Rhabdomyosarcoma is the most common soft tissue sarcoma in children, accounting for 4.5% of all cases of cancer in childhood. Although the head and neck are the most common sites of rhabdomyosarcoma, oral lesions are relatively rare and account for only 10% to 12% of head and neck rhabdomyosarcoma cases. This is a case report of a girl aged 2 years and 1 month who initially presented with an upper lip mass that invaded the oral mucosa, oral skin, and nostril skin, causing narrowing of the airway. Through our case, we show that rapidly growing small round cell malignancies, especially rhabdomyosarcoma, can be effectively diagnosed and treated at the same time using primary resection with intraoperative frozen section biopsy and that the time spent waiting for the results of preoperative biopsy can be saved in this way, particularly when the patient's symptoms are intensifying rapidly and require immediate operation.
{"title":"Simultaneous diagnosis and resection of orofacial rhabdomyosarcoma with frozen section biopsy: a case report.","authors":"Youngwoong Choi, Ki Pyo Sung, Soo Hyang Lee","doi":"10.7181/acfs.2023.00052","DOIUrl":"https://doi.org/10.7181/acfs.2023.00052","url":null,"abstract":"<p><p>Rhabdomyosarcoma is the most common soft tissue sarcoma in children, accounting for 4.5% of all cases of cancer in childhood. Although the head and neck are the most common sites of rhabdomyosarcoma, oral lesions are relatively rare and account for only 10% to 12% of head and neck rhabdomyosarcoma cases. This is a case report of a girl aged 2 years and 1 month who initially presented with an upper lip mass that invaded the oral mucosa, oral skin, and nostril skin, causing narrowing of the airway. Through our case, we show that rapidly growing small round cell malignancies, especially rhabdomyosarcoma, can be effectively diagnosed and treated at the same time using primary resection with intraoperative frozen section biopsy and that the time spent waiting for the results of preoperative biopsy can be saved in this way, particularly when the patient's symptoms are intensifying rapidly and require immediate operation.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4c/e1/acfs-2023-00052.PMC10475698.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Beom Jin Lim, Jin Yong Shin, Si-Gyun Roh, Nae-Ho Lee, Yoon Kyu Chung
Background: Free tissue transfer is the preferred method of reconstructing head and neck defects, with a success rate of approximately 95%. Although flap failure is uncommon, it has a major impact on patient morbidity and diminishes quality of life, making it is important to investigate the causes of flap failure.
Methods: This retrospective chart review analyzed patients who underwent free tissue transfer during head and neck reconstruction at a single institution between 2016 and 2021.
Results: During the study period, 58 patients underwent 60 free flap procedures. Revision surgery was needed in 14 patients. Subsequent free flap surgery was performed in one patient, and three free flaps (5%) could not be salvaged. Cardiovascular disease was significantly associated with flap failure, and venous congestion (thrombosis) was the most common reason for revision surgery.
Conclusion: Cardiovascular disease clearly emerged as a factor related to the failure of free flap surgery, and this issue warrants particular attention in patients for whom free tissue transfer is planned.
{"title":"Clinical analysis of factors affecting the failure of free flaps used in head and neck reconstruction.","authors":"Beom Jin Lim, Jin Yong Shin, Si-Gyun Roh, Nae-Ho Lee, Yoon Kyu Chung","doi":"10.7181/acfs.2023.00325","DOIUrl":"https://doi.org/10.7181/acfs.2023.00325","url":null,"abstract":"<p><strong>Background: </strong>Free tissue transfer is the preferred method of reconstructing head and neck defects, with a success rate of approximately 95%. Although flap failure is uncommon, it has a major impact on patient morbidity and diminishes quality of life, making it is important to investigate the causes of flap failure.</p><p><strong>Methods: </strong>This retrospective chart review analyzed patients who underwent free tissue transfer during head and neck reconstruction at a single institution between 2016 and 2021.</p><p><strong>Results: </strong>During the study period, 58 patients underwent 60 free flap procedures. Revision surgery was needed in 14 patients. Subsequent free flap surgery was performed in one patient, and three free flaps (5%) could not be salvaged. Cardiovascular disease was significantly associated with flap failure, and venous congestion (thrombosis) was the most common reason for revision surgery.</p><p><strong>Conclusion: </strong>Cardiovascular disease clearly emerged as a factor related to the failure of free flap surgery, and this issue warrants particular attention in patients for whom free tissue transfer is planned.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/91/acfs-2023-00325.PMC10475704.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: This study aimed to identify the location of the optic foramen in relation to the anterior sphenoid sinus wall, which is essential information for surgeons in planning and performing endoscopic transnasal surgery.
Methods: Computed tomography scans of 200 orbits from 100 adult patients with no abnormalities were examined. The results included the location of the optic foramen in relation to the anterior sphenoid sinus wall and the distance between them, as well as the distance from the optic foramen and the anterior sphenoid sinus wall to the carotid prominence in the posterior sphenoid sinus.
Results: The optic foramen was anterior to the anterior sphenoid sinus wall in 48.5% of orbits, and posterior in the remaining 51.5%. The mean distance from the optic foramen to the anterior sphenoid sinus wall was 3.82 ± 1.25 mm. The mean distances from the optic foramen and the anterior sphenoid sinus wall to the carotid prominence were 7.67 ± 1.73 and 7.95 ± 2.53 mm, respectively.
Conclusion: The optic foramen was anterior to the anterior wall of the sphenoid sinus in approximately half of the orbits examined in this study, and posterior in the remaining half. The mean distance from the optic foramen to the anterior sphenoid sinus wall of the sphenoid sinus was 3.82 ± 1.25 mm.
{"title":"Optic foramen location on computed tomography.","authors":"Vuong Duc Nguyen, Minh Tran Quang Le, Chuong Dinh Nguyen, Tho Thi Kieu Nguyen","doi":"10.7181/acfs.2023.00339","DOIUrl":"https://doi.org/10.7181/acfs.2023.00339","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify the location of the optic foramen in relation to the anterior sphenoid sinus wall, which is essential information for surgeons in planning and performing endoscopic transnasal surgery.</p><p><strong>Methods: </strong>Computed tomography scans of 200 orbits from 100 adult patients with no abnormalities were examined. The results included the location of the optic foramen in relation to the anterior sphenoid sinus wall and the distance between them, as well as the distance from the optic foramen and the anterior sphenoid sinus wall to the carotid prominence in the posterior sphenoid sinus.</p><p><strong>Results: </strong>The optic foramen was anterior to the anterior sphenoid sinus wall in 48.5% of orbits, and posterior in the remaining 51.5%. The mean distance from the optic foramen to the anterior sphenoid sinus wall was 3.82 ± 1.25 mm. The mean distances from the optic foramen and the anterior sphenoid sinus wall to the carotid prominence were 7.67 ± 1.73 and 7.95 ± 2.53 mm, respectively.</p><p><strong>Conclusion: </strong>The optic foramen was anterior to the anterior wall of the sphenoid sinus in approximately half of the orbits examined in this study, and posterior in the remaining half. The mean distance from the optic foramen to the anterior sphenoid sinus wall of the sphenoid sinus was 3.82 ± 1.25 mm.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/28/acfs-2023-00339.PMC10475700.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Young Hoon Chi, Joo Young Woo, Tae Kyung Koh, Soo Kweon Koo, Hyuni Son
Fibrofolliculoma is a benign, perifollicular, connective tissue tumor that usually arises in the form of multiple lesions; it is rarely seen as a solitary lesion. The lesions are clinically asymptomatic, 2 to 4 mm skin-colored, soft dome-shaped papules. Here, we report a patient who visited our hospital with a palpable lesion on the nasal septum. The lesion did not cause pain upon palpation, and nasal endoscopy confirmed an irregular wart-like lesion measuring 6 × 6 mm in the left anterior nasal septum near the columella. Other otolaryngology findings were normal, and there were no similar lesions in other parts of the body. None of the patient's family members were known to have had such lesions. An excisional biopsy was performed on the mass for removal of the lesion, and histological examination confirmed the lesion as fibrofolliculoma. We report the first case of solitary fibrofolliculoma in the nasal septum in a healthy 62-year-old woman along with a review of the relevant literature.
{"title":"Solitary fibrofolliculoma on the nasal septum: a case report.","authors":"Young Hoon Chi, Joo Young Woo, Tae Kyung Koh, Soo Kweon Koo, Hyuni Son","doi":"10.7181/acfs.2023.00185","DOIUrl":"https://doi.org/10.7181/acfs.2023.00185","url":null,"abstract":"<p><p>Fibrofolliculoma is a benign, perifollicular, connective tissue tumor that usually arises in the form of multiple lesions; it is rarely seen as a solitary lesion. The lesions are clinically asymptomatic, 2 to 4 mm skin-colored, soft dome-shaped papules. Here, we report a patient who visited our hospital with a palpable lesion on the nasal septum. The lesion did not cause pain upon palpation, and nasal endoscopy confirmed an irregular wart-like lesion measuring 6 × 6 mm in the left anterior nasal septum near the columella. Other otolaryngology findings were normal, and there were no similar lesions in other parts of the body. None of the patient's family members were known to have had such lesions. An excisional biopsy was performed on the mass for removal of the lesion, and histological examination confirmed the lesion as fibrofolliculoma. We report the first case of solitary fibrofolliculoma in the nasal septum in a healthy 62-year-old woman along with a review of the relevant literature.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/57/acfs-2023-00185.PMC10365899.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dong Wan Kim, Soo Hyuk Lee, Jun Ho Choi, Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee
Background: Midfacial fractures frequently involve the maxillary sinus, leading to maxillary sinus pathology. We aimed to examine the incidence and contributing factors of maxillary sinus pathology in patients who underwent open reduction and internal fixation (ORIF) for midfacial fractures.
Methods: A retrospective analysis was conducted on patients who underwent ORIF for midfacial fractures at our department over the past 10 years. The incidence of maxillary sinus pathology was identified clinically and/or by computed tomography findings. Factors that significantly influenced the groups with and without maxillary sinus pathology were examined.
Results: The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was found to be 11.27%, with sinusitis being the most common pathology. Maxillary sinus pathology was significantly associated with the presence of a blowout fracture involving both the medial and the inferior orbital walls. Factors such as sex, age, diabetes mellitus, hypertension, smoking, inflammatory disease, follow-up period, use of absorbable plates, and use of titanium plates did not have a significant impact on the development of maxillary sinus pathology.
Conclusion: The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was relatively low, and in most cases, it resolved without the need for specific treatment. Consequently, there may not be a significant need for concern regarding postoperative maxillary sinus pathology.
{"title":"Relationship between midfacial fractures and maxillary sinus pathology.","authors":"Dong Wan Kim, Soo Hyuk Lee, Jun Ho Choi, Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee","doi":"10.7181/acfs.2023.00283","DOIUrl":"https://doi.org/10.7181/acfs.2023.00283","url":null,"abstract":"<p><strong>Background: </strong>Midfacial fractures frequently involve the maxillary sinus, leading to maxillary sinus pathology. We aimed to examine the incidence and contributing factors of maxillary sinus pathology in patients who underwent open reduction and internal fixation (ORIF) for midfacial fractures.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent ORIF for midfacial fractures at our department over the past 10 years. The incidence of maxillary sinus pathology was identified clinically and/or by computed tomography findings. Factors that significantly influenced the groups with and without maxillary sinus pathology were examined.</p><p><strong>Results: </strong>The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was found to be 11.27%, with sinusitis being the most common pathology. Maxillary sinus pathology was significantly associated with the presence of a blowout fracture involving both the medial and the inferior orbital walls. Factors such as sex, age, diabetes mellitus, hypertension, smoking, inflammatory disease, follow-up period, use of absorbable plates, and use of titanium plates did not have a significant impact on the development of maxillary sinus pathology.</p><p><strong>Conclusion: </strong>The incidence of maxillary sinus pathology in patients who underwent ORIF for midfacial fractures was relatively low, and in most cases, it resolved without the need for specific treatment. Consequently, there may not be a significant need for concern regarding postoperative maxillary sinus pathology.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/ec/acfs-2023-00283.PMC10365897.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Frosolini, Simone Benedetti, Paolo Gennaro, Guido Gabriele
143 Ltter To the Editor: We read with interest the article by Jung et al. [1], entitled “Proposal for a modified classification of isolated zygomatic arch fractures,” in which existing classifications for zygomatic arch fractures are compared and a new functional tool for clinical and research purposes in the field of maxillofacial traumatology is proposed. As stated by the authors, a textbook classification of zygomatic fractures has not yet been established. Recent systematic reviews have highlighted the existence of considerable variation in classifications, outcome definitions and data collection; therefore, there is an urgent need for standardization to provide high-quality data [2]. In particular, no consensus exists regarding the treatment strategy or the best surgical approaches, including the number and modality of open-access reductions and internal fixations. To overcome these limits, in our opinion, a useful grading system should be applied more clearly to evaluate the outcomes of interventions, which appear to be a neglected aspect in the current classifications [1]. Radiology, particularly computed tomography (CT), is an important tool in maxillofacial surgical planning and postoperative evaluation. CT scans can provide detailed images of the bones and soft tissues in the facial region, allowing surgeons to accurately plan and perform procedures [3]. In cases of zygomatic fractures, CT scans can be used to measure changes in the affected area after surgery. In the study of Wang et al. [4], standard maxillofacial CT was preliminarily applied using a specific region of interest (ROI) calculator to compare preand postoperative zygomatic measures; this technique was shown to be sensitive enough to detect significant differences on the fractured side and nonsignificant differences on the healthy side in five patients. Moreover, computer-aided design and computer-aided manufacturing (CAD/CAM) tools, derived from orthognathic surgery, have been proposed in the recent guidelines of the Chinese Stomatological Association to compare the preoperative and postoperative results of zygomatic fractures. These tools may provide even greater accuracy and precision in measuring changes in facial structures; thus, in the future, new interesting prospective data are expected [5]. Traditional CT scans are widely available in many healthcare settings and are considered to be relatively affordable, especially compared to other advanced imaging technologies such as magnetic resonance imaging or positron emission tomography. ROI calculators and CAD/CAM tools are more specialized technologies that may not be available in all healthcare settings; however, as this technology continues to evolve and become more widely adopted in the medical field, it is possible that these costs will steadily decrease. In addition, there may be opportunities to access these technologies through clinical research studies and collaborations with academic medical centers, which ma
{"title":"Comment on \"Proposal for a modified classification of isolated zygomatic arch fractures\".","authors":"Andrea Frosolini, Simone Benedetti, Paolo Gennaro, Guido Gabriele","doi":"10.7181/acfs.2023.00192","DOIUrl":"https://doi.org/10.7181/acfs.2023.00192","url":null,"abstract":"143 Ltter To the Editor: We read with interest the article by Jung et al. [1], entitled “Proposal for a modified classification of isolated zygomatic arch fractures,” in which existing classifications for zygomatic arch fractures are compared and a new functional tool for clinical and research purposes in the field of maxillofacial traumatology is proposed. As stated by the authors, a textbook classification of zygomatic fractures has not yet been established. Recent systematic reviews have highlighted the existence of considerable variation in classifications, outcome definitions and data collection; therefore, there is an urgent need for standardization to provide high-quality data [2]. In particular, no consensus exists regarding the treatment strategy or the best surgical approaches, including the number and modality of open-access reductions and internal fixations. To overcome these limits, in our opinion, a useful grading system should be applied more clearly to evaluate the outcomes of interventions, which appear to be a neglected aspect in the current classifications [1]. Radiology, particularly computed tomography (CT), is an important tool in maxillofacial surgical planning and postoperative evaluation. CT scans can provide detailed images of the bones and soft tissues in the facial region, allowing surgeons to accurately plan and perform procedures [3]. In cases of zygomatic fractures, CT scans can be used to measure changes in the affected area after surgery. In the study of Wang et al. [4], standard maxillofacial CT was preliminarily applied using a specific region of interest (ROI) calculator to compare preand postoperative zygomatic measures; this technique was shown to be sensitive enough to detect significant differences on the fractured side and nonsignificant differences on the healthy side in five patients. Moreover, computer-aided design and computer-aided manufacturing (CAD/CAM) tools, derived from orthognathic surgery, have been proposed in the recent guidelines of the Chinese Stomatological Association to compare the preoperative and postoperative results of zygomatic fractures. These tools may provide even greater accuracy and precision in measuring changes in facial structures; thus, in the future, new interesting prospective data are expected [5]. Traditional CT scans are widely available in many healthcare settings and are considered to be relatively affordable, especially compared to other advanced imaging technologies such as magnetic resonance imaging or positron emission tomography. ROI calculators and CAD/CAM tools are more specialized technologies that may not be available in all healthcare settings; however, as this technology continues to evolve and become more widely adopted in the medical field, it is possible that these costs will steadily decrease. In addition, there may be opportunities to access these technologies through clinical research studies and collaborations with academic medical centers, which ma","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/2c/acfs-2023-00192.PMC10365901.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jung Kwon An, Seong Oh Park, Lan Sook Chang, Youn Hwan Kim, Kyunghyun Min
Scalp defects necessitate diverse approaches for successful reconstruction, taking into account factors such as defect size, surrounding tissue, and recipient vessel quality. This case report presents a challenging scenario involving a temporal scalp defect where ipsilateral recipient vessels were unavailable. The defect was effectively reconstructed utilizing a transposition flap and a latissimus dorsi free flap, which was anastomosed to the contralateral recipient vessels. Our report underscores the successful reconstruction of a scalp defect in the absence of ipsilateral recipient vessels, emphasizing the importance of employing appropriate surgical interventions without necessitating vessel grafts.
{"title":"Reconstruction of a temporal scalp defect without ipsilateral donor vessel possibilities using a local transposition flap and a latissimus dorsi free flap anastomosed to the contralateral side: a case report.","authors":"Jung Kwon An, Seong Oh Park, Lan Sook Chang, Youn Hwan Kim, Kyunghyun Min","doi":"10.7181/acfs.2023.00129","DOIUrl":"https://doi.org/10.7181/acfs.2023.00129","url":null,"abstract":"<p><p>Scalp defects necessitate diverse approaches for successful reconstruction, taking into account factors such as defect size, surrounding tissue, and recipient vessel quality. This case report presents a challenging scenario involving a temporal scalp defect where ipsilateral recipient vessels were unavailable. The defect was effectively reconstructed utilizing a transposition flap and a latissimus dorsi free flap, which was anastomosed to the contralateral recipient vessels. Our report underscores the successful reconstruction of a scalp defect in the absence of ipsilateral recipient vessels, emphasizing the importance of employing appropriate surgical interventions without necessitating vessel grafts.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/af/acfs-2023-00129.PMC10365903.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
White-eyed blowout fractures with extraocular muscle (EOM) entrapment necessitate emergency surgical intervention. However, even after surgery, diplopia or EOM motion limitations may persist due to the incomplete reduction of soft tissue herniation caused by inadequate dissection or unresolved muscle strangulation. In this report, we present a case of postoperative EOM movement limitation in a 5-year-old girl who experienced recurrent restriction in the upward gaze of her right eye 14 days after surgery. Instead of revision surgery, the patient was treated with targeted EOM exercises focusing on the inferior rectus muscle and inferior oblique muscle. The patient was instructed to slowly move her pupils from the central point to the upper and outer sides, then in a straight line from the central point to the lower and inner sides before returning to the center point. On the 28th postoperative day, 2 weeks after initiating the exercises, the patient's EOM motion fully recovered. This case highlights the effectiveness of EOM exercises as a non-surgical treatment approach for improving recurrent EOM movement limitations in the absence of soft tissue herniation following surgical management of blowout fractures in children.
{"title":"Exercise rehabilitation for recurrent extraocular muscle movement limitation after pediatric blowout fracture surgery: a case report.","authors":"Jeong Do Park, Syeo Young Wee, Se Young Kim","doi":"10.7181/acfs.2023.00178","DOIUrl":"https://doi.org/10.7181/acfs.2023.00178","url":null,"abstract":"<p><p>White-eyed blowout fractures with extraocular muscle (EOM) entrapment necessitate emergency surgical intervention. However, even after surgery, diplopia or EOM motion limitations may persist due to the incomplete reduction of soft tissue herniation caused by inadequate dissection or unresolved muscle strangulation. In this report, we present a case of postoperative EOM movement limitation in a 5-year-old girl who experienced recurrent restriction in the upward gaze of her right eye 14 days after surgery. Instead of revision surgery, the patient was treated with targeted EOM exercises focusing on the inferior rectus muscle and inferior oblique muscle. The patient was instructed to slowly move her pupils from the central point to the upper and outer sides, then in a straight line from the central point to the lower and inner sides before returning to the center point. On the 28th postoperative day, 2 weeks after initiating the exercises, the patient's EOM motion fully recovered. This case highlights the effectiveness of EOM exercises as a non-surgical treatment approach for improving recurrent EOM movement limitations in the absence of soft tissue herniation following surgical management of blowout fractures in children.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/91/acfs-2023-00178.PMC10365905.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9869031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ali Sundoro, Dany Hilmanto, Hardisiswo Soedjana, Ronny Lesmana, Kevin Leonard Suryadinata
Background: In Indonesia, the prevalence of cleft lip and palate increased from 0.08% to 0.12% between 2013 and 2018. Children with cleft deformities typically undergo staged surgery. However, the coronavirus disease 2019 (COVID-19) pandemic has had negative impacts on the healthcare sector, including the suspension of elective procedures; this has raised concerns about the safety of performing surgery and the functional consequences of delaying treatment, the latter of which is associated with poor prognosis. The purpose of this study was to report the characteristics of clefts treated by the Bandung Cleft Lip and Palate Center team during the pandemic period.
Methods: This brief comparative study based on a chart review was conducted at the Bandung Cleft Lip and Palate Center. We statistically evaluated data from all patients treated between September 2018 and August 2021. Frequency analysis was performed to analyze the average number of each procedure by age before and during the COVID-19 pandemic.
Results: Data from 18-month periods before (n = 460) and during (n = 423) the pandemic were compared. Cheiloplasty procedures were examined (pre-pandemic, n = 230; pandemic, n = 248); before the pandemic, 86.1% were performed according to the treatment protocol (patient < 1 year old), and this proportion non-significantly dropped to 80.6% during the pandemic (p = 0.904). Palatoplasty procedures were also compared (pre-pandemic, n = 160; pandemic, n = 139); the treatment protocol (patient 0.5-2 years old) was followed for 65.5% of procedures before the pandemic and 75.5% during the pandemic (p = 0.509). Additionally, 70 (mean age, 7.94 years) revision and other procedures were performed before the pandemic and 36 (mean age, 8.52 years) during the pandemic.
Conclusion: The cleft procedures performed at the Bandung Cleft Lip and Palate Center did not significantly change during the COVID-19 pandemic.
{"title":"Cleft lip and palate surgery during COVID-19 pandemic in Indonesia: a 36-month experience at the Bandung Cleft Lip and Palate Center.","authors":"Ali Sundoro, Dany Hilmanto, Hardisiswo Soedjana, Ronny Lesmana, Kevin Leonard Suryadinata","doi":"10.7181/acfs.2023.00213","DOIUrl":"https://doi.org/10.7181/acfs.2023.00213","url":null,"abstract":"<p><strong>Background: </strong>In Indonesia, the prevalence of cleft lip and palate increased from 0.08% to 0.12% between 2013 and 2018. Children with cleft deformities typically undergo staged surgery. However, the coronavirus disease 2019 (COVID-19) pandemic has had negative impacts on the healthcare sector, including the suspension of elective procedures; this has raised concerns about the safety of performing surgery and the functional consequences of delaying treatment, the latter of which is associated with poor prognosis. The purpose of this study was to report the characteristics of clefts treated by the Bandung Cleft Lip and Palate Center team during the pandemic period.</p><p><strong>Methods: </strong>This brief comparative study based on a chart review was conducted at the Bandung Cleft Lip and Palate Center. We statistically evaluated data from all patients treated between September 2018 and August 2021. Frequency analysis was performed to analyze the average number of each procedure by age before and during the COVID-19 pandemic.</p><p><strong>Results: </strong>Data from 18-month periods before (n = 460) and during (n = 423) the pandemic were compared. Cheiloplasty procedures were examined (pre-pandemic, n = 230; pandemic, n = 248); before the pandemic, 86.1% were performed according to the treatment protocol (patient < 1 year old), and this proportion non-significantly dropped to 80.6% during the pandemic (p = 0.904). Palatoplasty procedures were also compared (pre-pandemic, n = 160; pandemic, n = 139); the treatment protocol (patient 0.5-2 years old) was followed for 65.5% of procedures before the pandemic and 75.5% during the pandemic (p = 0.509). Additionally, 70 (mean age, 7.94 years) revision and other procedures were performed before the pandemic and 36 (mean age, 8.52 years) during the pandemic.</p><p><strong>Conclusion: </strong>The cleft procedures performed at the Bandung Cleft Lip and Palate Center did not significantly change during the COVID-19 pandemic.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/2a/acfs-2023-00213.PMC10365898.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Conventional radial forearm free flaps (RFFFs) are known to be safe, but can result in donor site complications. Based on our experiences with suprafascial and subfascial RFFFs, we evaluated the safety of flap survival and surgical outcomes.
Methods: This was a retrospective study of head and neck reconstructions using RFFFs from 2006 to 2021. Thirty-two patients underwent procedures using either subfascial (group A) or suprafascial (group B) dissection for flap elevation. Data were collected on patient characteristics, flap size, and donor and recipient complications, and the two groups were compared.
Results: Thirteen of the 32 patients were in group A and 19 were in group B. Group A included 10 men and three women, with a mean age of 56.15 years, and group B included 16 men and three women, with a mean age of 59.11 years. The mean defect areas were 42.83 cm² and 33.32 cm², and the mean flap sizes were 50.96 cm² and 44.54 cm² in groups A and B, respectively. There were 13 donor site complications: eight (61.5%) in group A and five (26.3%) in group B. Flexor tendon exposure occurred in three patients in group A and in none in group B. All flaps survived completely. A recipient site complication occurred in two patients (15.4%) in group A and three patients (15.8%) in group B.
Conclusions: Complications and flap survival were similar between the two groups. However, tendon exposure at the donor site was less prevalent in the suprafascial group, and the treatment period was shorter. Based on our data, suprafascial RFFF is a reliable and safe procedure for reconstruction of the head and neck.
{"title":"Surgical outcomes of suprafascial and subfascial radial forearm free flaps in head and neck reconstruction.","authors":"Sae Hwi Ki, Tae Jun Park, Jin Myung Yoon","doi":"10.7181/acfs.2023.00171","DOIUrl":"https://doi.org/10.7181/acfs.2023.00171","url":null,"abstract":"<p><strong>Background: </strong>Conventional radial forearm free flaps (RFFFs) are known to be safe, but can result in donor site complications. Based on our experiences with suprafascial and subfascial RFFFs, we evaluated the safety of flap survival and surgical outcomes.</p><p><strong>Methods: </strong>This was a retrospective study of head and neck reconstructions using RFFFs from 2006 to 2021. Thirty-two patients underwent procedures using either subfascial (group A) or suprafascial (group B) dissection for flap elevation. Data were collected on patient characteristics, flap size, and donor and recipient complications, and the two groups were compared.</p><p><strong>Results: </strong>Thirteen of the 32 patients were in group A and 19 were in group B. Group A included 10 men and three women, with a mean age of 56.15 years, and group B included 16 men and three women, with a mean age of 59.11 years. The mean defect areas were 42.83 cm² and 33.32 cm², and the mean flap sizes were 50.96 cm² and 44.54 cm² in groups A and B, respectively. There were 13 donor site complications: eight (61.5%) in group A and five (26.3%) in group B. Flexor tendon exposure occurred in three patients in group A and in none in group B. All flaps survived completely. A recipient site complication occurred in two patients (15.4%) in group A and three patients (15.8%) in group B.</p><p><strong>Conclusions: </strong>Complications and flap survival were similar between the two groups. However, tendon exposure at the donor site was less prevalent in the suprafascial group, and the treatment period was shorter. Based on our data, suprafascial RFFF is a reliable and safe procedure for reconstruction of the head and neck.</p>","PeriodicalId":52238,"journal":{"name":"Archives of Craniofacial Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/78/acfs-2023-00171.PMC10365904.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}