The Journal of craniofacial surgery
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Case Reports
A novel application of computer-aided design and manufacturing for reduction cranioplasty.
Macrocephaly is a rare presentation of untreated hydrocephalus. In cases where medical management has failed, macrocephaly can be managed with reduction cranioplasty. Traditionally, reduction cranioplasty is highly dependent on intraoperative tailoring of bone segments to obtain the best possible result and involves high risks of associated severe blood loss and mortality. ⋯ We also utilized computer-aided manufacturing to produce cutting guides, positioning guides, and models to increase precision and improve the final positioning of the cranium. Computer-aided design and manufacturing technology has enabled a shift of the planning burden of complicated craniofacial reconstructions from the intraoperative to the preoperative phase. With a completed plan and premade guides and models, it is possible to minimize the risks, improve efficiency, and obtain a precise, aesthetic result.
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Uvular necrosis after long-term endotracheal intubation has been previously reported, but there have been no reports regarding soft palate necrosis after endotracheal intubation. Recently, we encountered 2 patients who had a high degree of soft palate necrosis following endotracheal intubation during long-term care in the intensive care unit. This study reports noncongenital soft palate cleft caused by endotracheal intubation. ⋯ Postoperative courses were uneventful in both of the cases, and neither patient experienced a recurrence. Although rare, long-term intensive care unit care with endotracheal intubation can cause noncongenital soft palate cleft. In cases with iatrogenic cleft palate that does not heal with conservative treatment, surgical procedures such as pharyngeal flap and palatoplasty can be helpful.
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Comparative Study
Efficacy of bone healing in calvarial defects using piezoelectric surgical instruments.
This study compared bone healing following the use of 2 piezoelectric surgery units or conventional mechanical cutting with carbide and diamond drills to explore their future applications for bone surgery. ⋯ The Surgystar and Piezoelectric System are suitable for bone osteotomy and provide faster bone healing in comparison with mechanical instrumentation.
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Tissue expansion is a reconstruction method often used to repair the tissue loss that results after removing soft tissue lesions such as scars, tumors, and giant hairy nevi. However, because the pressure of a tissue expander applies in all directions almost equally, along with the desired expansion of skin and subcutaneous fat tissue, the muscle and bone underneath the expander become depressed simultaneously. Even with a successful expansion of the tissue itself, the conventional surgical procedure results to frequent aesthetically dissatisfying outcomes because of contour irregularities. However, no studies have been conducted regarding the correction of these secondary deformities. ⋯ Secondary depression deformity induced by a tissue expander can be effectively prevented with a simple operative technique using capsule flaps, scar tissue flaps, and free capsule grafts.
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Letter Case Reports
Prostate adenocarcinoma metastasis to the oral cavity.