To provide anatomic basis for the retrosigmoid supra-tentorium to infra-tentorium keyhole approach and to explore the feasibility, 60 skulls were observed and measured to demonstrate the position relations among related bony landmarks, 12 cadaveric heads were dissected and measured for localization of the keyhole and the incision through tentorium. For giving the angle and depth for endoscopic approach, 40 adult volunteers were performed head MRI scan and the pictures were measured and analyzed....
Sun Sep 01, 2019 03:00
Background: Molding helmet therapy is used for the treatment of infants with deformational brachycephaly (DB). There is a lack of rigorous outcome measures of helmet therapy in patients with DB using 3-dimensional (3D) imaging, with most reports rely on either subjective or 2-dimensional analyses. Furthermore, the longitudinal assessment of head shape improvement over the course of helmet therapy has not been documented. Our goal was to assess the outcome of molding helmet therapy using 3D surface...
Sun Sep 01, 2019 03:00
Purpose: Several post-processing algorithms for 3D visualization of the skull in craniosynostosis with their specific advantages and disadvantages have been already described. The Finite Element Method (FEM) described herein can also be used to evaluate the efficacy of the cutting patterns with respect to an increase in the projected surface area under assumed uniform loading of the manipulated and cut bone segments. Methods: The FEM analysis was performed. Starting with the classic cranial...
Sun Sep 01, 2019 03:00
The Golden Ratio (Phi, or Φ = 1.618…) is a potentially unifying quantity of structure and function in nature, as best observed in phyllotactic patterns in plants. For centuries, Φ has been identified in human anatomy, and in recent decades, Φ has been identified in human physiology as well. The anatomy and evolution of the human skull have been the focus of intense study. Evolving over millenia, the human skull embodies an elegant harmonization of structure and function. The authors explored the...
Sun Sep 01, 2019 03:00
Bone graft augmentation in the anterior maxilla has a high successful rate. However, suture dehiscence and consequent bone graft exposure can compromise and fail this procedure. Therefore, this article presents a new strategy of closure technique to guarantee the bone graft augmentation. The sutures occur in muscular and mucous planes to avoid suture tension, thus decreasing complications of bone graft augmentation in the anterior maxilla.
Sun Sep 01, 2019 03:00
Maxillary hypoplasia is a common developmental deformity affecting patients with cleft lip and palate. Various surgical techniques including conventional orthognathic surgery, total maxillary distraction osteogenesis, and anterior maxillary segmental distraction have been applied to address the deformity. With the evolution of 3D computed tomography imaging, the visualization of skeletal complexities in different perspectives is greatly enhanced and comprehensive surgical planning is achieved. Intraoperative...
Sun Sep 01, 2019 03:00
Pierre Robin sequence is a triad of micrognathia, glossoptosis, and airway obstruction that has reported associations with numerous birth defects and anomalies including craniocervical pathologies. Given the number of airway assessments and neck manipulations these neonates experience, undetected cervical instability can result in detrimental consequences. The authors present a case of a neonate with non-syndromic Pierre Robin sequence planned for mandibular distraction osteogenesis that developed...
Sun Sep 01, 2019 03:00
The Craniofacial Collaboration United Kingdom (CC-UK) was established across the 4 Highly Specialized Craniofacial Centres (HSCCs) in the UK in 2015. This is the first wave of data to be analyzed, looking at 3-year-old children with sagittal synostosis who have had primary corrective surgery. This is a comprehensive, homogenous dataset, looking at parental measures of development and behavior. The results indicate that the majority of children are rated by their parents as falling within one standard...
Sun Sep 01, 2019 03:00
No abstract available
Sun Sep 01, 2019 03:00
No abstract available
Sun Sep 01, 2019 03:00
Collet-Sicard syndrome is an unusual disorder. The authors here demonstrated the Magnetic resonance (MR) imaging findings of the Collet-Sicard syndrome associated with glomus jugulare tumor. Neoplastic or non-neoplastic lesion of skull base can cause Collet-Sicard syndrome. MR imaging can be used successfully to demonstrate the etiology of this syndrome.
Sun Sep 01, 2019 03:00
Background: Cranial vault surgeries are invasive, extensive procedures with blood transfusions being frequently required. Previous interventions have been described to attempt to decrease the transfusion burden. The objective of this study is to determine if a Pediatric Blood Management (PBM) team can reduce transfusion requirements in children undergoing cranial vault surgery. Methods: A protocol was developed which involved preoperative optimization of hemoglobin (Hb), intraoperative use...
Sun Sep 01, 2019 03:00
Background: The role of virtual surgical planning and three-dimensional printing in improving the accuracy, precision, functional and aesthetic outcomes have been demonstrated in the literature; however, there is a dearth of studies evaluating these parameters. Objective: This study was carried out at a tertiary care center in North India to assess the accuracy of virtual surgical planning in mandibular reconstruction. Method: All the included patients were preoperatively assessed with...
Sun Sep 01, 2019 03:00
The aim of this study is to describe the experience of a multidisciplinary skull base team with transnasal endoscopic surgery for anterior cranial base tumors. A retrospective chart review was conducted on patients who underwent an exclusive expanded transnasal approach to the anterior skull base in the period from December 2014 to November 2015. Data on patient demographics, tumor characteristics, surgical information, imaging, and postoperative complications were collected and analyzed. From...
Sun Sep 01, 2019 03:00
Objective: Lymphatic malformations (LMs) are rare and benign diseases. This article aimed to present a series of surgically treated giant cervicofacial LMs in children. Methods: A retrospective analysis of giant cervicofacial LMs (tumor diameter greater than 10 cm) in children over the past 8 years was performed in our department. Results: The 10 patients included 4 males and 6 females. Macrocystic lesion presented in 4 patients, mixed cystic lesion presented in 4 patients, and microcystic...
Sun Sep 01, 2019 03:00
Background: Radical resections of ethmoidal tumors with intracranial extension present highly complex surgical and reconstructive problems. The purpose of report is to describe the authors’ use of adipofascial radial forearm free flaps following unsuccessful anterior cranial fossa oncological surgery. Methods: Adipofascial radial forearm free flaps were used to treat 3 similar cases of cutaneous fistula following bone resorption with communication to anterior cranial fossa and nasal cavity. ...
Sun Sep 01, 2019 03:00
Background: Rhinophyma is a rare disease characterized by chronic inflammation and hypertrophy of sebaceous glands, blood vessels, and fibrous tissue, associated with end-stage severe acne rosacea. There are multiple approaches to treatment and repair, including dermal shaving, secondary intention healing, free skin graft, and skin flaps. However, these methods have various disadvantages, such as prolonged healing, obvious scarring, and skin texture mismatch. Therefore, the authors adopted surgical...
Sun Sep 01, 2019 03:00
Purpose: Long-term neurocognitive sequelae of nonsyndromic craniosynostosis (NSC) patients are just beginning to be clarified. This study uses functional MRI (fMRI) to determine if there is evidence of altered brain functional connectivity in NSC, and whether these aberrations vary by form of synostosis. Methods: Twenty adolescent participants with surgically treated NSC (10 sagittal synostosis, 5 right unilateral coronal synostosis [UCS], 5 metopic synostosis [MSO]) were individually matched...
Sun Sep 01, 2019 03:00
Purpose: To assess the incidence of anatomical variations of the paranasal region on computed tomography in migraine patients compared with control subjects. Methods: Paranasal computed tomography scans of 2 groups consisting of 50 migraine patients and 50 control subjects were evaluated, retrospectively. The presence of anatomic variations and the unilateral or bilateral presence of these variations were noted. Appropriate statistical tests were performed to compare the migraine and control...
Sun Sep 01, 2019 03:00
Background: Different techniques have been described to correct scaphocephaly. In authors’ institution, total cranial vault remodeling (TCVR) was the standard of care. To limit the extent of surgery and the need for transfusion, the technique was minimized to extended strip craniectomy (ESC) without helmet therapy. This retrospective study compares outcome and morbidity between ESC and TCVR. Methods: Twenty-seven scaphocephalic patients were included. The ESC was performed in 9 patients between...
Sun Sep 01, 2019 03:00
Object: Intracranial mirror aneurysm is a type of multiple aneurysms, which is rare in clinical and literature. There is no unified conclusion on the treatment strategy of mirror aneurysms. Therefore, our study evaluated the surgical approach and prognosis of a series of mirror aneurysms, and explored the clinical features and treatment strategies of mirror aneurysms. Methods: This study retrospectively analyzed the clinical features, imaging data, treatment methods and post-hospital results...
Sun Sep 01, 2019 03:00
Infants with deformational plagiocephaly may be indicated for a cranial remolding orthosis (CRO) depending on the severity of deformation. Studies have found torticollis and prematurity to be risk factors for the development of deformational plagiocephaly and indicate younger infants have faster and greater correction. However, clinical decisions about which infants should be recommended for CRO treatment differ among healthcare providers and insurance coverage criteria vary. In order to provide...
Sun Sep 01, 2019 03:00
Congenital masses in the lateral brow are most commonly dermoid cysts and can often be excised surgically without additional investigation. These dermoids may rarely develop intracranial extension due to underlying bony erosions and become less prominent over time – a “disappearing dermoid.” However, the authors present an unusual alternative case in which an off-midline frontal encephalocele initially presented as a firm irreducible mass but exhibited changing characteristics over time.
Sun Sep 01, 2019 03:00
Aim: In this study the authors aimed to evaluate craniofacial morphology and facial soft tissue thickness of the patients with cleft lip and palate.(CLP), and to compare the results with a sex and age-matched noncleft healthy control group. Methods: Craniofacial and soft tissue thickness measurements of 20 patients with unilateral cleft lip palate (UCLP) and 20 patients with bilateral cleft lip palate (BCLP) were compared with 20 noncleft control subjects. Angles between Sella-Nasion-A point,...
Sun Sep 01, 2019 03:00
Frontal sinus osteomas are benign bone-forming neoplasms. Ongoing advancements in endoscopic surgery have allowed less invasive surgical approaches to be adopted for removal. The authors systematically reviewed the literature to provide analysis and recommendations for management. One hundred ninety-three publications encompassing 1399 patients met inclusion, with mean age 42.1 ± 13.8 years and a male predominance (59.2%). Symptoms included pain (70.8%); orbital/ocular (20.7%); sinonasal (36.4%);...
Sun Sep 01, 2019 03:00
The present study evaluated the surgical outcomes of intraconal cavernous venous malformation according to their location in 4 right-angled sectors. Data regarding the surgical method and approach, surgical outcome, and postoperative complications were retrospectively analyzed for 18 patients with intraconal cavernous venous malformations that were surgically treated at the authors’ center between March 2006 and May 2017. The lesion location was defined using 2 perpendicular lines connecting the...
Sun Sep 01, 2019 03:00
Intracranial artery fenestration is segmental duplication of the lumen into 2 distinct channels and is known to have a low angiographical incidence of 0.3 to 0.9%. Intracranial artery fenestration is frequently associated with aneurysms, and aneurysms arising at the site of fenestrated middle cerebral artery (MCA) is extremely rare. To our best knowledge, there are only 10 such patients have been reported. Herein, the authors describe the 11th case of aneurysm arising from the fenestrated MCA. As...
Sun Sep 01, 2019 03:00
Introduction: Proper temporalis resuspension following craniotomy or craniectomy is necessary to prevent significant temporofacial deformity. Several methods of temporalis reconstruction have been described with varying success; currently there are no reports of suture anchor utilization. Methods: A patient is presented displaying successful temporalis resuspension using suture anchor fixation. An incision was made in the temporal hair-bearing scalp to access and lengthen the retracted temporalis...
Sun Sep 01, 2019 03:00
No abstract available
Sun Sep 01, 2019 03:00
Background: Posterior vault distraction osteogenesis (PVDO) has been demonstrated to effectively increase intracranial volume, treat increased intracranial pressure, and improve head shape in syndromic patients. The purpose of this study is to compare changes along the posterior cranial base before and after distraction. Methods: A retrospective review was completed of subjects who underwent PVDO with computed tomography scans at 2 time-points: within 3 months preoperatively and 1 to 6 months...
Sun Sep 01, 2019 03:00
No abstract available
Sun Sep 01, 2019 03:00
Objectives: To assess changes in head and neck posture, airway, hyoid, tongue, and soft palate in skeletal class III individuals whose cephalograms were taken using dynamic natural head positioning method with an inclinometer. Materials and Methods: This study was conducted on 20 class III patients operated with double jaw surgery. Natural head positions were determined before and 6 months after the surgery. Craniocervical, pharyngeal airway, tongue, and hyoid positions were measured. In...
Sun Sep 01, 2019 03:00
Purpose: Computer-aided surgical simulation (CASS) is an evolving technology which has significantly affected surgical correction of dentofacial deformities, a key step of which is orientation of the virtual skull model to allow for analysis and treatment planning. Explored in this study is the coplanarity of a 3-dimensional Frankfort horizontal plane (3D FHP). Materials and Methods: The 122 17.0 cm field-of-view cone-beam computed-tomogram (CBCT) scans were oriented to a 3D FHP using right...
Sun Sep 01, 2019 03:00
The surgical procedure is viewed as a typical treatment choice for patients with Chiari malformation (CM). Decompression is the preferred method for surgery, but it is not always possible to understand whether decompression has been successful especially in an early period. The present study focuses on investigating the shape differences in the cerebellums of Chiari patients compared with healthy controls, and to assess the clinical application of this situation whether if present. The MRI scans...
Sun Sep 01, 2019 03:00
Background: Surgical precision in the reconstruction of the orbital floor is crucial to functional visual and aesthetic outcomes. Increasingly, computer-aided design is being utilized to aid in precise preoperative planning by using the mirror images of the unaffected side. The authors aim to use 3-dimensional (3D) quantitative analysis to establish whether the native orbital floor topography is sufficiently symmetric to support this practice. Methods: Ten high resolution head and neck computed...
Sun Sep 01, 2019 03:00
Background: Plastic surgery evaluates residents on milestones. This study defines a model of education including pre and post-test assessments paired with didactics intended for evaluating residents in the unique technical skills of craniofacial surgery. Methods: At the first institution, instrument identification, and time/accuracy of burr hole placement, craniotomy, and plating on Saw Bones Craniofacial Models were tested before and after a 7.5-hour craniofacial orthognathic surgery workshop....
Sun Sep 01, 2019 03:00
The visibility of cartilage grafts underneath the skin is a complication of rhinoplasty particularly in patients with thin nasal skin. Preparing the graft with optimum dimensions, symmetry, and smoothness is crucial for the fine crafting of the cartilage to prevent visibility. The camouflage of the visible cartilage graft with a crushed cartilage, a resected cephalic portion of the lower lateral cartilage, fascia, connective and/or fatty tissues is another option for hiding the visibility. The nasal...
Sun Sep 01, 2019 03:00
Background and Purpose: Treatment of metopic craniosynostosis often involves bitemporal expansion of the anterior cranium. This report compares perioperative variables of a surgical technique in which the fronto-orbital bandeau is bent in situ to traditional fronto-orbital advancement and remodeling (FOAR). Method/Description: Six patients undergoing the hinge technique were compared to the senior author's 6 most recent conventional FOARs. Study and control cohorts were reasonably well matched...
Sun Sep 01, 2019 03:00
Introduction: Orbital hypertelorism (HTO) is a challenging craniofacial problem seen in association with some congenital deformities. The age of HTO correction is a matter of debate. The Aim of the work: to evaluate the outcome of HTO correction and determine the optimal timing for intervention, striving for the earliest possible intervention with the lowest relapse. Patients and methods: A standard craniofacial approach with medial bone resection, 4 walls orbital box osteotomy and orbital...
Sun Sep 01, 2019 03:00
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