bluuebunny/crossref_metadata_2025_split huggingface dataset:
Botulinum Toxin Injection to Treat Masticatory Movement Disorder Corrected Mandibular Asymmetry in a Growing Patient
Authors: Cho Yu-Min , Kim Seong-Gon , Choi Dong-Soon , Jang Insan , Cha Bong-Kuen 
Published: August 2019

Abstract
An 8-year-old girl with masticatory movement disorder received botulinum toxin-A (BTX-A) injection and orthodontic treatment. She showed facial asymmetry with right masseter muscle hyperplasia. After BTX-A injection combined with orthodontic treatment, the transverse discrepancy between right and left maxillary dentition completely corrected. Cone-beam computed tomography images revealed that the height of the left mandibular ramus had increased by 2.3 mm, considerably more than on the right side, the discrepancy in mandibular ramus height between the left and the right decreased dramatically. In a short period, BTX-A injection combined with orthodontic treatment corrected a mandibular movement disorder with asymmetric mandibular growth in a growing patient.
Perioperative Management and Factors Associated With Transfusion in Cranial Vault Reconstruction
Authors: Hall Bradley R. , Barrientos Stephan , Flores Laura E. , Cemaj Sophie , Kugler Jane , Miller Jason J. 
Published: August 2019

Background:
Bleeding is the most common adverse event in patients undergoing cranial vault reconstruction. The authors compare the transfusion rates against a national sample to determine whether the patients experience lower transfusion rates.

Methods:
The authors queried the Pediatric National Surgical Quality Improvement Program (Peds-NSQIP) for patients who underwent cranial vault reconstruction (CPT 61559) and compared them to patients who underwent cranial vault reconstruction for sagittal craniosynostosis at Children's Hospital and Medical Center (CHMC) in Omaha, Nebraska. Patients over the age of 24 months were excluded. Binary logistic regression analysis was performed using IBM-SPSS v24.0 to determine factors associated with transfusion at CHMC.

Results:
Patient demographics, preoperative hematocrit and platelet counts, readmission rates, and reoperation rates did not differ between CHMC (N = 54) and Peds-NSQIP (N = 1320) cohorts. Patients in the CHMC cohort had shorter preincision anesthesia times (47 versus 80 minutes, P < 0.001), shorter operative times (108 versus 175 minutes, P < 0.001), lower transfusion rates (50% versus 73%, P < 0.001), and smaller mean transfusion volumes (16 versus 33 mL/kg, P < 0.001); however mean length of stay was longer (4.1 versus 3.6 days, P < 0.001). Factors independently associated with transfusion at CHMC included preoperative hematocrit (odds ratio [OR] 0.423, P = 0.002), administration of an antifibrinolytic agent (OR 0.004, P = 0.001) and temperature at the time of incision (OR 0.020, P = 0.043).

Conclusion:
Patients at CHMC require less transfused blood and experience low transfusion rates. Preoperative hematocrit, administration of antifibrinolytic agents, and temperature at the time of incision are all modifiable factors associated with perioperative transfusion.
Application of a Lateral Pedicled Cranial Bone Flap for the Treatment of Secondary Zygomaticomaxillary Defects
Authors: He Wenpeng , Gong Xi , He Yang , Zheng Lei , Zhang Yi , Lai Renfa 
Published: August 2019

Abstract
This study aimed to evaluate the effect of laterally-based pedicled cranial bone flap (LBPCBF) for the repair of secondary zygomaticomaxillary defects. Between December 2014 and December 2016, 6 patients with unilateral zygomaticomaxillary defects were selected; of these, 5 had trauma, and 1 was exposed to titanium mesh in the infraorbital area due to radiotherapy following total maxillectomy for right maxillary squamous cell carcinoma. Preoperatively, 3 patients suffered from an intraoral vestibular groove fistula, 2 suffered from an extraoral fistula, and 1 from local exposure of titanium mesh. Surgical treatment was implemented in all 6 patients, of which, the 5 trauma patients underwent debridement, reduction, and fixation of periorbital fracture, followed by repair of the defects in the infraorbital margin, anterior wall of maxillary sinus, and zygomatic body with LBPCBF, and then, reconstruction of the orbital floor with titanium mesh. The other patient with exposed titanium mesh underwent repair of defects in the infraorbital margin and anterior wall of the maxillary sinus with LBPCBF after titanium mesh trimming. Postoperative review at 6 months revealed disappearance of intraoral fistula, wound healing, and improvement of facial deformity in all 6 patients, of which 2 patients demonstrated postoperative ectropion. The application of LBPCBF can simultaneously repair bone defects in the infraorbital margin, anterior wall of maxillary sinus, and zygomatic body, as well as, supplement the soft tissue, thereby indicating a satisfactory treatment effect.
Tick-bite–Induced Sudden Sensorineural Hearing Loss and Peripheral Facial Palsy
Authors: Gökçe Kütük Sinem 
Published: August 2019

Abstract
Sudden sensorineural hearing loss (SSHL) and facial paralysis are 2 important otolaryngology emergencies and diagnosing the etiology is very crucial to determine the treatment strategy. Cerebellopontin angle tumors and herpes simplex infections may lead to these situations simultaneously. Also, neurodegerative and systemic infection diseases can affect the cranial nerves VII and VII together. In this article, a patient is presented who had SSHL and facial palsy that occurred after tick bite.
Alcohol Intoxication-Related Soft Tissue Injuries in Patients With Orbital Wall Fractures
Authors: Song Yu Kwan , Kim Soon Heum , Jo Dong In 
Published: August 2019

Background:
To date, involvement of alcohol intoxication (AI) in the occurrence of traumatic bone injuries has been well described in the literature. Still, however, there is a paucity of data regarding its involvement with soft tissue injuries in the oral and maxillofacial region. Considering that it is one of the significant predisposing factors that are involved in facial bone fractures in assault victims, we have speculated that they are also vulnerable to soft tissue injuries. We therefore examined the incidence, type and, pattern of soft tissue injuries in patients with trauma owing to the AI in a single-institution setting.

Materials and Methods:
A total of 488 patients underwent reconstructive surgery for orbital wall fracture at our medical institution between 2012 and 2017. Of these, 162 eligible patients were enrolled in the present study; they were divided into 2 groups (the AI group and the control group) based on a history of the AI. Then, we compared baseline and clinical characteristics, including the incidence, type, and pattern of soft tissue injury, between the 2 groups.

Results:
In our series, assault was the most common cause of traumatic injuries. We found that the patients with AI were at increased risks of preoperatively developing subconjunctival hemorrhage and diplopia and postoperatively developing infraorbital nerve (ION) hypesthesia.

Conclusions:
In conclusion, our results indicate that the AI is closely associated with the preoperative risks of subconjunctival hemorrhage and diplopia and the postoperative risks of ION hypesthesia. But further large-scale, multicenter studies are warranted to establish our results.
Using a Modified Postauricular Hemicoronal Incision to Manage Unilateral Zygomaticomaxillary Complex Fracture
Authors: Liu Min , Lv Kun , Li Zubing , Yang Xuewen 
Published: August 2019

Background:
The surgical approach of the zygomaticomaxillary complex fracture is usually performed with preauricular coronal incision assisted with intraoral maxillary sulcus incision. There will be preauricular scars postoperatively.

Methods:
The authors introduce a postauricular hemicoronal incision to avoid the formation of scars in front of the ear.

Results and Discussion:
The postauricular hemicoronal incision can avoid vascular damage caused by careless operation in the preauricular approach. It eliminates the possibility of dissection or ligation of the superficial arteries and veins when preauricular approach was used. It results in no scar in front of ear, while reducing suture time and complexity.
The Use of Dehydrated Human Amniotic/Chorionic Membrane Skin Substitute in the Treatment of Pediatric Facial Burn
Authors: Puyana Salomon , Elkbuli Adel , Ruiz Samuel , Bernal Eileen , McKenney Mark , Lim Rizal , Askari Morad , Mir Haaris 
Published: August 2019

Background:
Facial burns have lasting physical and psychological effects on pediatric patients. Proper management to minimize morbidities challenges reconstructive surgeons. New technologies allowed the development of skin substitutes such as amniotic and chorionic membranes, yet the use of these skin dressings and their impact on burn outcomes have not been sufficiently studied to guide practices. The objective of this study is to report on the outcomes of dehydrated amniotic membrane as a biologic skin dressing in pediatric facial burn injury compared to cadaveric allografts.

Methods:
Retrospective review of data collected from our institutional burn registry from 2012 to 2016. The study population included patients younger than 16 years with facial burns. Patients between 2012 and 2014 received cadaveric allografts, whereas during 2015 to 2016 patients received dehydrated human amniotic/chorionic membrane as standard treatment. Demographic characteristics and outcome measures were compared between the 2 groups.

Results:
Included 30 patients with a mean age of 3.7 years and with an average total body surface area burn of 6.8% (2%–27%). Mean injury severity scores did not significantly differ between both groups, 1.8 in amniotic group versus 2.3 in cadaveric skin group (P > 0.05). There were 4 complications (3 hypertrophic scars and 1 wound infection) in the cadaveric allografts group versus no complications in the amniotic membrane group (P < 0.05).

Conclusion:
Dehydrated amniotic/chorionic membrane wound dressings are a safe alternative to cadaveric allografts in treating pediatric partial thickness facial burns.
Surgical Techniques and Prevention of Complications in the Treatment of Basal Ganglia Hemorrhage Through the Distal Transsylvian Approach
Authors: Gao Wenbo , Li Zefu , Zhang Liangwen 
Published: August 2019

Objective:
Basal ganglia hemorrhage can damage the internal capsule and lead to high rates of disability and mortality. The distal transsylvian approach is a validated approach in the treatment of basal ganglia hemorrhage. However, this approach is difficult and prone to complications. The present study was performed to investigate the surgical techniques and prevention of complications of basal ganglia hemorrhage through the distal transsylvian approach.

Patients and Methods:
From January 2015 to January 2018, the authors treated 40 cases of basal ganglia hemorrhage using the distal transsylvian approach. The surgical video recordings and the patients’ clinical data were retrospectively analyzed. The authors discussed the surgical techniques and prevention of complications through the distal transsylvian approach.

Results:
Thirty-eight cases of basal ganglia hemorrhage were successfully treated through the distal transsylvian approach. The other 2 cases were converted to the transcortical transtemporal approach. In the early cases, complications occurred in 3 stages: sylvian fissure dissection, insula lobectomy, and hematoma removal. In the subsequent cases, the authors implemented appropriate surgical techniques to prevent complications.

Conclusion:
Basal ganglia hemorrhage can be treated through the distal transsylvian approach, but not in all patients. The distal transsylvian approach is highly technical and more problematic than the transcortical transtemporal approach. Mastering certain operative skills can reduce the surgical complications.
Risk Factors Influencing Recovery of Neurosensory Disturbances Following Sagittal Split Ramus Osteotomy
Authors: Demirbas Ahmet Emin , Yilmaz Gökhan , Topan Cihan , Kütük Nükhet , Kilic Erdem , Alkan Alper 
Published: August 2019

Purpose:
The aim of this study is to determine the risk factors influencing the recovery time of neurosensory disturbances (NSD) following sagittal split ramus osteotomy.

Methods:
One hundred twenty-seven patients (254 operated sites) underwent sagittal split ramus osteotomy due to dentofacial deformities between the period of 2011 and 2017. These patients were followed up for at least 1 year, and the data obtained from changes in sensation of inferior alveolar nerve were recorded subjectively. The subjects were categorized according to age, gender, type of deformity, nerve manipulation, side of the jaw, and the amount of the mandibular movement. The relationship between the above-mentioned parameters, and the recovery time of NSD were investigated. Pearson χ
2 analysis was used, and the value of significance was accepted as P < 0.05.

Results:
The recovery time of NSD is significantly correlated with the age of the patients, the amount of the mandibular movement (>7 mm), and the nerve manipulation (P < 0.05). There was no statistically significant correlation found between the recovery time of NSD and gender, type of deformity, side of the jaw (P > 0.05).

Conclusions:
The recovery time of NSD may prolong in cases of large amounts of mandibular movements more than 7 mm or the nerve manipulation. The older age may increase the risk of permanent NSD.
Virtual Surgical Planning for Mandible Reconstruction With a Double Barrel Fibula Flap and Immediate Implant Placement
Authors: Berrone Mattia , Crosetti Erika , Battiston Bruno , Succo Giovanni 
Published: August 2019

AbstractThis brief clinical report describes our experience with virtual surgical planning in a case of mandibulectomy and mandibular reconstruction with a double barrel vascularized osteofasciocutaneous fibula free flap and immediate implant placement in a case of mandibular ameloblastoma. Fibular segments were positioned to obtain the best result both for masticatory function and for aesthetic facial appearance. Furthermore, in this particular case, as well as being positioned for future masticatory rehabilitation, the implants have served to stabilize the fibula segments in the reconstructive intraoperative phase. A superimposition of programed surgery and 6 months postoperative computed tomography scan was performed and results are presented.
Mandibular Fracture as First Sign of an Occult Intraosseous Hemangioma
Authors: Albarracin-Arjona Beatriz , Rodriguez-Jara Pablo , Montes-Carmona Jose-Francisco , Hernandez-Guisado Jose-Maria , Gonzalez-Perez Luis-Miguel , Infante-Cossio Pedro 
Published: August 2019

Abstract
Intraosseous hemangioma (IH) in the maxillofacial area is a very uncommon neoplasm. Here, the authors show an exceptional case not previously reported in the literature of a 65-year-old man who presented with a pathological mandibular fracture following a facial trauma that was the first sign of an occult cavernous IH. Complete excision of the tumor in the mandibular ramus reduced the risk of severe bleeding and prevented long-term recurrence, whereas immobilization of the fracture obtained an excellent functional result. This clinical report highlights the possibility that a previously unknown primary IH may debut as a pathological fracture and the importance of differential diagnosis in this location.
Extended Maxillotomy for Nasopharynx Access in Infantile Immature Teratoma
Authors: Kobayashi Shinji , Yasumura Kazunori , Yabuki Yuichiro , Satake Toshihiko , Maegawa Jiro , Tanaka Yukichi 
Published: August 2019

Abstract
Infantile immature teratoma located in the nasopharynx is a rare congenital tumor that is not easily removed. Three surgeries and chemotherapy for recurrence of the tumor have been performed since a male infant with a nasopharyngeal mass was born at a gestational age of 35 weeks. Extended maxillotomy combining Le Fort I osteotomy with midline palatal split was performed at 2 years and 6 months of age. Residual tumor left in the intracranial region had not increased as of 4 years of age. Careful follow-up is needed until the patient reaches adulthood.
Morphometric Analysis of Sella Turcica Using Cone-Beam Computed Tomography in Patients With Cleft Lip and Palate
Authors: Yalcin Eda Didem 
Published: August 2019

Objective:The purpose of this study is to evaluate morphometric analysis of sella turcica using cone-beam computed tomography (CBCT) in patients with cleft lip and palate (CLP) and healthy controls.Methods:Cone-beam computed tomography images of 68 patients (36 males, 32 females, age range 7–20 years) with CLP and 68 healthy individuals (36 males, 32 females, age range 8–19 years) were examined retrospectively. Sella turcica shapes were analyzed by 2 different methods in CLP and control groups. Length, depth, and diameter of sella turcica were measured in both groups. The data were statistically assessed by age, gender using Independentt-test and one-way analysis.Results:Diameter of sella turcica was smaller in CLP group compared to healthy individuals (P < .05). Length and depth of sella turcica were lower than in control group, but not statistically significant (P > .05). Sella turcica shape significantly differed between groups (P < .05). The most common sella turcica types were flattened and irregular shapes in CLP group, whereas round and normal shapes were in control group. There was no significant difference between groups in any dimension of sella turcica by gender (P > .05). Sella turcica depth was significantly higher at age of 15 years and above in CLP group.Conclusion:This study showed that flattened and irregular shapes of sella turcica were the most common types in CLP group. Smaller sella turcica was detected in CLP group compared to healthy individuals. Cone-beam computed tomography can be useful for evaluation of sella turcica.
Anatomical Study of the Posterior Auricular Branch of the Facial Nerve: Application to Parotid Surgery
Authors: Kikuta Shogo , Iwanaga Joe , Watanabe Koichi , Kusukawa Jingo , Tubbs R. Shane 
Published: August 2019

AbstractThe posterior auricular nerve (PAN) is the first branch of the facial nerve after it leaves the stylomastoid foramen. The literature describing the anatomy of the PAN is very sparse. Therefore, the purpose of this study was to clarify the detailed anatomical features of the PAN and consider its clinical and surgical applications. The authors examined 10 sides from 6 fresh frozen adult cadaveric Caucasian heads. The PAN was observed as the first branch of the facial nerve in all specimens. During the dissection of the PAN, the posterior auricular artery was constantly near the PAN. Moreover, the PAN was located under the investing layer of deep cervical facia covering the sternocleidomastoid and mastoid process in all specimens. The diameter of the PAN was 0.82 ± 0.21 mm (range from 0.55 to 1.21). The distance from the stylomastoid foramen to where the PAN branched from the facial nerve was 0.40 ± 1.25 mm (range from 0 to 4.35). The distance from the location of this branching point of the PAN to the entering point of the PAN to any muscles was 28.03 ± 5.51 mm (range from 19.71 to 38.75). Understanding the anatomical features of the PAN is essential for performing surgical procedures in this region.
Consensus on Methodology for Experimental Studies of Nasal Mucosal Injury
Authors: Kar Murat , Bayar Muluk Nuray , Bafaqeeh Sameer Ali , Cingi Cemal 
Published: August 2019

Objectives:
The way wounds heal involves significant complexity, resulting in restoration of functional and anatomical integrity to tissues damaged as a result of trauma (whether mechanical, chemical, or radiation-induced). The authors reviewed the consensus on methodology for experimental studies of nasal mucosal injury.

Methods:
The review aims to find where consensus exists amongst different experimental studies in nasal wound healing about the use of animal models. To achieve this, the authors queried the Pubmed, Proquest Central and Google databases for the last 20 years (i.e. 1996–2016). The search terms were: “mucosa injury,” “nasal mucosa injury,” “injury,” “wound healing,” “nasal,” “nasal wound healing,” “experimental,” “animal,” “model,” “rat,” “rabbit,” “guinea pig,” and “mice.” These terms were searched for whether they occurred singly or in combination. The search uncovered 18 papers, on the basis of which this review has been prepared.

Results:
The choice of an appropriate animal model is key in investigating nasal mucosal injury. Suitable animals include rodents such as rats or guinea pigs. There are reports in the literature concerning mechanical injury in rat nasal mucosae without attempts to treat it. Mechanical injury was induced unilaterally by means of an interdental brush. Other techniques involved the use of distilled water or irradiating the tissue to induce trauma.

Conclusion:
In this review, the use of a rat, guinea pig or rabbit model for human nasal mucosal injury is reviewed. Such models are suitable for use in well-designed experimental studies.
Management of Locally Advanced Pancreatic Cancer
Authors: Reames Bradley N. , Blair Alex B. , Krell Robert W. , Groot Vincent P. , Gemenetzis Georgios , Padussis James C. , Thayer Sarah P. , Falconi Massimo , Wolfgang Christopher L. , Weiss Matthew J. , Are Chandrakanth , He Jin 
Published: August 2019

Objective:
The aim of this study was to investigate surgeon preferences for the management of patients with locally advanced pancreatic cancer (LAPC).

Background:
Select patients with LAPC may become candidates for curative resection following neoadjuvant therapy, and recent reports of survival are encouraging. Yet the optimal management approach remains unclear.

Methods:
An extensive electronic survey was systematically distributed by email to an international cohort of pancreas surgeons. Data collected included practice characteristics, management preferences, attitudes regarding contraindications to surgery, and 6 clinical vignettes of patients that ultimately received a margin negative resection (with detailed videos of post-neoadjuvant imaging) to assess propensity for surgical exploration if resection status is not known.

Results:
A total of 153 eligible responses were received from 4 continents. Median duration of practice is 12 years (interquartile range 6–20) and 77% work in a university setting. Most surgeons (86%) are considered high volume (>10 resections/yr), 33% offer a minimally-invasive approach, and 50% offer arterial resections in select patients. Most (72%) always recommend neoadjuvant chemotherapy, and 65% prefer FOLFIRINOX. Preferences for the duration of chemotherapy varied widely: 39% prefer ≥2 months, 43% prefer ≥4 months, and 11% prefer ≥6 months. Forty-one percent frequently recommend neoadjuvant radiotherapy, and 53% prefer 5 to 6 weeks of chemoradiation. The proportion of surgeons favoring exploration following neoadjuvant varied extensively across 5 vignettes of LAPC, from 14% to 53%. In a vignette of oligometastatic liver metastases, 31% would offer exploration if a favorable therapy response is observed.

Conclusions:
In an international cohort of pancreas surgeons, there is substantial variation in management preferences, perceived contraindications to surgery, and the propensity to consider exploration in LAPC. These results emphasize the importance of a robust and nuanced multidisciplinary discussion for each patient, and suggest an evolving concept of “resectability.”