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Craniomaxillofacial Trauma & Reconstruction

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
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
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
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
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
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
Andrew Ow, Winston Tan, Lukasz Pienkowski
The use of virtual surgical planning and computer-aided design/computer-aided manufacturing has been reported to enhance the planning for the reconstruction of mandibular continuity defects. This case report illustrates the use of this technology in the fabrication of a custom-made titanium prosthesis to restore a segmental mandibular defect. The design specifications and sequence of the custom-made titanium prosthesis are discussed. Although successful in this case, there are limitations in its application and case selection is of vital importance...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Ramesh K Sharma, Guru Karna Vemula, Jerry R John
We report an unusual case of a large metallic foreign body embedded in the maxillary antrum leading to extensive bony destruction of the mid-face following a road side accident in a 12-year-old boy. There was extensive bony loss that necessitated reconstruction for both aesthetic and functional reasons. The same was accomplished by using split cranial bone graft in a delayed primary manner after a gap of 7 days following initial debridement. There was primary healing with good aesthetic and functional results...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Mark Fisher, Miguel Medina, Branko Bojovic, Edward Ahn, Amir H Dorafshar
The complex three-dimensional relationships in congenital craniofacial reconstruction uniquely lend themselves to the ability to accurately plan and model the result provided by computer-aided design and manufacturing (CAD/CAM). The goal of this study was to illustrate indications where CAD/CAM would be helpful in the treatment of congenital craniofacial anomalies reconstruction and to discuss the application of this technology and its outcomes. A retrospective review was performed of all congenital craniofacial cases performed by the senior author between 2010 and 2014...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Sudheesh K M, Rajendra Desai, Siva Bharani K Sn, Subhalakshmi S
There are no clearly defined guidelines for when an open or closed treatment is indicated for treatment of mandibular condylar fractures. The aim of the study is to analyze the mandibular function after nonsurgical treatment of unilateral subcondylar fractures, in a prospective study. A prospective study was conducted on 30 patients with unilateral mandibular subcondylar fracture undergoing nonsurgical treatment. Clinical and radiographic examinations were done prior to treatment and at 12-month follow-up. Pain, perceived occlusion, mouth opening, protrusion, and horizontal movements of the mandible were evaluated by clinical examination...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Suresh Menon, Veerendra Kumar, Srihari V, Yogitha Priyadarshini
The mandibular angle and condylar regions are most prone to fractures and this has been attributed to the presence/absence or the position of the third molars. This retrospective study was undertaken to analyze the correlation between the third molars and incidence of condylar and angle fractures in 104 patients treated for these fractures during the period from June 2009 to December 2013. Clinical and radiographic records of these patients were studied to look for the presence and position of third molars and their relation to incidence of condylar or angle fractures...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Dana Johns, Erin Anstadt, Daniel Donato, John Kestle, Jay Riva-Cambrin, Faizi Siddiqi, Barbu Gociman
Posterior cranial vault distraction (PCVD) has become an important modality in the management of complex craniosynostosis to increase intracranial volume and improve the cranial vault appearance. This technique can safely be performed as early as 3 months of age for the initial management of patients with complex craniosynostosis. A retrospective review was performed of all the patients with syndromic, multiple-suture synostosis treated with PCVD at Primary Children's Hospital in Salt Lake City, Utah, between 2012 and 2014...
September 2016: Craniomaxillofacial Trauma & Reconstruction
J Rodrigo Diaz-Siso, Natalie M Plana, Paul N Manson, Eduardo D Rodriguez
Historically, periodic academic meetings held by surgical societies have set the stage for discussion and exchange of ideas, which in turn have led to advancement of clinical practices. Since 2007, the AONA State of the Art: Facial Reconstruction and Transplantation Meeting (FRTM) has been organized to provide a forum for specialists around the world to engage in open conversation about the approaches currently at the forefront of facial reconstruction. Review of registration data of FRTM iterations from 2007 to 2015 was performed...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Giuseppe Spinelli, Davide Lazzeri, Francesco Arcuri, Domenico Valente, Tommaso Agostini
Fractures of the mandibular angle account for 23 to 42% of all facial fractures with a high complication rate (0-32%). Although the ideal treatment remains debatable, two main procedures are commonly used to manage the majority of mandibular angle fractures that are open reduction and internal fixation by a noncompression miniplate placed on the external oblique ridge with or without a second miniplate on the outer cortex. The purpose of this study was to describe our management of mandibular angle fractures by two noncompression miniplates placed on the outer cortex via a transbuccal approach...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Babatunde Olayemi Akinbami
BACKGROUND: The use of NVBG for mandibular defects seems to be gradually giving way for more advanced reconstructive techniques but it has the advantages of shorter operating time and lesser amount of blood loss. The aim of this study was to review the available data on the success and failure rates of use of NVBG and factors associated with failure. METHOD: Studies published from 1978 to 2014 regarding the use of NVBG were searched. Most important information was graft success and failure outcomes...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Andreas Thor
This paper describes the course of treatment of a severely diplaced bilateral mandibular body fracture, where the first osteosynthesis failed. The subject developed an open bite due to a posterior rotation of the distal part of the mandible and anterior rotation of the proximal parts of the mandible. This situation was evaluated with CBCT and the facial skeleton was segmented using computer software. Correct occlusion was virtually established by bilateral virtual osteotomies in the fracture areas of the mandible...
June 2016: Craniomaxillofacial Trauma & Reconstruction
Raj Dedhia, Travis T Tollefson
There is a lack of consensus regarding preferred implant materials for orbital floor fracture reconstruction, leading to surgeon- and institution-dependent preferences. A variety of implants are used for orbital floor fracture reconstruction, each with their own complication profile. Knowledge of different implant materials is critical to identifying complications when they present. We report a delayed periorbital abscess 5 years after orbital floor reconstruction using a silicone implant.
June 2016: Craniomaxillofacial Trauma & Reconstruction
Ryan Williams, Matthew K Lee, Sam P Most
Septal perforations present a challenging dilemma for surgical intervention when medical therapy fails. Multiple techniques have been described in the literature to address perforations using numerous techniques; however, there have been varying rates of success and reproducibility reported. The use of a large, pericranial flap was previously described to repair large septal perforation. The objective of this case report is to describe the use of a pedicled pericranial flap in combination with intraoperative fluorescence angiography to quantify vascular perfusion...
June 2016: Craniomaxillofacial Trauma & Reconstruction
Josher Molendijk, Bob Vervloet, Eppo B Wolvius, Maarten J Koudstaal
In the Netherlands, it is a tradition of setting off fireworks to celebrate the turn of the year. In our medical facility, each year patients with severe skeletal maxillofacial trauma inflicted by recreational fireworks are encountered. We present two cases of patients with severe blast injury to the face, caused by direct impact of rockets, and thereby try to contribute to the limited literature on facial blast injuries, their treatment, and clinical outcome. These patients require multidisciplinary treatment, involving multiple reconstructive surgeries, and the overall recovery process is long...
June 2016: Craniomaxillofacial Trauma & Reconstruction
José Luis D'Addino, Laura Piccoletti, María Mercedes Pigni, Maria José Rodriguez Arenas de Gordon
The objective of this study is to report a large, rare, and ulcerative infiltrated skin lesion. Its diagnosis, therapeutic management, and progress are described. The patient is a 78-year-old white man, who presented with a 12-month ulcerative perforated lesion that had affected and infiltrated the skin, with easy bleeding. He had a history of hypertension, although controlled, was a 40-year smoker, had chronic atrial fibrillation, diabetes, and microangiopathy. During the consultation, the patient also presented with ocular obstruction due to an inability to open the eye...
June 2016: Craniomaxillofacial Trauma & Reconstruction
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