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Craniomaxillofacial Trauma & Reconstruction

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https://www.readbyqxmd.com/read/27833717/two-stage-cranioplasty-tissue-expansion-directly-over-the-craniectomy-defect-prior-to-cranioplasty
#1
Ellianne Jacira Dos Santos Rubio, Eelke M Bos, Ruben Dammers, Maarten J Koudstaal, Anton G Dumans
Performing a skull reconstruction for a long-term existing large cranium defect usually needs either skin enhancement or skin flaps and cranioplasty. This procedure can be accompanied with aesthetic and functional complications. The presented case describes a 27-year-old man in need of a cranial reconstruction following decompressive craniectomy as treatment for severe traumatic brain injury. Autologous cranioplasty after decompressive craniectomy failed due to bone flap infection. Because of cognitive behavioral problems, a protective helmet needed to be worn in awaiting cranioplasty...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833716/transoral-segmental-resection-and-disarticulation-of-mandible-with-immediate-nonvascularized-reconstruction-a-case-report
#2
Hemant Gupta, Deepak Singh, Sumit Gupta, Hemant Mehra, Jasmeet Singh, Ravish Mishra
Disarticulation resections are required for treatment of variety of pathologies of the jaws. These resections are mostly carried out through extraoral approach, which bear significant postoperative morbidity. The transoral approach may be used for this purpose in benign pathological cases of the mandible to limit the postoperative morbidity of extraoral approach, as it provides sufficient access not only for resection and disarticulation but also for immediate reconstruction. This article shares our experience with transoral approach for resection and disarticulation in a case of kerato cystic odontogenic tumor and simultaneous reconstruction...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833715/large-sublingual-dermoid-cyst-a-case-of-mandibular-prognathism
#3
Pablo Berbel, Alejandro Ostrosky, Franco Tosti
Dermoid cysts are unusual neoplasms and can occur in every part of the human body. They represent only 6.9% of all dermoid cysts in the head and neck region; in the oral cavity, the incidence is low, approximately 1.6% of all dermoid cysts. Our aim is to present an unusual case of a large sublingual dermoid cyst with mandibular prognathism caused by cyst growth. We reported a case of a large sublingual dermoid cyst in an 8-year-old female patient. A bibliographic research from 1937 to 2013 is reviewed and we found only three cases of mandibular deformity, of which only one was a dermoid cyst of the floor of the mouth...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833714/maxillary-sinus-mucocele-as-a-late-complication-in-zygomatic-orbital-complex-fracture
#4
Juliana Dreyer da Silva de Menezes, Lucas Borin Moura, Valfrido Antonio Pereira-Filho, Eduardo Hochuli-Vieira
This article presents an unusual case of maxillary sinus mucocele as a late complication of zygomatic-orbital complex fracture, 23 years after the initial treatment. The patient was referring diplopia and decreased visual acuity with signs of dystopia, proptosis, and epiphora. Computed tomographic scan revealed an expansive lesion in the maxillary sinus with surrounding bone erosion and displacement of the eyeball. Treatment option was excisional biopsy and orbital floor reconstruction with titanium mesh restoring the appropriate orbital position...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833713/extensive-cervicomediastinal-emphysema-from-mastoid-injury
#5
Yasmina Ahmed, Matthew Ng
Traumatic cervicomediastinal emphysema resulting from isolated head trauma is a rare occurrence. Herein, we describe a patient who sustained a closed mastoid injury after being struck with a batted baseball, resulting in acute extensive cervicomediastinal emphysema. Upon further assessment, the patient's aerodigestive tract was determined to have remained intact and unaffected by the injury. The source of soft-tissue air originated from the fractured mastoid. This case demonstrates the protective properties of a well-pneumatized mastoid...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833712/partially-thrombosed-internal-maxillary-pseudoaneurysm-after-gunshot-wound
#6
Menachem Gold
A 29-year-old man arrived in our emergency department after being shot on the face. Computed tomography (CT) revealed multiple facial bone fractures along the bullet trajectory. On day 10 of admission, CT angiogram of the neck revealed a partially thrombosed pseudoaneurysm in the parapharyngeal fat pad. The pseudoaneurysm was successfully treated with coil embolization. This report discusses diagnosis and treatment of a partially thrombosed internal maxillary artery pseudoaneurysm. Although digital subtraction angiography is the gold standard for pseudoaneurysm diagnosis, CT angiography may provide complimentary information, as seen in this case...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833711/percutaneous-tracheostomy-and-percutaneous-angiography-the-diuturnity-of-sven-ivar-seldinger-of-mora-pasquale-ciaglia-of-utica
#7
Richard A Pollock
In the latter part of the 20th century, three developments intersected: skin-to-artery catheterization, percutaneous tracheostomy, and market introduction of video-chip camera-tipped endoscopes. By the millennium, every vessel within the body could be visualized radiographically, and percutaneous tracheostomy (with tracheal-ring "dilation," flawless high-resolution intratracheal video-imagery, and tracheal intubation) could consistently be achieved at the patient's bedside. Initiated through the skin and abetted by guide-wire insertion, these procedures are the lasting gifts of Sven-Ivar Seldinger (1921-1998) of Mora, Sweden, and Pasquale Ciaglia (1912-2000) of Utica, New York...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833710/current-management-of-zygomaticomaxillary-complex-fractures-a-multidisciplinary-survey-and-literature-review
#8
Scott J Farber, Dennis C Nguyen, Gary B Skolnick, Albert S Woo, Kamlesh B Patel
Despite the prevalence of zygomaticomaxillary complex (ZMC) fractures, there is no consensus regarding the best approach to management. The aim of this study is to determine differences in ZMC fracture treatment among various surgical specialties. A survey was conducted regarding treatment of patients with different ZMC fractures that included a minimally displaced fracture (Case 1), a displaced fracture without diplopia (Case 2), a displaced fracture with diplopia (Case 3), and a complex comminuted fracture (Case 4)...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833709/immediate-reconstruction-of-large-full-thickness-segmental-anterior-maxillary-defect-with-bone-transport
#9
Alberto Rocha Pereira, Nuno Montezuma, Luis Oliveira, Miguel Magalhães, José Rosa
Maxillary segmental defects are a reconstructive challenge particularly when the anterior arch is involved. Missing bone, mucosa, and teeth should be replaced; fistulae closure should be guaranteed by bone and mucosa continuity; stable functional occlusion should be achieved; and facial aesthetics restored. These defects resulting from tumor excisions, if left untreated, will cause additional problems related to interposed scar and collapse of lip and nose. Immediate reconstruction should avoid these problems and should be considered when safe tumor-free margins are obtained...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833708/surgical-treatment-of-orbital-blowout-fractures-complications-and-postoperative-care-patterns
#10
Matthew Shew, Michael P Carlisle, Guanning Nina Lu, Clinton Humphrey, J David Kriet
Orbital fractures are a common result of facial trauma. Sequelae and indications for repair include enophthalmos and/or diplopia from extraocular muscle entrapment. Alloplastic implant placement with careful release of periorbital fat and extraocular muscles can effectively restore extraocular movements, orbital integrity, and anatomic volume. However, rare but devastating complications such as retrobulbar hematoma (RBH) can occur after repair, which pose a risk of permanent vision loss if not addressed emergently...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833707/a-modified-technique-for-placing-prebent-plates-during-a-le-fort-i-osteotomy-a-technical-note
#11
Marwa Ragaey, Joseph Van Sickels
Prebent plates have gained popularity in recent years as a fixation appliance for large maxillary advancements. They are larger than standard plates used for maxillary procedures and appear to give greater stability. Due to their size and configuration, they have the potential to be more palpable than standard plates, possibly causing discomfort following placement. With a simple "box" osteotomy of the maxilla at the site of placement and a minor modification of the plate, the plate is less palpable and better tolerated by the patient...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833706/variant-anatomy-of-the-nasal-and-labial-branches-of-the-infraorbital-nerve
#12
Joseph Munyiri Nderitu, Fawzia Butt, Hassan Saidi
Comprehensive understanding of the variations in the branches of the infraorbital nerve (ION) is vital to the prevention of iatrogenic nerve injury and successful ION blockade during orbitozygomatic facial procedures. Only a few studies exist on the variant anatomy of the branching patterns of this nerve. This article provides a detailed description of the variations of the nasal and superior labial branches of the ION. This study was performed on 84 IONs by dissecting 42 formalin-fixed cadavers from the Laboratory of Topographic Anatomy, Department of Human Anatomy, University of Nairobi...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833705/post-ankylotic-temporomandibular-joint-reconstruction-using-autogenous-alloplastic-materials-our-protocol-and-treatment-outcomes-in-22-patients
#13
Yogesh Bhardwaj, Saurabh Arya
The purpose of this study was to evaluate the various options of autogenous and alloplastic reconstruction modalities available for posttraumatic temporomandibular joint (TMJ) ankylosis. In a retrospective study of 22 patients, various autogenous/alloplastic materials were used based on type and severity of ankylosis and age of patient. Final outcome of reconstruction was critically evaluated in terms of maximal mouth opening, occlusion, and facial symmetry. Fourteen patients (63.63%) developed TMJ ankylosis due to road traffic accidents and eight patients (36...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27833704/superior-orbital-fissure-syndrome-in-lateral-orbital-wall-fracture-management-and-classification-update
#14
REVIEW
Claudio Caldarelli, Rodolfo Benech, Caterina Iaquinta
The superior orbital fissure syndrome (SOFS) is an uncommon complication rarely occurring in association with craniofacial trauma. Work-up of a patient injured by a traumatic right orbitozygomatic complex fracture and SOFS is presented. Accurate computed tomography scan and three-dimensional reconstruction showed a medial displacement of the lateral orbital wall, compressing the right superior orbital fissure (SOF), without intraorbital bone fragment displacement or hemorrhage. Imaging also revealed a frontosphenotemporal fracture, according to Pellerin et al, that is, frequently associated with visual impairment...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27516847/orbital-osteoblastoma-technical-innovations-in-resection-and-reconstruction-using-virtual-surgery-simulation
#15
REVIEW
Giorgio Novelli, Marco Gramegna, Gabriele Tonellini, Gabriella Valente, Pietro Boni, Alberto Bozzetti, Davide Sozzi
Osteoblastoma is a benign tumor of bone, representing less than 1% of bone tumors. Craniomaxillofacial localizations account for up to 15% of the total and frequently involve the posterior mandible. Endo-orbital localization is very rare, with most occurring in young patients. Very few of these tumors become malignant. Orbital localization requires radical removal of the tumor followed by careful surgical reconstruction of the orbit to avoid subsequent aesthetic or functional problems. Here, we present a clinical case of this condition and describe a surgical protocol that uses and integrates state-of-the art technologies to achieve orbital reconstruction...
September 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27516846/persistent-upgaze-restriction-after-orbital-floor-fracture-repair
#16
Sarah Willcox DeParis, F Lawson Grumbine, M Reza Vagefi, Robert C Kersten
Here we present two cases of marked postoperative upgaze restriction after successful repair of orbital floor fracture and release of inferior rectus entrapment. In both cases, follow-up imaging showed enlargement of the inferior rectus, and gradual resolution of gaze limitation was observed over several months of conservative management. Thus, in patients with postoperative findings suggestive of residual inferior rectus entrapment, follow-up imaging is indicated prior to returning to the operating room. With a markedly swollen inferior rectus muscle but no radiographic evidence of residual muscle entrapment in the fracture, a trial of conservative management may be warranted...
September 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27516845/patient-specific-implant-for-residual-facial-asymmetry-following-orthognathic-surgery-in-unilateral-craniofacial-microsomia
#17
Femke Staal, Britt Pluijmers, Eppo Wolvius, Maarten Koudstaal
Craniofacial microsomia (CFM) is a congenital anomaly with a variable phenotype. The most prominent feature of CFM is a predominantly unilateral hypoplasia of the mandible, leading to facial asymmetry. Even after correction of the midline, there is often a remaining hard- and soft-tissue deficiency over the body of the mandible and cheek on the affected side. This clinical report describes the skeletal augmentation of the mandible with a patient-specific implant to treat residual facial asymmetry in two female patients with unilateral CFM...
September 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27516844/unusual-case-of-sinusitis-related-to-ectopic-teeth-in-the-maxillary-sinus-roof-orbital-floor-a-report
#18
Otacílio Luiz Chagas Júnior, Lucas Borin Moura, Camila Leal Sonego, Eduardo Oliveira Campos de Farias, Caroline Comis Giongo, Alisson André Robe Fonseca
This article presents a case report of an adult patient with chronic sinusitis related to the presence of two erupted ectopic teeth located atypically in the maxillary sinus roof/orbital floor after a long latency period associated with childhood facial trauma. This article aims to show the treatment of chronic sinusitis of odontogenic origin by surgical removal of ectopic teeth in an unusual position by direct visualization. This case report discusses the signs and symptoms of chronic sinusitis linked to the presence of ectopic elements and associated with an inflammatory cyst, the choice of complementary tests for diagnosis and surgical treatment through the Caldwell-Luc procedure...
September 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27516843/long-term-results-of-orbital-roof-repair-with-titanium-mesh-in-a-case-of-traumatic-intraorbital-encephalocele-a-case-report-and-review-of-literature
#19
Erhan Arslan, Selçuk Arslan, Selçuk Kalkısım, Ahmet Arslan, Kayhan Kuzeyli
Orbital roof fractures associated with cranial and maxillofacial trauma are rarely encountered. Traumatic intraorbital encephaloceles due to orbital roof fractures developing in the early posttraumatic period are even rarer. A variety of materials, such as alloplastic implants or autogenous materials, have been used for the reconstruction of orbital roof, but data regarding the long-term results of these materials are very limited. We report a case of intraorbital encephalocele developing in the early posttraumatic period (2 days) in a child patient and the long-term results of titanium mesh used for the reconstruction of the orbital roof...
September 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27516842/anesthetic-complication-during-maxillofacial-trauma-surgery-a-case-report-of-intraoperative-tension-pneumothorax
#20
Al Haitham Al Shetawi, Leonard Golden, Michael Turner
Tension pneumothorax is a life-threatening emergency that requires a high index of suspension and immediate intervention to prevent circulatory collapse and death. Only five cases of pneumothorax were described in the Oral and Maxillofacial Surgery literature. All cases were postoperative complications associated with orthognathic surgery. We report a case of intraoperative tension pneumothorax during a routine facial trauma surgery requiring emergency chest decompression. The possible causes, classification, and reported cases will be presented...
September 2016: Craniomaxillofacial Trauma & Reconstruction
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