Oral and Maxillofacial Surgery Cases最新文献

Temporomandibular joint (TMJ) ankylosis can lead to complete or partial obliteration of the articular space and subsequent limited mouth opening. In children, ankylosis may lead to growth disturbance of the mandible, facial deformity, obstructive sleep apnea, impaired mastication and speech with subsequent nutritional deficiencies. Reconstruction of the condyle to restore facial deformities and TMJ function is recommended as soon as ankylosis is diagnosed. Surgical treatment options vary based on age, type and extent of the ankylosis and whether its uni-or bilateral. Different treatment modalities, such as distraction osteogenesis, gap arthroplasty, costochondral graft (CCG), sternoclavicular graft and alloplastic total joint reconstruction (ATJR) are common reconstruction choices.

We present a case of a long lasting bilateral TMJ ankylosis in a 5-year-old boy with severe OSA who was treated with bilateral alloplastic total joint reconstruction with successful outcome. Even though ATJR in growing children is controversial, the potential benefits of function and quality of life should to be considered in selected cases.

Granulomatosis with Polyangiitis previously called Wegener's granulomatosis is quite a rare condition that affects multiple organs. It's a serious disorder marked by inflammation that causes tissue damage in the upper and lower respiratory tract, glomerulonephritis, and vasculitis, which can be fatal. This illness can present in either a limited or generalized form. The limited version tends to progress slowly, while the more widespread form can rapidly lead to failure of multiple organs. One of the challenges in diagnosing is that its early symptoms are nonspecific.

We are presenting a case of 16-year-old girl come in with a rather unusual presentation. Her symptoms kicked off with strawberry gingivitis and swelling of the salivary glands. In our report, we delve into the details of her clinical signs, what we found on the radiological scans, and how we approached treatment.

Study design

Case report.

Objective

To present two cases of young children with Hyaline Fibromatosis Syndrome and their oral and maxillofacial manifestations.

Methods

The different oral and maxillofacial manifestations were clinically examined in detail. The patients were treated with surgical excisions of their gingival hyperplasias and soft tissue tumors of the head.

Results

Relief of pain from ears, scalp and intraoral was obtained, resulting in a normal eating and nutritional habits despite absence of teeth. Improved esthetics.

Conclusion

This paper underscores the importance of early diagnosis and prompt therapeutic interventions in managing Hyaline Fibromatosis Syndrome. This report contributes to the growing body of knowledge regarding this rare disorder and emphasizes the importance of a multidisciplinary approach in achieving favorable outcomes for patients afflicted with HFS.

Radiation therapy in treatment of head and neck cancer has contributed to improved survival rate of cancer patients. However, this is accompanied by a potential rise in post radiation complications including radiation induced malignancies and osteoradionecrosis.

Radiation Induced Osteosarcoma (RIOS) is rarely reported. In this paper, we report an unusual case of RIOS involving the parotid gland and mandible that was initially misdiagnosed as Osteoradionecrosis (ORN) provide a comprehensive review of the literature.

Myositis ossificans traumatica (MOT) is a rare condition characterized by nonneoplastic, heterotopic bone formation in the masticatory muscles following acute trauma. It usually occurs between the second and seventh decades of life in both genders. Although MOT of the masticatory muscles is not frequently reported in the literature, a common clinical finding is the progressive limitation of motion in the mandible. Managing this condition can be challenging. The available evidence regarding the effectiveness of conservative management, such as physical therapy and interpositional materials, is inconclusive based on the literature. Therefore, the preferred treatment for MOT is the surgical excision of the osseous mass. Under general anesthesia, the calcified muscle is completely removed. Surgical excision often leads to remission, although some patients may experience recurrent episodes. The purpose of this article is to review and discuss cases of MOT of masticatory muscles reported from 2014 to date. In addition to this literature review, we report a rare case involving a 9-year-old boy with recurring MOT of the right medial pterygoid muscles. The boy had a history of receiving a right-side mandibular nerve block injection and subsequently experienced a gradual decrease in the maximum incisal opening.

The intermixed mandibular lesion of cemento-ossifying fibroma (COF) and aneurysmal bone cyst (ABC) is a rare occurrence with dramatic ramifications if left untreated. COF is a benign fibro-osseous neoplasm that predominantly affects the tooth bearing regions of the jaws. It is most commonly observed in women during their third and fourth decades of life. ABC, alternatively, is a vascular lesion characterized by blood-filled spaces within the bone. The coexistence of these two distinct pathologies in the mandible presents diagnostic challenges due to their overlapping radiographic features. Once a diagnosis is obtained, smaller lesions can be enucleated and curettaged, although for larger and mixed lesions, en bloc resection is advised to reduce risk of recurrence. We present a case of a 17-year-old female with an intermixed lesion of the left mandible, undiagnosed for over 1 year, which led to severe facial asymmetry and mass effect on surrounding tissues. Treatment was completed with a left hemimandibulectomy and reconstruction with a custom plate, condylar head and free fibular flap transfer.

Calcium pyrophosphate deposition (CPPD) is a condition where calcium pyrophosphate crystals cause arthritis. Its occurrence in the temporomandibular joint (TMJ) is sparingly reported in the literature. Non-surgical treatment modalities consist of non-steroidal anti-inflammatory drugs, colchicine, and intra-articular cortisone injection. In the TMJ, previous reports have described resection of affected joint with reconstruction. We present a case of an extensive CPPD lesion affecting the left TMJ requiring surgical resection and reconstruction with a custom made TMJ prosthesis alongside with a review of the existing literature.

Simple bone cysts (SBCs) are nonneoplastic intraosseous cavities without an epithelial lining, surrounded by bony walls and either empty or containing liquid and/or connective tissue: they were first described in 1929 as a distinct entity of disease. The characteristic that distinguishes SBCs from true cysts is the absence of epithelial lining, that allow us to regard SBCs as pseudocysts.

In the literature, SBCs have been referred to as solitary bone cysts, idiopathic bone cysts, unicameral cysts, traumatic bone cysts, hemorrhagic bone cysts, primary bone cysts, and extravasation cysts.

The pathogenesis of SBC remains uncertains. Radiographically, SBCs usually present as isolated unilocular radiolucencies with well-defined borders. When SBC extends to the interdental bone, the characteristic radiographic “scalloping effect” can be observed. The differential diagnosis includes apical periodontitis, odontogenic keratocyst, central giant cell granuloma, ameloblastoma, odontogenic myxoma, and central and neurogenic neoplasms.

Surgery (curettage) is the gold standard treatment as it allows both diagnosis and treatment by generation of a blood clot in the vacant cavity of SBCs: bone usually regenerates progressively within 6–12 months. Recurrence rate is almost negligible.

The aim of the present article is to present and discuss the diagnosis and management of a case of SBC.

Kaposi's sarcoma (KS) is an uncommon angioproliferative tumour. In its classic form, it rarely affects the head and neck. The etiologic agent in KS is Human Herpesvirus type-8 (HHV-8) infection. Populations in which KS occurs in the setting of immunocompetence tend to have high rates of seropositivity for HHV-8, including Mediterranean and Jewish people. Descriptions of KS in immunocompetent Polynesian individuals are almost non-existent. A reason for this may be the relative inaccessibility, both geographically and culturally, of indigenous peoples living in the Oceanic area. High rates of HHV-8 seropositivity have recently been reported in indigenous Melanesian populations of Vanuatu, New Caledonia and Papua New Guinea, a region neighbouring Polynesia. This paper is the first to describe classic KS isolated to the oral cavity in an immunocompetent patient of Polynesian ancestry and highlights the need for further research to clarify the risk of KS emerging in this region.