The Journal of craniofacial surgery
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Fronto-orbital advancement and remodeling for craniosynostosis is extensive surgery and is associated with potential risks; the most significant of these is blood loss. We prospectively studied 116 consecutive patients undergoing fronto-orbital advancement by the same surgical team for a 5-year 6-month period to determine what factors are associated with blood loss and transfusion of blood products. The data collected on the calvarial sutures involved were whether the patient had a diagnosed syndrome, the age at operation, the length of the operation, the estimated blood volume lost during the perioperative course, the number of units of packed cells transfused (donor exposures), and the use of other blood products. ⋯ Other blood products were given in 28% of the cases. There was significantly greater blood loss in those patients with recognized craniofacial syndromes, pansynostosis, an operating time longer than 5 hours, and an age of 18 months or younger at operation. The use of other blood products was associated with those patients losing a blood volume higher than the mean.
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A variety of etiologies may result in functional and aesthetic deficiencies requiring orbital reconstruction. Fractures of the zygomaticomaxillary complex in the acute stage are frequently accompanied by sensory disturbances of the zygomatic nerve (ZN). The purpose of the current study was to describe the anatomic and topographic landmarks of the ZN in 18 adult human cadavers regarding the localization and dimensions in the orbit. ⋯ The mean (SD) distance between the orbital opening of the ZFN and the infraorbital margin of the orbit was 13.04. (3.21) mm. A detailed knowledge of the ZN's passage in the orbit is necessary for a surgeon while performing maxillofacial surgery. If these measurements are taken into account, there will be little surgical risk, and this will be helpful in identifying the extent of the operative field.