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https://www.readbyqxmd.com/read/28228324/extended-maxillotomy-for-skull-base-access-in-contemporary-management-of-chordomas-rationale-and-technical-aspect
#1
Muhammad Fahmi Abdul Jalil, Rowan D Story, Myron Rogers
Minimally invasive approaches to the central skull base have been popularized over the last decade and have to a large extent displaced 'open' procedures. However, traditional skull base surgery still has its role especially when dealing with a large clival chordoma where maximal surgical resection is the principal goal to maximize patient survival. In this paper, we present a case of a 25year-old male patient with chordoma in the inferior clivus which was initially debulked via a transnasal endoscopic approach...
February 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28195897/base-of-skull-blocks-for-open-reduction-and-internal-fixation-of-faciomaxillary-fractures
#2
Sandeep Mehrotra, Sunil Anand
INTRODUCTION: Faciomaxillary fractures (FMF) occur in a significant proportion of trauma patients. Nearly all polytrauma patients and even those with isolated FMF are managed under general anesthesia for definitive management. We propose the use of regional nerve blocks as a safe and effective means for open reduction and fixation of isolated FMF. AIM AND OBJECTIVES: The aim is to evaluate the feasibility, effectiveness and safety of base of skull maxillomandibular and distal trigeminal nerve blocks in the management of FMF...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28181788/measuring-effectiveness-of-orthognathic-surgery-by-electromyography-a-restrospective-clinical-study
#3
Giovanni B Grossi, Umberto Garagiola, Franco Santoro
BACKGROUND: This study investigates retrospectively if the initial electromyography (EMG) status of patients who underwent orthognathic surgery correlates with the extent of post-surgical EMG functional recovery. METHODS: Clinical records concerning 20 patients who underwent Le Fort I and/or sagittal osteotomy of the mandibular ramus to correct skeletal dental class III malocclusions were retrieved and pre-surgical and post-surgical EMG data were analyzed and compared...
February 9, 2017: Minerva Stomatologica
https://www.readbyqxmd.com/read/28154745/transverse-expansion-and-stability-after-segmental-le-fort-i-osteotomy-versus-surgically-assisted-rapid-maxillary-expansion-a-systematic-review
#4
REVIEW
Thomas Starch-Jensen, Tue Lindberg Blæhr
OBJECTIVES: The objective of the present systematic review was to test the hypothesis of no difference in transverse skeletal and dental arch expansion and relapse after segmental Le Fort I osteotomy versus surgically assisted rapid maxillary expansion. MATERIAL AND METHODS: A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted by including human studies published in English from January 1, 2000 to June 1, 2016...
October 2016: Journal of Oral & Maxillofacial Research
https://www.readbyqxmd.com/read/28153564/computer-assisted-surgical-planning-and-simulation-for-unilateral-condylar-benign-lesions-causing-facial-asymmetry
#5
Chuan Lu, Dongmei He, Chi Yang, Dong Huang, Edward Ellis
OBJECTIVE: The purpose of this study was to investigate the best surgical sequence for the treatment of unilateral condylar benign lesions causing facial asymmetry by applying computer-assisted surgical planning and simulation. STUDY DESIGN: Computed tomography (CT) data from 12 patients whose maxillary cant was corrected by maintaining the vertical position of the central incisors and equally intruding the long side of the maxilla and extruding the short side were analyzed by ProPlan CMF 1...
December 7, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28141644/midfacial-changes-through-anterior-maxillary-distraction-osteogenesis-in-patients-with-cleft-lip-and-palate
#6
Hiroyuki Kanzaki, Yoshimichi Imai, Tetsu Nakajo, Takayoshi Daimaruya, Akimitsu Sato, Masahiro Tachi, Youhei Nunomura, Yusuke Itagaki, Kazuaki Nishimura, Shoko Kochi, Kaoru Igarashi
Maxillary hypoplasia is a major issue in cleft lip and palate patients, and predictable surgical maxillary advancement is required. In the present study, the changes and stability of the maxilla and soft tissue profile achieved after the application of anterior maxillary distraction osteogenesis (AMDO) using intraoral expander in unilateral cleft lip and palate and isolated cleft palate patients were investigated by comparing to the Le Fort I osteotomy (LFI) and maxillary distraction osteogenesis (DO) with rigid external distraction (RED) system...
January 30, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28130079/risk-analyses-of-pressure-ulcer-in-tetraplegic-spinal-cord-injured-persons-a-french-long-term-survey
#7
Marc Le Fort, Maude Espagnacq, Brigitte Perrouin-Verbe, Jean-François Ravaud
OBJECTIVE: To identify the long-term clinical, individual, and social risk factors for the development of pressure ulcers (PUs) in traumatic spinal cord-injured persons with tetraplegia (TSCIt). DESIGN: Cohort survey with self-applied questionnaires in 1995 and 2006. SETTING: Thirty-five French-speaking European physical medicine and rehabilitation centers participating in the Tetrafigap surveys. PARTICIPANTS: A total of 1641 tetraplegic adults were surveyed after an initial post-traumatic period of at least 2 years...
January 24, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28128659/remifentanil-reduces-blood-loss-during-orthognathic-surgery
#8
Nobuyuki Matsuura, Taiki Okamura, Satoko Ide, Tatsuya Ichinohe
Remifentanil is reported to reduce oral tissue blood flow. We performed a retrospective investigation using logistic regression analysis of anesthesia records to investigate whether the use of remifentanil infusion in a balanced anesthesia technique was useful as a primary technique to reduce blood loss during orthognathic surgery. Subjects were 80 patients who underwent Le Fort I osteotomy and sagittal split ramus osteotomy of the mandible. The variables included gender, age, weight, type of maintenance anesthetic, type and dose or infusion rate of opioid, mean systolic blood pressure (SBP-mean), coefficient of variation of systolic blood pressure (CVSBP) during surgery, mean heart rate (HR-mean), duration of surgery, total blood loss, volume of infusion used, amount of local anesthetic used, body temperature, and urine output...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28106695/velopharyngeal-insufficiency-after-le-fort-i-osteotomy-in-a-patient-with-undiagnosed-occult-submucous-cleft-palate
#9
Rushil R Dang, Bonnie L Padwa, Cory M Resnick
The authors present a 16-year-old patient with no known history of cleft palate who developed velopharyngeal insufficiency after a Le Fort I osteotomy performed for the correction of maxillary hypoplasia and a Class III malocclusion. Postoperative evaluation revealed the presence of velopharyngeal insufficiency and subtle findings of an occult submucous cleft palate. She had a pharyngeal flap 6 months later with successful correction of the velopharyngeal insufficiency. This case illustrates the need to screen for submucous cleft palate prior to orthognathic surgery...
January 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28089389/three-dimensional-finite-element-model-to-predict-patterns-of-pterygomaxillary-dysjunction-during-le-fort-i-osteotomy
#10
H Fujii, N Kuroyanagi, T Kanazawa, S Yamamoto, H Miyachi, K Shimozato
The aim of this study was to determine whether non-linear three-dimensional finite element analysis (3D-FEA) can be applied to simulate pterygomaxillary dysjunction during Le Fort I osteotomy (LFI) not involving a curved osteotome (LFI-non-COSep), and to predict potential changes in the fracture pattern associated with extending the cutting line. Computed tomography (CT) image data (100 snapshots) after LFI were converted to 3D-CT images. 3D-FEA models were built using preoperative CT matrix data and used to simulate pterygomaxillary dysjunction...
January 12, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28063531/traitements-visant-la-vessie-hyperactive-accent-sur-la-pharmacoth%C3%A3-rapie
#11
Roxana Geoffrion
OBJECTIF: Offrir des lignes directrices en matière de pharmacothérapie pour la prise en charge du syndrome de la vessie hyperactive (VHA). OPTIONS: Parmi les agents pharmacothérapeutiques permettant la prise en charge du VHA, on trouve les anticholinergiques (antimuscariniques) et les œstrogènes administrés par voie vaginale. Des préparations anticholinergiques orales et transdermiques sont disponibles. ISSUES: Fournir une compréhension des données actuellement disponibles au sujet de l'innocuité et de l'efficacité clinique de la pharmacothérapie dans la prise en charge du VHA; orienter la sélection du traitement anticholinergique en fonction des caractéristiques personnelles des patientes...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28060091/midface-distraction-osteogenesis-using-a-modified-external-device-with-elastic-distraction-for-crouzon-syndrome
#12
Haizhou Tong, Lei Liu, Xiaojun Tang, Tao Song, Ningbei Yin, Zhiyong Zhang, Zhenmin Zhao
PURPOSE: Midface distraction osteogenesis has been popularized for the correction of midface hypoplasia associated with exophthalmos and obstructive sleep apnea in patients with Crouzon syndrome. The purpose of this study was to present the method of utilizing the modified external device with elastic distraction for the midface advancement in Crouzon syndrome, and the clinical outcomes and skeletal changes were analyzed. METHODS: Five consecutive patients with Crouzon syndrome underwent Le Fort III osteotomy with midface advancement using a modified external device with elastic distraction...
January 5, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28049608/electromagnetic-navigated-positioning-of-the-maxilla-after-le-fort-i-osteotomy-in-preclinical-orthognathic-surgery-cases
#13
Moritz Berger, Igor Nova, Sebastian Kallus, Oliver Ristow, Urs Eisenmann, Christian Freudlsperger, Robin Seeberger, Jürgen Hoffmann, Hartmut Dickhaus
OBJECTIVES: Inaccuracies in orthognathic surgery can be caused during face-bow registration, model surgery on plaster models, and intermaxillary splint manufacturing. Electromagnetic (EM) navigation is a promising method for splintless digitized maxillary positioning. STUDY DESIGN: After performing Le Fort I osteotomy on 10 plastic skulls, the target position of the maxilla was guided by an EM navigation system. Specially implemented software illustrated the target position by real-time multistage colored three-dimensional imaging...
March 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28045827/bone-substitutes-in-le-fort-i-osteotomy-to-promote-bone-union-and-skeletal-stability
#14
Leonardo Matos Santolim Zanettini, Guilherme Genehr Fritscher, Ricardo Giacomini De Marco, Fernando de Oliveira Andriola, Rogério Miranda Pagnoncelli
Maxillary advancement by Le Fort I osteotomy has become the standard procedure to restore function and facial esthetics, correct skeletal and occlusal discrepancies, and treat obstructive sleep apnea in patients with facial deformities. Incomplete ossification between the bone segments at the jaw osteotomy site has proven to be a major problem in these patients. There are several studies in the literature that address orthognathic surgery, but only a limited number that discuss the use of graft materials in maxillary osteotomy...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28027171/measurement-of-distraction-force-in-cleft-lip-and-palate-patients-during-le-fort-i-maxillary-advancement-with-rigid-external-distraction
#15
Hiromi Sawada, Takuya Ogawa, Keiichi Kataoka, Yoshiyuki Baba, Keiji Moriyama
OBJECTIVE: Maxillary distraction osteogenesis (DO) is a mainstream surgical technique for patients who have severe maxillary hypoplasia associated with craniofacial syndromes and cleft-related deformities. However, limited information about the biomechanical aspects of maxillary DO is available limiting broad utilization and improvements to the procedure. The objective of this study was to analyze force levels during the active distraction process and to investigate the relationship between distraction force and maxillary movement during Le Fort I maxillary DO using a rigid external distraction (RED) system...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005730/correction-of-a-long-face-simultaneous-reduction-of-the-upper-lip-using-a-modified-endonasal-technique-and-le-fort-i-osteotomy-superior-impaction
#16
Seungil Chung, Sanghoon Park
BACKGROUND: Although Le Fort I osteotomy superior impaction during bimaxillary surgery is beneficial for patients with a long face, achieving satisfactory results can be challenging due to the redundant upper lip. However, upper-lip reduction has rarely been performed during or following bimaxillary surgery because of the difficulty in estimating the required amount of cutaneous resection needed and the apparent horizontal scars left behind. Therefore, no simultaneous cutaneous upper-lip reduction with orthognathic surgery has been reported...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005656/skeletal-changes-of-an-osteomyocutaneous-facial-allograft-five-years-following-transplantation
#17
Bahar Bassiri Gharb, Antonio Rampazzo, Gaby Doumit, Steven Bernard, Maria Siemionow, Francis Papay, Risal Djohan
BACKGROUND: More than 30 face transplantations have been performed worldwide, most including part of the facial skeletal framework. In this study, the modifications of the skeletal component of a facial allograft were evaluated. METHODS: Standard head computed tomography (CT) scans, CT angiogram, and bone mineral densitometry were evaluated. Cephalometric analysis was performed. The pre and postoperative CT images were overlapped and the skeletal changes were expressed in a numeric and color-coded scale...
December 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27997450/acellular-dermal-matrix-as-an-adjunct-material-in-cleft-le-fort-i-osteotomies
#18
Srinivas M Susarla, Zoe M MacIsaac, Edward Swanson, Edward Davidson, Anand Kumar
PURPOSE: To evaluate the use of acellular dermal matrix in the management of nasal lining deficiency at the time of Le Fort I osteotomy. METHODS: This was a retrospective cohort study of patients with residual/recurrent oronasal fistulae who underwent Le Fort I osteotomy. In instances where there was an inadequate volume of nasal mucosa for tension-free closure or for defects >1 cm in width, the acellular dermal matrix was used for augmentation. Demographic and cleft-related factors were recorded...
January 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27986471/retrospective-clinical-study-of-maxillary-sagittal-fractures-predictors-of-postoperative-outcome
#19
Krishna Prasad Regmi, JunBo Tu, SuMeng Ge, ChengQun Hou, XiaoYi Hu, ShiXian Li, JingTing Du
PURPOSE: Because of less attention to the sagittal component of maxillary fractures, these fractures are often misdiagnosed and the reduction leading to maxillary transverse discrepancies is missed. Therefore, the purpose of this study was to identify factors associated with good or adverse postoperative outcomes of maxillary sagittal fractures. MATERIALS AND METHODS: This study was a single-center retrospective cohort study. The sample was composed of cases of maxillary sagittal fractures treated at the Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Trauma Unit of Xi'an Jiaotong University (Xi'an, China) from January 2008 through December 2013...
November 23, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27977828/modified-lip-repositioning-with-esthetic-crown-lengthening-a-combined-approach-to-treating-excessive-gingival-display
#20
Isis M Sánchez, Sadja Gaud-Quintana, Jacob K Stern
Lip repositioning surgery to address excessive gingival display induced by different etiologies has received major attention recently. Several techniques and variations have been reported, including myotomy or repositioning of the levator labii superioris muscle, Le Fort impaction, maxillary gingivectomies, botulinum toxin injections, and lip stabilization. This study reports a case of excessive gingival display treated by a modified combined approach. A 25-year-old woman with a 4- to 8-mm gingival display when smiling caused by a combination of short clinical crowns induced by an altered passive eruption and hypermobility of the upper lip underwent a staged esthetic crown-lengthening procedure followed by a modified lip repositioning technique...
January 2017: International Journal of Periodontics & Restorative Dentistry
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