Management of the Mandibular Deformity in the Growing Patient with Craniofacial Microsomia

Author(s):  
Cory M. Resnick ◽  
Bonnie L. Padwa
2021 ◽  
Author(s):  
Xiaopeng Xu ◽  
Bingqing Wang ◽  
Zhuoyuan Jiang ◽  
Qi Chen ◽  
Ke Mao ◽  
...  

Abstract Craniofacial microsomia (CFM, OMIM%164 210) is one of the most common congenital facial abnormalities worldwide, but it’s genetic risk factors and environmental threats are poorly investigated, as well as their interaction, making the diagnosis and prenatal screening of CFM impossible. We perform a comprehensive association study on the largest CFM cohort of 6074 samples. We identify 15 significant (P < 5 × 10−8) associated genomic loci (including eight previously reported) and decipher 107 candidates based on multi-omics data. Gene Ontology term enrichment found that these candidates are mainly enriched in neural crest cell (NCC) development and hypoxic environment. Single-cell RNA-seq data of mouse embryo demonstrate that nine of them show dramatic expression change during early cranial NCC development whose dysplasia is involved in pathogeny of CFM. Furthermore, we construct a well-performed CFM risk-predicting model based on polygenic risk score (PRS) method and estimate seven environmental risk factors that interacting with PRS. Single-nucleotide polymorphism-based PRS is significantly associated with CFM [P = 7.22 × 10−58, odds ratio = 3.15, 95% confidence interval (CI) 2.74–3.63], and the top fifth percentile has a 6.8-fold CFM risk comparing with the 10th percentile. Father’s smoking increases CFM risk as evidenced by interaction parameter of −0.324 (95% CI −0.578 to −0.070, P = 0.011) with PRS. In conclusion, the newly identified risk loci will significantly improve our understandings of genetics contribution to CFM. The risk prediction model is promising for CFM prediction, and father’s smoking is a key environmental risk factor for CFM through interacting with genetic factors.


2018 ◽  
Vol 1 (1) ◽  
pp. 65-78
Author(s):  
David John David AC

Distraction Osteogenesis was introduced into the management of Craniofacial Microsomia some decades ago. It assumed almost instant popularity without evidence of advantage. Poor long-term results and high rates of relapse prove this technique is unsuitable for all but the most carefully selected patients. While innovation and technological advances are to be celebrated, it is vital that new procedures are rigorously tested against current protocols. It is also imperative, that thorough knowledge of disease pathology and pathogenesis are applied against new procedures. It is the view of the author that many painful, useless operations would be avoided if surgeons better understood these key fundamentals. Furthermore, there must be clear guidelines for the introduction of new techniques and devices, and this must happen independently of manufacturers.


2012 ◽  
Vol 94 (12) ◽  
pp. 990-995 ◽  
Author(s):  
Daniela V. Luquetti ◽  
Babette S. Saltzman ◽  
Daniela Vivaldi ◽  
Luiz A. Pimenta ◽  
Anne V. Hing ◽  
...  

2018 ◽  
Vol 46 (12) ◽  
pp. 2032-2041 ◽  
Author(s):  
Britta D.P.J. Maas ◽  
Britt I. Pluijmers ◽  
Paul G.M. Knoops ◽  
Clifford Ruff ◽  
Maarten J. Koudstaal ◽  
...  

Development ◽  
1988 ◽  
Vol 103 (Supplement) ◽  
pp. 207-212
Author(s):  
David Poswillo

Craniofacial malformations have been recorded since time immemorial. While observational studies have assisted in the recognition of syndromes, little light has been shed on the causal mechanisms which interfere with craniofacial development. Animal studies in which malformations occur spontaneously or have been induced by teratogenic agents have permitted step-by-step investigation of such common deformities as cleft lip and palate. The role of the ectomesenchymal cells of the neural crest and the possible phenomenon of disorganized spontaneous cell death are described in relation to lip clefts. The factors associated with isolated cleft palate, Pierre Robin syndrome and submucous clefts are described by reference to animal models. The haemorrhagic accident preceding the onset of craniofacial microsomia is discussed as is the distinctly different phenomenon of disturbance to the migration or differentiation of neural crest cells in the pathogenesis of Treacher Collins syndrome. The more severe anomalies of the calvarium such as plagiocephaly, Crouzon and Apert syndrome still defy explanation, in the absence of an appropriate animal system to study; some thoughts on the likely mechanism of abnormal sutural fusions are discussed.


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