Knowledge Is Power, Sympathy For The Ignorant: Forgiven, For They Do Not Know No abstract available

How to Hold an Osteotome? Michelangelo Grip No abstract available

Facial Cleft in a Mayan Figurine No abstract available

Humankind's Endless Quest for Youth No abstract available

A Comparison of Surgical Outcomes of Two Combination Surgeries for Involutional Entropion: Fixing 3 vs 2 Pathologic Components The purpose of this study was to compare the surgical outcomes of two combinational surgeries for involutional entropion: Inferior retractor tightening (IRT) + lateral tarsal strip (LTS) + skin muscle excision (SME) vs LTS + SME. The authors reviewed the records of 2 groups which were made up of 80 (85 eyelids) and 58 (63 eyelids) involutional entropion patients with 71.4 and 71.8 years on average respectively. The 2 groups were categorized into Group A and Group B by different surgical techniques. The former underwent IRT + LTS + SME surgery between April 2004 and February 2014, while the latter received LTS + SME surgery between March 2014 and February 2018. The authors evaluated the surgical outcomes of 2 combinational surgeries. In Group A, 84 out of 85 (98.8%) lids were successfully corrected and 1 (1.2%) lower eyelid suffered from recurrence during the follow-up period of 26.5 ± 4.6 months. Two canthal deformity cases occurred in this group. In Group B, 62 out of 63 (98.2%) lids were successfully treated and there was 1 (1.8%) case of recurrence during the follow-up period of 21.0 ± 10.0 months. No cases of complications were noted. IRT + LTS + SME procedure took 26.4 ± 2.4 minutes and LTS + SME procedure took 20.6 ± 3.9 minutes (P < 0.001). The LTS + SME technique exhibited a comparable success rate with the IRT + LTS + SME operation. LTS + SME appeared to be significantly faster and safer compared to the IRT + LTS + SME procedure.

Brazilian-Portuguese Linguistic Validation of the Velopharyngeal Insufficiency Effects on Life Outcome Instrument Background: The purpose of this study was to conduct a linguistic validation of the velopharyngeal insufficiency (VPI) Effects on Life Outcome (VELO) instrument for use in Brazilian-Portuguese patients with VPI. Methods: The original English version of the VELO instrument was translated into Brazilian-Portuguese, back-translated, and adapted among the Brazilian patients (n = 21) with VPI and their parents, based on the standardized guidelines for the cross-culture adaption process. Discrepancies in the forward and backward translation steps were computed. Comprehension rates were captured for each debriefing interview. The content validity index (CVI) per item (I-CVI) and of the scale (S-CVI universal agreement [S-CVI/UA] and averaging [S-CVI/Ave]) were calculated. Results: Reconciliation of the 2 forward translations and the comparison between the back translation and the original VELO version resulted in some item wordings with discrepancies which were reviewed by the research team (translators, expert committee, and original developers of instrument). Three rounds of cognitive interviews also led to some revisions of wording. Comprehension rates of patients and their parents were 60% to 100%, 80% to 100%, and 100% in the first, second, and third rounds of cognitive interviews, respectively. The I-CVI, S-CVI/AU, and SCI/Ave for the Brazilian-Portuguese VELO version were 0.83 (or higher), 0.83 (or higher), and 0.97, respectively. Conclusions: The linguistic validation process of the VELO instrument created a cross-culturally equivalent Brazilian-Portuguese version for use in Brazilian-Portuguese speaking patients with VPI.

Osteoplastic Anterior Transoral Approach for Tumors of the Middle Cranial Fossa Surgical access to tumors involving the midline skull base remains a considerable challenge for surgeons. Various surgical approaches for treating these tumors like transnasal, transantral, and endoscopic approaches sometimes have anatomical limitations. This paper describes a transoral approach with a Lefort I osteotomy that allows a great visualization, not only to the center of the skull base but also the infratemporal fossa. This technique may be used for the surgical resection of extracranial and intracranial benign tumors, and non-neoplastic intradural pathology, which does not require dural resection. The authors will review proper patient selection, surgical exposure, operative procedure, and complications.

Vitamin E Promotes Bone Formation in a Distraction Osteogenesis Model The long consolidation period of distraction osteogenesis (DO) may lead to complications such as pain, infection, fracture, scar formation, malunion and delayed union. The aim of this study was to evaluate the effect of systemic Vitamin E application during mandibular DO on new bone regeneration in a rabbit model. 16 adult male 8 months old New Zealand rabbits underwent mandibular lengthening with a distractor for the study. After the latency period of 5 days, the distractor was activated at a rate of 0.5 mm/12 hours for 7 days. Experimental animals received 200 mg/kg injections of α-tocopherol intraperitoneally for 7 days starting with the operation. After the consolidation period of 30 days, rabbits were sacrificed. Lengthened mandibles were obtained and subjected to dual-energy X-ray absorptiometry (DXA), radiologic and histomorphometric analysis. Statistically, bone mineral density and bone mineral content values were found to be significantly higher in the experimental group than the control group during DXA analysis. Rabbits in the experimental group had statistically higher scores in terms of osteoblast, osteoclast, vessel numbers and newly formed bone area than the control group. Results of the present study showed that systemic Vitamin E application during DO may stimulate new bone formation in rabbits and thus results in shortened treatment time.

Accuracy of Computer-Aided Design/Computer-Aided Manufacturing-Assisted Mandibular Reconstruction With a Fibula Free Flap Background: The recent increase in computer-aided design and computer-aided manufacturing (CAD/CAM)-assisted surgery has warranted a thorough evaluation of the accuracy of virtual plan execution. Mandibular reconstructions with a fibula free flap were evaluated by comparing the fibular segments postoperatively with the virtual surgical plans. Methods: This study included computed tomography data for 20 patients (11 males; mean age 61.3 years, range 47–74) that received a mandibular reconstruction with a fibula free flap. Linear distances (superior and inferior borders) of 41 fibula segments and intercoronoid distances were measured. Results: The mean difference was 3.11 ± 2.80 mm for superior borders (range 0.02–12.20 mm), and 2.75 ± 2.61 mm for inferior borders (range 0.22–13.58 mm). The mean intercoronoid difference was 3.57 ± 1.80 mm (range 0.91–6.11 mm). Conclusion: This study confirmed the presumed accuracy regarding the use of fibular and mandibular cutting guides. CAD/CAM is an attractive technique which enhances efficiency and assurance during surgery and preoperative planning.

Bilateral Sagittal Split Osteotomy: Description of Surgical Technique to Complement the Procedural Cognition Simulation in the Craniofacial Interactive Virtual Assistant-Professional Edition Operative experience for the contemporary trainee has become exceedingly more challenging in the setting of more stringent hospital regulations. Surgical training is thus shifting toward more self-directed, independent learning to maximize operative opportunities as they become available; yet, this can prove difficult for complex surgeries like craniofacial procedures. The intricate anatomy and fine reconstructive techniques employed cannot be readily depicted onto a two-dimensional page. To address this educational gap, the Craniofacial Interactive Virtual Assistant-Pro Edition (CIVA-Pro) was developed as a web-based surgical simulator to aid learners with conceptualizing the surgical principles utilized in these cases. The current work reviews the Bilateral Sagittal Split Osteotomy module of CIVA-Pro, providing detailed narratives for each chapter with expert commentary on broadened indications and future directions.