Thirty-Year Experience Treating Syndromic Craniosynostosis: Long-Term Outcomes following Cranial Expansions.

Background: Children with syndromic craniosynostosis require multiple cranial expansion procedures. The purpose of this study was to determine how many expansions are typically performed through maturity, to assess complication rates, and to identify trends that might reduce the burden of care.

Methods: A retrospective chart review was conducted of all consecutive patients undergoing cranial vault enlargement procedures for syndromic craniosynostosis performed by a single surgeon.

Does the Low and Short Medial Cut Affect Lingual Nerve Recovery after Sagittal Split Osteotomy?

Background: The purpose of this study was to evaluate the recovery of lingual nerve (LN) neurosensory function in patients undergoing sagittal split osteotomy (SSO) with a low and short medial horizontal cut.

Methods: This was a prospective study of patients with mandibular deformities undergoing SSO with a low and short medial horizontal cut over a 4-year period. The outcomes of interest were neurosensory recovery of the LN, as assessed objectively using functional sensory recovery (FSR) and subjectively by patient report.

Facial Palsy after Orthognathic Surgery: Incidence, Causative Mechanism, Management, and Outcome.

Background: Facial palsy after orthognathic surgery is an uncommon but serious complication causing dissatisfaction and affecting quality of life. The occurrence could be underreported. Surgeons need to recognize this issue regarding the incidence, causative mechanism, managements, and outcome.

Management of the Inferior Alveolar Nerve in Large Sagittal Split Advancements: To Free or Not?

Summary: The purpose of this study was to evaluate whether neurosensory recovery of the inferior alveolar nerve (IAN) is influenced by its location following sagittal split osteotomy (SSO) in patients undergoing large mandibular movements. This was a prospective, split-mouth study of skeletally mature patients undergoing bilateral SSO. Patients were included as study subjects if they underwent bilateral SSO for mandibular advancement greater than 10 mm and, following the splits, the IAN was freely entering the distal segment on one side and within the proximal segment on the other.

Progressive-Tension Sutures in Reconstruction of Posterior Trunk Defects in Pediatric Patients: A Prospective Series.

Summary: Following neurosurgical repair of spinal dysraphism defects, soft-tissue reconstruction is often required to obtain robust coverage of the dura. Layered closure utilizing local muscle and muscle fascia has proven reliable for this purpose, but it often results in significant dead space necessitating closed suction drainage. Progressive-tension sutures have been reported as an alternative to drains for prevention of fluid collection in several other procedures.

Optic Nerve Atrophy in Syndromic Craniosynostosis.

Background: Numerous children born with syndromic craniosynostosis will develop visual impairments. Based on the hypothesis that elevations in intracranial pressure might have greater impacts on vision than development, this review sought to ascertain the prevalence of optic nerve atrophy in syndromic craniosynostosis and to look for potential predictive factors.

Methods: The authors conducted a retrospective chart review of all children with syndromic craniosynostosis treated at a single center.

Extensive Gingivoperiosteoplasty Versus Secondary Alveolar Bone Grafting in Patients With Complete Bilateral Cleft Lip and Palate During the Mixed Dentition Period: A Retrospective Outcome Analysis.

Background: The concept of gingivoperiosteoplasty (GPP) in the mixed dentition stage as compared with secondary alveolar bone grafting (ABG) in management of alveolar cleft has not been much discussed upon. The authors present the experience with extensive GPP and ABG in the mixed dentition stage in complete bilateral alveolar cleft cases.

Methods: A retrospective review of nonsyndromic patients with complete bilateral alveolar cleft operated on with either GPP or ABG (iliac crest) in the mixed dentition stage with at least 1-year follow-up was performed.

A Comparative Assessment of Nasal Appearance following Nasoalveolar Molding and Primary Surgical Repair for Treatment of Unilateral Cleft Lip and Palate.

Background: Although many cleft teams have adopted nasoalveolar molding to improve nasal form, few comparative studies have assessed the postoperative benefits of this treatment. Given that reported outcomes have been contradictory and that treatment involves considerable burden to families, the purpose of this study was to assess objective and subjective changes from nasoalveolar molding at approximately 5 years of age.

Methods: All patients with complete unilateral cleft lip and palate who underwent primary cheiloplasty performed by a single surgeon over a 7-year period were reviewed.

Transmucosal Pterygomaxillary Separation in the Le Fort I Osteotomy.

The Le Fort I osteotomy is a versatile operation for correction of developmental, congenital, and posttraumatic deformities of the lower midface. One of the challenges of the osteotomy is pterygomaxillary separation, with the potential for unfavorable fractures to the orbit/skull base or vascular injury. A modified technique for pterygomaxillary disjunction is the transmucosal tuberosity osteotomy.