Perssonrosenthal9252
Crouzon syndrome is a known craniosynostosis syndrome with a heterogenous presentation. Suture closure can rapidly develop postnatally and involve multiple sutures, requiring vigilant clinical monitoring to prevent delay in diagnosis and developing intracranial hypertension. The authors present the case of a male patient with Crouzon syndrome who developed postnatal pansynostosis at 18 months of age when several missed appointments led to diagnosis after complete closure of all sutures and signs of elevated intracranial pressure. Posterior cranial vault distraction was performed soon after, and the patient improved clinically. There is a need for improved monitoring and management of these patients to prevent delay in diagnosis and potential permanent sequelae as well as minimizing radiation exposure through watchful CT scanning.
Crouzon syndrome is a known craniosynostosis syndrome with a heterogenous presentation. Suture closure can rapidly develop postnatally and involve multiple sutures, requiring vigilant clinical monitoring to prevent delay in diagnosis and developing intracranial hypertension. The authors present the case of a male patient with Crouzon syndrome who developed postnatal pansynostosis at 18 months of age when several missed appointments led to diagnosis after complete closure of all sutures and signs of elevated intracranial pressure. Posterior cranial vault distraction was performed soon after, and the patient improved clinically. There is a need for improved monitoring and management of these patients to prevent delay in diagnosis and potential permanent sequelae as well as minimizing radiation exposure through watchful CT scanning.Brooke-Spiegler Syndrome (BSS) is a very rare autosomal dominant hereditary disease which arises from heterozygous mutations in the CYLD gene. Patients with BSS are predisposed to multiple skin appendage tumors such as cylindromas, which are benign tumors occurring mainly on the scalp. The tumors mostly appear around puberty and usually show slow growth throughout life. Malignant cylindroma formation in BSS patients has been reported. Apart from the skin, major and minor salivary glands have rarely been involved.We here report a case of a 46-year-old female patient with BSS presenting with multiple aesthetically and functionally unpleasing cylindromas covering almost her entire hair-bearing scalp with further tumors on her face. Interestingly, her parotid glands were enlarged and showed multiple lesions with a diameter up to 18 to 20 mm. She was successfully treated by total subgaleal scalp excision and coverage through a dermal substitute and split thickness skin graft. Constant follow-up imaging was initiated to prevent unhindered tumor growth of salivary glands.
Unilateral complete cleft lip and palate (UCCLP) is associated with apparent nasal deformities before the Cheilorrhaphy. The aim of this study was to determine whether preoperative correction techniques are effective in the treatment of nasal deformities in infant with unilateral UCCLP used by the systematic review and meta-analysis.
We searched Medline, Cochrane Library, EMBASE, PubMed, and Chinese BioMedical Literature Database (CBM) until January 31, 2019, to identify studies that compared the effectiveness of preoperative correction techniques in the treatment of nasal deformities in infant with UCCLP. Two authors individually extracted the data and performed the quality assessments. The height of nasal columella, the width of the affected side nasal ala and the inclination of the nasal columella were evaluated.
Seven articles were incorporated into the systematic review, and 5 (274 participants) in the meta-analysis according to the inclusion criteria. The preoperative correction could increase then of the nasal columella.
Bioprinting has shown promise in the area of microtia reconstruction. However clinical translation has been challenged by the lack of robust techniques to control delivery of stem cells. Hybrid printing allowing multiple materials, both cell and support, to be printed together may overcome these challenges.
This study assesses the degradation behavior and tissue compatibility of hybrid scaffolds (PCL-Hydrogel) compared to single material Polycaprolactone (PCL) scaffolds in-vitro and in-vivo. Sheep demonstrate similar fascial anatomy to humans. This is the first reported study using a sheep model to study hybrid scaffolds for microtia.
PCL and PCL-Hydrogel samples of increasing porosity were subjected to an accelerated enzymatic degradation assay to study degradation behavior in-vitro. In addition, a 6-month study using Merino-Dorset sheep was conducted to compare the biological reaction of the host to PCL and PCL-hydrogel scaffolds.
In-vitro degradation showed homogenous degradation of the scaffold. PCL presented the dominating influence on degradation volume compared to hydrogel. In-vivo, there was no evidence of skin irritation or infection over 6 months in both control and test, though PCL-hydrogel scaffolds showed higher levels of tissue ingrowth.
Homogenous degradation pattern of porous scaffolds may create less surrounding tissue irritation. Hybrid scaffolds had good biological compatibility and showed better tissue ingrowth than PCL alone.
Homogenous degradation pattern of porous scaffolds may create less surrounding tissue irritation. Hybrid scaffolds had good biological compatibility and showed better tissue ingrowth than PCL alone.
In the United States, the use of herbal supplements on a regular basis ranges from 32% to 97%. Prevalence of supplement use is particularly elevated after facial surgery. It has been reported as high as 50%. Unfortunately, there is a paucity of literature on the dietary use of supplements. They are not regulated by the FDA. Often, they are not reported by patients. This study examines the role of dietary supplements as adjuncts to healing in craniofacial and facial aesthetic surgeries.
A comprehensive literature review was conducted using MEDLINE, PubMed, and EMBASE. Databases were screened for papers describing the use of supplements in craniofacial procedures in adult patients using relevant search terms. Data on criteria, outcomes, and patient satisfaction were collected.
A total of 19 articles were selected from the 806 identified. Fifteen different supplements or combinations of supplements have been studied for use in facial surgeries. Of these 15 supplements, the following demonstrated potential nts may have a synergistic beneficial effect on wound healing following craniofacial surgery. However, there is a need for additional reporting to allow for the creation of stronger guidelines and increased patient screening, reporting, and compliance.Carotid-cavernous fistulas (CCFs) are abnormal connections between the carotid arterial system and the cavernous sinus. These acquired vascular malformations may result in severe orbital congestion and sight-threatening complications. The authors present their experience in gaining access to the superior ophthalmic vein to embolize indirect CCFs in three different patients. Surgical exposure and cannulation of the SOV were successful in all 3 cases. One patient developed an orbital compartment syndrome towards the end of the embolization process, after the irrigation cannula was inadvertently dislodged from the SOV. He required a lateral canthotomy and inferior cantholysis but did not suffer from any related sequelae. Signs and symptoms resolved gradually in all patients and cosmetic results were excellent. In our experience, the SOV offers a reliable access to indirect CCFs, but patients should be monitored closely during the embolization process to prevent ophthalmic complications.We explored the clinical application of a 3-dimensional (3D) digital reconstruction technique for personalized and precise traumatic ear defect treatment. A 3D scanner was used to obtain 3D images of the unaffected ear. The data were converted into an ear contour model through mirroring using the software, and imported to a rapid prototyping 3D printer to construct an ipsilateral ear model. For treating different types of ear defect patients with individualized treatment programs, the defective ear model was constructed with individualized autogenous costal cartilage carving. We constructed ipsilateral ear defect models in 16 cases and rebuilt the auricular with >10 outer ear substructure units, maintaining a stable cranial angle. At the 6-month follow-up, the reconstructed ear was similar to the unaffected one, and the patient satisfaction was high. Based on a paired t test, the differences in the width of both auricles was statistically significant, with P values of 0.023, respectively. C75 in vivo The differences in the P values of the auricle length, circumference and height, at 0.261, 0.333, and 0.197, respectively, were not statistically significant. Compared to the model utilizing the traditional 2D film template of the ear, the 3D reconstruction technology was more intuitive and stereoscopic, and the personalized ear reconstruction was accurate. Thus, 3D digital technology can avail the most suitable personalized treatment for various traumatic ear defects. It can assist in precisely engraving the reconstructed cartilage stent and objectively analyzing the postoperative results. The therapeutic effect was significant.The aim of this study was to test if the marker rs196929 in IRE1 associated with cleft lip and palate depending on the family history for cancer. A consecutive sample of 836 individuals were recruited between April and October of 2019 (303 born with cleft lip and palate, 256 relatives mostly of the maternal side of individuals born with cleft lip and palate, and 277 unaffected unrelated individuals). Parents or guardians of the children answered a questionnaire with basic demographic information about their children and their family history of cleft lip and palate and cancer. DNA was obtained from whole saliva and IRE1 rs196929 was genotyped using TaqMan chemistry and end-point analysis. Over-representation of alleles was determined using chi-square as implemented in PLINK using an alpha of 0.05. There was an excess of less common homozygotes of IRE1 rs196929 among relatives of individuals born with cleft lip and palate when they had positive family history of cancer in comparison with individuals born with cleft lip and palate or with unrelated unaffected individuals (P = 0.0006 and P less then 0.001, respectively). This pattern was similar when families reported one type of cancer or multiple ones, or when cancer affecting females (breast or reproductive tract) or the structures of the gastro-intestinal tract were considered. These results provide support for a role of the ER stress IRE1-XPB1 pathway in the higher frequency of cancer in families of individuals born with cleft lip and palate.In this experimental anatomic study, the authors examined the number and distribution of muscle spindles in the levator palpebrae superioris (LPS) muscle of human adults. This study included 11 orbits from 11 cadavers (mean age at death, 81.9 years). The LPS muscles were harvested and equally divided into 5 sections using transverse incisions. Muscle spindles were counted in each section. Consequently, muscle spindles were identified in 4 (36.4%) of the 11 orbits studied. One to 4 muscle spindles were identified in each of these 4 orbits. All muscle spindles were found in the most proximal section (the muscle origin), and no muscle spindles were identified in the other sections. The results indicate that the LPS muscle is associated with a smaller number of muscle spindles as compared with the rest of the extraocular muscles. Since higher muscle spindle numbers are associated with finer motor movements, eyelid opening does not seem to require much precision, compared to ocular movement.
