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Maxillofacial reconstruction

Amir Wolff, Gabriel F Santiago, Micah Belzberg, Omri Emodi, Chad R Gordon
INTRODUCTION: Combined mid-face and nasal apparatus trauma injuries pose a significant challenge to airway patency (AW), in the immediate postoperative setting following fracture reduction. As such, the authors describe a modified technique with the goal of maintaining a patent nasal AW, while at the same time, minimizing nasopharyngeal bleeding and nasal AW edema-which can complicate patients requiring intermaxillary fixation (IMF) in the setting of pan-facial trauma. METHODS: A modified technique was devised to assist the reconstruction surgeon in avoiding the risks associated with tracheostomy placement...
March 20, 2018: Journal of Craniofacial Surgery
Daniele Gibelli, Michaela Cellina, Stefano Gibelli, Antonio Giancarlo Oliva, Giovanni Termine, Valentina Pucciarelli, Claudia Dolci, Chiarella Sforza
PURPOSE: Surgical reconstruction of zygomatic bones in cases of traumatic injuries is a frequent event: assessment of symmetry is mandatory for a correct restoration of zygomatic shape, but the literature is discordant about its quantification. The purpose of this study is to show a novel method for assessing symmetry of zygomatic bone through mirroring of 3D models segmented on CT-scan. MATERIALS AND METHODS: A total of 100 patients (50 male and 50 female), divided into two age groups (18-49 years and 50-92 years) were selected from the computed tomography (CT) scan database of a hospital in northern Italy...
February 22, 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
Keisuke Sugahara, Yoshiharu Katsumi, Masahide Koyachi, Yu Koyama, Satoru Matsunaga, Kento Odaka, Shinichi Abe, Masayuki Takano, Akira Katakura
Background: Along with the advances in technology of three-dimensional (3D) printer, it became a possible to make more precise patient-specific 3D model in the various fields including oral and maxillofacial surgery. When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model. However, while models created with a separate mandible and maxilla have operability, it can be difficult to fully restore the position of the condylar after simulation...
December 2018: Maxillofacial Plastic and Reconstructive Surgery
A Llobet, N Nieto, A Damecourt, S Galmiche, M de Boutray
INTRODUCTION: The omental free flap is an effective tool for craniofacial reconstruction. However it is generally under-utilised by a large number of practitioners. This paper's goal is to increase awareness of this free flap's accessibility and to demonstrate that it can be an attractive option for reconstructive surgery. CLINICAL REPORT: This article outlines the details of a 57-year-old patient who required coverage of a fronto-parietal wound with dura mater exposure...
March 9, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Andrea Amaroli, Dimitrios Agas, Fulvio Laus, Vincenzo Cuteri, Reem Hanna, Maria Giovanna Sabbieti, Stefano Benedicenti
The literature has supported the concept of mesenchymal stromal cells (MSCs) in bone regeneration as one of the most important applications in oro-maxillofacial reconstructions. However, the fate of the transplanted cells and their effects on the clinical outcome is still uncertain. Photobiomodulation (PBM) plays an important role in the acceleration of tissue regeneration and potential repair. The aim of this in vitro study is to evaluate the effectiveness of PBM with 808 nm diode laser therapy, using a flat-top hand-piece delivery system at a higher-fluence (64 J/cm2 ) irradiation (1 W, continuous-wave) on bone marrow stromal cells (BMSCs)...
2018: Frontiers in Physiology
Oliver C Thiele, Matthias Kreppel, Anton Dunsche, Andre M Eckardt, Michael Ehrenfeld, Bernd Fleiner, Volker Gaßling, Gerd Gehrke, Marcus Gerressen, Martin Gosau, Alexander Gröbe, Stefan Haßfeld, Max Heiland, Bodo Hoffmeister, Frank Hölzle, Cornelius Klein, Maximilian Krüger, Alexander C Kübler, Norbert R Kübler, Johannes J Kuttenberger, Constantin Landes, Günter Lauer, Markus Martini, Erich T Merholz, Robert A Mischkowski, Bilal Al-Nawas, Emeka Nkenke, Jörn U Piesold, Winnie Pradel, Michael Rasse, Martin Rachwalski, Rudolf H Reich, Daniel Rothamel, Jan Rustemeyer, Martin Scheer, Henning Schliephake, Rainer Schmelzeisen, Alexander Schramm, Wiebke Schupp, Wolfgang J Spitzer, Erwin Stocker, Christian Stoll, Hendrik Terheyden, Alexander Voigt, Wilfried Wagner, Dieter Weingart, Richard Werkmeister, Jörg Wiltfang, Christoph M Ziegler, Joachim E Zöller
The current surgical techniques used in cleft repair are well established, but different centers use different approaches. To determine the best treatment for patients, a multi-center comparative study is required. In this study, we surveyed all craniofacial departments registered with the German Society of Maxillofacial Surgery to determine which cleft repair techniques are currently in use. Our findings revealed much variation in cleft repair between different centers. Although most centers did use a two-stage approach, the operative techniques and timing of lip and palate closure were different in every center...
February 6, 2018: Journal of Cranio-maxillo-facial Surgery
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
Chalinee Thanasupsombat, Saowapak S Thongvigitmanee, Sorapong Aootaphao, Pairash Thajchayapong
The quality of images obtained from cone-beam computed tomography (CBCT) is important in diagnosis and treatment planning for dental and maxillofacial applications. However, X-ray scattering inside a human head is one of the main factors that cause a drop in image quality, especially in the CBCT system with a wide-angle cone-beam X-ray source and a large area detector. In this study, the X-ray scattering distribution within a standard head phantom was estimated using the Monte Carlo method based on Geant4. Due to small variation of low-frequency scattering signals, the scattering signals from the head phantom can be represented as the simple predetermined scattering signals from a patient's head and subtracted the projection data for scatter reduction...
2018: BioMed Research International
Nima Khavanin, Edward H Davidson, Diana Y Lee, Patrick Byrne, Amir H Dorafshar
Concomitant temporomandibular joint (TMJ) transplantation is an obvious advancement in the reconstructive armamentarium for face transplantation in scenarios involving TMJ ankylosis. This study investigates the fidelity of mandibular morphology and explores the feasibility of bilateral mandibular condyle transfer in facial vascularized composite allotransplantation. Geometric analysis was performed on 100 skeletally mature maxillofacial computed tomography scans. Exclusion criteria included mandibular trauma and dentoalveolar disease...
March 1, 2018: Journal of Craniofacial Surgery
Liyun Bai, Linlin Li, Kexin Su, Anthony Bleyer, Yuanyuan Zhang, Ping Ji
Maxillofacial injuries can be complex and are clinically important due to their functional and cosmetic significance. Maltreated and missed fractures might cause deformity of the face; thus, accurate evaluation of the fracture provided by X-ray images is critical. In this study, we explore the application of cone-beam computed tomography (CBCT) for diagnosis of severe maxillofacial traumas. A patient with a complex fracture that affects the maxilla, mandible, wall of the maxillary sinus, zygoma, zygomatic arch and nasal bone was diagnosed using 3D reconstruction of CBCT images...
2018: Journal of X-ray Science and Technology
Hamid Neshandar Asli, Zahra Dalili Kajan, Fatemeh Gholizade
STATEMENT OF PROBLEM: Cement-retained implant-supported restorations have advantages over screw-retained restorations but are difficult to retrieve. Identifying the approximate location of the screw access hole (SAH) may reduce damage to the prosthesis. PURPOSE: The purpose of this in vitro study was to evaluate the ability of cone beam computed tomography (CBCT) imaging to determine the location and direction of SAHs in cement-retained implant prostheses. MATERIAL AND METHODS: Five clear acrylic resin casts were made based on a mandibular model...
February 21, 2018: Journal of Prosthetic Dentistry
A Yu Zaytcev, K V Dubrovin, V A Svetlov
BACKGROUND: The development of modern video - and endoscopic equipment allows for revision and adjust to modern protocols for maintaining patency of the difficult airway, especially in maxillofacial or ENT -surgery. THE PURPOSE OF THE STUDY: Comparison the efficacy ofvarious methods of maintaining the airway patency in the practice of reconstructive maxillofacial surgery. MATERIALS AND METHODS: 89 patients, who were divided into 4 groups, were examined...
September 2017: Anesteziologiia i Reanimatologiia
Marco A Rendón-Medina, Laura Andrade-Delgado, Jose E Telich-Tarriba, Antonio Fuente-Del-Campo, Carlos A Altamirano-Arcos
Rapid prototyping models (RPMs) had been extensively used in craniofacial and maxillofacial surgery, especially in areas such as orthognathic surgery, posttraumatic or oncological reconstructions, and implantology. Economic limitations are higher in developing countries such as Mexico, where resources dedicated to health care are limited, therefore limiting the use of RPM to few selected centers. This article aims to determine the dimensional error of a low-cost fused deposition modeling 3D printer (Tronxy P802MA, Shenzhen, Tronxy Technology Co), with Open source software...
January 2018: Plastic and Reconstructive Surgery. Global Open
Akina Tohya, Atsushi Kohjitani, Sachi Ohno, Kaoru Yamashita, Yozo Manabe, Mitsutaka Sugimura
Background: Secretion of hormones, which antagonize the action of insulin, is facilitated in response to surgery, and acute resistance to the action of insulin develops. Our aim is to elucidate the effects of intraoperative glycemic control by glucose-insulin (GI) infusion on postoperative complications and outcomes in major oral and maxillofacial surgery. Findings: Thirty patients aged ≥ 60 years undergoing a radical operation of oral malignant tumors with tissue reconstruction (≥ 8 h) were analyzed...
2018: JA Clin Rep
Luigi Angelo Vaira, Olindo Massarelli, Giovanna Deiana, Silvio Mario Meloni, Giovanni Dell'aversana Orabona, Pasquale Piombino, Giacomo De Riu
The loss of a portion or the totality of the nose has great relevance on the perception of the beauty of a face and can result in a catastrophic quality of life impairment. Several surgical techniques are currently available for the reconstruction of the nasal pyramid. However, there are very few nasal reconstruction quality evaluation protocols that allow the surgeon to choose objectively the best technique for each kind of defects. Six total nasal reconstruction performed in University of Sassari Maxillofacial Unit were evaluated with a protocol that investigate objectively and subjectively the surgical aesthetic and functional outcome...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Neil Bodagh, Elena Pappa, Fahad Farooqi
We report an unusual case of an elderly man presenting with a fast-growing large malignant tumour involving the skin overlying his permanent pacemaker site. The fast-growing cutaneous squamous cell carcinoma appeared 2 years after pacemaker implantation. Joint specialist input was required to tackle this complex problem as a wide surgical excision would expose the pacemaker generator risking device infection particularly if the skin graft reconstruction failed. Having established that the patient had minimal pacing needs, it was determined through expedited multidisciplinary discussion that the best option was excision of the lesion with skin grafting of the defect by maxillofacial surgical team and pacemaker generator removal by a cardiologist in a joint surgical procedure...
February 6, 2018: BMJ Case Reports
Ji-Hyeon Oh
With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality...
December 2018: Maxillofacial Plastic and Reconstructive Surgery
Hideo Shigeishi, Masaru Sugiyama, Kouji Ohta, Sho Yokoyama, Miyuki Sakuma, Hiroshi Murozumi, Hiroki Kato, Masaaki Takechi
In a previous study, the present research group reported that males had a significantly higher prevalence of human papillomavirus (HPV)16 than females in oral rinse samples. The objective of the present study was to examine the relationship between HPV16 viral load and clinical factors, including remaining teeth, denture use and numbers of oral bacteria. A total of 124 patients (48 males and 76 females; mean age, 61.6 years; age range, 20-97 years) who visited the Department of Oral and Maxillofacial Reconstructive Surgery of Hiroshima University Hospital (Hiroshima, Japan) between November 2016 and August 2017 were analyzed...
January 2018: Biomedical Reports
Katinka Kansy, Andreas Albert Mueller, Thomas Mücke, Friederike Koersgen, Klaus Dietrich Wolff, Hans-Florian Zeilhofer, Frank Hölzle, Winnie Pradel, Matthias Schneider, Andreas Kolk, Ralf Smeets, Julio Acero, Piet Haers, G E Ghali, Jürgen Hoffmann
INTRODUCTION: Microvascular surgery following tumor resection has become an important field of oral and maxillofacial surgery (OMFS). Following the results from management of T1/T2 floor-of-mouth and tongue squamous cell carcinoma (SCC) in German-speaking countries, Europe, and worldwide, this paper presents specific concepts for the management of resection and reconstruction of T3/T4 SCC of the maxillary and mandibular alveolar process and tongue. METHODS: The DÖSAK questionnaire was distributed in three different phases to a growing number of maxillofacial units worldwide...
January 8, 2018: Journal of Cranio-maxillo-facial Surgery
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