Metastatic sarcomas of the oral cavity: A systematic review.

Oral metastatic sarcomas (OMSs) occur only occasionally, and information about their characteristics is based on the restricted number of cases reported in the literature. This study aims to systematically review the English literature to recognize the clinicopathologic characteristics of OMSs. An electronic search was performed in PubMed Central and Scopus databases. The search included all the published articles (human case reports and case series) up till April 2023, with no time restrictions. OMSs were slightly more prevalent in males in their fifth to seventh decades of life. However, a high percentage of OMSs has been reported in the second decade of life. Lower extremities, breasts and uterus are the most common primary origin of metastatic sarcoma. Gingiva and mandible were common locations in the oral cavity for metastatic deposits. Generally, they demonstrated widespread affliction. The mean time interval between primary tumor detection and diagnosis of the oral metastasis was about 33.54 ± 36.19 months. Death was reported in 83 patients (67.48 %) with a mean survival rate of 7.98 ± 10.30 months. The most common microscopic tumor types were leiomyosarcoma (n = 21, 17 %), followed by angiosarcoma (n = 20, 16.26 %) and osteosarcoma (n = 18, 14.63 %). In conclusion, while oral metastases of sarcomas are not common, those should be considered in the differential diagnosis of the oral lesions. Although OMSs show a high occurrence in the 7th decade of the life, the average age of patients with oral involvement is lower than the overall metastatic lesions. OMSs may present as widespread disease with poor prognosis.

Effects of distraction osteogenesis with Le Fort osteotomies on upper airway volumes: a systematic review and meta-analyses.

OBJECTIVE: Distraction osteogenesis is one of the treatment options in patients with severe maxillomandibular abnormalities to treat morphological and respiratory problems (obstructive sleep apnea syndrome). The study aimed to evaluate the effect of Le Fort I, II and III distraction osteogenesis (DO) on upper airway dimensions and respiratory function. METHODS: Electronic search was performed in PubMed, Scopus, Embase, Google Scholar and Cochrane databases. Studies that only involved two dimensional analyses were excluded. Besides, studies that performed DO in conjunction with orthognathic surgery were not considered. NIH quality assessment tool was used to evaluate the risk of bias. Meta-analyses were performed to assess sleep apnea indices and the mean differences in the airway dimensions before and after DO. Gradings of Recommendations, Assessment, Development and Evaluation were used to analyze the evidence level. RESULTS: Among the 114 studies that went under full-text analyses, 11 articles met the inclusion criteria. Results of the quantitative analyses showed that maxillary Le Fort III DO significantly increased the amounts of oropharyngeal, pharyngeal and upper airway volumes. However, apnea-hypopnea index (AHI) showed a non-significant improvement after this procedure. Besides, the dimensions of the airways increased with Le Fort I and II DO, according to a qualitative analysis. Considering the design of the included studies, our results had a low level of evidence. CONCLUSION: Maxillary Le Fort DO does not significantly impact AHI, while it significantly increases the airway dimensions. Meanwhile, multicentric studies with standardized evaluation are still required to confirm the effects of maxillary Le Fort DO on airway obstruction.

Applications of Machine Learning in Facial Cosmetic Surgeries: A Scoping Review.

OBJECTIVE: To review the application of machine learning (ML) in the facial cosmetic surgeries and procedures METHODS AND MATERIALS: Electronic search was conducted in PubMed, Scopus, Embase, Web of Science, ArXiv and Cochrane databases for the studies published until August 2022. Studies that reported the application of ML in various fields of facial cosmetic surgeries were included. The studies' risk of bias (ROB) was assessed using the QUADAS-2 tool and NIH tool for before and after studies. RESULTS: From 848 studies, a total of 29 studies were included and categorized in five groups based on the aim of the studies: outcome evaluation (n = 8), face recognition (n = 7), outcome prediction (n = 7), patient concern evaluation (n = 4) and diagnosis (n = 3). Total of 16 studies used public data sets. ROB assessment using QUADAS-2 tool revealed that six studies were at low ROB, five studies were at high ROB, and others had moderate ROB. All studies assessed with NIH tool showed fair quality. In general, all studies showed that using ML in the facial cosmetic surgeries is accurate enough to benefit both surgeons and patients. CONCLUSION: Using ML in the field of facial cosmetic surgery is a novel method and needs further studies, especially in the fields of diagnosis and treatment planning. Due to the small number of articles and the qualitative analysis conducted, we cannot draw a general conclusion about the impact of ML in the sphere of facial cosmetic surgery. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .