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Related Concept Videos

Sutures of the Skull01:22

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The human skull is composed of several bones that come together to protect the brain and support the structures of the face. The junctions where these bones meet are called sutures.
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
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Overview of the Skull01:08

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The cranium (skull) is the skeletal structure of the head that supports the face and protects the brain. It is subdivided into the facial bones and the brain case, or cranial vault. The facial bones underlie the facial structures, form the nasal cavity, enclose the eyeballs, and support the teeth of the upper and lower jaws.
The cranial vault surrounds and protects the brain and houses the middle and inner ear structures. This cavity is bounded superiorly by the rounded top of the skull, which...
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Cranial Bones: Superior and Posterior View01:14

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The superior view of the cranium shows the frontal and paired parietal bones.
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Association areas are regions of the cerebral cortex that do not have a specific sensory or motor function. Instead, they integrate and interpret information from various sources to enable higher cognitive processes such as memory, learning, and decision-making. Some key association areas include the following:
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Muscles for Facial Expressions01:14

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The craniofacial muscles are a collection of approximately 20 thin skeletal muscles situated beneath the skin of the face and scalp. These muscles, primarily responsible for the vast array of human facial expressions, originate from the bones or fibrous structures of the skull and extend outwards to connect with the skin. While most skeletal muscles in the body are enveloped in thick fascia, facial muscles generally have a more delicate fascial covering, with the buccinator muscle being a...
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Cranial Bones: Lateral View01:27

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The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...
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Craniofacial fellowship training: where are we now?

Niyant Patel1, Kanlaya Dittakasem, Jeffrey A Fearon

  • 1Akron, Ohio; and Dallas, Texas From the Craniofacial Clinic and Plastic and Reconstructive Surgery Center at Akron Children's Hospital; the Medical City Children's Hospital; and The Craniofacial Center.

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Summary

Craniofacial fellowships in the US offer diverse training, with most focusing on cleft care and trauma rather than traditional midface procedures. Many fellows desire improved training structure and core case minimums for better preparation.

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Area of Science:

  • Plastic Surgery
  • Craniofacial Surgery
  • Surgical Education

Background:

  • Craniofacial training programs in the US were evaluated to understand current practices and identify areas for improvement.
  • The study aimed to provide perspective on changes in craniofacial training over time.

Purpose of the Study:

  • To assess the current state of craniofacial fellowship training in the United States.
  • To identify potential improvements in craniofacial surgical education.

Main Methods:

  • A review of San Francisco Match listings and an internet search identified craniofacial fellowship programs.
  • An anonymous online survey was distributed to fellows completing training in 2013.

Main Results:

  • Thirty out of 33 identified fellows responded, reporting a mean caseload of 380 cases.
  • Fellowship strengths varied, with 35% focusing on cleft/intracranial/midface, while others emphasized cleft care, general pediatrics, or trauma.
  • Eighty-six percent of programs were residency-type, and 20% of fellows felt inadequately trained, suggesting a need for standardized core training areas and case minimums.

Conclusions:

  • Craniofacial fellowships exhibit significant heterogeneity in clinical experiences.
  • The majority of programs now focus on cleft care, pediatric plastic surgery, and trauma, diverging from traditional intracranial/midface procedures.
  • The shift from apprenticeships to residency-type models necessitates that prospective fellows align their goals with program-specific strengths.