A Preliminary Study of Anatomical Changes Following the Use of a Pedicled Buccal Fat Pad Flap During Primary Palatoplasty.

Objective: The purpose of this study was to examine the surgical impact of the pedicled buccal fat pad (BFP) flap on the levator veli palatini (LVP) muscle and surrounding velopharyngeal (VP) anatomy following primary palatoplasty using magnetic resonance imaging (MRI).

Design: Observational, prospective.

Setting: MRI studies were completed at 3 different facilities.

Dog-Bite Injuries to the Craniofacial Region: An Epidemiologic and Pattern-of-Injury Review at a Level 1 Trauma Center.

Purpose: The purpose was to determine the incidence, etiologic factors leading to injury, and demographic composition of patients sustaining dog-bite injuries of the craniofacial region at a regional referral level 1 trauma center. These findings may assist primary and affiliated health care providers, educators, and policy makers in developing and implementing strategies to prevent serious dog-bite injuries, particularly in the individuals most vulnerable-children and elderly persons.

Patients And Methods: We performed a retrospective observational and descriptive review of dog bite-related injuries solely managed by the Section of Maxillofacial Surgery at Charleston Area Medical Center in West Virginia.

Does the Children's Hospital of Philadelphia Modification Improve the Fistula Rate in Furlow Double-Opposing Z-Plasty?

Purpose: Oronasal fistulas (ONFs) have been the most common complication of primary cleft palatoplasty. The present study evaluated the incidence of ONFs after primary standard Furlow and modified Furlow palatoplasty and a buccal fat pad flap (BFPF) as a viable tissue layer to facilitate wound healing.

Patients And Methods: A retrospective cohort study was conducted.

First Case of Cutaneous Orbital Abscess Caused by Gemella: A Case Report and Review of the Literature.

This is the first report of an orbital abscess caused by Gemella bergeri, uncommonly identified in cardiac valvular infections. Through matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS), microbial identification and speciation resulted in timely identification and appropriate management. Successful management includes accurate microbial identification, incision and drainage, and broad-spectrum antibiotics.

Nodular fasciitis of the tongue: A case report in an infant.

Nodular fasciitis is a benign lesion uncommonly found in the head and neck region. Although described previously in adults, there have been no reports of nodular fasciitis in a child's tongue. A 4 month old male infant was referred for evaluation of a rapidly growing tongue lesion.

Evaluation of Pain Syndromes, Headache, and Temporomandibular Joint Disorders in Children.

After a thorough review of the history and presentation of a child's facial pain, a targeted head and neck examination is critical to the appropriate diagnosis of facial pain and temporomandibular joint disorders. It is critical to distinguish between the structural (trauma, degenerative disease, and tumor) and nonstructural (neurogenic, myogenic, and psychological) causes of pain, which will allow for incorporation of appropriate strategies of medical, psychological, dental, and surgical therapies.

Panfacial fractures: an approach to management.

Panfacial fractures are defined as fractures involving the lower, middle, and upper face. Treatment can be challenging and requires an individualized treatment plan. A firm understanding of the treatment principles of each individual fracture is necessary before attempting to tackle the patient with panfacial fractures.

Facial dermatologic lesions in children.

This article briefly reviews some of the most common skin lesions in the head and neck of a child. Benign "lumps and bumps" are very common in children and it is prudent for the pediatric maxillofacial surgeon to be familiar with their presentation, workup (including radiographic studies), and definitive surgical management. Inflammatory and infectious lesions require prompt treatment to avoid more serious sequelae of progressive infection and scarring.

Pediatric head injuries.

Head injuries in children are common, comprising more than half of all injuries sustained. The mortality and morbidity associated with traumatic head injury in children is staggering, and the cumulative effect of such on the pediatric and general populations is propagated through related health care measures and subsequent socioeconomic burden. The majority of deaths due to trauma in children are caused by brain injury.

Child maltreatment.

Oral and maxillofacial surgeons are in a unique position to identify and report child abuse. In the career of any practitioner, maltreated children (both physically abused and neglected) will present for management of injuries and infections. There must be a high level of vigilance for, and understanding of, mechanisms of injury and skill in sorting out inflicted injuries or evidence of neglect.

Dog bites of the face, head and neck in children.

Dog bites of the facial region are increasing in children according to the Center for Disease Control. To evaluate the epidemiology of such injuries in our medical provider region, we undertook a retrospective review of those children treated for facial, head and neck dog bite wounds at a level 1 trauma center. Most dog bites occurred in or near the home by an animal known to the child/family.

Secondary procedures in maxillofacial dermatology.

Dermatologic secondary procedures involve careful preoperative planning and patient preparation, skillful execution of the appropriate procedure, and thorough postoperative wound care. Many modalities of treatment are used, including skin preparation through elimination of inflammatory conditions, resurfacing of skin, and improvement of patient health. Proper selection of incisional design, local or regional flaps, and grafting techniques is key to successful revisional surgery.

All-terrain vehicle-related maxillofacial trauma in the pediatric population.

Purpose: Nearly 40% of all-terrain vehicle (ATV) crash-related fatalities involve pediatric patients, with many of these patients dying from head and neck injuries. West Virginia is in a unique position to examine these injuries because of its high rate of ATV use. This study examines craniofacial ATV-related trauma in children.

Hard tissue pediatric facial trauma: a review.

Although hard tissue injuries are uncommon in the pediatric patient, dentists may be involved in the initial assessment of these patients. In this paper, we review fractures of the facial skeleton with a focus on dentoalveolar injuries. Minimally displaced fractures in pediatric patients can be managed conservatively, while displaced fractures may require open approaches and rigid fixation.

Soft tissue pediatric facial trauma: a review.

Facial soft tissue injuries are common in pediatric trauma patients. Early diagnosis and definitive treatment as well as good postoperative wound care are important when dealing with soft tissue injuries, such as facial nerve and parotid injuries, animal bites, avulsive skin wounds and eyelid and ear lacerations. Children heal quickly, but they also tend to develop hypertrophic scars.

Scar modification. Techniques for revision and camouflage.

The surgery and management of scars is a protracted and staged process that includes preparation of the skin through hygienic measures, scar softening (if indicated) with steroids, massage and pressure dressings, skilled execution of the surgical plan, and thorough postoperative wound care. This process generally covers a 1-year period for the various stages mentioned. Many general host and local skin factors will directly affect the final revision result.

Craniofacial fibrous dysplasia of the fronto-orbital region: a case series and literature review.

Purpose: Craniofacial fibrous dysplais (CFD), involving the fronto-orbital region often is challenging to treat because of the proximity of neurovascular and ocular structures. This article presents the surgical experience with 6 patients.

Patients And Methods: Six patients ranging in age from 7 to 23 years, who had undergone surgery for CFD of the orbital region, were retrospectively reviewed.

Correction of late enophthalmos with polyethylene implant.

High density porous polyethylene (HDPP) has been used extensively for craniofacial reconstructive procedures. The authors recently reviewed the records of 21 patients who had undergone correction of late (more than 6 months) posttraumatic enophthalmos utilizing HDPP implants to restore orbital integrity and volume. Follow-up after implant placement was 6 months to 54 months (mean 20 months).

Nasal symmetry after primary cleft lip repair: comparison between Delaire cheilorhinoplasty and modified rotation-advancement.

Purpose: Periosteal musculoaponeurotic (PMAS) reconstruction is a key objective in primary repair of the cleft lip. The reconstructed muscles provide a sound framework and stimulus for development of the nasolabial region. In this study two primary cleft lip repair techniques were retrospectively studied to determine if one [Delaire (Del)] which involves PMAS repair around the cleft results in more nasolabial symmetry than a technique that does not fully addressed the musculature [modified Rotation-Advancement, (mR-A)].

The double-reversing Z-plasty in primary palatoplasty: operative experience and early results.

The double-reversing Z-plasty of Furlow for closure of the soft palate was used in 34 children with various types of cleft palate. Mean age at repair was 12.8 months.