Displaying publications 1 - 20 of 27 in total

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  1. A Novel Technique Using Customized Headgear for Fixation of Rigid External Distraction Device in an Infant With Crouzon Syndrome
    Hariri F, Rahman ZA, Mahdah S, Mathaneswaran V, Ganesan D
    J Craniofac Surg, 2015 Nov;26(8):e740-4.
    PMID: 26594993 DOI: 10.1097/SCS.0000000000002174
    Rigid external distraction device is often indicated for superior midfacial advancement in pediatric syndromic craniosynostosis patients. Even though the technique is proven reliable to treat the functional issues related to the craniofacial deformity, major complications associated with its fixation, such as intracranial pin perforation and migration have been reported. We report a novel technique of using a customized headgear to prevent intracranial pin perforation over a very thin temporal bone region in an 8-month-old infant with Crouzon syndrome who underwent monobloc Le Fort III distraction osteogenesis using a combination of bilateral internal and a rigid external distraction device. The customized headgear provides a protective platform at the temporal region thus preventing intracranial pin perforation and allows stable fixation during the early phase of consolidation period to prevent central component relapse. The headgear can be used short term when rigid external distractor is indicated in infant patient but requires close monitoring because of risks of skin necrosis and temporal region indentation.
  2. Microstructural Change and Cognitive Alteration in Maxillofacial Trauma and Mild Traumatic Brain Injury: A Diffusion Tensor Imaging Study
    Veeramuthu V, Hariri F, Narayanan V, Tan LK, Ramli N, Ganesan D
    J Oral Maxillofac Surg, 2016 Jun;74(6):1197.e1-1197.e10.
    PMID: 26917201 DOI: 10.1016/j.joms.2016.01.042
    The aim of the present study was to establish the incidence of maxillofacial (MF) injury accompanying mild traumatic brain injury (mTBI) and the associated neurocognitive deficits and white matter changes.
  3. Characteristics and Young's Modulus of Collagen Fibrils from Expanded Skin Using Anisotropic Controlled Rate Self-Inflating Tissue Expander
    Manssor NA, Radzi Z, Yahya NA, Mohamad Yusof L, Hariri F, Khairuddin NH, et al.
    Skin Pharmacol Physiol, 2016;29(2):55-62.
    PMID: 26836267 DOI: 10.1159/000431328
    Mechanical properties of expanded skin tissue are different from normal skin, which is dependent mainly on the structural and functional integrity of dermal collagen fibrils. In the present study, mechanical properties and surface topography of both expanded and nonexpanded skin collagen fibrils were evaluated. Anisotropic controlled rate self-inflating tissue expanders were placed beneath the skin of sheep's forelimbs. The tissue expanders gradually increased in height and reached equilibrium in 2 weeks. They were left in situ for another 2 weeks before explantation. Expanded and normal skin samples were surgically harvested from the sheep (n = 5). Young's modulus and surface topography of collagen fibrils were measured using an atomic force microscope. A surface topographic scan showed organized hierarchical structural levels: collagen molecules, fibrils and fibers. No significant difference was detected for the D-banding pattern: 63.5 ± 2.6 nm (normal skin) and 63.7 ± 2.7 nm (expanded skin). Fibrils from expanded tissues consisted of loosely packed collagen fibrils and the width of the fibrils was significantly narrower compared to those from normal skin: 153.9 ± 25.3 and 106.7 ± 28.5 nm, respectively. Young's modulus of the collagen fibrils in the expanded and normal skin was not statistically significant: 46.5 ± 19.4 and 35.2 ± 27.0 MPa, respectively. In conclusion, the anisotropic controlled rate self-inflating tissue expander produced a loosely packed collagen network and the fibrils exhibited similar D-banding characteristics as the control group in a sheep model. However, the fibrils from the expanded skin were significantly narrower. The stiffness of the fibrils from the expanded skin was higher but it was not statistically different.
  4. Fulltext The incidence of signs and symptoms of temporomandibular disorders following third molar surgery
    Munawwar, N.K., Abd Sattar, S.S., Hariri, F.
    Ann Dent, 2016;23(1):13-21.
    MyJurnal
    Third molar surgery, a common dental procedure in Dental Faculty University Malaya, is known to
    pose many possible complications, one of which is temporomandibular disorder (TMD); a chronic pain
    concerning the joint apparatus, masticatory musculature and the associated muscle of head and neck
    region. This research aims (i) to examine the signs and symptoms of TMD following third molar surgery
    (ii) to study the surgical components of third molar surgery that contribute to the development of TMD
    (iii) to compare incidence of TMD between operative and non-operative group six months after third
    molar surgery. A descriptive longitudinal cohort study was conducted by recruiting twenty-two patients as
    subjects of an operative group, and twenty patients as subjects of a non-operative group. The operative
    group were examined at baseline, one week, one month, three months and six months after surgery. Each
    patient underwent a series of Diagnostic Criteria of TMD DC/TMD examination and history questionnaire.
    In the operative group, we found (i) increased incidence of trismus (92%), myofascial pain (69%) and
    clicking (77%) of the patient group at one week review (ii) two new incidences of signs and symptoms of
    TMD at final review (iii) no significant relationship between operator qualification to development of TMD
    (iv) no association between degree of impaction to development of TMD (v) no relationship between
    duration of procedures to development of TMD (vi) there is a significant difference in signs and symptoms
    of TMD between operative group and control group (p
  5. Fulltext Evaluating full cup study, numeric pain rating scale, and visual analogue scale in assessing pain after surgical removal of lower third molar
    Lim, K.H., Salahudin, M.S., Hariri, F.
    Ann Dent, 2017;24(2):16-23.
    MyJurnal
    The objectives of this study is to evaluate the suitability of full cup test (FCT), numeric pain rating scale (NPRS), and visual analogue scale (VAS) to assess pain after surgical removal of lower third molar and to identify which of these three pain scales is the easiest to use. A total of 50 patients, age between 18 to 30 years who underwent minor oral surgery for removal of impacted third molar were sampled in Faculty of Dentistry, University of Malaya. The patients were provided with forms containing three pain scales and they were required to mark each pain scales – FCT, NPRS and VAS daily for three consecutive post-operative days. The forms were collected a week later when patients came back for review. The validity between NPRS with VAS, FCT with NPRS and FCT with VAS were tested using Spearman rank correlation coefficient. Results showed that the correlation coefficient values for each pair were very high and significant. The findings when comparing Day 1, Day 2 and Day 3 and the combination for those three days showed no significant differences. No evidences indicated that the findings for Day 1 were more superior in comparison with other days. In conclusion, FCT was as valid as NPRS and VAS. The pain scale which was claimed to be the easiest to use by patients was NPRS, followed by FCT and VAS. However, further studies are needed to investigate the reliability and sensitivity of FCT.
  6. Crouzon Syndrome: A Case Series of Craniomaxillofacial Distraction Osteogenesis for Functional Rehabilitation
    Hariri F, Abdul Rahman ZA, Bahuri NFA, Azmi MN, Abdullah NA, Ganesan D
    J Oral Maxillofac Surg, 2018 03;76(3):646.e1-646.e12.
    PMID: 29268076 DOI: 10.1016/j.joms.2017.11.029
    Crouzon syndrome (CS) is the most common craniosynostosis syndrome and requires a comprehensive management strategy for the optimization of care and functional rehabilitation. This report presents a case series of 6 pediatric patients diagnosed with CS who were treated with distraction osteogenesis (DO) to treat serious functional issues involving severe orbital proptosis, an obstructed nasopharyngeal airway, and increased intracranial pressure (ICP). Three boy and 3 girls were 8 months to 6 years old at the time of the operation. The mean skeletal advancement was 16.1 mm (range, 10 to 27 mm) with a mean follow-up of 31.7 months (range, 13 to 48 months). Reasonable and successful outcomes were achieved in most patients as evidenced by adequate eye protection, absence of signs and symptoms of increased ICP, and tracheostomy tube decannulation except in 1 patient. Complications were difficult fixation of external stabilizing pins in the distraction device (n = 1) and related to surgery (n = 4). Although DO can be considered very technical and can have potentially serious complications, the technique produces favorable functional and clinical outcomes in treating severe CS.
  7. Distraction osteogenesis in the surgical management of syndromic craniosynostosis: a comprehensive review of published papers
    Al-Namnam NMN, Hariri F, Rahman ZAA
    Br J Oral Maxillofac Surg, 2018 06;56(5):353-366.
    PMID: 29661509 DOI: 10.1016/j.bjoms.2018.03.002
    Our aim was to summarise current published evidence about the prognosis of various techniques of craniofacial distraction osteogenesis, particularly its indications, protocols, and complications. Published papers were acquired from online sources using the keywords "distraction osteogenesis", "Le Fort III", "monobloc", and "syndromic craniosynostosis" in combination with other keywords, such as "craniofacial deformity" and "midface". The search was confined to publications in English, and we followed the guidelines of the PRISMA statement. We found that deformity of the skull resulted mainly from Crouzon syndrome. Recently craniofacial distraction has been achieved by monobloc distraction osteogenesis using an external distraction device during childhood, while Le Fort III distraction osteogenesis was used in maturity. Craniofacial distraction was indicated primarily to correct increased intracranial pressure, exorbitism, and obstructive sleep apnoea in childhood, while midface hypoplasia was the main indication in maturity. Overall the most commonly reported complications were minor inflammatory reactions around the pins, and anticlockwise rotation when using external distraction systems. The mean amount of bony advancement was 12.3mm for an external device, 18.6mm for an internal device and 18.7mm when both external and internal devices were used. Treatment by craniofacial distraction must be validated by long-term studies as there adequate data are lacking, particularly about structural relapse and the assessment of function.
  8. Fulltext Crouzon syndrome: Genetic and intervention review
    Al-Namnam NM, Hariri F, Thong MK, Rahman ZA
    J Oral Biol Craniofac Res, 2018 08 29;9(1):37-39.
    PMID: 30202723 DOI: 10.1016/j.jobcr.2018.08.007
    Crouzon syndrome exhibits considerable phenotypic heterogeneity, in the aetiology of which genetics play an important role. FGFR2 mediates extracellular signals into cells and the mutations in the FGFR2 gene cause this syndrome occurrence. Activated FGFs/FGFR2 signaling disrupts the balance of differentiation, cell proliferation, and apoptosis via its downstream signal pathways. However, very little is known about the cellular and molecular factors leading to severity of this phenotype. Revealing the molecular pathology of craniosynostosis will be a great value for genetic counselling, diagnosis, prognosis and early intervention programs. This mini-review summarizes the fundamental and recent scientific literature on genetic disorder of Crouzon syndrome and presents a graduated strategy for the genetic approach, diagnosis and the management of this complex craniofacial defect.
  9. Tongue necrosis secondary to mucormycosis in a diabetic patient: A first case report in Malaysia
    Fattah SY, Hariri F, Ngui R, Husman SI
    J Mycol Med, 2018 Sep;28(3):519-522.
    PMID: 30205883 DOI: 10.1016/j.mycmed.2018.06.004
    Mucormycosis is a rare fungal infection and high mortality that commonly affects patients with the weakened immune system. We present an unusual case of tongue necrosis probably due to the healthcare-associated mucormycosis (HCM) in a diabetic patient. Although cannot be proved with certainty, we surmise that intubation as a risk factor in our case. The diagnosis was confirmed by histopathological examination (HPE) of the necrotic tissue specimen. The patient was responded well to lipid complex amphotericin B (250mg) regime after surgery. Subsequent follow up revealed that no signs of recurrence. Early, recognition, diagnosis, prompt treatment and awareness among clinician are representing the most effective way of managing the disease.
  10. Mandibulotomy: an analysis of its morbidities
    Nabil S, Nazimi AJ, Nordin R, Hariri F, Mohamad Yunus MR, Zulkiflee AB
    Int J Oral Maxillofac Surg, 2018 Dec;47(12):1511-1518.
    PMID: 30837061 DOI: 10.1016/j.ijom.2018.05.020
    The mandibulotomy is a procedure that was developed to improve access in tumour resection. This study aimed to investigate the complications associated with mandibulotomy and analyze factors that could affect the risks of developing these complications. The hospital records of all patients who underwent a mandibulotomy as part of their tumour ablative surgery at two major centres in Malaysia were reviewed retrospectively. Demographic, clinical, and complications data were recorded and analyzed. Early postoperative complications occurred in 46.5% of the patients and post-radiation therapy complications in 16.1%. Wound dehiscence (27.9%) and inferior alveolar nerve injury (25.6%) were the common early postoperative complications. Dental injuries (9.7%) and plate exposure/infection (9.7%) were the common post-radiation therapy complications. Furthermore, inferior alveolar nerve injury and early abscess formation were significantly associated with the site of the mandibulotomy. The T-stage of a tumour but not the site of mandibulotomy was significantly associated with tumour margin clearance. Mandibulotomy does pose an added risk of complications for a patient undergoing tumour surgery. The benefits of mandibulotomy in terms of gaining margin clearance could not be proven in this study. The site of mandibulotomy appears to increase the risk of developing an inferior alveolar nerve injury.
  11. Validity and reliability of the Neuropsychological Assessment Battery - Screening Module (S-NAB) in a subset of Malaysian population with mild traumatic brain injury (mTBI)
    Hamzah N, Mohamad NA, Thiruselvam I, Hariri F, Veeramuthu V, Mazlan M, et al.
    Appl Neuropsychol Adult, 2019 08 21;28(4):416-426.
    PMID: 31431094 DOI: 10.1080/23279095.2019.1648264
    This study assessed the validity (construct validity) and reliability (internal consistency) of the Neuropsychological Assessment Battery Screening Module (S-NAB) in detecting mild cognitive deficit/alteration in multicultural, multilingual, and multiethnic mild traumatic brain injury (mTBI) population of Malaysia. S-NAB and Montreal Cognitive Assessment (MoCA) data from 114 patients with mTBI (93 males; 21 females) aged 18 to 60 years old were obtained at University Malaya Medical Center, Malaysia. The mean age was 28.17 ± 8.57 years and mean education years was 12.40 ± 2.01. Convergent validity was assessed between S-NAB domain scores and MoCA total scores by using Pearson's correlation and internal consistency was assessed using Cronbach's alpha. Acceptable internal consistency (α ≥ .70) was found for Attention, Language, and Memory domains but weak internal consistencies (α 
  12. Fulltext Coordinated Dispersion and Aggregation of Gold Nanorod in Aptamer-Mediated Gestational Hypertension Analysis
    Bao X, Huo G, Li L, Cao X, Liu Y, Lakshmipriya T, et al.
    J Anal Methods Chem, 2019;2019:5676159.
    PMID: 31827972 DOI: 10.1155/2019/5676159
    Gestational hypertension is one of the complicated disorders during pregnancy; it causes the significant risks, such as placental abruption, neonatal deaths, and maternal deaths. Hypertension is also responsible for the metabolic and cardiovascular issues to the mother after the years of pregnancy. Identifying and treating gestational hypertension during pregnancy by a suitable biomarker is mandatory for the healthy mother and foetus development. Cortisol has been found as a steroid hormone that is secreted by the adrenal gland and plays a pivotal role in gestational hypertension. A normal circulating level of cortisol is involved in the regulation of blood pressure, and it is necessary to monitor the changes in the level of cortisol during pregnancy. In this work, aptamer-based colorimetric assay is demonstrated as a model with gold nanorod to quantify the level of cortisol using the coordinated aggregation (at 500 mM of NaCl) and dispersion (with 10 μM of aptamer), evidenced by the scanning electron microscopy observation and UV-visible spectroscopy analysis. This colorimetric assay is an easier visual detection and reached the limit of detection of cortisol at 0.25 mg/mL. This method is reliable to identify the condition of gestational hypertension during the pregnancy period.
  13. Determining the Accuracy of the Mandibular Canal Region in 3D Biomodels Fabricated from CBCT Scanned Data: A Cadaveric Study
    Abd Fattah SYAS, Hariri F, Nambiar P, Abu Bakar Z, Abdul Rahman ZA
    Curr Med Imaging Rev, 2019;15(7):645-653.
    PMID: 32008512 DOI: 10.2174/1573405614666181012144745
    OBJECTIVE: To validate the accuracy of the mandibular canal region in 3D biomodel produced by using data obtained from Cone-Beam Computed Tomography (CBCT) of cadaveric mandibles.

    METHODS: Six hemi-mandible samples were scanned using the i-CAT CBCT system. The scanned data was transferred to the OsiriX software for measurement protocol and subsequently into Mimics software to fabricate customized cutting jigs and 3D biomodels based on rapid prototyping technology. The hemi-mandibles were segmented into 5 dentoalveolar blocks using the customized jigs. Digital calliper was used to measure six distances surrounding the mandibular canal on each section. The same distances were measured on the corresponding cross-sectional OsiriX images and the 3D biomodels of each dentoalveolar block.

    RESULTS: Statistically no significant difference was found when measurements from OsiriX images and 3D biomodels were compared to the "gold standard" -direct digital calliper measurement of the cadaveric dentoalveolar blocks. Moreover, the mean value difference of the various measurements between the different study components was also minimal.

    CONCLUSION: Various distances surrounding the mandibular canal from 3D biomodels produced from the CBCT scanned data was similar to that of direct digital calliper measurements of the cadaveric specimens.

  14. Fulltext Glucose oxidase complexed gold-graphene nanocomposite on a dielectric surface for glucose detection: a strategy for gestational diabetes mellitus
    Ge Y, Lakshmipriya T, Gopinath SC, Anbu P, Chen Y, Hariri F, et al.
    Int J Nanomedicine, 2019;14:7851-7860.
    PMID: 31632005 DOI: 10.2147/IJN.S222238
    BACKGROUND: Gestational diabetes mellitus is a commonly occurring metabolic disorder during pregnancy, affecting >4% of pregnant women. It is generally defined as the intolerance of glucose with the onset or initial diagnosis during pregnancy. This illness affects the placenta and poses a threat to the baby as it affects the supply of proper oxygen and nutrients.

    PURPOSE: Due to the high percentage of affected pregnant women, it should be mandatory to evaluate glucose levels during pregnancy and there is a need for a continuous monitoring system.

    METHODS: Herein, the investigators modified the interdigitated (di)electrodes (IDE) sensing surface to detect the glucose on covalently immobilized glucose oxidase (GOx) with the graphene. The characterization of graphene and gold nanoparticle (GNP) was performed by high-resolution microscopy.

    RESULTS: Sensitivity was found to be 0.06 mg/mL and to enhance the detection, GOx was complexed with GNP. GNP-GOx was improved the sensitive detection twofold from 0.06 to 0.03 mg/mL, and it also displayed higher levels of current changes at all the concentrations of glucose that were tested. High-performance of the above IDE sensing system was attested by the specificity, reproducibility and higher sensitivity detections. Further, the linear regression analysis indicated the limit of detection to be between 0.02 and 0.03 mg/mL.

    CONCLUSION: This study demonstrated the potential strategy with nanocomposite for diagnosing gestational diabetes mellitus.

  15. Fulltext Cerebral white matter microstructural changes in isolated maxillofacial trauma and associated neuropsychological outcomes
    Sreedharan S, Veeramuthu V, Hariri F, Hamzah N, Ramli N, Narayanan V
    Int J Oral Maxillofac Surg, 2020 Sep;49(9):1183-1192.
    PMID: 32224001 DOI: 10.1016/j.ijom.2020.03.002
    Isolated traumatic maxillofacial injury without concomitant brain injury may cause delayed post-concussive symptoms. Early identification allows optimal diagnosis, prognostication, and therapeutic intervention. The aim of this prospective observational study was to investigate longitudinal microstructural changes of the white matter (WM) tracts based on diffusion tensor imaging (DTI) indices in patients with isolated maxillofacial injuries, immediately and 6 months post-trauma, and to correlate these DTI indices with neuropsychological changes observed. Twenty-one patients with isolated maxillofacial injuries and 21 age-matched controls were recruited. DTI was performed and indices were calculated for 50 WM tracts. The neuropsychological evaluation was done using the screening module of the Neuropsychological Assessment Battery. Patients were subjected to repeat DTI and neuropsychological evaluation at 6 months post-trauma. Reduced fractional anisotropy (FA) and increased median (MD) and radial diffusivity (RD) in the acute phase were seen in major association, projection, and commissural fibre bundles, indicative of vasogenic oedema. These changes correlated with attention and executive function deficits in the acute phase, as well as improvement in memory and visuospatial function in the chronic phase. Isolated maxillofacial trauma patients develop WM microstructural damage, which may impair cognitive performance acutely and over time. DTI indices can serve as predictive imaging biomarkers for long-term cognitive deficits in isolated maxillofacial injuries.
  16. Optic Canal Analysis in Syndromic Craniosynostosis: Volumetric and Surface Area Validation Study Using Different Measurement Modalities
    Hariri F, Zainudin NAA, Anuar AMS, Ibrahim N, Abdullah NA, Aziz IA, et al.
    J Craniofac Surg, 2020 11 7;32(1):355-359.
    PMID: 33156163 DOI: 10.1097/SCS.0000000000006981
    BACKGROUND: In syndromic craniosynostosis (SC), unlike persistent corneal irritation due to severe exophthalmos and increased intracranial pressure, optic canal (OC) stenosis has been scarcely reported to cause visual impairment. This study aimed to validate the OC volumetric and surface area measurement among SC patients.

    METHODS: Sixteen computed tomography scan of SC patients (8 months-6 years old) were imported to Materialise Interactive Medical Image Control System (MIMICS) and Materialise 3-matics software. Three-dimensional (3D) OC models were fabricated, and linear measurements were obtained. Mathematical formulas were used for calculation of OC volume and surface area from the 3D model. The same measurements were obtained from the software and used as ground truth. Data normality was investigated before statistical analyses were performed. Wilcoxon test was used to validate differences of OC volume and surface area between 3D model and software.

    RESULTS: The mean values for OC surface area for 3D model and MIMICS software were 103.19 mm2 and 31.27 mm2, respectively, whereas the mean for OC volume for 3D model and MIMICS software were 184.37 mm2 and 147.07 mm2, respectively. Significant difference was found between OC volume (P = 0.0681) and surface area (P = 0.0002) between 3D model and software.

    CONCLUSION: Optic canal in SC is not a perfect conical frustum thus making 3D model measurement and mathematical formula for surface area and volume estimation not ideal. Computer software remains the best modality to gauge dimensional parameter and is useful to elucidates the relationship of OC and eye function as well as aiding intervention in SC patients.

  17. Analysis of complications following multidisciplinary functional intervention in paediatric craniomaxillofacial deformities
    Hariri F, Abdullah MF, Adam KBC, Bahuri NFA, Kulasegarah J, Nathan AM, et al.
    Int J Oral Maxillofac Surg, 2021 Apr;50(4):457-462.
    PMID: 32891466 DOI: 10.1016/j.ijom.2020.08.002
    Paediatric craniomaxillofacial (CMF) surgery requires a multidisciplinary team approach to ensure the optimal and holistic management of children with craniofacial deformities. The aim of this retrospective study was to analyse the complications following functional interventions among 34 CMF deformity patients in a single multidisciplinary craniofacial centre. Electronic data including patient demographic characteristics and clinical entry were analysed. Inclusion criteria were all paediatric patients with CMF deformities who underwent various functional interventions. A total of 64 interventions (48 intermediate and 16 definitive) were conducted. Based on the Sharma classification of complications, 20.3% were type I, 4.7% were type II, 1.6% were type III, and 4.7% were type IV . Most complications were type I, which included local infection (3.1%) and premature opening of tarsorrhaphy (3.1%). More serious complications (types III and IV) included temporary visual loss (1.6%) and intraoperative haemorrhage (1.6%). Although a low complication rate was observed in intermediate interventions, a higher complication rate was observed in more complex definitive interventions such as monobloc distraction osteogenesis. Although most complications were manageable, effective prevention remains mandatory, as serious complications may lead to permanent damage and mortality. This analysis highlights the importance of a multidisciplinary team approach to optimize the outcomes in CMF patient management.
  18. Ophthalmic features of craniosynostosis: A Malaysian experience
    Rafique Ali AA, Ismail F, May May C, Mohd Abdullah AA, Khaliddin N, Hariri F, et al.
    Eur J Ophthalmol, 2021 Jul 05.
    PMID: 34219491 DOI: 10.1177/11206721211030093
    BACKGROUND: This study aims to collect local Malaysian data regarding the ophthalmic features and complications in craniosynostosis patients who attended the Combined Craniofacial Clinic (CFC) in University Malaya Medical Centre (UMMC).

    METHODS: Retrospective study of medical notes of craniosynostosis patients who attended the CFC in UMMC from 2014 to December 2020.

    RESULTS: Out of 37 patients, 29 had syndromic craniosynostosis, and 8 had non-syndromic craniosynostosis. Visual impairment was present in 32.1% of patients. Causes for visual impairment were as follows - amblyopia (25.0%), exposure keratopathy (3.6%), and optic atrophy (3.6%). Hypermetropia and myopia were each seen in 20.6% of patients. Astigmatism was seen in 47.1% of patients, and 29.1% had anisometropia. Proptosis was present in 78.6% and lagophthalmos in 53.3% of patients. Strabismus in primary position occurred in 51.7% of patients. Thirty-one percent of the patients had exposure keratopathy. Optic disc atrophy was seen in 13.7% of patients, and 8.3% had optic disc swelling. Optic disc swelling was resolved in all patients who underwent craniofacial surgery.

    CONCLUSION: Our experience in Malaysia was consistent with previously reported data on ophthalmic features of craniosynostosis patients. Additionally, we found that non-syndromic craniosynostosis patients are also at risk of ocular complications just as much as syndromic patients. Appropriate treatment of amblyogenic risk factors, ocular complications, and timely detection of papilledema, and prompt surgical intervention are crucial in preserving long-term visual function in these patients.

  19. Fabrication of a three-dimensional temporomandibular joint model for arthrocentesis and arthroscopy simulation
    Foo QC, Hariri F, Abdul Rahman ZA
    Int J Oral Maxillofac Surg, 2021 Aug;50(8):1095-1099.
    PMID: 33422383 DOI: 10.1016/j.ijom.2020.12.007
    Arthrocentesis and arthroscopy are relatively safe treatments for arthrogenic temporomandibular disorders. Hands-on training in both procedures is essential for surgeons to become competent. In this study, a three-dimensional (3D) temporomandibular joint (TMJ) prototype was developed at a relatively low cost, and arthrocentesis and arthroscopy were performed successfully on the model. Despite its limitations, this model is a viable adjunct to TMJ surgical training and can be fabricated easily by any training centre with a 3D printer.
  20. Three-dimensional surgical contouring of craniofacial fibrous dysplasia via patient-specific cutting guides and depth screws
    Rengarajoo J, Syed Husman SI, Hariri F
    Br J Oral Maxillofac Surg, 2021 09;59(7):843-844.
    PMID: 34210576 DOI: 10.1016/j.bjoms.2020.09.028
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