Journal of Cranio-Maxillofacial Surgery最新文献_第7页

Accuracy of 3D simulation in soft tissue change after orthognathic surgery in class III malocclusion: Influence of different vertical facial patterns III类错颌正颌手术后软组织变化三维模拟的准确性：不同垂直面部模式的影响

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.09.012

Carol Yi-Hsuan Chen , Tong Xi , Ellen Wen-Ching Ko , Shih-Ying Tsao

This study aimed to evaluate the accuracy of 3D soft tissue prediction with Simplant O&O software in skeletal Class III patients who received double-jaw orthognathic surgery (OGS). The influences of different vertical facial patterns on the accuracy of surgical prediction were also assessed.

Sixty consecutive skeletal class III patients treated with bimaxillary surgery and orthodontic treatment were included. Patients were divided into the high-angle (HA) group and low-angle (LA) group according to the mandibular plane angle. Cone-beam computerized tomographs were acquired before surgery and after debonding. All patients received 3D virtual surgical planning. The accuracy of soft tissue prediction was calculated in terms of 3D regional soft tissue changes between the preoperative simulation and debonding. Independent t-test, chi-square test were used to test for intergroup differences, in combination with. Pearson correlation, Spearman correlation and multiple logistic regression.

3D soft tissue simulation in Class III patients provided an overall clinical acceptable accuracy (mean error <2.0 mm). However, the chin area is less predictable (mean simulation error 1.63 ± 1.64 mm and 1.47 ± 1.21 mm in HA and LA group respectively). The predicted anterior movement of soft tissue in the cheek and lower lip regions were often underestimated. Although the simulation accuracy between the high-angle group and low-angle groups were generally comparable, the upper lip region prediction showed a higher accuracy in the high-angle group compared to the low-angle group. In conclusion, the accuracy of 3D soft tissue prediction should be viewed carefully, and further validation is recommended to fully understand its clinical utility in optimizing surgical outcomes.

本研究旨在评估Simplant O&O软件对接受双颌正颌手术（OGS）的骨骼III类患者三维软组织预测的准确性。不同的垂直面部模式对手术预测准确性的影响也进行了评估。本研究包括60例连续接受双颌手术和正畸治疗的骨骼III类患者。根据下颌平面角度将患者分为高角度组（HA）和低角度组（LA）。手术前和脱粘后进行锥形束计算机断层扫描。所有患者均接受三维虚拟手术计划。根据术前模拟与脱粘之间的三维区域软组织变化来计算软组织预测的准确性。组间差异采用独立t检验、卡方检验，并结合。Pearson相关、Spearman相关及多元logistic回归。III类患者的三维软组织模拟提供了总体临床可接受的准确性（平均误差）

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引用次数: 0

Artificial intelligence in joint face–skeletal prediction for orthognathic procedures: A systematic review 人工智能在正颌手术面部骨骼预测中的应用：系统综述。

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.11.002

Xiaozhe Wang , Jiahao Chen , Qianhan Zheng , Ting Kang , Gengyu Hu , Mengqi Zhou , Huogen Wang , Weifang Zhang , Xuepeng Chen

Objective

This systematic review aimed to produce an overview of the development of AI in joint skeletal–soft tissue prediction after orthognathic surgery, and to assess its accuracy comprehensively.

Materials and methods

Following PRISMA guidelines, a systematic search was conducted in PubMed, Web of Science, IEEE Xplore, EMBASE, and Scopus (as of July 20, 2025). The initial search yielded 885 records, with eight studies meeting the inclusion criteria. The PICOS principle was applied to focus on AI models’ joint predictive ability and their clinical validation. QUADAS-2 and JBI tools were used to assess bias, and GRADE was applied to evaluate outcome certainty.

Results

The included AI models significantly enhanced prediction accuracy through innovations like CPSA, P2P-Conv, and DGCFP. Surface bias errors in critical areas were reduced, and clinical acceptance rates increased. However, challenges remain, including insufficient modeling of anatomical details, high sample homogeneity, and lack of standardized assessments.

Conclusion

AI-driven joint predictive modeling shows great potential for improving surgical accuracy and efficiency. Future work should focus on creating multicenter, cross-ethnic datasets, exploring hybrid architectures, and conducting prospective clinical validation to enhance generalizability. Establishing uniform evaluation standards, improving model interpretability, and enhancing ethical and privacy frameworks are also crucial for clinical translation.

Clinical relevance

Based on model evaluations, AI-based orthognathic prediction shows region-dependent accuracy: highest for the chin (genioplasty), followed by the mandibular body, and partial for the maxillary nasal base. Current models lack precision for lip aesthetics and 3D rotational displacement, but offer high value for rapid chin–mandible continuity predictions.

目的：本系统综述了人工智能在正颌手术后关节骨骼-软组织预测中的发展概况，并对其准确性进行了全面评价。材料和方法：遵循PRISMA指南，在PubMed， Web of Science, IEEE explore， EMBASE和Scopus（截至2025年7月20日）中进行了系统搜索。最初的检索产生了885条记录，其中8项研究符合纳入标准。应用PICOS原理，重点研究人工智能模型的联合预测能力及其临床验证。使用QUADAS-2和JBI工具评估偏倚，使用GRADE评估结果确定性。结果：纳入的人工智能模型通过CPSA、P2P-Conv和DGCFP等创新显著提高了预测精度。减少了关键部位的表面偏置误差，提高了临床接受率。然而，挑战仍然存在，包括解剖细节建模不足，样本同质性高，缺乏标准化评估。结论：人工智能驱动的关节预测建模在提高手术精度和效率方面具有很大的潜力。未来的工作应侧重于创建多中心、跨种族的数据集，探索混合架构，并进行前瞻性临床验证，以增强可泛化性。建立统一的评估标准，提高模型的可解释性，加强伦理和隐私框架对临床翻译也至关重要。临床相关性：基于模型评估，基于人工智能的正颌预测显示出区域依赖的准确性：下颌（颏成形术）最高，其次是下颌体，上颌鼻基部分。目前的模型在唇美学和三维旋转位移方面缺乏精度，但在快速预测下颌连续性方面具有很高的价值。

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引用次数: 0

Open reduction and internal fixation with disc reduction for pediatric condylar fractures: three-dimensional CT evaluation and follow-up results 儿童髁突骨折切开复位内固定配合椎间盘复位：三维CT评价及随访结果。

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.11.009

Jieyun Zhao , Chuan Lu , Huimin Zhu , Xiaoli Zhang , Hengxiang Sun , Xin Nie , Chi Yang , Dongmei He

Purpose

To evaluate the efficacy of open reduction and internal fixation (ORIF) with disc reduction for pediatric condylar fractures (CFs) and assess mandibular growth outcomes using three-dimensional (3D) CT measurement.

Materials and methods

Patients under 18 years with CF who underwent ORIF with disc reduction were recruited in the study. CT data including pre-operation, post-operation and at least 1 year follow-up were measured by ProPlan CMF 3.0 software for mandibular ramus height, mandibular body length, chin deviation and retrusion. Complications including bone resorption, fixation failure, temporomandibular joint ankylosis (TMJA), etc. were recorded.

Results

18 patients with 25 condylar fractures were included in the study. There were 6 males and 12 females with the mean age of 13.44 years (SD 2.87). 40 % (n = 10) of them were intracapsular condylar fractures, 52 % (n = 13) were condylar neck fractures and 8 % (n = 2) were subcondylar fractures. After ORIF, the mandibular ramus height was restored 4.53 mm (SD 2.89). Chin deviation was corrected 3.87 mm (SD 2.29) and chin retrusion was improved 3.29 mm (SD 2.88). After an average follow-up of 26.39 months (SD 13.19), the ramus grew 2.48 mm (SD 3.87) with no progressing jaw deformity. There were no complications such as hardware failure and ankylosis.

Conclusions

ORIF with disc reduction is effective for the treatment of pediatric CFs with regard to restoration of mandibular ramus height and prevention of progressive jaw deformity, bone resorption and ankylosis.

目的：评价切开复位内固定（ORIF）联合椎间盘复位治疗小儿髁突骨折（CFs）的疗效，并利用三维（3D） CT测量评估下颌骨生长情况。材料和方法：研究招募了18岁以下的CF患者，他们接受ORIF合并椎间盘复位。术前、术后及随访至少1年的CT资料采用ProPlan CMF 3.0软件测量下颌支高、下颌体长、下颌偏移、后缩情况。并发症包括骨吸收、固定失败、颞下颌关节强直（TMJA）等。结果：18例25例髁突骨折纳入研究。男性6例，女性12例，平均年龄13.44岁（SD 2.87）。其中，髁囊内骨折占40% (n = 10)，髁颈骨折占52% (n = 13)，髁下骨折占8% （n = 2）。ORIF术后下颌支高度恢复4.53 mm （SD 2.89）。下颌偏移矫正3.87 mm (SD 2.29)，下颌后缩改善3.29 mm （SD 2.88）。平均随访26.39个月（SD 13.19），支长2.48 mm (SD 3.87)，无进展性颌骨畸形。无硬件故障、强直等并发症。结论：ORIF联合椎间盘复位在恢复下颌支高度、防止进行性颌骨畸形、骨吸收和强直方面是治疗小儿慢性脊髓炎的有效方法。

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引用次数: 0

Design and application of submental island "kiss flap" 颏下岛“吻瓣”的设计与应用。

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.09.014

Lin Wang , Meng Wang , Fengzhi Liu , Dongpo Li , Yubo Wei , Shuangyi Wang , Xiurong Chen

This study aimed to investigate the clinical effects of the kiss flap and the conventional submental island flap for reconstruction after tongue cancer resection. From March 2023 to March 2025, 60 patients with T2–T4 tongue cancer underwent surgical resection. Of these, 16 patients underwent kiss flap reconstruction, and 44 underwent conventional submental island flap reconstruction. The patients were divided into two groups (kiss flap group and conventional flap group) using a double-blind method. The recovery times for speech, swallowing, tongue movement, and donor site complications were evaluated at the 6-month follow-up. SPSS 26.0 software was used for statistical analysis. There was no significant difference in speech intelligibility between the two groups (clarity: p = 0.717; acceptability: p = 0.823). However, the recovery of swallowing function in the kiss flap group was significantly better than that in the conventional flap group (MTF grade good: p = 0.021; acceptable: p = 0.002). Regarding tension at the donor site, the tension of the kiss flap was significantly lower than that of the conventional flap. Kiss flap repair provides tissue volume to the tongue and preserves its movement, speech intelligibility, and swallowing ability. The limitations of this study, including the unbalanced sample size and short follow-up period, along with the need for long-term aesthetic and functional assessments, are acknowledged and discussed in detail. The kiss flap needs further improvement to reduce complications and enhance patients’ quality of life. This study lays a foundation for such further improvement.

摘要本研究旨在探讨舌癌切除后吻骨瓣与传统颏下岛状皮瓣重建的临床效果。从2023年3月至2025年3月，60例T2-T4舌癌患者行手术切除。其中16例患者行吻瓣重建术，44例行常规颏下岛状皮瓣重建术。采用双盲法将患者分为两组（吻瓣组和常规瓣组）。随访6个月，观察两组患者言语、吞咽、舌动及供区并发症的恢复时间。采用SPSS 26.0软件进行统计分析。两组的语音可理解性无显著差异（清晰度：p = 0.717；可接受性：p = 0.823）。但吻接皮瓣组吞咽功能恢复明显优于常规皮瓣组（MTF分级良好：p = 0.021；可接受：p = 0.002）。在供区张力方面，吻合器瓣的张力明显低于常规皮瓣。舌瓣修复提供舌头的组织体积，并保持其运动，言语清晰度和吞咽能力。本文承认并详细讨论了本研究的局限性，包括样本量不平衡和随访时间短，以及需要长期的美学和功能评估。吻合器瓣需要进一步改进，以减少并发症，提高患者的生活质量。本研究为进一步完善奠定了基础。

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引用次数: 0

Bone from the bottom Up: Investigating dura-dependent osteoinduction in porous 3D-Printed ceramic scaffolds 骨自下而上：在多孔3d打印陶瓷支架中研究硬脑膜依赖性骨诱导。

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.10.006

Matthew Brett , John N. Muller , Lukasz Witek , Andrea Torroni , Nick Tovar , Edmara Bergamo , Bruno Luís Graciliano Silva , Roberto L. Flores

引用次数: 0

The skull base in NF1 phenotypes on lateral cephalograms 侧位脑电图上NF1表型的颅底。

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.09.011

Enno K. Lilienthal , Hannah T. Scheuer , Hanna A. Scheuer , Reinhard E. Friedrich

Neurofibromatosis type 1 (NF1) influences skeletal growth processes. We investigated the effect of the disease and associated neurogenic craniofacial tumors on the skull base.

We examined skull base parameters on lateral cephalograms in patients with (N = 74) facial plexiform neurofibroma (FPNF) and 92 without and the same number of age- and sex-matched controls. The measurements were analyzed for mean differences and certain parameters (sex, age (< or ≥ 18 years), tumor type). The application of the skull base angle as a diagnostic parameter was explored.

We found statistically significant elongation of the anterior and a shortening of the posterior skull base, as well as an increase of the skull base angle in NF1 patients compared with controls. The effect sizes of comparisons varied in strength. The effect of tumor type in NF1 patients on the parameter was revealed in adults.

NF1 and especially FPNF affect the development of the skull base. The changes in the posterior skull base may indicate the beginning of a continuum of posterior skull base dysplasia, as has been repeatedly described in NF1. However, differences in the measurements were small. The skull base relationships do not provide a skeletal basis defining a proposed pathognomonic NF1 facies.

1型神经纤维瘤病（NF1）影响骨骼生长过程。我们研究了该疾病和相关的颅底神经源性颅面肿瘤的影响。我们检查了面部丛状神经纤维瘤（FPNF）患者（N = 74）和92名非面部丛状神经纤维瘤患者（年龄和性别匹配的对照组）侧位脑电图上的颅底参数。分析测量结果的平均差异和某些参数（性别、年龄（<或≥18岁）、肿瘤类型）。探讨了颅底角作为诊断参数的应用。我们发现与对照组相比，NF1患者的前颅底明显延长，后颅底缩短，以及颅底角增加。比较的效应大小在强度上有所不同。在成人中发现NF1患者的肿瘤类型对该参数的影响。NF1，尤其是FPNF影响颅底发育。后颅底的变化可能表明后颅底发育不良连续体的开始，正如NF1中反复描述的那样。然而，测量结果的差异很小。颅底关系不能提供一个骨骼基础来定义NF1的病理特征。

{"title":"The skull base in NF1 phenotypes on lateral cephalograms","authors":"Enno K. Lilienthal , Hannah T. Scheuer , Hanna A. Scheuer , Reinhard E. Friedrich","doi":"10.1016/j.jcms.2025.09.011","DOIUrl":"10.1016/j.jcms.2025.09.011","url":null,"abstract":"<div><div>Neurofibromatosis type 1 (NF1) influences skeletal growth processes. We investigated the effect of the disease and associated neurogenic craniofacial tumors on the skull base.</div><div>We examined skull base parameters on lateral cephalograms in patients with (N = 74) facial plexiform neurofibroma (FPNF) and 92 without and the same number of age- and sex-matched controls. The measurements were analyzed for mean differences and certain parameters (sex, age (< or ≥ 18 years), tumor type). The application of the skull base angle as a diagnostic parameter was explored.</div><div>We found statistically significant elongation of the anterior and a shortening of the posterior skull base, as well as an increase of the skull base angle in NF1 patients compared with controls. The effect sizes of comparisons varied in strength. The effect of tumor type in NF1 patients on the parameter was revealed in adults.</div><div>NF1 and especially FPNF affect the development of the skull base. The changes in the posterior skull base may indicate the beginning of a continuum of posterior skull base dysplasia, as has been repeatedly described in NF1. However, differences in the measurements were small. The skull base relationships do not provide a skeletal basis defining a proposed pathognomonic NF1 facies.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 12","pages":"Pages 2118-2132"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226428","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

Long-term stability of outcomes in pediatric facial dysmorphic surgery: a retrospective analysis 儿童面部畸形手术预后的长期稳定性：回顾性分析。

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.09.018

Ambre Perrillat , Audrey Gallucci , Jean-Marc Foletti , Shani Diai , François Cheynet , Nicolas Graillon

This study aimed to assess occlusal stability following early orthognathic surgery. Complications, patient satisfaction, and correction of dysfunction were also assessed. Orthognathic surgery is considered early when it is performed before the end of growth. To this end, a retrospective study was conducted, involving patients aged between 11 and 16. In total, 51 patients were included (24 females and 27 males), with an average age of 14.7 years. The occlusal stability score at 3 years postoperatively was equal or superior to 8 in 76.5 % of the cases. The average occlusal stability score was 8.52/10 (SD = 2.17). Facial deformities recurred in seven patients (13.7 %). Three patients (5.8 %) required a second orthognathic surgery to correct facial deformity recurrence. Three patients (5.8 %) had bilateral partial sensory deficits of the inferior alveolar nerves. Two patients (3.9 %) had partial unilateral sensory deficits. Oral breathing significantly decreased from 54.9 % preoperatively to 25.5 % at 3 years postoperatively. Tongue position improved significantly at 3 years postoperatively, with 27.5 % of patients having a lower tongue versus 56.9 % during the preoperative period (p < 0.001). Our study revealed stable aesthetic and functional results at 3 years, as well as improved self-esteem and quality of life.

本研究旨在评估早期正颌手术后的咬合稳定性。对并发症、患者满意度和功能障碍矫正也进行了评估。在生长结束前进行的正颌手术被认为是早期手术。为此，我们对11 - 16岁的患者进行了回顾性研究。共纳入51例患者，其中女性24例，男性27例，平均年龄14.7岁。术后3年咬合稳定性评分等于或高于8分的占76.5%。平均咬合稳定性评分为8.52/10 （SD = 2.17）。面部畸形复发7例（13.7%）。3例患者（5.8%）需要第二次正颌手术来矫正面部畸形复发。3例患者（5.8%）有双侧下牙槽神经部分感觉缺损。2例患者（3.9%）有部分单侧感觉缺陷。术后3年，口腔呼吸率由术前的54.9%下降至25.5%。术后3年舌位明显改善，27.5%的患者有下舌，而术前为56.9%

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引用次数: 0

A portable mixed reality navigation system for oral and maxillofacial surgery: Design and preliminary clinical evaluation 一种用于口腔颌面外科的便携式混合现实导航系统：设计和初步临床评估。

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.10.007

Zhongjie Shi , Tianyi Li , Jianguo Ke , Jia Li , Xin Gao , Xinfeng Zhang , Xuan Wang , Yameng Si , Zhanxiang Wang

Objective

To develop a novel mixed reality (MR)-based portable navigation system for oral and maxillofacial surgery (OMFS) and to evaluate its feasibility and spatial accuracy in clinical applications.

Methods

The MR-based system was developed using Microsoft HoloLens 2, leveraging its built-in near-infrared cameras for reflective marker tracking. A customized software module, developed on the 3D Slicer platform, enabled automatic registration and real-time 3D anatomical visualization through a spatial pose filtering algorithm. A non-invasive patient-specific dental bracket was fabricated using silicone rubber for fixation and registration. A prospective clinical trial involving 24 patients was conducted. Navigation performance was quantitatively assessed by comparing preoperative and intraoperative registration errors, and qualitatively evaluated based on lesion overlap observed through the MR headset.

Results

The proposed MR system successfully achieved real-time 3D visualization and immersive intraoperative navigation without the use of external tracking devices. The mean preoperative localization error was 1.64 ± 0.78 mm, and the intraoperative error was 1.65 ± 1.00 mm (p = 0.44), indicating no significant difference. Among the 24 cases, 83.3 % demonstrated high virtual-to-actual concordance, while 16.7 % showed moderate concordance. The average data processing time was 8.38 ± 0.83 min, with improved efficiency observed over repeated trials.

Conclusion

The MR-based navigation system demonstrated good feasibility, accuracy, and usability for OMFS procedures. Its low cost, non-invasive design, and flexibility make it a promising intelligent surgical guidance tool for routine clinical practice, particularly in primary healthcare settings.

目的：研制一种新型的基于混合现实（MR）的口腔颌面外科（OMFS）便携式导航系统，并评估其在临床应用中的可行性和空间精度。方法：采用Microsoft HoloLens 2开发基于mr的系统，利用其内置的近红外相机进行反射标记跟踪。在3D Slicer平台上开发定制软件模块，通过空间姿态滤波算法实现自动配准和实时三维解剖可视化。使用硅橡胶制作非侵入性患者专用牙托进行固定和定位。对24例患者进行前瞻性临床试验。通过比较术前和术中配准误差对导航性能进行定量评估，并通过MR头显观察到的病变重叠对导航性能进行定性评估。结果：所提出的MR系统成功实现了实时三维可视化和沉浸式术中导航，无需使用外部跟踪设备。术前平均定位误差为1.64±0.78 mm，术中平均定位误差为1.65±1.00 mm (p = 0.44)，差异无统计学意义。在24例病例中，83.3%表现出高度的虚实一致性，16.7%表现为中度一致性。平均数据处理时间为8.38±0.83 min，在重复试验中效率有所提高。结论：磁共振导航系统在OMFS手术中具有良好的可行性、准确性和可用性。其低成本、非侵入性设计和灵活性使其成为常规临床实践中有前途的智能手术指导工具，特别是在初级卫生保健环境中。

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引用次数: 0

Diagnostic accuracy of ultrasound guided core needle biopsy in parotid gland neoplasms: A retrospective comparative study 超声引导下芯针活检对腮腺肿瘤诊断准确性的回顾性比较研究。

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.10.012

Giorgio Lo Giudice , Enrico Nastro Siniscalchi , Pasquale Arena , Antonio Bottari , Salvatore Silipigni , Alessandro Calvo , Francesco Saverio De Ponte , Alberto Stagno

Ultrasound-guided Core Needle Biopsies (CNBs) are minimally invasive procedures for diagnosing parotid gland neoplasms, aiming to reduce diagnostic uncertainty and guide management. This study evaluates the efficacy and reliability of CNBs in this context. We retrospectively analyzed 89 patients undergoing 98 CNB procedures. Diagnostic agreement and accuracy were assessed in two distinct subgroups with definitive histological confirmation from resected specimens. The first subgroup evaluated the initial CNB result, while a second subgroup assessed the final conclusive CNB result obtained through the diagnostic pathway. Statistical analyses included Fleiss' and Cohen's kappa coefficients, sensitivity, specificity, and predictive values. The initial CNB had a 7.0 % inconclusive rate. For initial CNB results (N = 40 for accuracy), agreement with histology was moderate (κ = .779), showing 80 % sensitivity and 97.14 % specificity in malignancy assessment. For final conclusive CNB results (N = 42 for accuracy), agreement was strong (κ = .853), demonstrating 100 % sensitivity and 97.37 % specificity. Overall accuracy improved from 95 % to 97.67 % when considering the complete diagnostic pathway. Salivary gland CNBs are a reliable tool for parotid neoplasm diagnosis. While initial attempts may sometimes be inconclusive, the comprehensive CNB diagnostic pathway, including repeat biopsies when necessary, significantly enhances diagnostic accuracy and provides critical guidance for patient management.

超声引导下的核心穿刺活检（CNBs）是诊断腮腺肿瘤的微创手术，旨在减少诊断的不确定性和指导治疗。本研究在此背景下评估CNBs的有效性和可靠性。我们回顾性分析了89例接受98例CNB手术的患者。在两个不同的亚组中评估诊断的一致性和准确性，并从切除的标本中获得明确的组织学证实。第一个亚组评估初始CNB结果，而第二个亚组评估通过诊断途径获得的最终结论性CNB结果。统计分析包括Fleiss和Cohen的kappa系数、敏感性、特异性和预测值。最初的CNB有7.0%的不确定率。对于初始CNB结果（准确性N = 40），与组织学的一致性中等（κ = .779），在恶性肿瘤评估中显示80%的敏感性和97.14%的特异性。对于最终的CNB结论性结果（准确性N = 42），一致性很强（κ = .853），显示100%的敏感性和97.37%的特异性。当考虑完整的诊断途径时，总体准确率从95%提高到97.67%。唾液腺cnb是腮腺肿瘤诊断的可靠工具。虽然最初的尝试有时可能不确定，但综合的CNB诊断途径，包括必要时的重复活检，可显着提高诊断准确性，并为患者管理提供重要指导。

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引用次数: 0

Sandwich osteotomy for 18 patients with insufficient fibular height after mandibular reconstruction using vascularized single-barrel free fibular flap: a retrospective study 带血管的单管游离腓骨瓣下颌骨重建术后腓骨高度不足的夹心截骨18例回顾性研究。

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

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.11.012

Chenxiao Zhu, Haibin Sun, Ming Su

The insufficient fibular height after mandibular reconstruction using vascularized single-barrel free fibular flap is a Gordian knot for implantation. Numerous studies have demonstrated that sandwich osteotomy is an effective technique for bone augmentation,so it is worth investigating whether it can achieve the same result used for transplanted fibula.A total of 18 patients were retrospectively enrolled. All patients underwent single-barrel free fibula flap repair for segmental mandibular defects but the fibular height was not sufficient for subsequent implantation, so sandwich osteotomy was used to increase the height of the fibula. Cone beam computed tomography was performed prior to and 1 day, 3 months, 6 months after sandwich osteotomy. Mimics 21.0 software was used to measure the bone height obtained.The mean vertical bone augmentation was 5.15 ± 0.4 mm (range, 3.3–6.92 mm) on the 1st day post-operation and gradually decreased, eventually stabilized about 6 months post-op.All patients received implants 6–8 months post-op. The implants achieved clinical osseointegration approximately 3 months after placement, and all patients successfully completed the subsequent crown restoration. In this study, the bone augmentation of the fibula and subsequent implant restoration were both successful. We believe that sandwich osteotomy is a convenient, safe and effective technique for fibular augmentation.

带血管的单管游离腓骨瓣重建下颌骨后腓骨高度不足是植入的难题。大量研究表明，夹心截骨术是一种有效的增骨技术，是否能达到与腓骨移植相同的效果值得探讨。回顾性研究共纳入18例患者。所有患者均行单桶游离腓骨瓣修复下颌骨节段性缺损，但腓骨高度不足以进行后续植入术，因此采用夹心截骨术增加腓骨高度。在夹层截骨术前、1天、3个月、6个月分别进行锥形束计算机断层扫描。采用Mimics 21.0软件测量所得骨高度。术后第1天平均垂直骨增高5.15±0.4 mm（范围3.3 ~ 6.92 mm），逐渐下降，术后6个月左右稳定。所有患者术后6-8个月接受种植。种植体在植入约3个月后实现临床骨整合，所有患者均成功完成后续的冠修复。在本研究中，腓骨的骨增强和随后的种植体修复都是成功的。我们认为夹心截骨术是一种方便、安全、有效的腓骨增强术。

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引用次数: 0