The Journal of craniofacial surgery
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Polyetheretherketone (PEEK) has emerged as one of the most promising alloplastic materials for calvarial reconstruction because of a number of desirable qualities including resistance to heat and ionizing radiation, biocompatibility, biomechanically similar to native bone, and being nonferromagnetic for postoperative monitoring. We aimed to evaluate and compare the outcomes of alloplastic cranioplasty performed with PEEK, titanium mesh only (Ti-only), and titanium mesh with acrylic cement (Ti-AC); titanium mesh has previously recorded many successes with low complication rates. ⋯ Early results suggest that PEEK may be superior to Ti-only or Ti-AC as an alloplastic cranioplasty choice. Further research should include randomized trials between computer-aided, prefabricated titanium and PEEK cranioplasties with larger sample sizes and longer follow-up.
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Growth factors contained in platelet-rich plasma (PRP) can induce osteoblast differentiation in certain studies, whereas in others, osteogenesis of PRP on mandible bone defects has not been proved clinically. The aim of the study was to investigate the effect of autologous PRP on the osteogenic potential of combining bovine porous bone mineral (BPBM) and bio-guide membrane (BGM) in promoting mandible bicortical bony defects in rabbits. ⋯ The study suggested that PRP combination of BPBM and BGM had significant therapeutic effects on mandible bicortical bony defects of rabbits. The effects are associated with the high concentration of platelet in PRP and the porous configuration of BPBM. Although we cannot reveal the detailed statistical relationship of PRP on promoting BPBM/GBM osteoinductive effects, PRP demonstrated superior results of bone regeneration.
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Incidence estimates for postoperative vision loss after nonocular surgery range from 0.013% for all surgeries up to 0.2% following spine surgery. The most common neuro-ophthalmologic causes of postoperative vision loss are the ischemic optic neuropathies (IONs), either anterior or posterior. ⋯ The specific pathogenesis and risk factors underlying these neuro-ophthalmic complications remain unknown, and physicians should be alert to the potential for loss of vision in the postoperative period. We report the only cases of ION after carotid body tumor resection in the literature and review current theories regarding the etiology and diagnosis of vision loss.
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Total face skin and soft-tissue defects remain one of the biggest challenges in reconstructive surgery. Reconstruction of the entire face with uniform coverage and delicate features is difficult to achieve. ⋯ In this article, we present our experience from our case series that provides universally matched skin and near-normal facial contour. It is a reliable and an excellent reconstructive option for massive facial skin defect.
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Remote epidural hematoma (REDH) is an uncommon complication of decompressive craniectomy. Remote epidural hematomas of the parietal occiput region have been reported only rarely. ⋯ Postoperatively, serial computed tomographic scans performed 3 days later showed that the REDH had been completely evacuated. Two months later, the patient regained full consciousness and obtained a near-complete recovery except for right facial paralysis.