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Backgrounds: The main objective of Frontoethmoidal encephalomeningocele (FE) treatment are neural morbidities defect correction and aesthetically pleasing looks. Staged procedures are used to be performed in Indonesia. This article aimed to reveal the result of FE correction through the single-stage modified Chula technique (ST-MCT) procedure in collaboration with the neurosurgery team. Case Reports: A rare case of 5 years old girl diagnosed with FE was reported in this study. The FE was slowly increased in size, causing apparent facial deformity and the appearance of telecanthus. An ST-MCT procedure in collaboration with the neurosurgery team was conducted to correct the defects. The IOD values, IPD values, postoperative complications, and anesthetic improvements were evaluated in this study. Result: The patient was well after the surgery, with no complications and short length of stay. There were noted improvement of ICD, IOD and IPD postoperative follow up. At three years after the surgery ICD= 29mm; IOD= 26mm; IPD= 52 mm (normal range). Summary: ST-MCT procedure conducted in collaboration with neurosurgery team had shown excellent correction of ICD, IOD, and IPD values, no complication, shorter length of stay, and minimal scars. It considers as the most proper technique to reach a good result of correction and aesthetically pleasing looks in FE cases.

Introduction: dentofacial deformities are mainly congenital problems that distort the face structure. However, they have many adverse effects on adolescents’ quality of life and self-esteem. Case presentation: We report a case of an 18-year-old female with no family history or previous surgical method. She presented to our hospital with a facial deformity, including a midline shift of 1.5 teeth to the left side and a malalignment of dentation. Orthopantomography (OPG) X-ray and cephalometric X-ray assessed the deformity extent and determined the appropriate surgical procedure. As a result, the patient underwent genioplasty and bimaxillary (BiMax) surgery to correct the problem. Discussion: Facial deformities occur during the normal embryonic phase and develop clearly when the patient reaches puberty due to a growth spurt. Some researchers encourage early correction, while others recommend the surgery only after completing the growth. However, the perfect age for this surgery is 19 years old for boys and 17 for girls after the cessation of facial growth. Therefore, our patient underwent surgery at 18 years old, which is the desirable age. Conclusion: Genioplasty and BiMax are reasonable procedures to treat facial deformities and correct malalign-ment of dentation in an 18-year-old patient without major complications., Annals of Medicine and Surgery, 79, art. no. 104088; 2022

Background Mammary analogue secretory carcinoma (MASC) is a rare low-grade malignant salivary gland tumor. The morphological and immunohistochemical features of MASC closely resemble those of breast secretory carcinoma. The key characteristics of the lesion are a lack of pain and slow growth. There is no obvious specificity in the clinical manifestations and imaging features. The diagnosis of the disease mainly depends on the detection of the MASC-specific ETV6-NTRK3 fusion gene. Case summary This report describes a rare case of a 32-year-old male patient who presented with a gradually growing lesion that was initially diagnosed as breast-like secretory carcinoma of the right parotid gland. Imaging and histological investigations were used to overcome the diagnostic difficulties. The lesion was managed with right parotidectomy, facial nerve preservation, biological patch implantation to restore the resulting defect, and postoperative radiotherapy. On postoperative follow-up, the patient reported a mild facial deformity with no complications, signs of facial paralysis, or Frey's syndrome. Conclusion The imaging and histological diagnostic challenges for MASC are discussed.

Introduction: Cleft lip with or without palate (CL/P) is a common facial deformity requiring surgical intervention whose aesthetic outcomes are typically represented by Before and After Photographs (BAPhotos). With the growing presence of social media, there are concerns about the role of BAPhotos in plastic surgery and their impact on patient’s expectations. Methods: A retrospective analysis of quality assurance survey and interview data was conducted to explore the impact of BAPhotos on parents and their expectations in the context of CL/P. Results: Thirty-five parents were interviewed regarding use of BAPhotos; 91% viewed BAPhotos on the following platforms: Google (n = 26), Facebook (n = 8), Instagram (n = 4), YouTube (n = 4), Snapchat (n = 1), and Other (n = 11). Half of the parents believed that BAPhotos influenced their treatment expectations and these parents were not less satisfied with their child’s surgical outcome than those who did not perceive being influenced (Mann-Whitney U = 124.5, P = .05). A higher proportion of parents who viewed BAPhotos on social platforms felt that their treatment expectations were influenced by BAPhotos (χ2, X (df = 1) = 4.49, P = .03). Thematic analysis revealed that parents’ emotional reaction to BAPhotos was shaped by the context of the photos; photos on social platforms that include patient stories (ie, Instagram, Facebook) were more often sources of emotional support. Conclusion: This study furthers our understanding of the impact BAPhotos have on parents of children with CL/P and areas of education regarding the dissemination of BAPhotos which have the potential to positively impact viewing of these photos.

The aim of this article is to provide an overview on paediatric facial paralysis, looking into aetiology, epidemiology, assessment and investigation and subsequent treatment options available. Facial paralysis describes the inability to activate the muscles of fascial expression. Overall, it affects 2.7 per 100 000 children under 10 years old and 10.1 per 100 000 children over 10 years old each year. There are many causes of facial paralysis and the outcomes and necessary treatments vary depending on the cause. The mainstays of medical management are corticosteroids and facial therapy; however, when the facial palsy persists, facial deformity surgery is an option to improve the facial symmetry, protect vision and recreate dynamic movement.

Since the first report of a nasal septal abscess (NSA) from a dental origin (1920), six articles have been published in the English literature to date. The most common cause of NSA is an infection of the nasal septal hematoma after trauma. This is a report of an uncommon cause of NSA with a dental origin. A PubMed search performed regardless of year and country using the terms ("nasal septal abscess") OR ("nasal septum abscess") initially yielded 229 articles. After screening, seven articles (eight patients) were selected. Addition of two related articles produced a total of nine articles (10 patients) to be included. The age of the included patients ranged from 7 to 69 years (mean, 32.82 years; standard deviation, ±23.86 years). The sex composition was as followed: males (n=7; 63.6%), females (n=4; 36.4%). Dental histories were various: periapical lesions, caries, extraction, endodontic therapy, and cystic lesions. The maxillary incisor dominated as the tooth of origin. Early diagnosis and treatment of NSAs are important to avoid not only facial deformity, but also severe complications (e.g., intracranial infection). If NSA is suspected in patients without facial trauma, the possibility of a dental origin, especially from the maxillary incisor area, should be considered.

The aim of this investigation was to define the volume and area of the airway in subjects with Class II and Class III skeletal deformity. A cross-sectional study was designed including subjects with facial deformity defined by Steiner's analysis in subjects with indication of orthognathic surgery who presented diagnosis by cone beam computerised tomography. We determined the measurements of maximum area, minimum area and volume of the airway. The data were compared using Spearman's test, with statistical significance defined as p

The surgery-first approach (SFA) has become a recent alternative to the conventional 3-stage approach to orthognathic surgery. Skeletal anchorage in orthodontics has facilitated the resurgence of this treatment sequence. By eliminating the presurgical phase of orthodontic treatment, patients have immediate resolution to their facial deformity. Treatment duration has been shown to be reduced; the difference with the conventional approach being approximately 5 months. Patient satisfaction with this approach is very high as measured by quality-of-life surveys. This article describes the indications and step-by-step approach of this technique in conjunction with virtual surgical planning.

Hypertrophy of the facial region is rare developmental malformation. The aim of this study is to report a case of partial facial hemihypertrophy describing its clinical features and debatable heterogeneity of etiologies, along with the review of literature to supplement to its current knowledge in English literature. PubMed search was done from 1986 to 2018, using the terms “Partial facial hemi-hypertrophy” or “Facial hemi-hypertrophy” or “Facial Gigantism” and 95 articles were identified. After manual reviewing and screening, 27 results were included in the analysis. Men are more commonly affected than women, with right side showing more involvement than the left side. Both hard and soft tissues are involved on the affected site. Reconstructive surgeries are usually planned after cessation of physiological growth. It includes orthognathic surgeries or osteotomies. Multiple soft tissue debulking procedures may be performed including excision of excess subcutaneous tissue and masticatory muscles, face-lift surgeries, lip reduction surgery, or parotidectomy. No malignant transformation has been reported in literature. The great variation of asymmetries caused by facial hemihypertrophies requires a combination and variety of sequential treatment procedures to gain adequate functional and cosmetic results. Hence, treatment of such malformation varies radically.

Craniofacial deformities represent a great challenge for the patient and the plastic surgeon. Fat grafting has allowed a shift in paradigm for craniofacial reconstruction by providing a less invasive and safer alternative than traditional reconstructive options. Increasing evidence supports its use with optimal results. This article examines the evidence and practical aspects involved in the decision making and technique of fat grafting to treat secondary craniofacial deformities.

Cherubism is a non-neoplastic, fibro-osseous, self-limiting, autosomal dominant disorder of the jaws. It is also called as familial fibrous dysplasia and familial multi-locular cystic lesion of the jaws. Its typical dento-facial deformities are caused by mutations in the SH3BP2 gene. The lesion regresses during puberty and the disease stabilizes after the growth period. But it leaves some facial deformity along with disturbances in occlusion. Cherubism may occur as an individual case or in multiple members of the same family, oftenly in multiple generations. Radiographic examination of the lesion shows bilateral multi-locular radiolucent areas.The aim of this case report is to present a case of 12-years old cherubic child, with its clinical and radiological features and discussion about the clinical outcome.This patient was diagnosed with Cherubism and being followed up periodically.

The etiology of suicide among students around the world revolves issues such as communication, education, family problems and parents’ relationship. We intend to report a case with serious recurrent suicide attempt by gun shot during COVID-19 period. We also present psychiatric and clinical evaluation, cosmetic surgery consultation, as well as microbial assessments in this survey. The seventeen-year-old single male student from southwest of Iran with asymmetric deformed face was observed with the loss of parts of the mouse, nose, chin and mandible region .He had experienced a serious suicide attempt by a threatening plan following rejection. The patient had blurred, hypo phonic and hypotonic speech. Following the shooting, the soft and hard palate, facial, frontal bone and sinus had been destroyed and a foreign body was seen in the frontal sinus. After suicide risk as assessment, It was detected multiple predictive risk factors for recent suicide attempt and the possibility of recurrent suicide in future. Finally, reconstructive surgery was performed. We assessed him via face to face interview in order to identify psychiatric disorders. Also, he was evaluated as probability of committing recurrent suicide. It is emphasized that in families which young children are prone to psychiatric disorders or emotional problems, availability of a dangerous device such as a gun can be harmful and it should be removed as soon as possible. We suggest the need for psychiatric evaluation especially suicide phenomenon in adolescents and their families as various conflicts in family context.

Importance: Reconstruction of facial deformity poses a significant surgical challenge due to the psychological, functional, and aesthetic importance of this anatomical area. There is a need to provide not only an excellent colour and contour match for skin defects, but also a durable cartilaginous structural replacement for nasal or auricular defects. The purpose of this review is to describe the history of, and state-of-the-art techniques within, facial cartilaginous surgery, whilst highlighting recent advances and future directions for this continually advancing specialty.Observations: Limitations of synthetic implants for nasal and auricular reconstruction, such as silicone and porous polyethylene, have meant that autologous cartilage tissue for such cases remains the current gold standard. Similarly, tissue engineering approaches using unrelated cells and synthetic scaffolds have shown limited in vivo success. There is increasing recognition that both the intrinsic and extrinsic microenvironment are important for tissue engineering and synthetic scaffolds fail to provide the necessary cues for cartilage matrix secretion.Conclusions and Relevance: We discuss the first-in-man studies in the context of biomimetic and developmental approaches to engineering durable cartilage for clinical translation. Implementation of engineered autologous tissue into clinical practise could eliminate donor site morbidity and represent the next phase of the facial reconstruction evolution.

Background : Naso-orbital-ethmoid (NOE) fracture is one of the common injury and the management remains difficult and controversial due to the anatomic complexity. Severe facial deformity and dysfunction are the results from the untreated injury. Moreover, the results from many procedures are not aesthetically satisfying. Meanwhile diced cartilage graft popularity is increasing in order to correct nasal deformity whether post trauma, revision (secondary) rhinoplasty or cleft nose. The procedure is less time consuming, easy to perform and also highly malleable. Methods : This study presents our experience in managing four patients with NOE fracture using costal cartilage graft technique immediately after injury. A columellar V-shaped incision was made, the finely diced cartilage harvested from the eight rib was injected to the glabella, dorsum and nasal tip using one cc syringe needle with cut tip. Demographic data were obtained from the patients’ medical record. Post-operative results were observed. Result: The four surgeries were done, with average 5.75 (range, 2-9) days after injury. During the observation, nasal tip misalignment was observed in only one patient. Diced cartilage were not visible through the skin, although it could be palpable. No cartilage extrusion were occurred. After averange follow up 10.25 mo (range 8-12 mo) All patients were satisfied with their facial appearance. Conclusion: The fracture of NOE can be manage with immediate diced costal cartilage graft, since this treatment can achieve a normal facial function and appearance. The complications are low and manageable, making it as serious contender technique of choice in managing NOE fracture to other techniques. Keywords: NOE fracture, diced costal cartilage graft, facial fracture

The differences between Caucasian and East Asian faces could lead to different age-related bony changes. We analyzed computed tomography (CT) scan images of East Asians to find objective differences in midface rejuvenation strategy between East Asians and Caucasians. We reviewed 54 East Asian individuals’ charts and facial CT images ranging in age-group: Group A (21–30 years), Group B (41–50 years), and Group C (61–70 years). No patients had congenital or acquired facial deformity and history of facial trauma. The anteroposterior length of the orbital roof and floor (LOR, LOF) and the angle of the anterior wall of the maxilla were recorded on parasagittal images through the midline of the orbit. The LORs at their midpoints showed significant differences between Groups A and B (p

Our aim was to give a morphometric description of the interproximal bone between the anterior maxillary teeth of subjects with class III facial deformity, who were candidates for segmented Le Fort I osteotomy. We measured the width of the interproximal bone from the upper right canine to the upper left canine in cone-beam computed tomographic images of 35 subjects, and identified five interproximal areas of measurement. The lower and upper measurements were established 5mm and 10mm from the cervical crest of the interproximal bone. A paired samples t test and Pearson's correlation coefficient were applied and probabilities of less than 0.05 were accepted as significant. In all the scans of interproximal bone, the apical zone was significantly wider than the inferior zone (p

We propose the deep hierarchical network (DHN) for the quantitative analysis of facial palsy. Facial palsy, also known as Bell’s palsy, is the most common type of facial nerve palsy that results in the loss of muscle control in the affected facial regions. Typical symptoms include facial deformity and facial expression dysfunction. To the best of our best knowledge, all approaches for the automatic detection of facial palsy consider hand-crafted features. This paper reports the first deep-learning-based approach developed for the real-time quantitative analysis of facial palsy. The proposed DHN consists of three component networks: the first detects the subject’s face, the second detects the facial landmarks and line segments on the detected face, and the third detects the local palsy regions. The first component network is built on the YOLO2 detector. The second component network is developed on a fused network architecture that incorporates a line segment learning network for locating the facial landmarks and line segments. The third component network is developed on an object detection network with the line-segment-embedded input that combines the landmarked region and the line segments detected by the second component network. The novelties of this research include: 1) the modification of a state-of-the-art edge detector for extracting the facial line segments; 2) the embedding of the line segment learning for the detection of facial landmarks and local palsy regions; 3) the quantitative description of the facial palsy syndrome intensity; and 4) the release of the first clinically labeled database, the YouTube Facial Palsy (YFP) database. The making of the YFP database solves the issue that previous methods were all evaluated on proprietary databases, making the comparison of different methods extremely difficult. The YFP database includes 32 videos of 21 patients collected from YouTube and labeled by clinic specialists. To enhance the robustness against facial expression variations, we include the CK+ facial expression database in the training. We show that the proposed DHN not only just detects the local palsy regions but also captures the intensity of the facial palsy syndrome over time, enabling the quantitative description of the syndrome. The experiments show that the proposed approach offers an accurate and efficient real-time solution for facial palsy analysis.

This study evaluated the impact of facial deformity on pain perception of patients undergoing orthodontic and orthodontic-surgical treatment. A case-control study was carried out with a population-based of individuals in orthodontic treatment. Cases and controls were defined by the Oral Health Impact Profile (OHIP-14). The case group (n=54) included individuals who responded “never” to at least one of the questions, and in control (n=44), those who responded “rarely and sometimes” frequently and “always” to both questions. Cases and controls were paired by sex, age, and clinical conditions in the ratio of 1:1. For data analysis, the odds ratios were estimated with respective confidence intervals of 90%. There was no significant difference between the groups with and without deformities relative to the distribution of the female and male sexes (p=1.000), which allowed pairing the case and control groups in a ratio of 1: 1. Patients with facial deformity showed 2.14 (CI90%: 1.08-4.24) times more chance of reporting the impact on physical pain (p=0.0662). Patients with a facial deformity and orthodontic surgical treatment are twice as likely to perceive physical pain. Este estudio evaluó el impacto de la deformidad facial en la percepción del dolor en pacientes sometidos a tratamiento ortodóncico y ortodóncico-quirúrgico. Se realizó un estudio de casos y controles con una población de individuos sometidos a tratamiento de ortodoncia. Los casos y controles se definieron por el dominio de dolor físico del Perfil de Impacto en la Salud Oral (OHIP-14). El grupo de casos (n = 54) incluyó individuos que respondieron "nunca" a al menos una de las preguntas, y en el grupo de control (n = 44), aquellos que respondieron "rara vez y a veces" con frecuencia y "siempre" a ambas preguntas. Los casos y controles se emparejaron por sexo, edad y condiciones clínicas en una proporción de 1:1. Para el análisis de datos, se estimaron las razones de posibilidades con los respectivos intervalos de confianza del 90%. No hubo diferencia significativa entre los grupos con y sin deformidades en relación a la distribución de los sexos femenino y masculino (p = 1.000), lo que permitió emparejar los grupos de casos y controles en la proporción de 1:1. Los pacientes con deformidad facial tenían 2.14 (IC90%: 1.08-4.24) veces más probabilidades de informar el impacto sobre el dolor físico (p = 0.0662). Un paciente con deformidad facial y sometido a tratamiento ortodóncico-quirúrgico tiene el doble de probabilidades de percibir dolor físico. Este estudo avaliou o impacto da deformidade facial na percepção da dor de pacientes submetidos a tratamento ortodôntico e ortodôntico-cirúrgico. Estudo caso-controle realizado com uma população de indivíduos em tratamento ortodôntico. Casos e controles foram definidos pelo domínio dor física do Oral Health Impact Profile (OHIP-14). O grupo caso (n = 54) incluiu indivíduos que responderam "nunca" a pelo menos uma das perguntas, e no controle (n = 44), aqueles que responderam "raramente e às vezes" com frequência e "sempre" a ambas as perguntas. Casos e controles foram pareados por sexo, idade e condições clínicas na proporção de 1:1. Para a análise dos dados, os odds ratios foram estimados com respectivos intervalos de confiança de 90%. Não houve diferença significativa entre os grupos com e sem deformidades em relação à distribuição dos sexos feminino e masculino (p = 1.000), o que permitiu parear os grupos caso e controle na proporção de 1:1. Pacientes com deformidade facial apresentaram 2.14 (IC90%: 1.08-4.24) vezes mais chance de relatar o impacto na dor física (p = 0.0662). Pacientes com deformidade facial e em tratamento ortodôntico-cirúrgico tem duas vezes mais chance de perceber a dor física.

Monobloc and bipartition advancement by external distraction plays a major role in the treatment of syndromic craniosynostosis. They can reverse the associated facial deformity and play a role in the management of ocular exposure, intracranial hypertension, and upper airway obstruction. Facial bipartition distraction corrects the intrinsic facial deformities of Apert syndrome. Both procedures are associated with relatively high complication rates principally related to ascending infection and persistent cerebrospinal fluid leaks. Modern perioperative management has resulted in a significant decline in complications. External distractors allow fine tuning of distraction vectors and improve outcome but are less well tolerated than internal distractors.

Orthognathic surgery is a common treatment modality for moderate to severe dentofacial deformities. This study aimed to determine the early postoperative changes in quality of life (QoL) after orthognathic surgery.Twenty patients were evaluated preoperatively (T0), postoperatively after 1 month (T1), and postoperatively after 3 months (T2). Short Form Oral Health Impact Profile and Orthognathic Quality of life Questionnaire were used as generic oral health-related and condition-specific QoL measures.Oral Health Impact Profile -14 and Orthognathic Quality of life Questionnaire scores significantly decreased from T0-T2. Physical pain, psychological disability, social disability, and handicap scores significantly decreased during this interval. Facial esthetic, function, awareness of facial deformity, and social aspects of deformity were also found to significantly improve. No significant difference was found between age groups; female patients had significantly greater preoperative Oral Health Impact Profil-14 scores than did male patients.Orthognathic surgery not only enhances the skeletal and facial relations, but also has significant positive effects on the patients' QoL, oral health, and psychological status.

Aim: The aim of the current survey was conducted to assess the knowledge, attitude, and awareness regarding orthognathic surgery among orthodontic patients. Materials and Methods: This is cross-sectional web-based questionnaire survey conducted among orthodontic patients in Tamil Nadu. The self-administered questions related to awareness of orthognathic surgery were collected from 500 subjects. The statistical analysis was done using the Statistical Package for the Social Sciences (V 22.0). The frequency distribution was computed. Results: This survey revealed that 466 (93.2%) respondents had awareness about the role of orthognathic surgery. 332 (66.4%) had given the correct responses related to differentiating skeletal and dental malocclusion, 454 (90.6%) had the awareness of risk factors associated with orthognathic surgery and 40 (7.0%) were experienced regarding the procedure. Conclusion: The result of the current study showed that it clearly implies that the population was aware of orthognathic surgery as a treatment modality for correcting skeletal deformities.

The nasolabial cyst is a rare, non-odontogenic, soft tissue cyst that develops submucosally in the anterior nasal floor. This cyst accounts for 0.7% of all non-odontogenic cysts. Bilateral nasolabial cyst represents only 10% of the cases. This cyst originates from the remnants of embryonic nasolacrimal duct tissue. Generally, patients present with swelling and facial deformity and rarely local pain. The definite diagnosis should be based on clinical, radiological and above all histopathologic findings. The treatment is enucleation of the cystic tissue. Following is a case report of a bilateral nasolabial cyst in a 40-year-old woman who presented with a chronic nasal obstruction.

Parry-Romberg syndrome (PRS) is a rare facial deformity characterised by slowly progressive hemifacial atrophy. We present a new case of hemifacial atrophy in an 18-year-old lady. Rudimentary understanding of the pathogenesis poses a challenge in deciding optimal timing and surgical intervention. Current suggested management are reviewed and discussed.

Acromegaly is a medical condition where elevated growth hormone or insulin-like growth factor I levels cause several changes in the craniofacial soft and hard features. We report the correction of facial deformity and posterior open bite with Le Fort I and modified subcondylar osteotomies in a patient affected by acromegaly. Computer-aided design and manufacturing generated saw and drill guides were used to perform osteotomies and segment removal. The placement of the patient-specific implants (PSIs) was guided by predesigned drill holes ensuring the required and planned movement of the jaws and position of the PSIs. After segment removal, the PSIs fitted the predesigned drill holes with high precision and were secured without problems. The planned amount of mandibular and maxillary movement was achieved. The occlusion and osteotomies remained stable for the follow-up of 22 months. The use of PSIs combined with guided surgery can be beneficial for selected cases with asymmetry or posterior open bite enabling new approaches and yielding good functional and aesthetic outcome. The modification of conventional ramus osteotomy combined with utilization of ramus segment removal and the use of PSI for reposition is an interesting and promising technique for rare conditions with ramus height asymmetry.

Purpose Pruzansky-Kaban III hemifacial microsomia (HFM) is a rare congenital facial deformity, and it is challenging to reconstruct the facial appearance. The aim of the present study was to describe a technique of application of virtual planning for three-dimensional (3D) guided maxillofacial reconstruction of Pruzansky-Kaban III HFM using custom made fixation plate. Methods With the help of 3D models, a preoperative virtual planning and surgical simulation were performed. Computer-aided design/computer-aided manufacture (CAD/CAM) patient customized guides and custom fixation plates were designed to reconstruct the maxillofacial skull intraoperatively. Assessment was achieved through evaluation of the postoperative effects, such as imaging, facial appearance recovery and operation time. Results Five patients with Pruzansky-Kaban III HFM were enrolled into this study. The results showed an exceptional accuracy between the preoperative virtual planning and the outcomes actually achieved postoperatively. Intraoperative measurements were no longer needed and the different surgical steps became more simple and easier. The total time was distributed as: 160 minutes for the surgical time, 40 minutes for preoperative virtual plan, and 80 minutes for designing the patient specific cutting guides and custom fixation plates. The operating time and tissue damage were reduced. All cases underwent uneventful healing without any complications. Conclusion The technique of patient specific guides and custom fixation plates is a reliable method of conveying the virtual plan to the operative field with higher efficiency in patients with Pruzansky-Kaban III HFM.

Ziel: Die Arbeit setzt sich mit den unterschiedlichen Formen der Mittelgesichts-Deformitäten auseinander, die im Rahmen der Le Fort II Osteotomie behandelt werden. Zum einen wendet sich die Auseinandersetzung mit der Diagnostik im Mittelgesicht und zum anderen den Le Fort Osteotomien zu. Methode: Die dieser Arbeit zugrunde liegende Methode ist die systematische Literaturrecherche. Im methodischen Rahmen werden Literaturrecherchen und Internetrecherchen durchgeführt. Folgende Datenbanken wie Google Scholar, PubMed und Springerlink werden mit Schlagwörtern wie „midfacial deformity“, „maxillofacial deformity“, cranio-maxillofacial deformity“, „facial deformity“, „maxillofacial hypoplasia“, „maxillary hypoplasia“, „nasomaxillary hypoplasia“, „Le Fort II osteotomy“, „intraoral quadrangular Le Fort II osteotomy“ und „Le Fort ostetomy“ durchsucht. Weiters werden Fachartikel, Zeitschriften, fachspezifische Literatur und weitere Datenbanken aus Bibliotheken wie beispielsweise der Medizinischen Universität Wien zur Informationsbeschaffung herangezogen. Ergebnisse: Le Fort II Frakturen zählen zu den zentralen Mittelgesichtsfrakturen. Die Fraktur charakterisiert sich durch einen „Abbruch des Oberkiefers zusammen mit dem Nasenskelett, dem Siebbein, Tränen- und Keilbein aus der mittleren Ebene des Gesichtes (pyramidale Absprengung des Oberkiefers)“ (IMC, 2020). Generell erweist sich der Le Fort II-Ansatz bei Dysgnathien als nützlich. Die Behandlung eines Fehlbisses mittels kieferorthopädischer Behandlung ist nachhaltig meist unzureichend, weshalb sich eine Kombination aus kieferorthopädischen und kieferchirurgischen Behandlungen empfiehlt. Das Le Fort II - Verfahren wird im Bereich des Zentralen Komplexes IV, II und unter Umständen auch im Bereich III (Heberer, 1986), nach Heberer (1986) angewandt. Indikationen für Le Fort II Osteotomien sind selten. Bei einer extremen Hypoplasie des Mittelgesichts empfiehlt sich die Vorgangsweise (Heberer, 1986). Zwecks Diagnostik umfassen die Erhebungen Röntgenuntersuchungen und weitere Basisuntersuchungen, die den Schädel von der Seite abbilden, im Idealfall mittels FRS. Wenn indiziert empfehlen sich ein CT und konventionelle Schichtaufnahmen (Heberer, 1986). Diskussion: Für Mund- und Kieferchirurgen zählt das Le Fort II Verfahren zum Standard-Repertoire. Gesichtsdeformitäten bedürfen der Zusammenarbeit unterschiedlicher Spezialisten. Anzudenken wäre im weiteren Sinne eine Planung und Simulation mit 3D-Druck, damit interdisziplinär die anatomischen Strukturen deutlicher zu erkennen sind und anhand dieser Verfahren ein Behandlungsplan erstellt werden kann. Aim: The work analyzes the different forms of midface deformities treated by Le Fort II osteotomy. On the one hand, the discussion will focus on diagnostics in the midface and on Le Fort osteotomies on the other. Methods: The method on which this work is based is a systematic literature research. Within the methodological framework, literature and internet research is carried out. Following databases like Google Scholar, PubMed and Springerlink are searched with keywords like "midfacial deformity", "maxillofacial deformity", "cranio-maxillofacial deformity", "facial deformity", "maxillofacial hypoplasia", "maxillary hypoplasia", "nasomaxillary hypoplasia", "Le Fort II osteotomy", "intraoral quadrangular Le Fort II osteotomy" and "Le Fort ostetomy". In addition, articles, journals, specialist literature and other databases from libraries such as the Medical University of Vienna are used for information gathering. Results: Le Fort II fractures belong to the central midface fractures. The fracture is characterized by a "fracture of the maxilla together with the nasal skeleton, ethmoid bone, lacrimal bone and sphenoid bone from the middle plane of the face (pyramidal dislocation of the maxilla)" (IMC, 2020). In general, the Le Fort II approach proves useful for dysgnathia. The treatment of a malocclusion by means of orthodontic treatment is usually insufficient in the long term, which is why a combination of orthodontic and oral surgery treatments is recommended. The Le Fort II procedure is used in the area of the Central Complex IV, II and possibly also in the area III (Heberer, 1986), according to Heberer (1986). Indications for Le Fort II osteotomies are rare. The procedure is recommended for extreme hypoplasia of the midface (Heberer, 1986). For diagnostic purposes, the examinations include x-rays and other basic examinations that depict the skull from the side, ideally using FRS. If indicated, a CT and conventional tomography are recommended (Heberer, 1986). Discussion: For oral and maxillofacial surgeons the Le Fort II procedure is part of the standard repertoire. Facial deformities require the cooperation of different specialists. In a broader sense, planning and simulation with 3D printing should be considered, so that the anatomical structures can be more clearly recognized in an interdisciplinary manner and a treatment plan can be created using these procedures.

Proboscis is a rare congenital facial deformity identified by a rudimentary pipe-like, structure located away from the vertical midline of the face generally originating from nasal process. It usually presents with other anomalies like cleft lip, cleft palate, and mental retardation. There have been multiple cases of proboscis lateralis reported in literature. Most of these cases are reported in neonates. Here, we report a rare case of “mental proboscis” in a 9-year-old girl with Down’s syndrome.

Os autores relatam um caso de deformidade facial decorrente de cirurgia oncológica com reconstrução protética. Para essa reconstrução foi realizada uma prótese óculo-pálpebro-maxilo-nasal e uma prótese total obturadora palatina. As próteses foram fixadas através de retenção magnética., The authors report a case of surgical induced facial deformity with prosthetics reconstruction. The reconstruction was performed with an ocular, palpebral, maxilo, nasal prostheses and a total denture with palatal obturation. The prosthesis was fixed with magnetic retention.

SUMMARY: The aim of this research was to analyze the morphology of the nasal septum and inferior nasal concha bone in class III facial deformities prior to orthodontic treatment in orthognathic surgery candidates. 40 subjects were included in this research. The inclusion criteria were an Angle class III, negative overjet and SNA angle less than 80º. Patients with facial asymmetry, facial trauma or who had undergone maxillofacial or ENT procedures were excluded. CBCT images were obtained for all the patients and the nasal septum deviation, morphology of inferior nasal concha bone and ostium of the maxillary sinus were analyzed and related to the complexity of the facial deformity expressed by the ANB angle and dental relations. The measurement was standardized by ICC and the data was analyzed using a chi square test and Spearman’s coefficient with a p value < 0.005 for statistical significance. Nasal septal deviation was observed in 77.5 %. The deviation angle was 13.28º (±4.68º) and the distance from the midline to the most deviated septum was 5.56 mm (±1.8 mm) with no statistical relation to the complexity of the facial deformity. The deviated nasal septum showed inferior nasal concha bone hypertrophy on the concave side of the nasal septum deviation (p=0.049). The open or closed condition of the maxillary sinus ostium was not related to any conditions in the septum or complexity of the facial deformity. Inferior nasal concha bone hypertrophy could be related to nasal septal deviation. The nasal condition in a class III facial deformity could not differ from the general population; careful in orthognathic surgery as to be assume in the Le Fort I Osteotomy and nasal approach related to nasal septum deviation and inferior nasal concha bone.

Non-invasive ventilation (NIV) has dramatically changed the treatment of both acute and chronic respiratory failure in the last 2 decades. The success of NIV is correlated to the application of the “best ingredients” of a patient’s “tailored recipe,” including the appropriate choice of the selected candidate, the ventilator setting, the interface, the expertise of the team, and the education of the caregiver. The choice of the interface is crucial for the success of NIV. Type (oral, nasal, nasal pillows, oronasal, hybrid mask, helmet), size, design, material and headgears may affect the patient’s comfort with respect to many aspects, such as air leaks, claustrophobia, skin erythema, eye irritation, skin breakdown, and facial deformity in children. Companies are paying great attention to mask development, in terms of shape, materials, comfort, and leak reduction. Although the continuous development of new products has increased the availability of interfaces and the chance to meet different requirements, in patients necessitating several daily hours of NIV, both in acute and in chronic home setting, the rotational use of different interfaces may remain an excellent strategy to decrease the risk of skin breakdown and to improve patient’s tolerance. The aim of the present review was to give the readers a background on mask technology and materials in order to enhance their “knowledge” in making the right choice for the interface to apply during NIV in the different clinical scenarios.

Juvenile idiopathic arthritis (JIA) of the temporomandibular joint (TMJ) is common in children, with an increasing awareness of the condition in all healthcare professionals. TMJ involvement presents a challenge in both diagnosis and treatment, as late presentation can still occur as the disease often develops asymptomatically. This can result in facial deformity and/or functional difficulties including obstructive sleep apnoea. Early diagnosis is therefore essential, requiring a high index of clinical suspicion coupled with the judicious use of gadolinium contrast magnetic resonance imaging (MRI). Long-term management is best provided by a multidisciplinary team as patients often need a combination of pharmacological management, surgical interventions, orthodontics, and psychological support. End stage deformity can be treated by different surgical options, each with their own risks and benefits, however recently there is increasing recognition for the role of total alloplastic TMJ replacement. This review focuses on the diagnosis and management of TMJ arthritis and aims to highlight the important role of maxillofacial surgeons in JIA treatment.

Zygomatic osteotomies for correction of late presentation zygomatic complex fractures or hypoplasia resulting in facial deformity has traditionally required access to the zygomatic complex via a coronal approach. Coronal access can be time consuming and carries a relatively high morbidity rate, leaving a large scar that can be obvious when the hair is short, absent or wet.

Made available in DSpace on 2020-12-12T02:21:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-09-01 Dental transplantation is an alternative for rehabilitation with a high success rate. This article presents a clinical case of autogenous dental transplantation in a 17-year-old male patient undergoing treatment for Class III dento-facial deformity. After 32 months followup, low-cost rehabilitation was possible, and without prejudice to ortho-surgical treatment. Division of Oral and Maxillofacial Surgery Department of Diagnosis and Surgery Dental School at Araraquara-UNESP Division of Oral and Maxillofacial Surgery Department of Diagnosis and Surgery Dental School at Araraquara-UNESP

Despite the introduction of next-generation sequencing in the realm of DNA sequencing technology, it is not often used in the investigation of oral squamous cell carcinoma (OSCC). Oral cancer is one of the most frequently occurring malignancies in some parts of the world and has a high mortality rate. Patients with this malignancy are likely to have a poor prognosis and may suffer from severe facial deformity or mastication problems even after successful treatment. Therefore, a thorough understanding of this malignancy is essential to prevent and treat it. This review sought to highlight the contributions of next-generation sequencing (NGS) in unveiling the genetic alterations and differential expressions of miRNAs involved in OSCC progression. By applying an appropriate eligibility criterion, we selected relevant studies for review. Frequently identified mutations in genes such as TP53, NOTCH1, and PIK3CA are discussed. The findings of existing miRNAs (e.g., miR-21) as well as novel discoveries pertaining to OSCC are also covered. Lastly, we briefly mention the latest findings in targeted gene therapy and the potential use of miRNAs as biomarkers. Our goal is to encourage researchers to further adopt NGS in their studies and give an overview of the latest findings of OSCC treatment.

Skeletally mature patients with cleft lip and palate commonly present with skeletofacial deformities characterized by varying degrees of intrinsic and acquired dentoskeletal and soft tissue abnormalities. These abnormalities are associated with scarring from previous surgeries and the asymmetric midline and facial contour that impose challenges for adequate reconstruction. These patients frequently require 2-jaw orthognathic surgery to improve occlusal function and for correction of facial deformities. In this article, we have detailed a 3-dimensional computer-assisted single-splint 2-jaw orthognathic surgery technique as a surgical approach for cleft skeletofacial reconstruction, allowing for the surgery to be tailored according to the specific needs and requests of the patients. Further, we have addressed the multidimensionality and specificities of cleft treatment, the wide versatility, adaptability, and applicability of this technique, and the patient-centered rationale for the adoption of this method.

Various methods of landmark reconstruction have been discussed in medical literature, but few describe defects involving the rim of the landmark. For landmark malposition, such as eyelid ectropion, borders are abnormally elongated by scar contracture. The reconstruction should thus restore both the cutaneous defect and the anatomical structure. We suggest the combination of local flaps via end-to-end connection and transposition for facial landmark reconstruction.Ten patients who had facial landmark malpositions caused by scar contractions, and 5 patients who had landmark defects, were successfully treated using this combination flap technique. Among the 15 patients, landmark malposition repairs of the nasal ala, nasal columella, eyelid margin, Cupid's bow, and eyebrow were performed.Most flaps survived without complications; one procedure resulted in the cutaneous tip developing necrosis, which was successfully healed within 2 weeks of conservative treatment. The landmark was reconstructed with aesthetics in mind, and no subsequent scar contracture was observed. After a 6- to 14-month follow-up period, successful landmark reconstruction had been achieved in all 15 patients via a single-stage procedure.A combination of local flaps is a viable option for facial landmark reconstruction in selected patients having landmark rim destruction.Diverses méthodes de reconstruction phares par repères anatomiques sont abordées dans les publications médicales, mais peu décrivent les anomalies touchant le pourtour des repères anatomiques. En cas de malposition de ces repères, telles que l’ectropion des paupières, les bordures sont anormalement prolongées par la contracture entourant les cicatrices. La reconstruction doit donc restaurer à la fois l’anomalie cutanée et la structure anatomique. Les chercheurs proposent de combiner des lambeaux locaux par des connexions de bout en bout et la transposition de la reconstruction des repères faciaux.Dix patients qui présentaient des malpositions des repères faciaux causées par une contracture cicatricielle et cinq patients qui présentaient des anomalies de ces repères ont été traités avec succès au moyen de la technique des lambeaux combinés. Parmi les 15 patients, les réparations des malpositions des repères des ailes du nez, de la columelle nasale, du bord des paupières, des ridules de la lèvre supérieure et des sourcils.La plupart des lambeaux ont survécu sans complications; une intervention s’est soldée par une nécrose de la pointe cutanée qui a guéri dans les deux semaines grâce à un traitement classique. Le repère a été reconstruit en tenant compte de l’esthétique, et aucune contracture cicatricielle subséquente ne s’est produite. Après une période de suivi de six à 14 mois, les 15 patients ont profité d’une reconstruction réussie des repères par une intervention en une étape.Une combinaison de lambeaux locaux est une option viable pour la reconstruction de repères faciaux chez certains patients présentant une destruction du pourtour des repères anatomiques.

SUMMARY: The aim of this investigation was to define the volume and area of the airway in subjects with Class II and Class III skeletal deformity. A cross-sectional study was designed including subjects with facial deformity defined by Steiner's analysis in subjects with indication of orthognathic surgery who presented diagnosis by cone beam computerised tomography. We determined the measurements of maximum area, minimum area and volume of the airway. The data were compared using Spearman's test, with statistical significance defined as p

SUMMARY: The aim of this investigation was to define the volume and area of the airway in subjects with Class II and Class III skeletal deformity. A cross-sectional study was designed including subjects with facial deformity defined by Steiner's analysis in subjects with indication of orthognathic surgery who presented diagnosis by cone beam computerised tomography. We determined the measurements of maximum area, minimum area and volume of the airway. The data were compared using Spearman's test, with statistical significance defined as p

Aim -The purpose of this systematic review is to summarise the findings evaluating changes in patient quality of life (QOL) following orthognathic surgery.Material and Methods - On‐line searches were undertaken to identify suitable studies. Prospective cohort or case‐control studies using questionnaires or similar assessment instruments to evaluate pre‐ and post‐orthognathic surgery QOL were included in the analysis. QOL was assessed in the following five domains: physical functioning and limitations, physical pain, psychological well‐being and self‐esteem, self‐perception with regards to aesthetics, and social functioning and relationships.Results - Of the 13 studies included in the analysis most noted significant improvements in all QOL domains. The domains in which the greatest improvements were noted postoperatively were psychological well‐being and self‐esteem and self‐perception with regards to aesthetics. The results of the Short Form Health Survey (SF‐36) revealed that patients experienced no considerable changes in QOL after orthognathic surgery, while the other assessment instruments used demonstrated that patients experienced changes primarily in self‐perception within the aesthetics domain.Conclusions - The results indicate that orthognathic surgery significantly improved QOL in the five domains detailed. In particular, surgery elicited the greatest improvements in QOL in the psychological well‐being and self‐esteem and self‐perception in the aesthetics domains.

The effects of facial paralysis can be devastating. Primarily affecting the muscles of facial expression and hence the ability to communicate both speech and emotions, this debilitating condition also affects the protective function for the eyes, ventilatory function of the nose and competence of the oral sphincter. The resultant facial deformity is also significant and may impact enormously on quality of life. Surgical aspects of management are discussed.

Binder Syndrome occurs in less than 1 per 10,000 live births. Mean features of the syndrome include arhinoid face, abnormal position of the nasal bones, intermaxillary hypoplasia with associated malocclusion, reduced or absent anterior nasal spine, atrophy of the nasal mucosa and absence of the frontal sinus. Treatment of these facial deformities is obviously surgical. In the present work, the authors describe, step by step, their technique in secondary rhinoplasty in a 36-years-old patient affected by Binder Syndrome. In this case, the authors used autologous cartilage graft and heterologous bone graft.Satisfying results are achieved in 12 months of follow-up: graft resorption is acceptable, position of the graft is stable, the authors have no signs of infection and the patient is satisfied with the aesthetical and functional results. The authors believe that the first option, in complex nose's reconstruction, is the use of autologous grafts but, the use of cartilage heterologous bone graft should be taken in account, in the future, as a secondary option in Binder Syndrome and in malformed patients.

Bachelor thesis deals with the issue of Treacher Collins syndrome. Treacher Collins Syndrome is a rare genetic disease that is distinctly manifested by deformities in the face. Due to the different appearance and ignorance of the syndrome, it is difficult, for the public, to integrate individuals into society. These factors impede the mental well-being of both the individual and his family. This work is divided into theoretical and research part. In the theoretical part, the subject of this syndrome is elaborated based on relevant sources, so that the reader be well versed in this issue. It deals with the definition of Treacher Collins syndrome, its history, description of symptoms, and causes. The thesis also mentions methods of prenatal diagnosis and the development of such an individual. The next part focuses on comprehensive care of individuals. It includes special pedagogical care, health and social care. It deals primarily with the education of individuals, surgical interventions, compensatory aids, and the integration of individuals with Treacher Collins syndrome into society. The research part consists of a case study of a specific individual with Treacher Collins syndrome and his family. This part has been aimed to obtain and process information concerning the state of health, personal and family case history, available medical care, education, interests and life quality of the individual and his family. An in-depth interview and analysis of specific documents were used to obtain data. The research revealed a lot of interesting information. It turned out that the quality of life is influenced by levels of parental competencies, quality of health care, and the functionality of integration into the education system.

Autologous fat transfer for correcting contour defects of face has gained wide popularity in aesthetic surgery. However, quantification of fat requirement and its survival is still a fertile area for research to improve the predictability of volume retention of injected fat. There have been no detailed studies of the calculation for the amount of fat to be injected and percentage of fat retained. The objective of this study was to quantify the amount of fat required for correcting a facial deformity and amount retained postoperatively over a period of 6 months. Thirty patients were recruited in a prospective study where in, the fat requirement for augmenting the soft tissue defect was assessed using USG preoperatively and followed up at 1, 3 and 6 months by the same technique. It was found that USG is a simple, objective, reliable, cost-effective method of assessing the fat requirement and retention in autologous fat transfer.

Made available in DSpace on 2019-10-06T16:08:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-12-01 Objectives: The aim of the present study was to evaluate the quality of life of patients with dentofacial deformities and of patients subjected to orthognathic surgery to compare their results with those of patients who have no dentofacial deformity by applying the Orthognathic Quality of Life Questionnaire (OQLQ). Study Design: Three groups of patients were interviewed, and the OQLQ instrument was applied to them by one examiner. Results: Results showed statistical differences between groups and suggested that patients with no deformity and those subjected to orthognathic surgery have better quality of life compared with those with facial deformity. Conclusions: Orthognathic surgery with the consequent dentofacial correction seems to have a positive effect on quality of life. Oral and Maxillofacial Surgery Department Dental School Campus (Araraquara) Sao Paulo State University (Unesp) Campus (Ribeirão Preto) Moura Lacerda Institution Oral and Maxillofacial Surgery Department Dental School Campus (Araraquara) Sao Paulo State University (Unesp)

O presente trabalho visou relatar um caso clínico de deformidade facial de etiologia traumática, reabilitado através de prótese óculo-palpebral no Programa de Extensão em Prótese Bucomaxilofacial da Faculdade de Odontologia da UFRGS. Assim como levantar informações que sustentem uma discussão sobre esse tema, permitindo um amplo e detalhado conhecimento. Descrição do caso: Paciente A.O.N., 62 anos, sexo masculino, relatou acidente automobilístico há 40 anos e ter realizado 10 cirurgias plásticas até o momento para corrigir a deformidade. Em um primeiro momento foi realizada a moldagem da região óculo-palpebral e confeccionado modelo de trabalho em gesso. Após foi confeccionada a prótese ocular com a íris obtida pela técnica da pintura a mão. No modelo de gesso com a prótese ocular em posição foi realizada escultura com plastilina. Com a escultura pronta foi realizada a inclusão da peça em mufla e a inserção do silicone na cópia negativa com a realização da pintura intrínseca. Com o paciente presente, foi realizada a pintura extrínseca e caracterização com cílios. A prótese foi fixada com cola, e foi recomendada a utilização de óculos para apoio da prótese. Conclusão: Nem sempre é possível restaurar os defeitos da face com uma abordagem cirúrgica, desta forma o conhecimento por parte do cirurgião-dentista sobre as reabilitações protéticas faciais é importante, pois as mutilações faciais provocam alterações morfofuncionais e psicossociais nos pacientes portadores das deformidades, levando-os ao isolamento social e familiar. Através das reconstituições protéticas faciais, o indivíduo poderá ser reintegrado à sociedade e melhorar sua qualidade de vida.

Fractures of the orbit are a very common injury, and are often treated by multiple facial subspecialties. Many fractures can be asymptomatic and do not require surgical therapy, but for those fractures where intervention is indicated, neglect, delay, or inappropriate technique can have permanent consequences on visual function and facial deformity. In this article, the indications and techniques of repair for specific fractures will be discussed, as well as possible risks and complications.