibular and external ear anomalies was significantly associated with the prevalence and severity of hearing loss, clinicians should remain alert for concomitant or isolated contralateral hearing loss, given the high prevalence of hearing loss in ears without ipsilateral facial involvement or external abnormalities.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 2","pages":"Pages 167-176"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}