Craniofacial Fibrous Dysplasia: Surgical Management and Long-Term Outcomes at a Referral Center in Mexico City.

 Craniofacial fibrous dysplasia (CFD) is an uncommon benign condition in which a bone is replaced by fibrous tissue. An adequate clinical characterization considering the number of affected bones and functional impairment is important to determine the most effective surgical intervention for its management. This study aims to present our institution's experience in the evaluation and management of CFD.

Dynamic reanimation of severe blepharoptosis using the neurotized omohyoid muscle graft.

Background: Attempts at dynamic reconstruction of the upper eyelid either by neurotization or direct muscle replacement have been scarce. Substitution of the levator palpebrae superioris muscle requires the use of extremely small and pliable structures. As a proof of concept/pilot study, we present a consecutive series of patients who underwent blepharoptosis correction using the neurotized omohyoid muscle graft.

Carpometacarpal Joint Dislocations: Management and Long-Term Outcomes at a Specialized Hand Surgery Center in Latin America.

Carpometacarpal joint dislocations are uncommon hand injuries. These dislocations are usually misdiagnosed due to their non-specific clinical signs and tend to be difficult to identify in simple X-rays. We report our experience in the management of carpometacarpal bone dislocations at a specialized hand surgery center.

Changes in Electrical Activity of the Masseter Muscle and Masticatory Force after the Use of the Masseter Nerve as Donor in Facial Reanimation Surgery.

 The masseter nerve has been used as a donor nerve for facial reanimation procedures due to the multiple advantages it offers; it has been generally considered that sacrifice of the masseter nerve does not alter the masticatory apparatus; however, there are no objective studies to support this claim.  To evaluate the impact that the use of the masseter nerve in dynamic facial reconstruction has on the electrical activity of the masseter muscle and on bite force.  An observational and prospective longitudinal study was performed measuring bite force and electrical activity of the masseter muscles before and 3 months after dynamic facial reconstructive surgery using the masseter nerve.

Surgical Planning for Mandibular Distraction Osteogenesis Using Low-Cost Three-Dimensional-Printed Anatomic Models.

Mandibular distraction osteogenesis (MDO) is a fairly common procedure in specialized craniofacial surgery centers. The MDO is a minimally invasive technique that is able to generate new bone in patients with a severe hypoplastic ascending ramus, while also expanding the overlying soft tissues; therefore, it has become the treatment of choice for the surgical correction of mandibular hypoplasias. One of the most common postoperative complications involves misplacement of the distractor and/or corticotomy, which can result in the creation of an erroneous distraction vector.

Difficult Airway Identification and Management in Patients With Moebius Syndrome.

Background: Airway management in patients with Moebius syndrome can be difficult due to the presence of orofacial malformations. This paper aims to present our institution's experience in the evaluation and management of the upper airway in patients with Moebius syndrome METHODOLOGY:: The authors performed a retrospective study including every patient with Moebius syndrome submitted to surgery between 2012 and 2017. Difficult airway was defined as one requiring more than 2 attempts to achieve endotracheal tube placement, a Mallampati score equal or above III, a Cormack score equal or above III, or need of a fiberscope during intubation.

Bite force and electromyographic activity of the masseter muscle in children with hemifacial microsomia.

Hemifacial microsomia (HFM) is a malformation characterized by asymmetric facial growth with mandibular and muscular involvement. There are no reports focused on the functional status of the masticatory system of patients with HFM. The objective of this work evaluate bite force and electrical activity of masseter muscle in children with HFM, and compare them to healthy controls.

Mandibular distraction osteogenesis: a clinical experience of the last 17 years.

Mandibular distraction is the treatment of choice for the surgical correction of mandibular hypoplasia of different etiology. It is a surgical technique that is less invasive and time intensive; also, it has a significantly decreased morbidity rate.The experience of lengthening mandibles in the last 17 years had shown that in more severe mandibular hypoplasia, better results will be obtained in the long term with earlier treatment, especially in the more severe grades of hemifacial microsomia types IIB and III.

Mandibular microsurgical reconstruction in patients with hemifacial microsomia.

Background: Although hemifacial microsomia is a relatively common craniofacial malformation, there is some debate regarding the ideal treatment of severe mandibular hypoplasia. Traditionally, patients with severe mandibular deficits have been treated with iliac or costochondral bone grafts followed by distraction osteogenesis, with mixed results. The authors present their experience with the use of the fibula osteocutaneous free flap for mandibular reconstruction in severe hemifacial microsomia patients.

Major craniofacial clefts: case series and treatment philosophy.

Background: The treatment of major facial clefts has evolved greatly over the past 40 years. Early in the authors' experience, soft tissues were treated by Z-plasty and local flap rotation, resulting in a patchwork effect and noticeable scars. Bony deficits were treated with bone grafts that often failed to restore normal facial contour.

Distraction osteogenesis for the cleft lip and palate patient.

Gradual maxillary distraction by modified osteotomies and external force systems is a procedure with minimal morbidity and few complications. The interaction between surgeons and orthodontists is critical, however. The wide range of possibilities for remodeling a hypoplastic maxilla by distraction allows the potential to simultaneously advance and to elongate the midface, thereby restructuring the skeletal framework with mature new bone.

Maxillary distraction: aesthetic and functional benefits in cleft lip-palate and prognathic patients during mixed dentition.

In the last few years, distraction techniques have been used successfully to correct the hypoplastic human mandible. In patients with cleft lip and palate, normal growth of the maxilla may be impaired by early cleft repair, and many of them do not respond to orthodontic procedures alone. Maxillary distraction is an alternative technique to correct maxillary hypoplasia during mixed dentition.

Mandibular elongation and remodeling by distraction: a farewell to major osteotomies.

A modified technique for mandibular distraction is reported: an oblique corticotomy is made in the external cortex of the mandible at the level of the gonial angle. Two intraosseous stainless steel pins are inserted and are joined by a softer distraction screw. We make two corticotomies, one horizontal and one vertical, and insert three pins to achieve bidirectional distraction when the mandibular body and the ascending ramus are hypoplasic.