bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal and Epidural Anesthesia in Patients With Recent Stable Fractures of Vertebral Column
Authors: Gurajala Indira , Iyengar Raju , Durga Padmaja , Gopinath Ramachandran 
Published: June 2015

Background:
The use of central neuraxial block (CNB) in patients with spinal injuries with or without spinal cord injury continues to be a contentious issue due to paucity of evidence supporting or refuting its use. There are only a few case reports reporting the use of the technique in these patients. We performed a retrospective record review of patients who underwent neuraxial blockade for lower limb orthopedic surgery in the presence of coexisting recent spine injury (defined as spine injury within 1 month) to assess the occurrence of postoperative deterioration of spinal cord function or occurrence of new spinal cord dysfunction.

Materials and Methods:
The hospital records of patients with recent stable traumatic fractures of the vertebral column who underwent lower limb orthopedic surgery under CNB from January 2010 to December 2013 were reviewed. Data collected included age, sex, level of fracture, number of vertebrae injured, presence of neurological deficits, interval between injury and surgery, number of surgeries, level of CNB, number of vertebral segments between the site of injury and CNB, position of patient used for CNB and surgery, and perioperative adverse hemodynamic events. All patients underwent detailed postoperative neurological examination and any deterioration or occurrence of new spinal cord dysfunction was noted.

Results:
Nineteen patients underwent 21 CNBs for lower limb orthopedic procedures. There were 12 men and 7 women. Thoracolumbar area (18/19) was the commonest site of fractures. Two patients had neurological deficits due to cervical spine trauma. More than 50% of the patients had multiple bone fractures and nearly 30% had associated nonorthopedic trauma. Six patients underwent surgery within the first week (4 to 7 d) after trauma. In 80% of the patients, there was a gap of atleast 2 vertebrae between the level of injury and CNB administration. There were no perioperative adverse hemodynamic events requiring prolonged inotropic support. None of the patients had neurological deterioration or new changes.

Conclusions:
Spinal and epidural anesthesia in patients with recent stable fractures of the spine was not associated with adverse neurological events. The findings of this study may be particularly relevant to patients with recent stable vertebral fractures who require surgery but present with conditions that place them at high risk for general anesthesia.
Presentation of Adolescent Idiopathic Scoliosis: The Bigger the Kid, the Bigger the Curve
Authors: Goodbody Christine M. , Sankar Wudbhav N. , Flynn John M. 
Published: June 2015

Background:
It is our clinical suspicion that children with higher body mass index (BMIs) who are diagnosed with scoliosis tend to have larger curves on presentation. The purpose of this study was to determine the effect of BMI on severity of curve at initial presentation of adolescent idiopathic scoliosis.

Methods:
This is a retrospective, descriptive cohort study of consecutive patients age 10 or greater referred to a single large tertiary care center with concern for spinal asymmetry. Patients were separated into 3 BMI categories as measured on the presenting visit: normal weight—≥5th and <85th percentile, overweight—≥85th and <95th percentile, and obese—≥95th percentile. In addition to demographic information, data collected included BMI, curve magnitude, curve location, Risser stage, and where or by whom spinal asymmetry was noted.

Results:
A total of 150 patients, 50 in each the normal weight, overweight, and obese categories, were included in this study. Average curve at presentation for normal weight patients was 18.1 degrees, for overweight patients 23.9 degrees (P=0.02), and for obese patients 24.5 degrees (P=0.02). As compared with the normal weight group, odds ratio of presenting with a curve of 40 degrees or above was 10.8 for the overweight group (95% confidence interval, 1.3-88.5, P=0.03) and 12.2 for the obese group (95% confidence interval, 1.5-99.8, P=0.02). Assuming a cut-off of 45 degrees as surgical range, no normal weight patients presented in surgical range (0%), but 7/50 (14%, P=0.01) overweight and 8/50 (16%, P<0.01) obese patients did. Moreover, higher BMI patients were significantly more likely to present at a higher degree of skeletally maturity, with an average Risser of 1.8 for normal weight patients, 2.7 (P=0.01) for overweight patients, and 2.9 (P=0.01) for obese patients.

Conclusions:
Overweight and obese patients with adolescent idiopathic scoliosis present at significantly larger curve magnitudes and significantly higher degrees of skeletal maturity. Moreover, these patients were significantly more likely to present with very large curves and, in our study, all patients presenting with a surgical range curve were either overweight or obese.

Level of Evidence:
Level III—Retrospective case-control.
Total Auricular Rehabilitation
Authors: Littlefield Philip D. , Tolisano Anthony M. , Sabol Jennifer V. , Herberg Matthew E. , Coppit George L. 
Published: June 2015

Objective:
The aim of the study was to describe 3 cases of total auricular rehabilitation, including the novel use of iliac crest bone grafts to support bone-anchored auricular prostheses.

Study Design:
This study is a retrospective case series from a single institution.

Results:
Three cases with large lateral temporal bone and soft tissue defects were successfully treated with total auricular rehabilitation. Rehabilitation included the following: soft tissue coverage with an anterolateral thigh microvascular free flap, iliac crest–free bone graft with staged placement of a bone-anchored auricular prosthesis into the bone graft, and audiologic rehabilitation with a bone-anchored hearing aid (BAHA).
All of the cases with grafts and flaps survived and were without significant donor site morbidity. Bone-anchored hearing aid abutment skin overgrowth was seen in 2 cases and was revised under local anesthesia. All of the patients had expected functional recovery on postoperative audiologic testing. Each patient continues to consistently wear his/her auricular prosthesis and BAHA during 3 years of follow-up.

Conclusions:
Total auricular rehabilitation is a complex task involving reconstruction of extensive soft tissue defects, bony defects, and the hearing apparatus. Acceptable cosmetic and functional outcomes and high patient satisfaction is possible in committed patients.
Evaluation of the Cortical Bone Reaction Around of Implants Using a Single-Use Final Drill
Authors: Gehrke Sergio Alexandre 
Published: June 2015

Objectives:
This study was designed to compare the cortical bone reaction following traditional osteotomy or the use of a single-use final drill in the osseointegration of implants in the tibia of rabbits.

Materials and Methods:
For this study, 48 conical implants, of standard surface type and design and manufactured by the same company, were inserted into the tibiae of 12 rabbits and removed after 30 or 60 days for histologic analysis. Two test groups were prepared according to the drill sequence used for the osteotomy at the preparation sites: in the control group was used a conventional drill sequence with several uses, whereas the test group (tesG) used a single-use final drill. The bone-to-implant contact and qualitative factors of the resulting cortical bone were assessed.

Results:
Both techniques produced good implant integration. Differences in the linear bone-to-implant contact were observed between the drilling procedures as time elapsed in vivo, with the tesG appearing to have clinical advantages. Both groups exhibited new bone in quantity and in quality; however, the tesG exhibited a higher level of new bone deposition than the control group.

Conclusions:
Within the limitations of this study, the findings suggest that the use of a single-use final drill leads to better and faster organization of the cortical bone area during the evaluated period and may avoid the possible problems that can be caused by worn drills.
High-Energy Traumatic Maxillofacial Injury
Authors: Christensen Jacob , Sawatari Yoh , Peleg Michael 
Published: June 2015

Abstract
High-energy blunt or penetrating impact leads to great variability in facial injury patterns. Although the mechanism, pattern, and distribution of forces vary, the resultant damage to hard and soft tissues requires dedicated planning and execution of debridement and reconstructive procedures. This article evaluates the initial management of patients sustaining high-energy facial impact injuries resulting in one or more comminuted or displaced facial fractures, with accompanying severe facial lacerations and/or soft tissue defects and avulsion injuries. Seventy-three patients met the criteria for high-energy traumatic injuries at Jackson Memorial/University of Miami Medical Center between 2003 and 2013 and are included in this article. Thirty-nine patients sustained one or more gunshot wounds to the face, and 34 patients were involved in high-speed motor vehicle collisions; all patients met our criteria for high-energy trauma. The treatment protocol for these injuries involves meticulous surgical exploration and assessment, aggressive debridement, early definitive reduction/fixation, and reconstruction as necessary.
A Hypothesis for the Pathologic Mechanism of Idiopathic Exophthalmos Based on Computed Tomographic Evaluations
Authors: Takada Keiko , Sakamoto Yoshiaki , Shimizu Yusuke , Nagasao Tomohisa , Kishi Kazuo 
Published: June 2015

Abstract
The causes of idiopathic exophthalmos were still unknown. We used computed tomography to compare the orbital structures of patients with idiopathic exophthalmos and those of a healthy Japanese population. A total of 18 orbits (ranged 17–52 years) in idiopathic exophthalmos and 334 normal orbits (ranged 17–59 years) were included. On computed tomography, the eyeball and orbit sizes, lateral wall thickness and length, perpendicular distance from the interzygomatic line to the medial orbital rim, and the nasal cavity width were measured. No significant differences in eyeball or orbit sizes were found between the idiopathic exophthalmos and control groups (P > 0.05). In contrast, the mean lateral wall thickness of the idiopathic exophthalmos group was significantly thicker than that of the control group (P < 0.01). The lateral wall length was shorter with significant difference (P < 0.05). The perpendicular distance and the width of the nasal cavity in the idiopathic exophthalmos group were longer with significant difference (P < 0.05). The cause of idiopathic exophthalmos is compression of orbital contents by the medial wall expansion. The force of expansion of medial wall also influences the zygoma according to Wolff law.
Sir William Arbuthnot Lane and His Contributions to Plastic Surgery
Authors: Breakey Richard William F. , Mulliken John B. 
Published: June 2015

Abstract
Surgical subspecialties were just emerging at the turn of the 20th Century, before this time, general surgeons had to adjust their operative skills to address disorders throughout the body. Sir William Arbuthnot Lane was a British surgeon, whose restless mind led him to wander throughout the field of general surgery and beyond. Although controversial, he advanced in the repair of cleft lip and palate, introduced the “no touch” operative technique, internal fixation of fractures, and is credited as the first surgeon to perform open massage of the heart. During The Great War, he established the British Plastic Surgery unit at Sidcup and delegated the care of facial and jaw injuries to young Major Harold Gillies. Lane later founded The New Health Society, an organization that stimulated the natural food movement. Sadly, in his latter years Lane's thinking drifted further away from with the times and his professional credibility waned. Nevertheless, Lane's variegated life is of sufficient interest to deserve reassessment.
Severe Pediatric Midface Trauma
Authors: Davidson Edward H. , Schuster Lindsay , Rottgers S. Alex , Smith Darren M. , Naran Sanjay , Goldstein Jesse A. , Losee Joseph E. 
Published: June 2015

Abstract
Severe pediatric facial trauma is characterized by multiple, comminuted, and unstable fractures, frequently necessitating operative intervention. Disruption of facial growth is a primary concern in the long-term sequelae of such conditions. Children suffering from midface fractures were followed over time in a long-term growth and development study. Lateral cephalograms at longest-term follow-up were traced, digitized, and averaged. Seven landmarks of the midface (A point, ANS, orbitale, bridge of nose, distal U6, upper lip, stomion superius) were identified for comparative measurements with age and sex-matched superimposed Bolton norms as controls. Differences in x and y axes between test and control metrics were measured. Clinical significance was defined as a 2-mm discrepancy from the norm. Statistical significance for each patient was determined using t tests of the x and y arrays of patient values versus normal controls. Seven patients met the inclusion criteria with mean age of 8.9 years at the time of injury. Mean cephalometric follow-up was 4.6 years (range 2–10 years). Six out of 7 patients (86%) showed clinically significant impairment in growth in horizontal (29%), vertical (29%), or both planes (29%). T Tests confirmed statistical significance (P ≤ 0.05) for all clinically significant differences. Mean deficiency in growth for all landmarks was 3.7 mm (range −4.0 to 13.7 mm) in the x axis and 2.9 mm (range −1.1 to 8.8 mm) in the y axis. Severe pediatric midface trauma often results in compromised bone growth and permanent facial deformity. New methodologies of management that better allow for growth are needed.
The Effect of Subcutaneous Platelet-Rich Plasma Injection on Viability of Auricular Cartilage Grafts
Authors: Bulam Hakan , Ayhan Suhan , Yilmaz Guldal , Sezgin Billur , Sibar Serhat , Tuncer Serhan , Findikcioglu Kemal , Latifoglu Osman 
Published: June 2015

Introduction:
Although cartilage grafts are frequently used for structural integrity and volume restoration, one of the main concerns dealing with cartilage grafting is gradual volume loss and unpredictable viability rates of cartilage grafts. Platelet-rich plasma (PRP) is a well known platelet concentrate reported to enhance cartilage repair and stimulates chondrocyte proliferation and matrix biosynthesis. The purpose of the current study was to investigate the effect of subcutaneous PRP injection on improving the viability of cartilage grafts.

Materials and Methods:
Six circular cartilage grafts were obtained from auricular cartilages of 6 New Zealand white rabbits. Cartilage grafts were prepared in 3 forms: block, crushed, and crushed/wrapped with Surgicel (Surgical, Ethicon, Somerville, NJ). Grafts were placed to 6 dorsal subcutaneous pockets and pockets were closed. Autologous PRP was prepared and injected subcutaneously into the pockets of experiment groups. At the end of 8 weeks, cartilage grafts were removed. Cartilage mass reduction rates were measured. Resorption rates of cartilage grafts and formation of fibroelastic and bone tissue were microscopically evaluated.

Results:
All of the cartilage grafts lost significant weight. Viability scores of block cartilages were higher than crushed cartilages. Although less weight loss rates and higher histopathologic scores were obtained in subcutaneously PRP injected cartilage graft groups, these results were not statistically significant.

Conclusions:
Although our study gives a new insight about increasing the viability of cartilage grafts, the subcutaneous PRP injection did not result in improving the viability of cartilage grafts in this experimental design.
Image-Guided Sinus Surgery in Sinonasal Pathologies With Skull Base/Orbital Erosion
Authors: Al-Qudah Mohannad 
Published: June 2015

Objective:
The aim of the study was to review the use and outcomes of image-guided sinus surgery (IGSS) in sinonasal pathologies with skull base/orbital erosion without intracranial or intraorbital extension.

Method:
A retrospective charts and medical records review was performed for 474 consecutive sinonasal surgeries performed by a single surgeon at tertiary, academic center from August 2010 to December 2013.

Result:
Fourteen subjects (mean age 27 years; 8 men and 6 women) were identified. Mucocele and tumor were the most common pathological indication for IGSS use in this case series. Orbital wall erosion was detected in 57%, skull base in 29%, and both sites in 14%. The average blood loss was 80 mL, the average operative time was 190 minutes, and the average hospital stay was 3 days. There was no major intra- or postoperative complications. Two patients required revision endoscopic sinus surgery. The mean follow-up was 14 months (range 8–36 months).

Conclusion:
Image-guided sinus surgery alone is safe and effective procedure for a variety of sinonasal pathologies with orbital and skull base erosion.
Occurrence of Pneumatic Cavities Surrounding the Temporomandibular Joint
Authors: Sen Yilmaz Berza , Aksakalli Sertac , Birlik Muhammet , Dadasli Ferit , Bolukbasi Esra , Aytugar Emre 
Published: June 2015

Objectives:
The aim of this study was to investigate the occurrence, the location, and the characteristics of the pneumatic cavities (PCAs) surrounding the temporomandibular joint (TMJ) by using cone-beam computed tomography.

Methods:
A retrospective study was performed by using the three-dimensional data archives from Faculty of Dentistry, Bezmialem University, Istanbul, Turkey. The age and sex had been previously recorded for all of the patients. The location and the morphologic characteristics of the PCAs were documented.

Results:
Pneumatic cavities were found in 18 patients (15%): 11 women (61%) and 7 men (39%). Eleven (57.9%) of the patients showed unilocular pneumatic air cells and 8 (42.1%) of them showed multilocular ones. The unilateral-to-bilateral ratio was 2.3:1. The age range was 8 to 76 years (mean 29.5 ± 21.86 years), and the female-to-male ratio was 1.57:1.

Conclusion:
Cone-beam computed tomography provides images without superimposition that allows accurate and easy evaluation of the PCAs surrounding the TMJ. Our results suggest that the occurrence of PCAs is higher than has been previously reported; therefore, it is recommended for clinicians who are planning to perform TMJ surgery to think about the PCAs to understand the exact morphology for avoiding intraoperative complications.
A Three-Dimensional Statistical Average Skull
Authors: Teshima Tara Lynn , Patel Vaibhav , Mainprize James G. , Edwards Glenn , Antonyshyn Oleh M. 
Published: June 2015

Purpose:
The utilization of three-dimensional modeling technology in craniomaxillofacial surgery has grown exponentially during the last decade. Future development, however, is hindered by the lack of a normative three-dimensional anatomic dataset and a statistical mean three-dimensional virtual model. The purpose of this study is to develop and validate a protocol to generate a statistical three-dimensional virtual model based on a normative dataset of adult skulls.

Method:
Two hundred adult skull CT images were reviewed. The average three-dimensional skull was computed by processing each CT image in the series using thin-plate spline geometric morphometric protocol. Our statistical average three-dimensional skull was validated by reconstructing patient-specific topography in cranial defects. The experiment was repeated 4 times. In each case, computer-generated cranioplasties were compared directly to the original intact skull. The errors describing the difference between the prediction and the original were calculated.

Results:
A normative database of 33 adult human skulls was collected. Using 21 anthropometric landmark points, a protocol for three-dimensional skull landmarking and data reduction was developed and a statistical average three-dimensional skull was generated. Our results show the root mean square error (RMSE) for restoration of a known defect using the native best match skull, our statistical average skull, and worst match skull was 0.58, 0.74, and 4.4 mm, respectively.

Conclusions:
The ability to statistically average craniofacial surface topography will be a valuable instrument for deriving missing anatomy in complex craniofacial defects and deficiencies as well as in evaluating morphologic results of surgery.
Shared Surgical Decision Making and Youth Resilience Correlates of Satisfaction With Clinical Outcomes
Authors: Kapp-Simon Kathleen A. , Edwards Todd , Ruta Caroline , Bellucci Claudia Crilly , Aspirnall Cassandra L. , Strauss Ronald P. , Topolski Tari D. , Rumsey Nichola J. , Patrick Donald L. 
Published: June 2015

Abstract
The aim of this study was to identify factors associated with youth satisfaction with surgical procedures performed to address oral cleft or craniofacial conditions (CFCs). It was hypothesized that youth mental health, participation in decision making, perceived consequences of living with a CFC, and coping strategies would be associated with satisfaction with past surgeries. A total of 203 youth between the ages of 11 and 18 years (mean age = 14.5, standard deviation = 2.0, 61% male participants, 78% oral cleft) completed a series of questionnaires measuring depression, self-esteem, participation in decision making, condition severity, negative and positive consequences of having a CFC, coping, and satisfaction with past surgeries. Multiple regression analysis using boot-strapping techniques found that youth participation in decision making, youth perception of positive consequences of having a CFC, and coping accounted for 32% of the variance in satisfaction with past surgeries (P < 0.001). Youth age, sex, and assessment of condition severity were not significantly associated with satisfaction with surgical outcome. Depression, self-esteem, and negative consequences of having a CFC were not associated with satisfaction with past surgeries. Youth should be actively involved in the decision for craniofacial surgery. Youth who were more satisfied with their surgical outcomes also viewed themselves as having gained from the experience of living with a CFC. They felt that having a CFC made them stronger people and they believed that they were more accepting of others and more in touch with others’ feelings because of what they had been through.