Factors Associated With Adherence to Nasoalveolar Molding (NAM) by Caregivers of Infants Born With Cleft Lip and Palate.

Objective: Identify factors associated with adherence to nasoalveolar molding (NAM) therapy.

Design: Retrospective case-control study.

Setting: Tertiary referral center.

Implementation of a Tranexamic Acid Protocol to Reduce Blood Loss During Cranial Vault Remodeling for Craniosynostosis.

Objective: Pediatric cranial vault remodeling for repair of craniosynostosis is associated with significant blood loss and transfusion requirements. Beginning in 2011, the authors evaluated the impact tranexamic acid (TXA) on blood loss and blood product transfusion for children less than 15 months of age undergoing primary surgical repair of nonsyndromic single suture craniosynostosis.

Methods: Following institutional review board approval, the authors performed a retrospective study of all children undergoing surgical correction of craniosynostosis at Oregon Health & Science University from 2005 to 2015.

Local Wound Care for Primary Cleft Lip Repair: Treatment and Outcomes With use of Topical Hydrogen Peroxide.

Objectives: This study highlights and validates a peroxide-based wound healing strategy for treatment of surgically closed facial wounds in a pediatric population. The authors identified pediatric patients undergoing primary cleft lip repair as a specific population to evaluate the outcomes of such a protocol. Through analysis of defined outcome measures, a reliable and reproducible protocol for postoperative wound care following primary cleft lip repair with favorable results is described.

Computed tomography-generated anthropometric measurements of orbital relationships in normal infants and children.

OBJECTIVE The aim of this study was to develop soft-tissue and bony anthropometric orbital measurements in a normal pediatric population based upon CT scans. METHODS This was a retrospective stratified study of children with ages ranging from birth to 36 months. Head CT images for 204 children were available and obtained with 0.

Age at the Time of Surgery and Maintenance of Head Size in Nonsyndromic Sagittal Craniosynostosis.

Background: Repair of nonsyndromic sagittal craniosynostosis should durably improve intracranial volume and cranial index. The optimal timing of surgery is not known. The authors previously reported reoperation in patients aged younger than 6 months at primary repair.

A Reduction in Radiation Exposure During Pediatric Craniofacial Computed Tomography.

Background: Radiation exposure during computed tomography (CT) evaluation in children is the subject of growing professional and public concern. The authors previously demonstrated an 18% reduction in effective radiation dose during craniofacial CT imaging using a modified head position ("exaggerated sniff"), without any compromise of image diagnostic quality. The current study reports additional reduction of radiation exposure using a commercially available iterative reconstruction CT technique.

The American Society of Maxillofacial Surgery Preceptorship Program: A Product of the 2013 American Society of Maxillofacial Surgery Executive Board Strategy Session and Survey.

One of the main goals of the American Society of Maxillofacial Surgery (ASMS) is to develop educational programs that increase expertise in maxillofacial surgery. We describe the outline of the new ASMS Preceptorship Program, a collective effort by ASMS members to increase access to all areas of maxillofacial surgery. Furthermore, we discuss the original survey pertinent to the development of this program, the results of the survey, and specifics regarding the structure of the program.

Transcriptional profiling of rapamycin-treated fibroblasts from hypertrophic and keloid scars.

Excess scar formation after cutaneous injury can result in hypertrophic scar (HTS) or keloid formation. Modern strategies to treat pathologic scarring represent nontargeted approaches that produce suboptimal results. Mammalian target of rapamycin (mTOR), a central mediator of inflammation, has been proposed as a novel target to block fibroproliferation.

Effectiveness and safety of independent pediatric nurse practitioners in evaluating plagiocephaly.

Background: The American Academy of Pediatrics Back to Sleep program in 1992 dramatically increased the incidence of posterior plagiocephaly in infants. In 2000, the craniofacial disorders program at Oregon Health & Science University established a plagiocephaly screening clinic staffed by pediatric nurse practitioners.

Methods: Electronic medical records of patients seen in a single accredited craniofacial disorders clinic from 2005 to 2011 were reviewed retrospectively to identify patients screened independently by pediatric nurse practitioners for positional plagiocephaly versus synostosis.

Benign radiographic coronal synostosis after sagittal synostosis repair.

Whether cranial vault remodeling surgery for nonsyndromic, isolated sagittal suture synostosis affects the patency of initially normal, unaffected sutures is unknown. The influence of coronal and lambdoidal suture patency after cranial vault remodeling on the trajectory of subsequent cranial growth is also unknown. Disruption of normal sutural anatomy during cranial vault reconstruction could influence the incidence of secondary craniosynostosis and need for reoperation in a small proportion of these patients.

Tacrolimus fails to regulate collagen expression in dermal fibroblasts.

Background: The purpose of this study was to investigate the effects of tacrolimus on human fibroblasts derived from unwounded skin, hypertrophic scars (HTS), and keloids. We hypothesized that tacrolimus, a potent anti-inflammatory and immunosuppressant drug known to attenuate solid organ transplant fibrosis, would block collagen expression in human dermal fibroblasts.

Methods: We performed genomewide microarray analysis on human dermal fibroblasts treated with tacrolimus in vitro.

Delayed intracranial hypertension after cranial vault remodeling for nonsyndromic single-suture synostosis.

Object: Delayed intracranial hypertension may occur after cranial vault remodeling for synostosis and may result in visual loss and developmental delay. Delayed intracranial hypertension is relatively common in children with syndromic, multisuture synostosis, but the incidence is poorly defined in children with single-suture nonsyndromic synostosis. This study evaluates the frequency of reoperation for delayed intracranial hypertension after single-suture synostosis repair.

Focal adhesion kinase links mechanical force to skin fibrosis via inflammatory signaling.

Exuberant fibroproliferation is a common complication after injury for reasons that are not well understood. One key component of wound repair that is often overlooked is mechanical force, which regulates cell-matrix interactions through intracellular focal adhesion components, including focal adhesion kinase (FAK). Here we report that FAK is activated after cutaneous injury and that this process is potentiated by mechanical loading.

Decreasing the effective radiation dose in pediatric craniofacial CT by changing head position.

Background: Children are exposed to ionizing radiation during pre- and post-operative evaluation for craniofacial surgery.

Objective: The primary purpose of the study was to decrease effective radiation dose while preserving the diagnostic quality of the study.

Materials And Methods: In this prospective study 49 children were positioned during craniofacial CT (CFCT) imaging with their neck fully extended into an exaggerated sniff position, parallel to the CT gantry, to eliminate the majority of the cervical spine and the thyroid gland from radiation exposure.

Novel use of osmotic tissue expanders to treat difficult anterior palatal fistulas.

Objective: Novel use of osmotic tissue expanders to recruit local palatal mucoperiosteum for the treatment of difficult anterior palatal fistulas.

Design: This is a retrospective review of our experience with osmotic tissue expanders for closure of secondary palatal fistulas.

Setting: The study occurred at Oregon Health and Science University, a tertiary care level academic hospital.

Application of the vacuum-assisted closure in pediatric patients with orthopedic sequelae of meningococcemia: report of a case successfully treated.

Patients who survive the initial acute phase of fulminant meningococcemia are at an increased risk for serious complications as a result of poor tissue perfusion. It is rare that early surgical intervention is required, as it is relatively difficult to determine the degree of tissue loss early on. Once the patient is stable, debridement of all necrotic tissue is essential and may necessitate extensive removal of skin, subcutaneous tissue, and muscle.

TRAIL-R as a negative regulator of innate immune cell responses.

TRAIL receptor (TRAIL-R) signaling has been implicated in inducing apoptosis in tumor cells, but little is understood about its physiological function. Here, we report the generation and characterization of TRAIL-R(-/-) mice, which develop normal lymphocyte populations but possess enhanced innate immune responses. TRAIL-R(-/-) mice exhibited increased clearance of murine cytomegalovirus that correlated with increased levels of IL-12, IFN-alpha, and IFN-gamma.