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Asymmetric distraction with different expansions of left and right maxillary parts is a serious complication of surgically assisted rapid maxillary expansion. An individual, highly standardized surgical intervention based on three-dimensional finite element analysis (FEA) is a new method to improve the quality of therapy. We describe a fundamental simulation-based workflow for preoperative evaluation of the osteotomies in a pilot study to achieve symmetry. A CT scan of the skull was used for analysis. Many feasible osteotomy configurations were generated and optimized using Latin hypercube sampling method and FEA choosing an individual osteotomy and maxillary movement. We successfully applied this workflow to 14 patients with symmetrical distraction. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess the outcomes of free dermal fat graft (FDFG) reconstruction following parotidectomy, evaluating both clinical complications and patient satisfaction with the procedure., Methods: We conducted a systematic review and meta-analysis according to PRISMA guidelines, searching MEDLINE (via PubMed), Scopus, and the Cochrane Library for studies reporting on FDFG outcomes post-parotidectomy. Eligible studies included single-arm studies with data on recipient and donor site complications as well as patient satisfaction. Pooled complication rates were analyzed using a random-effects model to account for study heterogeneity., Results: A total of 20 studies, representing 922 reconstructions in 919 patients, were included in the analysis. The overall rates of recipient site complications were low, with hematoma observed in 1.31% (95% CI: 0.50-3.34) and infection in 1.84% (95% CI: 0.95-3.53) of cases. The incidence of Frey's syndrome was 1.95% (95% CI: 0.74-5.02), and fat necrosis was noted in 1.74% (95% CI: 0.57-5.23) of patients. Donor site complications were minimal, with hematoma, infection, and seroma rates each below 1%. While there was high variability in satisfaction measures, results indicated favorable patient satisfaction with FDFG outcomes., Conclusion: FDFG reconstruction following parotidectomy is a safe and effective method for correcting contour deformities, showing minimal complications and high patient satisfaction. The low incidence of complications, including Frey's syndrome, underscores FDFG as a viable option for facial contour restoration in parotid surgery, providing favorable aesthetic and functional outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no competing interest., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

A multidisciplinary committee developed evidence-based guidelines for the management of cystic fibrosis transmembrane conductance regulator-related metabolic syndrome/cystic fibrosis screen-positive, inconclusive diagnosis (CRMS/CFSPID). A total of 24 patient, intervention, comparison, and outcome questions were generated based on surveys sent to people with CRMS/CFSPID and clinicians caring for these individuals, previous recommendations, and expert committee input. Four a priori working groups (genetic testing, monitoring, treatment, and psychosocial/communication issues) were used to provide structure to the committee. A systematic review of the evidence was conducted, and found numerous case series and cohort studies, but no randomized clinical trials. A total of 30 recommendations were graded using the US Preventive Services Task Force methodology. Recommendations that received ≥80% consensus among the entire committee were approved. The resulting recommendations were of moderate to low certainty for the majority of the statements because of the low quality of the evidence. Highlights of the recommendations include thorough evaluation with genetic sequencing, deletion/duplication analysis if <2 disease-causing variants were noted in newborn screening; repeat sweat testing until at least age 8 but limiting further laboratory testing, including microbiology, radiology, and pulmonary function testing; minimal use of medications, which when suggested, should lead to shared decision-making with families; and providing communication with emphasis on social determinants of health and shared decision-making to minimize barriers which may affect processing and understanding of this complex designation. Future research will be needed regarding medication use, antibiotic therapy, and the use of chest imaging for monitoring the development of lung disease.

As of December 2009, cystic fibrosis (CF) newborn screening (NBS) is performed in all 50 US states and the District of Columbia. Widespread implementation of CF newborn screening (CFNBS) in the US and internationally has brought about new and varied challenges. Immunoreactive trypsinogen (IRT) remains the first, albeit imperfect, biomarker used universally in the screening process. Advances in genetic testing have provided an opportunity for newborn screening programs to add CFTR sequencing tiers to their algorithms. This in turn will enable earlier identification of babies with CF and improve longer-term outcomes through prompt treatment and intervention. CFTR sequencing has led to the ability to identify infants with CF from diverse ethnic and racial backgrounds more equitably while also identifying an increasing proportion of infants with inconclusive diagnoses. Using the evolution of the New York State CF newborn screening program as a guide, this review outlines the basic steps in a universal CF newborn screening program, considers how to reduce bias, highlights challenges, offers guidance to address these challenges and provides recommendations for future consideration.

Introduction: This study analyses the treatment of isolated mandibular fractures between 1.1.2015 and 21.31.2017 at Dortmund General Hospital., Materials and Methods: Patient documentation and radiological images have been assessed, and a descriptive statistical analysis has been performed., Results: Three hundred and twenty-eight patients were identified with isolated mandibular fractures (259 male, 69 female). The male-to-female ratio is 3.75: 1. A total of 541 fracture sites have been identified (1.65 fractures/patient). Forty of these were observed in the dentoalveolar region (fracture of the alveolar process, dental injuries), and the other 501 injuries were distributed in the remaining parts of the lower jaw.A detailed analysis of the osteosynthesis implants is provided. A total of 20 serious complications were observed (6% in all primary cases, 4.5% without osseointegrated implants)., Discussion: The demographic data and the anatomical distribution of the fracture sites are comparable with international literature. Dentoalveolar injuries mostly occur in younger patients. The complication rate in this study (4.5%) is below the international data; however, we found a considerably higher rate than in the midfacial region (central midface: 0%, lateral midface: 1.43%). Despite this complication rate, the procedure can be considered safe., Supplementary Information: The online version of this article (10.1007/s12663-021-01513-4)., (© The Association of Oral and Maxillofacial Surgeons of India 2021.)

Background: People with cystic fibrosis (pwCF) may be at risk of complications from COVID-19 but the impact of COVID-19 on pwCF remains unknown., Methods: We conducted a multicenter retrospective cohort study to assess the impact of the COVID-19 pandemic first wave on pwCF in the New York metropolitan area (NY) from March 1, 2020 to August 31, 2020. Objectives were to determine (1) the prevalence of COVID-19 by PCR and IgG antibody testing, (2) the clinical characteristics of COVID-19, (3) delay in routine outpatient care, and (4) the effect on anxiety and depression in pwCF., Results: There were 26 COVID-19 cases diagnosed by PCR or antibody testing among the study cohort of 810 pwCF. The prevalence of COVID-19 by PCR (1.6%) and IgG antibody (12.2%) testing was low. 58% of cases were asymptomatic and 82% were managed at home. 8% were hospitalized and 1 person died. 89% of pwCF experienced delay in care. The prevalence of anxiety increased from 43% baseline to 58% during the pandemic (P<0.01). In post-hoc analysis, the proportion of patients with diabetes (38% versus 16%, P<0.01) and pancreatic insufficiency (96% versus 66%, P<0.01) were higher while CFTR modulator use was lower (46% versus 65%, P = 0.05) in pwCF who tested positive for COVID-19., Conclusions: The prevalence of COVID-19 among pwCF in NY during the pandemic first wave was low and most cases were managed at home. CFTR modulators may be protective. PwCF experienced delay in routine care and increased anxiety., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest., (Copyright © 2022 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.)

Purpose: A post-operative cooling method in oral and maxillofacial surgery is the cooling with hilotherapy. The aim of this study was the post-operative comparison of cooling temperatures of 18°C and 22°C. The parameters of this trial were swelling and the post-operative pain levels., Methods: This study included 156 patients, divided into two groups among whom a mono-one, bignathic osteotomy or genioplasty was indicated. The post-operative assessment of swelling was performed using a 3D optical scanner. This examination was repeated on post-operative days 1, 2, 3, 7, 14, 30, and 90. The examination on day 90 served as a reference value in respect of swelling and pain., Results: Group 1 (18°C, 78 patients) showed an increase in post-operative swelling on the 1 st post-OP day of 52.06 ± 35.41ml. The maximum was reached on the 2 nd post-OP day with 75.82 ± 38.97ml. On the 30 th post-OP day, residual swelling measured 11.60 ± 12.62ml. Group 2 (22 °C, 78 patients) showed an increase in postoperative swelling on the 1 st post-OP day of 76.07 ± 63.15ml. The maximum was reached on the 2 nd post-OP day with 106.97 ± 69.63 ml. On the 30 th post-OP day, residual swelling measured 14.36 ± 32.26ml. The differences between the two groups and between different visits were statistically significant., Conclusion: The study results indicate less residual swelling in group 1 on the 30 th post-OP day, possible based on the lower cooling temperature. The post-operative pain exhibits a comparable level of pain intensity between the two groups. In overall terms, a subjectively more agreeable treatment was observed in group 1., (© 2021. The Author(s).)