Journal of Craniofacial Surgery

OBJECTIVE: Dermatochalasis is a common condition that can cause obstruction of peripheral visual fields and impairment of daily activities. These effects can be addressed with a blepharoplasty, which may be considered a cosmetic procedure by American health insurers. The authors assessed insurance coverage of all indications of blepharoplasty and their medical necessity criteria. METHODS: A cross-sectional analysis was conducted of 70 insurance policies for blepharoplasty...

OBJECTIVE: To investigate the clinical effect of the double insurance method of flexible suspension and semiflexible suspension in bionic blepharoplasty. METHODS: Between January 2020 and January 2022, a total of 115 patients (230 eyes) underwent double eyelid plastic surgery with flexible suspension and semiflexible suspension. Herein, we present a new type of double eyelid surgery that preserves the orbicular muscle of the anterior tarsus without removing the tissue...

OBJECTIVE: Nasal dermoid sinus cysts (NDSCs) with intracranial extension in the form of dermal sinus tracts require careful and complete resection to prevent recurrence. Resection techniques necessitate adequate intracranial exposure, but morbidity associated with historical resection approaches has presented unique multidisciplinary challenges for surgeons treating cysts with intracranial extension. METHODS: The authors primarily employed a transnasal approach through a midline nasal incision, utilizing endoscopic or microscopic access between the lateral cartilages for resection of NDSCs with intracranial extension...

PURPOSE: The reconstruction of full-thickness nasal defects poses a significant challenge following oncologic resection. This study aims to share a technique using paired pericranial forehead flap (PCF) with contralateral paramedian flap (PMF) for such defects. Patient outcomes were reviewed, and the advantages and disadvantages of the reconstructive technique are discussed. METHODS: A retrospective review of a single surgeon practice was done between 2019 and 2024...

In a challenging and extremely rare case, a 40-year-old female presented with an orthodontic miniscrew inadvertently lodged in the prevertebral space near the internal carotid artery following an incident at a local clinic. Traditional blind removal techniques posed significant risks due to the miniscrew's dangerous location. An optical navigation system that utilized advanced real-time tracking and 3D imaging to precisely locate and safely remove the foreign body was applied. The successful procedure, confirmed by postoperative imaging, underscored the vital role of navigation-guided surgery in enhancing surgical precision and patient safety in complex cases...

Although metastases to the paranasal sinuses are exceedingly rare, when they do occur, renal clear cell carcinoma is the most frequent primary tumor involved. The aim of this work was to present a case of metastatic clear cell renal carcinoma in the frontal sinus and orbit region, 7 years after the initial diagnosis and treatment. The patient was referred to our clinic due to drooping of the left eyelid and displacement of the left eyeball. Computed tomography revealed an expansive lesion in the left frontal sinus and orbit, causing destruction of its anterior, lateral, and roof walls...

OBJECTIVE: This study aims to investigate the relationship between caregivers' perception of child weight, their concern about children's weight, pressed eating behaviors, and children's BMI. METHODS: A Child Feeding Questionnaire was administered to 442 primary caregivers of school-aged children (6-12 y old) in Hangzhou, China. RESULTS: Significant differences were observed in age, family average monthly income, and family care type among children with different weight statuses (P<0...

OBJECTIVE: To investigate the status of patients' post-pituitary tumor resection and analyze influencing factors, providing evidence for improved long-term management. METHODS: The authors screened 1209 patients who underwent pituitary tumor resection at Zhejiang University's Second Affiliated Hospital from August 2020 to July 2022 using electronic medical records. Patients were classified into return visits (≥2 reviews/y or within 6 mo) and missing visit groups...

Microvascular decompression (MVD) plays a pivotal role in the treatment of cranial neurovascular compression syndromes, yet the safety and precision of the surgery remain a focus of clinical attention. This article delves into the application of multimodal reconstruction and 3D printing technologies in MVD surgeries, evaluating their effectiveness in preoperative planning. Multimodal reconstruction, by integrating various imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT), provides high-resolution anatomical information, offering comprehensive data support for preoperative planning and intraoperative navigation...

The aim of this study is to capture the enduring fascination with youth and transformation. These themes, epitomized by the myth of Medea, resonate in the context of modern plastic surgery and cosmetic enhancements. Book 7 of Metamorphosis was read and analyzed. Medea is a sorceress and daughter of King Aeëtes. Her magical abilities are highlighted in 2 notable stories: (1) her rejuvenation of Aeson and (2) her attempt to rejuvenate herself. Aeson, the father of Jason, had grown old and frail. Medea, eager to assist Jason's father, employed her magical abilities to restore Aeson's youth...

BACKGROUND: Airbags have significantly decreased fatalities in frontal vehicle accidents, but their deployment can lead to more severe injuries and rarely death. The authors present a case of a penetrating injury causing tissue loss in the left cheek, an "explosion" of the zygomatic arch, and facial nerve damage, discussing the management in the contest of literature examining similar injuries in the head and neck region. MATERIALS AND METHODS: Reviewing English literature from 1995 to 2023, 9 patients experienced severe airbag-related penetrating head and neck injuries, in 3 cases resulting in death...

BACKGROUND: Traumatic ear amputation is a rare injury. Ear replantation is the gold standard in dealing with amputated ears. However, this is not always feasible. In this case series, the authors discuss the immediate reconstruction of traumatic ear amputation using temporoparietal fascia with the same skin from the amputated ear, which provided a high esthetic result and patient satisfaction. PATIENTS AND METHODS: The authors present a case series of 3 patients from July 2018 to May 2020 who suffered from traumatic ear amputation due to a human bite and were successfully reconstructed using temporoparietal fascia and the same skin from the amputated ear as FTSG...

OBJECTIVE: Patients with Beckwith-Wiedemann syndrome commonly have macroglossia, which can negatively affect dentoskeletal development, breathing, speaking, and eating. Tongue reduction surgery can improve symptoms, but there is no standardized surgical approach. METHODS: A video and observational commentary highlighting the effectiveness of a tongue reduction technique for BWS were presented. RESULTS: The peripheral resection with a keyhole approach safely reduced tongue volume, maintained the lateral neurovascular pedicles, optimized intraoperative visualization, and limited bleeding...

This study aims to evaluate the use of bone substitute blocks (BSBs) in minimally invasive orthognathic surgery for the maxilla, mandible, and chin, highlighting their impact on jaw stability and bone healing. A retrospective analysis was conducted on 47 consecutive patients (33 females, 14 males; mean age: 27 y) who underwent bimaxillary advancement surgery. Procedures employed the minimally invasive orthognathic surgery approach. Bovine BSBs (Bio-Oss Collagen) were used to fill gaps in all cases. Postoperative follow-up included computed tomography scans at immediate and 1-year intervals...

OBJECTIVE: Liposuction of the face and neck is a common treatment for fat deposition. If conventional methods are used for tumescent anesthesia, patients will experience pain, affecting their surgery experience. Using general anesthesia for liposuction of the face and neck can increase the cost to the patient and cause various adverse effects. METHODS: The authors selected appropriate parts of the patient's neck, angle of the mandible, and face as needle entry points, and performed nerve block in different directions...

The hair-bearing superficial temporal artery flap is one of the traditional options for total eyebrow reconstruction. The anatomical variation of the superficial temporal artery has been well discussed; however, the anatomy of the superficial temporal vein is highly diverse. The authors report the use of preoperative computed tomography (CT) angiography in a 27-year-old man with a total eyebrow defect caused by thermal burn injury. The authors harvested a 6×1.5-cm pedicled hair-bearing superficial temporal artery flap from the area where the parietal branches of the superficial temporal artery and vein were running in close proximity, according to the CT angiography findings...

OBJECTIVE: Superficial temporal artery (STA) pseudoaneurysms, characterized by arterial wall defects leading to blood leakage into perivascular tissues, present as pulsatile edematous masses, often originating from trauma or iatrogenic causes. Although rare (<1% of vascular lesions), anticoagulation agent use may contribute to their increasing incidence. METHODS: Traditional surgical ligation and resection have been standard, but the advent of endovascular techniques offers minimally invasive alternatives that mitigate surgical risks, especially in patients with multiple medical comorbidities...

OBJECT: Observations of preoperative and postoperative orbital morphology following fronto-orbital advancement and cranial vault remodeling (FOA and CVR) in patients with unilateral coronal synostosis (UCS). METHODS: This retrospective cohort included patients diagnosed with unilateral coronal synostosis and treated with fronto-orbital advancement and cranial vault remodeling at the Children's Hospital of Fudan University. The orbital height, orbital width, and orbital volume were obtained from head 3-dimensional computed tomography of preoperation and postoperation...

A novel method for unilateral cleft lip repair based on lip anatomic subunits was presented in 2005 by David M. Fisher. It has about 25 landmarks with 2 arbitrary markings for the nostril. It is an important subunit when it comes to nose reconstruction. This article sheds light on the variance in nostril sill disposition among cleft lip patients. A novel marking technique based on differences in sills is presented. Furthermore, the unique anatomical structure of the philtrum-white roll junction is highlighted with a suggested modification to the subunit approximation leading to its reconstitution...

OBJECTIVE: The aim of this study is to assess psychopathology and maternal interactions in infants, toddlers, and preschool children with nonsyndromic clefts of the lip and/or palate (NSCLP) and association of psychopathology with cleft-related factors and maternal interactions. DESIGN: Twenty-six children from 4 to 72 months of age with NSCLP, who were attending the Plastic, Reconstructive and Aesthetic Surgery Department were included as the case group. Fifty-two healthy children who were matched on age and sex with the case group were taken as controls...