Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37981345
·
Publisher ↗
Vascular anomalies of the head and neck frequently involve the upper aerodigestive tract and can cause some level of airway obstruction. It is important to fully evaluate the extent of a lesion and resultant functional i...Vascular anomalies of the head and neck frequently involve the upper aerodigestive tract and can cause some level of airway obstruction. It is important to fully evaluate the extent of a lesion and resultant functional impairment with a flexible fiberoptic laryngoscopy. Treating these lesions is difficult and considering how to manage the airway during a procedure is critical. A multidisciplinary approach should be used for airway management with alternative intubation plans established prior to induction of anesthesia. Edema and hemorrhage are expected complications from the treatment of vascular anomalies and should be considered when planning for extubation at the end of a procedure.
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37981344
·
Publisher ↗
The majority of the vascular anomalies are seen in the head and neck region. Even though the incidence of this anomaly could be construed as a rare disease entity, with only 5% of overall affliction, the lack of knowledg...The majority of the vascular anomalies are seen in the head and neck region. Even though the incidence of this anomaly could be construed as a rare disease entity, with only 5% of overall affliction, the lack of knowledgeable management has disfigured many. A comprehensive understanding of this benign yet complex life-changing entity is essential. A historical perspective, pathophysiology-logical evolution, and the current knowledge of management modalities are essential for rendering clinical care in this subspecialty care. We propose a very succint Head and Neck Surgical classification for vascular anamolies, which has been a good guide for surgical approaches.
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37981343
·
Publisher ↗
Discovery of inherited and somatic genetic mutations, along with advancements in clinical and scientific research, has improved understanding of vascular anomalies and changed the treatment paradigm. With aim of minimizi...Discovery of inherited and somatic genetic mutations, along with advancements in clinical and scientific research, has improved understanding of vascular anomalies and changed the treatment paradigm. With aim of minimizing need for invasive procedures and improving disease outcomes, molecularly targeted medications and anti-angiogenesis agents have become important as both adjuncts to surgery, and increasingly, as the primary treatment of vascular anomalies. This article highlights the commonly used and emerging therapeutic medications for non-malignant vascular tumors and vascular malformations in addition to medical management of associated hematologic abnormalities.
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37903662
·
Publisher ↗
Osseous vascular anomalies can be characterized as vascular tumors or malformations. Classification is vital for prognosis and treatment. Much remains unknown about conditions such as Gorham-Stout disease. Treatments tar...Osseous vascular anomalies can be characterized as vascular tumors or malformations. Classification is vital for prognosis and treatment. Much remains unknown about conditions such as Gorham-Stout disease. Treatments target the proposed genetic pathways such as PI3KCA/AKT/mTOR pathway.
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37875385
·
Publisher ↗
Vascular anomalies, broadly classified as nonmalignant tumors and malformations, consist of a multitude of disorders that have a wide range of symptoms and complications as well as overlapping clinical, radiologic, and h...Vascular anomalies, broadly classified as nonmalignant tumors and malformations, consist of a multitude of disorders that have a wide range of symptoms and complications as well as overlapping clinical, radiologic, and histologic findings. Although usually difficult, distinguishing between nonmalignant vascular tumors and malformations, as well as the precise diagnosis within these distinctions, is critical because prognosis, therapy, and chronicity of care vary greatly. In contrast to normal endothelial turnover in vascular malformations, vascular tumors are characterized by the abnormal proliferation of endothelial cells and aberrant blood vessels.
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37872048
·
Publisher ↗
The discovery of inherited and somatic genetic mutations, along with advancements in clinical and scientific research, has improved the understanding of vascular anomalies and changed the treatment paradigm. With the aim...The discovery of inherited and somatic genetic mutations, along with advancements in clinical and scientific research, has improved the understanding of vascular anomalies and changed the treatment paradigm. With the aim of minimizing the need for invasive procedures and improving disease outcomes, molecularly targeted medications and anti-angiogenesis agents have become important as both adjuncts to surgery, and increasingly, as the primary treatment of vascular anomalies. This article highlights the commonly used and emerging therapeutic medications for nonmalignant vascular tumors and vascular malformations.
Woodis KM, Garlisi Torales LD, Wolf A
… +2 more, Britt A, Sheppard SE
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37867039
·
Full text
Vascular anomalies include benign or malignant tumors or benign malformations of the arteries, veins, capillaries, or lymphatic vasculature. The genetic etiology of the lesion is essential to define the lesion and can he...Vascular anomalies include benign or malignant tumors or benign malformations of the arteries, veins, capillaries, or lymphatic vasculature. The genetic etiology of the lesion is essential to define the lesion and can help navigate choice of therapy. . In the United States, about 1.2% of the population has a vascular anomaly, which may be underestimating the true prevalence as genetic testing for these conditions continues to evolve.
Vidaurri de la Cruz H, Valderrama FV, Chambergo RB
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37845106
·
Publisher ↗
Vascular anomalies (VAs) can be present in any organ; however, the skin being the largest one, it is there where many of them are evident; some are visible at birth, others develop throughout life. Pediatric dermatologis...Vascular anomalies (VAs) can be present in any organ; however, the skin being the largest one, it is there where many of them are evident; some are visible at birth, others develop throughout life. Pediatric dermatologists are specially trained to distinguish VAs from their mimickers, which require different treatments and may harbor distinct prognoses. We resume the diagnostic and therapeutic tasks of pediatric dermatologist at our vascular anomaly clinics, as well as the differential diagnoses of mimickers of VAs.
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37821289
·
Publisher ↗
There continuous to be widespread misuse of nomenclature used to described vascular anomalies, This is even more pronounced in the case of intra-osseous lesions. Bone involvement is more common with vascular malformation...There continuous to be widespread misuse of nomenclature used to described vascular anomalies, This is even more pronounced in the case of intra-osseous lesions. Bone involvement is more common with vascular malformations and extremely rare in haemangiomas. An accurate diagnosis is mandatory for tailored management and often based on a thorough history, clinical examination, and cross-sectional imaging. Surgery remains the main stay for the management of symptomatic venous malformations. Embolisation with or without surgery is the main stay for arteriovenous malformations. Virtual surgical planning, with surgical guides and patient specific implants help achieve predictably excellent results.
Rattan R, Mezghani N, Kaleem A
… +1 more, Melville JC
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37813707
·
Publisher ↗
Head and neck vascular pathology is routinely encountered by the maxillofacial surgeon. Although these anomalies have been traditionally managed by surgical means, adjunctive therapies have been popularized in recent yea...Head and neck vascular pathology is routinely encountered by the maxillofacial surgeon. Although these anomalies have been traditionally managed by surgical means, adjunctive therapies have been popularized in recent years. The use of laser therapy has gained attention for its ability to better access and to provide more predictable outcomes in the highly intricate and vascular areas of the head and neck. Laser therapy allows for the selective targeting of diseased tissue while maintaining the integrity of surrounding healthy tissue.
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37806906
·
Publisher ↗
Interventional approaches to head and neck vascular anomalies have evolved with our understanding of disease pathologic condition and advances in medical and surgical treatment. Embolization's role in the disease managem...Interventional approaches to head and neck vascular anomalies have evolved with our understanding of disease pathologic condition and advances in medical and surgical treatment. Embolization's role in the disease management ranges from stand-alone treatment with curative intent to adjunctive or even palliative, depending on the lesion. This decision is best made through multidisciplinary collaboration among surgeons, interventionalists, and medical specialists. Finally, setting realistic expectations with the patient and family is a crucial step preceding any intervention. This article elaborates on the considerations influencing a given treatment plan and specific interventional strategy.
Oral Maxillofac Surg Clin North Am
· 2024 Feb · PMID 37777468
·
Publisher ↗
The treatment of hemangiomas and vascular malformations should be individualized, based upon the size of the lesion(s), morphology, location, presence or possibility of complications, the potential for scarring or disfig...The treatment of hemangiomas and vascular malformations should be individualized, based upon the size of the lesion(s), morphology, location, presence or possibility of complications, the potential for scarring or disfigurement, the age of the patient, and the rate of growth or involution at the time of evaluation. The major challenge is the location in a head and neck can lead to unsightly scars if approached improperly, or with inadequate approaches can lead to intraoperative and postoperative morbidity with neurovascular damage and inadequate lesion excision. Facial, trigeminal, and other cranial nerve branches are of key importance in the functional outcome while accessing and approaching head and neck vascular lesions.
Oral Maxillofac Surg Clin North Am
· 2023 Nov · PMID 37640587
·
Publisher ↗
Dental and dentoalveolar injuries are common in the pediatric population. Management is predicated on the type of tooth injured (primary or permanent), extent of injury, the dental and behavioral age of the patient, and...Dental and dentoalveolar injuries are common in the pediatric population. Management is predicated on the type of tooth injured (primary or permanent), extent of injury, the dental and behavioral age of the patient, and ability of the patient to tolerate treatment. Although many dental injuries occur in isolation, a systematic evaluation of the patient is mandatory to confirm the absence of basal bone fractures of the maxilla or mandible, traumatic brain injury, cervical spine injury, and/or facial soft tissue injury. Long-term follow-up is paramount to achieving a functional occlusion and optimal dental health following injury.
Oral Maxillofac Surg Clin North Am
· 2023 Nov · PMID 37625944
·
Publisher ↗
Trauma is a leading cause of morbidity and mortality for children in the United States. Access to trauma care, injury burden, and outcomes following injury, are inequitable. There are many anatomic and physiologic differ...Trauma is a leading cause of morbidity and mortality for children in the United States. Access to trauma care, injury burden, and outcomes following injury, are inequitable. There are many anatomic and physiologic differences between children and adults that affect injury patterns and necessary trauma treatment. The principles of advanced trauma life support (ATLS) should be used by clinicians in high-resource settings for the immediate in-hospital treatment of the injured child.
Oral Maxillofac Surg Clin North Am
· 2023 Nov · PMID 37567828
·
Publisher ↗
Airway injury, Ocular injury and neurovascular tissue damage, burns is all a spectrum of pediatric soft tissue injury complex. Soft tissue injuries to the head and neck area in children are challenging to manage, because...Airway injury, Ocular injury and neurovascular tissue damage, burns is all a spectrum of pediatric soft tissue injury complex. Soft tissue injuries to the head and neck area in children are challenging to manage, because these injuries significantly affect the child's overall health and development. Management of such injuries requires a multidisciplinary approach involving surgical and nonsurgical interventions and close collaboration among health care professionals, parents, and caregivers. This article reviews the various causes of injuries, specific considerations for each region of the head and neck, and approaches to the surgical management of soft tissue injuries in pediatric patients, including surgical and adjuvant therapies. Specific anatomic regions reviewed include the scalp/forehead, periorbital region, nose, cheeks, lips, ears, and neck/airway.Laceration repair in the growing pediatric populations may require revisions in the future. Facial soft tissue injuries are prone to poor cosmesis as in many occasions as may be constrained by available surgical specialists, thus proper multispecialty team approach along with surgical alignment and symmetry should be considered comprehensively.
Oral Maxillofac Surg Clin North Am
· 2023 Nov · PMID 37537081
·
Publisher ↗
Pediatric facial fractures are uncommon, and fortunately, the majority can be managed with conservative measures. Rigid fixation of the pediatric facial skeleton can potentially be associated with delayed hardware issues...Pediatric facial fractures are uncommon, and fortunately, the majority can be managed with conservative measures. Rigid fixation of the pediatric facial skeleton can potentially be associated with delayed hardware issues and growth inhibition. When appropriate, resorbable fixation is most commonly used for this purpose. Titanium plates and screws are advantageous when rigid fixation is a priority because properly placed hardware that respects natural suture lines is not thought to significantly inhibit growth. Furthermore, titanium fixation may be removed following healing.
Oral Maxillofac Surg Clin North Am
· 2023 Nov · PMID 37517978
·
Publisher ↗
The management of pediatric facial fractures requires several considerations by the treating surgeon. Pediatric facial fractures occur less commonly than in adults. Among fracture patterns in children, studies have repea...The management of pediatric facial fractures requires several considerations by the treating surgeon. Pediatric facial fractures occur less commonly than in adults. Among fracture patterns in children, studies have repeatedly demonstrated that mandible fractures are the most common facial fracture particularly the condyle. Most fractures in children are amenable to nonsurgical or closed treatment; however, certain indications exist for open treatment. The literature describing epidemiology, treatment trends, and long-term outcomes are limited in comparison with adult populations. The purpose of the article is to review the etiology, workup, and management of mandible fractures in children.
McAvoy M, Hopper RA, Lee A
… +2 more, Ellenbogen RG, Susarla SM
Oral Maxillofac Surg Clin North Am
· 2023 Nov · PMID 37442667
·
Publisher ↗
Cranial vault and skull base fractures in children are distinctly different from those seen in adults. Pediatric skull fractures have the benefit of greater capacity to remodel; however, the developing pediatric brain an...Cranial vault and skull base fractures in children are distinctly different from those seen in adults. Pediatric skull fractures have the benefit of greater capacity to remodel; however, the developing pediatric brain and craniofacial skeleton present unique challenges to diagnosis, natural history, and management. This article discusses the role of surgical treatment of these fractures, its indications, and techniques.