This study aims to investigate the postoperative maxillofacial growth and bone formation after gingivoperiosteoplasty (GPP) performed in early childhood for patients with bilateral cleft lip and palate (BCLP). Thirty non-syndromic patients with complete BCLP who underwent a two-stage palatoplasty protocol were enrolled. Their alveolar cleft sides were categorized into two groups based on whether GPP was applied at the timing of hard palate closure (GPP group, n = 33) or not (non-GPP group, n = 27). Computed tomography (CT) and lateral cephalograms both taken at 8 years of age were analysed. Bone bridge formation was significantly higher in the GPP group (93.9 %) compared to the non-GPP group (11.1 %). However, the mean proportion of the bone created within the alveolar cleft site measured at multiple vertical levels in the GPP group was 54.4 %. Lateral cephalometric analysis revealed that the GPP group showed both anteroposterior length of the maxilla (GPP: 46.5 ± 3.0 mm, non-GPP: 50.2 ± 2.3 mm) and ANB (GPP: 3.4 ± 3.0°, non-GPP: 6.6 ± 2.5°) significantly smaller than the non-GPP group. These results demonstrated that GPP, performed at 1.5 years of age for BCLP, resulted in insufficient new bone formation and negatively impacted maxillary development. Based on these findings, we have discontinued our GPP protocol for patients with BCLP.
{"title":"Clinical outcomes of gingivoperiosteoplasty performed in early childhood in patients with bilateral cleft lip and palate","authors":"Yuki Arimura , Tadashi Yamanishi , Takahiro Nishio , Setsuko Uematsu , Aiko Hyodo , Katsuhiko Amano , Seiji Iida , Juntaro Nishio","doi":"10.1016/j.jcms.2025.12.002","DOIUrl":"10.1016/j.jcms.2025.12.002","url":null,"abstract":"<div><div>This study aims to investigate the postoperative maxillofacial growth and bone formation after gingivoperiosteoplasty (GPP) performed in early childhood for patients with bilateral cleft lip and palate (BCLP). Thirty non-syndromic patients with complete BCLP who underwent a two-stage palatoplasty protocol were enrolled. Their alveolar cleft sides were categorized into two groups based on whether GPP was applied at the timing of hard palate closure (GPP group, n = 33) or not (non-GPP group, n = 27). Computed tomography (CT) and lateral cephalograms both taken at 8 years of age were analysed. Bone bridge formation was significantly higher in the GPP group (93.9 %) compared to the non-GPP group (11.1 %). However, the mean proportion of the bone created within the alveolar cleft site measured at multiple vertical levels in the GPP group was 54.4 %. Lateral cephalometric analysis revealed that the GPP group showed both anteroposterior length of the maxilla (GPP: 46.5 ± 3.0 mm, non-GPP: 50.2 ± 2.3 mm) and ANB (GPP: 3.4 ± 3.0°, non-GPP: 6.6 ± 2.5°) significantly smaller than the non-GPP group. These results demonstrated that GPP, performed at 1.5 years of age for BCLP, resulted in insufficient new bone formation and negatively impacted maxillary development. Based on these findings, we have discontinued our GPP protocol for patients with BCLP.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104423"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800898","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}
Pub Date : 2026-02-01Epub Date: 2025-12-18DOI: 10.1016/j.jcms.2025.11.018
Zhen Zhu , Junhui Yuan , Xu Zhang , Liyuan Dai , Wei Du , Xiaoli Liu
Recurrent high-grade salivary gland carcinomas (SGCs) have limited treatment options, and immunotherapy's role remains unclear. This study evaluated radiologic and pathologic responses to immunotherapy in resectable recurrent high-grade SGCs. We retrospectively analyzed 108 patients from a tertiary center: 41 received neoadjuvant immunotherapy, while 67 underwent upfront surgery. Radiologic response (RECIST 1.1) and pathologic response (immune-related criteria) were discordant—34.1 % showed partial radiologic responses, but only 9.8 % achieved partial pathologic responses, with no complete responses. PD-L1 amplification correlated with response (25 % vs. 8.1 % in non-responders, p = 0.042), whereas B2M loss (29.3 % post-treatment, p = 0.032) and TP53/PIK3CA co-mutations (37.8 % in non-responders) were linked to resistance. Survival did not differ between groups (3-year event-free survival: 19.5 % vs. 23.9 %, p = 0.447; overall survival: 26.8 % vs. 31.3 %, p = 0.593). These findings highlight immunotherapy's limited pathologic efficacy in recurrent high-grade SGCs, with response rates lower on pathologic than radiologic assessment. PD-L1 and B2M alterations underscore the need for biomarker-driven strategies. This study provides a foundation for improving outcomes in this aggressive disease.
复发性高级别唾液腺癌（SGCs）的治疗选择有限，免疫治疗的作用尚不清楚。本研究评估了可切除复发的高级别SGCs的放射学和病理反应。我们回顾性分析了来自三级中心的108例患者：41例接受了新辅助免疫治疗，67例接受了前期手术。放射反应（RECIST 1.1）和病理反应（免疫相关标准）不一致- 34.1%显示部分放射反应，但只有9.8%达到部分病理反应，没有完全反应。PD-L1扩增与应答相关（25% vs. 8.1%，无应答者，p = 0.042），而B2M丢失（治疗后29.3%,p = 0.032）和TP53/PIK3CA共突变（无应答者，37.8%）与耐药性相关。两组间生存率无差异（3年无事件生存率：19.5% vs. 23.9%, p = 0.447；总生存率：26.8% vs. 31.3%, p = 0.593）。这些发现强调了免疫疗法对复发性高级别SGCs的有限病理疗效，病理评估的反应率低于放射评估。PD-L1和B2M的改变强调了生物标志物驱动策略的必要性。本研究为改善这种侵袭性疾病的预后提供了基础。
{"title":"Pathologic assessment Reveals limited efficacy of immunotherapy in recurrent high-grade salivary gland carcinomas: A clinicopathologic and genomic study","authors":"Zhen Zhu , Junhui Yuan , Xu Zhang , Liyuan Dai , Wei Du , Xiaoli Liu","doi":"10.1016/j.jcms.2025.11.018","DOIUrl":"10.1016/j.jcms.2025.11.018","url":null,"abstract":"<div><div>Recurrent high-grade salivary gland carcinomas (SGCs) have limited treatment options, and immunotherapy's role remains unclear. This study evaluated radiologic and pathologic responses to immunotherapy in resectable recurrent high-grade SGCs. We retrospectively analyzed 108 patients from a tertiary center: 41 received neoadjuvant immunotherapy, while 67 underwent upfront surgery. Radiologic response (RECIST 1.1) and pathologic response (immune-related criteria) were discordant—34.1 % showed partial radiologic responses, but only 9.8 % achieved partial pathologic responses, with no complete responses. PD-L1 amplification correlated with response (25 % vs. 8.1 % in non-responders, p = 0.042), whereas B2M loss (29.3 % post-treatment, p = 0.032) and TP53/PIK3CA co-mutations (37.8 % in non-responders) were linked to resistance. Survival did not differ between groups (3-year event-free survival: 19.5 % vs. 23.9 %, p = 0.447; overall survival: 26.8 % vs. 31.3 %, p = 0.593). These findings highlight immunotherapy's limited pathologic efficacy in recurrent high-grade SGCs, with response rates lower on pathologic than radiologic assessment. PD-L1 and B2M alterations underscore the need for biomarker-driven strategies. This study provides a foundation for improving outcomes in this aggressive disease.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104415"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800920","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}
Hemifacial Microsomia (HFM) is the second most common craniofacial malformation after clefts and it is characterized by mandibular hypoplasia and facial asymmetry.
This retrospective study aimed to evaluate mandibular morphology in growing HFM patients using three-dimensional (3D) computed tomography (CBCT), focusing on volumetric asymmetries.
A total of 26 patients aged 5–13 years with unilateral HFM were analyzed. They were stratified into two age groups (5–8 and 9–13 years) and classified according to Pruzansky-Kaban system in two severity categories (mild/severe deformity). CBCT data were processed to reconstruct 3D mandibular models, segmenting the condylar, coronoid and gonion regions. Volumetric differences between affected and unaffected sides were compared across age and severity subgroups.
Results showed that all the three functional units were significantly smaller on the affected side, especially in severe HFM cases. However, no statistically significant differences were found between the two age groups, suggesting that mandibular asymmetry remains substantively unchanged over the two consecutive time points examined. Multivariable regression confirmed that HFM severity was strongly associated with condylar and gonial volume discrepancies.
This study highlights the value of CBCT-based 3D reconstruction for precise assessment of mandibular morphology and supports its role in individualized diagnosis and treatment planning for HFM patients.
{"title":"Evaluation of mandibular morphology in untreated growing patients with hemifacial Microsomia: a 3D computed tomography study","authors":"Roberto Uomo , Wanda Maldonato , Alessandra Putrino , Luca Borro , Marta Cecchitelli , Lucilla Ravà , Aurelio Secinaro , Angela Galeotti","doi":"10.1016/j.jcms.2025.11.019","DOIUrl":"10.1016/j.jcms.2025.11.019","url":null,"abstract":"<div><div>Hemifacial Microsomia (HFM) is the second most common craniofacial malformation after clefts and it is characterized by mandibular hypoplasia and facial asymmetry.</div><div>This retrospective study aimed to evaluate mandibular morphology in growing HFM patients using three-dimensional (3D) computed tomography (CBCT), focusing on volumetric asymmetries.</div><div>A total of 26 patients aged 5–13 years with unilateral HFM were analyzed. They were stratified into two age groups (5–8 and 9–13 years) and classified according to Pruzansky-Kaban system in two severity categories (mild/severe deformity). CBCT data were processed to reconstruct 3D mandibular models, segmenting the condylar, coronoid and gonion regions. Volumetric differences between affected and unaffected sides were compared across age and severity subgroups.</div><div>Results showed that all the three functional units were significantly smaller on the affected side, especially in severe HFM cases. However, no statistically significant differences were found between the two age groups, suggesting that mandibular asymmetry remains substantively unchanged over the two consecutive time points examined. Multivariable regression confirmed that HFM severity was strongly associated with condylar and gonial volume discrepancies.</div><div>This study highlights the value of CBCT-based 3D reconstruction for precise assessment of mandibular morphology and supports its role in individualized diagnosis and treatment planning for HFM patients.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104416"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866678","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}
Pub Date : 2026-02-01Epub Date: 2025-12-31DOI: 10.1016/j.jcms.2025.104429
Martin Scheer , Fiona Willenberg , Alexey Surov , Benedikt Passmann , Julius Niehoff , Jan Borggrefe
Computed tomography (CT) is an essential tool for staging head and neck cancer. PCCT-detectors can convert the incoming photons directly into electrical signals. This study investigated the potential of PCCT in OSCCs and OPSCCs. The study population comprised 26 patients with an average age of 65.1 years, all of whom were receiving therapy for OSCC (n = 21) or OPSCC (n = 5). PCCT images were analysed using virtual monoenergetic reconstructions (VMIs) with energies ranging from 40 to 100 keV. Blinded VMIs were analysed using a Likert scale. Optimal tumour delineation and image quality were observed at low energies (40–45 keV). Conversely, infiltration into adjacent structures, notably the mandible, was most effectively visualized at an average energy of 80 keV. The effective dose was found to be 1.46 mSv for PCCT representing an almost 50 % reduction compared to conventional CT. However, artefacts caused by metallic restorations remain problematic in PCCT. Nevertheless PCCT has the capacity to enhance soft tissue contrast, thereby facilitating higher spatial resolution and improved diagnostic quality when staging OSCC.
{"title":"Photon-counting CT in the diagnostic workup of OSCC and OPSCC: A prospective evaluation of tumour conspicuity using virtual monoenergetic imaging","authors":"Martin Scheer , Fiona Willenberg , Alexey Surov , Benedikt Passmann , Julius Niehoff , Jan Borggrefe","doi":"10.1016/j.jcms.2025.104429","DOIUrl":"10.1016/j.jcms.2025.104429","url":null,"abstract":"<div><div>Computed tomography (CT) is an essential tool for staging head and neck cancer. PCCT-detectors can convert the incoming photons directly into electrical signals. This study investigated the potential of PCCT in OSCCs and OPSCCs. The study population comprised 26 patients with an average age of 65.1 years, all of whom were receiving therapy for OSCC (n = 21) or OPSCC (n = 5). PCCT images were analysed using virtual monoenergetic reconstructions (VMIs) with energies ranging from 40 to 100 keV. Blinded VMIs were analysed using a Likert scale. Optimal tumour delineation and image quality were observed at low energies (40–45 keV). Conversely, infiltration into adjacent structures, notably the mandible, was most effectively visualized at an average energy of 80 keV. The effective dose was found to be 1.46 mSv for PCCT representing an almost 50 % reduction compared to conventional CT. However, artefacts caused by metallic restorations remain problematic in PCCT. Nevertheless PCCT has the capacity to enhance soft tissue contrast, thereby facilitating higher spatial resolution and improved diagnostic quality when staging OSCC.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104429"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886505","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}
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。
{"title":"Super-Passive Alveolar Correcting Equipment (SPACE): a novel presurgical cleft device with 5-year outcomes following one-stage repair.","authors":"Akihiko Oyama, Emi Funayama, Toru Okamoto, Takahiiro Miura, Yuki Sasaki, Noriko Nishizawa, Satoko Imai, Taku Maeda, Kosuke Ishikawa, Masahiro Hojo, Yuhei Yamamoto","doi":"10.1016/j.jcms.2025.12.001","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.12.001","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":"104422"},"PeriodicalIF":2.1,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946848","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}
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 (20O 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.
{"title":"Surgical treatment of displaced intraarticular pediatric condyle fractures.","authors":"Aleš Vesnaver, Vojko Didanovič, Anže Birk, Tadej Dovšak","doi":"10.1016/j.jcms.2025.104428","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.104428","url":null,"abstract":"<p><strong>Aim: </strong>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.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>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<sup>O</sup> 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":"104428"},"PeriodicalIF":2.1,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919259","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}
Pub Date : 2026-01-01Epub Date: 2025-12-18DOI: 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}
Pub Date : 2026-01-01Epub Date: 2025-11-29DOI: 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.
{"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}
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