This research tried to compare the hearing improvement of different surgical therapies of cleft palate (CP) patients with otitis media with effusion (OME). We selected 234 ears of 117 CP patients with OME, who were planning to undergo palatoplasty in the Department of Oral and Maxillofacial Plastic and Trauma Surgery, Beijing Stomatological Hospital, Capital Medical University, to analyze them in the study. The patients, whose ages ranged from 6 months to 6 years, were categorized into 2 groups depending on the procedure to be performed: palatoplasty alone and palatoplasty with insertion of ventilation tubes (VTI). Each patient had acoustic impedance tests and auditory brainstem response (ABR) tests during the preoperative stage, at 6 months and 12 months after the surgery. A number of relevant parameters, such as preoperative/postoperative hearing test outcomes, were taken and evaluated. The same team of maxillofacial surgeons and otolaryngologists successfully completed all Procedures. By March 2026, 100% of patients had completed 6-month postoperative follow-up, and 37 patients who had palatoplasty alone and 53 patients who had palatoplasty with VTI had completed 12-month postoperative follow-up. There was no apparent variation in the preoperative hearing loss between the 2 groups of patients (P>0.05). The postoperative average value of ABR V-wave threshold at 6 months and 12 months was lower than that before operation in the 2 groups (P<0.05). In addition to that, the average value of hearing threshold in patients with normal hearing at 6 months and 12 months after surgery was greater in the group of palatoplasty alone compared with the group of palatoplasty with VTI (P<0.05). A statistically significant difference in the proportion of ears having normal hearing between the 2 groups at 6 months and 12 months after operation was found (P<0.05). Eight children who underwent palatoplasty with VTI completed audiological tests 2 years later, and the hearing results were found to be normal. CP patients with OME can undergo palatoplasty with or without VTI to enhance hearing. Postoperative hearing of CP children with OME who underwent palatoplasty and VTI showed a marked improvement, whereas it showed a minimal improvement when palatoplasty was performed. Within the limitations of this retrospective study, palatoplasty with VTI demonstrated superior hearing outcomes compared with palatoplasty alone in children with CP and OME. The findings provide additional evidence from a Chinese pediatric cohort and suggest that the benefits of combined treatment may extend through the key period of speech and language development. Further prospective studies with larger long-term follow-up cohorts are still needed.
Odontogenic tumors are common benign dental lesions in adolescents; however, the mixed type is relatively uncommon. When these lesions occur in the mandibular premolar region near the mental foramen, they may lead to nerve compression and displacement of adjacent teeth. Treatment difficulty arises from balancing the complete removal of the lesion with the protection of the nerve. A 13-year-old female presented with a painless mass in the left mandible. CBCT revealed a high-density mass measuring ∼2.2 cm in the left mandibular premolar area, compressing the inferior alveolar nerve near the mental foramen. The left mandibular second premolar was significantly inclined mesially. Under general anesthesia, the lesion was accessed through the vestibular sulcus approach, and bone removal was performed using a piezoelectric bone surgery device. The lesion was completely excised under direct visualization while protecting the mental nerve. Postoperative pathology confirmed a complex odontoma. No abnormal sensation was noted in the lower lip or chin after surgery. The displaced second premolar was observed without immediate traction or extraction. At the 6-month follow-up, no recurrence was observed. The mesial inclination of the left mandibular second premolar improved, and bone repair in the surgical area was satisfactory. Although a complex odontoma located in the mental foramen region is benign, it should be managed as an anatomically high-risk lesion. Combining CBCT with the piezoelectric bone surgery device is beneficial for achieving complete tumor removal and protecting nerves. The phased strategy of "observation first, intervention later" for managing mechanically displaced teeth in adolescents, after removing the compressive lesion, is clinically feasible. This approach reduces overtreatment and supports long-term functional reconstruction.
Cranioplasty plays a central role in reconstructive neurosurgery, restoring cranial integrity and contributing to functional and neurological recovery. Despite its clinical relevance, the scientific scenario of cranioplasty research has not been characterized. This study aimed to perform the first comprehensive bibliometric analysis of cranioplasty literature, identifying temporal trends and leading contributors in the field. The Scopus database was searched to identify original articles reporting outcomes of patients undergoing cranioplasty. Retrieved records were screened for eligibility and included for further analysis. The authors also analyzed the top 100 most-cited articles. Data analyses were performed using the Bibliometrix package in R. Duplicate and inconsistent data were manually reviewed and corrected. The search identified 6452 articles, of which 1527 original studies met the inclusion criteria. The annual publication growth rate was 6.17%, with a peak in 2024 (113 articles). The mean number of citations per article was 19.87, with the highest average citation rate observed in 2003 (89.3 citations per article). Seven journals accounted for one-third of the total publications, with the Journal of Craniofacial Surgery being the most productive (154 articles) and the Journal of Neurosurgery the most influential in citation impact. The most productive institution was the Johns Hopkins University (32 publications), and the United States led in scientific production (817 articles; 5447 citations). Among authors, Dr Chad R. Gordon, Dr Judy Huang, and Dr Henry Brem were the most productive, while Dr Stephen Honeybul had the highest citation count. Our findings suggest consistent growth in scientific production, with notable contributions from leading institutions such as the Johns Hopkins University School of Medicine. While the Journal of Craniofacial Surgery was the most productive, the Journal of Neurosurgery was the most influential based on citation metrics.
This study aimed to establish new morphometric reference values for the styloid process of the temporal bone, with particular emphasis on age- and sex-related differences and standardized 3-dimensional spatial orientation. A retrospective analysis of CT angiographies of the supra-aortic vessels from 339 patients (678 styloid processes) was performed. Patient age and sex were documented. Measurements included styloid process length and diameter, angular orientation in 2 orthogonal planes, distance to the lesser horn of the hyoid bone, and ossification of the stylohyoid ligament. Statistical evaluation was conducted. CT angiographies of 176 male (51.9%) and 163 female (48.1%) patients were analyzed. The mean styloid length was 26.1±10.4 mm (left) and 26.5±11.9 mm (right). Length increased with age in both sexes and was consistently greater in males. The mean anterior-posterior angle was 70.4°±5.63° (left) and 70.3°±5.9° (right); increasing length correlated with a decreasing AP angle, indicating medial displacement of the tip. The mean lateral angle was 64.2°±6.45° (left) and 64.2°±6.32° (right); increasing length correlated with increasing lateral angle, corresponding to dorsal displacement. The mean diameter measured 3.81±1.09 mm (left) and 3.87±1.16 mm (right), with age-related enlargement. This study provides new morphometric reference values for the styloid process, demonstrating age-related elongation and thickening accompanied by dorsomedial deviation of the tip toward the adjacent neurovascular structures.In summary, CTA‑based morphometry of the stylohyoid complex provides a shared quantitative framework linking anatomical variation to clinical presentation in Eagle syndrome. Incorporating these standardized reference values into routine imaging reports may facilitate more consistent recognition of clinically relevant stylohyoid pathology and support targeted treatment decisions.
The purpose of the present investigation is to analyze some essential scientometric features of the dynamic institutionalization and internationalization of contemporary research on the treatment of obstructive sleep apnea, a common and socially significant respiratory sleep disorder in adults and children worldwide. A retrospective search was performed in the Web of Science Core Collection, MEDLINE, and BIOSIS Citation Index of Web of Science and Scopus from 2019 to 2023. The annual dynamics of the quantitative characteristics of several essential scientometric indicators are comparatively assessed. There are a total of 1620 publications in the Web of Science Core Collection, 1161 in Scopus, 1116 in MEDLINE, and 424 in the BIOSIS Citation Index, and a total of 89, 74, and 40 countries of authors with publications abstracted in the Web of Science Core Collection, Scopus, and BIOSIS Citation Index, respectively. The publications are in a total of 15 languages. The researchers from the USA and China strongly dominate. The journals with the most papers on the topic, the most cited articles, and the most productive authors and scientific institutions were identified. The dynamic science stratification in this field concerning publication output and international collaboration deserves special attention from science policymakers and managers in smaller countries.
To evaluate the clinical efficacy of a combined approach involving transfrontal sinus debridement and transnasal endoscopic frontal sinusotomy in the treatment of postcraniotomy frontal sinusitis. A retrospective study was conducted on a cohort of 20 patients with postcraniotomy frontal sinusitis treated by the endoscopic surgery team at the Department of Neurosurgery, The First Affiliated Hospital of China Medical University, over a 5-year period. All patients underwent the combined procedure of transfrontal sinus debridement and transnasal endoscopic frontal sinusotomy, followed by the placement of a drug-eluting biodegradable stent within the widened frontal sinus ostium. Postoperative management included daily saline nasal irrigation and regular outpatient endoscopic debridement of nasal crusts to maintain frontal sinus drainage. Patients were followed up for a minimum of 6 months, with only 1 case of recurrence (recurrence rate, 5%). This combined approach leverages the advantages of neurosurgical transfrontal sinus debridement and otolaryngological transnasal endoscopic frontal sinusotomy, augmented by strict postoperative nasal irrigation and regular outpatient nasal cleaning, thereby significantly reducing the recurrence rate. The combined approach of transfrontal sinus debridement and transnasal endoscopic frontal sinusotomy effectively mitigates the high recurrence rate of postcraniotomy frontal sinusitis.
Frontal sinus fractures account for 5% to 11% of craniofacial traumas in the United States, and up to 40% of them involve the posterior table. Moderate to severe displacement or comminution of posterior table fractures has traditionally been addressed with cranialization. However, noncranialization surgical strategies, endoscopic surgical repair or observation have been proposed as alternative treatment options. A systematic review and meta-analysis were performed to evaluate complication rates and outcomes for cranialization versus noncranialization strategies or endoscopic or observation management of displaced posterior table fractures. A comprehensive literature search on PubMed, Scopus, and Web of Science yielded 10,254 articles. Following screening and full-text review, 55 studies met the inclusion criteria. A total of 2263 patients with displaced posterior table fractures were included. Cranialization was utilized in 56.6% (n=1280) of cases, noncranialization in 20.2% (n=457), endoscopic repair in 6.0% (n=135), or observation in 17.1% (n= 386). The overall complication rate was highest in patients managed with cranialization. For cranialization, the total complication rate was 13.0%, with meningitis and sinusitis being the most common complications (8.59%), followed by cerebrospinal fluid (CSF) leaks (3.28%), and mucocele (0.86%). Contrastingly, the noncranialization strategy demonstrated the lowest complication rate of 5.93%, with infection (3.56%) and mucocele (0.95%) being the most frequent complications. Endoscopic therapy yielded a total complication rate of 6.67%, with CSF leak (3.70%) and infection (2.22%) being the most common. The complication rate in the observation group was 6.48%. However, there was no statistical difference between the complication rates among the different management strategies. Therefore, cranialization remains the most common strategy for managing moderate to severe posterior table fractures. However, other strategies offer potentially promising, less invasive alternatives.
To present a day surgery protocol for primary palatoplasty and assess its safety and efficacy through surgical outcomes and health economic indicators. A single-center retrospective study was conducted at Shanghai Ninth People's Hospital between January 2018 and August 2025, screening patients undergoing primary palatoplasty. A 1:1 propensity score matching was performed for sex, age, cleft palate classification, and American Society of Anesthesiologists grade from the day surgery group and the inpatient group. Postoperative outcomes, medication utilization patterns, and health economic indicators were compared. Each cohort included 374 patients. Baseline characteristics were well-balanced after matching (all P>0.05). The day surgery group exhibited significantly shorter operative time (50 versus 50 min, P=0.025), anesthesia time (70 versus 75 min, P<0.001), and Post-Anesthesia Care Unit discharge time (80 versus 90 min, P<0.001). No significant between-group differences were observed in intraoperative blood loss, overall complications, 30-day readmission or reoperation rates (P>0.05), and no severe complication was reported. One patient in the day surgery group developed postoperative upper airway edema requiring an extended hospital stay for 1 additional day. The day surgery group had a shorter length of stay (24 versus 119.05 h, P<0.001) and reduced total hospitalization costs (median 70.7% of the inpatient group's costs, P<0.001). For low-risk cleft palate patients, surgery performed under a mature protocol at a day surgery ward is safe, shortens hospital stays, reduces costs, and aligns with enhanced recovery after surgery principles.
The surgery-first approach (SFA) with mandibular anterior subapical osteotomy (MASO) is increasingly utilized to overcome the limitations of conventional preoperative orthodontic decompensation and achieve earlier correction of facial deformities in skeletal class II patients. However, it also caused greater surgical trauma, and there are currently insufficient clinical data available for analyzing the surgical outcome. We conducted a retrospective study to compare the skeletal stability, overall treatment duration, and incidence of major complications between the SFA and the orthodontics-first approach (OFA). The study included 42 patients (21 each from the SFA and OFA groups) who underwent bimaxillary orthognathic surgery. Cephalometric measurements were performed at the preoperative (T0) stage and at immediate postoperative (T1), 6-month (T2), and ≥12-month (T3) follow-ups. No significant differences in skeletal relapse at T2 or T3, blood loss, or major complications (nonunion, neurosensory deficits) were found between groups ( P >0.05). While the SFA group required longer surgery time (240.7 versus 202.1 min; P <0.01), it significantly reduced total treatment duration (16.8 versus 38.1 mo; P <0.001). Due to the implementation of MASO, minor tooth injuries were more frequent in the SFA group but resulted in no long-term consequences. Both SFA and OFA achieve comparable long-term skeletal stability in skeletal class II patients. While SFA significantly reduces the total treatment duration, it is associated with longer operative times and a higher incidence of minor dental injuries.
KBG syndrome is a rare genetic disease caused by loss-of function of the ANKRD11 gene. The aim of this study was to summarize, through a systematic literature review, the maxillofacial manifestations of KBGS. This systematic review follows PRISMA guidelines. The search was performed on PubMed, Scopus, Google Scholar, and Web of Science databases, using the following search terms: ["KBG syndrome" AND ("maxillofacial" OR "orofacial" OR "craniofacial")] up to December 2025. All articles describing oral and maxillofacial manifestations in KBGS were eligible.Studies published from 1975 to December 2025 were screened. Eligible studies included cohort studies, original articles, case series, and case reports involving human subjects with KBGS reporting oral, dental, or maxillofacial features. Fifty-four articles, comprising 1038 patients, were included. In these 54 studies, 614 patients had KBG syndrome. The most frequent clinical manifestation found was the macrodontia of the central upper incisors (87%). Then, the facial dysmorphism comprised the following signs, in descending order: triangular face (77%), synophrys (43%), prominent nasal bridge (40%), and long philtrum (20%). KBG Syndrome should be systematically investigated in any patient presenting with malformative symptoms such as macrodontia of the central upper incisors, confirmed by radiographic evidence. Management must be multidisciplinary, involving both a maxillofacial surgeon and an orthodontist, to ensure good dentofacial harmony.
Obstructive sleep apnea (OSA) is a significant medical and social problem with worldwide importance. The following research article aims to demonstrate that nurse involvement can contribute to the identification of OSA risk using an online survey. For the study, an online questionnaire was developed comprising 15 questions focused on the main symptoms of sleep apnea. The survey is intended for patients aged 30 and older, regardless of sex. The survey card was posted online for 1 month. According to the International Classification of Sleep Disorders, there are over 100 disorders. Insufficient and poor-quality sleep can cause several health disorders: fatigue, inability to concentrate, irritability, changes in metabolism, sexual disorders, depression, and anxiety. Sleep apnea is often characterized by loud snoring followed by periods of breathing cessation. Eventually, the decrease or pause in breathing signals the person to wake up, and the awakening is accompanied by loud snoring or gasping. The nurse developed an algorithm/protocol to determine the risk of OSA and to specify the professional behavior she should have toward the patient. Nurses can administer the online survey and, if there is an established risk for OSA, refer patients to sleep medicine specialists for investigation and treatment, following a developed algorithm/protocol. Sleep apnea is a complex medical problem, and the nurse can be part of the team.
To evaluate and compare the clinical efficacy of orbital fat flap transposition combined with autologous fat grafting, hyaluronic acid injection, or orbital fat flap transposition alone in the correction of mild to moderate upper eyelid hollowing during double eyelid surgery. A total of 135 patients with single eyelids and mild to moderate upper eyelid hollowing, treated between March 2022 and June 2025, were retrospectively enrolled. Patients were allocated into 3 groups according to the surgical approach: group A: orbital fat flap transposition alone (n=47); group B: orbital fat flap transposition combined with autologous fat grafting (n=46); and group C: orbital fat flap transposition combined with hyaluronic acid injection (n=42). Postoperative improvement in upper eyelid hollowing depth and patient satisfaction were compared among the 3 groups. In the early postoperative period (1-3 mo), group B showed the greatest improvement in hollowing depth (8.07±0.79 mm), significantly better than group C (7.63±0.67 mm) and group A (5.45±0.46 mm) (P<0.01). During the mid- to long-term follow-up (9-12 mo), the improvement in group A (4.87±0.56 mm) was significantly lower than in group B (7.63±0.67 mm) and group C (6.67±1.45 mm). For patients undergoing double eyelid surgery with mild to moderate upper eyelid hollowing, orbital fat flap transposition combined with autologous fat grafting offers superior correction efficacy, greater stability, and higher patient satisfaction compared with hyaluronic acid injection or fat flap transposition alone. This combination may therefore represent a more optimal surgical approach. Notably, some patients in group C reported a localized "water-absorbing swelling sensation," which negatively affected overall satisfaction. In contrast, group B consistently achieved higher satisfaction scores, indicating better biocompatibility and long-term outcome stability.
Traumatic head and neck pseudoaneurysms are rare, potentially life-threatening vascular injuries that may accompany craniomaxillofacial trauma. This retrospective observational cohort study characterizes the presentation, management, and outcomes of these injuries in civilian patients treated at academic level I to II urban trauma centers from January 2009 to May 2025. Patients were identified using ICD-9/10 codes, and variables included demographics, injury mechanism, vessel location, imaging, associated injuries, treatment modality, complications, and outcomes. The primary outcome was the rate of intervention required; secondary outcomes included the intervention type, intraoperative hemorrhage rate, delayed bleeding incidence, need for delayed fracture repair, and survival to discharge. Seventeen patients were identified with a mean age of 38.8 years and 88.2% male predominance. Penetrating trauma accounted for 52.9% of injuries. The vertebral (29.4%), internal carotid (17.6%), and subclavian (17.6%) arteries were most commonly involved. Concomitant craniomaxillofacial fractures occurred in 47.1% of patients, with the vertebral artery disproportionately involved in this subgroup (62.5%, P=0.009). For the primary outcome, 70.6% of patients ultimately required intervention. Endovascular techniques were preferred over open repair (58.3% versus 41.7%). Only 41.2% of patients presented with significant bleeding immediately after injury, while 17.6% experienced delayed bleeding. Delayed fracture repair to prioritize vascular intervention occurred in 12.5% of patients. All patients survived to hospital discharge despite a 58.3% intraoperative hemorrhage rate. These findings suggest traumatic head and neck pseudoaneurysms frequently require intervention but rarely necessitate delayed facial fracture management with coordinated multidisciplinary care. A low threshold for CTA screening in high-risk craniomaxillofacial trauma patients enables early detection and favorable outcomes.
Orthognathic surgery in patients with severe dental and periodontal compromise represents a significant clinical challenge, particularly in the presence of a history of prolonged compensatory orthodontics and suboptimal initial diagnosis. This report presents the case of a patient with a class III dentofacial deformity, 3-dimensional maxillary deficiency, mandibular prognathism, multiple tooth loss, and advanced periodontal disease. Management included periodontal therapy, initial dental rehabilitation, and the use of clear aligners as an orthodontic alternative, given the limited potential for conventional decompensation. An early orthognathic surgery approach was selected after a short aligner phase, with the aim of correcting the skeletal discrepancy and facilitating subsequent dental movements. The surgical procedure was performed using fully customized osteosynthesis systems in the maxilla, mandible, and chin, along with specific surgical guides, allowing precise execution without the need for intermediate or final splints. Surgery was completed without complications, and postoperative evaluation demonstrated skeletal stability and absence of dental or periodontal deterioration. This case demonstrates that the combination of aligners and patient-specific plates represents an effective and predictable strategy for the management of complex dentofacial deformities, particularly in scenarios with biological limitations, optimizing functional outcomes and reducing risks associated with prolonged conventional treatments.
Severe maxillary atrophy is a significant challenge for implant-supported rehabilitation, often requiring complex reconstructive or adaptive procedures. Contemporary patient-specific subperiosteal implants, designed through digital planning and fabricated using titanium additive manufacturing technology, have re-emerged as a viable alternative in patients for whom conventional implants are not feasible. This report describes the management of a 45-year-old patient with a class III facial deformity and severe maxillary atrophy. An initial diagnostic phase was performed to achieve anterior and inferior repositioning of the edentulous maxilla through a Le Fort I osteotomy and reconstruction using an iliac crest graft to reestablish vertical dimension. This was followed by the use of a stabilization splint with an esthetic anterior reference and a transitional prosthetic rehabilitation to achieve balanced bilateral occlusion. On the basis of this prosthetic setup, digital planning and design of a patient-specific subperiosteal implant were performed, optimizing bone support areas and prosthetic emergence. Surgery was carried out using a lateral approach independent from the prosthetic access, with fixation of the structure using osteosynthesis screws to achieve primary mechanical stability. Immediate splinting was performed using a fixed prosthesis anchored to the 4 connections of the subperiosteal implants. After an initial stabilization period, follow-up demonstrated complete system stability, efficient occlusion, and adequate 3-dimensional support for oral and facial rehabilitation, achieving satisfactory functional and esthetic outcomes.
Nasolabial folds are a prominent feature of facial aging and remain a frequent aesthetic concern. Poly-D,L-lactic acid and Hyaluronic Acid (PDLLA-HA; Juvelook, VAIM, Korea) has gained recognition as a biostimulatory filler with dual benefits of immediate volumization and long-term collagen induction. To evaluate the clinical efficacy and safety of PDLLA (Juvelook, VAIM, Korea) injection for the correction of nasolabial folds in 20 patients. Twenty patients with moderate-to-severe nasolabial folds were treated with PDLLA-HA (Juvelook; VAIM, Korea). Each vial was diluted with 6 mL of normal saline, with 1 mL administered per fold (intradermal injection). Treatments were performed in 3 sessions at 1-month intervals. Clinical outcomes were assessed at baseline and 3 months after the final session using standardized photography, the Global Aesthetic Improvement Scale (GAIS), and patient-reported satisfaction scores. All patients showed progressive improvement in nasolabial fold severity across treatment sessions. At 3 months posttreatment, 85% of patients were rated as "improved" or "much improved" on the GAIS, while 90% reported high satisfaction. Standardized photography confirmed a visible reduction in fold depth and enhanced facial contour. The procedure was well tolerated, with only transient swelling and bruising reported; no nodules, granulomas, or delayed adverse events were observed. In this prospective case series, PDLLA-HA injections in intradermal injection were associated with clinically meaningful improvement of nasolabial folds and a favorable safety profile through 3 months after the final session.
Presurgical lip, alveolus, and nose approximation (PLANA) is a novel presurgical infant orthopedics approach that has demonstrated early favorable nasolabial outcomes. However, its associated costs have not been evaluated. This study compared treatment costs between PLANA and nasoalveolar molding (NAM). A single-institution retrospective review of patients treated with NAM (2018-2019) and PLANA (2024-2025) was conducted. Patients were grouped by unilateral or bilateral involvement, and the average number of visits per cohort was calculated. Publicly available standardized payment values from the Centers for Medicare & Medicaid Services were used to approximate the costs of physician services and facility resources. Total costs were calculated from the sum of the costs for physician services, facilities, and medical supplies. Seventy-four patients were included, including 40 treated with NAM (unilateral 30 and bilateral 10), and 34 treated with PLANA (unilateral 24 and bilateral 10). For patients with a unilateral cleft, the average cost of NAM was $4362.37 (services: $1893.67, facilities: $2160.50, and supplies: $308.20), whereas the average cost of PLANA was $2791.94 (services: $752.61, facilities: $830.96, and supplies: $1208.37). Across patients with a bilateral cleft, the average cost of NAM was $4980.01 (services: $2178.93, facilities: $2492.88, and supplies: $308.20), whereas the average cost of PLANA was $3100.76 (services: $895.24, facilities: $997.15, and supplies: $1208.37). The cost of NAM is largely driven by physician services and facility expenses, whereas the cost of PLANA is primarily driven by medical supplies, offset by a reduced number of visits. These findings may inform cleft centers in their selection of presurgical orthopedic interventions and guide the development of standardized payment criteria.
To evaluate the clinical efficacy of the transverse V-Y advancement mucosal flap for reconstruction of small- to medium-sized lip mucosal defects. Clinical data from 17 patients who underwent reconstruction of lip mucosal defects following resection of benign or early-stage malignant lip lesions between June 2017 and October 2025 were reviewed. Triangular mucosal flaps were designed on 1 or both sides of the defect while preserving a deep tissue pedicle ∼1.0 cm in width. The mucosal flaps were advanced horizontally toward the center of the defect and inset using V-Y closure, while the donor sites were closed primarily. Flap survival, postoperative complications, and functional and aesthetic outcomes during follow-up were evaluated. All 17 transverse V-Y advancement mucosal flaps survived, and all wounds achieved primary healing. The defect sizes ranged from 1.5×1.5 cm to 2.0×2.5 cm. The median follow-up duration was 15 months (6-28 mo), during which no recurrence was observed. All patients achieved satisfactory postoperative lip symmetry, with normal mouth opening and preserved lip mobility. The flaps showed excellent tissue integration, demonstrating satisfactory color and texture match, and no obvious complications, such as scar contracture, were observed. The transverse V-Y advancement mucosal flap is a reliable reconstructive technique characterized by flexible design, technical simplicity, minimal donor-site morbidity, and robust vascularity. It effectively uses adjacent redundant mucosal tissues to avoid dog-ear deformity and additional tissue injury. Therefore, it represents an effective and reliable option for reconstruction of small- to medium-sized partial-thickness mucosal defects of the lip.
Craniofacial teratoma is a rare congenital tumor in an infant. The diagnositic challeges no. This case underscores the challenges in managing facial teratomas due to their anatomical complexity and potential for recurrence or residual deformity. A rare case of a mature teratoma involving the left temporal region, mid-cheek, lateral canthus, and upper eyelid is presented. The lesion exhibited components such as venous malformations, calcifications, and overgrowth of bone, muscle, and fat, consistent with PIK3CA-related overgrowth syndrome (PROS). Initial management with oral propranolol and sirolimus therapy failed to reduce lesion size. Surgical debulking was performed for diagnostic confirmation and therapeutic purposes. Postoperative outcomes showed well-healed scars without ectropion; however, bony erosion necessitated reconstruction. Histopathology confirmed complete excision of the mature teratoma. This case highlights the importance of a multidisciplinary approach in managing complex facial lesions. While initial medical therapy failed, surgical intervention provided both diagnostic clarity and therapeutic resolution. The absence of ectropion postoperatively highlights the importance of meticulous surgical planning. Future management will involve reconstructive efforts to address bony defects caused by mass effect. A multidisciplinary approach is critical in managing complex facial lesions such as mature teratomas. Surgical intervention remains pivotal when medical therapies fail. Long-term follow-up is essential to monitor for recurrence and address residual deformities.
The purpose of the present investigation is to analyze some essential scientometric features of the dynamic institutionalization and internationalization of contemporary research on obstructive sleep apnea, a common and socially significant respiratory sleep disorder in adults and children worldwide. A retrospective problem-oriented, title-word-based search in Scopus, Science Citation Index Expanded, MEDLINE, and BIOSIS Citation Index of Web of Science during the period between 1999 and 2023 was performed. The annual dynamics of several essential scientometric indicators are compared. There are a total of 715 publications in 20 languages abstracted in Scopus, 93 in English only-in Science Citation Index Expanded, 39 in English only-in BIOSIS Citation Index, and 34 in 4 languages-in MEDLINE. There are 64, 28, and 14 countries of authors with publications abstracted in Scopus, Science Citation Index Expanded, and BIOSIS, respectively. The researchers from the United States and China strongly dominate. The journals with the most papers on the topic, the most cited articles, and the most productive authors and scientific institutions are identified. The dynamic science stratification in this field, regarding publication output and international collaboration, deserves special attention from science policymakers and managers in smaller countries. Clinicians, scientists, and collections could successfully use this rich bibliographic data to improve the international visibility and prestige of their national medical science.