Background/Objectives: Natural head position (NHP) is an important reference for orthodontic and orthognathic assessment. Although postoperative changes in head posture have been reported previously, simultaneous three-dimensional changes across yaw, pitch, and roll in different skeletal classes remain incompletely characterized. This exploratory study quantified six-month changes in three-dimensional head orientation and compared their direction and magnitude between skeletal Class II and Class III patients. Methods: Fifty-four adults (17 Class II, 37 Class III) undergoing Le Fort I osteotomy and bilateral sagittal split osteotomy were evaluated preoperatively (T0) and 6 months postoperatively (T1). Standardized 3D facial surface acquisitions were obtained using a calibrated structured-light scanner and a fixed external Cartesian laser reference. T0 and T1 datasets were registered using stable upper-facial landmarks (nasion and bilateral exocanthia), and changes in yaw, pitch, and roll were calculated within the common external reference system. Results: Statistically significant T0–T1 changes were observed across all three axes in both skeletal groups (p < 0.01). Class II patients showed mean changes of +2.28° in yaw, −1.30° in pitch, and +2.89° in roll, whereas Class III patients showed +4.61°, +1.96°, and +4.04°, respectively. Between-group differences were significant for yaw, pitch, and roll, with an opposite mean pitch direction and larger mean yaw and roll changes in Class III. Conclusions: At six months, this retrospective cohort demonstrated direction-specific changes in three-dimensional head orientation. Because repeated acquisitions, study-specific observer-reliability and measurement-error analyses, an untreated comparator, an independent validation cohort, and functional or patient-reported outcomes were not available, the findings should be interpreted as exploratory measurements rather than evidence of physiological normalization, neuromuscular adaptation, or clinical benefit. Formal prospective validation is required before the workflow can support predictive or patient management recommendations.

Background: Facial volume depletion and skin laxity have increasingly been reported during weight loss associated with glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment. However, these changes are not recognized as a distinct clinical entity and may overlap with those occurring after other forms of rapid or massive weight loss. Evidence regarding their treatment remains limited. Methods: This systematic review was conducted according to PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261415797). PubMed/MEDLINE, Embase, and Scopus were searched from inception to June 5, 2026. Clinical studies evaluating interventions for facial changes associated with GLP-1RA-related weight loss were included. Study characteristics, interventions, outcomes, safety, and methodological limitations were synthesized narratively. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools. Results: Four uncontrolled observational studies involving 98 treated participants met the eligibility criteria. Two studies enrolled exclusively patients receiving GLP-1RAs or related incretin-based medications, whereas two included mixed weight-loss etiologies. Investigated interventions included injectable biostimulators and fillers, endotissutal bipolar radiofrequency, and a topical formulation. All studies reported favorable within-group findings; however, heterogeneous populations, weight-loss trajectories, interventions, outcomes, and follow-up durations, together with the absence of comparator groups, precluded conclusions regarding treatment effectiveness or superiority. Conclusions: The available evidence is preliminary and insufficient to support a validated therapeutic algorithm. The proposed framework is hypothesis-generating and integrates limited review findings with established principles of post-weight-loss facial rejuvenation. Comparative studies evaluating surgical and nonsurgical interventions are required. Level of Evidence V: 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 . Trial registration number PROSPERO Registration CRD420261415797

Background: The optimal management of the clinically node-negative (cN0) neck in maxillary squamous cell carcinoma (MSCC) remains controversial due to the relatively low yet clinically relevant risk of occult cervical metastasis. While elective neck dissection (END) has been proposed to improve oncologic outcomes, others advocate observation to avoid overtreatment. This study aimed to evaluate the impact of END versus observation on overall survival (OS) in cN0 MSCC patients. Methods: A systematic literature search was conducted in PubMed, Embase, and Scopus according to the PRISMA 2020 statement. The protocol was registered in PROSPERO (CRD420261345038). Studies including patients with maxillary SCC and clinically N0 neck comparing END with observation were eligible. Fourteen studies were included in the qualitative synthesis, and five were suitable for quantitative meta-analysis. The primary endpoint was OS. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Risk of bias was assessed using ROBINS-I, and certainty of evidence was evaluated using the GRADE framework. Results: The meta-analysis demonstrated a statistically significant survival benefit associated with END. The pooled HR for OS was 0.76 (95% CI 0.67–0.86; p < 0.001), indicating a 24% relative reduction in the hazard of death compared with observation. Importantly, statistical heterogeneity was negligible (I² = 0%), although interpretation should be cautious given the limited number of included studies. Despite this, most included studies were retrospective in design. Conclusions: END appears to provide a survival advantage in selected patients with cN0 MSCC. However, the evidence is largely derived from retrospective data. High-quality prospective multicenter studies are needed to better define the role of elective neck management in this population.

Background: The radial forearm free flap (RFFF) remains one of the most reliable and widely adopted reconstructive options for head and neck defects because of its consistent vascular anatomy, long pedicle, and excellent tissue pliability. Nevertheless, donor-site morbidity continues to represent its principal drawback and may negatively affect postoperative recovery, upper-limb function, and patient satisfaction. Although numerous surgical modifications and donor-site reconstruction techniques have been proposed to reduce morbidity, the available evidence remains fragmented and heterogeneous. This systematic review and meta-analysis aimed to quantify the incidence of the principal donor-site complications following RFFF harvest and critically evaluate the current evidence regarding strategies to minimize donor-site morbidity. Methods: This systematic review and meta-analysis was conducted according to the PRISMA 2020 statement and prospectively registered in PROSPERO (CRD420261423543). PubMed/MEDLINE, Embase, and Scopus were systematically searched from inception to June 2026. Clinical studies reporting donor-site outcomes after RFFF harvest for head and neck reconstruction were eligible. Primary outcomes were tendon exposure and skin graft loss/failure. Random-effects meta-analyses were performed to estimate pooled incidence rates. Secondary complications, functional outcomes, and patient-reported outcome measures were synthesized qualitatively. Methodological quality and certainty of evidence were assessed using the Joanna Briggs Institute critical appraisal tools and the GRADE framework. Results: Twenty-two studies met the inclusion criteria for qualitative synthesis. Fourteen studies were included in the meta-analysis of tendon exposure and twelve in the meta-analysis of graft loss/failure. The pooled incidence of tendon exposure was 8% (95% CI, 7–11%; I² = 0%), whereas the pooled incidence of graft loss/failure was 11% (95% CI, 7–16%; I² = 67.1%). Delayed wound healing, infection, sensory disturbances, scar-related morbidity, and functional impairment were reported inconsistently across studies, precluding quantitative synthesis. Available studies generally reported limited long-term functional impairment, although substantial heterogeneity in assessment methods and follow-up precluded quantitative synthesis. Overall certainty of evidence was rated as low. Conclusions: Donor-site morbidity following RFFF harvest remains clinically relevant despite the excellent reconstructive reliability of the flap. Approximately one in twelve patients experiences tendon exposure and one in ten experiences graft loss or failure. Current evidence does not support the superiority of any specific donor-site reconstruction technique. Future high-quality prospective comparative studies adopting standardized outcome definitions and validated patient-reported measures are required to optimize donor-site management and improve reconstructive decision-making.

Background/Objectives: Postoperative facial nerve paresis remains clinically relevant after nerve-preserving parotidectomy. This scoping review aimed to identify, map, and characterize reported therapeutic strategies and summarize clinical recovery outcomes. Methods: Following Joanna Briggs Institute guidance and PRISMA-ScR, the protocol was deposited on Figshare before data extraction. PubMed, Embase, and Scopus were searched through 24 August 2026. English-language original studies of treatments initiated after the recognition of paresis were eligible. Two reviewers independently selected and appraised studies; one reviewer charted the data and another verified the extraction. Results: Eight studies involving 211 patients were included; reported ages were 17–86 years. Procedures included partial, superficial, subtotal, total, and revision parotidectomy, as well as parotid lobectomy for benign or malignant disease. Immediate or early weakness predominated; two reports described delayed-onset palsy. Evidence comprised two randomized trials, one case–control study, one multicenter cohort, and four case reports. Interventions included corticosteroids, corticosteroid–antiviral therapy, home or supervised exercises, Kabat rehabilitation, neuromuscular retraining, Matrix Rhythm Therapy (MRT), and proprioceptive neuromuscular facilitation with electrical stimulation. The trials found no benefit of prednisolone over placebo and no statistically significant difference between supervised rehabilitation and home exercises; equivalence was not established. Observational findings could not be separated from spontaneous recovery or co-treatment. Conclusions: No intervention has established superiority. Standardized protocols, validated outcomes, and adequately powered comparative studies are needed.