Digital Poster

Accepted E-Poster presentations from registered participants.

Category: All Case Report Research

E-Poster RP-0019

RP-0019

Title: Early Growth Trajectories in Infants with Cleft Lip and Palate Receiving Digital NAM: A Longitudinal Comparison with WHO Child Growth Standards
Author(s): Suteera Pradubwong
Affiliation: Tawanchai Cleft Center, Khon Kaen University, Thailand

Suteera Pradubwong · Research

Introduction
Infants with cleft lip and palate are at risk of feeding difficulties and impaired early growth. Digital nasoalveolar molding (NAM) may support feeding and presurgical management, but evidence on early growth trajectories during NAM therapy remains limited. Monitoring growth alongside caregiver competency may help optimize early, family-centered care.
Objective
To evaluate early growth trajectories in infants with cleft lip and palate receiving digital nasoalveolar molding (NAM) and to compare growth patterns with WHO Child Growth Standards.
Methods
A prospective cohort study was conducted among 12 infants with cleft lip and palate enrolled at ≤4 weeks of age at the Cleft Center of Excellence, Northeastern Thailand. Infants received digital nasoalveolar molding (NAM) therapy with caregiver training and feeding support. Data were collected at approximately 1, 2–3, and 5–6 months of age. Weight, length, head circumference, feeding methods, and caregiver appliance-management skills were assessed. Growth trajectories were analyzed using descriptive statistics and mixed-effects restricted maximum likelihood (REML) regression.
Results
Most participants were male (58.33%) and had unilateral complete cleft lip and palate (91.67%). Caregivers demonstrated progressively improved appliance management skills over time, with few complications. Feeding was primarily achieved through alternative methods, while direct breastfeeding was limited. Weight increased significantly over time, with age significantly predicting weight gain. Mixed formula bottle feeding showed a positive trend but was not statistically significant. Caregiver competence in device-assisted feeding, particularly during the nasal and alveolar molding phase, was significantly associated with improved weight gain.
Conclusions
Early growth in infants with cleft lip and palate receiving digital NAM is influenced by both biological factors and caregiver competency. These findings support the importance of integrated, family-centered care consistent with WHO child growth and development principles.

E-Poster RO-0078

RO-0078

Title: Robust assessment based on unreliable measurements: Construction and testing of an experimental device for the assessment of oral-nasal balance
Author(s): Yifei CHEN
Affiliation: Department of Speech-Language Pathology, Temerty Faculty of Medicine, University of Toronto

Yifei CHEN · Research

Cécile Yifei Chen, Zhaohua Zhang, Somayah Al-Ees, Sarah Bodenbach, Tim Bressmann
Department of Speech-Language Pathology, Temerty Medicine, University of Toronto

Introduction: Nasometry is an important tool for quantifying oral-nasal balance in children with cleft palate. However, the Nasometer is expensive and not available to clinicians in resource-limited settings. Designs for alternative low-cost devices have been published, yet different devices may produce different mean scores, limiting between-device comparability and diagnostic cutoffs. Experimental “Nasophone” devices were built from readily available materials. Mean nasalance scores as well as derived relative measures (including speech tasks with nose-pinching) were compared.

Methods: The balance of eight electret microphone pairs was quantified on a test bench with multi-speaker babble stereo panoramas. Experimental nasalance measurements were made by rerecording nasal, mixed and non-nasal sentences spoken by 10 typical speakers (8 females), who produced normal speech as well as simulations of hypernasality, hyponasality and mixed nasality. Nasalance distance, ratio, and two new composite measures were calculated.

Results: Across the eight microphone pairs, the mean difference in nasalance scores for the babble panoramas was 1.18 (SD = 0.72), with 96.3% falling within 2 nasalance points. For the re-recorded sentences, the mean difference in nasalance scores between the microphone pairs was 3.75 (SD = 3.1), with 85% falling within 6 nasalance points. For the nose-pinch condition, the mean difference was 5.34 (SD = 3.3), with 80% falling within 6 nasalance points. Using a combination of the nasalance distance, ratio, and two composite measures, a linear discriminant analysis demonstrated a mean classification accuracy of 77%, based on 128 test samples from 8 speakers.

Conclusion: Different microphone pairs may return different nasalance scores. Using relative rather than mean-based nasalance measures may reduce the effect of device-specific microphone balances and support diagnostic differentiation across different devices. Further testing with clinical data is required.

RP-0010

Title: An analysis of mandibular characteristics according to biological sex using 3D CT scans in Koreans
Author(s): Soyeon Jung
Affiliation: Hallym University Dongtan Sacred Heart Hospital

Soyeon Jung · Research

Introduction: With the increasing demand for facial feminization surgery (FFS), precise knowledge of sex-based andibular morphology has become clinically relevant. In this study, “male” and “female” refer to biological sex as recorded in medical records; gender identity was not assessed. We aimed to analyze sex differences in mandibular morphology using three-dimensional (3D) computed tomography (CT) in a Korean population and to provide anatomic data applicable to mandibular contouring in FFS.
Methods: A retrospective analysis was conducted on 275 Korean patients who underwent facial CT between 2017 and 2019. Three- dimensional cephalometric analysis was performed to evaluate angular, linear, and transverse mandibular parameters, as well as non-metric features including chin shape and inferior mandibular border contour. Statistical comparisons were performed between sexes.
Results: Significant gender differences were observed in mandibular angle, mandible length, antegonial notch distance, intercondylar width, and intergonial width (all p < 0.001). Ramus length and chin width did not demonstrate statistically significant differences. Non-metric analysis revealed significant gender differences in chin morphology and inferior mandibular border contour (p < 0.001). Males predominantly exhibited a round or square chin (79.5%) and a rocker-shaped inferior border, whereas females commonly demonstrated a pointed chin (82.3%) and a straight inferior mandibular border (94.4%).
Conclusions: The gender-specific mandible features are characterized by differences in angularity, transverse width, antegonial morphology, and inferior border contour. These findings provide population-specific morphological reference ranges that may support individualized preoperative assessment for mandibular contouring in facial feminization surgery.

E-Poster RO-0047

RO-0047

Title: Mandibular Distraction Osteogenesis Aids in the Growth and Development with Severe Robin sequence in Neonates
Author(s): YI JI
Affiliation: Children's Hospital of Nanjing Medical Ui

YI JI · Research

Objective
At present, the main treatments for Robin sequence include mandible distraction osteogenesis (MDO), tracheostomy, tongue-lip adhesion (TLA), conservative treatment, etc. The purpose of this study is to analyze the necessity of MDO in severe Robin sequence , and to demonstrate that MDO is the best option for treating severe Robin sequence in neonates compared with conservative treatment.

Method
We reviewed 400 cases of Robin sequence within the three months in our hospital from 2018 to 2024. Of these 90% of cases were treated with MDO, 10% conservatively. None of the patients were treated with tracheostomy and tongue-lip adhesion (TLA). According to the improvement of breathing and eating, and growth and development status were compared and analyzed.

Results
90% of children who received MDO achieved the desired results. The mandible was shifted forward by 0.8cm-1.6 cm, the removal time of the mandibular distractor was 110-122 days after surgery, and the postoperative follow-up time was 26-2263 days postoperatively. There were 18 cases (5%) of screw detachment, and 3 cases (0.8%) of re-MDO. 13 (3.6%) had incomplete distraction problems, of which 5 (1.4%) required MDO again 3 months after surgery, and all respiratory problems were caused by glossoptosis recurrence. So a total of 8 (2.2%) patients required MDO. All respiratory and feeding problems were resolved after the MDO. No patient requires tracheostomy and TLA.Infants who underwent surgery within three months of birth exhibited significantly better weight and growth development curves compared to those who received conservative treatment within the same period.
Conclusion
The clinical results showed that the result of MDO was satisfi

E-Poster CP-0006

CP-0006

Title: A Novel Turn-Over Upper Helical Cartilage Flap Augmented with Ninth Costal Cartilage Graft for Type I Microtia Reconstruction: A Case Report
Author(s): Fajar Sartika Hadi
Affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Airlangga; Plastic Reconstructive and Aesthetic Surgery Unit, Universitas Airlangga Hospital

Fajar Sartika Hadi · Case Report

Introduction: Type I microtia is an exceedingly rare congenital auricular anomaly characterized by a hypoplastic auricle with preservation of all anatomical components, with an estimated incidence of fewer than 1 in 300,000 live births. Epidemiological data from Southeast Asia remain limited, restricting accurate assessment of its prevalence in this region. The low reported incidence may reflect the subtle nature of the deformity, which is often unrecognized or not considered severe enough to warrant medical attention, resulting in an iceberg phenomenon where the true disease burden is likely underestimated. Despite its mild external appearance, surgical correction presents unique challenges, as patients seeking reconstruction often have high expectations for achieving a near-normal auricular appearance. We report a case of Type I microtia reconstructed using a turn-over upper helical cartilage flap augmented with an autologous ninth costal cartilage graft.

Case Presentation: A 12-year-old boy with bilateral microtia presented with right-sided type IV and left-sided type I deformities according to the Hunter classification. Reconstruction of the left auricle was prioritized to establish a morphological template for subsequent contralateral reconstruction. Intraoperative assessment revealed hypoplasia of the upper helix and scapha with preservation of the remaining auricular framework. Reconstruction was performed using a turn-over upper helical cartilage flap augmented with an autologous ninth costal cartilage graft to restore helical projection and contour. A bolster dressing was maintained for 7 days postoperatively.

Results : The postoperative course was uneventful, the reconstructed auricle demonstrated a well-defined helical rim, improved scaphal contour, satisfactory structural support, and resulting in a more natural auricular appearance compared with the preoperative deformity.
Conclusion : The turn-over upper helical cartilage flap augmented with an autologous ninth costal cartilage graft is a feasible technique for Type I microtia reconstruction, providing satisfactory aesthetic contour and structural support while preserving native auricular tissue.

E-Poster CP-0014

CP-0014

Title: Nasal reconstruction using costal cartilage and paramedian forehead flap in nasomaxillary hypoplasia in Binder’s syndrome; a case report
Author(s): Nurardhilah Vityadewi
Affiliation: Plastic Reconstructive and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia

Nurardhilah Vityadewi · Case Report

• Introduction: The condition of nasomaxillary hypoplasia in Binder’s syndrome has a very wide range of variations. Nasal reconstruction in patients with severe nasal hypoplasia is very difficult and complex. The stages of reconstruction are also adapted to the patient’s age. In adult patients, definitive nasal reconstruction can be determined. Costal cartilage remains the superior choice for reconstructing the nasal framework. In cases with soft tissue deficiency, the paramedian forehead flap is the most ideal option.
• Methods: Patient, male, 18 year old with flattened nasal bridge, lack of a defined nasal tip, and a widened, flattened, and short columella. The 3D CT scans clearly show complete severe hypoplasia of the nasal bones. The anterior nasal spine appears to be missing. Nasal reconstruction performed with autologous costal cartilage to create the framework of the nasal bridge and the tip. The nasal framework was created using the costal graft. The design incision placed above the nostril to keep the alar and columella. The widen and flattened columella are move inferiorly and outward to create the tip projection. The soft tissue defect was covered with paramedian forehead flap.
• Results: One month postoperatively, the projection of the tip and nasal bridge was adequate. No skin necrosis was observed despite division and release of the nostril and columella, with only minimal complications. No functional disturbances were reported, and the aesthetic outcome was acceptable.
• Conclusion: The degree of nasal malformation in Binder’s syndrome varies significantly and surgical correction needs to be tailored individually. The reconstruction surgery is very challenging and successful nasal reconstruction is highly dependent on a good understanding of the pathological anatomy, which involves both the bony structures and the soft tissues. Structural grafting is very helpful in reshaping the nose that requires maximal projection from the bridge to the tip.

E-Poster RO-0056

RO-0056

Title: Usefulness of the pedicled latissimus dorsi flap for diverse defective wounds developed in the trunk.
Author(s): Junghyun Lee
Affiliation: Department of Plastic and Reconstructive Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea

Junghyun Lee · Research

Introduction: The latissimus dorsi (LD) flap is a reliable regional flap with consistent vascularity, a broad arc of rotation, and sufficient soft-tissue volume. It remains useful for reconstruction of complex defects requiring durable vascularized coverage. This study aimed to evaluate the clinical utility of pedicled LD flap reconstruction for trunk defects in various reconstructive settings.

Methods: A retrospective review was conducted of 8 patients who underwent pedicled LD flap reconstruction between January 2024 and February 2026. Defect locations included the axilla, upper chest, mid back with spinal exposure, flank, upper back, and breast. The defects that came from hidradenitis suppurativa, postoperative wound complications, breast cancer-related soft-tissue defects, and defects after wide oncologic resection of melanoma, sarcoma, and dermatofibrosarcoma protuberans were included in.

Results: All 8 patients achieved stable soft-tissue coverage without total flap loss. No patient required reoperation for total flap failure; however, 3 patients underwent revision surgery for a surgical delay procedure. One patient subsequently underwent debulking surgery because of excessive flap bulk. Adjunctive negative-pressure wound therapy was applied to promote flap settlement, stabilize the wound, subside the edema and facilitate healing.

Conclusion: Pedicled LD flap reconstruction is a versatile and dependable option for complex truncal defects. It provides robust vascularized tissue and durable coverage in oncologic, infected, postoperative, and implant-based breast reconstruction settings. Especially, the pedicled LD flap is a versatile and reliable option for patients who underwent postoperative radiation therapy after oncologic reconstruction.

E-Poster RO-0000

RO-0000

Title: Changetitle
Author(s): Waranya Test
Affiliation: Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

E-Poster CP-0009

CP-0009

Title: Postoperative Retrobulbar Hematoma With Irreversible Visual Loss After Orbital Fracture Reconstruction In An Older Patient
Author(s): Junghyun Lee
Affiliation: Department of Plastic and Reconstructive Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea

Junghyun Lee · Case Report

Introduction: Retrobulbar hematoma is a rare but vision-threatening complication after orbital fracture repair. Because visual prognosis depends on rapid decompression, delayed symptom recognition may result in irreversible blindness. This report describes postoperative retrobulbar hematoma after orbital fracture reconstruction in an older patient and emphasizes preventive monitoring strategies.

Methods: The clinical course, operative findings, ophthalmologic examinations, and computed tomography findings of an 82-year-old woman who underwent reconstruction for right zygomaticomaxillary complex and orbital floor fractures were reviewed. Open reduction and internal fixation were performed through subciliary and upper vestibular approaches, and the orbital floor was reconstructed with titanium mesh. Preoperative visual acuity and pupillary reflexes were normal.

Results: No intraoperative bleeding or abnormal ocular tension was observed. On postoperative day 1, the patient developed blurred vision and a sensation of retro-orbital pressure but did not immediately report these symptoms. On postoperative day 2, she presented with severe orbital pain, proptosis, a fixed dilated pupil, and no light perception. Computed tomography revealed a dense retrobulbar hematoma compressing the posterior globe and optic nerve. Emergency orbital exploration and hematoma evacuation were performed through the previous subciliary incision, and approximately 4 mL of clotted blood was removed. No active arterial bleeding was identified, suggesting that the hematoma resulted from postoperative oozing. Although orbital decompression successfully normalized the intraocular pressure and follow-up computed tomography confirmed complete resolution of the hematoma with satisfactory fracture healing, visual function did not recover. At the 1-month follow-up, optic disc pallor and a profound visual field defect confirmed permanent visual loss.

Conclusion: Postoperative retrobulbar hematoma requires immediate recognition and decompression within the critical ischemic window. In older patients, clear symptom education, meticulous hemostasis, early ophthalmologic collaboration, and structured postoperative visual monitoring are essential to prevent avoidable blindness after orbital reconstruction.

E-Poster RP-0011

RP-0011

Title: Reconstruction with bilateral hatchet flaps for medium sized scalp defects.
Author(s): Junghyun Lee
Affiliation: Department of Plastic and Reconstructive Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea

Junghyun Lee · Research

Introduction: Reconstruction of scalp defects is challenging because of the convex contour, hair-bearing skin, and need for durable calvarial coverage. The hatchet flap combines advancement and rotation, redistributes tension, and preserves adjacent hair-bearing tissue. This study evaluated the clinical utility and surgeon-assessed outcomes of hatchet flap reconstruction for medium-sized scalp defects after excision of benign or malignant lesions.

Methods: We retrospectively reviewed 18 patients who underwent hatchet flap-based scalp reconstruction between March 2024 and 2026. Indications included skin cancer, soft-tissue mass, nevus sebaceous, seborrheic keratosis, epidermal cyst, infected cystic mass, and scalp skin necrosis. After excision or debridement, primary closure was not feasible because of defect size, location, or closure tension. Flaps were designed according to defect location and surrounding tissue mobility. Postoperative flap viability, wound complications, revision surgery, hair-bearing appearance, aesthetic outcomes, and local symptoms were reviewed.

Results: Defects involved the scalp, occiput, vertex, or temple. All patients achieved successful wound closure. No total or partial flap necrosis occurred, and no patient required reoperation or secondary reconstruction. The operating surgeon assessed postoperative contour, tissue match, and preservation of hair-bearing scalp as satisfactory. Pain, pruritus, and other local discomfort were minimal or tolerable during follow-up.

Conclusion: Hatchet flap-based reconstruction is a reliable and versatile option for scalp defects that cannot be closed primarily. It provides durable coverage, favorable tissue matching, preservation of hair-bearing scalp, and satisfactory surgeon-assessed aesthetic outcomes. Longer follow-up is required to evaluate scar maturation, alopecia, long-term aesthetic results, and symptom changes.

E-Poster CP-0008

CP-0008

Title: Epiphora After Orbital Wall Reconstruction Caused by Migrated Mesh Implant
Author(s): Junghyun Lee
Affiliation: Department of Plastic and Reconstructive Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea

Junghyun Lee · Case Report

Introduction: Epiphora is an uncommon but clinically significant complication after orbital wall reconstruction. It may occur due to lacrimal drainage disturbance, soft tissue adhesion, or implant-related obstruction. We report a case of postoperative epiphora caused by mesh migration after reconstruction of medial orbital wall and orbital floor fractures.

Methods: A patient sustained left medial orbital wall, orbital floor, and nasal bone fractures following a head-on collision between a bicycle and a vehicle. Extraocular movements were intact, with no diplopia or visual impairment. Orbital wall reconstruction was performed through a transconjunctival-caruncular approach using a bioresorbable mesh which is radiopacity allowing the implant to be clearly visualized on postoperative computed tomography. One month after surgery, the patient developed persistent epiphora. Although ophthalmologic evaluation revealed no definite abnormalities, computed tomography demonstrated displacement of the radiopaque mesh, enabling precise localization of the migrated implant. Based on the correlation between the imaging findings and the patient’s symptoms, surgical exploration and implant complete removal were performed.

Results: The mesh was accurately localized and found to be displaced anteriorly with compressing the lacrimal drainage pathway. Adhesiolysis was performed, and the implant was completely removed. The intraoperative location of the migrated mesh corresponded closely with its position on preoperative computed tomography. At 3 months, the patient reported complete resolution of symptoms without diplopia, visual impairment, or limitation of extraocular movement.

Conclusion: Mesh migration after orbital wall reconstruction may cause delayed epiphora even when ocular motility and vision are normal. Careful evaluation of implant position should be considered in patients with persistent postoperative epiphora. Transcaruncular exploration with implant removal and adhesiolysis may be an effective treatment option.

E-Poster RP-0006

RP-0006

Title: Clinical guidelines for cleft lip and palate care: a systematic review
Author(s): Omar Barasain
Affiliation: University of Alberta

Omar Barasain · Research

Abstract

Objectives: The care of patients with cleft lip and/or cleft palate is not standardized across centres. High quality and evidence-based standards to guide clinical decision-making are critical. The objective of this review is to appraise the scope, quality, adequacy, consistency, and limitations of guidelines relating to the management of CL/CLP in children across all disciplines of care.
Design: (PRISMA) guidelines, MEDLINE, EMBASE, SCOPUS, Web of Science, and Cochrane Database of Systematic Reviews databases were systematically searched for guidelines relating to the care and management of children with CL/CLP. Guidelines were assessed utilizing the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument.

Results: Fifty-Four standards were selected for inclusion. Most studies were performed in the United States (44.4%) and United Kingdom (38.9%). Standards consisted of primarily expert consensus recommendations (38%). Recommendations were principally developed by a task force or after expert consensus (39.6%). Recommendations were coded according to nine thematic domains: "Feeding ", "Orthodontics", "Surgery", "Speech", "Breathing”, “Appearance", "Psychosocial Outcome", "Team Composition and Dynamics", and "Cost of Care ". No guideline encompassed all domains. Discrepancies were observed across domains, guideline setting, and data collection method.

Conclusions: Existing guidelines can effectively be organized into nine categories. Based on appraised quality of evidence for recommendations, they are supported by moderate quality of evidence and should be utilized to guide clinical decision-making to improve outcomes for CL/CLP patients. Nonetheless, there is an ongoing need for high-quality practice guidelines for comprehensive CL/CLP care.

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Digital Poster

Early Growth Trajectories in Infants with Cleft Lip and Palate Receiving Digital NAM: A Longitudinal Comparison with WHO Child Growth Standards RP-0019

Robust assessment based on unreliable measurements: Construction and testing of an experimental device for the assessment of oral-nasal balance RO-0078

An analysis of mandibular characteristics according to biological sex using 3D CT scans in Koreans RP-0010

Mandibular Distraction Osteogenesis Aids in the Growth and Development with Severe Robin sequence in Neonates RO-0047

A Novel Turn-Over Upper Helical Cartilage Flap Augmented with Ninth Costal Cartilage Graft for Type I Microtia Reconstruction: A Case Report CP-0006

Nasal reconstruction using costal cartilage and paramedian forehead flap in nasomaxillary hypoplasia in Binder’s syndrome; a case report CP-0014

Usefulness of the pedicled latissimus dorsi flap for diverse defective wounds developed in the trunk. RO-0056

Changetitle RO-0000

Postoperative Retrobulbar Hematoma With Irreversible Visual Loss After Orbital Fracture Reconstruction In An Older Patient CP-0009

Reconstruction with bilateral hatchet flaps for medium sized scalp defects. RP-0011

Epiphora After Orbital Wall Reconstruction Caused by Migrated Mesh Implant CP-0008

Clinical guidelines for cleft lip and palate care: a systematic review RP-0006