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6% versus 76.4%, respectively; P = 0.04). Injured cyclists in the alcohol/drug group experienced greater odds of sustaining a facial injury (odds ratio 2.21, 95% confidence interval 1.71-2.84, P < 0.0001) and a facial fracture (odds ratio 2.75, 95% confidence interval 1.83-4.13, P < 0.0001) than injured cyclists in the no alcohol/drug group.
Substance use while cycling is not safe and significantly increases the likelihood of a facial injury and of facial fractures. This prevalence of injuries would suggest that cycling under the influence should always be illegal, and the law strictly enforced.
Substance use while cycling is not safe and significantly increases the likelihood of a facial injury and of facial fractures. This prevalence of injuries would suggest that cycling under the influence should always be illegal, and the law strictly enforced.
Bilateral cleft lip deformities makeup 10% of orofacial clefts and are uncommon when compared to unilateral cleft lip.1,2 These cleft deformities have significant physical and long-term psychosocial effects on not only the patient but their family. With bilateral cleft lip deformity, the cutaneous approximation of the lateral lip segments are dependent on a sufficient prolabium to reconstruct the philtrum.3,4 Deficient skin equates to tight midline closure and subsequent unsightly scarringIn the subclinical phenotype of bilateral cleft lip and palate, where the patient has an absent or deficient prolabium, achieving tension free closure in the primary surgical setting is a reconstructive dilemma.5 This clinical report describes the use of a full-thickness skin graft to reconstruct the philtrum in a 12-month-old boy with bilateral cleft lip deformity, absent prolabium, absent columella and absent nasal septum to provide an aesthetic subunit repair.
Bilateral cleft lip deformities makeup 10% of orofacial clefts and are uncommon when compared to unilateral cleft lip.1,2 These cleft deformities have significant physical and long-term psychosocial effects on not only the patient but their family. With bilateral cleft lip deformity, the cutaneous approximation of the lateral lip segments are dependent on a sufficient prolabium to reconstruct the philtrum.3,4 Deficient skin equates to tight midline closure and subsequent unsightly scarringIn the subclinical phenotype of bilateral cleft lip and palate, where the patient has an absent or deficient prolabium, achieving tension free closure in the primary surgical setting is a reconstructive dilemma.5 This clinical report describes the use of a full-thickness skin graft to reconstruct the philtrum in a 12-month-old boy with bilateral cleft lip deformity, absent prolabium, absent columella and absent nasal septum to provide an aesthetic subunit repair.
Obvious scar and deformities are commonly observed with incision anterior to the alar-facial groove in alar excision surgery. The authors explored modified sill and alar excision to correct wide alar base and flare synchronously and decreased incident of unacceptable scar and deformities in Asian patients.
The authors conducted a retrospective cohort study including 52 consecutive patients undergoing this surgery. Contrary to previous studies, the incision for alar excision was located in the alar-facial groove and was closed by intracutaneous suture. Scars were assessed with visual analog scale and the Stony Brook Scar Evaluation Scale. Ratio of the interalar distance to intercanthal distance, nostril shape, and nostril symmetry was recorded.
The mean follow-up time was 18 months. Visual analog scale results showed 50 patients (96.2%) reported unnoticeable scar and 2 noticeable but acceptable scar. Stony Brook Scar Evaluation Scale results indicated 49 patients (94.2%) with good scar outcomes and 3 (5.ach with the incision for alar excision being placed in the alar-facial groove and closed by intracutaneous suture, which can avoid obvious scar and deformities in Asian patients.Level of evidence Level 4.
The purpose of this study is to quantitatively establish the volumetric changes observed with posterior vault distraction osteogenesis in the anterior, middle, and posterior thirds of the cranial vault; characterize change in cranial length, width, and height, correlating these changes to demographic variables that may help identify why younger kids gain more volume; and describe the short-term position of the transport segment.
Multisuture craniosynostosis patients who underwent posterior vault distraction osteogenesis were retrospectively reviewed. Pediatric, dose-reduced, thin cut helically acquired head computed tomography scans were analyzed on Materialise Mimics v22 (Materialise, Ghent, Belgium). Pre and post-PVDO and "old" and "young" cohort were compared.
Twenty-one patients met inclusion criteria. Phorbol12myristate13acetate The change in cranial length was significantly less at a median of 14.9 mm [Interquartile range (IQR) 11.8, 31.6] compared to the X-ray measured AP distraction distance (30 mm [IQR 24, 33]; P < 0.001) and significantly less than the theoretically calculated distance (23 mm [IQR 19, 31]; P = 0.012). Median anterior cranial height was shorter post PVDO (82.9 mm, [IQR 64.8, 92.6] versus 78.7 mm [IQR 57.0, 88.7]; P = 0.030). The younger cohort saw a greater increase in total intracranial volume (median 335.1 mL [IQR 163.2, 452.3, median 37.1%] versus 144.6 mL [IQR 119.0, 184.8, median 12.0%]; P = 0.011).
This is the first study to quantify volumetric changes to the anterior, middle, and posterior cranial vaults and demonstrates benefits of preforming PVDO at a younger age to help control turricephaly and produce greater percentage volumetric increases.
This is the first study to quantify volumetric changes to the anterior, middle, and posterior cranial vaults and demonstrates benefits of preforming PVDO at a younger age to help control turricephaly and produce greater percentage volumetric increases.
Unilateral coronal craniosynostosis (UCS) is the third most prevalent form of craniosynostosis. Traditional treatment of UCS has been achieved with fronto-orbital advancement and cranial vault remodeling (FOAR), but utilization of cranial distraction osteogenesis (DO) techniques has increased. This study aims to compare perioperative complications and reoperation trends in FOAR versus DO techniques at a single institution.
An Institutional Review Board-approved retrospective review was performed from January 1999 to November 2018 at a single institution. Patients were those that have undergone FOAR or DO with an anterior rotational flap technique as previously described. Indications for secondary procedures included contour deformities, relapse, surgical site infection, and persistent cranial defects.
Eighty-one patients with UCS were identified, 64 patients underwent FOAR and 17 patients underwent DO. When perioperative characteristics were compared, patients who underwent DO were younger in age, howevchniques for treatment of UCS. Longer-term follow-up studies are needed to elucidate whether outcomes are durable, but the unplanned reoperation rate in DO is less than that of FOAR at 5 years and presents several advantages that warrants its use in patients with UCS.
Zygomatic intraosseous vascular anomalies are uncommon. Most cases have been reported without a precise diagnosis. The prevalence is 31 women during the fourth decade of life. The study of these lesions includes clinical findings, radiological studies, such as computed tomography and magnetic resonance imaging scans, and a postoperative histological study of the specimen. Biopsy is not recommended because of the risk of bleeding. Complete surgical resection remains the gold standard elective treatment.The case of a patient with an intraosseous venous malformation of the zygomatic bone is presented, detailing the clinical, histological, and radiological characteristics and the surgical treatment with a primary reconstruction through Computer-Aided Design/Computer-Aided Manufacturing customized titanium implant guided by virtual surgical planning with a reduction of surgical time and morbidity in the donor area with optimal functional and aesthetic results.
Zygomatic intraosseous vascular anomalies are uncommon. Most cases have been reported without a precise diagnosis. The prevalence is 31 women during the fourth decade of life. The study of these lesions includes clinical findings, radiological studies, such as computed tomography and magnetic resonance imaging scans, and a postoperative histological study of the specimen. Biopsy is not recommended because of the risk of bleeding. Complete surgical resection remains the gold standard elective treatment.The case of a patient with an intraosseous venous malformation of the zygomatic bone is presented, detailing the clinical, histological, and radiological characteristics and the surgical treatment with a primary reconstruction through Computer-Aided Design/Computer-Aided Manufacturing customized titanium implant guided by virtual surgical planning with a reduction of surgical time and morbidity in the donor area with optimal functional and aesthetic results.
Aesthetics and function of maxillofacial district are closely related and could interfere with patient psychological conditions. The aim of this paper is to describe and to analyze the procedures necessary for a proper surgical visualized treatment objective (VTO) realization through the use of the tracing on lateral head film, applying the divine proportion (or golden ratio) in certain steps. link2 The method described is easy to realize, cheap and help both orthodontist and maxillo-facial surgeon to communicate each other and to the patients.For the following article, digital research and handheld research on surgical VTO planning for patients with skeletal or dentoalveolar severe deformities managed by surgeons and orthodontics were used. The research included articles in English published on dental and maxillofacial surgery journals.The surgical VTO consists of a "previsualization" of the objectives in order to make the desired changes for the individual patient. The result can thus be visualized and pre-evaled result, to give the patient a reasonable preview of the outcome, and to ensure communication between the orthodontist and the surgeon.This technique proves to be effective in planning surgical treatment and it allows the clinician to view changes before, during, and after orthognathic surgery. The skeletal, dental, and aesthetic complete cephalometric evaluation is the key point to the long-term success of the results.
The aim of this study was to investigate the possible relationship between disc displacement and the presence of reduction by comparing condyle anteroposterior (AP) diameter, condyle height, mandibular fossa AP diameter, and mandibular fossa depth.
A total of 588 joints of 294 patients were included in the study for evaluation. link3 Disc displacement and the presence of reduction, condyle AP diameter, condyle height, mandibular fossa AP diameter, and mandibular fossa depth were evaluated.
Of the 588 temporomandibular joint examined in the study, there was disc displacement in 141 (24%) and no disc displacement in 447 (76%). Of the joints with disc displacement, reduction was observed in 53 (9%) and not in 88 (15%).A statistically significant correlation was determined between condyle AP diameter and disc displacement (P = 0.00); in the cases with disc displacement, the condyle AP diameter was measured smaller. A statistically significant correlation was determined with condyle height, mandibular fossa AP diameter, and fossa depth.
