Journal of Cranio-Maxillofacial Surgery最新文献_第3页

Diagnosis and management of orbital compartment syndrome caused by retrobulbar hematoma following orbital fractures 眼眶骨折后球后血肿所致眼眶间室综合征的诊断与治疗。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-12 DOI: 10.1016/j.jcms.2026.104445

F. Bourquard , J.P. Foy , Q. Hennocq , Amor-Sahli , A. Bergon , J.L. Bourges , M. Benassarou , A. Chaine , T. Schouman , C. Bertolus , J. Bouaoud

While challenging, early diagnosis and appropriate management of retrobulbar hematoma (RBH) with orbital compartment syndrome (OCS) may improve patient prognosis. Our objective was to characterize OCS caused by RBH to establish clinically relevant management recommendations.

A retrospective monocentric study was performed between 2018 and 2024 to evaluate the management and visual outcomes of patients treated in our department for RBH with OCS. In addition, to compare our results, a scoping literature review was performed to include all patients with the same characteristics (RBH with OCS).

Our study involved a cohort of patients managed in our department for post-traumatic RBH with OCS. Visual acuity was assessed by the ability to count fingers at 1 m. In total, 3229 patients were managed in our department for a radiologically confirmed orbital fracture between 2018 and 2024. Of these, 81 patients (2.5 %) with a post-traumatic RBH were identified, including 14 (17 %) with OCS. Surgical decompression was most frequently realized for patients with an improvement in final visual acuity (recovery group; 72 %), compared with those without improvement or presence of blindness (sequelae group; 60 %). The median time between diagnosis and management was shorter in the recovery group compared with the sequelae group (6 h [20 minutes–12 h] versus 12 h [3–33h], respectively). These findings were supported by previously published data, with 81 reported RBH cases associated with OCS.

To assess these data, an analysis of cases published in the literature between January 1950 and December 2023 was performed. Overall, 93 cases of post-traumatic and/or postoperative RBH were identified in 32 articles.

Our study confirmed that OCS with visual acuity impairment caused by RBH is a maxillo-facial emergency, mainly occurring following orbital fractures. In cases of impaired visual acuity or relative afferent pupillary defect (RAPD), lateral canthotomy combined with cantholysis remains a simple procedure to reduce intraorbital pressure. Moreover, surgical decompression under general anesthesia should be performed emergently, ideally within 6 h following the trauma. However, visual recovery is possible even if surgery is performed beyond 6 h. Finally, visual acuity should be checked every 2 h for at least 24 h following orbital fracture surgery.

虽然具有挑战性，但早期诊断和适当处理球后血肿（RBH）合并眶间室综合征（OCS）可能改善患者预后。我们的目的是表征由RBH引起的OCS，以建立临床相关的管理建议。在2018年至2024年期间进行了一项回顾性单中心研究，以评估我科治疗RBH合并OCS患者的管理和视力结果。此外，为了比较我们的结果，我们进行了范围文献综述，纳入了所有具有相同特征的患者（RBH合并OCS）。我们的研究纳入了一组在我科治疗创伤后RBH伴OCS的患者。通过在1米处数手指的能力来评估视力。2018年至2024年，我科共收治3229例经影像学证实的眼眶骨折患者。其中，81例（2.5%）患者被确定为创伤后RBH，其中14例（17%）为OCS。手术减压最常用于最终视力改善的患者（恢复组，72%），而没有改善或存在失明的患者（后遗症组，60%）。与后遗症组相比，恢复组从诊断到治疗的中位时间更短（分别为6小时[20分钟-12小时]和12小时[3-33小时]）。这些发现得到了先前发表的数据的支持，有81例报道的RBH病例与OCS相关。为了评估这些数据，对1950年1月至2023年12月期间发表在文献中的病例进行了分析。总的来说，在32篇文章中发现了93例创伤后和/或术后RBH。我们的研究证实，眶内骨折引起的OCS伴视力损害是一种颌面急症，主要发生在眶内骨折后。在视力受损或相对传入瞳孔缺损（RAPD）的病例中，外侧眦切开术联合眦松解术仍然是降低眶内压力的简单方法。此外，全麻下的手术减压应紧急进行，最好在创伤后6小时内进行。然而，即使手术超过6小时，视力也有可能恢复。最后，视力应在眼眶骨折手术后至少24小时内每2小时检查一次。

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引用次数: 0

Machine learning models for predicting postoperative complications following mandibular third molar surgery: Development, validation, and explainable AI insights 预测下颌第三磨牙手术后并发症的机器学习模型：开发、验证和可解释的人工智能见解

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-08 DOI: 10.1016/j.jcms.2026.104449

Anuj Jain , Pratap Jadhav

The surgical removal of impacted mandibular third molars is a routine procedure in oral and maxillofacial surgery but is consistently associated with significant postoperative morbidity. Traditional indices of surgical difficulty rely mainly on positional and radiographic features, overlooking intraoperative and operator-related influences. This retrospective cohort study analyzed 472 cases of mandibular third molar extractions to develop and validate machine learning models for predicting postoperative complications. Demographic, radiographic, and intraoperative variables were included, and outcomes assessed were pain, swelling, trismus, alveolar osteitis, infection, paraesthesia, bleeding, and delayed wound healing. Five algorithms were compared, with Random Forest and XGBoost demonstrating superior predictive performance (AUC 0.91 and 0.89, respectively) compared with logistic regression (AUC 0.74). SHapley Additive exPlanations (SHAP) identified surgical duration, impaction type, root morphology, operator experience, and bone guttering as the most influential predictors. These findings highlight the potential of explainable artificial intelligence to provide clinically interpretable and individualized risk stratification, supporting better triage, patient counseling, and training allocation. While single-center and retrospective design limit generalizability, this study demonstrates that machine learning can enhance prediction of third molar surgery outcomes beyond conventional methods and provides a foundation for prospective multicenter validation.

手术切除下颌阻生第三磨牙是口腔颌面外科的常规手术，但一直与术后显著的发病率相关。传统的手术难度指标主要依赖于体位和影像学特征，忽略了术中和手术者相关的影响。本回顾性队列研究分析了472例下颌第三磨牙拔除，以开发和验证预测术后并发症的机器学习模型。包括人口统计学、放射学和术中变量，评估的结果是疼痛、肿胀、牙关、牙槽骨炎、感染、感觉异常、出血和伤口愈合延迟。比较了五种算法，随机森林和XGBoost的预测性能（AUC分别为0.91和0.89）优于逻辑回归（AUC为0.74）。SHapley加性解释（SHAP）确定手术时间、嵌塞类型、牙根形态、手术经验和骨漏是最具影响力的预测因素。这些发现强调了可解释的人工智能在提供临床可解释和个性化风险分层、支持更好的分诊、患者咨询和培训分配方面的潜力。虽然单中心和回顾性设计限制了通用性，但该研究表明，机器学习可以比传统方法更好地预测第三磨牙手术结果，并为前瞻性多中心验证提供了基础。

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引用次数: 0

Super-Passive Alveolar Correcting Equipment (SPACE): a novel presurgical cleft device with 5-year outcomes following one-stage repair. 超被动牙槽矫正设备（SPACE）：一种新型的外科手术腭裂设备，一期修复后可获得5年疗效。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-08 DOI: 10.1016/j.jcms.2025.12.001

Akihiko Oyama, Emi Funayama, Toru Okamoto, Takahiiro Miura, Yuki Sasaki, Noriko Nishizawa, Satoko Imai, Taku Maeda, Kosuke Ishikawa, Masahiro Hojo, Yuhei Yamamoto

In patients with unilateral cleft lip, alveolus, and palate (U-CLAP), wide clefts negatively affect facial aesthetics, alveolar alignment, and speech. Although various presurgical orthopedic devices have been used, none reliably achieve substantial cleft narrowing. This study introduces the Super-Passive Alveolar Correcting Equipment (SPACE), a molar-supported passive plate that significantly reduces cleft width, narrowing the mean alveolar gap to 1.87 mm before surgery (n = 83). SPACE enabled a one-stage repair - lip repair, gingivoperiosteoplasty, and palatoplasty - performed at approximately 6 months of age. All patients underwent the one-stage procedure, with no oronasal fistulas observed. Among them, 56 complete U-CLAP patients were assessed using six linear measurements from dental casts obtained at the initial visit, before surgery, and at 1 year. Five-year outcomes included evaluations of maxillofacial growth (via lateral cephalometry), need for secondary alveolar bone grafting (SBG), and speech development. At age 5, cephalometric values were comparable between the SPACE one-stage (SOG) and the conventional Hotz multistage groups (HMG), except for U1-NF. The SBG avoidance rate with the SOG was 38.6 %. Malarticulation occurred in 14.6 % of the SOG patients, versus 42.2 % for the HMG. SPACE provides reliable presurgical cleft narrowing and facilitates a simplified one-stage protocol with favorable mid-term outcomes.

在单侧唇腭裂（U-CLAP）患者中，宽裂对面部美观、牙槽排列和言语产生负面影响。虽然使用了各种手术前矫形装置，但没有一种能可靠地实现实质性的腭裂狭窄。本研究介绍了超被动牙槽矫正设备（SPACE），这是一种臼齿支持的被动板，可显着减少裂宽，将术前平均牙槽间隙缩小至1.87 mm （n = 83）。SPACE可以在大约6个月大的时候进行一期修复——唇修复、牙龈骨膜成形术和腭成形术。所有患者均接受一期手术，未观察到口鼻瘘。其中，56例完整的U-CLAP患者在首次就诊、术前和1年时使用牙模进行了6项线性测量。5年的结果包括评估颌面部生长（通过侧位测量），需要二次牙槽骨移植（SBG）和语言发育。在5岁时，除U1-NF外，SPACE一期组（SOG）和传统Hotz多期组（HMG）的头颅测量值具有可比性。SOG对SBG的回避率为38.6%。SOG患者中有14.6%出现了关节失调，而HMG患者中有42.2%。SPACE提供了可靠的术前腭裂狭窄，简化了一期手术方案，中期预后良好。

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引用次数: 0

Advanced platelets rich fibrin (A-PRF) as a sustained release vehicle of antibiotics 晚期富血小板纤维蛋白（a - prf）作为抗生素缓释载体

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-08 DOI: 10.1016/j.jcms.2026.104454

Karim Fawzy El-Sayed , Christian Flörke , Gina Jaber , Melissa Solano Marchini , Dominik Schulte , Christof Dörfer , Joerg Wiltfang

The present in-vitro study explored advanced-platelet-rich-fibrin (A-PRF) as sustained-release vehicle for three different antibiotics.

10 ml blood was withdrawn from six patients. Subsequently, 25 mg/ml penicillin (P) and 2.5 mg/ml metronidazole (M) in combination (P + M), 12.5 mg/ml ciprofloxacin (C) or 0.4 mg/ml NaCl were added to blood prior to centrifugation (8min/200g) to prepare A-PRF/P + M, A-PRF/C or A-PRF/NaCl respectively. A-PRFs were examined histologically and by scanning-electron-microscopy (SEM). Volume, length, weight and consistency of A-PRFs were measured and compared. A-PRF/P + M, A-PRF/C or A-PRF/NaCl anti-bacterial properties were examined, using antibiogram assay against Aggregatibacter actinomycetemcomitans (Aa) over 7 days. Release kinetics of A-PRF/P + M or A-PRF/C were characterized, via enzyme-linked-immunosorbent-assay (ELISA).

No differences were noted between A-PRF groups regarding volume, length, weight or consistency. A-PRF/C demonstrated denser fibrin histologically and by SEM. Antibiotics augmented A-PRFs preserved anti-bacterial properties over 7 days, with A-PRF/C followed by A-PRF/P + M, demonstrating higher antimicrobial activity against Aa than A-PRF/NaCl (p < 0.05). ELISA demonstrated antibiotics sustained-release, with metronidazole and ciprofloxacin showing decline, in contrast to penicillin, with steady increase in release over 10 days (p < 0.05; repeated-measures-ANOVA).

A-PRF could serve as a promising local-delivery vehicle for sustained antibiotic release of ciprofloxacin or penicillin/metronidazole combination over 10 days, highlighting its potential in clinical applications requiring extended antimicrobial action.

目前的体外研究探索了晚期富血小板纤维蛋白（A-PRF）作为三种不同抗生素的缓释载体。6例患者取血10ml。分别加入25 mg/ml青霉素(P)和2.5 mg/ml甲硝唑(M)联合用药（P + M）、12.5 mg/ml环丙沙星(C)或0.4 mg/ml NaCl，离心8min/200g，分别制备A-PRF/P + M、A-PRF/C或A-PRF/NaCl。对A-PRFs进行组织学和扫描电镜（SEM）检查。测量并比较A-PRFs的体积、长度、重量和一致性。采用放线菌聚集菌（Aa）抗菌谱法检测A-PRF/P + M、A-PRF/C或A-PRF/NaCl 7 d的抗菌性能。通过酶联免疫吸附法（ELISA）表征A-PRF/P + M或A-PRF/C的释放动力学。A-PRF组之间在体积、长度、重量或一致性方面没有差异。A-PRF/C在组织学和扫描电镜下显示出较致密的纤维蛋白。抗生素增强了A-PRF在7 d内的抗菌性能，A-PRF/C其次是A-PRF/P + M，对Aa的抗菌活性高于A-PRF/NaCl （P < 0.05）。酶联免疫吸附试验显示抗生素缓释，甲硝唑和环丙沙星缓释量下降，而青霉素缓释量在10天内稳定增加（p < 0.05；重复测量-方差分析）。a - prf可作为环丙沙星或青霉素/甲硝唑联合用药10天内持续释放抗生素的有希望的局部递送载体，突出了其在需要延长抗菌作用的临床应用中的潜力。

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引用次数: 0

Pediatric mandibular condyle fractures: A decade of experience 小儿下颌髁骨折：十年的经验

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-08 DOI: 10.1016/j.jcms.2026.104455

Mert Can Rador, Çağla Çi̇çek, Yunus Uğurlu, Gaye Taylan Fi̇li̇nte

The mandibular condyle is a common site of facial fractures in children; however, it remains a clinical challenge due to its unique remodeling capacity and the ongoing debate over optimal treatment strategies. This study presents the clinical experience of a tertiary trauma center in Istanbul, Turkey, according to the Plastic and Reconstructive Surgery Clinic's treatment guidelines. A retrospective analysis was conducted on patients treated between 2010 and 2020. Condylar fractures were evaluated in terms of clinical presentation, Helkimo index scores and radiological subtypes.

A total of 60 patients (mean age: 9.55 years) with 75 mandibular condyle fractures were managed using closed treatment methods. All fractures healed with restitutional remodeling, with only a few complications affecting quality of life and 20 % of patients experiencing minor complications. The capacity for restitutional remodeling declined with age, particularly after around age 12. With increasing age, irregular healing patterns and higher complication rates became more common.

Conservative management in this cohort resulted in favorable long-term functional and radiological outcomes across non-displaced, minimally displaced, and selected displaced fractures. These findings reflect the results achievable with conservative treatment in the pediatric population represented in this study. Further comparative studies are required to clarify treatment indications across different fracture types and age groups.

下颌髁是儿童面部骨折的常见部位；然而，由于其独特的重塑能力和对最佳治疗策略的持续争论，它仍然是一个临床挑战。根据整形和重建外科诊所的治疗指南，本研究介绍了土耳其伊斯坦布尔一家三级创伤中心的临床经验。对2010年至2020年间接受治疗的患者进行了回顾性分析。根据临床表现、Helkimo指数评分和影像学分型对髁突骨折进行评估。采用闭合性治疗方法治疗下颌髁骨折75例，共60例（平均年龄9.55岁）。所有骨折均通过修复性重建愈合，只有少数并发症影响生活质量，20%的患者出现轻微并发症。修复重建的能力随着年龄的增长而下降，尤其是在12岁左右。随着年龄的增长，不规则的愈合模式和更高的并发症发生率变得更加常见。在该队列中，保守治疗在非移位、轻度移位和选择性移位骨折中获得了良好的长期功能和放射学结果。这些发现反映了在本研究中所代表的儿科人群中保守治疗所能达到的结果。需要进一步的比较研究来明确不同骨折类型和年龄组的治疗适应症。

{"title":"Pediatric mandibular condyle fractures: A decade of experience","authors":"Mert Can Rador, Çağla Çi̇çek, Yunus Uğurlu, Gaye Taylan Fi̇li̇nte","doi":"10.1016/j.jcms.2026.104455","DOIUrl":"10.1016/j.jcms.2026.104455","url":null,"abstract":"<div><div>The mandibular condyle is a common site of facial fractures in children; however, it remains a clinical challenge due to its unique remodeling capacity and the ongoing debate over optimal treatment strategies. This study presents the clinical experience of a tertiary trauma center in Istanbul, Turkey, according to the Plastic and Reconstructive Surgery Clinic's treatment guidelines. A retrospective analysis was conducted on patients treated between 2010 and 2020. Condylar fractures were evaluated in terms of clinical presentation, Helkimo index scores and radiological subtypes.</div><div>A total of 60 patients (mean age: 9.55 years) with 75 mandibular condyle fractures were managed using closed treatment methods. All fractures healed with restitutional remodeling, with only a few complications affecting quality of life and 20 % of patients experiencing minor complications. The capacity for restitutional remodeling declined with age, particularly after around age 12. With increasing age, irregular healing patterns and higher complication rates became more common.</div><div>Conservative management in this cohort resulted in favorable long-term functional and radiological outcomes across non-displaced, minimally displaced, and selected displaced fractures. These findings reflect the results achievable with conservative treatment in the pediatric population represented in this study. Further comparative studies are required to clarify treatment indications across different fracture types and age groups.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 3","pages":"Article 104455"},"PeriodicalIF":2.1,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Orthognathic surgical accuracy and cost-efficiency of patient-specific implants using intraoperative 3D CBCT superposition: A prospective cohort study with retrospective standard miniplates controls 使用术中3D CBCT叠加的患者特异性植入物的正颌手术准确性和成本效益：回顾性标准微型钢板对照的前瞻性队列研究

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-07 DOI: 10.1016/j.jcms.2026.104453

Núria Adell-Gómez , Arnau Valls-Esteve , Albert Malet-Contreras , Jordi Raurich-Leandro , Raimon Ripoll-Palmés , Adaia Valls-Ontañón , Josep Rubio-Palau

Orthognathic surgery is widely used to correct dentofacial deformities. Recent advancements in virtual surgical planning have enhanced the precision of these procedures. However, ensuring the surgical outcome reflects the virtual plan remains a challenge. This study aims to compare surgical accuracy and cost-efficiency between standard miniplates and patient-specific implants, using intraoperative computed tomography and 3D superposition. A total of 90 patients were included: 75 retrospective controls treated with standard implants and 15 prospective patients treated with patient-specific implants. Surgeries included Le Fort I, BSSO, and genioplasty. Intraoperative computed tomography scans were acquired and superposed with virtual plans to assess 3D accuracy. Statistical comparisons were made using the Mann–Whitney U test. The patient-specific implant group demonstrated significantly improved surgical accuracy in maxillary midline, mandibular midline, maxillary dental plane, and pogonion (p < 0.05). One patient with patient-specific implant required intraoperative replacement of mandibular plates due to condylar repositioning. Cost analysis revealed higher costs for PSI cases compared to standard, with no significant difference in surgical time. While patient-specific implants offer benefits in standardization and intraoperative precision, their higher cost and reduced adaptability in the mandible limit their application. Future studies should explore hybrid approaches and broader cost-efficiency analysis.

正颌手术被广泛用于矫正牙面畸形。最近在虚拟手术计划方面的进步提高了这些手术的精度。然而，确保手术结果反映虚拟计划仍然是一个挑战。本研究旨在通过术中计算机断层扫描和3D叠加技术，比较标准微型钢板和患者特异性植入物的手术精度和成本效益。共纳入90例患者：75例使用标准种植体治疗的回顾性对照组和15例使用患者特异性种植体治疗的前瞻性患者。手术包括Le Fort I， BSSO和genplasty。获取术中计算机断层扫描并与虚拟平面图叠加以评估3D精度。采用Mann-Whitney U检验进行统计学比较。患者特异性种植组在上颌中线、下颌中线、上颌牙平面和牙槽面上的手术精度显著提高（p < 0.05）。1例患者由于髁突复位需要术中置换下颌钢板。成本分析显示，与标准手术相比，PSI病例的成本更高，手术时间没有显著差异。虽然患者特异性种植体在标准化和术中精度方面具有优势，但其较高的成本和下颌适应性降低限制了其应用。未来的研究应探索混合方法和更广泛的成本效益分析。

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引用次数: 0

Surgical treatment of displaced intraarticular pediatric condyle fractures. 移位的小儿髁内骨折的手术治疗。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-06 DOI: 10.1016/j.jcms.2025.104428

Aleš Vesnaver, Vojko Didanovič, Anže Birk, Tadej Dovšak

Aim: Conservative treatment of pediatric condyle fractures remains the generally accepted norm even today. However, longterm results of conservatively treated displaced pediatric condyle fractures often display adverse effects on the affected temporomandibular joint (TMJ), and also on the growing facial skeleton. We analyzed results of surgical treatment in pediatric intraarticular condyle fractures.

Patients and methods: Children with displaced intraarticular condyle fractures were treated surgically, with open reduction and internal fixation (ORIF). The articular disc was addressed in each case. Postoperatively, patients were controlled at 1 week, 1 month, 3-6 months, and yearly thereafter. Facial symmetry, maximal mouth opening (MMO), maximal lateropulsions, lateral chin deflection, TMJ pain, condylar translation, palpable pathological phenomena, occlusion and postoperative scars were assessed clinically. Fracture healing, condylar height, shape and growth were assessed radiologically. Possible surgical complications were also noted.

Results: From 2016 through 2022, 14 children with 19 displaced intraarticular condyle fractures were treated surgically, of whom 11 children with 16 fractures enrolled in the survey. In all the fractures, the TMJ was opened, and all the fractures save one reduced and fixed. In 5 fractures (31 %), the articular disc was displaced and ruptured, and was reduced and sutured. The age range was 4-12 years (average 9.7 years). Follow up time was 2-8 years (average 5.1 years). All of the patients maintained proper occlusion and MMO. Only one patient with ORIF developed mild facial asymmetry, limited condylar translation, and limited contralateral lateropulsion of the mandible. In the patient where only exploration was performed, the condyle grew angulated (20^O anteromedially) and its translation is slightly limited. In all the other patients, symmetrical growth and TMJ mobility were achieved. None of the patients presented with chewing difficulties or joint pain. There were 2 cases of postoperative facial nerve weakness, both of which completely resolved in 2 and 4 weeks. In 1 patient, the lag screw was removed after 2 months because of protrusion into the joint space. In another, a reoperation was performed 2 days after the initial surgery due to fragment malposition. No other intra- or postoperative complications were noted.

Conclusion: Surgical treatment of displaced intraarticular pediatric condylar fractures restores skeletal and soft-tissue anatomy and thereby enables unaltered TMJ function and symmetrical growth of the condyles and the entire facial skeleton.

目的：保守治疗儿童髁突骨折仍然是普遍接受的规范，即使在今天。然而，保守治疗移位的儿童髁状骨折的长期结果往往对受影响的颞下颌关节（TMJ）和正在生长的面部骨骼产生不良影响。我们分析了小儿关节内髁骨折的手术治疗结果。患者和方法：移位的儿童髁内骨折采用手术治疗，切开复位内固定（ORIF）。每个病例都对关节盘进行了定位。术后1周、1个月、3-6个月、1年对照。临床评估面部对称性、最大开口（MMO）、最大侧推、侧下巴偏斜、TMJ疼痛、髁突平移、可触及的病理现象、咬合和术后疤痕。影像学评估骨折愈合、髁突高度、形状和生长情况。可能的手术并发症也被注意到。结果：2016年至2022年，14例19例移位性髁内骨折患儿接受手术治疗，其中11例16例骨折纳入调查。所有骨折均打开TMJ，除1例骨折复位固定外，其余骨折均复位。在5例骨折（31%）中，关节盘移位和破裂，复位并缝合。年龄4 ~ 12岁，平均9.7岁。随访时间2 ~ 8年，平均5.1年。所有患者均保持适当的咬合和MMO。只有1例ORIF患者出现轻度面部不对称、髁突移位受限、对侧下颌骨侧脱受限。在仅行探查的患者中，髁突呈角度（前内侧为200°），其平移略受限制。在所有其他患者中，均实现了对称生长和TMJ活动。没有患者出现咀嚼困难或关节疼痛。术后面神经无力2例，均于术后2周、4周完全缓解。1例患者2个月后因突出关节间隙取出拉力螺钉。在另一例中，由于碎片错位，首次手术后2天再次手术。未发现其他手术内或术后并发症。结论：移位型儿童髁突骨折的手术治疗恢复了骨骼和软组织解剖结构，从而使TMJ功能保持不变，髁突和整个面部骨骼对称生长。

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引用次数: 0

Beyond the common ground: Unmasking unique toxicity signatures of cisplatin, docetaxel, and fluorouracil with implications for head and neck cancer treatment 超越共同点：揭示顺铂、多西紫杉醇和氟尿嘧啶独特的毒性特征与头颈癌治疗的意义。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.jcms.2025.11.013

Simin Li , Xiong Zhang , Faping Sun , Shaonan Hu , Deborah Kreher , Gerhard Schmalz , Hui Xiao

Head and neck cancers (HNCs) affect approximately 650,000 individuals annually worldwide, with cisplatin, docetaxel, and fluorouracil serving as cornerstone agents in the widely employed Taxane [docetaxel], Platinum [cisplatin], and Fluorouracil (TPF) regimen; however, despite their demonstrated survival benefits, a comprehensive comparative pharmacovigilance analysis quantifying the distinctive safety profiles and adverse drug reaction (ADR) burdens of these agents remains absent from the literature. This study aimed to conduct a systematic pharmacovigilance analysis using the EudraVigilance database to quantify drug-specific safety signals and characterize comparative toxicity profiles of cisplatin, docetaxel, and fluorouracil through rigorous disproportionality methodologies. Analysis of 244,769 ADR reports revealed markedly distinct toxicity profiles: cisplatin demonstrated the highest death reporting rate (0.56 %) and exhibited disproportionately elevated associations with renal and urinary disorders (ROR: 5.96, 95 % CI: 5.57–6.37) and ear and labyrinth disorders (ROR: 10.80, 95 % CI: 9.35–12.47), with nephrotoxicity, ototoxicity, neutropenia (4.19 %), and myelosuppression (4.07 %) representing its characteristic profile. Docetaxel revealed an extraordinary psychiatric burden previously underappreciated in clinical trials, showing a 20.67-fold increased signal for psychiatric disorders (95 % CI: 19.20–22.26) and 34.28-fold association with adverse social circumstances (95 % CI: 27.69–42.44), with alopecia (12.99 %), psychological trauma (5.82 %), and emotional distress (4.03 %) constituting the most common adverse reactions, alongside prominent skin and subcutaneous tissue disorders (18.55 %). Fluorouracil demonstrated distinctive cardiovascular toxicities including coronary arteriospasm and cardiogenic shock (ROR: 1.71, 95 % CI: 1.46–2.01), the highest bone marrow suppression rate (5.73 %), and extensive gastrointestinal manifestations including ischemic colitis and hemorrhagic diarrhea. Additionally, 116 common ADR signals were identified across all three agents, predominantly hematological toxicities distributed across 18 System Organ Classes (SOCs). These quantified safety signals provide clinically actionable intelligence for evidence-based risk stratification, enabling personalized treatment selection based on patient-specific vulnerability profiles, proactive implementation of targeted toxicity mitigation strategies including renal protection for cisplatin recipients, psychological support for docetaxel-treated patients, and cardiac monitoring for fluorouracil administration, ultimately transforming empirical clinical practice into precision pharmacovigilance for optimized therapeutic outcomes in HNC management.

头颈癌（HNCs）每年影响全球约65万人，在广泛使用的紫杉烷（多西紫杉醇）、铂（顺铂）和氟尿嘧啶（TPF）方案中，顺铂、多西紫杉醇和氟尿嘧啶是基础药物；然而，尽管证明了它们的生存益处，但文献中仍然缺乏对这些药物独特的安全性和药物不良反应（ADR）负担进行量化的综合比较药物警戒分析。本研究旨在使用EudraVigilance数据库进行系统的药物警戒分析，量化药物特异性安全信号，并通过严格的不相称性方法表征顺铂、多西紫杉醇和氟尿嘧啶的比较毒性特征。对244,769份不良反应报告的分析显示出明显不同的毒性特征：顺铂的死亡率最高（0.56%），与肾脏和泌尿系统疾病（ROR: 5.96, 95% CI: 5.57-6.37）以及耳朵和迷宫症（ROR: 10.80, 95% CI: 9.35-12.47）的相关性不成比例地升高，其中肾毒性、耳毒性、中性粒细胞减少症（4.19%）和骨髓抑制（4.07%）是其特征特征。多西他赛显示了之前在临床试验中未被重视的异常精神负担，显示精神疾病的信号增加了20.67倍（95% CI: 19.20-22.26），与不良社会环境的关联增加了34.28倍（95% CI: 27.69-42.44），脱发（12.99%）、心理创伤（5.82%）和情绪困扰（4.03%）构成了最常见的不良反应，以及突出的皮肤和皮下组织疾病（18.55%）。氟尿嘧啶表现出独特的心血管毒性，包括冠状动脉痉挛和心源性休克（ROR: 1.71, 95% CI: 1.46-2.01），最高的骨髓抑制率（5.73%），广泛的胃肠道表现，包括缺血性结肠炎和出血性腹泻。此外，在所有三种药物中发现了116种常见的不良反应信号，主要是血液毒性，分布在18个系统器官类别（soc）中。这些量化的安全信号为基于证据的风险分层提供了临床可操作的情报，使基于患者特定脆弱性的个性化治疗选择，主动实施有针对性的毒性缓解策略，包括对顺铂受体的肾脏保护，对多西他赛治疗患者的心理支持，以及对氟尿嘧啶给药的心脏监测。最终将经验临床实践转化为精确的药物警戒，以优化HNC管理的治疗效果。

{"title":"Beyond the common ground: Unmasking unique toxicity signatures of cisplatin, docetaxel, and fluorouracil with implications for head and neck cancer treatment","authors":"Simin Li , Xiong Zhang , Faping Sun , Shaonan Hu , Deborah Kreher , Gerhard Schmalz , Hui Xiao","doi":"10.1016/j.jcms.2025.11.013","DOIUrl":"10.1016/j.jcms.2025.11.013","url":null,"abstract":"<div><div>Head and neck cancers (HNCs) affect approximately 650,000 individuals annually worldwide, with cisplatin, docetaxel, and fluorouracil serving as cornerstone agents in the widely employed Taxane [docetaxel], Platinum [cisplatin], and Fluorouracil (TPF) regimen; however, despite their demonstrated survival benefits, a comprehensive comparative pharmacovigilance analysis quantifying the distinctive safety profiles and adverse drug reaction (ADR) burdens of these agents remains absent from the literature. This study aimed to conduct a systematic pharmacovigilance analysis using the EudraVigilance database to quantify drug-specific safety signals and characterize comparative toxicity profiles of cisplatin, docetaxel, and fluorouracil through rigorous disproportionality methodologies. Analysis of 244,769 ADR reports revealed markedly distinct toxicity profiles: cisplatin demonstrated the highest death reporting rate (0.56 %) and exhibited disproportionately elevated associations with renal and urinary disorders (ROR: 5.96, 95 % CI: 5.57–6.37) and ear and labyrinth disorders (ROR: 10.80, 95 % CI: 9.35–12.47), with nephrotoxicity, ototoxicity, neutropenia (4.19 %), and myelosuppression (4.07 %) representing its characteristic profile. Docetaxel revealed an extraordinary psychiatric burden previously underappreciated in clinical trials, showing a 20.67-fold increased signal for psychiatric disorders (95 % CI: 19.20–22.26) and 34.28-fold association with adverse social circumstances (95 % CI: 27.69–42.44), with alopecia (12.99 %), psychological trauma (5.82 %), and emotional distress (4.03 %) constituting the most common adverse reactions, alongside prominent skin and subcutaneous tissue disorders (18.55 %). Fluorouracil demonstrated distinctive cardiovascular toxicities including coronary arteriospasm and cardiogenic shock (ROR: 1.71, 95 % CI: 1.46–2.01), the highest bone marrow suppression rate (5.73 %), and extensive gastrointestinal manifestations including ischemic colitis and hemorrhagic diarrhea. Additionally, 116 common ADR signals were identified across all three agents, predominantly hematological toxicities distributed across 18 System Organ Classes (SOCs). These quantified safety signals provide clinically actionable intelligence for evidence-based risk stratification, enabling personalized treatment selection based on patient-specific vulnerability profiles, proactive implementation of targeted toxicity mitigation strategies including renal protection for cisplatin recipients, psychological support for docetaxel-treated patients, and cardiac monitoring for fluorouracil administration, ultimately transforming empirical clinical practice into precision pharmacovigilance for optimized therapeutic outcomes in HNC management.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104410"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IL-11 as a potential diagnostic and prognostic biomarker in oral submucous fibrosis-related oral squamous cell carcinoma: A single-center exploratory study IL-11作为口腔粘膜下纤维化相关口腔鳞状细胞癌的潜在诊断和预后生物标志物：一项单中心探索性研究

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.jcms.2025.11.017

Yuxin Liu , Hongzhi Quan

Background

Oral submucous fibrosis (OSF) has a high propensity for malignant transformation, and oral squamous cell carcinoma (OSCC) associated with OSF exhibits different clinical and pathological features compared to non-OSF-related OSCC. It aimed to investigate the expression characteristics of peripheral blood interleukins (ILs) in patients with OSF-related OSCC and their relationship with clinical and pathological features.

Methods

A total of 219 OSCC patients were included and divided into OSF group (OG, n = 115) and non-OSF group (nOG, n = 104). Additionally, 119 healthy volunteers were recruited through community health screening as the healthy control group (HCG). Clinical and pathological data were collected, and ILs in peripheral blood were measured. The levels of IL-11 in peripheral blood of OSF-related OSCC patients with different pathological features were compared.

Results

Compared to the nOG and HCG, the OG exhibited a lower proportion of individuals aged ≥65 years, a higher proportion of males, and significantly elevated levels of IL-2 and IL-11. Additionally, compared to the nOG, the OG demonstrated lower recurrence and mortality rates, as well as a higher proportion of oral tumors and well-differentiated pathological features (P < 0.05). The area under the curve (AUC) for diagnosing OSF-related OSCC based on the levels of IL-2, IL-4, IL-10, and IL-11 in peripheral blood were 0.671, 0.593, 0.570, and 0.725, respectively. IL-11 levels were correlated with the degree of differentiation, lymph node metastasis (LNM), clinical staging, prognosis, and 5-year survival status in patients with OSF-related OSCC (P < 0.05).

Conclusion

Elevated IL-11 in peripheral blood of patients with OSF-related OSCC are closely associated with clinical and pathological features.

背景：口腔粘膜下纤维化（OSF）具有较高的恶性转化倾向，与OSF相关的口腔鳞状细胞癌（OSCC）与非OSF相关的OSCC相比，表现出不同的临床和病理特征。目的探讨osf相关性OSCC患者外周血白细胞介素（il）的表达特征及其与临床病理特征的关系。方法：219例OSCC患者分为OSF组（OG, n = 115）和非OSF组（nOG, n = 104）。此外，通过社区健康筛查招募119名健康志愿者作为健康对照组（HCG）。收集临床及病理资料，测定外周血il。比较不同病理特征osf相关性OSCC患者外周血IL-11水平。结果：与nOG和HCG相比，OG年龄≥65岁的个体比例较低，男性比例较高，IL-2和IL-11水平显著升高。此外，与nOG相比，OG表现出更低的复发率和死亡率，以及更高的口腔肿瘤比例和分化良好的病理特征(P结论：osf相关性OSCC患者外周血IL-11升高与临床和病理特征密切相关。

{"title":"IL-11 as a potential diagnostic and prognostic biomarker in oral submucous fibrosis-related oral squamous cell carcinoma: A single-center exploratory study","authors":"Yuxin Liu , Hongzhi Quan","doi":"10.1016/j.jcms.2025.11.017","DOIUrl":"10.1016/j.jcms.2025.11.017","url":null,"abstract":"<div><h3>Background</h3><div>Oral submucous fibrosis (OSF) has a high propensity for malignant transformation, and oral squamous cell carcinoma (OSCC) associated with OSF exhibits different clinical and pathological features compared to non-OSF-related OSCC. It aimed to investigate the expression characteristics of peripheral blood interleukins (ILs) in patients with OSF-related OSCC and their relationship with clinical and pathological features.</div></div><div><h3>Methods</h3><div>A total of 219 OSCC patients were included and divided into OSF group (OG, n = 115) and non-OSF group (nOG, n = 104). Additionally, 119 healthy volunteers were recruited through community health screening as the healthy control group (HCG). Clinical and pathological data were collected, and ILs in peripheral blood were measured. The levels of IL-11 in peripheral blood of OSF-related OSCC patients with different pathological features were compared.</div></div><div><h3>Results</h3><div>Compared to the nOG and HCG, the OG exhibited a lower proportion of individuals aged ≥65 years, a higher proportion of males, and significantly elevated levels of IL-2 and IL-11. Additionally, compared to the nOG, the OG demonstrated lower recurrence and mortality rates, as well as a higher proportion of oral tumors and well-differentiated pathological features (<em>P <</em> 0.05). The area under the curve (AUC) for diagnosing OSF-related OSCC based on the levels of IL-2, IL-4, IL-10, and IL-11 in peripheral blood were 0.671, 0.593, 0.570, and 0.725, respectively. IL-11 levels were correlated with the degree of differentiation, lymph node metastasis (LNM), clinical staging, prognosis, and 5-year survival status in patients with OSF-related OSCC (<em>P <</em> 0.05).</div></div><div><h3>Conclusion</h3><div>Elevated IL-11 in peripheral blood of patients with OSF-related OSCC are closely associated with clinical and pathological features.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104414"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EACMFS Prizes & Awards EACMFS奖项

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/S1010-5182(25)00378-6

引用次数: 0