Archives of Craniofacial Surgery最新文献

Sublingual hematoma is a serious complication associated with anterior mandible surgery. It presents considerable risk due to the potential for airway obstruction, which can be life-threatening and necessitates prompt diagnosis and intervention. This case report describes the occurrence of sublingual hematoma following mandibular midline osteotomy and the subsequent management of this condition. Mandibular midline osteotomy is performed to correct skeletal or dental discrepancies in the transverse plane. Sublingual hematoma as a complication of a midline osteotomy has not been previously documented in the literature. This article provides a comprehensive review of the various etiologies associated with sublingual hematoma, along with its management modalities.

Background: This systematic review aimed to determine whether cone-beam computed tomography (CBCT) and panoramic radiography (PR) yield consistent results in determining the degree of impacted lower third molar teeth based on existing classification parameters.

Methods: A comprehensive literature search was conducted of PubMed, Embase, Cochrane, and PLOS One, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, a manual search was also carried out. There were no restrictions on publication dates, allowing a broader scope of literature. Only articles published in English were eligible for inclusion. Furthermore, all studies that compared the outcomes of CBCT and panoramic images concerning the position of impacted teeth, according to the Winter and the Pell & Gregory classifications, were included.

Results: Four studies met the inclusion criteria. One study used the Pell & Gregory classification to assess differences, finding a significant result (P< 0.001). Two studies used both the Winter and the Pell & Gregory classifications. In these assessments, one study found no significant differences in the Winter classification (p= 1.000) or the Pell & Gregory assessment (p= 0.500). However, another study identified significant differences using both the winter and the Pell & Gregory classifications (P< 0.001). One study conducted an assessment using only Winter classification and found no significant differences between PR and CBCT (P> 0.05).

Conclusion: There are inter-modality differences in the agreement concerning the degree of impaction of the third molar when using CBCT compared with panoramic imaging across various classification levels. Improved assessment methods are necessary to determine the most appropriate imaging modality for therapeutic management.

Background: The ongoing COVID-19 pandemic and the current shortage of speech-language pathologists in Thailand have limited access to speech services for children with cleft palate with or without cleft lip (CP± L). A combination of telepractice (TP) and face-to-face therapy could address the lack of continuous service and improve accessibility to speech therapy providers. This study aimed to compare the percentage of consonants correct (PCC) before and after speech therapy in children with CP± L.

Methods: This study included 19 children with CP± L, aged 5 to 13 years, who underwent primary cheiloplasty and palatoplasty. A perceptual assessment was conducted using the Thai Speech Parameters for Patients with Cleft Palate in a Universal Reporting System to evaluate speech before and after therapy. The intervention consisted of five 30-minute face-to-face speech therapy sessions and fifteen 30-minute TP sessions, totaling twenty sessions. Paired t-tests were used to analyze the mean differences in PCC for pre- and post-articulation errors, as well as caregiver satisfaction levels at the conclusion of the evaluation period.

Results: Children with CP± L exhibited a significant increase in PCC; the mean difference (standard deviation, SD) was 9.36 (11.87), with a 95% confidence interval (CI) of 3.64 to 15.08 at the word level, and a mean difference (SD) of 13.25 (13.71), with a 95% CI of 6.65 to 19.86 at the sentence level. Caregivers rated their satisfaction as excellent.

Conclusion: The integration of TP with traditional face-to-face speech therapy has proven to be a highly effective approach for reducing articulation errors in children with CP± L. Additionally, this method was well-suited for the constraints imposed by the COVID-19 pandemic.

Background: Coronavirus disease 2019 (COVID-19)-associated mucormycosis of the maxilla emerged as a significant concern in India during the second wave of the pandemic, necessitating surgical interventions such as maxillectomy. This study investigated the quality of life following prosthodontic rehabilitation with interim obturators in patients who underwent bilateral total maxillectomy due to COVID-19-associated mucormycosis of the jaws.

Methods: The study was conducted using questionnaire-based interviews administered by a single investigator employing the Oral Health Impact Profile-14 (OHIP-14) and Obturator Functioning Scale (OFS) questionnaires. Responses were evaluated on a Likert scale. All statistical analyses were performed using SPSS version 21.0 for Windows. A significance level of 5% was applied to all tests. The Wilcoxon signed-rank and chi-square tests were utilized to compare categorical and quantitative variables across groups. Responses to the questionnaires were recorded on numerical Likert scales ranging from 1 to 5 for OFS and 0 to 4 for OHIP-14. The mean OHIP-14 and OFS scores were compared between the pre-rehabilitation and post-rehabilitation stages.

Results: A comparison between the pre-rehabilitation and post-rehabilitation scores from the OHIP-14 questionnaire revealed a significant difference (p= 0.001). The OFS results indicated significant improvements across all domains following the use of obturators.

Conclusion: Interim obturators play a vital role in improving speech, swallowing, and mastication during the recovery period for patients who have undergone bilateral total maxillectomy. Despite the altered anatomy resulting from the resection, patients adapted effectively and exhibited improvements in their social, psychological, and mental health.

Background: Vascular anomalies are disorders of the vascular system. These anomalies are classified as either vascular tumors or vascular malformations, with each possessing distinct characteristics. This study was performed to analyze vascular anomaly referrals to a tertiary center, identify patterns of misdiagnosis, and create a proforma to ensure the comprehensiveness of clinical information.

Methods: We retrospectively analyzed vascular anomaly referral letters received by Hospital Tunku Azizah from 2018 to 2023. Specifically, we descriptively analyzed the inclusion of vascular anomaly characteristics, the demographic profiles of referrers and patients, and basic clinical findings. Subsequently, we developed a redesigned proforma.

Results: Overall, 47 referral letters were analyzed. The patients comprised 25 boys and 22 girls, with ages ranging from birth to 14 years. Patient name, sex, and date of birth, along with the referrer's name and address, were satisfactorily documented. The review revealed that 44 (93.6%) of the letters included the patient's presenting problem, 43 (91.5%) contained clinical findings, 37 (78.7%) reported diagnostic investigations, and 29 (61%) referenced medical history. Regarding characteristics of vascular conditions, over half of the letters detailed time of appearance (n= 40, 85%), growth (n= 24, 66%), complications (n= 25, 53.2%), color (n= 32, 68%), and shape (n= 34, 72%). However, fewer than half mentioned compressibility (n= 7, 14.8%), pulsation (n= 7, 14.7%), and associated conditions (n= 2, 4.3%), and none referenced involution.

Conclusion: Although demographic data were generally well-documented, critical medical history information was frequently omitted, including a lack of adequate pre-referral investigations. Key characteristics of vascular anomalies, namely compressibility, pulsation, associated conditions, and involution, were frequently overlooked. Accurate documentation of these features is crucial for determining treatment urgency. A standardized proforma must be implemented to ensure that vital information is captured, thus facilitating diagnosis and optimizing patient care.

The incidence of anaplastic large cell lymphoma is 0.25 cases per 100,000 people. It usually causes lymphadenopathy and B symptoms; however, diverse cutaneous manifestations can also be observed. We report a rare case of anaplastic large cell lymphoma of the scalp, which presented similarly to a ruptured epidermal cyst. A 77-year-old woman visited the outpatient clinic complaining of scalp masses that had appeared 2 months before. One week before her visit, she had undergone incision and drainage at a local clinic but showed no improvement. Before surgery, facial magnetic resonance imaging revealed two suspicious ruptured cystic masses. Surgical excision was performed with a 1-cm free margin from the soft mass. Histopathology confirmed anaplastic lymphoma kinase-negative anaplastic large cell lymphoma. After wide excision and skin grafting for wound reconstruction, followed by consultation with a hemato-oncologist and radiation oncologist, chemotherapy was planned to prevent recurrence. Differentiating anaplastic lymphoma kinase-negative anaplastic large cell lymphoma of the scalp from a ruptured epidermal cyst-like mass proved challenging. We recommend considering the possibility of anaplastic large cell lymphoma if an epidermal cyst-like mass does not respond to antibiotics or conventional dressing, as illustrated by our rare case.

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant neoplasm that originates from the deepest part of the eccrine sweat glands. Characterized by slow growth, PCMC often appears on the head and neck of older patients. Although it rarely metastasizes, its high recurrence rate leads to significant morbidity. Clinically differentiating PCMC from benign tumors is challenging due to its slow growth and asymptomatic nature, and a biopsy is often required for a definitive diagnosis. A 77-year-old man presented with a non-tender lesion on his left lower eyelid that had been gradually progressing over a decade. The lesion was excised, and histological examination confirmed it as PCMC. A positron emission tomography-computed tomography scan conducted to differentiate between primary and metastatic cancer showed no abnormal findings. Computed tomography was then performed to assess the remaining primary site, followed by a wide excision. The frozen biopsy revealed no cancer in the margins from five directions; however, the permanent biopsy confirmed the presence of cancer in the base margin. After consultation with the hematology-oncology department, the patient underwent additional radiation therapy. One year post-surgery, there were no signs of recurrence.

Background: This study investigated the predictive value of orthopantomography (OPG) for the difficulty of extracting impacted mandibular third molars, in comparison with cone-beam computed tomography (CBCT).

Methods: In this descriptive quantitative investigation, two oral and maxillofacial radiologists evaluated OPG and three-dimensional CBCT images according to the Pell-Gregory and Winter classifications. The results for the classification were compared using the chi-square test, and the prediction of difficulty was assessed using the Pederson scale, with a significance level of p< 0.05.

Results: The study included 30 patients (14 men and 16 women), providing a total of 53 samples of impacted mandibular third molars. Of these, 30 (56.6%) were from the right side and 23 (43.4%) from the left. There was a statistically significant difference between the OPG and CBCT images concerning their relation to the mandibular ramus (p< 0.05). However, evaluations based on occlusal lines and angulation showed no significant differences (p> 0.05). According to the Pederson scale, significant differences were observed between OPG and CBCT in predicting extraction difficulty (p< 0.05).

Conclusion: CBCT offered a more accurate assessment of the surgical difficulty associated with mandibular third molars than OPG. OPG views frequently failed to adequately visualize the region of the mandibular ramus, influencing the perceived difficulty of mandibular third molar surgery. In certain cases, the use of CBCT imaging is crucial.