Pub Date : 2023-12-15DOI: 10.1177/27325016231215124
{"title":"Craniomaxillofacial abstracts from the 66th annual meeting of the Ohio Valley Society of Plastic Surgeons","authors":"","doi":"10.1177/27325016231215124","DOIUrl":"https://doi.org/10.1177/27325016231215124","url":null,"abstract":"","PeriodicalId":508736,"journal":{"name":"FACE","volume":"263 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139177492","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 : 2023-12-15DOI: 10.1177/27325016231218672
Patrick A. Palines, Hannah E. Doran, Harel G. Schwartzberg, Devin M. Melancon, Matthew J. Bartow, Rizwan Aslam, H. St. Hilaire, Mark W. Stalder
Mandibular osteoradionecrosis (ORN) is a devastating complication of radiotherapy for oropharyngeal malignancy. Despite advancements in ORN treatment, risk of ORN recurrence remains high following surgical resection. Virtual surgical planning (VSP) for ORN treatment is an evolving application that may not only inform bony reconstruction but also therapeutic surgical margins, which remain inconclusively defined in the literature. A retrospective review was performed of 25 cases in which patients underwent VSP-guided resection of mandibular ORN followed by immediate free fibula flap reconstruction. Surgical margins of 1-cm from radiologically evident disease were taken. VSP accuracy was quantified by comparing measured anatomic parameters between the virtually planned outcomes and the final outcomes on postoperative imaging. Statistical analyses were performed to assess associations between preoperative factors and postoperative complications including ORN recurrence. The mandibular body was most frequently affected by ORN in this series of patients. Among risk factors, only the presence of a preoperative orocutaneous fistula was predictive of a complication, specifically partial flap failure (β = 1.41; P = .013). Intended anatomic parameters were achieved with the exception of the intergonial distance (x difference = 0.53 cm; P = .03). Finally, there were no cases of ORN recurrence after a mean follow-up of 27.4 months. VSP of free fibula flaps for mandibular reconstruction following ORN is a valid tool for effecting accurate anatomical outcomes. Furthermore, we demonstrate that a 1-cm margin around radiographically evident ORN may effectively implement a curative outcome free from relapse.
{"title":"“Virtual Surgical Planning Facilitates Surgical Resection in Mandibular Osteoradionecrosis and Optimize Reconstructive Outcomes”","authors":"Patrick A. Palines, Hannah E. Doran, Harel G. Schwartzberg, Devin M. Melancon, Matthew J. Bartow, Rizwan Aslam, H. St. Hilaire, Mark W. Stalder","doi":"10.1177/27325016231218672","DOIUrl":"https://doi.org/10.1177/27325016231218672","url":null,"abstract":"Mandibular osteoradionecrosis (ORN) is a devastating complication of radiotherapy for oropharyngeal malignancy. Despite advancements in ORN treatment, risk of ORN recurrence remains high following surgical resection. Virtual surgical planning (VSP) for ORN treatment is an evolving application that may not only inform bony reconstruction but also therapeutic surgical margins, which remain inconclusively defined in the literature. A retrospective review was performed of 25 cases in which patients underwent VSP-guided resection of mandibular ORN followed by immediate free fibula flap reconstruction. Surgical margins of 1-cm from radiologically evident disease were taken. VSP accuracy was quantified by comparing measured anatomic parameters between the virtually planned outcomes and the final outcomes on postoperative imaging. Statistical analyses were performed to assess associations between preoperative factors and postoperative complications including ORN recurrence. The mandibular body was most frequently affected by ORN in this series of patients. Among risk factors, only the presence of a preoperative orocutaneous fistula was predictive of a complication, specifically partial flap failure (β = 1.41; P = .013). Intended anatomic parameters were achieved with the exception of the intergonial distance (x difference = 0.53 cm; P = .03). Finally, there were no cases of ORN recurrence after a mean follow-up of 27.4 months. VSP of free fibula flaps for mandibular reconstruction following ORN is a valid tool for effecting accurate anatomical outcomes. Furthermore, we demonstrate that a 1-cm margin around radiographically evident ORN may effectively implement a curative outcome free from relapse.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"171 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178813","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 : 2023-12-11DOI: 10.1177/27325016231217946
Sarah A. Layon, Heather R. Burns, Daniel S. Wang, Edward P. Buchanan
The nasal columella presents one of the most intricate challenges in facial reconstruction due to its unique contours and limited availability of adjacent tissue. Several surgical techniques exist for successful columellar reconstruction, and the choice of approach depends on factors such as the size of the defect, surgical expertise, and overall esthetic goals. In cases involving substantial columellar defects, or deformities affecting multiple nasal subunits, local or regional flaps are often necessary to achieve optimal reconstruction. In this report, the authors present a case of pediatric columellar reconstruction utilizing a modified local flap technique derived from the upper lip lift used in esthetic surgery for facial rejuvenation and lip enhancement. This method distinguishes itself from previous adaptations by remaining entirely subnasal, without extending beyond the width of the alar base, disrupting the philtrum, or disturbing the orbicularis oris muscle. This technique offers notable advantages for pediatric patients, such as its ability to minimize scarring, prevent additional deformities, and be performed in a single stage. Level IV, case study.
{"title":"Modified Lip Lift Technique for Pediatric Columellar Reconstruction: A Case Report","authors":"Sarah A. Layon, Heather R. Burns, Daniel S. Wang, Edward P. Buchanan","doi":"10.1177/27325016231217946","DOIUrl":"https://doi.org/10.1177/27325016231217946","url":null,"abstract":"The nasal columella presents one of the most intricate challenges in facial reconstruction due to its unique contours and limited availability of adjacent tissue. Several surgical techniques exist for successful columellar reconstruction, and the choice of approach depends on factors such as the size of the defect, surgical expertise, and overall esthetic goals. In cases involving substantial columellar defects, or deformities affecting multiple nasal subunits, local or regional flaps are often necessary to achieve optimal reconstruction. In this report, the authors present a case of pediatric columellar reconstruction utilizing a modified local flap technique derived from the upper lip lift used in esthetic surgery for facial rejuvenation and lip enhancement. This method distinguishes itself from previous adaptations by remaining entirely subnasal, without extending beyond the width of the alar base, disrupting the philtrum, or disturbing the orbicularis oris muscle. This technique offers notable advantages for pediatric patients, such as its ability to minimize scarring, prevent additional deformities, and be performed in a single stage. Level IV, case study.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"19 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139184278","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 : 2023-12-11DOI: 10.1177/27325016231217152
Christina N. Canzoneri, James T. Thompson
The method of epidermal closure during cleft lip repair is important to consider, as it may affect complication rates, cosmetic outcomes, and patient comfort levels. Historically, this has most commonly been performed with permanent suture that requires subsequent removal, which is not well tolerated in infants. The purpose of this study is to compare the outcomes between 2-octyl cyanoacrylate liquid with a self-adhesive polyester mesh tape (2-OPMT) and typical suture closure techniques, which to our knowledge has never previously been investigated. In nine consecutive cleft lip repairs, the epidermal closure was performed with permanent suture, and in the subsequent nine consecutive cleft lip repairs, the epidermal closure was performed with 2-OPMT. Complication rates were compared between the groups. Esthetic scar outcomes were investigated via post-operative photograph analysis utilizing the Manchester Scar Scale. Statistical significance was determined with Fischer Exact Tests and Wilcoxon Rank-Sum tests. Subsequently, scar scores for 30 cleft lip repairs performed with 2-OPMT in our practice were compared to previously reported scores in the literature for 30 cleft lip repairs performed with typical suture technique. Three patients in the permanent suture group had documented scar-related complications and one patient in the 2-OPMT group had documented scar-related complications. No statistically significant difference was found in complication rates between the two groups. No statistically significant difference was found in esthetic scar scores between the two different closure techniques either within our practice or in comparison to reports in the literature. Overall, the use of 2-OPMT offers comparable esthetic outcomes and complication rates to the use of permanent suture in epidermal closure of cleft lip repairs.
{"title":"Esthetic Outcomes of Primary Cleft Lip Repair Utilizing 2-Octyl Cyanoacrylate Liquid and a Self-adhesive Polyester Mesh Tape","authors":"Christina N. Canzoneri, James T. Thompson","doi":"10.1177/27325016231217152","DOIUrl":"https://doi.org/10.1177/27325016231217152","url":null,"abstract":"The method of epidermal closure during cleft lip repair is important to consider, as it may affect complication rates, cosmetic outcomes, and patient comfort levels. Historically, this has most commonly been performed with permanent suture that requires subsequent removal, which is not well tolerated in infants. The purpose of this study is to compare the outcomes between 2-octyl cyanoacrylate liquid with a self-adhesive polyester mesh tape (2-OPMT) and typical suture closure techniques, which to our knowledge has never previously been investigated. In nine consecutive cleft lip repairs, the epidermal closure was performed with permanent suture, and in the subsequent nine consecutive cleft lip repairs, the epidermal closure was performed with 2-OPMT. Complication rates were compared between the groups. Esthetic scar outcomes were investigated via post-operative photograph analysis utilizing the Manchester Scar Scale. Statistical significance was determined with Fischer Exact Tests and Wilcoxon Rank-Sum tests. Subsequently, scar scores for 30 cleft lip repairs performed with 2-OPMT in our practice were compared to previously reported scores in the literature for 30 cleft lip repairs performed with typical suture technique. Three patients in the permanent suture group had documented scar-related complications and one patient in the 2-OPMT group had documented scar-related complications. No statistically significant difference was found in complication rates between the two groups. No statistically significant difference was found in esthetic scar scores between the two different closure techniques either within our practice or in comparison to reports in the literature. Overall, the use of 2-OPMT offers comparable esthetic outcomes and complication rates to the use of permanent suture in epidermal closure of cleft lip repairs.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"72 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139184256","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 : 2023-12-11DOI: 10.1177/27325016231217153
Joshua Kohan, Armin Edalatpour, Allison J. Seitz, Daniel Y. Cho, Brian H. Gander
Facial nerve blocks are widely used techniques for analgesia to the face and utilized by surgeons to facilitate facial procedures. The aim of this review is to explore the different nerve blocks of the face. Therefore, a comprehensive literature search of PubMed, Scopus, Elsevier, and Web of Science was conducted to identify relevant literature related to facial blocks. For each block reported, the literature was screened for relevant information on indications, techniques, and complications. The facial nerve blocks identified in the current literature for facial surgery procedures were supraorbital and supratrochlear blocks, maxillary nerve block, inferior alveolar nerve block, lingual nerve block, mental nerve block, nerve block of the nose, and auricular nerve block. Success rates in both achieving anesthesia and postoperative pain control has been reported to be between 70% and 90%. The most frequent adverse effects of these blocks were allergic reaction, bleeding or hematoma, infection, and nerve damage due to nerve compression. On the other hand, few studies have investigated the efficacy and patient-reported outcomes. Variable levels of analgesia and anesthesia have been reported between the discussed facial nerve blocks, with each yielding a different advantage. Further studies are necessitated to report on the block duration and patient outcomes reported by each facial nerve block discussed in this review.
面神经阻滞是面部镇痛的广泛应用技术，外科医生利用它来促进面部手术。本综述旨在探讨面部不同的神经阻滞。因此，我们对 PubMed、Scopus、Elsevier 和 Web of Science 进行了全面的文献检索，以确定与面部阻滞相关的文献。对于所报道的每一种阻滞，都对文献中的适应症、技术和并发症等相关信息进行了筛选。在目前的文献中，用于面部手术的面部神经阻滞包括眶上和眶上阻滞、上颌神经阻滞、下牙槽神经阻滞、舌神经阻滞、精神神经阻滞、鼻部神经阻滞和耳廓神经阻滞。据报道，实现麻醉和术后疼痛控制的成功率在 70% 至 90% 之间。这些阻滞最常见的不良反应是过敏反应、出血或血肿、感染以及神经压迫导致的神经损伤。另一方面，很少有研究对疗效和患者报告结果进行调查。据报道，不同面神经阻滞术的镇痛和麻醉程度各不相同，各自具有不同的优势。有必要进行进一步研究，以报告本综述中讨论的每种面神经阻滞的阻滞持续时间和患者报告的结果。
{"title":"Nerve Blocks Utilized in The Face: A Comprehensive Review","authors":"Joshua Kohan, Armin Edalatpour, Allison J. Seitz, Daniel Y. Cho, Brian H. Gander","doi":"10.1177/27325016231217153","DOIUrl":"https://doi.org/10.1177/27325016231217153","url":null,"abstract":"Facial nerve blocks are widely used techniques for analgesia to the face and utilized by surgeons to facilitate facial procedures. The aim of this review is to explore the different nerve blocks of the face. Therefore, a comprehensive literature search of PubMed, Scopus, Elsevier, and Web of Science was conducted to identify relevant literature related to facial blocks. For each block reported, the literature was screened for relevant information on indications, techniques, and complications. The facial nerve blocks identified in the current literature for facial surgery procedures were supraorbital and supratrochlear blocks, maxillary nerve block, inferior alveolar nerve block, lingual nerve block, mental nerve block, nerve block of the nose, and auricular nerve block. Success rates in both achieving anesthesia and postoperative pain control has been reported to be between 70% and 90%. The most frequent adverse effects of these blocks were allergic reaction, bleeding or hematoma, infection, and nerve damage due to nerve compression. On the other hand, few studies have investigated the efficacy and patient-reported outcomes. Variable levels of analgesia and anesthesia have been reported between the discussed facial nerve blocks, with each yielding a different advantage. Further studies are necessitated to report on the block duration and patient outcomes reported by each facial nerve block discussed in this review.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"114 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139183376","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 : 2023-12-11DOI: 10.1177/27325016231218006
Imran Rizvi, Sarah Jackson, Alex A. Kane, R. Hallac
Patients with cleft lip often have a secondary cleft-lip deformity (SCLD), resulting from the initial repair procedure for their congenital cleft. Patients with SCLD often undergo multiple surgeries to achieve symmetry of the lip and nose. However, little is known about how patients perceive their deformity, and if those deformities are noticeable to their peers. The purpose of this study is to use eye-tracking to evaluate how patients with cleft lip repair look at themselves and evaluate how this perception changes when the same photo is perceived by 2 different cohorts: patients who have undergone cleft-lip surgeries and control subjects who have no craniofacial pathology. Participants were divided into 4 cohorts: adolescents with SCLD viewing images of themselves (Cohort 1), adolescents with SCLD viewing images of peers with SCLD (Cohort 2), adolescents without SCLD viewing images of peers with SCLD (Cohort 3), and healthy adolescents without SCLD viewing images of themselves (Cohort 4). Surveys were conducted after the eye-tracking portion to determine correlations between objective gaze data and subjective opinions. Total fixation duration was highest in the eye region for all 3 cohorts, followed by the upper lip region. Cohort 2 fixated the longest on all areas of pathology, while Cohort 1 fixated the least on all areas of pathology. Cohort 4 spent significantly more time looking at the nose bridge compared to Cohort 1. The results provide insight into how adolescents with SCLD are perceived by themselves and others and can help to better understand the complexities of the roles different areas of pathology play in self-perception.
{"title":"Exploring Self-Perception and Peer-Perception in Adolescents With Secondary Cleft Lip Deformities Using Eye-Tracking","authors":"Imran Rizvi, Sarah Jackson, Alex A. Kane, R. Hallac","doi":"10.1177/27325016231218006","DOIUrl":"https://doi.org/10.1177/27325016231218006","url":null,"abstract":"Patients with cleft lip often have a secondary cleft-lip deformity (SCLD), resulting from the initial repair procedure for their congenital cleft. Patients with SCLD often undergo multiple surgeries to achieve symmetry of the lip and nose. However, little is known about how patients perceive their deformity, and if those deformities are noticeable to their peers. The purpose of this study is to use eye-tracking to evaluate how patients with cleft lip repair look at themselves and evaluate how this perception changes when the same photo is perceived by 2 different cohorts: patients who have undergone cleft-lip surgeries and control subjects who have no craniofacial pathology. Participants were divided into 4 cohorts: adolescents with SCLD viewing images of themselves (Cohort 1), adolescents with SCLD viewing images of peers with SCLD (Cohort 2), adolescents without SCLD viewing images of peers with SCLD (Cohort 3), and healthy adolescents without SCLD viewing images of themselves (Cohort 4). Surveys were conducted after the eye-tracking portion to determine correlations between objective gaze data and subjective opinions. Total fixation duration was highest in the eye region for all 3 cohorts, followed by the upper lip region. Cohort 2 fixated the longest on all areas of pathology, while Cohort 1 fixated the least on all areas of pathology. Cohort 4 spent significantly more time looking at the nose bridge compared to Cohort 1. The results provide insight into how adolescents with SCLD are perceived by themselves and others and can help to better understand the complexities of the roles different areas of pathology play in self-perception.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"56 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139184219","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 : 2023-11-28DOI: 10.1177/27325016231213555
P. Annie Chen-Carrington, Christopher Henry, Adam Goodreau, Jennifer Rhodes
Cleidocranial dysplasia (CCD) and Alexander disease (AxD) are rare, autosomal dominant disorders that are characterized by a mutation in the runt-related transcription factor 2 ( RUNX2) and the glial fibrillary acidic protein ( GFAP) genes, respectively. There is no known relationship between RUNX2 and GFAP which would cause co-morbidity. We report a rare case of a 13-year-old with CCD who came to the clinic complaining of a 2-year history of progressively worsening episodic exacerbations of bulbar, ataxia, nystagmus, kyphoscoliosis, and nausea, but was intact cognitively. Initial diagnosis was a difficult process because preliminary symptoms for Juvenile AxD overlapped with previously diagnosed CCD and the initial genetic test identified our patient’s GFAP gene as a variant of uncertain significance. Our experience emphasizes the importance of continuing to report pathogenic variants of GFAP for AxD to build on our existing compendium of variants for GFAP for quicker and more efficient diagnosis of AxD.
{"title":"Juvenile Alexander Disease and Cleidocranial Dysplasia: A Rare Combination of Genetic Abnormalities in a Pediatric Patient","authors":"P. Annie Chen-Carrington, Christopher Henry, Adam Goodreau, Jennifer Rhodes","doi":"10.1177/27325016231213555","DOIUrl":"https://doi.org/10.1177/27325016231213555","url":null,"abstract":"Cleidocranial dysplasia (CCD) and Alexander disease (AxD) are rare, autosomal dominant disorders that are characterized by a mutation in the runt-related transcription factor 2 ( RUNX2) and the glial fibrillary acidic protein ( GFAP) genes, respectively. There is no known relationship between RUNX2 and GFAP which would cause co-morbidity. We report a rare case of a 13-year-old with CCD who came to the clinic complaining of a 2-year history of progressively worsening episodic exacerbations of bulbar, ataxia, nystagmus, kyphoscoliosis, and nausea, but was intact cognitively. Initial diagnosis was a difficult process because preliminary symptoms for Juvenile AxD overlapped with previously diagnosed CCD and the initial genetic test identified our patient’s GFAP gene as a variant of uncertain significance. Our experience emphasizes the importance of continuing to report pathogenic variants of GFAP for AxD to build on our existing compendium of variants for GFAP for quicker and more efficient diagnosis of AxD.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139215695","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 : 2023-11-25DOI: 10.1177/27325016231212564
Melinda Lem, Jason T Pham, Jagmeet Arora, Shivang Trivedi, Omotayo A. Arowojolu, Ruben Castro, Joseph Mocharnuk, Raj Vyas, Miles J. Pfaff
Background:To date, there is little guidance regarding current adjuvant therapies for primary surgical repair of cleft lip. There are studies on the effect of botulinum toxin type A, revision fat grafting, silicone gel and sheeting, intense pulsed light, and carbon dioxide lasers to ameliorate contracture and hypertrophic scar formation, but a comprehensive review of these options is lacking. The aim of this scoping review is to examine adjuvant techniques and therapies that modulate scar outcomes for primary cleft lip repair outcomes in the perioperative period. Methods: PROSPERO, PubMed/MEDLINE, SCOPUS, Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrial.gov were searched for studies that evaluated adjuvant therapies for primary cleft lip repair. Results: The initial search resulted in 688 studies, with 48 studies including relevant key terms in the title and abstract screening. After the full-text screening, 11 studies were included in the final scoping review. These included 3 studies about use of botulinum toxin injection, 2 studies about fat grafting, 2 studies about nasal stents, and 4 studies about various topical treatments. In the Jadad quality index evaluation and MINORS assessment of the methodological quality of the included papers, there was a strong level of agreement among the 2 raters respectively (weighted κ = 1, κ = 0.817, both P-value < .0001). Conclusion: From this scoping review, adjuvant therapies such as utilizing botulinum toxin and immediate fat grafting intraoperatively and nasal stents and topical treatments including antibiotic ointment, lidocaine, hydrogen peroxide, and silicone gels postoperatively are worthwhile to consider as a combination of adjuvant treatments to prevent adverse scar formation in patients undergoing primary cleft lip repair. The most robust evidence lies with botulinum toxin use.
{"title":"A Scoping Review of Adjuvant Perioperative Therapies for Primary Cleft Lip Repair","authors":"Melinda Lem, Jason T Pham, Jagmeet Arora, Shivang Trivedi, Omotayo A. Arowojolu, Ruben Castro, Joseph Mocharnuk, Raj Vyas, Miles J. Pfaff","doi":"10.1177/27325016231212564","DOIUrl":"https://doi.org/10.1177/27325016231212564","url":null,"abstract":"Background:To date, there is little guidance regarding current adjuvant therapies for primary surgical repair of cleft lip. There are studies on the effect of botulinum toxin type A, revision fat grafting, silicone gel and sheeting, intense pulsed light, and carbon dioxide lasers to ameliorate contracture and hypertrophic scar formation, but a comprehensive review of these options is lacking. The aim of this scoping review is to examine adjuvant techniques and therapies that modulate scar outcomes for primary cleft lip repair outcomes in the perioperative period. Methods: PROSPERO, PubMed/MEDLINE, SCOPUS, Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrial.gov were searched for studies that evaluated adjuvant therapies for primary cleft lip repair. Results: The initial search resulted in 688 studies, with 48 studies including relevant key terms in the title and abstract screening. After the full-text screening, 11 studies were included in the final scoping review. These included 3 studies about use of botulinum toxin injection, 2 studies about fat grafting, 2 studies about nasal stents, and 4 studies about various topical treatments. In the Jadad quality index evaluation and MINORS assessment of the methodological quality of the included papers, there was a strong level of agreement among the 2 raters respectively (weighted κ = 1, κ = 0.817, both P-value < .0001). Conclusion: From this scoping review, adjuvant therapies such as utilizing botulinum toxin and immediate fat grafting intraoperatively and nasal stents and topical treatments including antibiotic ointment, lidocaine, hydrogen peroxide, and silicone gels postoperatively are worthwhile to consider as a combination of adjuvant treatments to prevent adverse scar formation in patients undergoing primary cleft lip repair. The most robust evidence lies with botulinum toxin use.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139236972","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 : 2023-11-25DOI: 10.1177/27325016231209051
S. Ombashi, V. V. van Roey, Jolanda M. E. Okkerse, Mariska van Veen-van der Hoek, Esther E. B. van Oers-Hazelzet, A. B. Mink van der Molen, S. L. Versnel
Background:The CLEFT-Q is a questionnaire developed for patients with a cleft lip and/or palate (CL/P). Numerous scales have been implemented as part of the ICHOM Standard Set for CL/P. Although validated for completion by patients only, clinicians noted that caregivers are often involved in completion of the scales. Aim of the study was to promote further standardization of Patient Reported Outcome Measures (PROMs) in pediatric patients by examining the preferences of patients and parents concerning the reporter type. Moreover, possible discrepancies in outcomes between reporter types were explored. Methods: Data from 567 patients with CL/P and their caregivers that completed scales of the CLEFT-Q questionnaire were collected. Reporter group sizes and proportions were examined at the ages of 8, 12, and 15 years to determine the preferred manner of completion. Mean outcomes were analyzed per scale at the 3 ages, and compared between the 3 reporter groups: “patient,” “caregiver,” and “together.” Results: In all age-groups, the majority completed the PROMs together. Concerning the reporter types per age-group, an upward trend was seen in the proportion of patients that completed the scales alone. In the caregiver group, a downward trend was observed, and the highest proportion of parents that completed the scales was found at age 8. No significant differences were found between the reporter types in any of the scales. Conclusion: Even if a PROM questionnaire is validated for patient report only, it is recommended to record the reporter type when a pediatric PROM is completed. In order to capture outcomes that represent the patient’s voice validly and reliably, though with support of the caregiver, a pediatric PROM should be filled out by the patient alone and thereafter evaluated with the caregiver(s). Concerning the CLEFT-Q, there seems to be demand for a validated parent-version of the scales.
{"title":"Who Should Fill Out a Pediatric PROM? Psychometric Assessment From a Clinical Perspective in 567 Children With a Cleft","authors":"S. Ombashi, V. V. van Roey, Jolanda M. E. Okkerse, Mariska van Veen-van der Hoek, Esther E. B. van Oers-Hazelzet, A. B. Mink van der Molen, S. L. Versnel","doi":"10.1177/27325016231209051","DOIUrl":"https://doi.org/10.1177/27325016231209051","url":null,"abstract":"Background:The CLEFT-Q is a questionnaire developed for patients with a cleft lip and/or palate (CL/P). Numerous scales have been implemented as part of the ICHOM Standard Set for CL/P. Although validated for completion by patients only, clinicians noted that caregivers are often involved in completion of the scales. Aim of the study was to promote further standardization of Patient Reported Outcome Measures (PROMs) in pediatric patients by examining the preferences of patients and parents concerning the reporter type. Moreover, possible discrepancies in outcomes between reporter types were explored. Methods: Data from 567 patients with CL/P and their caregivers that completed scales of the CLEFT-Q questionnaire were collected. Reporter group sizes and proportions were examined at the ages of 8, 12, and 15 years to determine the preferred manner of completion. Mean outcomes were analyzed per scale at the 3 ages, and compared between the 3 reporter groups: “patient,” “caregiver,” and “together.” Results: In all age-groups, the majority completed the PROMs together. Concerning the reporter types per age-group, an upward trend was seen in the proportion of patients that completed the scales alone. In the caregiver group, a downward trend was observed, and the highest proportion of parents that completed the scales was found at age 8. No significant differences were found between the reporter types in any of the scales. Conclusion: Even if a PROM questionnaire is validated for patient report only, it is recommended to record the reporter type when a pediatric PROM is completed. In order to capture outcomes that represent the patient’s voice validly and reliably, though with support of the caregiver, a pediatric PROM should be filled out by the patient alone and thereafter evaluated with the caregiver(s). Concerning the CLEFT-Q, there seems to be demand for a validated parent-version of the scales.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139236317","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 : 2023-11-22DOI: 10.1177/27325016231211921
Jaemin Ko, Xuanyu Lu, M. Urata, J. Hammoudeh, S. Yen
With surgery-first approach, the skeletal discrepancy is corrected with orthognathic surgery at the start of treatment, but the teeth remain in their original compensated positions. This change in treatment sequence means clinicians have to determine what the occlusion immediately after the surgery, which is called transitional occlusion, should look like during the planning process. This report describes the surgical and orthodontic planning for a surgery-first case that corrected a large Cl III malocclusion. Virtual planning was used to reverse engineer the transitional postsurgical occlusion from the final ideal position. A multiplatform software can be a powerful tool for analyzing problems in finishing a surgery-first case, predicting outcomes, and improving the accuracy in planning surgery-first approach.
{"title":"Precise Prediction of Transitional Occlusion Using Reverse Engineering in Surgery-first Orthognathic Surgery Case","authors":"Jaemin Ko, Xuanyu Lu, M. Urata, J. Hammoudeh, S. Yen","doi":"10.1177/27325016231211921","DOIUrl":"https://doi.org/10.1177/27325016231211921","url":null,"abstract":"With surgery-first approach, the skeletal discrepancy is corrected with orthognathic surgery at the start of treatment, but the teeth remain in their original compensated positions. This change in treatment sequence means clinicians have to determine what the occlusion immediately after the surgery, which is called transitional occlusion, should look like during the planning process. This report describes the surgical and orthodontic planning for a surgery-first case that corrected a large Cl III malocclusion. Virtual planning was used to reverse engineer the transitional postsurgical occlusion from the final ideal position. A multiplatform software can be a powerful tool for analyzing problems in finishing a surgery-first case, predicting outcomes, and improving the accuracy in planning surgery-first approach.","PeriodicalId":508736,"journal":{"name":"FACE","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139249221","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：