MyMedR

Unilateral Zygomatic Complex Fracture - A Comparison Between Nonsurgical Treatment and Surgical Treatment

Ling XF, Yew CC, Mohd Nazri SB, Tew MM

J Craniofac Surg, 2021 Oct 01;32(7):e627-e630.

PMID: 33654041 DOI: 10.1097/SCS.0000000000007603

BACKGROUND: Medical advances have enabled zygomatic complex (ZMC) fractures to be treated by various approaches. This study aims to analyze the demographics and treatment outcomes of unilateral ZMC fractures, treated nonsurgically or surgically.

METHODS: This 5-year nonrandomized prospective study had included 65 cases of unilateral ZMC fractures from October 2014 until December 2019. Patients were treated and divided into nonsurgical and surgically treated group. Treatment outcomes in terms of step deformities, malar depression, diplopia, infraorbital hypoaesthesia, and mouth opening were evaluated up to six months post-trauma/intervention.

RESULTS: Road traffic accident (96.9%) was the main cause, with predominant male involvement (80%) and median age of 28 years. Significant improvements (P < 0.05) were observed for step deformities and malar depression among the surgically treated group at postoperative day 1 and week 1. Throughout the six months review, infraorbital hypoesthesia and diplopia showed no significant differences between both groups, (P > 0.05). Besides, all patients showed significant mouth opening improvement (P

Matched MeSH terms: Skull Fractures*

Frontoethmoidal encephalomeningocoele with colpocephaly: case report and clinical review

Bhattacharjee A, Chakraborty A, Purkaystha P

J Laryngol Otol, 2008 Mar;122(3):321-3.

PMID: 17666141

Frontoethmoidal encephalomeningocoele is a rare congenital disease in which an intracranial mass protrudes through a midline defect from the anterior cranial fossa into the facial skeleton. The condition affects patients in South East Asian countries, such as Thailand, Burma, Malaysia and Indonesia, with frequency of 1 in 5000. The pathogenesis of encephalocoeles may be regarded as a 'late' neurulation defect during the fourth gestational week. We present a case of frontoethmoidal encephalomeningocoele with corpus callosal agenesis and colpocephaly; this may well be the first report of this combination. The patient had a bulging mass in the middle frontonasal area, with broadening of the nasal bridge and hypertelorism. Computed tomography scans delineated the skull defect and associated brain anomalies. A one-stage, combined transfacial-transcranial approach, correctional procedure was performed. We present here a discussion of the findings, with special reference to the condition's pathogenesis, morphological classification and evolving surgical treatments. Early diagnosis and referral, involving multidisciplinary teamwork, are of paramount importance because of the distorting influence of the extruding mass on facial growth.

Matched MeSH terms: Skull Base*

Topographical anatomy of asterion by an innovative technique using transillumination and skiagram

Srijit D, Rajesh S, Vijay K

Chin Med J (Engl), 2007 Oct 5;120(19):1724-6.

PMID: 17935679

Matched MeSH terms: Skull/anatomy & histology*

Fulltext Evaluation of the osteogenic potential of demineralized and decellularized bovine bone granules following implantation in rat calvaria critical-size defect model

Al Qabbani A, Rani KGA, AlKawas S, Sheikh Abdul Hamid S, Yap Abdullah A, Samsudin AR, et al.

PLoS One, 2023;18(12):e0294291.

PMID: 38127838 DOI: 10.1371/journal.pone.0294291

The aim of this study was to compare the ability of demineralized (DMB) and decellularized (DCC) bovine bone granules to support bone regeneration in rat calvaria critical-size defects. DMB and DCC were prepared using a previously published method. The granule size used ranged between 500 and 750 μm. A total of forty-eight Sprague-Dawley rats were divided into two groups (n = 24). A pair of 5 mm diameter defects were created on the calvaria of the rats in the right and left parietal bone in both groups. Group A animals received DMB granules and Group B received DCC granules in the right parietal defect side while the left parietal untreated defect acted as sham surgery for both groups. Four animals per group were euthanized in a CO2 chamber at day 7, 14 and 21 post-surgery and the calvaria implantation site biopsy harvested was subjected to osteogenic gene expression analysis. Another four animals per group were euthanized at days 15, 30 and 60 post surgery and the calvaria implantation site biopsy harvested was subjected to histological, immunohistochemistry, RAMAN spectroscopy and Micro-CT analysis at the mentioned time points. Statistical analysis was conducted using t-tests and ANOVA. Histomorphometry showed significantly higher new bone formation in the DCC sites (p<0.05) compared to DMB. Both DMB and DCC implantation sites showed distinct staining for osteocalcin and osteopontin proteins compared to their respective sham sites. By day 21 after implantation, DCC sites demonstrated significantly elevated mRNA levels of osteonectin (p<0.001), osteopontin (p<0.001), osteocalcin (p<0.0001), ALP (p<0.01), and BMP-2 (p<0.001) compared to DMB. However, VEGF expression showed no significant differences at this time point between the two groups. Micro-CT analysis also showed enhanced defect closure and higher bone density in DCC implanted sites while RAMAN spectra demonstrated increased abundance of collagen and bone minerals, especially, PO43- ions than DMB. In conclusion, both DMB and DCC granules demonstrated favorable osteogenic potential in critical-sized defects, with DCC exhibited superior osteoconductive, osteoinductive and osteogenesis properties.

Matched MeSH terms: Skull/pathology

Fulltext Craniofacial reconstruction using rational cubic ball curves

Majeed A, Mt Piah AR, Gobithaasan RU, Yahya ZR

PLoS One, 2015;10(4):e0122854.

PMID: 25880632 DOI: 10.1371/journal.pone.0122854

This paper proposes the reconstruction of craniofacial fracture using rational cubic Ball curve. The idea of choosing Ball curve is based on its robustness of computing efficiency over Bezier curve. The main steps are conversion of Digital Imaging and Communications in Medicine (Dicom) images to binary images, boundary extraction and corner point detection, Ball curve fitting with genetic algorithm and final solution conversion to Dicom format. The last section illustrates a real case of craniofacial reconstruction using the proposed method which clearly indicates the applicability of this method. A Graphical User Interface (GUI) has also been developed for practical application.

Matched MeSH terms: Skull/surgery*

Fulltext Inflammatory pseudotumour of skull base - diagnostic challenge and treatment outcome

Kahairi A, Ahmad RL, Wan Ishlah L, Norra H

Med J Malaysia, 2012 Oct;67(5):526-8.

PMID: 23770873

We report a case of an inflammatory pseudotumour (IP) involving the floor of the skull base, which demonstrated aggressive behavior both clinically and radiologically. In this case, the diagnosis was established by clinical presentation, magnetic resonance imaging (MRI), histopathological examination (HPE) and the dramatic response towards high dose steroid therapy. The clinical features improved with oral cyclophosphamide in combination with oral steroid, which were given for a period of three months.

Matched MeSH terms: Skull Base*

A preliminary study of using active vision guided robotic arm for bone drilling in a developing country

Abdullah MZ, Awang MS, Tan YC, Abdullah JM

J Neurol Surg A Cent Eur Neurosurg, 2014 Mar;75(2):155-7.

PMID: 23636911 DOI: 10.1055/s-0032-1330954

The study assesses the capability and accuracy of a robotic arm to perform burr holes.

Matched MeSH terms: Skull/surgery*

Skull-photograph superimposition: elucidating and resolving misinterpretations pertaining to methods and reliability

Jayaprakash PT

Int J Legal Med, 2023 Mar;137(2):379-381.

PMID: 36520208 DOI: 10.1007/s00414-022-02931-w

Matched MeSH terms: Skull*

Fulltext Solitary osteochondroma in the body of the pubic bone: a cadaveric case report

Nayak SB, Kumar N, Sirasanagandla SR, Srinivas SP, Pamidi N, Shetty SD

Anat Cell Biol, 2018 Jun;51(2):136-138.

PMID: 29984059 DOI: 10.5115/acb.2018.51.2.136

Osteochondromas develop as cartilaginous nodules in the periosteum of bones. They are the commonest benign tumors of the skeleton, generally observed in the long bones. Rarely, they are also found in the axial skeleton, flat bones of skull and facial bones. During a regular dissection, we came across a solitary osteochondroma in posterior surface of the body of the right pubic bone. Histopathology of the bony projection confirmed the typical features of the osteochondroma. The symptomatic osteochondromas are usually evaluated during radiographic examination. Though, the observed osteochondroma is relatively smaller its unusual location is remarkable and knowledge of occurrence of such nodules is clinically important during the diagnosis and planning of treatment.

Matched MeSH terms: Skull

Fenestrated Falx Cerebri and Additional Sinuses in the Tentorium Cerebelli

Nayak SB, Vasudeva SK

J Craniofac Surg, 2020 Sep;31(6):e585-e586.

PMID: 32502106 DOI: 10.1097/SCS.0000000000006604

Morphological variations of falx cerebri and tentorium cerebelli are extremely rare. The authors report an extremely rare type of combined variation of falx cerebri and dural venous sinuses in the tentorium cerebelli. During the removal of the brain from cranial cavity, it was noted that the anterior part of the falx cerebri had fenestrations and it looked like a mesh. There was no associated variations of medial surface of cerebrum. Further, there were unusual sinuses within the tentorium cerebelli. Two of them were present in the right half of the tentorium cerebelli and one in the left half of the tentorium cerebelli. There variations could be of importance to radiologists and neurosurgeons. The fenestrations of falx cerebri might lead to misinterpretations in cases of head injuries and the additional sinuses in the tentorium cerebelli might cause unexpected bleeding during surgeries of posterior cranial fossa.

Matched MeSH terms: Skull

Fulltext Verrucous carcinoma of maxillary antrum

Indudharan R, Das PK, Thida T

Singapore Med J, 1996 Oct;37(5):559-61.

PMID: 9046219

Verrucous carcinoma of the paranasal sinuses is a rare malignant tumour. It occurs most frequently in the oral cavity and larynx. We present a case of extensive verrucous carcinoma of the maxillary sinus. This paper discusses the clinical and histological features and modes of treatment. All previous reports of verrucous carcinoma cases of paranasal sinuses are reviewed.

Matched MeSH terms: Skull Neoplasms/diagnosis*; Skull Neoplasms/pathology; Skull Neoplasms/therapy

Use of bovine xenograft in reconstruction of traumatic anterior cranial fossa bone defects involving the frontal sinus

Abdullah J, Rushdan A, Hamzah M, Ariff AR, Rani A

Ann. Transplant., 1999;4(3-4):28-31.

PMID: 10853777

Four patients underwent reconstruction of anterior cranial fossa of skull defects between November 1997 and January 1998. All of them had traumatic anterior cranial fossa defect and were reconstructed with lyophilised bovine cortical bone graft. There was no cerebrospinal fluid leakage, meningitis, extradural abscess or other infections. This study demonstrates that the use of bovine bone graft in the reconstruction of anterior base defects is safe.

Matched MeSH terms: Skull Base/injuries; Skull Base/radiography; Skull Base/surgery*

Fulltext Dimensional accuracy of the skull models produced by rapid prototyping technology using stereolithography apparatus

Nizam, A., Gopal, R.N., Naing, L., Hakim, A.B., Samsudin, A.R.

Archives of Orofacial Sciences, 2006;1(1):60-66.

MyJurnal

The purpose of this study was to determine the dimensional accuracy of the skull models produced by Rapid prototyping technology using stereolithography apparatus. Computed tomography images were captured from four dry normal adult human skulls. The resultant 2-D images were stored in Digital Imaging and Communications in Medicine (DICOM) format. The segmentation of the images was prepared in MIMICS software. The slice files were then exported to a stereolithography apparatus (SLA) to produce the replica of each skull. Eight linear measurements were repeatedly made between identified landmarks on each of the original skull and its replica model using an electronic digital calliper. Each of the linear measurements was repeated 5 times and the average was taken to determine the absolute difference and percent difference between the original skull and its replica model. The overall absolute difference between the four human adult skulls and its replica models was 0.23 mm with a standard deviation of 1.37 mm. The percent difference was 0.08% with a standard deviation of 1.25%. The degree of error established by this system seems affordable in clinical applications when these models are used in the field of dental surgery for surgical treatment planning.

Matched MeSH terms: Skull

Fulltext Head injury with temporal bone fracture: one year review of case incidence, causes, clinical features and outcome

Amin Z, Sayuti R, Kahairi A, Islah W, Ahmad R

Med J Malaysia, 2008 Dec;63(5):373-6.

PMID: 19803293 MyJurnal

To investigate the case incidence, causes, clinical profile and outcome of temporal bone fracture complicating head trauma. A 1-year (2005) retrospective study of head injured patients presented to the Emergency Department, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia. Gender distribution, cause of injury, radiological findings and otorhinolaryngological clinical presentations were analyzed. Of 1309 patients, 61 patients were diagnosed to have temporal bone fracture (4.7%). Majority of cases were caused by motor vehicle accident (85.9%) and were predominantly male (88.5%). The right temporal bone was more frequently fractured (62.3%). Most (88.5%) were petro-mastoid fractures. Sixty-seven percent of the petrous fractures were longitudinal type. Clinical presentations mostly reported were blood rhinorrhea (36%) and blood otorrhea (32.7%). Other clinical presentations were hearing loss (9.8%), cranial nerve palsy (8.2%), cerebrospinal fluid oto-rhinorrhea (8.2%) and labyrinth concussion (6.5%). Four out of five cranial nerve palsies were facial nerve. Out of the 61 cases, 16 (26.2%) had no clinical presentation at the time of Emergency Department consultation. Thirteen (21.3%) died due to severe head injury. The case incidence of temporal bone fracture in head injured patients in our centre is 4.7%. The petro-mastoid type fracture predominates. Proper early diagnosis and management minimize complications.

Matched MeSH terms: Skull Fractures/diagnosis; Skull Fractures/epidemiology*; Skull Fractures/therapy

Fulltext Superselective embolisation for control of intractable epistaxis from maxillary artery injury

Singam P, Thanabalan J, Mohammed Z

Biomed Imaging Interv J, 2011 01 01;7(1):e3.

PMID: 21655112 MyJurnal DOI: 10.2349/biij.7.1.e3

Traumatic intractable epistaxis following fractures of the facial and base of skull rarely may be life-threatening. Common sites of injury are the internal carotid and maxillary artery. When conventional methods of arresting haemorrhage fail, the choices are then an open arterial ligation or superselective embolisation. This paper presents a patient with life-threatening epistaxis from a Le Fort type II fracture. Angiography revealed a maxillary artery injury in which superselective embolisation was performed and the haemorrhage was successfully arrested. A literature review of this technique is discussed, including its advantages and the relationship of the internal maxillary artery to facial fractures.

Matched MeSH terms: Skull Base

Fulltext Tuberculosis of the skull mimicking multiple myeloma

Pan KL, Zulkarnaen M

Med J Malaysia, 2014 Aug;69(4):197-8.

PMID: 25500853 MyJurnal

There is a resurgence of tuberculosis globally but lesions affecting the skull are rare. Cases reported are of single, focal lesions as seen on plain x-rays. We report a 34 yearold patient with tuberculosis of the skull where multiple punched out lesions are seen, mimicking that of multiple myeloma.

Matched MeSH terms: Skull

Fulltext The impact of cranioplasty on cerebral blood flow and its correlation with clinical outcome in patients underwent decompressive craniectomy

Mah JK, Kass RA

Asian J Neurosurg, 2016 Jan-Mar;11(1):15-21.

PMID: 26889273 DOI: 10.4103/1793-5482.172593

Decompressive craniectomy is commonly use as the treatment for medically refractory intracranial hypertension. Unexpected improvement in patient's neurological status has been observed among patients that underwent cranioplasty. Restoration of cerebral blood flow (CBF) hemodynamics is one of the contributing factors. This study was conducted to determine the impact of cranioplasty on CBF and its correlation with clinical outcome.

Matched MeSH terms: Skull

Inexpensive home-assembled human skull model for training and learning the peribulbar block technique

Chua AW, Chua MJ, Harrisberg BP, Kumar CM

Anaesth Intensive Care, 2022 09;50(5):400-402.

PMID: 36076352 DOI: 10.1177/0310057X211063892

Matched MeSH terms: Skull

Study on the criteria for assessing skull-face correspondence in craniofacial superimposition

Ibáñez O, Valsecchi A, Cavalli F, Huete MI, Campomanes-Alvarez BR, Campomanes-Alvarez C, et al.

Leg Med (Tokyo), 2016 Nov;23:59-70.

PMID: 27890106 DOI: 10.1016/j.legalmed.2016.09.009

Craniofacial superimposition has the potential to be used as an identification method when other traditional biological techniques are not applicable due to insufficient quality or absence of ante-mortem and post-mortem data. Despite having been used in many countries as a method of inclusion and exclusion for over a century it lacks standards. Thus, the purpose of this research is to provide forensic practitioners with standard criteria for analysing skull-face relationships. Thirty-seven experts from 16 different institutions participated in this study, which consisted of evaluating 65 criteria for assessing skull-face anatomical consistency on a sample of 24 different skull-face superimpositions. An unbiased statistical analysis established the most objective and discriminative criteria. Results did not show strong associations, however, important insights to address lack of standards were provided. In addition, a novel methodology for understanding and standardizing identification methods based on the observation of morphological patterns has been proposed.

Matched MeSH terms: Skull/anatomy & histology*

Surgical Outcome After Less "Rigid" Fixation in Open Cranial Vault Remodeling for Craniosynostosis

Koh KL, Zain A

J Craniofac Surg, 2018 Jun;29(4):861-867.

PMID: 29438206 DOI: 10.1097/SCS.0000000000004347

: Open cranial vault remodeling techniques require rigid fixation with hardware such as plates and screws; however, complications can occur. The purpose of this study was to assess the surgical outcome after open reconstruction for craniosynostosis with less rigid fixation using nonabsorbable suture.

METHODS: Retrospective review of patients who underwent open craniofacial reconstruction for craniosynostosis at the Hospital Kuala Lumpur between January 2011 and December 2016 were performed. Demographic data, surgical complications, and postoperative aesthetic outcomes and reoperations were evaluated using Whitaker classification. Statistical analyses were performed using SPSS.

RESULTS: Thirty-four (n = 34) cases were included in this review consisting of 16 males and 18 females (ratio 1:1.25). Sixteen patients were syndromic with multiple suture synostoses: Apert syndrome (n = 8), Crouzon syndrome (n = 6), and Muenke's syndrome (n = 2). Eighteen patients were nonsyndromic: isolated single-suture craniosynostosis (n = 12) and multiple suture involvement (n = 6). Mean age of presentation was 17.4 months (4-16 months) with mean age of surgery of 23.8 months (6-68 months). Mean length of surgery was 6.1 hours (range 3-10 hours) and mean length of hospital stay was 10 days (mean 7-20 days). Mean duration of follow-up was 2.2 years (6 month-4 years). There were a total of 9 complications postoperatively: massive blood loss (n = 4), seroma (n = 2), exposure keratitis (n = 1), hand extravasation (n = 1), and occipital sore (n = 1). Analysis showed multiple suture craniosynostoses were associated with longer operative times (4.3 hours vs 6.5 hours, P = 0.0082 24 months of age, P = 0.00059). Patients were categorized as 88.2% (n = 30) Whitaker I and II and 11.8% (n = 4) Whitaker III and IV. Reoperation rates were 2.9% (n = 1). Whitaker III and IV class were higher among patients with syndromic synostosis, unicoronal and multiple suture synostoses.

CONCLUSIONS: Our technique of open cranial reconstruction with nonabsorbable suture nylon 2/0 as sole method of fixation has resulted in good aesthetic outcome with low reoperations and complications rate. Longer follow-up is needed to ascertain our long-term results.

Matched MeSH terms: Skull/surgery*

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