The Journal of craniofacial surgery
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Craniosynostosis, the premature fusion of one or more cranial sutures, may occur in isolation or in association with a syndromic constellation. Multiple-suture synostosis has consistently been associated with brain compression and increased intracranial pressure, and frequently decreased cognitive development. Single-suture craniosynostosis, however, has been thought by some to be an aesthetic problem with infrequent consequences on brain function and development. ⋯ Maximum glucose metabolic rate was increased up to 30.2% with a mean of 9.9%, and average glucose metabolic rates demonstrated a maximum increase of up to 18.8%. The results of this study indicate cerebral glucose metabolism consistently increases in the posterior occipital cortex after surgical release of single-suture craniosynostosis. Future developmental studies are being performed to examine the functional consequences of these metabolic changes.
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Randomized Controlled Trial Clinical Trial
Prophylactic use of ondansetron for emesis after craniofacial operations in children.
Children who undergo craniofacial operations are especially at risk of postoperative nausea and vomiting. These operations are more complex than the craniotomies for resective procedures. Postoperative vomiting is a common occurrence that can delay recovery and result in cerebrospinal fluid leak and fistula formation in these patients. ⋯ After surgery, episodes of vomiting were recorded separately in 0 to 2 hours, 2 to 6 hours, 6 to 12 hours, 12 to 24 hours, and 24 to 48 hours. Postoperative vomiting is significantly reduced in the ondansetron group compared with the placebo group (P = 0.000258). Ondansetron is effective in the prevention of postoperative vomiting in the pediatric population undergoing craniofacial operations.
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The purpose of this study was to evaluate the surgical outcomes of the 1.5-mm LactoSorb plating system (Walter Lorenz Surgical, Inc., Jacksonville, FL, U. S. A.) used to stabilize the osteotomized calvarial bone in pediatric patients who have undergone craniofacial surgery. ⋯ One patient had a postoperative wound infection, and LactoSorb plates were palpable postoperatively in four patients. The LactoSorb plating system provided adequate rigidity for stabilizing the osteotomized calvarial bone during surgery and maintained adequate rigidity after surgery during the bone healing period before absorption. This plating system showed satisfactory results in pediatric craniofacial surgery patients.
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Review Case Reports
Traumatic optic neuropathy complicating facial fracture repair.
Blindness can result from traumatic optic neuropathy following facial trauma and can complicate the management of concomitant facial fractures. Traumatic optic neuropathy can cause a substantial delay in the repair of facial fractures, leading to compromised surgical results. It can also result in postoperative visual loss following facial fracture repair. ⋯ The management of facial fractures in patients with traumatic optic neuropathy must proceed cautiously. Delayed primary repair of midface fractures by postponing surgery for 10 to 14 days may be of benefit in avoiding further deterioration of vision. In addition, megadose corticosteroids and/or optic nerve decompression is useful in the management of these patients.
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The iliac bone is one of the most common donor sites for bone graft. Despite such potential and clinical usefulness, the anthropometric data on the iliac bone are lacking. The purpose of this study is to construct a thickness map that provides the mean iliac bone thickness of its various points and their differences. ⋯ From the superoinferior perspective of superior iliac crest and inferior acetabulum, the thickness became inferiorly thinner in the anterior part between ASIS and iliac tuberosity. However, in the posterior part between the sacroiliac joint and PSIS, there was no significant difference of thickness. We hope that our thickness map can serve as a practical guide to the choice of an ideal site of the iliac bone for bone graft to obtain desired thickness.