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Objective To determine whether exposure to monopolar electrosurgery during subsequent surgeries following Bonebridge implantation has negative impact on the implant. Study Design Retrospective study. Setting Tertiary medical center. Methods Fifty‐six patients who received Bonebridge implantation between December 2014 and June 2024 were reviewed. Twelve patients with exposure to monopolar electrosurgery during subsequent operation were included. Bonebridge‐aided sound field thresholds, as well as subjective outcomes based on patient experience were analyzed to determine if there are any adverse effects on the implant after monopolar electrosurgery exposure. Results The mean age at receiving Bonebridge implantation and subsequent operation were 15.1 ± 6.8 (range, 7.7‐29.9) years and 16.5 ± 6.5 (range, 10.2‐30.1) years, respectively. Each of the included patients experienced one episode of monopolar electrosurgery exposure after Bonebridge implantation. All monopolar electrosurgery exposures were in the head‐and‐neck region, but none of them involved the ipsilateral temporoparietal area. The mean pre‐monopolar electrosurgery and post‐monopolar electrosurgery Bonebridge aided sound field thresholds pure tone average were 31.8 ± 3.3 decibel hearing level and 29.5 ± 3.9 decibel hearing level, respectively (Wilcoxon signed‐rank test, P = .203). No adverse events associated with implant malfunction occurred after monopolar electrosurgery exposure. Conclusion No adverse events or hearing impairment were observed in this series of Bonebridge‐implanted patients who underwent operations involving monopolar electrosurgery. Notably, the exposures were of relatively brief duration and limited to areas outside the ipsilateral temporoparietal region. Further multicenter, prospective studies with larger cohorts and comprehensive adverse event analysis are warranted to better corroborate these findings.

Resective surgery through pterional approach is an effective treatment for drug-resistant temporal lobe epilepsy, but it may lead to temporal asymmetry in the craniofacial region. Nonetheless, recent systematic reviews showed that there is no gold standard method for the discrimination of a clinically visible abnormal temporal asymmetry from a normal fluctuating asymmetry. This study compares the ability of trained and untrained observers to detect temporal asymmetry and establishes a threshold for clinically detecting abnormal asymmetry. Standardized magnetic resonance imaging (MRI)-derived three-dimensional (3D) frontal views of adult patients who underwent temporal lobe epilepsy surgery were used to create a continuum spectrum of preoperative (  = 96) and 12-month postoperative (  = 96) craniofacial images. A panel of 32 untrained lay observers (family members and laypeople) and 32 trained clinicians (surgeons and clinical specialists) independently appraised randomly displayed 3D craniofacial soft-tissue images to assess the presence or absence of temporal asymmetry. Objective linear quantifications of temporal thickness differences were obtained from each preoperative and postoperative MRI scan to identify a potential threshold for subjective asymmetry detection. Temporal asymmetry was further categorized into severity levels I to IV based on incremental asymmetry values. The temporal thickness difference was significantly ( < 0.001) greater in postoperative images (18.3% ± 9.6%) compared to preoperative images (4.6% ± 1.9%). As temporal asymmetry increased from Level I to IV, a significantly higher proportion of 3D craniofacial images were perceived as asymmetrical by all observer categories (  < 0.001). Both trained clinicians and untrained observers-including surgeons, clinical specialists, family members, and laypeople-demonstrated increased ( < 0.001) detection rates with increasing asymmetry severity. A temporal thickness difference exceeding 10% was clinically detected with over 90% accuracy across all observer categories ( < 0.001), establishing a 10% threshold for the clinical perception of temporal asymmetry.

Background: Although the human body generally exhibits bilateral symmetry, achieving perfect symmetry is exceedingly uncommon. During preadolescent development, a face that approximates symmetry is considered both aesthetically and functionally ideal. This study aimed to investigate the relationship between craniofacial traits and hand predominance, using three-dimensional (3D) stereophotogrammetry to discern whether facial soft-tissue characteristics are correlated with hand preference. Materials and Methods: The study involved children aged 9 and 10 years who were free from any diagnosed craniofacial anomalies. Three-dimensional stereophotogrammetry was conducted to analyze their facial morphology, and 37 distinct anatomical landmarks were manually identified using a MATLAB-developed program. Results: A total of 188 Taiwanese children participated in the study. All participants were healthy, with a mean age of 9.79 years. Among them, 93.1% (175) were right-hand predominant, and 6.9% (13) were left-hand predominant. There were no significant differences in linear parameters or facial asymmetry between right-hand-predominant and left-hand-predominant participants (p > 0.05). However, a consistent trend toward right laterality, especially in the right lateral frontal region of the cranium, was observed, as illustrated by heat maps of the average three-dimensional model. Conclusions: The study found no association between facial morphology and hand predominance. A normal asymmetry with a rightward tendency was noted in children aged 9 to 10 years, which was particularly notable in the lateral frontal region of the head.

Longitudinal epidemiological studies are considered the gold standard for understanding craniofacial morphologic development, but participant recruitment and retention can be challenging. This study describes strategies used to recruit and maintain a high level of participation in a longitudinal study involving annual three-dimensional (3D) craniofacial soft-tissue imaging from healthy Taiwanese Chinese elementary school students aged 6 to 12 years. The key aspects for project delineation, implementation, and the initial three-year practical experiment are portrayed in an integrated multistep workflow: ethics- and grant-related issues; contact, approval, and engagement from partners of the project (school stakeholders and parents); a didactic approach to recruit the students; research staff composition with task design; three station-based data collection days with two educative activities (oral hygiene and psychosocial interaction stations) and one 3D craniofacial imaging activity; and reinforcement tactics to sustain the longitudinal annual participation after the first enrollment. Randomly selected students and teachers answered an experience satisfaction questionnaire (five-point Likert scale ranging from one to five) designed to assist in understanding what they think about the data collection day. Measures of frequency (percentage) and central tendency (mean) were adopted for descriptive analysis. Six of seven contacted schools accepted participation in the project. All parents who attended the explanatory meetings agreed to join the project. A cohort of 676 students (336 girls) participated at baseline enrollment, with a follow-up rate of 96% in the second data collection. The average questionnaire-related scores were 4.2 ± 0.7 and 4.4 ± 0.6 for teachers and students, respectively. These 3D craniofacial norms will benefit multidisciplinary teams managing cleft-craniofacial deformities in the globally distributed ethnic Chinese population, particularly useful for phenotypic variation characterization, conducting quantitative morphologic comparisons, and therapeutic planning and outcome assessment. The described pathway model will assist other groups to establish their own age-, sex-, and ethnic-specific normative databases.

This study aimed to investigate whether orbital fracture increases the risk of dry eye syndrome (DES) and identified the profile of prognostic factors. We studied a cohort from the Taiwan National Health Insurance Research Database (NHIRD). Overall, 46,179 and 184,716 participants were enrolled in the study and control groups, respectively. Each patient in the case group was age- and gender-matched to four individuals without orbital fracture that served as the control group. Cox proportional hazards analysis regression was used to estimate the risks of incident DES. During the follow-up period, the case group was more likely to develop incident DES (0.17%) than the control group (0.11%) (p = 0.001). Multivariate Cox regression analysis demonstrated that the case group had a 4.917-fold increased risk of DES compared to the controls. In the stratified age group, orbital fracture had the highest impact on patients aged 18–29 years. Furthermore, patients with orbital roof fracture have a greater risk of developing DES. Regardless of whether having received surgery or not, the patients with orbital fracture have higher risks of DES. Our study demonstrated that orbital fracture increases the risk of developing subsequent DES. Early recognition by thorough examinations with raised awareness in the clinical setting could preserve visual function and prevent further complications.