Lundsgaardyoung7073

6%), and one cranioplasty displacement (0.7%). At follow-up, in 85.3% of cases the CPL is still in place with satisfactory cosmetic and functional outcome (86.5% of HM CPL, 84.5% of CM CPL).HM CPL may still represent an effective and economic alternative procedure, when specific patient selection criteria are respected. This technique requires a long learning learning curve and demanding surgical maneuvers. Our handmade reconstruction technique with some hints to improve the esthetic result is presented.Freeman-Burian syndrome (FBS) is a rare congenital myopathic craniofacial syndrome. Since publication of the genotype-correlated clinical diagnostic criteria, no complete survey of the literature has been accomplished. As part of the clinical practice guideline development, we evaluate diagnostic accuracy for FBS from 1938 to 2019 and range of findings, complications, treatments, and outcomes. Published manuscripts in PubMed, Google Scholar, and OMIM describing cases with a reported diagnosis of FBS, Sheldon-Hall syndrome, and distal arthrogryposes type 1 and 3 are initially included. Articles with sufficient case-level data for diagnosis verification are analyzed further. Of 724 unique papers considered, 188 papers describing 304 unique patients are included; 101 papers and 119 patients reflect an FBS diagnosis, with 80 patients meeting the full diagnostic criteria. Most cases are re-screened as distal arthrogryposis type 1. Among all cases re-screened as FBS, the presence of FBS pathognomonic craniofacial findings is not correlated with other physical findings. There are no significant differences between patients meeting the full diagnostic criteria and those not, but both are distinct from other diagnoses. Plastic surgery demonstrates the highest cumulative diagnostic accuracy for FBS overall (86.66%), while orthopedic surgery shows the lowest (44.83%). No statistically usable treatment-related or psychosocial data are available. Quality of case reports and patient data vary widely, reducing the statistical strength and significance. Major knowledge gaps exist in treatment, psychosocial, and longitudinal outcomes. At this point, it is impossible to derive clinical practice guidelines exclusively from the literature.The anatomical characteristics of the superior ophthalmic vein (SOV), which is crucial when performing craniofacial surgeries and transvenous access to the cavernous sinus, have not been documented. The present study aimed to explore them using magnetic resonance angiography (MRA). A volumetric, phase-contrast MRA was performed in 74 outpatients not bearing vascular or tumorous pathologies in the face, orbit, and cavernous sinus. The entire course of the SOV was delineated in 46 patients (62%), for 76% on the right side and 83% on the left. These SOVs consistently showed a characteristic morphology with a laterally coursing proximal segment and a medially coursing distal segment. The latter segment was connected to the angular, supraorbital, supratrochlear, facial, and external nasal veins that were inconsistently delineated. The angular vein was tortuous in 51% of the patients on the right and 53% on the left. The morphology of the proximal part of the SOV was also variable and involved a tortuous segment in 11% of the patients on the right and in 7% on the left. Furthermore, in 4 patients (8.7%), a fenestration was found in the right SOVs. Inconsistent tributaries of the SOV, tortuous angular vein, and possible tortuous segment and fenestration of the SOV can make orbital transvenous access to the cavernous sinus difficult.Submucous cleft palate (SMCP) is a congenital condition related to abnormal muscle attachments within the soft palate. Even though hypernasality and nasal emission, the primary symptom of SMCP, have been well-documented, research on articulation errors is currently lacking. The object of this study was to examine the consonant articulation in patients with unoperated SMCP and its possible correlation with the velopharyngeal function. This study analyzed the perceptual speech assessment and nasopharyngoscopy data of 338 patients with unoperated SMCP between years 2008 and 2016 retrospectively. The mean age of the patients was 13.27 years. About 125 patients showed velopharyngeal competence (VPC), 174 velopharyngeal incompetence (VPI), and 39 marginal VPI (MVPI). Among the 338 patients, 137 presented normal articulation, 124 consonant omission, 25 compensatory articulation, 36 consonant weakening, 51 consonant substitution, and 36 posterior placement. selleck inhibitor About 70.40% VPC patients, 17.24% VPI patients, and 48.72% MVPI patients demonstrated normal articulation. About 59.20% VPI patients showed consonant omission. The results demonstrated that consonant articulation varied among patients with unoperated SMCP and was correlated with their velopharyngeal functions, while consonant omission was the most common articulation error. Velopharyngeal closure pattern was not associated with either velopharyngeal function or consonant articulation.The aim of the present work is to evaluate the most suitable surgical technique in relation to location and extent of medication-related osteonecrosis of the jaws (MRONJ) through comparison of success rate between the routinely used mucoperiostal flaps and different local flaps designs and propose a standardization of surgical procedures according to MRONJ stage and localization with 2 objectives to provide the surgeon with an algorithm of treatment according to MRONJ localization and extension; to maximize the success of surgical treatment.Thirteen consecutive patients affected by focal MRONJ were surgically treated with radical osteotomy at the Center for Treatment of the Osteonecrosis of the Jaws (University of Messina, Italy).Initial defects were classified according to the classification of the Italian Societies of Oral Medicine and Maxillofacial Surgery (the SICMF-SIPMO staging system) which consider not only bone exposure but also radiological bone involvement. Treatment outcome was retrospectively assessed according to the different adopted surgical procedure mucoperiostal flaps (GROUP A) advanced mucoperiostal flaps or rotation flaps (GROUP B) local flaps (GROUP C).Outcome after surgical treatment of focal MRONJ was positive in every group irrespective of MRONJ localization and extension. This may be due to the appropriate selection of surgical procedure.The results obtained demonstrated that focal MRONJ surgical treatment is a reliable procedure irrespective of the initial clinical situation. Radical osteotomy combined with appropriate selection of soft tissue management is crucial.