Mandibular Reconstruction Utilizing the Reamer-Irrigator-Aspirator to Obtain Nonvascularized Femur Grafts
Between July 2021 and February 2024, 6 patients with biopsy-confirmed benign pathologic lesions had mandibular defects reconstructed using a reamer-irrigator-aspirator at the University of Cincinnati Medical Center. Patients' ages ranged from 34 to 73, 5 of which were males and one female. Primary end points were bony continuity of the mandible, recovery time, and ability of the graft to receive implants. The reamer-irrigator-aspirator obtained 40 to 100 cm of uncompressed bone from donor sites. All patients ambulated on the day of surgery or postoperative day one. No neurosensory disturbances were reported at the donor site. Five patients achieved radiographic continuity of the mandible postoperatively. Of the patients with continuity, 4 received implants, and one received a removable prosthesis. The patient without mandibular continuity declined further intervention and received a removable prosthesis. The findings lend support to the possibility of harvesting medullary bone from the femur for mandibular defect reconstruction.
Planning the Cut: Gender-Affirming Considerations in Orthognathic Surgery
RE: Do Platelet-Rich Concentrates Improve the Adverse Sequelae of Impacted Mandibular Third Molar Removal?
RE: Is ChatGPT an Accurate and Readable Patient Aid for Third Molar Extractions?
Prevalence of and Risk Factors for Hearing Impairment in Craniofacial Microsomia
While ear anomalies and hearing impairment are common in patients with craniofacial microsomia (CFM), their prevalence, characteristics, and relationship to speech-language development remain unclear.
A New Hope: Patient-Specific Bone-Anchored Subperiosteal Implants: Perspective of 3 US Institutions on This Resurrected Treatment Modality
TMJ Concepts Patient-Fitted Temporomandibular Joint Reconstruction Prosthesis System: Results From a Food and Drug Administration Postmarket Surveillance Prospective Cohort Study
Custom-designed and patient-fitted temporomandibular joint replacement (TMJR) devices are used to manage end-stage temporomandibular joint (TMJ) pathology, distorted bony TMJ architecture, or in patients who have undergone multiple prior failed TMJ surgeries.
Postoperative Antibiotics May Be Unnecessary in Pediatric Patients Hospitalized With Minor Odontogenic Infections
Antibiotic overuse is a growing concern in health care. For pediatric odontogenic infections, the necessity of postoperative antibiotics lacks clear, evidence-based guidelines.
Machine Learning Differentiates Between Benign and Malignant Parotid Tumors With Contrast-Enhanced Ultrasound Features
Contrast-enhanced ultrasound (CEUS) is frequently used to distinguish benign parotid tumors (BPTs) from malignant parotid tumors (MPTs). Introducing machine learning may enable clinicians to preoperatively diagnose parotid tumors precisely.
Patterns of Paging Activity Among Oral and Maxillofacial Surgery Residents: Implications for Patient Care
One-way alphanumeric pagers remain a primary communication method for health care providers, despite the rise of app-based communication systems. Frequent nonurgent pages can disrupt workflows and potentially impact patient care, particularly in high-demand specialties like Oral and Maxillofacial Surgery (OMS).
Radiographic Predictors of Postoperative Inferior Alveolar Nerve Injury in Mandibular Third Molar Surgery
Cone-beam computed tomography (CBCT) provides additional 3-dimensional information on the relationship between the mandibular third molar (M3M) and the inferior alveolar nerve (IAN). As such, CBCT is being increasingly utilized in preoperative M3M assessment.
Airway Management in Microvascular Reconstruction of the Oral Cavity: Is Immediate Extubation Possible?
A tracheostomy is routinely performed following free tissue transfer (FTT) for oral cavity reconstruction; however, its avoidance whenever possible is advocated to enhance patient recovery and reduce hospital length of stay (LOS).
Does a Modified Endaural Incision (Inviscision) Reduce Facial Nerve Injury and Improve Cosmesis When Compared to the Alkayat-Bramely Incision for Management of Temporomandibular Joint Ankylosis?
Facial nerve injury (FNI) and unesthetic scar are distressing complications of temporomandibular joint (TMJ) surgery. Insufficient evidence on whether a modified endaural incision can reduce FNI and serve as an aesthetic alternative is a concern.
Impact of Cleft and Craniofacial Surgery Experience in Oral and Maxillofacial Surgery Residency Training Programs
The impact of cleft and craniomaxillofacial surgeons (CCMFSs) on oral and maxillofacial surgery (OMS) resident training is not well known.
Dumbbell-Shaped Bipaddled Pectoralis Major Myocutaneous Flap for Composite Commissural Defects: A Defect-Driven Modification
Pectoralis major myocutaneous flap (PMMF) has been a workhorse in orofacial reconstruction. Although microvascular tissue transfer has gained popularity in major tertiary centers, several infrastructural factors limit its use in many facilities, particularly in developing countries with high caseloads. Numerous modifications have been made to the PMMF since its inception. Here, we present a novel technique for reconstructing composite commissural defects with PMMF by modifying the skin paddle design to a dumbbell shape. Both ends of the paddle are used to line intraoral and extraoral defects, while the constricted middle portion recreates the commissure. We report the outcomes of a cohort of 7 patients treated at our institution, describing the modified PMMF design, harvesting, and in-setting techniques used in oral carcinoma cases involving the commissure. We have detailed the study outcomes for each patient, including the various complications related to the flap, donor, and recipient sites.
What Happens After the Free Flap? Evaluation of Aesthetic and Functional Elective Revisions
Microvascular free flap reconstruction of a defect, as a single-stage procedure, does not always achieve the desired functional and esthetic result. Revisions may be necessary to achieve ideal contour, symmetry, and suspension of soft tissues, or to support dental rehabilitation.
Histopathology of Idiopathic Condylar Resorption Differs From Temporomandibular Joint-Only Juvenile Idiopathic Arthritis
Idiopathic condylar resorption (ICR) is a rare condition of unknown etiology characterized by progressive decrease in volume and pathologic remodeling of a previously normal mandibular condyle. Juvenile idiopathic arthritis (JIA) affecting only the temporomandibular joint (TMJ-only JIA) is characterized by synovitis and destruction of TMJ tissues without involvement of other joints. It is often difficult to differentiate the 2 conditions because they exhibit similar phenotypes.
Application of Handheld Point-of-Care Ultrasound in the Setting of Craniomaxillofacial Trauma: A Technical Note
Computed tomography (CT) is the standard of care imaging in craniomaxillofacial (CMF) trauma. Despite the clear advantages of high-resolution multiplanar and three-dimensional reconstructions, which facilitate accurate diagnosis and provide intraoperative (IO) real-time visual feedback, CT's main drawbacks remain availability, cost, and high radiation exposure. The decision to perform a CT scan is based on the integration of the patient's trauma mechanism, clinical examination, subjective judgment of the CMF surgeon, and the complexity of the surgery if used IO. Handheld point-of-care ultrasound is a small, portable device that can provide valuable additional data directing clinical decisions for CT referral in minor trauma cases and assist IO maneuvers. We describe a novel handheld point-of-care ultrasound application concept as a clinical supplementary tool in CMF trauma diagnosis and surgery.
The Modified Caldwell-Luc Approach for Treating Odontogenic Maxillary Sinusitis Without Need for Functional Endoscopic Sinus Surgery: A Retrospective Study
Odontogenic maxillary sinusitis is a common inflammatory condition resulting from the violation of the Schneiderian membrane by conditions arising from the dentoalveolar unit, which includes teeth, their supporting structures, and adjacent tissues. This study aims to evaluate a modified surgical approach for treating this condition.
Depth of Invasion Threshold for Recommending Elective Neck Dissection in T1 or T2 Oral Squamous Cell Carcinoma
There is variability in the literature on the role of the depth of invasion (DOI) for recommending an elective neck dissection (END).