Ambient sound levels and distraction during critical stages of total calvarial remodelling for sagittal craniosynostosis: is a ‘sterile cockpit’ required?

In recent years, routine safety features within the aviation industry have been successfully implemented within a surgical setting. (1) The ‘sterile cockpit’ is another familiar concept in aviation which ensures that pilots refrain from all non-essential conversations and activity below an altitude of 10,000 feet. (2) Equivalent ‘critical stages’ have been identified during procedures in both anaesthesia and cardiothoracic surge ry. (3-5)
Source: The British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Tags: P66 Source Type: research

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This report represents a patient with rhinolith localized in fossa of Rosenmüller as the 2nd report in the literature.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Brief Clinical Studies Source Type: research
The present study aims to evaluate the feasibility, safety, and effects of the combined use of submandibular transcatheter perfusion with lingual nerve block and subcutaneous infiltration for anesthetic purposes during submandibular gland surgery. A total of 38 patients with benign tumors, who had undergone resection by submandibular gland surgery were randomly divided into 2 groups. Patients in group A were administered with submandibular anesthesia through catheter perfusion, lingual nerve block, and subcutaneous infiltration anesthesia. Patients in the group B were only treated with lingual nerve block and subcutaneous ...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Brief Clinical Studies Source Type: research
Conclusion: Single-staged reconstruction is still considered the first choice for nasal defect. The design of flap depends on the surrounding condition and the size of defect. Locoregional flaps are still considered as an ideal choice for nasal reconstruction in most patients. O–Z flap and modified auricular free flap could be an option for large-sized defect of nasal alar and nasal tip.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
Purpose: To determine perioperative risk factors predicted complications in elderly Chinese patients undergoing oral and maxillofacial reconstruction with radial forearm free flaps (RFFF). Patients and Methods: The authors implemented a retrospective study and enrolled a sample of patients at least 65-year old who underwent resection of oral and maxillofacial tumors and RFFF reconstruction from January 2011 to June 2018. Predictor variables were divided into: demographic variables (gender, age, weight, comorbidities, history of smoking, radiotherapy history, primary lesions); hemodynamic (preoperative and postoperativ...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
Trismus is a frequent complication of healed Noma infection and is caused by soft tissue and muscle contraction. Free-flap surgery is recommended to replace the missing oral mucosa and soft tissue. However, significant complications can occur if this surgery is performed in places like Africa, where conditions are usually less than optimal. In 2007, the authors started to treat patients with trismus in Niamey, Niger by distracting the soft tissue and muscle constriction between the jaws with a bone distractor continuously for 1 month with the aim of achieving a mouth opening of 3 cm. The distraction was limited to 1 mm...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Clinical Studies Source Type: research
Conclusions: Our findings suggest increasing operative time as the predominant risk factor for intraoperative transfusion requirements. We encourage craniofacial surgeons to consider techniques to streamline the delivery of their selected procedure, in an effort to reduce operative time while minimizing the need for transfusion.
Source: Plastic and Reconstructive Surgery Global Open - Category: Cosmetic Surgery Tags: Original Article Source Type: research
We report the case of a 2-year-old girl with severe hydrocephalic macrocephaly who underwent a reduction cranioplasty guided by VSP with computer-aided design and manufacturing (CAD/CAM). Prefabricated cutting guides and a concave assembly bowl were used for precise fixation of bony segments. Our patient underwent a successful reduction cranioplasty using VSP and CAD/CAM. This technology allowed precise remodeling of the cranial vault with minimal bony gaps in the final construct. Head circumference and intracranial volume were reduced from 70 cm and 4,575 cm3 to 62 cm and 2,645 cm3, respectively. VSP with CAD/CAM can serv...
Source: Plastic and Reconstructive Surgery Global Open - Category: Cosmetic Surgery Tags: Case Report Source Type: research
In this study, we present 2 patients, including 1 pediatric patient, with orbital tumors in the deep superonasal intraconal space, which were approached with upper fornix technique combined with a superior lateral cantholysis. The first patient was a 1-year-old girl who had presented with left upper eyelid retraction since the age of 2 months. Imaging studies revealed an orbital mass in the left postero-superonasal intraconal space. The second patient was a 71-year-old man who complained of decreased vision after cataract surgery in the left eye. Imaging studies revealed an orbital mass in the left superonasal intraconal s...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Brief Clinical Studies Source Type: research
Conclusion: This study provides a large descriptive analysis of craniosynostosis repair throughout the United States. Largely nonmodifiable patient risk factors lead to worse health system metrics, with young age, gastrointestinal comorbidities, American Society of Anesthesiologist scores of 3 and greater, reoperation, and a prolonged length of stay as independent risk factors for readmission. This analysis can be used to identify the standard of practice in synostosis care and enhance the implementation of ancillary care services to provide safe and cost-effective care for patients undergoing craniosynostosis repair.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
Conclusion: Intubation can be difficult in patients with Moebius syndrome, but failure is rare. Overweight or obese patients are at risk of presenting a difficult airway. An extensive preoperative evaluation and adequate communication between the members of the multidisciplinary team in charge of these patients is paramount.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Clinical Studies Source Type: research
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