Surgical Correction of Proptosis in Craniofacial Benign Bone Lesions Involving the Orbit.

Craniofacial bone lesions involving the orbit are often associated with symptoms, including proptosis, orbital dystopia, and overall facial asymmetry. Fibrous dysplasia and osteoma are the 2 most commonly observed bone tumors in the craniofacial area. Nine patients with either craniofacial fibrous dysplasia or osteoma and an unacceptable aesthetic appearance were treated from January 2015 to July 2016. All patients underwent preoperative craniofacial 3-dimensional computed tomographic (CT) scanning, and standard photographs were obtained. Proptosis measurements were performed on CT images using an annotation ruler provided by the imaging system both pre- and postoperatively. All patients were treated surgically, and a coronal incision was used. Outcomes were assessed by CT scans, and photographs were obtained during routine follow-ups at 1 week, 3 to 6 months, and 1 year after surgery. The Likert scale was used to investigate patients' postoperative satisfaction rate. Favorable outcomes were achieved in all patients. The mean difference between eyeball proptosis was reduced from 3.6 mm before surgery to 1.6, 0.6, and 0.3 mm after the surgery at 1 week, 3 to 6 months, and 1 year, respectively. No complications, such as facial and/or optic nerve injury, recurrence, and malignant degeneration, were noted. This study demonstrated that surgical treatment of craniofacial bone lesions involving the orbit achieved acceptable results shortly after the surgery, and more prominently, starting from 3 to 6 months.

Literature Review to Optimize the Autologous Fat Transplantation Procedure and Recent Technologies to Improve Graft Viability and Overall Outcome: A Systematic and Retrospective Analytic Approach.

OBJECTIVE: Investigation and evaluation of the current methods and steps of autologous fat transplantation to optimize the viability of fat grafts and procedure outcome in quest of a more standardized protocol. METHODS: A thorough literature search was performed across the CNKI, Wan Fang, PubMed, Ovid and EMBASE databases from the year 1970 to December 2014, collecting and classifying all of the autologous fat transplantation-related reports and articles, and after screening, a critical retrospective analysis was performed on the included data. RESULTS: A total of 65 articles were included in the study. However, there were limited numbers of cases dealing with procedure-related steps such as the selection of donor sites, fat acquisition, graft treatment and methodology of transplant, resulting in a significant lack of evidence support, furthermore urging the need for more standardized protocol for the steps of autologous fat transplant to improve graft viability and overall outcome while decreasing procedure-related morbidity. CONCLUSION: No good evidence was obtained to optimize the donor site, acquisition, processing and transplantation steps of the whole process of autologous fat transplantation. Tissue engineering and stem cell research have the potential to revolutionize the future of reconstructive surgery by replacing tissue, obviating the need for donor site morbidity. However, the use of stem cell therapies to expand and grow tissue for reconstruction must occur in the context of risk management. Balancing ease of harvest with yield and efficacy has been a delicate and often difficult trade-off which has prompted the scientific community to investigate alternative sources. However, there is much hope in the evaluation and implementation of multimodality approaches for autologous fat transplant, including thriving technologies such as ultrasound-assisted, water jet-assisted, nanotechnology-assisted liposuction in combination with revolutionary fat treatment technologies such as the VASER system. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Advancing and Lengthening Genioplasty in Contouring of the Receding and Short Chin.

BACKGROUND: In East Asia, receding and short chin are common complaints of patients who do not have satisfied lower face. In most former studies, receding and short chin are considered and treated separately. But during the clinical work, the authors found that, in many patients, neither vertical elongation nor horizontal advancement of the chin is sufficient to achieve a harmonious result. In regards of this problem, the authors performed an advancing and lengthening genioplasty and the results were aesthetically satisfactory. STUDY DESIGN: Twenty-six patients with receding and short chin were involved in this study. After presurgical computed tomography (CT) scan, advancing and lengthening genioplasty with/without other osteotomy operations were performed on all the patients. All patients underwent postoperative CT scan and had at least 3-month follow-up. RESULT: All patients were satisfied with the final results. According to the postoperative CT images and 3-month follow-up, no severe complications occurred. CONCLUSION: For patients with receding and short chin, advancing and lengthening genioplasty is a reliable therapy to obtain harmonious East Asian lower face.

Bone morphogenetic protein is required for fibroblast growth factor 2-dependent later-stage osteoblastic differentiation in cranial suture cells.

BACKGROUND: Understanding the pathophysiological process of calvarial bones development is important for the treatments on relative diseases such as craniosynostosis. While, the role of fibroblast growth factor (FGF) and bone morphogenetic protein (BMP) and how they interacted in osteoblast differentiation remain unclear. METHODS: we digested bone fragments around the coronal and sagittal sutures from newborn rats to harvest suture cells. Markers expression at different osteoblast differentiation stage was analyzed by increasing FGF2 concentration and BMP2 blocking in these cells. RESULTS: BMP2 expression could be stimulated by FGF2 in a dose and time dependent manner. FGF2 stimulation may decrease early marker of osteoblast differentiation (collagen type-1, COL-1) and increase the expression of continuously-expressed or late markers (alkaline phosphatase, ALP; osteocalcin, OC and bone sialoprotein, BSP) to accelerate mineralization. Inhibition of BMP2 signaling by Noggin weakens the effect of FGF2 on induction of later-stage osteoblastic differentiation of cranial suture cells. CONCLUSION: Our data suggest that BMP2 signaling is required for FGF2-dependent induction of later-stage of cranial suture cell osteoblastic differentiation.

Combined use of rapid-prototyping model and surgical guide in correction of mandibular asymmetry malformation patients with normal occlusal relationship.

OBJECTIVE: The aim of this study is to discuss the application of rapid-prototyping model and surgical guide in the treatment of mandibular asymmetry malformation with normal occlusal relationship. STUDY DESIGN: Twenty-four mandibular asymmetry malformation patients with relatively normal occlusal relationship were included in this study. Surgical 3-dimensional rapid-prototyping mandibular models were made for all patients from the computed tomography (CT) DICOM data. The presurgical plan was designed on the model, and the surgical guiders for the osteotomy lines were manufactured. Genioplasty and/or mandibular osteotomy based on the presurgical plan were performed on these patients with the combined use of the rapid-prototyping model and surgical guides. All patients underwent postoperative CT scan and had at least 3-month follow-up. RESULT: All patients were satisfied with the final results. According to the postoperative CT images and 3-month follow-up, all patients' mandibular asymmetry malformation was significantly improved, and the operation time was distinctly shortened relative to the conventional method. CONCLUSION: Rapid-prototyping model and surgical guide are viable auxiliary devices for the treatment of mandibular asymmetry malformation with relatively normal occlusal relationship. Combined use of them can make precise preoperative design, improve effects of operation, and shorten operating time.