Pub Date : 2024-03-27DOI: 10.1177/27325016241241826
Victor J. Yu, Aseela Samsam, Rajendra Sawh-Martinez, Joseph Lopez
Salivary gland malignancy (SGM) is a rare surgical pathology in the pediatric population, with currently ambiguous surgical management guidelines for the pediatric population. Therefore, we aim to use a national database to provide demographical and episode-of-care comparisons between the adult and pediatric population suffering from SGMs, with the interest of discovering baseline characteristic differences and outcomes, in addition to assessing the overall level of reporting at a national scale. The 2012 to 2019 American College of Surgeons’ National Surgical Quality Improvement Program Adult and Pediatric (ACS NSQIP, NSQIP-P) databases were queried to identify diagnoses of salivary gland malignancies based on postoperative ICD-10 codes. Age was stratified into adult (age ≥ 22 years) or pediatric (age < 22 years). Each age-based cohort were further stratified based on cancer site. Demographics, comorbidities, and complications were compared between adults and children. Overall, 1967 adult and 67 pediatric cases were included. Parotid gland malignancy comprised the majority of both adult and pediatric cases. Within cases of parotid gland malignancies, there were proportionally more adult compared to pediatric males. A lower comorbidity burden was also noted across pediatric cases. Operative time was slightly lower for pediatric cases compared to adult, with roughly 1 day less of total hospital stay. Complication rates were similar between adult and pediatric cases without statistically significant difference. Documentation of surgical outcomes in children with SGMs is severely lacking and continued reporting is imperative in order to improve outcomes of both oncologic and necessary reconstructive surgery. Optimal management of pediatric SGM demands use of a longitudinal multidisciplinary approach by surgeons cross-trained in head and neck surgery and plastic surgery. This is a burgeoning field with a need for studies aimed at developing guidelines specific for children.
{"title":"Comparison of Short-Term Outcomes Following Surgical Intervention of Salivary Gland Malignancies in Adult and Pediatric Patients: A National Database Analysis","authors":"Victor J. Yu, Aseela Samsam, Rajendra Sawh-Martinez, Joseph Lopez","doi":"10.1177/27325016241241826","DOIUrl":"https://doi.org/10.1177/27325016241241826","url":null,"abstract":"Salivary gland malignancy (SGM) is a rare surgical pathology in the pediatric population, with currently ambiguous surgical management guidelines for the pediatric population. Therefore, we aim to use a national database to provide demographical and episode-of-care comparisons between the adult and pediatric population suffering from SGMs, with the interest of discovering baseline characteristic differences and outcomes, in addition to assessing the overall level of reporting at a national scale. The 2012 to 2019 American College of Surgeons’ National Surgical Quality Improvement Program Adult and Pediatric (ACS NSQIP, NSQIP-P) databases were queried to identify diagnoses of salivary gland malignancies based on postoperative ICD-10 codes. Age was stratified into adult (age ≥ 22 years) or pediatric (age < 22 years). Each age-based cohort were further stratified based on cancer site. Demographics, comorbidities, and complications were compared between adults and children. Overall, 1967 adult and 67 pediatric cases were included. Parotid gland malignancy comprised the majority of both adult and pediatric cases. Within cases of parotid gland malignancies, there were proportionally more adult compared to pediatric males. A lower comorbidity burden was also noted across pediatric cases. Operative time was slightly lower for pediatric cases compared to adult, with roughly 1 day less of total hospital stay. Complication rates were similar between adult and pediatric cases without statistically significant difference. Documentation of surgical outcomes in children with SGMs is severely lacking and continued reporting is imperative in order to improve outcomes of both oncologic and necessary reconstructive surgery. Optimal management of pediatric SGM demands use of a longitudinal multidisciplinary approach by surgeons cross-trained in head and neck surgery and plastic surgery. This is a burgeoning field with a need for studies aimed at developing guidelines specific for children.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"71 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140375994","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 : 2024-03-27DOI: 10.1177/27325016241235621
Vince DiFabio, Eman Mirdamadi, Sangyoon Kim
Studies identifying TMJ synovitis biomarkers are few and far between. During the late 1990s, Chuck Milam’s oxidative stress and re-perfusion models elucidated the molecular mechanisms of TMJ synovitis which centrally involves the cytokines TNF-α, IL-1β, and IL-6. However, a new understanding of TMJ synovitis has been developed given the fields current knowledge on pattern recognition receptors (PRRs), damageassociated molecular patterns (DAMPs), pathogen-associated molecular patterns (PAMPs) and most notably, high mobility group box 1 (HMGB1). Among these molecular markers, the oxidation of HMGB1 plays a key role in promoting pathological inflammation. In this perspective, we explore the role of HMGB1 during TMJ synovitis and how a traumatized TMJ responds to different HMGB1 post translational modifications (PTMs). Specifically, synovial inflammation will be explored in the context of how different PTMs of HMGB1 directs leukocytes to produce chemokines or cytokines. We will also look at the different modifications of HMGB1 molecule via Reduction Oxygenation Reactions. These recently identified mechanisms provide a suitable addition to the currently understood molecular actions of TMJ synovitis noted by Milam and others in the late 1990s and early 2000s. We will then conclude with a discussion on the use of antibodies to the HMGB1 molecule for a variety of conditions: cancers, sepsis, liver disease, traumatic brain injuries and early intervention for joint synovitis along with the use of different delivery modalities.
{"title":"A Review of Temporomandibular Joint (TMJ) Synovitis and the Important Role of the Nuclear Protein, High Mobility Group Box 1 (HMGB1)","authors":"Vince DiFabio, Eman Mirdamadi, Sangyoon Kim","doi":"10.1177/27325016241235621","DOIUrl":"https://doi.org/10.1177/27325016241235621","url":null,"abstract":"Studies identifying TMJ synovitis biomarkers are few and far between. During the late 1990s, Chuck Milam’s oxidative stress and re-perfusion models elucidated the molecular mechanisms of TMJ synovitis which centrally involves the cytokines TNF-α, IL-1β, and IL-6. However, a new understanding of TMJ synovitis has been developed given the fields current knowledge on pattern recognition receptors (PRRs), damageassociated molecular patterns (DAMPs), pathogen-associated molecular patterns (PAMPs) and most notably, high mobility group box 1 (HMGB1). Among these molecular markers, the oxidation of HMGB1 plays a key role in promoting pathological inflammation. In this perspective, we explore the role of HMGB1 during TMJ synovitis and how a traumatized TMJ responds to different HMGB1 post translational modifications (PTMs). Specifically, synovial inflammation will be explored in the context of how different PTMs of HMGB1 directs leukocytes to produce chemokines or cytokines. We will also look at the different modifications of HMGB1 molecule via Reduction Oxygenation Reactions. These recently identified mechanisms provide a suitable addition to the currently understood molecular actions of TMJ synovitis noted by Milam and others in the late 1990s and early 2000s. We will then conclude with a discussion on the use of antibodies to the HMGB1 molecule for a variety of conditions: cancers, sepsis, liver disease, traumatic brain injuries and early intervention for joint synovitis along with the use of different delivery modalities.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"14 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140374465","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 : 2024-03-11DOI: 10.1177/27325016241238441
Tatevik Malisetyan, Joshua L. Harrison, S. Shahriari, Tegan N. Clarke, Elizaveta V. Rogol, Gregory L. Borah
Over the past two decades, autologous fat transfer has garnered significant recognition and widespread adoption within esthetic and reconstructive surgical domains. In craniofacial surgery, fat transplantation is frequently employed to address soft tissue volumetric deficiencies and asymmetries that influence facial contours. While adipose tissue (AT) is widely regarded as an optimal choice for augmentation due to its abundant availability and biocompatibility, the unpredictability and heightened resorption rates observed with traditional lipofilling techniques present a challenge for clinicians. Adipose-derived stem cells (ASCs) housed within the grafted tissue play a pivotal role in graft survival and offer avenues for tissue repair due to their angiogenic, anti-inflammatory, and immunosuppressive properties. Micro Fragmentation of Adipose Tissue (MFAT), utilized in several FDA-approved processing devices, has demonstrated promising outcomes in treating osteoarthritic joints, with success primarily attributed to enhanced paracrine function of ASCs via preservation of the perivascular niche. Currently, its application for treating bone or articular defects in the craniofacial region, including abnormalities of the temporomandibular joint, remains limited. This scarcity underscores the need for further investigation prior to its widespread integration into clinical practice.
{"title":"Autologous Fat Transfer in Craniofacial Surgery","authors":"Tatevik Malisetyan, Joshua L. Harrison, S. Shahriari, Tegan N. Clarke, Elizaveta V. Rogol, Gregory L. Borah","doi":"10.1177/27325016241238441","DOIUrl":"https://doi.org/10.1177/27325016241238441","url":null,"abstract":"Over the past two decades, autologous fat transfer has garnered significant recognition and widespread adoption within esthetic and reconstructive surgical domains. In craniofacial surgery, fat transplantation is frequently employed to address soft tissue volumetric deficiencies and asymmetries that influence facial contours. While adipose tissue (AT) is widely regarded as an optimal choice for augmentation due to its abundant availability and biocompatibility, the unpredictability and heightened resorption rates observed with traditional lipofilling techniques present a challenge for clinicians. Adipose-derived stem cells (ASCs) housed within the grafted tissue play a pivotal role in graft survival and offer avenues for tissue repair due to their angiogenic, anti-inflammatory, and immunosuppressive properties. Micro Fragmentation of Adipose Tissue (MFAT), utilized in several FDA-approved processing devices, has demonstrated promising outcomes in treating osteoarthritic joints, with success primarily attributed to enhanced paracrine function of ASCs via preservation of the perivascular niche. Currently, its application for treating bone or articular defects in the craniofacial region, including abnormalities of the temporomandibular joint, remains limited. This scarcity underscores the need for further investigation prior to its widespread integration into clinical practice.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"17 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140252792","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 : 2024-02-28DOI: 10.1177/27325016241234043
Srdjan Kamenko, Elizabeth Shepard, Andrew M. Ferry, Brynn A. Hathaway, Jens U. Berli, Reid V. Mueller
Three-dimensional (3D) modeling and printing technologies have been increasingly used throughout healthcare for research, educational, and clinical purposes. Despite the benefits associated with their use in surgical training, the literature poorly outlines the value of establishing an in-house, resident-driven 3D printing lab. Herein, we outline our quantifiable experience with our 3D printing lab and outline all necessary components needed to establish a lab such that the reader can replicate our experience at their institution. Additionally, we outline the process of creating a 3D-printed model from patient imaging with supplementary tutorial videos. A retrospective review of all 3D-printed models created in our in-house 3D printing lab since its creation in 2022 was performed. 3D-printed models that were utilized for formal educational or clinical purposes were included in this study. All 3D-printed models were created using the Raise3D 2 Pro. Cost estimates associated with each print were collected from the printer’s cost estimation function. A total of 14 3D-printed models met the inclusion criteria for our study. Of these, 4 (28.6%) were utilized for patient and/or resident education with the remaining 10 (71.4%) being used in patient care. By and large, the average cost of educational 3D-printed models was greater than clinical models ($12.00 vs $1.50, respectively). Ten 3D-printed models of mandibular fractures were successfully used to pre-bend plates prior to reconstructive surgery, and minimal intraoperative adjustment of the plate was required for each case. The processes of establishing a 3D printing lab along with creating a 3D-printed model from patient imaging are outlined. Establishing a 3D printing lab is an attainable feat for most institutions. High-value clinical and educational tools can be created for a reasonable price once the initial overhead costs of establishing a lab are covered.
三维（3D）建模和打印技术已越来越多地用于医疗保健领域的研究、教育和临床目的。尽管三维建模和打印技术在外科培训中的应用带来了诸多益处，但文献中对建立一个由住院医师主导的内部三维打印实验室的价值却缺乏概述。在此，我们概述了我们的 3D 打印实验室的量化经验，并概述了建立实验室所需的所有必要组件，以便读者可以在自己的机构复制我们的经验。此外，我们还通过辅助教学视频概述了根据患者成像创建 3D 打印模型的过程。我们对自 2022 年内部三维打印实验室成立以来创建的所有三维打印模型进行了回顾性审查。本研究包括用于正式教育或临床目的的三维打印模型。所有 3D 打印模型均使用 Raise3D 2 Pro 创建。打印机的成本估算功能收集了每次打印的相关成本估算。共有 14 个 3D 打印模型符合我们的研究纳入标准。其中 4 个（28.6%）用于患者和/或住院医师教育，其余 10 个（71.4%）用于患者护理。总体而言，教育用 3D 打印模型的平均成本高于临床模型（分别为 12.00 美元和 1.50 美元）。10 个下颌骨骨折的 3D 打印模型被成功用于重建手术前的钢板预弯，每个病例都只需要在术中对钢板进行最小程度的调整。本文概述了建立三维打印实验室以及根据患者图像创建三维打印模型的过程。对于大多数医疗机构来说，建立 3D 打印实验室是一项可以实现的壮举。只要支付了建立实验室的初期管理费用，就能以合理的价格制作出高价值的临床和教育工具。
{"title":"Establishing a Resident-Driven Three-Dimensional Printing Lab Within an Academic Institution","authors":"Srdjan Kamenko, Elizabeth Shepard, Andrew M. Ferry, Brynn A. Hathaway, Jens U. Berli, Reid V. Mueller","doi":"10.1177/27325016241234043","DOIUrl":"https://doi.org/10.1177/27325016241234043","url":null,"abstract":"Three-dimensional (3D) modeling and printing technologies have been increasingly used throughout healthcare for research, educational, and clinical purposes. Despite the benefits associated with their use in surgical training, the literature poorly outlines the value of establishing an in-house, resident-driven 3D printing lab. Herein, we outline our quantifiable experience with our 3D printing lab and outline all necessary components needed to establish a lab such that the reader can replicate our experience at their institution. Additionally, we outline the process of creating a 3D-printed model from patient imaging with supplementary tutorial videos. A retrospective review of all 3D-printed models created in our in-house 3D printing lab since its creation in 2022 was performed. 3D-printed models that were utilized for formal educational or clinical purposes were included in this study. All 3D-printed models were created using the Raise3D 2 Pro. Cost estimates associated with each print were collected from the printer’s cost estimation function. A total of 14 3D-printed models met the inclusion criteria for our study. Of these, 4 (28.6%) were utilized for patient and/or resident education with the remaining 10 (71.4%) being used in patient care. By and large, the average cost of educational 3D-printed models was greater than clinical models ($12.00 vs $1.50, respectively). Ten 3D-printed models of mandibular fractures were successfully used to pre-bend plates prior to reconstructive surgery, and minimal intraoperative adjustment of the plate was required for each case. The processes of establishing a 3D printing lab along with creating a 3D-printed model from patient imaging are outlined. Establishing a 3D printing lab is an attainable feat for most institutions. High-value clinical and educational tools can be created for a reasonable price once the initial overhead costs of establishing a lab are covered.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"134 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140423344","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 : 2024-02-19DOI: 10.1177/27325016241233754
Andrew D. Linkugel, Gary B. Skolnick, Sybill D. Naidoo, Matthew D. Smyth, Kamlesh Patel
Achievement of normal head shape is one of the primary goals of all treatment modalities for craniosynostosis, in addition to maintenance of normal intracranial pressure and allowing normal brain development. Pre- and postoperative quantification of head shape in sagittal craniosynostosis has largely relied on cephalic index (width divided by anterior-posterior length of skull). However, many infants with sagittal craniosynostosis have a head that is short in addition to long and narrow. Height is not captured by the cephalic index. Patients who underwent endoscopic repair of sagittal craniosynostosis between 2016 and 2019 with available pre- and 1-year postoperative head computed tomography (CT) scans were identified. Age-matched controls with available CT scans were used for comparison. Twenty-one patients with sagittal craniosynostosis who underwent endoscopic repair, 10 preoperative, and 10 postoperative age-matched controls were identified. CT scans were measured with Analyze 12.0 software using soft tissue windows. Head height was defined as the vertical distance from the opisthocranion to the top of the head along a line crossing the tragus. Patients with sagittal craniosynostosis had a shorter head height (mean 6.01 cm) than age-matched controls (mean 6.94 cm, P = .0003), and, after endoscopic repair and helmeting, the head height (mean 8.05 cm) was similar to age matched controls (mean 8.22 cm, P = .515). This head height measurement quantifies the third dimension of abnormal head shape in sagittal craniosynostosis. Additionally, it is adequately corrected in endoscopic repair with helmeting.
{"title":"Evaluation of Head Height After Endoscopic Strip Craniectomy and Orthotic Therapy for Sagittal Craniosynostosis","authors":"Andrew D. Linkugel, Gary B. Skolnick, Sybill D. Naidoo, Matthew D. Smyth, Kamlesh Patel","doi":"10.1177/27325016241233754","DOIUrl":"https://doi.org/10.1177/27325016241233754","url":null,"abstract":"Achievement of normal head shape is one of the primary goals of all treatment modalities for craniosynostosis, in addition to maintenance of normal intracranial pressure and allowing normal brain development. Pre- and postoperative quantification of head shape in sagittal craniosynostosis has largely relied on cephalic index (width divided by anterior-posterior length of skull). However, many infants with sagittal craniosynostosis have a head that is short in addition to long and narrow. Height is not captured by the cephalic index. Patients who underwent endoscopic repair of sagittal craniosynostosis between 2016 and 2019 with available pre- and 1-year postoperative head computed tomography (CT) scans were identified. Age-matched controls with available CT scans were used for comparison. Twenty-one patients with sagittal craniosynostosis who underwent endoscopic repair, 10 preoperative, and 10 postoperative age-matched controls were identified. CT scans were measured with Analyze 12.0 software using soft tissue windows. Head height was defined as the vertical distance from the opisthocranion to the top of the head along a line crossing the tragus. Patients with sagittal craniosynostosis had a shorter head height (mean 6.01 cm) than age-matched controls (mean 6.94 cm, P = .0003), and, after endoscopic repair and helmeting, the head height (mean 8.05 cm) was similar to age matched controls (mean 8.22 cm, P = .515). This head height measurement quantifies the third dimension of abnormal head shape in sagittal craniosynostosis. Additionally, it is adequately corrected in endoscopic repair with helmeting.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"47 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140452307","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 : 2024-02-19DOI: 10.1177/27325016241232713
S. Othman, Nissim Hazkour, Jose Palacios, Nicholas Bastidas
Objective: Branchial arch remnants are a well-encountered pathology in pediatric patients. In the majority of cases, these vestiges are superficial and benign, save for minor cosmetic deformity or discomfort. Although branchial arch remnants in the form of skin vestiges are commonly removed, there remains a lack of in-depth study regarding appropriate protocol and experience under local anesthesia. Design: A retrospective review of subjects undergoing first branchial arch vestige excision utilizing local anesthesia was conducted (2017-2021). Demographics were recorded, including age, sex, comorbidities, vestige location, presence of tracts, post-operative complications, and significant associations. Results: A total of 178 subjects were identified for inclusion. The mean patient age during the procedure was 18.4 ± 38.3 months. A total of 34 patients presented with a current or prior comorbidity (24.7%). The most common location of the branchial remnant was the preauricular region (79.2%). Most patients were without complication (96.1%). Secondarily developed branchial anomalies were significantly associated with complications as compared to congenital anomalies (22.2% vs 3.0%, P < .042). Additionally, patients with a past medical history were significantly more likely to develop a post-operative complication (71.4% vs 22.6%, P < .13). Conclusion: In-office branchial remnant removal is a safe procedure in the young pediatric patient. Complication rates are low; patients with a significant past medical history may be more likely to incur postoperative complications. Additionally, patients with secondary vestige development may also be more likely to develop complications. Further in-office procedures are encouraged.
目的：腮弓残余是儿童患者中经常遇到的一种病理现象。在大多数病例中，这些残余都是浅表性的良性病变，仅有轻微的外观畸形或不适。虽然皮肤残基形式的腮弓残留物通常会被切除，但关于局部麻醉下的适当方案和经验仍缺乏深入研究。设计：对首次使用局部麻醉进行杈弓残迹切除术的受试者进行回顾性研究（2017-2021 年）。记录了人口统计学特征，包括年龄、性别、合并症、残基位置、有无束带、术后并发症和重要关联。结果：共确定了 178 名纳入对象。手术期间患者的平均年龄为（18.4 ± 38.3）个月。共有 34 名患者目前或之前患有合并症（24.7%）。耳前区域是最常见的残余腮腺位置（79.2%）。大多数患者没有并发症（96.1%）。与先天性畸形相比，后天形成的腮腺畸形与并发症有显著相关性（22.2% vs 3.0%，P < .042）。此外，有既往病史的患者发生术后并发症的几率明显更高（71.4% vs 22.6%，P < .13）。结论对于年轻的儿科患者来说，诊室内残余腮腺切除术是一种安全的手术。并发症发生率较低；有严重既往病史的患者可能更容易出现术后并发症。此外，有继发性残迹的患者也更容易出现并发症。我们鼓励更多的诊室内手术。
{"title":"Branchial Arch Remnants in the Pediatric Patient Under Local Anesthesia","authors":"S. Othman, Nissim Hazkour, Jose Palacios, Nicholas Bastidas","doi":"10.1177/27325016241232713","DOIUrl":"https://doi.org/10.1177/27325016241232713","url":null,"abstract":"Objective: Branchial arch remnants are a well-encountered pathology in pediatric patients. In the majority of cases, these vestiges are superficial and benign, save for minor cosmetic deformity or discomfort. Although branchial arch remnants in the form of skin vestiges are commonly removed, there remains a lack of in-depth study regarding appropriate protocol and experience under local anesthesia. Design: A retrospective review of subjects undergoing first branchial arch vestige excision utilizing local anesthesia was conducted (2017-2021). Demographics were recorded, including age, sex, comorbidities, vestige location, presence of tracts, post-operative complications, and significant associations. Results: A total of 178 subjects were identified for inclusion. The mean patient age during the procedure was 18.4 ± 38.3 months. A total of 34 patients presented with a current or prior comorbidity (24.7%). The most common location of the branchial remnant was the preauricular region (79.2%). Most patients were without complication (96.1%). Secondarily developed branchial anomalies were significantly associated with complications as compared to congenital anomalies (22.2% vs 3.0%, P < .042). Additionally, patients with a past medical history were significantly more likely to develop a post-operative complication (71.4% vs 22.6%, P < .13). Conclusion: In-office branchial remnant removal is a safe procedure in the young pediatric patient. Complication rates are low; patients with a significant past medical history may be more likely to incur postoperative complications. Additionally, patients with secondary vestige development may also be more likely to develop complications. Further in-office procedures are encouraged.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"25 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140450610","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 : 2024-02-15DOI: 10.1177/27325016241232822
Kristen S. Whalen, Sarah Moffitt, Nicole K. Le, Jared S. Troy
Composite scalp and cranial defects present a challenge due to the unique elements that need to be reconstructed. The goals of reconstruction are to protect intracranial contents, prevent cerebrospinal fluid leak (CSF) and infection, and to provide durable soft tissue coverage. We present a case of an immunocompromised patient with history of craniotomy who developed osteomyelitis and a cranial abscess resulting in a composite defect with dural, bony, and soft tissue loss. To achieve vascularized watertight dural repair and durable soft tissue coverage for resolution of infection and eventual staged cranioplasty, we performed a free tensor fascia lata (TFL) myofascial and anterolateral thigh (ALT) fasciocutaneous chimeric flap. The patient healed well without CSF leak or infection at 5-month follow-up and cranioplasty is planned. Use of a chimeric TFL and ALT flap is effective in the treatment of large, composite cranial defects in the setting of active infection.
{"title":"Scalp and Dural Reconstruction With a Tensor Fascia Lata Myofascial and Anterolateral Thigh Fasciocutaneous Chimeric Flap: A Case Report","authors":"Kristen S. Whalen, Sarah Moffitt, Nicole K. Le, Jared S. Troy","doi":"10.1177/27325016241232822","DOIUrl":"https://doi.org/10.1177/27325016241232822","url":null,"abstract":"Composite scalp and cranial defects present a challenge due to the unique elements that need to be reconstructed. The goals of reconstruction are to protect intracranial contents, prevent cerebrospinal fluid leak (CSF) and infection, and to provide durable soft tissue coverage. We present a case of an immunocompromised patient with history of craniotomy who developed osteomyelitis and a cranial abscess resulting in a composite defect with dural, bony, and soft tissue loss. To achieve vascularized watertight dural repair and durable soft tissue coverage for resolution of infection and eventual staged cranioplasty, we performed a free tensor fascia lata (TFL) myofascial and anterolateral thigh (ALT) fasciocutaneous chimeric flap. The patient healed well without CSF leak or infection at 5-month follow-up and cranioplasty is planned. Use of a chimeric TFL and ALT flap is effective in the treatment of large, composite cranial defects in the setting of active infection.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"52 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139775056","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 : 2024-02-15DOI: 10.1177/27325016241232822
Kristen S. Whalen, Sarah Moffitt, Nicole K. Le, Jared S. Troy
Composite scalp and cranial defects present a challenge due to the unique elements that need to be reconstructed. The goals of reconstruction are to protect intracranial contents, prevent cerebrospinal fluid leak (CSF) and infection, and to provide durable soft tissue coverage. We present a case of an immunocompromised patient with history of craniotomy who developed osteomyelitis and a cranial abscess resulting in a composite defect with dural, bony, and soft tissue loss. To achieve vascularized watertight dural repair and durable soft tissue coverage for resolution of infection and eventual staged cranioplasty, we performed a free tensor fascia lata (TFL) myofascial and anterolateral thigh (ALT) fasciocutaneous chimeric flap. The patient healed well without CSF leak or infection at 5-month follow-up and cranioplasty is planned. Use of a chimeric TFL and ALT flap is effective in the treatment of large, composite cranial defects in the setting of active infection.
{"title":"Scalp and Dural Reconstruction With a Tensor Fascia Lata Myofascial and Anterolateral Thigh Fasciocutaneous Chimeric Flap: A Case Report","authors":"Kristen S. Whalen, Sarah Moffitt, Nicole K. Le, Jared S. Troy","doi":"10.1177/27325016241232822","DOIUrl":"https://doi.org/10.1177/27325016241232822","url":null,"abstract":"Composite scalp and cranial defects present a challenge due to the unique elements that need to be reconstructed. The goals of reconstruction are to protect intracranial contents, prevent cerebrospinal fluid leak (CSF) and infection, and to provide durable soft tissue coverage. We present a case of an immunocompromised patient with history of craniotomy who developed osteomyelitis and a cranial abscess resulting in a composite defect with dural, bony, and soft tissue loss. To achieve vascularized watertight dural repair and durable soft tissue coverage for resolution of infection and eventual staged cranioplasty, we performed a free tensor fascia lata (TFL) myofascial and anterolateral thigh (ALT) fasciocutaneous chimeric flap. The patient healed well without CSF leak or infection at 5-month follow-up and cranioplasty is planned. Use of a chimeric TFL and ALT flap is effective in the treatment of large, composite cranial defects in the setting of active infection.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"129 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139834643","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 : 2024-02-10DOI: 10.1177/27325016241230672
Gwendolyn E. Daly, Rebecca A. Luh, Darius Balumuka, Lori K. Howell, Erik M. Wolfswinkel
The Sonopet iQ® Ultrasonic Aspirator is a surgical tool used for the fragmentation and emulsification of bone and soft tissue. Ultrasonic vibrations emulsify bone with cited benefits of decreased damage to surrounding soft tissue and minimal heat dispersion. Despite these potential benefits, there is a paucity of published articles on the safety and efficacy of the Sonopet® in the setting of craniofacial surgery. In accordance with PRISMA guidelines, MEDLINE and Pubmed were searched for articles that studied use of the Sonopet® for osteotomies in the craniofacial setting. Studies exclusively investigating soft tissue aspiration were excluded. Out of 61 articles discovered, 22 met inclusion criteria and discussed a total of 816 patients. Of the 22 articles, there were 8 retrospective chart reviews, 7 case series, 5 cadaver models, and 2 case reports. Studies spanned multiple disciplines including otolaryngology, ophthalmology, craniofacial surgery, neurosurgery, and oral and maxillofacial surgery. Despite its frequent use in orthognathic and cranial vault remodeling surgery, only 4 studies described its use in these fields. The most commonly cited benefits of the Sonopet® were enhanced ergonomics and safety, discussed in 20 of the included studies. Eighteen studies claimed the Sonopet® was safer to use in surgically tight spaces compared to traditional drills. Four studies found decreased bone dust generation by the Sonopet® compared to conventional cutting devices. No studies reported an increase in postoperative complications due to the device. The most commonly cited disadvantage was the cost of the device, however, the majority of authors believed the benefits of the device outweighed the increase in cost. There is a dearth of research investigating the use of the Sonopet® in craniofacial surgery. Available studies emphasize the ergonomic and safety benefits of the Sonopet® and encourage expanded use of the device despite its cost.
{"title":"The Sonopet iQ® Ultrasonic Bone Aspirator in Craniofacial Surgery: A Scoping Review and Qualitative Analysis","authors":"Gwendolyn E. Daly, Rebecca A. Luh, Darius Balumuka, Lori K. Howell, Erik M. Wolfswinkel","doi":"10.1177/27325016241230672","DOIUrl":"https://doi.org/10.1177/27325016241230672","url":null,"abstract":"The Sonopet iQ® Ultrasonic Aspirator is a surgical tool used for the fragmentation and emulsification of bone and soft tissue. Ultrasonic vibrations emulsify bone with cited benefits of decreased damage to surrounding soft tissue and minimal heat dispersion. Despite these potential benefits, there is a paucity of published articles on the safety and efficacy of the Sonopet® in the setting of craniofacial surgery. In accordance with PRISMA guidelines, MEDLINE and Pubmed were searched for articles that studied use of the Sonopet® for osteotomies in the craniofacial setting. Studies exclusively investigating soft tissue aspiration were excluded. Out of 61 articles discovered, 22 met inclusion criteria and discussed a total of 816 patients. Of the 22 articles, there were 8 retrospective chart reviews, 7 case series, 5 cadaver models, and 2 case reports. Studies spanned multiple disciplines including otolaryngology, ophthalmology, craniofacial surgery, neurosurgery, and oral and maxillofacial surgery. Despite its frequent use in orthognathic and cranial vault remodeling surgery, only 4 studies described its use in these fields. The most commonly cited benefits of the Sonopet® were enhanced ergonomics and safety, discussed in 20 of the included studies. Eighteen studies claimed the Sonopet® was safer to use in surgically tight spaces compared to traditional drills. Four studies found decreased bone dust generation by the Sonopet® compared to conventional cutting devices. No studies reported an increase in postoperative complications due to the device. The most commonly cited disadvantage was the cost of the device, however, the majority of authors believed the benefits of the device outweighed the increase in cost. There is a dearth of research investigating the use of the Sonopet® in craniofacial surgery. Available studies emphasize the ergonomic and safety benefits of the Sonopet® and encourage expanded use of the device despite its cost.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"116 50","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139786466","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 : 2024-02-10DOI: 10.1177/27325016241230672
Gwendolyn E. Daly, Rebecca A. Luh, Darius Balumuka, Lori K. Howell, Erik M. Wolfswinkel
The Sonopet iQ® Ultrasonic Aspirator is a surgical tool used for the fragmentation and emulsification of bone and soft tissue. Ultrasonic vibrations emulsify bone with cited benefits of decreased damage to surrounding soft tissue and minimal heat dispersion. Despite these potential benefits, there is a paucity of published articles on the safety and efficacy of the Sonopet® in the setting of craniofacial surgery. In accordance with PRISMA guidelines, MEDLINE and Pubmed were searched for articles that studied use of the Sonopet® for osteotomies in the craniofacial setting. Studies exclusively investigating soft tissue aspiration were excluded. Out of 61 articles discovered, 22 met inclusion criteria and discussed a total of 816 patients. Of the 22 articles, there were 8 retrospective chart reviews, 7 case series, 5 cadaver models, and 2 case reports. Studies spanned multiple disciplines including otolaryngology, ophthalmology, craniofacial surgery, neurosurgery, and oral and maxillofacial surgery. Despite its frequent use in orthognathic and cranial vault remodeling surgery, only 4 studies described its use in these fields. The most commonly cited benefits of the Sonopet® were enhanced ergonomics and safety, discussed in 20 of the included studies. Eighteen studies claimed the Sonopet® was safer to use in surgically tight spaces compared to traditional drills. Four studies found decreased bone dust generation by the Sonopet® compared to conventional cutting devices. No studies reported an increase in postoperative complications due to the device. The most commonly cited disadvantage was the cost of the device, however, the majority of authors believed the benefits of the device outweighed the increase in cost. There is a dearth of research investigating the use of the Sonopet® in craniofacial surgery. Available studies emphasize the ergonomic and safety benefits of the Sonopet® and encourage expanded use of the device despite its cost.
{"title":"The Sonopet iQ® Ultrasonic Bone Aspirator in Craniofacial Surgery: A Scoping Review and Qualitative Analysis","authors":"Gwendolyn E. Daly, Rebecca A. Luh, Darius Balumuka, Lori K. Howell, Erik M. Wolfswinkel","doi":"10.1177/27325016241230672","DOIUrl":"https://doi.org/10.1177/27325016241230672","url":null,"abstract":"The Sonopet iQ® Ultrasonic Aspirator is a surgical tool used for the fragmentation and emulsification of bone and soft tissue. Ultrasonic vibrations emulsify bone with cited benefits of decreased damage to surrounding soft tissue and minimal heat dispersion. Despite these potential benefits, there is a paucity of published articles on the safety and efficacy of the Sonopet® in the setting of craniofacial surgery. In accordance with PRISMA guidelines, MEDLINE and Pubmed were searched for articles that studied use of the Sonopet® for osteotomies in the craniofacial setting. Studies exclusively investigating soft tissue aspiration were excluded. Out of 61 articles discovered, 22 met inclusion criteria and discussed a total of 816 patients. Of the 22 articles, there were 8 retrospective chart reviews, 7 case series, 5 cadaver models, and 2 case reports. Studies spanned multiple disciplines including otolaryngology, ophthalmology, craniofacial surgery, neurosurgery, and oral and maxillofacial surgery. Despite its frequent use in orthognathic and cranial vault remodeling surgery, only 4 studies described its use in these fields. The most commonly cited benefits of the Sonopet® were enhanced ergonomics and safety, discussed in 20 of the included studies. Eighteen studies claimed the Sonopet® was safer to use in surgically tight spaces compared to traditional drills. Four studies found decreased bone dust generation by the Sonopet® compared to conventional cutting devices. No studies reported an increase in postoperative complications due to the device. The most commonly cited disadvantage was the cost of the device, however, the majority of authors believed the benefits of the device outweighed the increase in cost. There is a dearth of research investigating the use of the Sonopet® in craniofacial surgery. Available studies emphasize the ergonomic and safety benefits of the Sonopet® and encourage expanded use of the device despite its cost.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"18 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139846174","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：