Perioperative anticoagulation in head and neck free flap reconstructions: Experience of an anticoagulative scheme and its modification.

Objectives: Microvascular anastomoses in microvascular reconstructions induce rheological changes in the anastomosed vessels and are usually counteracted by anticoagulative medication. There is no regimen commonly agreed on. This study provides an easy to use anticoagulative regimen.

Infantile human labial glands: Distribution of aquaporins and claudins in the context of paracellular and transcellular pathways.

Human labial glands consist of saliva-secreting cells which are formed by serous and predominantly mucous glandular cells. The following excretory duct system converts the isotonic saliva into a hypotonic fluid. Liquids are transported across the membrane of epithelial cells by paracellular or transcellular mode of action.

Three-Dimensional Analyses of Postoperative Effects of Surgically Assisted Rapid Palatal Expansion (SARPE) on the Soft Tissue of the Midface Region and the Upper Airway Space Using Stereophotogrammetry and Cone Beam Computed Tomography (CBCT).

Background: Surgically assisted rapid palatal expansion (SARPE) is an established method to treat transverse maxillary hypoplasia in skeletally mature adult patients. SARPE affects the surrounding soft tissue. In addition, effects on the airway and breathing have been described.

NAM-help or burden? Intercultural evaluation of parental stress caused by nasoalveolar molding: a retrospective multi-center study.

Objectives: Nasoalveolar molding (NAM) was developed to facilitate easier treatment and better outcomes for cleft lip and palate (CLP) patients. The aim of this study was to investigate the parental burden and possible intercultural differences of this treatment modality, which is often argued to burden parents to an extraordinary amount.

Materials And Methods: Standardized questionnaires (available in English, Mandarin, and German) with 15 non-specific and 14 NAM-specific items to be retrospectively answered by Likert scales by parents of unilateral CLP patients with completed NAM treatment.

Diversity of mucins in labial glands of infants.

Mucins as highly glycosylated proteins comprise multiple functions like protection, homeostasis, immune defense, cell signaling. Various epithelial tissues including glandular structures express different specific mucin types. We investigated labial salivary glands in infants for the occurrence of MUC1, MUC2, MUC3, MUC4, MUC5AC, MUC5B, and MUC7 by immunohistochemistry.

Author Correction: A semi-automated virtual workflow solution for the design and production of intraoral molding plates using additive manufacturing: the first clinical results of a pilot-study.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Identifying perioperative volume-related risk factors in head and neck surgeries with free flap reconstructions - An investigation with focus on the influence of red blood cell concentrates and noradrenaline use.

Introduction: The amount of fluids administered intraoperatively seems to influence the postoperative outcome, and especially the transfusion of red blood cell concentrates (RBC) are known to have an increased risk of postoperative complications. This prospective study focuses on patients planned with microvascular free flap reconstruction and investigates the effect of various types and amounts of volumes given intraoperatively and on the intensive care unit with regard to overall postoperative complications.

Material And Methods: In this prospective study, 52 consecutive patients planned for reconstruction with microvascular free flaps were included.

RapidNAM: Algorithm for the Semi-Automated Generation of Nasoalveolar Molding Device Designs for the Presurgical Treatment of Bilateral Cleft Lip and Palate.

Objective: Nasoalveolar molding (NAM) is an accepted presurgical treatment modality for newborns with cleft lip and palate (CLP). However, the therapy is time-consuming and requires high expertise. To facilitate the treatment, we reveal an algorithm for the automated generation of patient individual NAM devices for neonates with bilateral cleft lip and palate (BCLP) and present results of software validation.

Prenatal intrauterine maxillary development - An evaluation with three-dimensional ultrasound.

Objectives: The aim of this prospective study was to investigate normal fetal maxillary development with volume ultrasound during the prenatal phase, for a better estimation of maxillary growth processes.

Methods: Some 210 3D volumes were obtained in two measurement series from 38 healthy women (gestational age: 19 to 31 weeks) using a GE Voluson™ E10 ultrasound system. Maxillary length and width were determined in the axial and sagittal planes.

The absolute and relative effects of presurgical nasoalveolar moulding in bilateral cleft lip and palate patients compared with nasal growth in healthy newborns.

Background: This study investigated the efficiency of nasoalveolar moulding (NAM) in patients presenting with bilateral cleft lip and palate (BCLP). It focused explicitly on nasal outcome and therefore made comparisons with healthy age-matched infants with normal nasal development.

Methods: Nasal impressions from 19 BCLP patients were analysed at the beginning and at the end of NAM treatment.

Evaluation of a portable low-budget three-dimensional stereophotogrammetry system for nasal analysis.

Background: Three-dimensional (3D) photogrammetry has reached high standards and accuracy but is mainly conducted with stationary and expensive systems. The purpose of this study was to evaluate the accuracy of a low-budget portable system with special regard to the gracile and challenging nasal region.

Material And Methods: 3D models of the perinasal area were acquired by impression-taking and the scanning of the generated plaster models (3Shape D500) or with a portable low-budget 3D stereophotogrammetry (FUEL3D SCANIFY) system.

Stress Distribution Patterns within Viscero- and Neurocranium during Nasoalveolar Molding: a Finite Element Analysis.

Background: The purpose of this study was to evaluate the stress distribution patterns within the viscero- and neurocranium of neonates during nasoalveolar molding.

Methods: Finite element models of 3 different healthy neonates at different times of life (date of birth, 4 weeks, and 3.5 months) were generated on the basis of computed tomography scans.

Facilitating CAD/CAM nasoalveolar molding therapy with a novel click-in system for nasal stents ensuring a quick and user-friendly chairside nasal stent exchange.

Nasoalveolar molding (NAM) aims to improve nasal symmetry with a nasal stent in cleft lip and palate (CLP) patients. When plates have to be exchanged because of dentoalveolar growth or cleft reduction, the nasal stent has to be mounted onto a new plate. This procedure elongates visiting hours for patients and parents or requires second treatment sessions.

A semi-automated virtual workflow solution for the design and production of intraoral molding plates using additive manufacturing: the first clinical results of a pilot-study.

Computer-aided design and computer-aided manufacturing (CAD/CAM) technology has been implemented in the treatment of cleft lip and palates (CLP) by several research groups. This pilot study presents a technique that combines intraoral molding with a semi-automated plate generation and 3D-printing. The clinical results of two intraoral molding approaches are compared.

The possibilities of a portable low-budget three-dimensional stereophotogrammetry system in neonates: a prospective growth analysis and analysis of accuracy.

Background: With the technical development, portable three-dimensional (3D) photogrammetry systems are becoming more en vogue because of cost-effectiveness and comparable accuracy to common stationary 3D systems. The purpose of the study was to evaluate the feasibility and accuracy of a low-budget portable system for 3D image acquisition with special regard to the gracile nasal region in neonates. Furthermore, the study aimed to establish a 3D data set of the first 180 days post partum.

Establishment of a finite element model of a neonate's skull to evaluate the stress pattern distribution resulting during nasoalveolar molding therapy of cleft lip and palate patients.

Nasoalveolar Molding (NAM) is associated with ambivalent acceptance regarding effectiveness and unknown long-term results. Our purpose was to analyze the stress distribution patterns within the viscero- and neurocranium of neonates during the first phase of NAM therapy. A finite element (FE) model of a healthy four-week-old neonate was generated, derived from a computed tomography scan allowing the implementation of a bone-density-dependent material model.

A prospective longitudinal study of postnatal dentoalveolar and palatal growth: The anatomical basis for CAD/CAM-assisted production of cleft-lip-palate feeding plates.

This study describes the dentoalveolar and palatal growth during the first months of life. Knowledge concerning this development is essential to avoid unwanted events such as mucosal ulcerations or restriction of growth when cleft-lip and palate (CLP) patients are treated. The results involve the generation of CAD/CAM CLP-feeding plates.

RapidNAM: generative manufacturing approach of nasoalveolar molding devices for presurgical cleft lip and palate treatment.

Nasoalveolar molding (NAM) is an accepted treatment strategy in presurgical cleft therapy. The major drawbacks of the treatment listed in the literature relate to the time of the treatment and the coordination of the required interdisciplinary team of therapists, parents, and patients. To overcome these limitations, we present the automated RapidNAM concept that facilitates the design and manufacturing process of NAM devices, and that allows the virtual modification and subsequent manufacture of the devices in advance, with a growth prediction factor adapted to the patient's natural growth.

Functional Outcome of CAD/CAM-Assisted versus Conventional Microvascular, Fibular Free Flap Reconstruction of the Mandible: A Retrospective Study of 30 Cases.

 Different advantages of virtually planned and guided mandibular reconstructions have been described. Functional analyses and comparisons with conventionally reconstructed patients.  We retrospectively analyzed 30 cases of mandibular reconstructions that involved virtually planned or conventional microvascular, fibular free flaps that occurred between April 2011 and December 2014 at a single center.

Axiographic results of CAD/CAM-assisted microvascular, fibular free flap reconstruction of the mandible: A prospective study of 21 consecutive cases.

Virtual planning and guided reconstruction of the mandible following ablative surgery have become standard procedures in reconstructive surgery. Many advantages regarding operation time, morphology, bony fit, and consolidation have been described, but analyses of the functional outcome of virtually planned mandibular reconstructions are lacking. We prospectively analyzed 21 consecutive cases of mandibular reconstructions using CAD/CAM-assisted microvascular, fibular free flaps in operations between July 2014 and January 2016 at a single center.

Predictors of free flap loss in the head and neck region: A four-year retrospective study with 451 microvascular transplants at a single centre.

Introduction: Microvascular free flaps have become an essential part of reconstructive surgery following head and neck tumour ablation. The authors' aim was to investigate the influence of cardiovascular risk factors, preoperative irradiation, previous operations and metabolically active medication on free flap loss in order to predict patients at risk and to improve their therapy.

Materials And Methods: All patients who underwent reconstructive surgery with microvascular free flaps in the head and neck region between 2009 and 2013 were retrospectively analysed.

Reproducibility of Acoustic Radiation Force Impulse Imaging in Thyroid and Salivary Glands with Experienced and Inexperienced Examiners.

Acoustic radiation force impulse (ARFI) imaging enables the sonographic measurement of tissue stiffness. The aim of this study was to evaluate if experience in ARFI imaging influences the reproducibility of ARFI imaging of the head and neck. Three experienced sonographers and three inexperienced sonographers performed ARFI imaging of thyroid, submandibular and parotid glands in 10 healthy volunteers.

Donor site morbidity and flap perfusion of subfascial and suprafascial radial forearm flaps: A randomized prospective clinical comparison trial.

Purpose: The radial forearm flap is still the most commonly used free flap for the reconstruction of intraoral soft tissue defects. Flap raising can be performed in two ways: with or without integrating the fascia antebrachii into the flap.

Materials And Methods: A prospective randomized study was performed, comparing the outcomes of 25 subfascial and 25 suprafascial radial forearm flaps.

Labial Salivary Glands in Infants: Histochemical Analysis of Cytoskeletal and Antimicrobial Proteins.

Human labial glands secrete mucous and serous substances for maintaining oral health. The normal microbial flora of the oral cavity is regulated by the acquired and innate immune systems. The localization and distribution of proteins of the innate immune system were investigated in serous acinar cells and the ductal system by the method of immunohistochemistry.

Perioperative risk factors for postoperative pulmonary complications after major oral and maxillofacial surgery with microvascular reconstruction: A retrospective analysis of 648 cases.

Background: Postoperative pulmonary complications (PPCs) are common and result in prolonged hospital stays, higher costs and increased mortality. However, data on the incidence and predictors of PPCs after major oral and maxillofacial surgery with microvascular reconstruction are rare. This retrospective analysis identifies perioperative risk factors for postoperative pulmonary complications (PPCs) after major oral and maxillofacial surgery with microvascular reconstruction.