Pub Date : 2024-07-26DOI: 10.1177/27325016241266598
Caleb H. Bercu, Luccie M. Wo, Savannah L. Moon, Carole Brathwaite, Chad A. Perlyn, Jordan P. Steinberg
Trabecular juvenile ossifying fibromas (JTOFs) are uncommon aggressive benign neoplasms frequently involving the maxilla. Reports of JTOFs involving the entire maxilla in children 5 years or younger are exceptionally rare. Although various treatment options for maxillary reconstruction exist, there is no consensus on best practices following JOF resection. In this case study, we present a young girl with an extensive JTOF managed with a single-stage total maxillectomy and reconstruction utilizing split calvarial bone grafting and bilateral temporalis muscle flaps.
{"title":"A Rare Case of Massive Juvenile Ossifying Fibroma Requiring Total Maxillectomy and Craniofacial Reconstruction","authors":"Caleb H. Bercu, Luccie M. Wo, Savannah L. Moon, Carole Brathwaite, Chad A. Perlyn, Jordan P. Steinberg","doi":"10.1177/27325016241266598","DOIUrl":"https://doi.org/10.1177/27325016241266598","url":null,"abstract":"Trabecular juvenile ossifying fibromas (JTOFs) are uncommon aggressive benign neoplasms frequently involving the maxilla. Reports of JTOFs involving the entire maxilla in children 5 years or younger are exceptionally rare. Although various treatment options for maxillary reconstruction exist, there is no consensus on best practices following JOF resection. In this case study, we present a young girl with an extensive JTOF managed with a single-stage total maxillectomy and reconstruction utilizing split calvarial bone grafting and bilateral temporalis muscle flaps.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1177/27325016241262959
Nicolas Kaplan, Brenda Guillen, Akriti Choudhary, Chad A. Purnell
Genioglossus advancement is a surgical technique performed to treat obstructive sleep apnea. The genial tubercle, where the genioglossus muscle attaches, is not visible during dissection due to its location on the posterior mandible. Computer-aided design, particularly for the production of cutting guides, has arisen as a modern modification in the procedure to support accurate location of the tubercle. This study aims to demonstrate the utility of cutting guides designed by virtual surgical planning in a series of 7 genioglossus advancement cases. Computed Tomography (CT) data were preoperatively collected and rendered in three-dimension. The surgeon designed patient-specific cutting guides, registered to the occlusion, to ensure the genial tubercle was included in the osteotomy and stayed below the incisor tooth roots. These surgical guides were then 3D-printed. All the virtual surgical planning-designed guides fit appropriately, the genial tubercle was successfully included in the osteotomy in all cases, and no tooth roots were injured. We conclude that occlusal-based 3D printed cutting guides are a useful adjunct to help guide a genioglossus advancement procedure by accurately incorporating the genial tubercle. This provides a safe way to concurrently address correction of obstructive sleep apnea in patients undergoing other procedures.
{"title":"The Utility of 3D-printed Cutting Guides in Genioglossus Advancement","authors":"Nicolas Kaplan, Brenda Guillen, Akriti Choudhary, Chad A. Purnell","doi":"10.1177/27325016241262959","DOIUrl":"https://doi.org/10.1177/27325016241262959","url":null,"abstract":"Genioglossus advancement is a surgical technique performed to treat obstructive sleep apnea. The genial tubercle, where the genioglossus muscle attaches, is not visible during dissection due to its location on the posterior mandible. Computer-aided design, particularly for the production of cutting guides, has arisen as a modern modification in the procedure to support accurate location of the tubercle. This study aims to demonstrate the utility of cutting guides designed by virtual surgical planning in a series of 7 genioglossus advancement cases. Computed Tomography (CT) data were preoperatively collected and rendered in three-dimension. The surgeon designed patient-specific cutting guides, registered to the occlusion, to ensure the genial tubercle was included in the osteotomy and stayed below the incisor tooth roots. These surgical guides were then 3D-printed. All the virtual surgical planning-designed guides fit appropriately, the genial tubercle was successfully included in the osteotomy in all cases, and no tooth roots were injured. We conclude that occlusal-based 3D printed cutting guides are a useful adjunct to help guide a genioglossus advancement procedure by accurately incorporating the genial tubercle. This provides a safe way to concurrently address correction of obstructive sleep apnea in patients undergoing other procedures.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"54 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1177/27325016241263992
Rema Shah, Mariana N. Almeida, Christina Liu, Mitchel Wride, Donovan Lockwood, Jonathan Lee, Yan Lee
Skull base fracture management depends on location, severity, and can range from observation to surgical intervention. A comparison between the different locations of skull base fractures, namely anterior versus lateral, with regards to hospital length of stay (LOS), need for intensive care, and surgery has not been studied. Patients with skull base fractures between 2012 and 2019 were reviewed. Demographics and inpatient events were collected. Multivariate logistic and linear regressions evaluated the association between fracture location, multiple traumas, loss of consciousness, and mechanism of injury with hospital course and sequalae. There were 134 patients (74.6% male) with skull base fractures (67 anterior and 67 lateral), with an average age of 44.2 years. The mechanism of injury was more likely to be MVCs in anterior fractures and falls in lateral fractures (MVC: 56.7% vs 34.3%; falls: 28.4% vs 44.8%, P = .03). Patients with anterior fractures were more likely to undergo any surgery ( P < .002), and surgeries for facial fractures ( P < .005), but less likely to need ICU care ( P = .01). When admitted, patients with anterior skull base fractures had longer ICU stays ( P = .03). They were also more likely to experience vision difficulties whereas patients with lateral fractures were more likely to experience hearing loss ( P = .02). Patients with lateral skull base fractures are more likely to require an ICU admission compared to anterior fractures, but anterior fractures are more likely to need surgery and have longer ICU stays when admitted. A better understanding of the expected hospital course for patients based on skull base fracture location can improve care-coordination, hospital resource management and patient counseling.
颅底骨折的治疗取决于骨折的位置和严重程度，从观察到手术干预都有可能。目前尚未对颅底骨折的不同位置（即前侧骨折与侧方骨折）与住院时间（LOS）、重症监护需求和手术治疗进行比较研究。研究人员对2012年至2019年期间的颅底骨折患者进行了回顾。收集了人口统计学资料和住院事件。多变量逻辑回归和线性回归评估了骨折位置、多次外伤、意识丧失和损伤机制与住院过程和后遗症之间的关联。134名患者（74.6%为男性）患有颅底骨折（67例为前方骨折，67例为侧方骨折），平均年龄为44.2岁。前方骨折的受伤机制更可能是MVC，而侧方骨折的受伤机制更可能是跌倒（MVC：56.7% vs 34.3%；跌倒：28.4% vs 44.8%，P = .03）。前方骨折患者更有可能接受任何手术（P < .002），也更有可能接受面部骨折手术（P < .005），但需要重症监护室护理的可能性较低（P = .01）。前颅底骨折患者入院后在重症监护室的住院时间较长（P = .03）。他们还更有可能出现视力障碍，而侧方骨折患者则更有可能出现听力损失（P = 0.02）。与前方骨折相比，侧方颅底骨折患者更有可能需要入住重症监护室，但前方骨折患者更有可能需要手术治疗，入住重症监护室的时间也更长。根据颅底骨折位置更好地了解患者的预期住院过程可以改善护理协调、医院资源管理和患者咨询。
{"title":"Anterior Versus Lateral Skull Base Fractures: Differences in Hospital Course and Need for Surgery","authors":"Rema Shah, Mariana N. Almeida, Christina Liu, Mitchel Wride, Donovan Lockwood, Jonathan Lee, Yan Lee","doi":"10.1177/27325016241263992","DOIUrl":"https://doi.org/10.1177/27325016241263992","url":null,"abstract":"Skull base fracture management depends on location, severity, and can range from observation to surgical intervention. A comparison between the different locations of skull base fractures, namely anterior versus lateral, with regards to hospital length of stay (LOS), need for intensive care, and surgery has not been studied. Patients with skull base fractures between 2012 and 2019 were reviewed. Demographics and inpatient events were collected. Multivariate logistic and linear regressions evaluated the association between fracture location, multiple traumas, loss of consciousness, and mechanism of injury with hospital course and sequalae. There were 134 patients (74.6% male) with skull base fractures (67 anterior and 67 lateral), with an average age of 44.2 years. The mechanism of injury was more likely to be MVCs in anterior fractures and falls in lateral fractures (MVC: 56.7% vs 34.3%; falls: 28.4% vs 44.8%, P = .03). Patients with anterior fractures were more likely to undergo any surgery ( P < .002), and surgeries for facial fractures ( P < .005), but less likely to need ICU care ( P = .01). When admitted, patients with anterior skull base fractures had longer ICU stays ( P = .03). They were also more likely to experience vision difficulties whereas patients with lateral fractures were more likely to experience hearing loss ( P = .02). Patients with lateral skull base fractures are more likely to require an ICU admission compared to anterior fractures, but anterior fractures are more likely to need surgery and have longer ICU stays when admitted. A better understanding of the expected hospital course for patients based on skull base fracture location can improve care-coordination, hospital resource management and patient counseling.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"46 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-14DOI: 10.1177/27325016241257468
Molly F. MacIsaac, S. A. Rottgers
Any surgeon providing care to patients with congenital, oncologic, infectious, or traumatic processes impacting the head and neck should have an intimate knowledge of the local anatomy. The complex fascial system in this region results in a series of loosely and tightly bound spaces that can both harbor and/or facilitate the rapid spread of infections through these fascial planes and potential spaces. Deep neck space infections may occur spontaneously from cutaneous, lymphatic, odontogenic, otologic, salivary gland, sinus, and hematogenous sources or develop as the result of surgical/iatrogenic manipulation. These infections are typically polymicrobial, involving a mixture of Gram-positive cocci, Gram-negative rods, and beta-lactam-resistant anaerobes commonly found in the oropharyngeal flora. Other populations, such as immunocompromised or hospitalized patients, are particularly vulnerable to infection by certain opportunistic and antibiotic-resistant pathogens. Understanding the deep neck anatomy is crucial for predicting the spread of infection and guiding treatment strategies. The superficial and deep cervical fascial planes form a series of compartments and spaces including the retropharyngeal, danger, prevertebral, carotid, parapharyngeal, submandibular, sublingual, parotid, masticator, temporal, and infrahyoid spaces. Despite their rarity in the post-antibiotic era, deep neck space infections pose a significant threat as they progress rapidly and can quickly lead to life-threatening complications. Delayed clinical presentation is common due to the compartmentalization by fascial planes, therefore early recognition requires a high index of suspicion, thorough clinical examination, and diagnostic imaging studies, typically contrast-enhanced computed tomography (CECT). Treatment requires a multidisciplinary approach, including advanced airway management, administration of empirical broad-spectrum antibiotics, and surgical drainage when indicated. This review provides a comprehensive overview of deep neck space anatomy and its defining fascial planes, as well as discussions on epidemiology, specific microbiology, clinical presentation, diagnosis, antibiotic selection, and surgical treatment options.
{"title":"Anatomy, Diagnosis, and Clinical Management of Deep Neck Space Infections","authors":"Molly F. MacIsaac, S. A. Rottgers","doi":"10.1177/27325016241257468","DOIUrl":"https://doi.org/10.1177/27325016241257468","url":null,"abstract":"Any surgeon providing care to patients with congenital, oncologic, infectious, or traumatic processes impacting the head and neck should have an intimate knowledge of the local anatomy. The complex fascial system in this region results in a series of loosely and tightly bound spaces that can both harbor and/or facilitate the rapid spread of infections through these fascial planes and potential spaces. Deep neck space infections may occur spontaneously from cutaneous, lymphatic, odontogenic, otologic, salivary gland, sinus, and hematogenous sources or develop as the result of surgical/iatrogenic manipulation. These infections are typically polymicrobial, involving a mixture of Gram-positive cocci, Gram-negative rods, and beta-lactam-resistant anaerobes commonly found in the oropharyngeal flora. Other populations, such as immunocompromised or hospitalized patients, are particularly vulnerable to infection by certain opportunistic and antibiotic-resistant pathogens. Understanding the deep neck anatomy is crucial for predicting the spread of infection and guiding treatment strategies. The superficial and deep cervical fascial planes form a series of compartments and spaces including the retropharyngeal, danger, prevertebral, carotid, parapharyngeal, submandibular, sublingual, parotid, masticator, temporal, and infrahyoid spaces. Despite their rarity in the post-antibiotic era, deep neck space infections pose a significant threat as they progress rapidly and can quickly lead to life-threatening complications. Delayed clinical presentation is common due to the compartmentalization by fascial planes, therefore early recognition requires a high index of suspicion, thorough clinical examination, and diagnostic imaging studies, typically contrast-enhanced computed tomography (CECT). Treatment requires a multidisciplinary approach, including advanced airway management, administration of empirical broad-spectrum antibiotics, and surgical drainage when indicated. This review provides a comprehensive overview of deep neck space anatomy and its defining fascial planes, as well as discussions on epidemiology, specific microbiology, clinical presentation, diagnosis, antibiotic selection, and surgical treatment options.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"56 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141338332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-14DOI: 10.1177/27325016241261010
Nataliya Biskup
{"title":"Reflections on Operating in War-Time Ukraine","authors":"Nataliya Biskup","doi":"10.1177/27325016241261010","DOIUrl":"https://doi.org/10.1177/27325016241261010","url":null,"abstract":"","PeriodicalId":508736,"journal":{"name":"FACE","volume":"21 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141341226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.1177/27325016241257497
Amelia L. Davidson, Joshua A. Grosser, Samuel Kogan, Mario Blondin, Ryan G. Layton, Daniel E. Couture, Christopher M. Runyan
Individuals with genetic or nutritional rickets frequently suffer from craniosynostosis. While cranial vault remodeling is most often performed, other approaches, such as distraction osteogenesis and endoscopic suturectomy, are infrequently reported. Here, we discuss the status of the current literature and describe 2 patients with rachitic craniosynostosis, one of whom had previously undergone endoscopic suturectomy, who both successfully underwent distraction osteogenesis. Two male patients with rickets-associated craniosynostosis, 1 genetic and 1 nutritional, underwent posterior-vault distraction osteogenesis (PVDO). The patient with genetic rickets previously underwent endoscopic-assisted cranial suturectomy of the sagittal suture with barrel-staving at an outside hospital and subsequently re-fused all cranial sutures 19 months postoperatively necessitating reintervention. Complete distraction was confirmed by X-ray and both patients recovered without complication and without re-synostosis at 18 month follow-up. The patient with nutritional rickets required subsequent fronto-facial advancement because of poor midface growth. PVDO effectively treats rachitic craniosynostosis associated with both genetic and nutritional etiologies. Long-term follow up is warranted to monitor for skull-base involvement and associated midface retrusion in these patients.
遗传性或营养性佝偻病患者经常会出现颅骨发育不良。虽然颅顶重塑是最常见的方法，但其他方法，如牵张成骨术和内窥镜缝合切除术，却鲜有报道。在此，我们讨论了目前的文献现状，并描述了两名佝偻病颅骨发育不良患者的情况，其中一人曾接受过内窥镜缝合术，他们都成功地接受了牵张成骨术。两名男性佝偻病相关颅骨发育不良患者（一名遗传性患者和一名营养性患者）均接受了后穹窿牵引成骨术（PVDO）。其中一名遗传性佝偻病患者曾在一家外院接受了内窥镜辅助下的颅骨矢状缝切除术，术后19个月再次融合了所有颅骨缝线，因此有必要重新进行手术。经 X 光检查确认完全松解，两名患者在 18 个月的随访中均无并发症，也未再发生颅骨融合。患有营养性佝偻病的患者由于中面部发育不良，需要进行后续的前面部前移手术。PVDO 能有效治疗与遗传和营养病因有关的佝偻病性颅骨发育不良。需要对这些患者进行长期随访，以监测颅底受累情况和相关的面中部后缩情况。
{"title":"Distraction Osteogenesis and Endoscopic Suturectomy in the Treatment of Rachitic Craniosynostosis: A Case Series and Updated Literature Review With Discussion of Cephalometrics","authors":"Amelia L. Davidson, Joshua A. Grosser, Samuel Kogan, Mario Blondin, Ryan G. Layton, Daniel E. Couture, Christopher M. Runyan","doi":"10.1177/27325016241257497","DOIUrl":"https://doi.org/10.1177/27325016241257497","url":null,"abstract":"Individuals with genetic or nutritional rickets frequently suffer from craniosynostosis. While cranial vault remodeling is most often performed, other approaches, such as distraction osteogenesis and endoscopic suturectomy, are infrequently reported. Here, we discuss the status of the current literature and describe 2 patients with rachitic craniosynostosis, one of whom had previously undergone endoscopic suturectomy, who both successfully underwent distraction osteogenesis. Two male patients with rickets-associated craniosynostosis, 1 genetic and 1 nutritional, underwent posterior-vault distraction osteogenesis (PVDO). The patient with genetic rickets previously underwent endoscopic-assisted cranial suturectomy of the sagittal suture with barrel-staving at an outside hospital and subsequently re-fused all cranial sutures 19 months postoperatively necessitating reintervention. Complete distraction was confirmed by X-ray and both patients recovered without complication and without re-synostosis at 18 month follow-up. The patient with nutritional rickets required subsequent fronto-facial advancement because of poor midface growth. PVDO effectively treats rachitic craniosynostosis associated with both genetic and nutritional etiologies. Long-term follow up is warranted to monitor for skull-base involvement and associated midface retrusion in these patients.","PeriodicalId":508736,"journal":{"name":"FACE","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141371773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1177/27325016241255141
Hannes Prescher, Shelby L. Nathan, Kanad Ghosh, Charlotte Henderson, Russell R. Reid
Robin Sequence (RS) is a collection of distinct morphologic features involving the face and upper airway that results from the abnormal development of the neonatal mandible. Typically described as the triad of micrognathia, glossoptosis, and upper airway obstruction, it is frequently associated with a cleft palate and can be found in isolation or as part of a syndromic presentation. Owing to the intimate relationship between the mandible and its soft tissue attachments, micrognathia manifests clinically with respiratory and feeding difficulties. There is significant heterogeneity in both the degree of anatomic aberration and the associated physiological compromise, which dictates the medical and surgical treatment plan. In severe cases requiring surgical intervention, mandibular distraction osteogenesis (MDO) has been shown to be successful in relieving airway obstruction by correcting the morphologic deficiency of the mandible. However, controversy persists regarding the best treatment method as the exact relationship between the anatomic changes affected by MDO and the physiologic improvement remains poorly understood. This controversy is fueled by differing opinions about the natural growth potential of the abnormal mandible in patients with RS and the lack of long-term data on the maxillomandibular relationship at skeletal maturity of patients who underwent MDO in infancy. The objective of this systematic review is to provide a comprehensive summary of the morphologic changes to the mandible, upper airway, and hyoid bone affected by MDO and the impact of these changes on physiologic improvement and long-term growth.
{"title":"Mandibular Distraction in Robin Sequence – A Systematic Review of Morphologic Changes and Implications for Long-Term Growth","authors":"Hannes Prescher, Shelby L. Nathan, Kanad Ghosh, Charlotte Henderson, Russell R. Reid","doi":"10.1177/27325016241255141","DOIUrl":"https://doi.org/10.1177/27325016241255141","url":null,"abstract":"Robin Sequence (RS) is a collection of distinct morphologic features involving the face and upper airway that results from the abnormal development of the neonatal mandible. Typically described as the triad of micrognathia, glossoptosis, and upper airway obstruction, it is frequently associated with a cleft palate and can be found in isolation or as part of a syndromic presentation. Owing to the intimate relationship between the mandible and its soft tissue attachments, micrognathia manifests clinically with respiratory and feeding difficulties. There is significant heterogeneity in both the degree of anatomic aberration and the associated physiological compromise, which dictates the medical and surgical treatment plan. In severe cases requiring surgical intervention, mandibular distraction osteogenesis (MDO) has been shown to be successful in relieving airway obstruction by correcting the morphologic deficiency of the mandible. However, controversy persists regarding the best treatment method as the exact relationship between the anatomic changes affected by MDO and the physiologic improvement remains poorly understood. This controversy is fueled by differing opinions about the natural growth potential of the abnormal mandible in patients with RS and the lack of long-term data on the maxillomandibular relationship at skeletal maturity of patients who underwent MDO in infancy. The objective of this systematic review is to provide a comprehensive summary of the morphologic changes to the mandible, upper airway, and hyoid bone affected by MDO and the impact of these changes on physiologic improvement and long-term growth.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"17 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1177/27325016241256671
Solomon Lee, Niel Panchal, William Hoffman, Jason Pomerantz, Benjamin Laguna, Jesse Courtier
Accurate diagnosis and spatial characterization of craniofacial fractures is critical for treatment planning and precise fracture reduction. Since augmented reality (AR) has potential for better diagnostic evaluation than traditional three-dimensional (3D) reformats, we tested whether our accessible mobile-based AR model improves diagnostic accuracy, spatial understanding, and decreases task cognitive load when clinicians evaluate facial fractures. Clinicians (n = 30) in specialties managing craniofacial trauma assessed a database of mandibular and maxillofacial complex fractures of varying severity using computed-tomography slices supplemented with either traditional 3D reformats (control) or the AR model (experimental), completed diagnostic and spatial characterization tasks, and were evaluated quantitatively and qualitatively on diagnostic accuracy, task cognitive load, and weighted preference for the traditional versus AR model. Most clinicians (83%) preferred the AR model overall. Control and experimental groups had equivalent diagnostic sensitivity and specificity. Less experienced clinicians found the AR model required less effort, was less frustrating, and was preferred for fracture displacement characterization. The AR model had no significant impact on more experienced clinicians. All clinicians found the AR model allowed more intuitive manipulation of the 3D object. Those with less experience preferred the AR model over traditional imaging for diagnostic and educational purposes, whereas more experienced clinicians found that the AR model did not significantly alter their established approach to fracture evaluation. Our mobile-based AR model may be preferable to traditional 3D formats for spatial assessment tasks and decreasing task cognitive load, most notably for less experienced clinicians for whom perioperative practices are less established.
颅颌面骨折的准确诊断和空间特征描述对于治疗规划和精确骨折复位至关重要。由于增强现实技术（AR）比传统的三维（3D）重制技术具有更好的诊断评估潜力，我们测试了我们基于移动设备的可访问 AR 模型是否能提高诊断准确性、空间理解能力，并降低临床医生评估面部骨折时的任务认知负荷。颅颌面创伤专科的临床医生（n = 30）使用计算机断层扫描切片评估了不同严重程度的下颌骨和颌面部复杂骨折数据库，并辅以传统三维重建图（对照组）或 AR 模型（实验组），完成了诊断和空间特征描述任务，并对诊断准确性、任务认知负荷以及传统模型与 AR 模型的加权偏好进行了定量和定性评估。总体而言，大多数临床医生（83%）更倾向于 AR 模型。对照组和实验组的诊断灵敏度和特异性相当。经验较少的临床医生认为，AR 模型所需的工作量较少，不容易产生挫败感，在骨折位移特征描述方面更受青睐。AR 模型对经验丰富的临床医生没有明显影响。所有临床医生都认为 AR 模型可以更直观地操作三维物体。在诊断和教育方面，经验较少的临床医生更喜欢 AR 模型，而经验较多的临床医生则认为 AR 模型并没有明显改变他们既定的骨折评估方法。在空间评估任务和减少任务认知负荷方面，我们基于移动设备的 AR 模型可能优于传统的 3D 格式，尤其是对于围手术期实践经验较少的临床医生而言。
{"title":"An Augmented Reality Model for Evaluating Traumatic Craniofacial Fractures","authors":"Solomon Lee, Niel Panchal, William Hoffman, Jason Pomerantz, Benjamin Laguna, Jesse Courtier","doi":"10.1177/27325016241256671","DOIUrl":"https://doi.org/10.1177/27325016241256671","url":null,"abstract":"Accurate diagnosis and spatial characterization of craniofacial fractures is critical for treatment planning and precise fracture reduction. Since augmented reality (AR) has potential for better diagnostic evaluation than traditional three-dimensional (3D) reformats, we tested whether our accessible mobile-based AR model improves diagnostic accuracy, spatial understanding, and decreases task cognitive load when clinicians evaluate facial fractures. Clinicians (n = 30) in specialties managing craniofacial trauma assessed a database of mandibular and maxillofacial complex fractures of varying severity using computed-tomography slices supplemented with either traditional 3D reformats (control) or the AR model (experimental), completed diagnostic and spatial characterization tasks, and were evaluated quantitatively and qualitatively on diagnostic accuracy, task cognitive load, and weighted preference for the traditional versus AR model. Most clinicians (83%) preferred the AR model overall. Control and experimental groups had equivalent diagnostic sensitivity and specificity. Less experienced clinicians found the AR model required less effort, was less frustrating, and was preferred for fracture displacement characterization. The AR model had no significant impact on more experienced clinicians. All clinicians found the AR model allowed more intuitive manipulation of the 3D object. Those with less experience preferred the AR model over traditional imaging for diagnostic and educational purposes, whereas more experienced clinicians found that the AR model did not significantly alter their established approach to fracture evaluation. Our mobile-based AR model may be preferable to traditional 3D formats for spatial assessment tasks and decreasing task cognitive load, most notably for less experienced clinicians for whom perioperative practices are less established.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"40 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141270048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-17DOI: 10.1177/27325016241252361
Sierra H. Willens, Lana Mamoun, Dana Meshkin, Joseph W. Mocharnuk, Miles J. Pfaff
{"title":"Plastic Surgery and the Epidemic of Pediatric Firearm Injuries in America","authors":"Sierra H. Willens, Lana Mamoun, Dana Meshkin, Joseph W. Mocharnuk, Miles J. Pfaff","doi":"10.1177/27325016241252361","DOIUrl":"https://doi.org/10.1177/27325016241252361","url":null,"abstract":"","PeriodicalId":508736,"journal":{"name":"FACE","volume":"51 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140965582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-11DOI: 10.1177/27325016241254507
Jordan Killingsworth, Evan Abdullah, Ikram Rostane, Shreeya Patel, Colin Jenkins, Brittany Graham, Rajesh Pandey, Matthew Greives
Acalvaria is a rare congenital malformation of unknown etiopathogenesis that affects the development of the skull and surrounding muscular structures. There is scant literature regarding the pathophysiology, and no standardized guidelines exist for patient management. Herein, we present a case of acalvaria in a newborn and our multidisciplinary approach from diagnosis to 1 year of age.
{"title":"Isolated Finding of Acalvaria in a Newborn Infant","authors":"Jordan Killingsworth, Evan Abdullah, Ikram Rostane, Shreeya Patel, Colin Jenkins, Brittany Graham, Rajesh Pandey, Matthew Greives","doi":"10.1177/27325016241254507","DOIUrl":"https://doi.org/10.1177/27325016241254507","url":null,"abstract":"Acalvaria is a rare congenital malformation of unknown etiopathogenesis that affects the development of the skull and surrounding muscular structures. There is scant literature regarding the pathophysiology, and no standardized guidelines exist for patient management. Herein, we present a case of acalvaria in a newborn and our multidisciplinary approach from diagnosis to 1 year of age.","PeriodicalId":508736,"journal":{"name":"FACE","volume":" 476","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140989805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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