Craniofacial and Reconstructive Plastic Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: 30 April 2024 | Viewed by 3262

Special Issue Editor


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Guest Editor
Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80131 Naples, Italy
Interests: plastic, reconstructive and aesthetic surgery; oral and maxillofacial surgery; facial reconstruction; facial surgery

Special Issue Information

Dear Colleagues,

Craniofacial surgery represents a complicated challenge for surgeons, especially due to the impact of the face region on individuals’ social life.

The pathologies that may require craniofacial surgery are innumerable; just think of the global burden of birth defects, such as clefts and craniostenosis, that involve a team of various specialties.

However, the challenges are not limited to congenital and malformation surgery in this Special Issue, and we must also consider traumatic pathologies and reconstructive surgery after tumor exision. The restoration of masticatory, swallowing and phonatory functions is essential in order to enable the patient to continue a normal life, without neglecting the importance of achieving a good aesthetic result. In this Special Issue, we welcome authors to submit papers on the new surgical and aesthetic techniques aimed at restoring facial functions and aesthetics for patients suffering from pathologies of the craniofacial district.

We look forward to receiving your submissions to this Special Issue.

Prof. Dr. Paola Bonavolonta
Guest Editor

Manuscript Submission Information

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Keywords

  • craniofacial surgery
  • reconstructive surgery
  • cleft surgery
  • orthognathic surgery
  • plastic surgery
  • craniofacial tissue engineering
  • salivary glands surgery

Published Papers (5 papers)

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Research

11 pages, 3605 KiB  
Article
Optical Three-Dimensional Imaging for Objective Evaluation of the Donor Site after Anterolateral Thigh Flap Surgery
by Marius Heitzer, Philipp Winnand, Mark Ooms, Anna Bock, Marie Sophie Katz, Florian Peters, Kristian Kniha, Stephan Christian Möhlhenrich, Frank Hölzle and Ali Modabber
J. Clin. Med. 2024, 13(6), 1805; https://doi.org/10.3390/jcm13061805 - 21 Mar 2024
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Abstract
Background: The high volume of the fasciomyocutaneous anterolateral thigh flaps (ALT) is suitable for the reconstruction of pronounced soft tissue defects. At the same time, harvesting ALT results in a drastic change in thigh shape. Here, we present an optical three-dimensional imaging method [...] Read more.
Background: The high volume of the fasciomyocutaneous anterolateral thigh flaps (ALT) is suitable for the reconstruction of pronounced soft tissue defects. At the same time, harvesting ALT results in a drastic change in thigh shape. Here, we present an optical three-dimensional imaging method for thigh comparison, which can be an objective and reproducible method for evaluating donor sites after ALT harvesting. Methods: In total, 128 thighs were scanned with an optical three-dimensional scanner, Vectra XT ®. Sixty-eight non-operated right and left thighs were compared and served as a control. Sixty thighs were scanned in the ALT group. The average surface area deviations, thigh volume, thigh circumference, and flap ratio to thigh circumference were calculated. The results were correlated with Δthigh circumference and Δvolume of the unoperated thighs of the control group. Results: No significant difference between the thigh volumes of the right and left thighs was found in the control group. Removal of an ALT flap showed a significant (p < 0.007) volume reduction compared to unoperated thighs (2.7 ± 0.8 L and 3.3 ± 0.9 L, respectively). Flap area correlated strongly with the Δthigh circumference (r = 0.66, p < 0.001) and Δvolume (r = 0.68, p < 0.001). Strong correlations were observed between flap ratio and thigh circumference with Δhigh circumference (r = 0.57, p < 0.001) and Δvolume (r = 0.46, p < 0.05). Conclusions: Optical three-dimensional imaging provides an objective and reproducible tool for detecting changes in thigh morphology volume differences after ALT harvesting. Full article
(This article belongs to the Special Issue Craniofacial and Reconstructive Plastic Surgery)
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15 pages, 4139 KiB  
Article
Patient’s Perception of Outcome after Extracapsular Fractures of the Mandibular Condyle Differs from Objective Evaluation—Experience of a Third-Level Hospital
by Michael Maurer, Tabea Klaes, Mathias Fiedler, Juergen Taxis, Johannes G. Schuderer, Waltraud Waiss, Maximilian Gottsauner, Johannes K. Meier, Torsten E. Reichert and Tobias Ettl
J. Clin. Med. 2024, 13(5), 1395; https://doi.org/10.3390/jcm13051395 - 28 Feb 2024
Viewed by 421
Abstract
Background: The aim of this study is to assess patients’ subjective perception of treatment outcome after extracapsular fractures of the mandibular condyle. Methods: A questionnaire survey regarding facial nerve palsy (FNP), malocclusion, pain, reduction in maximum mouth opening (MMO) and further [...] Read more.
Background: The aim of this study is to assess patients’ subjective perception of treatment outcome after extracapsular fractures of the mandibular condyle. Methods: A questionnaire survey regarding facial nerve palsy (FNP), malocclusion, pain, reduction in maximum mouth opening (MMO) and further discomfort after 3, 6, and 12 months was carried out. Patients aged 18 or more presenting with an extracapsular condylar fracture between 2006 and 2020 were identified by purposive sampling Questionnaires were received from 115 patients. Fractures were classified on the basis of the pre-treatment imaging, the way of treatment was obtained from patients’ medical records. Data were analyzed using Pearsons’ chi-square-test, descriptive statistics and Student’s t-test. Results: 93.0% of the fractures were treated by open reduction and internal fixation (ORIF). MMO reduction was the most common post-treatment complication (55.6%). ORIF was associated with less pain after 3 months (p = 0.048) and lower VAS scores compared to conservative treatment (p = 0.039). Comminuted fractures were more frequently associated with post-treatment malocclusion (p = 0.048), FNP (p = 0.016) and MMO reduction (p = 0.001). Bilateral fractures were significantly accompanied by malocclusion (p = 0.029), MMO reduction (p = 0.038) and pain occurrence (p < 0.001). Conclusions: Patients report less pain after ORIF. Comminuted and bilateral fractures seem to be major risk factors for complications. Subjective perception of complications after extracapsular condylar fractures differs from objectively assessed data. Full article
(This article belongs to the Special Issue Craniofacial and Reconstructive Plastic Surgery)
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11 pages, 534 KiB  
Article
Analgesic Efficacy of Oxycodone in Postoperative Dressings after Surgical Treatment of Burn Wounds: A Randomised Controlled Trial
by Grzegorz Kowalski, Wojciech Leppert, Małgorzata Domagalska, Monika Grochowicka, Artur Teżyk, Krzysztof Słowiński, Agnieszka Bienert, Danuta Szkutnik-Fiedler and Katarzyna Wieczorowska-Tobis
J. Clin. Med. 2024, 13(3), 784; https://doi.org/10.3390/jcm13030784 - 29 Jan 2024
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Abstract
Introduction: This study aimed to assess the analgesic efficacy of oxycodone at doses of 10 mg and 20 mg in dressings after surgery of burn wounds. Material and Methods: Twenty adult patients who underwent surgical treatment of third-degree burn wounds under general anaesthesia [...] Read more.
Introduction: This study aimed to assess the analgesic efficacy of oxycodone at doses of 10 mg and 20 mg in dressings after surgery of burn wounds. Material and Methods: Twenty adult patients who underwent surgical treatment of third-degree burn wounds under general anaesthesia were included. Burn wounds were treated with dressings, to which oxycodone was added at 20 mg in Group 1 and 10 mg in Group 2. After the surgery, plasma oxycodone and noroxycodone concentrations were assayed, and pain intensity was assessed with Numerical Rating Scale (NRS). Results: In Group 1, no patient reported pain; in Group 2, four patients reported pain. The pain intensity, according to NRS, was 1–8. Plasma concentration of oxycodone in the blood serum was in the range of 1.24–3.15 ng/mL and 1.09–1.28 ng/mL in Group 1 and Group 2, respectively. Noroxycodone was not detected in the plasma. Adverse effects were not observed in any of the treated patients. Conclusions: Oxycodone in dressings provides patients with adequate and safe analgesia. Full article
(This article belongs to the Special Issue Craniofacial and Reconstructive Plastic Surgery)
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12 pages, 1201 KiB  
Article
The Role of Intraoperative and Early Postoperative Blood Pressure Variations, Fluid Balance and Inotropics in Fibula Free Flap Head and Neck Reconstruction: A Retrospective Analysis
by John-Patrik Burkhard, Alena Wepfer, Lukas M. Löffel, Kaspar F. Bachmann and Patrick Y. Wuethrich
J. Clin. Med. 2023, 12(24), 7753; https://doi.org/10.3390/jcm12247753 - 18 Dec 2023
Viewed by 570
Abstract
Background: In head and neck reconstructive surgery, postoperative complications are a well-known concern. Methods: We examined 46 patients who underwent ablative surgery and received fibula free flap reconstruction. The main focus was to assess the influence of intraoperative blood pressure fluctuations and the [...] Read more.
Background: In head and neck reconstructive surgery, postoperative complications are a well-known concern. Methods: We examined 46 patients who underwent ablative surgery and received fibula free flap reconstruction. The main focus was to assess the influence of intraoperative blood pressure fluctuations and the administration of inotropic drugs on complications, either related to the flap or systemic, serving as the primary endpoint. Results: Utilizing logistic regression models, we identified that intraoperative mean arterial blood pressure (MAP) drops did not correlate with the occurrence of either flap-related complications (MAP < 70, p = 0.79; MAP < 65, p = 0.865; MAP < 60, p = 0.803; MAP < 55, p = 0.937) or systemic medical complications (MAP < 70, p = 0.559; MAP < 65, p = 0.396; MAP < 60, p = 0.211; MAP < 55, p = 0.936). The occurrence of flap-related complications significantly increased if a higher dosage of dobutamine was administered (median 27.5 (IQR 0–47.5) vs. 62 (38–109) mg, p = 0.019) but not if norepinephrine was administered (p = 0.493). This correlation was especially noticeable given the uptick in complications associated with fluid overload (3692 (3101–4388) vs. 4859 (3555–6216) mL, p = 0.026). Conclusion: Intraoperative and immediate postoperative blood pressure fluctuations are common but are not directly associated with flap-related complications; however, dobutamine application as well as fluid overload may impact flap-specific complications. Full article
(This article belongs to the Special Issue Craniofacial and Reconstructive Plastic Surgery)
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12 pages, 1306 KiB  
Article
Animal Bite Injuries to the Face: A Retrospective Evaluation of 111 Cases
by Michael Maurer, Cornelius Schlipköter, Maximilian Gottsauner, Waltraud Waiss, Johannes K. Meier, Mathias Fiedler, Johannes G. Schuderer, Juergen Taxis, Torsten E. Reichert and Tobias Ettl
J. Clin. Med. 2023, 12(21), 6942; https://doi.org/10.3390/jcm12216942 - 06 Nov 2023
Cited by 1 | Viewed by 1010
Abstract
The treatment of bite wounds to the face is discussed controversially in relation to surgery and antibiotics. The aim of this study is a retrospective evaluation of 111 cases of animal bite injuries to the face that presented to our unit of oral [...] Read more.
The treatment of bite wounds to the face is discussed controversially in relation to surgery and antibiotics. The aim of this study is a retrospective evaluation of 111 cases of animal bite injuries to the face that presented to our unit of oral and maxillofacial surgery over a 13-year period. Children under 10 years of age were predominantly involved. A total of 94.5% of the assessed injuries were caused by dogs. Wound infections occurred in 8.1%. Lackmann type II was the most common type of injury (36.9%). The perioral area was affected most frequently (40.5%). Primary wound closure was carried out in 74.8% of the cases. In 91.9% of the cases, antibiotic prophylaxis was prescribed. The most often administered type of antibiotic was amoxicillin with clavulanic acid (62.1%). Patients without antibiotics showed an increased infection rate without significance. Wound infections occurred significantly more frequently in wounds to the cheeks (p = 0.003) and when local flap reconstruction was necessary (p = 0.048). Compared to the other surgical treatment options, primary closure showed the lowest infection rates (4.8%, p = 0.029). We recommend antibiotic prophylaxis using amoxicillin with clavulanic acid and wound drains for wounds of Lackmann class II or higher. Primary closure seems to be the treatment of choice whenever possible. Full article
(This article belongs to the Special Issue Craniofacial and Reconstructive Plastic Surgery)
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