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Chris D Glover, Allison M Fernandez, Henry Huang, Christopher Derderian, Wendy Binstock, Russell Reid, Nicholas M Dalesio, John Zhong, Paul A Stricker
BACKGROUND/AIMS: The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. METHODS: We queried the Pediatric Craniofacial Surgery Perioperative Registry for children undergoing midface advancement involving distractor application from June 2012 to September 2016...
June 19, 2018: Paediatric Anaesthesia
Andrew M Simpson, Sagar T Mehta, Faizi Siddiqi, Duane Yamashiro, Barbu Gociman
The surgical management of midface hypoplasia in the setting of Nager syndrome remains a significant challenge for craniofacial surgeons. This study describes a novel technique using distraction osteogenesis and modified osteotomies for the treatment of midface bony defects in an 11-year-old child with Nager syndrome.Presurgical 3-dimensional planning was performed to design the osteotomies and placement of distractors. The surgical approach required upper buccal sulcus and extended transconjunctival incisions only...
June 18, 2018: Journal of Craniofacial Surgery
Lara S van de Lande, Britt I Pluijmers, Cornelia J J M Caron, Eppo B Wolvius, David J Dunaway, Maarten J Koudstaal, Bonnie L Padwa
INTRODUCTION: Mandibular reconstruction in craniofacial microsomia (CFM) has been described and reviewed at length although final results are not always (aesthetically) satisfactory due to maxillo-mandibular asymmetry, for which optimal correction techniques remain unclear. The aim of this systematic review is to provide an overview of the surgical options for maxillary correction in patients with unilateral CFM. MATERIAL AND METHODS: MEDLINE/Pubmed, Embase, Cochrane and Web of Science databases were searched up to April 15, 2017...
May 25, 2018: Journal of Cranio-maxillo-facial Surgery
Ashrafullah, Ramesh Kumar Pandey, Apurva Mishra
Objective: To determine the incidence and pattern of facial fracture in children of age 0-16 years of age. Material & methods: Patients with trauma reporting to department of paediatric and preventive dentistry and department of oral & maxillofacial surgery from January 2011 to December 2011 were selected for the present study. The records of patients treated for maxillofacial injuries were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma...
May 2018: Journal of Oral Biology and Craniofacial Research
Agnieszka Przystańska, Tomasz Kulczyk, Artur Rewekant, Alicja Sroka, Katarzyna Jończyk-Potoczna, Krzysztof Gawriołek, Agata Czajka-Jakubowska
Objective: The aim of the study based on CT images was to assess the age-related changes in maxillary sinus diameters in relation to diameters of the facial skeleton. Materials and Methods: The retrospective analysis of CT images of the head of 170 patients aged 0-18 years (85 females and 85 males) was performed. Specific orientation points (zy, zm, pr, ns, n, and P) were identified in every patient and the following distances were measured: zy-zy, maximum facial width; zm-zm, midfacial width; n-pr, upper facial height; ns-pr, alveolar facial height; and ns-P, distance not indicated in craniometry...
2018: BioMed Research International
Sean Delaney, Russell W H Kridel
Background: The midface is particularly prone to the senescent changes of soft tissue ptosis and volume loss, which in individuals with aging or low adiposity can manifest as submalar hollowing. Facelift alone in those with submalar hollowing inadequately addresses the volume loss and may result in a gaunt appearance postoperatively. Submalar implant augmentation is a powerful tool for permanent midface volume restoration for a more youthful and natural contour, as opposed to soft tissue fillers that diminish over time...
May 28, 2018: Aesthetic Surgery Journal
Rongrong Wang, Jie Yang, Ke Guo, Aimei Zhong, Jing Tong, Lingyun Xiong, Jiaming Sun
BACKGROUND: Facial aging is a complex process influencing every layer of the facial structure. Most accepted surgical techniques for facial rejuvenation involve certain manipulation of the superficial musculoaponeurotic system (SMAS). Out of these SMAS-based techniques, SMAS plication or suspension provides excellent outcomes with shorter convalescence and fewer potential complications. Herein, we would like to present our own technique combining SMAS plication, periauricular purse-string, and malar fat pad elevation technique for mid and lower facelift...
May 24, 2018: Annals of Plastic Surgery
Vasileios Vasilakis, Richard G Reish
Late epistaxis after rhinoplasty is a rare but potentially life-threatening occurrence. This case report concerns a 20-year-old woman who had severe epistaxis 5 and 10 days after a closed rhinoplasty with internal osteotomies and who ultimately required transcatheter arterial embolization for definitive control of the hemorrhagic source. Arterial hypervascularity, with signs of arteriovenous malformation, of the midface at the level of the piriform aperture and maxilla was seen on angiography.
May 24, 2018: Annals of Plastic Surgery
Lihong Wen, Jinhuang Wang, Yang Li, Dalie Liu
Objective: To review the research progress of midfacial fat compartments, and to thoroughly understand its current state of the anatomy and the aging morphologic characters of midfacial fat compartments, as well as the current status of clinical applications. Methods: The recent literature concerning the midfacial fat compartments and related clinical applications were extensively reviewed and analyzed. Results: Midfacial fat layer has been considered as a fusion and a continuous layer, experiencing a global atrophy when aging...
February 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Richard A Hopper, Hitesh Kapadia, Srinivas M Susarla
In this technical note, the authors describe a technique for correction of exorbitism with simultaneous correction of central midface vertical and sagittal deficiency. The technique involves a combination of a Le Fort III osteotomy with a Le Fort II distraction. The Le Fort III osteotomy allows for repositioning and fixation of the zygomas to correct lateral hypoplasia and exorbitism and maintains the globes in this more functional position. The Le Fort II distraction allows for movement of the central midface independent of the lateral orbits and zygomas, allowing sagittal and vertical correction without orbital distortion...
April 28, 2018: Journal of Oral and Maxillofacial Surgery
Ian C Welsh, James Hart, Joel M Brown, Karissa Hansen, Marcelo Rocha Marques, Robert J Aho, Irina Grishina, Romulo Hurtado, Doris Herzlinger, Elisabetta Ferretti, Maria J Garcia-Garcia, Licia Selleri
Orofacial clefting represents the most common craniofacial birth defect. Cleft lip with or without cleft palate (CL/P) is genetically distinct from cleft palate only (CPO). Numerous transcription factors (TFs) regulate normal development of the midface, comprising the premaxilla, maxilla and palatine bones, through control of basic cellular behaviors. Within the Pbx family of genes encoding Three Amino-acid Loop Extension (TALE) homeodomain-containing TFs, we previously established that in the mouse, Pbx1 plays a preeminent role in midfacial morphogenesis, and Pbx2 and Pbx3 execute collaborative functions in domains of coexpression...
May 23, 2018: Journal of Anatomy
Achim G Beule
Only about 8% of head and neck tumors affect the midface. This anatomical area is characterized by an enormous number of functionally important structures, and it is frequently only possible to achieve small resection margin distances. To avoid complications and unfavorable results, a dedicated preparation of both patient and surgeon is warranted. This review aims to provide encouragement for the postgraduate training of interested ENT specialists. Following the clinical course and based on recent literature, strategies to avoid complications of tumor surgery to the midface are given...
May 24, 2018: HNO
Tae Ho Kim, Seok Joo Kang, Seong Pin Jeon, Ji Young Yun, Hook Sun
Background: Nasal fracture and orbital blowout fracture often occur concurrently in cases of midface blunt trauma. Generally, these multiple fractures treatment is surgery, and typically, the nasal bone and orbit are operated on separately. However, we have found that utilizing a transconjunctival approach in patients with concurrent nasal bone fracture and orbital blowout fracture is a useful method. Methods: The participants in the present study included 33 patients who visited the Plastic Surgery outpatient department between March 2014 and March 2017 and underwent surgery for nasal fracture and orbital blowout fracture...
May 24, 2018: Archives of Craniofacial Surgery
Youn Hee Jee, Jeffrey Baron, Ola Nilsson
PURPOSE OF REVIEW: Genome-wide approaches including genome-wide association studies as well as exome and genome sequencing represent powerful new approaches that have improved our ability to identify genetic causes of human disorders. The purpose of this review is to describe recent advances in the genetic causes of short stature. RECENT FINDINGS: In addition to SHOX deficiency which is one of the most common causes of isolated short stature, PAPPA2, aggrecan, C-natriuretic peptide, C-type natriuretic peptide (CNP), NPR2 (CNP receptor), protein tyrosine phosphatase, non-receptor type 11(PTPN11) (and other rasopathies), Fibrillin 1 (FBN1), IHH and BMP2 have been identified in isolated growth disorders with or without other mild skeletal findings...
May 18, 2018: Current Opinion in Pediatrics
Roxana Fu, Nicholas Moore, Taha Z Shipchandler, Jonathan Y Ting, Travis Tollefson, Cyrus Rabbani, Meena Moorthy, William R Nunery, H B Harold Lee
PURPOSE: To present the results of treating combined lower eyelid laxity, retraction and midface descent secondary to facial nerve weakness with a hybrid surgical procedure. MATERIALS AND METHODS: A retrospective analysis of patients from January 2015 to January 2017 who underwent a hybrid surgical technique for the treatment of corneal exposure secondary to facial nerve paresis with a single surgeon was performed. Age, gender, and presence of exposure symptoms were recorded pre-operatively...
May 9, 2018: American Journal of Otolaryngology
Travis L Gibson, Barry H Grayson, Joseph G McCarthy, Pradip R Shetye
Le Fort III distraction osteogenesis may be indicated in the treatment of syndromic craniosynostosis with severe midface retrusion and proptosis. This study assesses the stability of proptosis correction over 10-years.A retrospective review identified 15 patients with syndromic craniosynostosis treated by Le Fort III distraction prior to age 10 (9 males, 6 females; age 4.9 ± 1.5 years). Untreated, non-craniosynostotic age- and gender-matched controls were obtained from historical growth records. Lateral cephalometric tracings at pre-surgery (T1), immediate (T2), 1 year (T3), 5 years (T4), and 10 years (T5) (n = 11) post-distraction were superimposed using the best-fit of cranial base...
May 15, 2018: Journal of Craniofacial Surgery
Mingi Hong, Robert S Krauss
Holoprosencephaly (HPE) is a common developmental defect caused by failure to define the midline of the forebrain and/or midface. HPE is associated with heterozygous mutations in Nodal and Sonic hedgehog (SHH) pathway components, but clinical presentation is highly variable, and many mutation carriers are unaffected. It is therefore thought that such mutations interact with more common modifiers, genetic and/or environmental, to produce severe patterning defects. Modifiers are difficult to identify, as their effects are context-dependent and occur within the complex genetic and environmental landscapes that characterize human populations...
May 11, 2018: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
Bomi Kim, Hyung-Chul Lee, Seong-Hun Kim, Yongil Kim, Woosung Son, Seong Sik Kim
Objective: This study examined cone-beam computed tomography (CBCT)-derived multiplanar-reconstructed (MPR) cross-sections to clarify the salient characteristics of patients with skeletal class III malocclusion with midface deficiency (MD). Methods: The horizontal and sagittal plane intersection points were identified for middle-third facial analysis in 40 patients in the MD or normal (N) groups. MPR images acquired parallel to each horizontal plane were used for length and angular measurements...
May 2018: Korean Journal of Orthodontics
Silvia Müller-Hagedorn, Cornelia Wiechers, Jörg Arand, Wolfgang Buchenau, Margit Bacher, Michael Krimmel, Siegmar Reinert, Christian F Poets
BACKGROUND: Infants and children with syndromic craniosynostosis (SCS), such as Apert-, Crouzon- or Pfeiffer syndrome, are prone to sleep disordered breathing (SDB) including obstructive sleep apnea and upper airway resistance syndrome (OSAS, UARS), potentially leading to tracheostomy. We modified the Tübingen Palatal Plate (TPP), an oral appliance with a velar extension effectively treating airway obstruction in Robin sequence, by attaching a tube to its velar extension to bridge the narrow pharyngeal airway in SCS patients...
April 23, 2018: Orphanet Journal of Rare Diseases
Benoît Schaller, John Patrik Matthias Burkhard, Madeleine Chagnon, Stefan Beck, Thomas Imwinkelried, Michel Assad
PURPOSE: This study compared the degradation profile, safety, and efficacy of bioresorbable magnesium alloy and polylactide-co-glycolide (PLGA) polymer osteosynthesis systems for the treatment of fractures in a load-sharing maxillofacial environment using a new mini-swine fracture fixation model. MATERIALS AND METHODS: Two types of clinically relevant situations were evaluated in 5 Yucatan miniature pigs. Defined porcine midface osteotomies of the supraorbital rim and zygoma were created and fixed with either a coated magnesium (test animals) or PLGA plate and screw osteosynthesis system (control animals)...
March 31, 2018: Journal of Oral and Maxillofacial Surgery
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