Facial fat grafting-related eye and brain fat embolism: A systemic review of reported cases

Comparator Not applicable.Study designs to be included Retrospective studies, case reports and case series of facial fat grafting-related eye and brain fat embolism.Eligibility criteria Exclusion criteria include duplicate publications (in cases of duplication, the version providing more comprehensive clinical information was retained), fat grafting combined with injections of other materials, case series without detailed data on individual patients, and reports lacking more than two essential elements (symptoms, diagnostic investigations, treatments, or outcomes).Information sources 1.PubMed, Embase, CENTRAL, Web of Science, and Google Scholar 2. References of potentially included studies are screened for additional articles. Main outcome(s)Patient characteristics, diagnostic investigations, treatment, and outcome of reviewed cases. Additional outcome(s)Details of eye and brain fat embolism, diagnostic investigations, treatment, and outcome of reviewed cases.Data management All articles are selected, screened and reviewed, and the data from each article collated and registered into a Microsoft Excel (Microsoft, Redmond, Washington, USA) s p r e a d s h e e t .D a t a e x t r a c t i o n i n c l u d e d demographic data (age, sex, comorbidity, and anatomical defects of head), details of facial fat graft (local or general anesthesia, locations and amount of fat graft, time from surgery to symptoms), Symptoms, diagnostic tools, findings of diagnostic images, treatment, visual and neurological outcome, mortality, and presumed mechanisms of fat embolism. Quality assessment / Risk of bias analysisRiskof-bias assessment for included studies is assessed using the Joanna Briggs Institute critical appraisal checklist for case reports. Strategy of data synthesisDescriptive statistics and narrative synthesis are employed to characterize the overall study sample. Subgroup analysisWe divide the included cases into brain and eye fat embolism.Then we describe the clinical features of each group. Sensitivity analysis No sensitivity analysis.