The Journal of craniofacial surgery
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Polyetheretherketone (PEEK) is a synthetic material that was used initially in spine and hip surgery. It has the properties of being biocompatible, resistant to thermal and ionizing radiation, and resembles cortical bone biomechanically. These favorable characteristics have led to the increasing use of PEEK implants for calvarial defects which remain a significant reconstructive challenge. ⋯ Computer-designed, patient-specific PEEK implants for cranioplasties are a viable alternative when autologous bone grafts are unavailable or unsuitable. Such prefabrication reduces operative times through minimal to no intraoperative adjustments. Although initial results are promising, longer-term follow-up and further comparative studies including randomized control trials to evaluate outcomes between different alloplastic materials for cranioplasty are necessary.
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Case Reports
Delayed synostoses of uninvolved sutures after surgical treatment of nonsyndromic craniosynostosis.
Craniosynostosis causes significant cranial deformity in the pediatric population. Open and endoscopic-assisted surgeries have led to increasingly successful management of this condition. Following surgical reconstruction, subsequent development of postnatal synostosis of previously patent sutures have been described and noted to be most frequently associated with multisuture synostosis patients with syndromic diagnoses. Very rarely, postsurgical new sutural fusion has been identified in nonsyndromic patients who initially present with isolated single-suture synostosis. The purpose of this study was to evaluate the incidence of new synostosis among patients who had undergone craniosynostosis reconstruction with either the open or endoscopic technique. ⋯ Management of craniosynostosis has evolved over time with increasing availability of effective and safe treatments. During long-term follow-up, a small number of patients may develop premature closure of a different suture that did not undergo surgical manipulation. In our case, series, we identified 3 patients undergoing open surgery and 2 patients undergoing endoscopic surgery for nonsyndromic, single-suture craniosynostosis. This finding supports the necessity of long-term clinical follow-up and the utility of delayed imaging when clinical suspicion indicates.
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Case Reports
Different onset pattern of oculocardiac reflex in pediatric medial wall blowout fractures.
We report the 2 pediatric patients who had radiographic confirmation of a rare case of medial orbital wall "trapdoor" fracture with extraordinary symptoms of oculocardiac reflex (OCR). ⋯ Prompt diagnosis and proper treatment are critical to maximize clinical outcome for this rare and critical trauma.
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Case Reports
Resection of the intracavernous sinus tumors using a purely endoscopic endonasal approach.
Resection of the cavernous sinus (CS) lesions has been a surgical challenge because the anatomy of the CS presents a high grade of complexity. This report describes the feasibility of the purely endoscopic endonasal approach to the CS. Twenty-five patients with intracavernous sinus tumors were treated with a purely endoscopic endonasal approach. ⋯ No patient experienced intraoperative complication and new neurological deficit. Only 1 case of postoperative cerebrospinal fluid leakage repaired via endoscopic endonasal approach on the 14th day after the surgery. The purely endoscopic endonasal approach to the CS in appropriately evaluated patients can be used to address a wide variety of benign and malignant tumor pathology with favorable outcomes and a low incidence of complications.
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This study examined the diagnostic value of ultrasound and radiography compared with clinical examinations as the gold standard method to determine whether ultrasound can be used for early diagnosis of nasal fracture. ⋯ The nasal bone ultrasound study is a useful method in determining the nasal fracture and radiography can be replaced with ultrasound in early diagnosis of fracture.