Does the Nostril Shape Change After Le Fort I Advancement in Patients With Unilateral Complete Cleft Lip?

Purpose: Patients with unilateral cleft lip and palate (UCLP) may require Le Fort I advancement to correct maxillary hypoplasia after reaching skeletal maturity. The underlying cleft anatomy, previous operations, and scarring can affect nostril changes after maxillary advancement. The purpose of the present study was to determine whether Le Fort I advancement affects the nostril configuration (ie, width, axis, shape) in patients with UCLP.

Incorporating Cleft Lip Simulation Into a "Bootcamp-Style" Curriculum.

Introduction: The traditions of surgical education have changed little over the years. However, the increasing focus on patient safety and duty hour restrictions mandates that residents start developing complex skill sets earlier to ensure they graduate with procedural competency. Surgical training is poised to exploit high-fidelity simulation technology to mitigate these pressures.

Can Robin Sequence Be Predicted From Prenatal Ultrasonography?

Purpose: Prenatal diagnosis of Robin sequence (RS) could promote safe delivery and improve perinatal care. The purpose of this study was to evaluate the correlation between prenatal ultrasonography (US) and magnetic resonance imaging (MRI) studies for assessing micrognathia to determine if US alone can be used to reliably screen for RS.

Materials And Methods: This was a retrospective case-control study of fetuses evaluated in the Advanced Fetal Care Center at Boston Children's Hospital from 2002 to 2017.

Retropalatal Cross-Sectional Area Is Predictive of Obstructive Sleep Apnea in Patients With Syndromic Craniosynostosis.

Objective: There is a high rate of obstructive sleep apnea (OSA) in patients with syndromic craniosynostosis (SCS). Little is known about the airway anatomy in this population. The purpose of this study is to characterize the 3 dimensional (3D) upper airway in patients with SCS with and without OSA.

Schneiderian Membrane Thickness Is Increased in Patients With Cleft Lip and Palate.

Objective: Patients with cleft lip and palate (CLP) are more likely to have sinusitis. The purpose of this study is to determine whether patients with CLP have thickening of the Schneiderian membrane. Specific aims were to (1) compare Schneiderian membrane thickness in patients with CLP to noncleft controls, (2) evaluate whether membrane thickening is associated with cleft side in patients with unilateral cleft lip and palate (UCLP), and (3) evaluate if age and sex are predictors of mucosal thickening.

Is Obstructive Apnea More Severe in Syndromic Than Nonsyndromic Patients With Robin Sequence?

Purpose: Patients with syndromic Robin sequence (RS) are known to have poorer outcomes from operations to relieve obstructive apnea (OA) compared with those with nonsyndromic RS. The reason for this is unknown. The purpose of this study was to compare OA in unoperated syndromic and nonsyndromic patients with RS.

Impact of Obstructive Sleep Apnea on Optic Nerve Function in Patients With Craniosynostosis and Recurrent Intracranial Hypertension.

Purpose: Assessment of combined impact of intracranial hypertension (ICH) and obstructive sleep apnea (OSA) on optic nerve function in children with craniosynostosis (CS).

Design: Retrospective cross-sectional study.

Methods: Patients treated at Boston Children's Hospital for CS who had an ophthalmic examination that included pattern reversal (pr)VEP (2013-2014) and history of ICH based on direct measurement, papilledema, or classic features on neuroimaging and during cranial vault expansion were included.

Is It Cost Effective to Add an Intraoral Scanner to an Oral and Maxillofacial Surgery Practice?

Purpose: Intraoral scanners (IOSs), which create digital "impressions" of dental arches, have become popular for prosthetic and orthodontic applications. Adoption in oral and maxillofacial surgery (OMS) practices has been slower, likely because of high implementation costs and low-volume use. The purpose of this study was to evaluate costs for introduction of an IOS into an OMS practice.

Craniofacial Anthropometry: Normative Data for Caucasian Infants.

Purpose: Craniofacial anthropometry is a valuable tool for characterization of facial dysmorphology and evaluation of treatment outcomes. Databases of normal anthropometric ranges are limited for infants. The aim of this study is to establish normative data for craniofacial anthropometric measurements in Caucasian infants.

Do Oral and Maxillofacial Surgeons Over-Prescribe Opioids After Extraction of Asymptomatic Third Molars?

Purpose: Opioid abuse is a public health concern. Oral opioids are prescribed after removal of third molars, but the amount needed for adequate postoperative analgesia is unknown. The purpose of this study was to quantify opioid need after third molar extractions.

Imaging of the Temporomandibular Joint in Juvenile Idiopathic Arthritis: How Does Quantitative Compare to Semiquantitative MRI Scoring?

Purpose: Contrast-enhanced magnetic resonance imaging (MRI) is commonly used to evaluate temporomandibular joint (TMJ) disease in patients with juvenile idiopathic arthritis (JIA). However, MRI assessments have been limited by qualitative reporting, the presence of enhancement in normal joints, and a lack of standardized protocols. The purpose of the present study was to compare a quantitative MRI analysis using an enhancement ratio (ER) to a new semiquantitative system developed by Outcome Measures in Rheumatology and Clinical Trials (OMERACT).

Early Management of Infants With Robin Sequence: An International Survey and Algorithm.

Purpose: There is no widely accepted protocol for management of infants with Robin sequence (RS) who present with airway obstruction and feeding impairment. The purposes of this study were to evaluate diagnostic and treatment preferences of clinicians from the United States and non-US countries and to use these data to propose an algorithm for early management of infants with RS.

Materials And Methods: A cross-sectional study was implemented using a survey, which was distributed to craniofacial surgeons and non-surgeon physicians involved in management of infants with RS.

Is Amniotic Fluid Level a Predictor for Syndromic Diagnosis in Robin Sequence?

Objective: The purpose of this study was to determine whether gestational amniotic fluid level abnormalities were associated with postnatal syndromic status in a series of patients with Robin sequence (RS).

Design: Retrospective study of participants with RS at Boston Children's Hospital from 1967 to 2017. Participants were divided into syndromic and nonsyndromic groups.

Is Tongue-Lip Adhesion or Mandibular Distraction More Effective in Relieving Obstructive Apnea in Infants With Robin Sequence?

Purpose: Tongue-lip adhesion (TLA) and mandibular distraction osteogenesis (MDO) are the most common operations for obstructive apnea (OA) in infants with Robin sequence (RS). The purpose of this study was to compare early outcomes of TLA and MDO on resolution of OA.

Materials And Methods: This is a retrospective cohort study of infants with RS treated with TLA or MDO from 2005 through 2018.

Does Mandibular Distraction Change the Laryngoscopy Grade in Infants With Robin Sequence?

Purpose: To review a series of infants with Robin sequence (RS) who underwent mandibular distraction osteogenesis (MDO) at the authors' institution and document changes in pre- and postoperative laryngoscopy grades.

Materials And Methods: Consecutive patients with RS who underwent MDO from March 2005 to June 2017 were identified. Patients were included if they had a preoperative polysomnogram confirming obstructive sleep apnea, had failed nonoperative airway management, had undergone MDO by the senior author (C.

Temporomandibular Joint Ankylosis After Ramus Construction With Free Fibula Flaps in Children With Hemifacial Microsomia.

Purpose: Patients with hemifacial microsomia (HFM) and Kaban-Pruzansky type III mandibular deformities require ramus construction with autologous tissue. The free fibula flap, an alternative to the costochondral graft, has favorable characteristics for this construction but may be associated with temporomandibular joint ankylosis. The purposes of this study were to present a series of patients with HFM who underwent free fibula flap ramus construction, to determine the incidence of ankylosis, and to identify perioperative factors associated with ankylosis.

Evaluation of Andrews' Analysis as a Predictor of Ideal Sagittal Maxillary Positioning in Orthognathic Surgery.

Purpose: There is no universally accepted method for determining the ideal sagittal position of the maxilla in orthognathic surgery. In "Element II" of "The Six Elements of Orofacial Harmony," Andrews used the forehead to define the goal maxillary position. The purpose of this study was to compare how well this analysis correlated with postoperative findings in patients who underwent bimaxillary orthognathic surgery planned using other guidelines.

In Utero Glossoptosis in Fetuses With Robin Sequence: Measurements From Prenatal MRI.

Objective: Glossoptosis causes airway obstruction in patients with Robin sequence (RS), but little is known about the in-utero tongue. The purpose of this study was to assess shape and position of the fetal tongue on prenatal magnetic resonance imaging (MRI) to determine if this is predictive of postnatal RS.

Design: Retrospective case-control study including fetuses with prenatal MRIs performed from 2002 to 2017.

An algorithm for predicting Robin sequence from fetal MRI.

Background: Infants with Robin sequence (RS) may present with airway compromise at delivery. Prenatal diagnosis would improve preparation and postnatal care. The purpose of this study was to devise a predictive algorithm for RS based on fetal magnetic resonance imaging (MRI).

Maxillary Sagittal Position in Relation to the Forehead: A Target for Orthognathic Surgery.

The relationship of the maxillary incisor to forehead position and angulation may be a predictor for the esthetic antero-posterior maxillary position in orthognathic surgery, but this has not been fully explored in the existing literature. Additionally, this analysis requires a lateral smiling photograph, which is not typically included in orthodontic/orthognathic records. This is a bidirectional study of Caucasian orthodontic patients with malocclusions correctable with nonsurgical and nonextraction treatment.

Pathogenesis of Cleft Palate in Robin Sequence: Observations From Prenatal Magnetic Resonance Imaging.

Purpose: The etiology of the palatal cleft in Robin sequence (RS) is unknown. The purpose of this study was to assess the position of the fetal tongue at prenatal magnetic resonance imaging (MRI) and to suggest a potential relation between tongue position and development of the cleft palate seen in most patients with RS.

Materials And Methods: This is a retrospective case-and-control study including fetuses with prenatal MRIs performed in the authors' center from 2002 to 2017.

Micrognathia and Oropharyngeal Space in Patients With Robin Sequence: Prenatal MRI Measurements.

Purpose: Micrognathia is the initiating feature of Robin sequence (RS) and leads to airway obstruction. Prenatal identification of micrognathia is currently qualitative and has not correlated with postnatal findings in previous studies. Oropharyngeal airway space has not been evaluated prenatally.