Oral Maxillofac Surg Clin North Am
· 2024 Aug · PMID 38724422
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Benign and malignant salivary gland disorders are uncommon in the pediatric population; however, these can be frequently seen in pediatric otolaryngology or oral and maxillofacial surgery practices. The astute clinician...Benign and malignant salivary gland disorders are uncommon in the pediatric population; however, these can be frequently seen in pediatric otolaryngology or oral and maxillofacial surgery practices. The astute clinician should be aware of the clinical presentation, diagnosis, and management options for common inflammatory, infectious, benign, and malignant disorders of salivary glands.
Linkugel AD, Markiewicz MR, Edwards S
… +1 more, Susarla SM
Oral Maxillofac Surg Clin North Am
· 2024 Aug · PMID 38705817
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Pediatric craniomaxillofacial reconstruction must be approached through the lens of growth and durability. A systematic approach of matching defects to donor tissue drives the selection of autologous reconstructive techn...Pediatric craniomaxillofacial reconstruction must be approached through the lens of growth and durability. A systematic approach of matching defects to donor tissue drives the selection of autologous reconstructive technique. The menu of available methods for reconstruction can be organized in a manner similar to adults, with special considerations for growth and development. Reconstructive surgeons have the opprtunity to promote and maintain young patients' sense of identity during psychosocial development.
Oral Maxillofac Surg Clin North Am
· 2024 Aug · PMID 38705816
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Craniofacial fibro-osseous lesions represent a diverse spectrum of pathologic conditions where fibrous tissue replaces healthy bone, resulting in the formation of irregular, woven bone. They are more commonly diagnosed i...Craniofacial fibro-osseous lesions represent a diverse spectrum of pathologic conditions where fibrous tissue replaces healthy bone, resulting in the formation of irregular, woven bone. They are more commonly diagnosed in young people, with treatment strategies dependent on clinical behavior and skeletal maturity. This article discusses the examples of craniofacial fibro-osseous lesions, based on the latest classifications, along with their diagnostic criteria and management.
Oral Maxillofac Surg Clin North Am
· 2024 Aug · PMID 38632013
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Craniomaxillofacial vascular anomalies encompass a diverse and complex set of pathologies that may have a profound impact on pediatric patients. They are subdivided into vascular tumors and vascular malformations dependi...Craniomaxillofacial vascular anomalies encompass a diverse and complex set of pathologies that may have a profound impact on pediatric patients. They are subdivided into vascular tumors and vascular malformations depending on biological properties, clinical course, and distribution patterns. Given the complexity and potential for leading to significant functional morbidity and esthetic concerns, a multidisciplinary approach is generally necessary to optimize patient outcomes. This article reviews the etiology, clinical course, diagnosis, and current management practices related to vascular anomalies in the head and neck.
Oral Maxillofac Surg Clin North Am
· 2024 Aug · PMID 38522979
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Pediatric orbital and skull base pathologies encompass a spectrum of inflammatory, sporadic, syndromic, and neoplastic processes that require a broad and complex clinical approach for both medical and surgical treatment....Pediatric orbital and skull base pathologies encompass a spectrum of inflammatory, sporadic, syndromic, and neoplastic processes that require a broad and complex clinical approach for both medical and surgical treatment. Given their complexity and often multicompartment involvement, a multidisciplinary approach for diagnosis, patient and family counseling, and ultimately treatment provides the best patient satisfaction and clinical outcomes. Advances in minimally invasive surgical approaches, including endoscopic endonasal and transorbital approaches allows for more targeted surgical approaches through smaller corridors beyond more classic transcranial or transracial approaches.
Oral Maxillofac Surg Clin North Am
· 2024 Aug · PMID 38462396
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Pediatric odontogenic cysts and tumors are rare and often associated with developing or impacted teeth. Odontogenic cysts are broadly categorized as inflammatory or developmental while odontogenic tumors are classified h...Pediatric odontogenic cysts and tumors are rare and often associated with developing or impacted teeth. Odontogenic cysts are broadly categorized as inflammatory or developmental while odontogenic tumors are classified histologically as epithelial, mesenchymal, or mixed tumors. This article will discuss the presentation, diagnosis, and treatment of odontogenic cysts and tumors in the pediatric population.
Oral Maxillofac Surg Clin North Am
· 2024 Aug · PMID 38462395
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Pediatric temporomandibular joint (TMJ) disorders represent a broad range of congenital and acquired diagnoses. Dentofacial deformities, including facial asymmetry, retrognathism, and malocclusion, commonly develop. Comp...Pediatric temporomandibular joint (TMJ) disorders represent a broad range of congenital and acquired diagnoses. Dentofacial deformities, including facial asymmetry, retrognathism, and malocclusion, commonly develop. Compared with adult TMJ conditions, pain and articular disc pathology are less common. Accurate diagnosis is paramount in planning and prognostication. Several specific considerations apply in preparation for skeletal correction, including timing in relation to disease progression and growth trajectory, expectation for postcorrection stability, reconstructive technique as it applies to expected durability and need for future revision, management of occlusion, and need for ancillary procedures to optimize correction. This article reviews common conditions and treatment considerations.
Akhavan AA, Pang JH, Morrison SD
… +1 more, Satterwhite T
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38458858
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For some patients, feminine facial features may cause significant gender dysphoria. Multiple nonsurgical and surgical techniques exist to masculinize facial features. Nonsurgical techniques include testosterone supplemen...For some patients, feminine facial features may cause significant gender dysphoria. Multiple nonsurgical and surgical techniques exist to masculinize facial features. Nonsurgical techniques include testosterone supplementation and dermal fillers. Surgical techniques include soft tissue manipulation, synthetic implants, regenerative scaffolding, or bony reconstruction. Many techniques are derived from experience with cisgender patients, but are adapted with special considerations to differing anatomy between cisgender and transgender men and women. Currently, facial masculinization is less commonly sought than feminization, but demand is likely to increase as techniques are refined and made available.
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38402141
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Facial feminization surgery (FFS) is a crucial intervention for transgender women. This article delves into comprehensive reconstruction of the upper third of the face, discussing anatomic differences between masculine a...Facial feminization surgery (FFS) is a crucial intervention for transgender women. This article delves into comprehensive reconstruction of the upper third of the face, discussing anatomic differences between masculine and feminine features, and surgical considerations. Technical considerations, preoperative planning, procedural approaches, and postoperative care are described in detail. Patient-centered operative planning and execution ensure safety and efficacy in FFS and uphold its transformative effect on quality of life in appropriately selected surgical candidates.
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38402140
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Facial feminization is a complex undertaking requiring skill in both craniofacial and aesthetic plastic surgery. As in aesthetic procedures, understanding the patient's goals and setting realistic expectations in light o...Facial feminization is a complex undertaking requiring skill in both craniofacial and aesthetic plastic surgery. As in aesthetic procedures, understanding the patient's goals and setting realistic expectations in light of an individual's anatomy is critical. Both soft tissue and bone must be addressed to adequately soften masculine facial features. This article delves into specific anatomic areas and delineates some of the pathways to successful outcomes.
Oral Maxillofac Surg Clin North Am
· 2024 Aug · PMID 38402139
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This article provides a comprehensive overview of benign non-odontogenic pathologies. Bone-derived lesions like osteoma, osteoid osteoma, osteoblastoma, and osteochondroma are discussed in detail, emphasizing their radio...This article provides a comprehensive overview of benign non-odontogenic pathologies. Bone-derived lesions like osteoma, osteoid osteoma, osteoblastoma, and osteochondroma are discussed in detail, emphasizing their radiographic features, locations, and treatment strategies. Cartilage-derived lesions such as chondroma, chondroblastoma, and chondromyxoid fibroma are also examined, noting their typical presentation and management approaches. The article then delves into fibroconnective tissue lesions. Mesenchymal and vascular lesions are detailed regarding their clinical and radiographic characteristics and treatment options. Lastly, nerve-derived lesions like schwannoma and neurofibroma are covered, providing insights into their association with diseases like neurofibromatosis and preferred management strategies.
Oral Maxillofac Surg Clin North Am
· 2024 Aug · PMID 38395668
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Benign intraoral soft tissue pathology in pediatric patients includes developmental, traumatic, inflammatory, and infectious lesions. Common pathology includes gingival cysts, mucoceles, fibromas, and parulis. Less commo...Benign intraoral soft tissue pathology in pediatric patients includes developmental, traumatic, inflammatory, and infectious lesions. Common pathology includes gingival cysts, mucoceles, fibromas, and parulis. Less common lesions include peripheral ossifying fibromas, congenital epulis of the newborn, and congenital mandibular duct atresia. Most of these lesions present at painless masses but can have significant effects on children and their caregivers. Although these lesions are generally harmless, evaluation and treatment is necessary for appropriate management and health of the child.
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38360459
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Facial feminization surgery (FFS) as applied to the midfacial region targets modifications to the nasal and malar esthetic complexes. Although a global assessment is paramount in achieving desired functional results, mos...Facial feminization surgery (FFS) as applied to the midfacial region targets modifications to the nasal and malar esthetic complexes. Although a global assessment is paramount in achieving desired functional results, most patients benefit from malar feminization in the form of bony and soft tissue augmentation, and nasal feminization in the form of reductive rhinoplasty. For patients with signs of aging, additional interventions in the form of rhytidectomy are powerful adjuncts to feminization. As with FFS techniques directed toward the upper and lower thirds, the overarching goal is to obtain complementary outcomes that enhance facial harmony and beauty.
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38310029
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Virtual surgical planning enables precise surgical planning and translation of this planning into the operating room. Preoperative maxillofacial computed tomography scans are compared to a reference skull to identify des...Virtual surgical planning enables precise surgical planning and translation of this planning into the operating room. Preoperative maxillofacial computed tomography scans are compared to a reference skull to identify desired surgical changes. In facial feminization surgery, these include forehead recontouring/frontal table setback, gonial angle reduction, and possible chin repositioning/reshaping, while in facial masculinization surgery, this includes forehead augmentation and gonial angle/chin augmentation. Cutting and recontouring guides as well as custom implants are then custom manufactured. Common guides include osteotomy guides, depth drilling guides, ostectomy guides, and guides for one/two-piece genioplasty or chin burring. Common implants include mandibular and chin implants.
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38281895
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This article provides context on the experiences and medical care of individuals who experience gender dysphoria for the benefit of oral and maxillofacial surgeons. The mechanism of action, effects, and side effects of m...This article provides context on the experiences and medical care of individuals who experience gender dysphoria for the benefit of oral and maxillofacial surgeons. The mechanism of action, effects, and side effects of medical therapies used for gender-affirming care are reviewed. Specific guidance for anesthetic care is given. Trauma-informed tools for care of transgender and gender-diverse patients are offered.
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38272781
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This article is intended to give the reader an overview of facial gender-affirming procedures applicable to the lower face and neck. A review of facial analysis in the context of masculine versus feminine facial features...This article is intended to give the reader an overview of facial gender-affirming procedures applicable to the lower face and neck. A review of facial analysis in the context of masculine versus feminine facial features and the contributions of both soft tissue and bone to this anatomy is provided. The use of systematic facial evaluation and patient-driven concerns as a guide for presurgical planning is reviewed. Detailed descriptions of the unique surgical interventions to feminize the soft tissues and the skeletal framework of the lower face and neck are provided.
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38216350
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In the United States, approximately 1.6 million individuals identify as transgender and gender diverse (TGD), encompassing a wide range of identities and experiences. Despite progress in visibility and acceptance, TGD pe...In the United States, approximately 1.6 million individuals identify as transgender and gender diverse (TGD), encompassing a wide range of identities and experiences. Despite progress in visibility and acceptance, TGD people continue to face health care and societal disparities, especially affecting racial minorities. Although legal advancements have been achieved, the key to addressing these persistent health care disparities lies in implementing comprehensive and culturally sensitive health care practices and supportive policies. With a growing number of TGD people seeking gender-affirming care, it is imperative that health care practitioners understand the unique challenges faced by this community and provide tailored services with sensitivity and expertise.
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38199931
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Transgender and gender diverse (TGD) patients may present to a surgical context with complex mental health challenges, many of which stem from external stressors. TGD patients also may face disparities regarding the acce...Transgender and gender diverse (TGD) patients may present to a surgical context with complex mental health challenges, many of which stem from external stressors. TGD patients also may face disparities regarding the accessibility and quality of health care experiences, which also erodes the mental health of patients. Providers who offer gender-affirming surgery need to be aware of the context that patients may arrive in and install practices that can address the needs of TGD patients.
Oral Maxillofac Surg Clin North Am
· 2024 May · PMID 38184479
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Transgender and gender-diverse patients face complex, multifactorial barriers to medically necessary gender-affirming care. Insurance coverage for facial feminizing and masculinizing surgeries is one such obstacle. Provi...Transgender and gender-diverse patients face complex, multifactorial barriers to medically necessary gender-affirming care. Insurance coverage for facial feminizing and masculinizing surgeries is one such obstacle. Providers and affiliated team members must have a comprehensive understanding of clinical standards of care, medical documentation, insurance policy and terminology, and related legislation to successfully navigate this administrative quagmire and ensure patient access to care..