Oral and Maxillofacial Surgery Cases最新文献

英文中文

Impressive regression of aggressive central giant cell granuloma with the use of intralesional corticosteroid injections

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-12-21 DOI: 10.1016/j.omsc.2024.100381

El Hamid Sami , Ilhami Ouail , Razem Bahaa , Oukerroum Abdelhakim , Slimani Faiçal

Introduction

and importance: Giant cell granuloma (GCG) is a begnin tumor usually occurring in the mandible or maxilla. Clinical presentation can vary from small peripheral GCG to aggressive central GCG for which a surgical procedure can damage functional structures and have a poor aesthetic outcome. Alternative therapies are of essential interest in those cases, as a monomodal treatment modality or as a neoadjuvant therapy.

Case presentation

We herein present a case of aggressive central GCG in a 11 year old infant with a suspected pycnodysostosis treated with neoadjuvant intralesional injections of corticosteroids. Impressive reduction of the lesion was observed and the patient underwent surgical curretage of the remaining mass. The GCG recurred 7 months after surgery and the patient benefited from the same treatment plan. No sign of recurrence was observed after 29 months. The case has been reported in line with the SCARE criteria.(1)

Clinical discussion

GCGs commonly occur in a young population making the conditions management challenging in the maxillofacial region because of its anatomical relationship with vital and functional structures as well as the associated deformity risk. Different medical therapies have been described such as corticosteroid injections, biphosphonates, interferon alpha and calcitonin with a various degrees of success.

Conclusion

Surgery is the gold standard in treating GCGs, however alternative therapies should be discussed in the management of extensive lesions.

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引用次数: 0

Desmoplastic fibroma of the maxilla in a 5-year-old patient with Tuberous Sclerosis Complex (TSC): Case report and review of the literature

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-12-18 DOI: 10.1016/j.omsc.2024.100378

Hunter Watson , Sarah Glass , Yotom Rabinowitz , Daniel Hawkins

The following case report details the presentation of a left maxillary painless expansile lesion in a five-year-old female that was proven to be desmoplastic fibroma (DF) of the maxilla, which was treated via a conservative excision. Given the paucity of DF cases in the Maxillofacial literature, there are no formally agreed-upon guidelines for the treatment of DF, especially in the maxillary sinus. A thorough review of the literature was completed and discussed, highlighting the correlation of DF with Tuberous Sclerosis Complex (TSC) and the proposed treatment when encountered in the maxillary sinus of a pediatric patient.

引用次数: 0

Recurrent clear cell odontogenic carcinoma initially diagnosed as ameloblastoma: A case report and review of literature

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-12-18 DOI: 10.1016/j.omsc.2024.100384

Thijs Bauwens , Frederik Piccart , Matthias Ureel , David Creytens , Wouter Bauters , Fréderic Duprez , Renaat Coopman

Clear cell odontogenic carcinoma (CCOC) is a rare, malignant tumor primarily affecting the mandible in middle-aged women, known to be highly recurrent post-surgery. A 56-year-old female, with an initial diagnosis of ameloblastoma based on radiological findings, had her diagnosis revised to CCOC at Ghent University Hospital after histopathological analysis and EWSR1::CREB1 gene fusion confirmation. Despite undergoing a Brown-Shah IID maxillectomy, radical neck dissection, and fibula flap reconstruction, she faced a recurrence within a year, complicated by an Aspergillus fumigatus infection requiring antifungal treatments and debridements. Diagnosis relies on immunohistochemical markers p40, p63, CK5, SMA, Calponin, and S-100. Additionally, over 80 % of CCOC cases show EWSR1 gene rearrangements. Treatment includes surgical resection and fibula free flap reconstruction. Adjuvant radiotherapy may be beneficial in cases with compromised margins or positive lymph nodes. Prophylactic antifungal treatment is recommended for at-risk patients. The complex nature of CCOC requires thorough follow-up and potentially adjuvant therapies.

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引用次数: 0

Case report: Chopstick penetrating into the left orbit and maxillary sinus without patient’s perception

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-12-16 DOI: 10.1016/j.omsc.2024.100383

Nguyen Trieu Viet, Do Hoi, Nguyen Thi Kieu Tuyen

Chopsticks are used very common in daily meals of Asian people. It can cause minor trauma during using without attention. But the serious trauma into the structures at the head and neck region is quite rare. Therefore, we would like to report a very rare case-a 24 yrs old male patient with chopstick penetrating into the left orbit destroying the orbit floor and lateral wall of maxillary sinusafter after an accident 3 weeks before admission and was treated with Caldwell-Luc surgery combined with paranasal endoscopy surgery to ensure completely removal of the foreign body and bone fragments.

引用次数: 0

Odontogenic myxoma of the maxillary sinus associated with an ectopic tooth

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-12-05 DOI: 10.1016/j.omsc.2024.100379

Robert S. Redman , Suman Chauhan , Brian B. Chang , Sonya C. Malekzadeh , Sarah K. Rapoport

Odontogenic myxoma is an uncommon, benign neoplasm that tends to recur because it locally invades or is trapped among the bony trabeculae. It is thought to arise from mesenchymal tissue associated with teeth and periodontium, as it develops in the tooth-bearing area of the jawbones, often in proximity to an unerupted tooth. Occasionally it may displace teeth. Those occurring in the maxilla often invade the maxillary sinuses. We report here a rare case of an odontogenic myxoma of the maxillary sinus associated with an ectopic tooth which was impinging on the nasal mucosa and accordingly was extracted through the nose.

引用次数: 0

Mandibular ramus distraction osteogenesis and Lefort I osteotomy for obstructive sleep apnea: A case report monitored with home respiratory polygraphy 下颌支牵张成骨和Lefort I截骨治疗阻塞性睡眠呼吸暂停：1例家庭呼吸测谎监测报告

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-11-28 DOI: 10.1016/j.omsc.2024.100377

Galder Hernando Martín , Pilar Rubio-Bueno , Ana Martínez Gil-Ortega , Joaquín Durán-Cantolla

A new monitoring protocol for orthognathic surgery for addressing obstructive sleep apnea syndrome in adult patients using bilateral internal ramus distraction (BIRD) followed by Lefort I osteotomy and monitored by HRP is presented. This strategy is part of an outpatient major surgery protocol and includes preoperative 3d virtual planning, followed by surgery under general anesthesia with endoscopic assistance.

Following the procedure, patients are typically discharged on the same day, with the vertical lengthening of the mandibular ramus starting after a 5-day period and progressing at a speed of 0.5–1 mm per day over a period of 10–50 days. The process carries on until the negative dental overjet exceeds 10 mm or the apnea-hypopnea index falls beneath 15 events per hour, demonstrating a curative level.

Mandibular advancement monitorization based on clinical, polygraphic, or polysomnographic criteria enables the surgeon to meet the individual needs of each patient. The distractors are typically maintained in position for six months following elongation of 10–25 mm to ensure proper consolidation.

BIRD followed by LeFort I osteotomy, has demonstrated significant efficacy as a treatment for obstructive sleep apnea syndrome in adult patients, irrespective of the presence of retrognathia. Furthermore, this approach may offer particular advantages for patients with severe cardiovascular disease or diabetes.

提出了一种新的监测方案，用于治疗成人患者的阻塞性睡眠呼吸暂停综合征的正颌手术，采用双侧内支牵张术（BIRD）和Lefort I截骨术，并由HRP监测。该策略是门诊大手术方案的一部分，包括术前3d虚拟计划，随后在内镜辅助下全身麻醉手术。手术后，患者通常在同一天出院，5天后开始下颌支垂直延长，以每天0.5-1 mm的速度进展，持续10-50天。这一过程一直持续到牙齿负覆盖超过10毫米或呼吸暂停低通气指数降至每小时15次以下，表明治疗水平。基于临床、多导睡眠图或多导睡眠图标准的下颌进展监测使外科医生能够满足每位患者的个性化需求。在拉伸10 - 25mm后，通常将牵张器保持在原位6个月，以确保适当的巩固。BIRD和LeFort I型截骨术治疗成人阻塞性睡眠呼吸暂停综合征的疗效显著，无论是否存在颌后畸形。此外，这种方法可能为患有严重心血管疾病或糖尿病的患者提供特别的优势。

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引用次数: 0

Noma recurrence in an adult: A case report from the Noma Children Hospital, Sokoto, Nigeria 成人坏疽性口炎复发：尼日利亚索科托诺马儿童医院的病例报告

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-11-12 DOI: 10.1016/j.omsc.2024.100376

Mujtaba Bala , K. Hakki Karagozoglu , Ramat Oyebunmi Braimah , Abdurrazaq Olanrewaju Taiwo , Ibrahim Kayode Suleiman , Abubakar Abdullahi Bello

Noma, also known as gangrenous stomatitis, is a devastating gangrenous infection of the mouth that predominantly affects children living in the poorest regions of the world. Although rare, noma can also affect adults, particularly those who are immunocompromised. Controversy exists about whether noma can recur. We report a case of a 65-year old man with recurrence of noma symptoms 2 years after his initial presentation. The patient responded well to antibiotic therapy, supportive care and serial debridement. This case demonstrates that noma can recur in adults, even after successful treatment of the initial treatment.

坏疽性口炎又称坏疽性口腔炎，是一种破坏性口腔坏疽感染，主要影响生活在世界最贫困地区的儿童。坏疽性口炎虽然罕见，但也会影响成年人，尤其是免疫力低下的成年人。关于坏疽性口炎是否会复发还存在争议。我们报告了一例坏疽性口炎复发的病例，患者是一名 65 岁的男性，在初次发病 2 年后症状复发。患者对抗生素治疗、支持性护理和连续清创反应良好。该病例表明，即使在初次治疗成功后，成人坏疽性口炎也可能复发。

引用次数: 0

Virtual surgical planning and custom titanium prosthesis for complex secondary mandibular reconstruction following gunshot injury: A case report 虚拟手术规划和定制钛假体用于枪伤后复杂的下颌骨二次重建：病例报告

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-10-24 DOI: 10.1016/j.omsc.2024.100375

Amir Jalal Abbasi , Somayeh Niakan , Seyed Mohammad Reza Noori , Rashin Bahrami , Nariman Nikparto

Advancements in reconstructive surgical techniques in the head and neck area have significantly improved the aesthetic and functional reconstruction of patients. Microsurgical techniques, virtual surgical planning (VSP), CAD-CAM technology, intraoperative dynamic navigation, and advanced implantology have greatly enhanced mandible reconstruction. The authors present a case report of a 30-year-old male who suffered a severe mandibular deformity from a gunshot injury. He underwent a complex reconstruction process that involved initial soft tissue repair followed by VSP for customized titanium prosthesis implantation and dental rehabilitation. Advanced software was used to aid in precise surgical and prosthetic design, ultimately restoring the patient's mandibular structure, chin alignment, and facial harmony. This innovative approach, which demonstrates the effectiveness of integrating digital technologies with surgical precision for intricate mandibular reconstructions following trauma, has a profound impact. It provides superior functional and aesthetic results compared to conventional methods, significantly improving the patient's quality of life.

头颈部整形外科技术的进步极大地改善了患者的美观和功能重建。显微外科技术、虚拟手术规划（VSP）、CAD-CAM 技术、术中动态导航和先进的种植技术大大提高了下颌骨重建的效果。作者报告了一例因枪伤导致下颌骨严重畸形的 30 岁男性患者的病例。他接受了复杂的重建过程，包括最初的软组织修复，然后进行 VSP 定制钛假体植入和牙齿康复。先进的软件用于辅助精确的手术和修复设计，最终恢复了患者的下颌骨结构、下巴排列和面部和谐。这种创新方法展示了数字技术与外科手术精确性相结合的有效性，对创伤后复杂的下颌骨重建产生了深远的影响。与传统方法相比，它能提供卓越的功能和美学效果，显著提高患者的生活质量。

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引用次数: 0

Simultaneous intraoral vertical ramus osteotomy and high condylectomy with custom internal fixation 口内垂直颌骨截骨术和高髁切除术同时进行，并定制内固定装置

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-10-11 DOI: 10.1016/j.omsc.2024.100374

Jeremie Oliver Piña , Gabriel Grisham , Chang min Richard Yim

Condylar hyperplasia is a rare disorder typically associated with excess bone growth presenting unilaterally causing facial asymmetry. Oftentimes, patients will present with temporomandibular joint discrepancies as well as occlusion issues. While the pathogenesis and etiology are not well understood, surgical treatment options have been well defined and typically result in favorable clinical outcomes. Herein, we present a case of an 18-year-old female patient with a history of right condylar hyperplasia Type 1B who underwent simultaneous right mandibular high condylectomy with disc repositioning and intraoral vertical ramus osteotomy (IVRO), left mandibular sagittal split osteotomy (SSO), and 3-piece Lefort I osteotomy with bone grafting. To our knowledge, this is the first reported case in which the patient received bilateral customized hardware for simultaneous high condylectomy and IVRO, SSO, Lefort osteotomy.

髁状突增生是一种罕见的疾病，通常与单侧骨质增生过多有关，会导致面部不对称。通常，患者会出现颞下颌关节差异以及咬合问题。虽然发病机理和病因尚不十分清楚，但手术治疗方案已得到明确界定，通常可获得良好的临床效果。在此，我们介绍了一例 18 岁女性患者的病例，她有右侧髁突增生 1B 型病史，同时接受了右下颌高髁切除术，并进行了椎间盘复位和口内垂直嵴截骨术（IVRO）、左下颌矢状劈开截骨术（SSO）和三件式 Lefort I 截骨术，并进行了植骨。据我们所知，这是第一例接受双侧定制硬件同时进行高髁切除术和 IVRO、SSO、Lefort 截骨术的病例。

引用次数: 0

The Djo technique: A novel technique for unilateral cleft lip Djo 技术：治疗单侧唇裂的新技术

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-10-10 DOI: 10.1016/j.omsc.2024.100373

Djohansjah Marzoeki

In unilateral cleft lip, elevation of the cleft side of the philtrum follows the elevation of the whole philtrum, beginning from the point where the philtral ridge of the normal side meets the vermilion. To inferiorly rotate this segment of the lip, the incision line must pass through the entire width of the philtrum. If the incision is limited only partially across the philtrum, anatomical correction will not be achieved. Here, the Djo technique for unilateral cleft lips is introduced. This technique is based on the accurate measurement of lip deficiency on the affected side. A triangular flap was created to fill the gap and correct the deficit.

The design is made by marking points A, B and C on the white roll where the philtrum meets the vermillion. D and E are points where the philtrum ridges meet the nasal sills. To achieve downward rotation of point C to the level of point A, line m is made from D to F at the philtrum ridge of the normal side. After incision, a triangular gap is produced. This gap will be filled by triangular isosceles flap the cleft side of the lip.

During the first week of healing process, the white skin roll was in a symmetrical line and the lip was not retracted. All the patients demonstrated a good result.

The main advantage of the Djo Technique is its design, where the points and lines on the part to be incised have been measured with an accurate calculation.

在单侧唇裂的情况下，从正常侧的颊嵴与朱砂交界处开始，抬高唇裂侧的颊脂垫，然后抬高整个颊脂垫。要下旋这部分唇部，切口线必须穿过整个咽鼓管宽度。如果切口仅部分穿过龈沟，则无法实现解剖矫正。在此，介绍治疗单侧唇裂的 Djo 技术。该技术基于对患侧唇缺损的精确测量。设计的方法是在龈沟与朱砂交界处的白卷上标记 A、B 和 C 点。D 和 E 点是咽鼓膜脊与鼻翼交界处。为了使 C 点向下旋转到 A 点的水平，在正常侧的咽鼓管嵴处从 D 到 F 划一条 m 线。切开后，会产生一个三角形间隙。在愈合过程的第一周，白色皮卷呈对称线，嘴唇没有回缩。所有患者都取得了良好的效果。Djo 技术的主要优势在于其设计，需要切开的部位上的点和线都经过精确的计算测量。

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