METHODS: A retrospective analysis has been performed on patients with dento-skeletal class III deformity who had undergone orthognathic 2-jaw surgery with segmentations, presenting both pre- and post-surgical cone-beam computed tomographys. Three-dimensional skeletal movements, pharyngeal airway changes and hyoid bone position were measured and correlated.
RESULTS: The mean short term postsurgical review period for all included 47 patients was 5.8 ± 2.2 months. Thirteen patients among them provided a mean long term period of 26.4 ± 3.4 months. The mean postsurgical maxillary movement was 2.29 ± 2.49 mm in vertical, 2.02 ± 3.45 mm in horizontal direction, respectively, while the mandibular movement was 6.49 ± 4.58 mm in vertical, and -5.85 ± 6.13 mm in horizontal direction. In short-term, the vertical length of nasopharynx was found to be reduced (P = 0.005) but increased for the oropharynx (P 0.05) detected between patients with and without genioplasty advancement.
CONCLUSION: Two-jaw orthognathic surgery in dento-skeletal class III patients led to a statistically non-significant reduction of the post-surgical airway volume in both short- and long-term. Although the post-surgical oropharyneal minimum cross-sectional area was decreased significantly in the short term, this finding did not persist in the long term.
OBJECTIVE: The aim of this study is to evaluate the ICV in primary craniosynostosis patients after the cranial vault reshaping with or without FOA and to compare between syndromic and nonsyndromic synostosis group, to determine factors that associated with significant changes in the ICV postoperative, and to evaluate the resolution of copper beaten sign and improvement in neurodevelopmental delay after the surgery.
METHODS: This is a prospective observational study of all primary craniosynostosis patients who underwent operation cranial vault reshaping with or without FOA in Hospital Kuala Lumpur from January 2017 until Jun 2018. The ICV preoperative and postoperative was measured using the 3D computed tomography (CT) imaging and analyzed. The demographic data, clinical and radiological findings were identified and analyzed.
RESULTS: A total of 14 cases (6 males and 8 females) with 28 3D CT scans were identified. The mean age of patients was 23 months. Seven patients were having syndromic synostosis (4 Crouzon syndromes and 3 Apert syndromes) and 7 nonsyndromic synostosis. The mean preoperative ICV was 880 mL (range, 641-1234 mL), whereas the mean postoperative ICV was 1081 mL (range, 811-1385 mL). The difference was 201 mL which was statistically significant (P 1.0). However, there was 100% (n = 13) improvement of this copper beaten sign. However, the neurodevelopmental delay showed no improvement which was statistically not significant (P > 1.0).
CONCLUSION: Surgery in craniosynostosis patient increases the ICV besides it improves the shape of the head. From this study, the syndromic synostosis had better increment of ICV compared to nonsyndromic synostosis.
OBJECTIVES: To evaluate and compare the depth and distances from various points of the orbital rim to the fissures and foramina of the orbital apex between genders in the local population.
METHODOLOGY: Linear measurements were conducted on 60 orbits from 30 patients who had undergone head computed tomography scan. These measurements were done utilizing the multiplanar reconstruction modes on computed tomography images with minimum slice thickness of 1 mm.
RESULTS: Males have statistically significant larger orbits than females with higher mean measurements in all parameters, except for the distance from posterior ethmoidal foramen to the optic canal which was the same. However, there were no significant differences in all parameters between the right and left orbits.
CONCLUSION: This study provides the absolute limit of safe internal orbital dissection in respect to the local population. Despite males having larger orbits than females, it is clinically negligible.
METHODOLOGY: A retrospective review was conducted from January 2008 until December 2011. All patients diagnosed with zygomatic complex fractured that met the inclusion and exclusion criteria were included in the study. Zingg's Classification was used in the study.
RESULTS: The median age was 23.5. Type A was the most common fracture type made up 26.6%. About 90.8% of the injury was caused by road traffic accident. Forty-four patients were treated with open reduction and internal fixation and 4 patients were treated with close reduction only. Fifty patients were treated conservatively. Gillies approach in combination with fixation is the most common procedure accounted for 50%. Three-point fixation at infraorbital, maxillary buttress, frontozygomatic suture, and zygomatic arch was the most common site. However, there were no significant associations between the number of fixation and the occurrence of the complication (P = 0.307). About 29.2% in the treatment group and 66% in the conservative group had complications. About 35.7% of patients in treatment group had complications, while 66% had trismus in conservative group.
CONCLUSION: There was a significant association between types of treatment and the occurrence of complication (P = 0.001). However, there were no significant association between number of fixation and the occurrence of complications (P = 0.307).
METHODS: A prospective study was conducted to evaluate the outcome of a new reconstruction technique that produces patient-specific hybrid polymethyl methacrylate-autologous cranial implant. Computer-assisted 3D modeling and printing was utilized to produce patient-specific molds, which allowed real-time reconstruction of bone flap with partial defect intra-operatively.
RESULTS: Outcome assessment for 11 patients at 6 weeks and 3 months post-operatively revealed satisfactory implant alignment with favorable cosmesis. The mean visual analog scale for cosmesis was 91. Mean implant size was 50cm, and the mean duration of intra-operative reconstruction was 30 minutes. All of them revealed improvement in quality of life following surgery as measured by the SF-36 score. Cost analysis revealed that this technique is more cost-effective compared to customized cranial prosthesis.
CONCLUSION: This new technique and approach produce hybrid autologous-alloplastic bone flap that resulted in satisfactory implant alignment and favorable cosmetic outcome with relatively low costs.