• Title/Summary/Keyword: Craniofacial surgery

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Necrotizing fasciitis of the masticator space with osteomyelitis of the mandible in an edentulous patient

  • Shin, Jongweon;Park, Song I;Cho, Jin Tae;Jung, Sung-No;Byeon, Junhee;Seo, Bommie Florence
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.270-273
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    • 2019
  • Necrotizing fasciitis (NF) is a rapidly progressive necrosis of the subcutaneous tissue and fascia, caused by bacterial infection. Usually presenting in the extremities, trunk, or perineum, it is uncommon in the craniofacial or cervical area. Cervicofacial NF is a potentially fatal infection, which should be managed with early detection and intervention. Most cases have a primary odontogenic source of infection, especially when the masticator space is involved. We report a case of masticator space NF that developed without odontogenic origin in a 78-year old female who was treated with prompt surgical drainage and intravenous antibiotics.

The Efficacy of Bioabsorbable Mesh in Craniofacial Trauma Surgery

  • Choi, Won Chul;Choi, Hyun Gon;Kim, Jee Nam;Lee, Myung Cheol;Shin, Dong Hyeok;Kim, Soon Heum;Kim, Cheol Keun;Jo, Dong In
    • Archives of Craniofacial Surgery
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    • v.17 no.3
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    • pp.135-139
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    • 2016
  • Background: The ultimate goal of craniofacial reconstructive surgery is to achieve the most complete restoration of facial functions. A bioabsorbable fixation system which does not need secondary operation for implant removal has been developed in the last decade. The purpose of this study is to share the experience of authors and to demonstrate the efficacy of bioabsorbable mesh in a variety of craniofacial trauma operations. Methods: Between October 2008 and February 2015, bioabsorbable meshes were used to reconstruct various types of craniofacial bone fractures in 611 patients. Any displaced bone fragments were detached from the fracture site and fixed to the mesh. The resulting bone-mesh complex was designed and molded into an appropriate shape by the immersion in warm saline. The mesh was molded once again under simultaneous warm saline irrigation and suction. Results: In all patients, contour deformities were restored completely, and bone segments were fixed properly. The authors found that the bioabsorbable mesh provided rigid fixation without any evidence of integrity loss on postoperative computed tomography scans. Conclusion: Because bioabsorbable meshes are more flexible than bioabsorbable plates, they can be molded and could easily reconstruct the facial bone in three dimensions. Additionally, it is easy to attach bone fragments to the mesh. Bioabsorbable mesh and screws is effective and can be easily applied for fixation in various craniofacial trauma reconstructive scenarios.

Late presenting bilateral squamosal synostosis

  • Diab, Jason;Anderson, Peter J.;Moore, Mark H.
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.106-108
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    • 2020
  • Premature fusion of one or other of the minor sutures can subtly influence the shape of the human skull. Although infrequently reported or not clinically recognized, it can such contribute to a variety of craniofacial dysmorphisms. We herein report a case of late presenting, isolated bilateral synostosis of the squamosal suture dysmorphologies whose presentation mimics aspects of sagittal synostosis.

Use of the facial dismasking flap approach for surgical treatment of a multifocal craniofacial abscess

  • Ishii, Yoshitaka;Yano, Tomoyuki;Ito, Osamu
    • Archives of Plastic Surgery
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    • v.45 no.3
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    • pp.271-274
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    • 2018
  • The decision of which surgical approach to use for the treatment of a multifocal craniofacial abscess is still a controversial matter. A failure to control disease progress in the craniofacial region can potentially put the patient's life at risk. Therefore, understanding the various ways to approach the craniofacial region helps surgeons to obtain satisfactory results in such cases. In this report, we describe a patient who visited the emergency department with a large swelling in his right cheek. A blood test and computed tomography revealed odontogenic maxillary sinusitis. The patient developed sepsis due to a progressive multifocal abscess. An abscess was seen in the temporal muscle, infratemporal fossa, and interorbital region. To control this multifocal abscess, we used the facial dismasking flap (FDF) approach. After debridement using the FDF approach, we succeeded in obtaining sufficient drainage of the abscess, and the patient recovered from sepsis. The advantages of the FDF approach are that it provides a wide surgical field, extending from the parietal region to the mid-facial region, and that it leaves no aesthetically displeasing scars on the face. The FDF approach may be one of the best options to approach multifocal abscesses in the craniofacial region.

Advancements in craniofacial prosthesis fabrication: A narrative review of holistic treatment

  • Jazayeri, Hossein E.;Kang, Steve;Masri, Radi M.;Kuhn, Lauren;Fahimipour, Farahnaz;Vanevenhoven, Rabecca;Thompson, Geoffrey;Gheisarifar, Maryam;Tahriri, Mohammadreza;Tayebi, Lobat
    • The Journal of Advanced Prosthodontics
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    • v.10 no.6
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    • pp.430-439
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    • 2018
  • The treatment of craniofacial anomalies has been challenging as a result of technological shortcomings that could not provide a consistent protocol to perfectly restore patient-specific anatomy. In the past, wax-up and impression-based maneuvers were implemented to achieve this clinical end. However, with the advent of computer-aided design and computer-aided manufacturing (CAD/CAM) technology, a rapid and cost-effective workflow in prosthetic rehabilitation has taken the place of the outdated procedures. Because the use of implants is so profound in different facets of restorative dentistry, their placement for craniofacial prosthesis retention has also been widely popular and advantageous in a variety of clinical settings. This review aims to effectively describe the well-rounded and interdisciplinary practice of craniofacial prosthesis fabrication and retention by outlining fabrication, osseointegrated implant placement for prosthesis retention, a myriad of clinical examples in the craniofacial complex, and a glimpse of the future of bioengineering principles to restore bioactivity and physiology to the previously defected tissue.

Aesthetic Facial Correction of Cleidocranial Dysplasia

  • Hwang, So-Min;Park, Beom;Hwang, Min-Kyu;Kim, Min-Wook;Lee, Jong-Seo
    • Archives of Craniofacial Surgery
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    • v.17 no.2
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    • pp.82-85
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    • 2016
  • We report two cases of cleidocranial dysplasia, which was managed without significant craniofacial osteotomy. A mother and daughter, both of normal intelligence, presented with central forehead depression, mid-face hypoplasia, and blepharoptosis. The fact that they have an identically deformed face implied a genetic basis. In both patients, radiologic evaluation revealed the underdeveloped maxilla, persistent fontanelle opening, and cleidal aplasia. Clinical findings and radiologic studies were consistent with the diagnosis of cleidocranial dysplasia. Both patients underwent forehead plasty via bicoronal approach, augmentation rhinoplasty using tip plasty, and epicanthoplasty. In addition, the mother underwent malar augmentation using Medpor implantation and reduction genioplasty. The patients did not experience any postoperative complication and remained satisfied with the operation at 6-year follow-up.

Half-and-Half Palatoplasty

  • Han, Hyun Ho;Kang, In Sook;Rhie, Jong Won
    • Archives of Craniofacial Surgery
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    • v.15 no.2
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    • pp.105-108
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    • 2014
  • A 14-month-old child was diagnosed with a Veau Class II cleft palate. Von Langenbeck palatoplasty was performed for the right palate, and V-Y pushback palatoplasty was performed for the left palate. The child did not have a special problem during the surgery, and the authors were able to elongate the cleft by 10 mm. Contrary to preoperative concerns regarding the hybrid use of palatoplasties, the uvula and midline incisions remained balanced in the middle. The authors named this combination method "half-and-half palatoplasty" and plan to conduct a long-term follow up study as a potential solution that minimizes the complications of palatoplasty.

TWO CASES OF MASSIVE CRANIOFACIAL FIBROUS DYSPLASIA (광범위한 두개안면부 섬유성골이형성증의 치험 2례)

  • Kim, Jong-Ryoul;Chung, Gi-Deon;Kim, Hong-Sik;Kim, Ki-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.1
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    • pp.61-68
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    • 1996
  • In Fibrous dysplasia(FD) of the jaws, the majority of cases can await the cessation of growth before surgical intervention, and it seems prudent to delay surgery whenever possible until growth has ceased. In craniofacial FD, however, the dangers of dystopia, dystopia and loss of vision may require early surgery to prevent or control cranio-orbital complications. Delaying surgery in those circumstances may be significantly detrimental to such patients. Conservative surgical management of FD is widely practised and we advocate an extension to this conservative treatment by combining surgical recontouring with appropriate osteotomies if indicated, to achieve an optimal esthetic and functional results in craniofacial FD. One case will be presented to illustrate the feasiblility of such combined treatment, to report the uneventful healing of osteotomies in the FD of the jaws, and to demonstrate the use of titanium miniplate fixation in dysplastic bone. The other case had expansile disease of the left facial and fronto-temporal bones and osteolytic change left mandible. This patient complained of severe spontaneous bleeding of left mandibular premolar area and it was suspected as central hemangioma of the left mandible and craniofacial FD. Angiogram disclosed generalized dilation of the external carotid artery and its branches, especially terminal branches of the left facial and inferior alveolar arteries. But no specific abnormalities, such as A-V shunt, venous lake, or early venous drainage, was seen. So it was diagnosed craniofacial FD with hypercellularity and generalized bony recontouring was performed via coronal and transoral approaches.

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