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Journal of Cranio-maxillo-facial Surgery

Lucas M Ritschl, Leonard H Schmidt, Andreas M Fichter, Alexander Hapfelmeier, Klaus-Dietrich Wolff, Thomas Mücke
Venous congestion results in tissue damage and remains the most common failure of free microvascular transfer if it is not recognized early. The purpose of this experimental study was to evaluate venous congestion and describe the findings with two different monitoring tools. A standardized epigastric flap was raised, and total occlusion of the draining vein was temporarily applied for 4, 5, 6, or 7 h. Blood flow measurements, including laser-Doppler flowmetry, and tissue spectrophotometry (O2C) and indocyanine green (ICG) videoangiography using the FLOW® 800 tool, were performed systematically after each surgical step, an interval of venous occlusion, and 1 week of clinical observation...
March 30, 2018: Journal of Cranio-maxillo-facial Surgery
Ambre Simon, Emmanuelle Bocquet, Philippe Pellerin, Matthieu Vinchon, Patrick Dhellemmes, Véronique Martinot, Alexis Wolber, Clotilde Calibre, Philippe Charlier, Pierre Guerreschi
Synostotic anterior plagiocephaly is a rare pathological cranial malformation. Therapeutic options are rarely studied due to the rarity of the malformation and difficulties in diagnosis and care management. The objective of this study was to analyze the results obtained with the Lille protocol based on 62 CT-scans done before and after surgery in 31 patients. A specific analysis was designed for this work. Nine cephalometric measures enabled to evidence on each CT-Scan the corrections made on the fronto-orbital bandeau and the potential impact of surgery on the craniofacial structures...
March 28, 2018: Journal of Cranio-maxillo-facial Surgery
Anson Dong, Kevin J Zuo, Georgina Papadopoulos-Nydam, Jaret L Olson, Gordon H Wilkes, Jana Rieger
Facial reanimation provides patients affected by chronic facial paralysis a chance to regain basic human functions such as emotional expression, verbal communication, and oral competence for eating and swallowing, but there is still no consensus as to the best way to measure surgical outcomes. We performed a literature review to investigate the different functional outcomes that surgeons use to evaluate facial function after reanimation surgery, focusing on outcomes other than facial expressions such as speech, oral competence, and patient quality of life/satisfaction...
March 22, 2018: Journal of Cranio-maxillo-facial Surgery
Rodrigo Fariña, Salvador Valladares, Araceli Raposo, Francisco Silva
PURPOSE: There are multiple conditions that may affect the development of the middle third of the face and with varying degrees of severity. The surgical treatment alternatives for major midfacial sagittal deficiencies consist in Le Fort I, II, or III with conventional osteotomies or with distraction osteogenesis (DO). Both techniques have advantages and disadvantages that should be evaluated specifically in each case. The aim of this report is to present a group of patients with severe hypoplasia of the middle third of the face, with different origins, and their treatment with a Modified Le Fort III osteotomy and distraction osteogenesis, using a minimally invasive surgical approach...
March 21, 2018: Journal of Cranio-maxillo-facial Surgery
Niyazi Aizezi, Tomohisa Nagasao, Tadaaki Morotomi, Motoki Tamai, Koji Imajo
PURPOSE: The authors hypothesized that the risks of optic canal injury in down-fracturing after Le Fort 3 osteotomy vary depending on the separation patterns of the orbital walls. This study verifies this hypothesis using biomechanical simulation. METHODS: Ten finite-element skull models were produced using computer tomography data from ten persons. These models were modified to simulate Le Fort 3 osteotomy models by removing junctions between the neurocranium and facial cranium...
March 21, 2018: Journal of Cranio-maxillo-facial Surgery
Matthias Zirk, Max Zinser, Johannes Buller, Viktor Bilinsky, Timo Dreiseidler, Joachim E Zöller, Matthias Kreppel
PURPOSE: Tranexamic acid (TXA) is widely used in the prevention of postsurgical oral bleeding. Tranexamic acid in addition to further surgical measures is widely utilized in prevention of post-surgical oral bleeding. The aim of the present study was to investigate: Can oral hemostasis be achieved by merely compression and topical application of tranexamic acid in different anticoagulant regimes among patients attending a general emergency department? Where are the limits to this procedure? Which has the greater impact on surgeons' choice for an invasive hemostatic approach-bleeding quality or oral anticoagulant therapy? MATERIALS AND METHODS: A retrospective cohort study of 542 patients who consecutively received treatment for oral bleeding was performed...
March 20, 2018: Journal of Cranio-maxillo-facial Surgery
Koryun Hakobyan, Yuri Poghosyan, Aram Kasyan
'Krokodil' is the street name of a new synthetic drug mixture. It is a light brown liquid that is used intravenously without previous purification. Osteonecrosis of the jaw (ONJ) is a common complication among Krokodil users. Krokodil drug-related ONJ presents as alveolar process exposure in the oral cavity. Surgery is the main method for treatment of Krokodil drug-related ONJ patients. In a study by Poghosyan et al., no cases of recurrence were seen after surgery on the maxilla, but 38% of cases (8/21) developed an oroantral communication after surgical treatment for maxillary osteonecrosis (Poghosyan et al...
March 20, 2018: Journal of Cranio-maxillo-facial Surgery
Oliver Ristow, Thomas Rückschloß, Jens Bodem, Moritz Berger, Eva Bodem, Steffen Kargus, Michael Engel, Jürgen Hoffmann, Christian Freudlsperger
INTRODUCTION: Mucosal wound closure plays a key role after surgery of manifested medication-related osteonecrosis of the jaw (MRONJ). Additional soft tissue layers promise better vascularization and mechanical stability. The objectives of this study were to examine success rates of double-layer closure techniques in MRONJ patients, namely the mylohyoideus muscle flap (MMF) for the lower jaw and the pedicled buccal fat flap (BFF) for the upper jaw. MATERIALS AND METHODS: We designed and implemented a restrospective cohort study and enrolled a sample of patients diagnosed with MRONJ that were treated between 2015 and 2017 with either the MMF or the BFF after removal of the necrotic bone areal...
March 14, 2018: Journal of Cranio-maxillo-facial Surgery
J Kraeima, B J Merema, M J H Witjes, F K L Spijkervet
OBJECTIVES: Patients suffering from osteoarthritis, ankylosis (e.g. post-trauma or tumour) in the temporomandibular joint (TMJ) can present with symptoms such as severely restricted mouth opening, pain or other dynamic restrictions of the mandible. To alleviate the symptoms, a total joint prosthesis can be indicated, such as the Groningen TMJ prosthesis. This was developed as a stock device with a lowered centre of rotation for improved translational and opening capacity. This study aimed to improve the design of the prosthesis, and produce a workflow for a customized Groningen TMJ prosthesis, in order to make it more accurate and predictable...
March 14, 2018: Journal of Cranio-maxillo-facial Surgery
Federico Biglioli, Federico Bolognesi, Fabiana Allevi, Dimitri Rabbiosi, Silvia Cupello, Antonino Previtera, Alessandro Lozza, Valeria M A Battista, Claudio Marchetti
Recent facial paralyses, in which fibrillations of the mimetic muscles are still detectable by electromyography (EMG), allow facial reanimation based on giving new neural stimuli to musculature. However, if more time has elapsed, mimetic muscles can undergo irreversible atrophy, and providing a new neural stimulus is simply not effective. In these cases function is provided by transferring free flaps into the face or transposing masticatory muscles to reinstitute major movements, such as eyelid closure and smiling...
March 14, 2018: Journal of Cranio-maxillo-facial Surgery
Jia-Zeng Su, Zhi-Gang Cai, Xiao-Jing Liu, Lan Lv, Guang-Yan Yu
BACKGROUND: Submandibular gland (SMG) transplantation is a successful treatment approach for patients with severe dry eye. However, duct obstruction can occur post-transplant. METHODS: We studied nineteen patients with duct obstruction of transplanted SMGs, including five interventional modalities: stone removal; secretory stimulation (to mimic "internal irrigation" with substantial secretory flow); irrigation; surgical opening of stenosis and orifice reconstruction; cephalic vein bypass and Wharton's duct reconstruction...
March 14, 2018: Journal of Cranio-maxillo-facial Surgery
Yunus Okcu, Jan Rustemeyer
Computer-aided design/manufacturing (CAD/CAM) is now widely used, but whether it can help to overcome complications in mandibular reconstruction and accelerate dental implantation is still a matter for debate. Therefore, we aimed to evaluate the benefits of this technique using vascularized iliac crest or fibula flaps in mandibular reconstruction, with respect to the time between reconstruction and implantation, and the ratio of planned to inserted implants. We reviewed retrospectively the records of 54 patients who underwent mandibular reconstructions between 2012 and 2016, and included in our study the last 10 cases representing each of the following groups: iliac crest flap with CAD/CAM (Group 1); fibula flap with CAD/CAM (Group 2); and fibula flap without CAD/CAM (Group 3)...
March 9, 2018: Journal of Cranio-maxillo-facial Surgery
Katinka Kansy, Jens Bodem, Michael Engel, Christian Freudlsperger, Markus A Möhlenbruch, Christian Herweh, Martin Bendszus, Jürgen Hoffmann, Steffen Kargus
INTRODUCTION: High-flow arteriovenous malformations (HF-AVMs) are congenital vascular malformations. Typical localizations include the face, oral cavity, and extremities. Due to the high recurrence rate of AVM after incomplete resection or embolization, a combination of both therapeutic modalities has become the preferred choice of treatment. Therefore, we have developed an interdisciplinary therapeutic treatment algorithm for facial HF-AVM and performed a systematic review of the literature...
March 9, 2018: Journal of Cranio-maxillo-facial Surgery
Davide Bartolomeo Gissi, Andrea Gabusi, Achille Tarsitano, Laura Luccarini, Luca Morandi, Lucio Montebugnoli
PURPOSE: Recent studies have emphasized the role of podoplanin in oral lesions at risk of malignant transformation. We investigated a group of oral leukoplakias (OLs) to determine a possible relation between altered podoplanin expression and dysplasia, and to compare the results with those obtained by other, widely used biomarkers. MATERIALS AND METHODS: The population consisted of 40 consecutive patients with a clinical and histological diagnosis of OL. Thirty-two OLs did not show dysplasia, whereas eight lesions presented with dysplasia...
March 9, 2018: Journal of Cranio-maxillo-facial Surgery
Hyung Hwa Jeong, Woo Shik Jeong, Jong Woo Choi, Seung Eun Jeong, Soon Yuhl Nam, Seung Ho Choi, Yoon Sei Lee, Hyeun A Kim, Young Jun Kim
BACKGROUND: A decreased flap volume can be an obstacle to proper phonation and swallowing. In this study we verified the proportion of volume decrease using 3D reconstructed images and identified the contributors to flap volume loss. METHODS: We retrospectively analyzed all patients who underwent radical excision of tongue cancer and reconstructive surgery in our institution from January 2003 to October 2016. Segmentation of the DICOM images, 3D rendering of the neotongue flap, and analysis of the reconstructed images were performed using SPlanner V1® software...
March 8, 2018: Journal of Cranio-maxillo-facial Surgery
Federico Biglioli, Fabiana Allevi, Dimitri Rabbiosi, Silvia Cupello, Valeria Marinella Augusta Battista, Alberto Maria Saibene, Giacomo Colletti
Recent facial palsies are those in which fibrillations of the mimetic musculature remain detectable by electromyography (EMG). Such fibrillations generally cease 18-24 months after palsy onset. During this period, facial re-animation surgery seeks to supply new neural inputs to the facial nerve. Neural usable sources were divided into qualitative (contralateral facial nerve) and quantitative (hypoglossus and masseteric nerve), depending on the type of stimulus provided. To further improve the extent and quality of facial re-animation, we here describe a new surgical technique featuring triple neural inputs: the use of the masseteric nerve and 30% of the hypoglossus nerve fibres as quantitative sources was associated with the contralateral facial nerve (incorporated via two cross-face nerve grafts) as a qualitative source in order to restore facial movements in 24 consecutive patients...
March 7, 2018: Journal of Cranio-maxillo-facial Surgery
Orhan Güven
PURPOSE: The formations of second or more condylar heads are considered as rare anomalies. Fourteen multi-headed condyles (MHC) were presented; 13 of these were bifid mandibular condyles (BMC), whereas one exceptionally rare case was a trifid mandibular condyle (TMC). The TMC presented in this paper is the eighth case reported in the literature. In this paper, etiopathogenesis, types, and treatments are discussed. MATERIALS AND METHODS: Patients were classified according to their status, etiologies, gender, functions of the mandible, interocclusal distances, pathological conditions, types, and treatment received...
March 1, 2018: Journal of Cranio-maxillo-facial Surgery
Fabio Rodríguez Sánchez, Carlos Rodríguez Andrés, Iciar Arteagoitia
OBJECTIVE: To assess which antibiotic regimen prevents dental implant failures or postoperative infections following dental implant placement. MATERIALS AND METHODS: Systematic review and meta-analysis. DATA SOURCES: Pubmed, Cochrane, Science Direct, and EMBASE via OVID were searched up to August 2017. Only randomized controlled clinical trials (RCT) using antibiotics were included. Outcome measures were set on dental implant failures or postoperative infection incidence after dental implant surgery...
February 26, 2018: Journal of Cranio-maxillo-facial Surgery
Jesper Jansen, Ruud Schreurs, Leander Dubois, Thomas J J Maal, Peter J J Gooris, Alfred G Becking
OBJECTIVE: Advanced three-dimensional (3D) diagnostics and preoperative planning are the first steps in computer-assisted surgery (CAS). They are an integral part of the workflow, and allow the surgeon to adequately assess the fracture and to perform virtual surgery to find the optimal implant position. The goal of this study was to evaluate the accuracy and predictability of 3D diagnostics and preoperative virtual planning without intraoperative navigation in orbital reconstruction. METHODS: In 10 cadaveric heads, 19 complex orbital fractures were created...
February 26, 2018: Journal of Cranio-maxillo-facial Surgery
R Lopez, P Gantet, A Julian, A Hitzel, B Herbault-Barres, S Alshehri, P Payoux
PURPOSE: To study an original 3D visualization of head and neck squamous cell carcinoma extending to the mandible by using [18F]-NaF PET/CT and [18F]-FDG PET/CT imaging along with a new innovative FDG and NaF image analysis using dedicated software. The main interest of the 3D evaluation is to have a better visualization of bone extension in such cancers and that could also avoid unsatisfying surgical treatment later on. PATIENTS AND METHODS: A prospective study was carried out from November 2016 to September 2017...
February 24, 2018: Journal of Cranio-maxillo-facial Surgery
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