Pub Date : 2024-10-01DOI: 10.1016/j.jormas.2024.101969
JB Caruhel , P Moulin , A Crambert , A Deygat
In rhinoplasty, diced cartilage with fascia (DC-F) is a commonly used technique to enhance dorsal projection and achieve a smooth dorsum. We have developed a modified technique by dissecting the thickness of the fascia along its width, called “Mini DC-F”. This method allows for effective camouflaging of dorsal irregularities and provides a slight increase in dorsal height. This simplified and less invasive technique not only reduces operative time but also enhances the surgeon's ability to achieve a refined aesthetic result. This technique offers an intermediate option in the surgical arsenal, bridging the gap between pure camouflaging methods and those aimed at significant dorsal augmentation.
{"title":"‘Mini DC-F’ in rhinoplasty: Diced cartilage and fascia grafts with the temporalis fascia dissected along its width – A technical note","authors":"JB Caruhel , P Moulin , A Crambert , A Deygat","doi":"10.1016/j.jormas.2024.101969","DOIUrl":"10.1016/j.jormas.2024.101969","url":null,"abstract":"<div><div>In rhinoplasty, diced cartilage with fascia (DC-F) is a commonly used technique to enhance dorsal projection and achieve a smooth dorsum. We have developed a modified technique by dissecting the thickness of the fascia along its width, called “Mini DC-F”. This method allows for effective camouflaging of dorsal irregularities and provides a slight increase in dorsal height. This simplified and less invasive technique not only reduces operative time but also enhances the surgeon's ability to achieve a refined aesthetic result. This technique offers an intermediate option in the surgical arsenal, bridging the gap between pure camouflaging methods and those aimed at significant dorsal augmentation.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"125 5","pages":"Article 101969"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jormas.2023.101499
Introduction. Although the related risk of vascular necrosis due to filler injection is low, the outcomes can be severe when they occur. This systematic review aims to report the occurrence and treatment of vascular necrosis due to filler injection. Materials and Methods: The systematic review was performed according to PRISMA guidelines. Results: The results showed the most used treatment is a combination of pharmacologic therapy and hyaluronidase application, which is efficacy when applied in the first 4 h. In addition, even though management recommendations are available in literature, proper guidelines are unavailable due to the low number of complications occurrence. Conclusion:Clinical and high-quality studies on treatment and management of filler injection combination are necessary to provide scientific evidence on what to do in case of vascular complication occurrence.
{"title":"Vascular complications with necrotic lesions following filler injections: Literature systematic review","authors":"","doi":"10.1016/j.jormas.2023.101499","DOIUrl":"10.1016/j.jormas.2023.101499","url":null,"abstract":"<div><div>Introduction. Although the related risk of vascular necrosis due to filler injection is low, the outcomes can be severe when they occur. This systematic review aims to report the occurrence and treatment of vascular necrosis due to filler injection. Materials and Methods: The systematic review was performed according to PRISMA guidelines. Results: The results showed the most used treatment is a combination of pharmacologic therapy and hyaluronidase application, which is efficacy when applied in the first 4 h. In addition, even though management recommendations are available in literature, proper guidelines are unavailable due to the low number of complications occurrence. Conclusion:Clinical and high-quality studies on treatment and management of filler injection combination are necessary to provide scientific evidence on what to do in case of vascular complication occurrence.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"125 5","pages":"Article 101499"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9453923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jormas.2023.101534
Regarding the three distinct types of zygomaticomaxillary complex (ZMC) fractures, this study developed finite element models (FEMs) of absorbable material and titanium material for repair and fixation, respectively. By applying a force of 120 N to the model to simulate the masseter muscle strength, the maximum stress and displacement of the repair materials and the fracture ends were measured. In discussing various models, the maximum stress values of absorbable and titanium materials are less than their yield strength, and the maximum displacement values of the titanium material and fracture end were less than 0.1 mm and 0.2 mm. The maximum displacement values of absorbable material and fracture end in incomplete zygomatic fracture and dislocation were less than 0.1 mm and 0.2 mm. While in the zygomatic complex complete fractures and dislocation, the maximum displacement values of the absorbable material and the fracture end exceeded 0.1 mm and 0.2 mm. Consequently, the distinction between the maximum displacement values of the two materials was 0.08 mm, and the distinction between the maximum displacement values of the fracture ends was 0.22 mm, despite the fact that the absorbable material can withstand the fracture end's strength, it is not as stable as the titanium material.
{"title":"Comparison of the biomechanical properties of internal fixation materials for zygomaticomaxillary complex fractures, A finite element analysis","authors":"","doi":"10.1016/j.jormas.2023.101534","DOIUrl":"10.1016/j.jormas.2023.101534","url":null,"abstract":"<div><div><span>Regarding the three distinct types of zygomaticomaxillary complex (ZMC) fractures, this study developed finite element models<span> (FEMs) of absorbable material and titanium material for repair and fixation, respectively. By applying a force of 120 N to the model to simulate the masseter muscle </span></span>strength<span>, the maximum stress and displacement of the repair materials and the fracture ends were measured. In discussing various models, the maximum stress values of absorbable and titanium materials are less than their yield strength, and the maximum displacement values of the titanium material and fracture end were less than 0.1 mm and 0.2 mm. The maximum displacement values of absorbable material and fracture end in incomplete zygomatic fracture and dislocation were less than 0.1 mm and 0.2 mm. While in the zygomatic complex complete fractures and dislocation, the maximum displacement values of the absorbable material and the fracture end exceeded 0.1 mm and 0.2 mm. Consequently, the distinction between the maximum displacement values of the two materials was 0.08 mm, and the distinction between the maximum displacement values of the fracture ends was 0.22 mm, despite the fact that the absorbable material can withstand the fracture end's strength, it is not as stable as the titanium material.</span></div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"125 5","pages":"Article 101534"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9637124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maxillofacial trauma often results in visible facial disfigurements and can lead to psychological complications such as post-traumatic stress disorder (PTSD). However, PTSD often remains unrecognized and un/undertreated. The goal of the current systematic review was to determine the incidence of PTSD after maxillofacial trauma, associated risk factors, assessment tools employed, and management.
Methods
A literature search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library databases following PRISMA guidelines up to March 2024. Collected variables included the number of patients included, PSTD assessment tool, PTSD incidence, and risk factors and management. The meta-analysis was conducted using random effect models in STATA 16.
Results
The review included 14 studies (1633 patients, male=1025, female=230, not mentioned=378). Assessment tools varied widely among studies. Meta-analysis revealed a pooled incidence of PTSD of 27 % (n = 14, 95 % CI, 24 %-30 %) at 1–3 months post-trauma and 10 % (n = 3, 95 % CI, 3 %-17 %) at the 6–12 months follow-up, with a statistically significant 60 % reduction between these periods.
Conclusion
The overall incidence of PTSD following maxillofacial trauma was 27 % at 1–3 months and decreased to 10 % after 6 months. The emphasis should be given to the importance of early intervention strategies and awareness among the treating surgeon to prevent PTSD.
{"title":"Post-traumatic stress disorder in maxillofacial trauma victims- A systematic review and meta-analysis","authors":"Babu Lal , Keshav Ganesh , Ragavi Alagarsamy , Snehil Gupta , Mohit Kumar , Arivarasan Barathi","doi":"10.1016/j.jormas.2024.101993","DOIUrl":"10.1016/j.jormas.2024.101993","url":null,"abstract":"<div><h3>Background</h3><div>Maxillofacial trauma often results in visible facial disfigurements and can lead to psychological complications such as post-traumatic stress disorder (PTSD). However, PTSD often remains unrecognized and un/undertreated. The goal of the current systematic review was to determine the incidence of PTSD after maxillofacial trauma, associated risk factors, assessment tools employed, and management.</div></div><div><h3>Methods</h3><div>A literature search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library databases following PRISMA guidelines up to March 2024. Collected variables included the number of patients included, PSTD assessment tool, PTSD incidence, and risk factors and management. The meta-analysis was conducted using random effect models in STATA 16.</div></div><div><h3>Results</h3><div>The review included 14 studies (1633 patients, male=1025, female=230, not mentioned=378). Assessment tools varied widely among studies. Meta-analysis revealed a pooled incidence of PTSD of 27 % (<em>n</em> = 14, 95 % CI, 24 %-30 %) at 1–3 months post-trauma and 10 % (<em>n</em> = 3, 95 % CI, 3 %-17 %) at the 6–12 months follow-up, with a statistically significant 60 % reduction between these periods.</div></div><div><h3>Conclusion</h3><div>The overall incidence of PTSD following maxillofacial trauma was 27 % at 1–3 months and decreased to 10 % after 6 months. The emphasis should be given to the importance of early intervention strategies and awareness among the treating surgeon to prevent PTSD.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"125 5","pages":"Article 101993"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jormas.2024.101798
Background
There is an urgent need to update the evidence available on the efficacy of photobiomodulation (PBM) in comparison to topical corticosteroids in the management of Oral Lichen Planus (OLP).
Methods
Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE Pubmed, SCOPUS, Lilacs and Google Scholar were searched. Other sources included US National Institutes of Health Ongoing Trials Register, World Health Organization International Clinical Trials Registry Platform and Clinical Trial Registry - India were searched using variations of the keywords “Laser” and “Oral Lichen Planus”. Randomized controlled trials comparing PBM and topical corticosteroids in the resolution of pain among OLP patients were included. The studies were assessed using the Cochrane Risk-of-Bias assessment tool. Publication bias was assessed using a funnel plot, and the certainty of evidence was evaluated according to the GRADE guidelines.
Results
Ten studies were included for qualitative assessment and of these eight were included in the meta-analysis. The included studies used laser parameters of varying strengths and duration. Meta-analysis favoured PBM (n = 274, MD =-0.48, CI -0.66- -0.30) for pain score. No adverse effects were reported for laser therapy. There was high heterogeneity and moderate certainty of evidence, and most studies had a high risk of bias.
Conclusion
There is improvement in the clinical parameters of OLP when treated with PBM in comparison to topical corticosteroids. However, the strength of the evidence for these findings in limited. It is recommended to conduct better long-term trials with large sample size.
{"title":"Efficacy of photobiomodulation in the management of oral Lichen Planus in comparison to topical corticosteroids: Systematic review, meta-analysis, and GRADE-based assessment of certainty of evidence","authors":"","doi":"10.1016/j.jormas.2024.101798","DOIUrl":"10.1016/j.jormas.2024.101798","url":null,"abstract":"<div><h3>Background</h3><div>There is an urgent need to update the evidence available on the efficacy of photobiomodulation (PBM) in comparison to topical corticosteroids<span> in the management of Oral Lichen Planus (OLP).</span></div></div><div><h3>Methods</h3><div><span>Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE Pubmed, SCOPUS, Lilacs and Google Scholar were searched. Other sources included US National Institutes of Health Ongoing Trials Register, World Health Organization International Clinical Trials Registry Platform and Clinical Trial Registry - India were searched using variations of the keywords “Laser” and “Oral Lichen Planus”. </span>Randomized controlled trials<span><span> comparing PBM and topical corticosteroids in the resolution of pain among OLP patients were included. The studies were assessed using the Cochrane Risk-of-Bias assessment tool. Publication bias was assessed using a </span>funnel plot, and the certainty of evidence was evaluated according to the GRADE guidelines.</span></div></div><div><h3>Results</h3><div>Ten studies were included for qualitative assessment and of these eight were included in the meta-analysis. The included studies used laser parameters of varying strengths and duration. Meta-analysis favoured PBM (<em>n</em><span><span> = 274, MD =-0.48, CI -0.66- -0.30) for pain score. No adverse effects were reported for </span>laser therapy. There was high heterogeneity and moderate certainty of evidence, and most studies had a high risk of bias.</span></div></div><div><h3>Conclusion</h3><div>There is improvement in the clinical parameters of OLP when treated with PBM in comparison to topical corticosteroids. However, the strength of the evidence for these findings in limited. It is recommended to conduct better long-term trials with large sample size.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"125 5","pages":"Article 101798"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139921681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jormas.2024.101853
Background
Tooth-supported surgical guides have demonstrated superior accuracy compared with bone-supported guides. This study aimed to modify the fabrication of tooth-supported guides for compatibility with tumor resection procedures and investigate their accuracy.
Methods
Patients with tumors who underwent osteotomy with the assistance of modified tooth- or bone-supported surgical guides were included. Virtual surgical planning (VSP) was employed to align three dimensional (3D) models extracted from intraoperative computed tomography (CT) images. The distances and angular deviations between the actual osteotomy plane and preoperative plane were recorded. A comparative analysis of osteotomy discrepancies between tooth-supported and bone-supported guides, as well as among tooth-supported guides based on CT, cone-beam CT (CBCT), or intraoral scanner (IOS) was conducted. The factors influencing the precision of the guides were analyzed.
Results
Sixty patients with 81 resection planes were included in this study. In the tooth-supported group, the mean deviations in the osteotomy plane and angle were 1.39 mm and 4.30°, respectively, whereas those of the bone-supported group were 2.16 mm and 4.95°. In the tooth-supported isotype guide groups, the mean deviations of the osteotomy plane were 1.39 mm, 1.47 mm, 1.23 mm across CT, CBCT, and IOS, respectively. The accuracy of the modified tooth-supported guides remained consistent regardless of number and position of the teeth supporting the guide and location of the osteotomy lines.
Conclusions
The findings indicate that the modified tooth-supported surgical guides demonstrated high accuracy in the maxillofacial region, contributing to a reduction in the amount of surgically detached soft tissue.
背景：与骨支持导板相比，牙支持手术导板具有更高的准确性。本研究旨在改进牙支持导板的制作，使其与肿瘤切除手术相兼容，并研究其准确性：方法：纳入在改良的齿或骨支持手术导板辅助下进行截骨术的肿瘤患者。采用虚拟手术规划（VSP）对齐从术中计算机断层扫描（CT）图像中提取的三维（3D）模型。记录实际截骨平面与术前平面之间的距离和角度偏差。对牙支撑和骨支撑导向器之间以及基于 CT、锥束 CT（CBCT）或口内扫描仪（IOS）的牙支撑导向器之间的截骨偏差进行了比较分析。结果：本研究共纳入了 60 例患者，81 个切除平面。在牙支持组中，截骨平面和角度的平均偏差分别为 1.39 mm 和 4.30°，而骨支持组为 2.16 mm 和 4.95°。在牙支持异型导板组中，CT、CBCT 和 IOS 截骨平面的平均偏差分别为 1.39 mm、1.47 mm 和 1.23 mm。无论支持导板的牙齿数量和位置以及截骨线的位置如何，改良的牙齿支持导板的准确性都保持一致：研究结果表明，改良牙齿支撑手术导板在颌面部区域表现出很高的精确度，有助于减少手术剥离软组织的数量。
{"title":"Accuracy of the modified tooth-supported 3D printing surgical guides based on CT, CBCT, and intraoral scanning in maxillofacial region: A comparison study","authors":"","doi":"10.1016/j.jormas.2024.101853","DOIUrl":"10.1016/j.jormas.2024.101853","url":null,"abstract":"<div><h3>Background</h3><div>Tooth-supported surgical guides have demonstrated superior accuracy compared with bone-supported guides. This study aimed to modify the fabrication of tooth-supported guides for compatibility with tumor resection procedures and investigate their accuracy.</div></div><div><h3>Methods</h3><div>Patients with tumors who underwent osteotomy with the assistance of modified tooth- or bone-supported surgical guides were included. Virtual surgical planning (VSP) was employed to align three dimensional (3D) models extracted from intraoperative computed tomography (CT) images. The distances and angular deviations between the actual osteotomy plane and preoperative plane were recorded. A comparative analysis of osteotomy discrepancies between tooth-supported and bone-supported guides, as well as among tooth-supported guides based on CT, cone-beam CT (CBCT), or intraoral scanner (IOS) was conducted. The factors influencing the precision of the guides were analyzed.</div></div><div><h3>Results</h3><div>Sixty patients with 81 resection planes were included in this study. In the tooth-supported group, the mean deviations in the osteotomy plane and angle were 1.39 mm and 4.30°, respectively, whereas those of the bone-supported group were 2.16 mm and 4.95°. In the tooth-supported isotype guide groups, the mean deviations of the osteotomy plane were 1.39 mm, 1.47 mm, 1.23 mm across CT, CBCT, and IOS, respectively. The accuracy of the modified tooth-supported guides remained consistent regardless of number and position of the teeth supporting the guide and location of the osteotomy lines.</div></div><div><h3>Conclusions</h3><div>The findings indicate that the modified tooth-supported surgical guides demonstrated high accuracy in the maxillofacial region, contributing to a reduction in the amount of surgically detached soft tissue.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"125 5","pages":"Article 101853"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jormas.2023.101514
Traumatic Ulcerative Granuloma with Stromal Eosinophilia (TUGSE)/Riga Fede disease is a rare mucosal and submucosal benign reactive inflammatory process, usually involving the tongue.
Trauma is believed to be a major factor amongst the multiple pathogenic mechanisms that have been hypothesized in TUGSE. The lesion presents as an isolated indurated or even ulcerated mass, which may mimic, clinically a squamous cell carcinoma (SCC).
We herein report a case of TUGSE in a 63-year-old male referred by his treating physician for high suspicion of tongue malignancy. Histopathological examination confirmed the diagnosis of TUGSE, without any evidence of a neoplasic, infectious or hematologic process.
TUGSE occurs in patients with an age range of 41–60 years. Sufficiently deep biopsies with comprehensive immunohistochemical and molecular analyses are mandatory to confirm the benign nature of the lesion and to, definitely, rule out malignancy.
This report highlights the need for adequate histological differential diagnosis to avoid inappropriate heavy treatments in a benign condition.
{"title":"Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE): Case report of a 63-year-old male patient with a rare self-healing oral mucosal lesion","authors":"","doi":"10.1016/j.jormas.2023.101514","DOIUrl":"10.1016/j.jormas.2023.101514","url":null,"abstract":"<div><div>Traumatic Ulcerative Granuloma with Stromal Eosinophilia<span> (TUGSE)/Riga Fede disease is a rare mucosal and submucosal benign reactive inflammatory process, usually involving the tongue.</span></div><div>Trauma is believed to be a major factor amongst the multiple pathogenic mechanisms that have been hypothesized in TUGSE. The lesion presents as an isolated indurated or even ulcerated mass, which may mimic, clinically a squamous cell carcinoma (SCC).</div><div>We herein report a case of TUGSE in a 63-year-old male referred by his treating physician for high suspicion of tongue malignancy. Histopathological examination confirmed the diagnosis of TUGSE, without any evidence of a neoplasic, infectious or hematologic process.</div><div>TUGSE occurs in patients with an age range of 41–60 years. Sufficiently deep biopsies with comprehensive immunohistochemical and molecular analyses are mandatory to confirm the benign nature of the lesion and to, definitely, rule out malignancy.</div><div>This report highlights the need for adequate histological differential diagnosis to avoid inappropriate heavy treatments in a benign condition.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"125 5","pages":"Article 101514"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9489119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jormas.2024.101927
Aim
The purpose of this clinical study was to evaluate the efficacy of the preseptal transconjunctival approach with Y modification of the cutaneous extension for the management of zygomaticomaxillary complex (ZMC) fractures.
Methods
This prospective interventional study was conducted at our institute from 2012 to 2020. The study included patients aged 15–65 years with displaced ZMC fractures. Patients with uncontrolled systemic conditions, infected and/or comminuted fractures were excluded. The variables evaluated were age, gender, mechanism of injury, fracture side, clinical features, surgical exposure time, adequacy of exposure, complications, scar evaluation scores and cosmetic outcomes. The parameters for comparison were operated versus non operated side Eye Fissure Index (EFI) and surgical exposure time was compared with respect to the types of scars.
Results
A total of 49 patients were included in this study. The average exposure time was 18.87 ± 1.92 min. The exposure of fracture site was excellent in 73.5 % and satisfactory in 26.5 %. The mean EFI of operated side was 34.2 ± 5.04 mm while that of non-operated side was 34.22 ± 5 mm. On comparison of the same there was no significant difference. Invisible scars were noted in 71.4 % and barely visible scars in 22.4 %. The comparison of exposure time with type of scars showed a significant association (p = 0.02). The complications noted were chemosis, lower eyelid edema, conjunctival granuloma and entropion. Cosmetic outcomes were fairly satisfactory.
Conclusion
The Y modification of the transconjunctival approach can provide excellent surgical exposure without the need for a second incision. Although this approach is technique sensitive and requires experience, the advantages outweigh the learning curve. Since this approach has been widely studied, a systematized review is recommended to further substantiate its reliability and advantages.
{"title":"‘Y’ Modification of the cutaneous incision of the preseptal transconjunctival approach for the management of zygomatico-maxillary complex fractures: A prospective clinical study","authors":"","doi":"10.1016/j.jormas.2024.101927","DOIUrl":"10.1016/j.jormas.2024.101927","url":null,"abstract":"<div><h3>Aim</h3><div>The purpose of this clinical study was to evaluate the efficacy of the preseptal transconjunctival approach with Y modification of the cutaneous extension for the management of zygomaticomaxillary complex (ZMC) fractures.</div></div><div><h3>Methods</h3><div>This prospective interventional study was conducted at our institute from 2012 to 2020. The study included patients aged 15–65 years with displaced ZMC fractures. Patients with uncontrolled systemic conditions, infected and/or comminuted fractures<span><span> were excluded. The variables evaluated were age, gender, mechanism of injury, fracture side, </span>clinical features, surgical exposure time, adequacy of exposure, complications, scar evaluation scores and cosmetic outcomes. The parameters for comparison were operated versus non operated side Eye Fissure Index (EFI) and surgical exposure time was compared with respect to the types of scars.</span></div></div><div><h3>Results</h3><div>A total of 49 patients were included in this study. The average exposure time was 18.87 ± 1.92 min. The exposure of fracture site was excellent in 73.5 % and satisfactory in 26.5 %. The mean EFI of operated side was 34.2 ± 5.04 mm while that of non-operated side was 34.22 ± 5 mm. On comparison of the same there was no significant difference. Invisible scars were noted in 71.4 % and barely visible scars in 22.4 %. The comparison of exposure time with type of scars showed a significant association (<em>p</em><span><span> = 0.02). The complications noted were chemosis<span>, lower eyelid edema<span>, conjunctival granuloma and </span></span></span>entropion. Cosmetic outcomes were fairly satisfactory.</span></div></div><div><h3>Conclusion</h3><div>The Y modification of the transconjunctival approach can provide excellent surgical exposure without the need for a second incision. Although this approach is technique sensitive and requires experience, the advantages outweigh the learning curve. Since this approach has been widely studied, a systematized review is recommended to further substantiate its reliability and advantages.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"125 5","pages":"Article 101927"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jormas.2024.101984
Istemihan Coban , Fulya Yaprak , Yelda Pinar
Introduction
Facial reanimation procedures are used in the treatment of the disorder that impairs mimetic function and jeopardizes physical and psychological health, and one of the most important instruments of these techniques is the masseteric neurovascular bundle (NVB) and proper identification at the mandibular notch level. In the current study, a triangular area (deep masseteric triangle, DMT) on the lateral surface of the masseter muscle that was identified to help reliable determination of the masseteric NVB at the mandibular notch level.
Material and methods
40 parotideomasseteric region dissections were performed in 10 female and 10 male donated cadavers. Structures lateral to the masseter muscle were removed. The edge length of the masseter muscle on the zygomatic arch side was measured. After the edges of the DMT were measured, the masseteric NVB was found by dissection and its distance (depth) from the skin line was measured.
Results
The mean lengths of the superior, posterior, and anterior margins were 17.3 (±4.5) mm, 25.9 (±6.2) mm, and 26.3 (±6.5) mm, respectively. The total length of the upper edge of the masseteric muscle attached to the zygomatic arch averaged 52.7 (±5.2) mm. The masseteric neurovascular bundle was detected at a depth of approximately 17 mm from the skin of the parotideamasseteric region.
Discussion
The visualization of the DMT can be used as an important landmark for access to branch-free part of the masseteric nerve. Moreover, an specific approach for masseteric NVB localization can be established by drawing a line between the mandibular angle and the midpoint of the upper edge of the DMT. This technique can greatly improve the accuracy of both masseteric nerve harvesting and masseteric nerve block procedures.
{"title":"Deep masseteric triangular area to define masseter neurovascular bundle: A cadaveric study","authors":"Istemihan Coban , Fulya Yaprak , Yelda Pinar","doi":"10.1016/j.jormas.2024.101984","DOIUrl":"10.1016/j.jormas.2024.101984","url":null,"abstract":"<div><h3>Introduction</h3><div>Facial reanimation procedures are used in the treatment of the disorder that impairs mimetic function and jeopardizes physical and psychological health, and one of the most important instruments of these techniques is the masseteric neurovascular bundle (NVB) and proper identification at the mandibular notch level. In the current study, a triangular area (deep masseteric triangle, DMT) on the lateral surface of the masseter muscle that was identified to help reliable determination of the masseteric NVB at the mandibular notch level.</div></div><div><h3>Material and methods</h3><div>40 parotideomasseteric region dissections were performed in 10 female and 10 male donated cadavers. Structures lateral to the masseter muscle were removed. The edge length of the masseter muscle on the zygomatic arch side was measured. After the edges of the DMT were measured, the masseteric NVB was found by dissection and its distance (depth) from the skin line was measured.</div></div><div><h3>Results</h3><div>The mean lengths of the superior, posterior, and anterior margins were 17.3 (±4.5) mm, 25.9 (±6.2) mm, and 26.3 (±6.5) mm, respectively. The total length of the upper edge of the masseteric muscle attached to the zygomatic arch averaged 52.7 (±5.2) mm. The masseteric neurovascular bundle was detected at a depth of approximately 17 mm from the skin of the parotideamasseteric region.</div></div><div><h3>Discussion</h3><div>The visualization of the DMT can be used as an important landmark for access to branch-free part of the masseteric nerve. Moreover, an specific approach for masseteric NVB localization can be established by drawing a line between the mandibular angle and the midpoint of the upper edge of the DMT. This technique can greatly improve the accuracy of both masseteric nerve harvesting and masseteric nerve block procedures.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"125 5","pages":"Article 101984"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jormas.2024.101814
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