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- Alinasab, Babak, et al.
(author)
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The Supratarsal Approach for Correction of Anterior Frontal Bone Fractures
- 2018
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In: The Journal of Craniofacial Surgery. - Philadelphia, PA : Lippincott Williams & Wilkins. - 1049-2275 .- 1536-3732. ; 29:7, s. 1906-1909
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Journal article (peer-reviewed)abstract
- Background: To approach isolated anterior frontal bone fracture, coronal incision is the common surgical access of choice. This approach has complications such as aesthetically undesirable scarring and alopecia along the incision line. An alternative approach to these fractures is through a supratarsal incision. The aim of the present study was to correct the frontal bone fracture, through supratarsal approach.Methods: Six consecutive patients with frontal bone fracture were operated through supratarsal incision and evaluated regarding: patient cosmetic satisfaction, forehead contour, scarring, sensibility and motility in forehead and upper eyelids.Results: Seven months (6–12) postoperatively, all the patients had normal mobility in the forehead and the upper eyelids and 17% (n = 1) had hypoesthesia of superior orbital nerve. The forehead contour was excellent in all patients. About 83% (n = 5) of the patients were very satisfied and 17% (n = 1) were satisfied with the surgical result.Conclusion: Correction of anterior frontal bone fracture through a supratarsal approach appears to be safe and offers a sufficient exposure to the frontal bone fracture correction with excellent contouring results and no noticeable scarring.
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- Ashammakhi, Nureddin, et al.
(author)
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Modelling Brain in a Chip
- 2023
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In: The Journal of Craniofacial Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 1049-2275 .- 1536-3732. ; 34:3, s. 845-847
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Journal article (other academic/artistic)
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- Bernhardt, Peter, 1966, et al.
(author)
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A novel quantitative image-based method for evaluating cranial symmetry and its usefulness in patients undergoing surgery for unicoronal synostosis.
- 2013
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In: The Journal of craniofacial surgery. - 1536-3732. ; 24:1, s. 166-9
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Journal article (peer-reviewed)abstract
- Background: Unicoronal synostosis presents with cranial asymmetry. Fixed points are difficult to identify; surgical results are therefore difficult to evaluate. The aim of this study was to develop a computer-based method for evaluation of forehead symmetry to enable evaluation of surgical results in unicoronal synostosis. Methods: The MATLAB tool was programmed to segment computed tomographic images, leaving the outermost contour. Cephalometric images were segmented manually due to lower contrast. A center-point (O) and an end-point were manually defined in the midline of the forehead and at the nonfused coronal suture, respectively. The program then found a point (p) on the fused side, at the same distance from the O as the end-point. The contours of the left and right side of the forehead were thereafter superimposed, and the position of minimal area mismatch of the sides was identified. To correct for growth between preoperative images and follow-up, the number of mismatching pixels was related to the area outlined by the contour of the forehead, the end-point and p. Two quantities, the relative symmetry change and the absolute symmetry change, were defined and evaluated by repeated measurements on spherical and elliptical phantoms and 15 patients. Results: Measurements with the MATLAB program were reliable with an SD of 0.26% to 5.39% for the expected range of differences. The SD was lower for measurements on computed tomographic images than for measurements on cephalometric images. The SD was also lower in patients with large surgical improvement than in patients with little improvement. The results support the use of relative symmetry change to evaluate surgical results. Conclusions: Our new computer-based method is capable of measuring forehead symmetry with good precision. This method can be used for systematic evaluation of surgical outcome for unicoronal synostosis and other asymmetric skull deformities.
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- Consolo, Ugo, et al.
(author)
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Histologic and Biomechanical Evaluation of the Effects of Implant Insertion Torque on Peri-Implant Bone Healing
- 2013
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In: The Journal of craniofacial surgery (Print). - : Lippincott Williams & Wilkins. - 1049-2275 .- 1536-3732. ; 24:3, s. 860-865
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Journal article (peer-reviewed)abstract
- The aim of this study was to evaluate histologically and biomechanically the peri-implant bone healing around implants placed with high torque after a follow-up of 8 and 12 weeks. A total of 12 implants were placed in the lower edge of the mandible of 2 sheep. In each sheep, 3 implants were placed with a low torque (<25 N center dot cm, LT group) as a control, and 3 implants were placed with a high insertion torque (maximum torque, HT group). The sheep were killed after 8 and 12 weeks of healing, and the implants were examined for removal torque, resonance frequency analysis, and histologic analysis. The mean insertion torque in the LT group was 24 N center dot cm, whereas it was 105.6 N center dot cm in HT. All the implants osseointegrated and histologic analysis showed similar aspects of the peri-implant bone tissue for both groups and both healing times. Mean removal torque values for LT implants were 159.5 and 131.5 N center dot cm after 8 and 12 weeks, respectively, whereas those for the HT were 140 and 120 N center dot cm at 8 and 12 weeks, respectively. Implant stability quotient values were 26.6 and 76 for the LT group and 74 and 76 for the HT group at 8 and 12 weeks, respectively. It could be concluded that high implant insertion torque does not induce adverse reaction in cortical bone and does not lead to implant failure.
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| 7. |
- Davis, Charles, et al.
(author)
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Do expansile cranial springs erode through the cranium?
- 2009
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In: The Journal of craniofacial surgery. - 1536-3732. ; 20:1, s. 168-70
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Journal article (peer-reviewed)abstract
- Expansile cranial springs are used in selected cases of craniosynostosis. The spring exerts moderate force against the relatively thin skull. We investigated whether the spring erodes through the bone and the clinical significance of any erosion relative to the cranial expansion achieved. METHODS: New Zealand white rabbits (n = 10) underwent sagittal suturectomy and spring insertion. Amalgam markers were placed perpendicular to the expected direction of suture erosion. A control group (n = 10) underwent suturectomy. Radiological evaluation was performed for 7 weeks to check for migration of the spring foot. RESULTS: The mean cranial thickness was 1.4 mm at the site of spring insertion. This compared with 1.8 mm in 7 children undergoing spring cranioplasty. The mean spring force was 9.4 N. In sagittal synostosis, the mean spring force used is 7 to 10 N.The cranial width increased 11.02 mm in the spring treatment group compared with 0.23 mm in the control group (P < 0.001). Spring erosion occurred in 4 (20%) of the 20 spring ends. Mean spring erosion for the treatment group was 0.18 mm. This was 3.2% of the mean increase in cranial width. The maximum percentage spring erosion versus cranial expansion in an individual rabbit was 14.17%. There was no statistical difference in cranial expansion between the rabbits in whom bone erosion did and did not occur. CONCLUSIONS: The degree of spring force required to effectively expand the cranium may cause bone erosion in some individuals. This degree of spring erosion was of minimal clinical significance in this animal model.
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| 8. |
- Davis, Charles, et al.
(author)
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Frontobasal suture distraction corrects hypotelorism in metopic synostosis.
- 2009
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In: The Journal of craniofacial surgery. - 1536-3732. ; 20:1, s. 121-4
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Journal article (peer-reviewed)abstract
- BACKGROUND: Spring-assisted cranioplasty has been demonstrated to correct hypotelorism associated with metopic synostosis. In addition, the fronto-orbital axis rotates toward a more normal orientation. We postulated that spring-induced shear forces and subsequent displacement across the frontobasal sutures are the primary initial mechanisms for change in cranio-orbital morphology. METHODS: Sixteen consecutive patients (32 orbits) with trigonocephaly operated on between 1999 and 2004 were studied retrospectively. After frontal remodeling, a spring was placed across the released metopic suture. Preoperative and 6-week postoperative cephalograms were used to measure the relative translation of the medial orbital wall from the midline at fixed vertical distances above and below the frontoethmoidal suture (FES). The vertical height of the spring above the frontonasal suture and the patient's age were analyzed with respect to the increase in bony interorbital distance (BIOD). RESULTS: There were significant increases in movement of the medial orbital wall above the FES at each measurement point (P < 0.001). There was no significant postoperative movement of the medial orbital wall below the FES at any measurement point. The relative movements above the suture suggest a degree of plastic deformation adjacent to the suture.There was no significant correlation between the age of patient or the height of the spring above the frontonasal suture and the increase in BIOD. CONCLUSION: Tensile spring forces are transmitted directly to the frontoethmoid suture. Most initial increases in BIOD and altered intraorbital morphology are due to distraction of cranial base sutures rather than plastic deformation.
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| 9. |
- Davis, Charles, et al.
(author)
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Spring expansion is influenced by cranial biomechanics.
- 2010
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In: The Journal of craniofacial surgery. - 1536-3732. ; 21:3, s. 843-6
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Journal article (peer-reviewed)abstract
- Spring cranioplasty is used in selected cases of craniosynostosis. A rabbit model was used to determine (1) if cranial biomechanics modify the expected rate of spring expansion, (2) the residual spring force in situ after cranial expansion, and (3) if the spring weakens during clinical use.
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| 10. |
- Demirtas, Nihat, et al.
(author)
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Recurrent cherubism in an adult patient
- 2015
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In: The Journal of craniofacial surgery (Print). - : Lippincott Williams & Wilkins. - 1049-2275 .- 1536-3732. ; 26:3, s. E225-E227
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Journal article (peer-reviewed)abstract
- Cherubism is an uncommon, nonneoplastic, fibro-osseous disorder of the jaws in childhood and adolescence. It affects the jaw bones by deforming the cortical shell. Clinical features include progressive painless and mostly bilateral expansion of the mandible and/or maxilla. Because fibrous connective tissue replaces osseous tissue, radiographic features generally include expansile osteolytic lesions and a ground-glass appearance. Several treatment protocols for cherubism have been recommended in the literature; however, despite surgical curettage treatment, recurrences may occur. Our aim was to emphasize the high recurrence rate of cherubic lesions. In this article, we present cherubism in a young girl that relapsed after 5 surgical operations before her appearance to our clinic.
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