Oral and Maxillofacial Surgery Cases最新文献

英文中文

Osteo-myo-cutaneous 5th rib-pectoralis major flap in complex mandibular ameloblastoma: A practical solution for low-resources settings 骨-肌-皮第5肋-胸大肌瓣治疗复杂的下颌成釉细胞瘤：一种低资源环境下的实用方法

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2025-03-06 DOI: 10.1016/j.omsc.2025.100393

Norman A. Rendón Mejía , Natanael Flores González , Yidam Irak Villa Martínez , Nancy Martinez Varela , Arturo Zamora Perea , Eric Sánchez Tellez , Hansel Gabriel Gómez Arámbula

Ameloblastoma, representing 1.3 % of all jaw tumors and ranking as the second most prevalent odontogenic neoplasm, is a benign yet locally invasive tumor. In developing countries, patients frequently present with advanced-stage lesions due to delayed medical intervention. Clinically, these tumors manifest as slow-growing, painless masses; however, their aggressive behavior often results in rapid expansion, causing tooth mobility, displacement, and facial deformity. Surgical resection remains the gold standard for management. Preoperative evaluation necessitates a comprehensive assessment of the patient's medical history, tumor location, macroscopic dimensions, and histopathological subtype. Post-resection, significant mandibular defects often necessitate reconstruction to restore shape and function. The fifth rib-pectoralis major osteo-myo-cutaneous flap has emerged as a robust reconstructive option, particularly in resource-limited settings. This technique leverages the flap's acromion-pectoral blood supply to transfer a spade-shaped segment of skin, subcutaneous tissue, and rib with reliability. It facilitates rapid oral rehabilitation, requires no microsurgical expertise, and minimizes operative time.

We present the case of a 44-year-old Rarámuri woman with a seven-year history of a left mandibular mass. Symptomatic progression—marked by pain and oral intolerance—prompted referral to our center. She underwent left mandibulectomy with immediate reconstruction using the osteo-myo-cutaneous flap. Postoperatively, she was discharged on day 14 with a gastrostomy tube and tracheostomy to manage neck edema, tolerating enteral feeds without complications. Follow-up revealed no significant adverse events, underscoring the flap's efficacy in challenging clinical contexts.

成釉细胞瘤是一种良性但局部侵袭性的肿瘤，占所有颌骨肿瘤的1.3%，是第二常见的牙源性肿瘤。在发展中国家，由于医疗干预延迟，患者经常出现晚期病变。临床表现为生长缓慢、无痛的肿块；然而，它们的攻击行为往往导致快速扩张，导致牙齿移动，移位和面部畸形。手术切除仍然是治疗的金标准。术前评估需要对患者的病史、肿瘤位置、宏观尺寸和组织病理学亚型进行综合评估。切除后，下颌缺损往往需要重建以恢复形状和功能。第五肋-胸大肌骨肌皮瓣已成为一种强大的重建选择，特别是在资源有限的情况下。这项技术利用皮瓣的肩峰-胸血供，可靠地转移一段铲子形状的皮肤、皮下组织和肋骨。它有助于快速口腔康复，不需要显微外科专业知识，并最大限度地减少手术时间。我们提出的情况下，44岁Rarámuri妇女与7年的历史，左侧下颌骨肿块。症状进展-以疼痛和口腔不耐受为特征-提示转介到我们中心。她接受了左下颌骨切除术，并立即使用骨肌皮瓣重建。术后第14天，患者行胃造口管和气管造口术，以控制颈部水肿，耐受肠内喂养，无并发症。随访显示无明显不良事件，强调皮瓣在具有挑战性的临床环境中的有效性。

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引用次数: 0

Integrating aligners with surgery first: A novel case report on single-jaw, multi-segmented maxillary osteotomy 先将矫正器与手术结合：单颌多节段上颌截骨术一例新报告

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2025-02-26 DOI: 10.1016/j.omsc.2025.100392

Inleel Lundgård Shino , Mohammedreza Sefidroodi , Stratos Vassis , Kasper Dahl Kristensen , Thomas Klit Pedersen , Jytte Buhl , Sven Erik Nørholt

Technological advancements have made the integration of clear aligner therapy (CAT) with orthognathic surgery a reality. This case report outlines an innovative, patient-specific workflow that merges CAT with the surgery first orthognathic approach (SFOA), developed in collaboration with engineers to facilitate in-house production of surgical guides and pre-adapted titanium plates. Objective evaluation was performed using the peer assessment rating (PAR) index. The patient achieved the intended occlusal relationship without discomfort in the temporomandibular joint (TMJ) and experienced no surgical complications. The surgical and occlusal outcomes have remained stable with reduced scores in the PAR index, reflecting improved objective assessment post treatment. This case report is the first of its kind to describe a single-jaw, multi-segmented maxillary osteotomy in SFOA using CAT. It demonstrates precise individualized planning in a multidisciplinary approach integrating CAT with SFOA making it feasible in cases involving a single jaw segmented Le Fort 1 osteotomy.

技术的进步使得清晰对准器治疗（CAT）与正颌手术的整合成为现实。本病例报告概述了一种创新的、针对患者的工作流程，该流程将CAT与手术第一正颌入路（SFOA）结合起来，与工程师合作开发，以促进手术指南和预适应钛板的内部生产。采用同行评价评分（PAR）指标进行客观评价。患者达到预期的咬合关系，颞下颌关节（TMJ）无不适，无手术并发症。手术和咬合结果保持稳定，PAR指数得分降低，反映了治疗后客观评估的改善。本病例报告是首次使用CAT描述SFOA的单颌多节段上颌截骨术。它展示了在多学科方法中精确的个性化规划，将CAT与SFOA相结合，使其在涉及单颚分段Le Fort 1截骨的病例中可行。

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引用次数: 0

Surgical excision of an ulcerating post-auricular infantile hemangioma with refractory hemorrhage 顽固性出血的婴幼儿耳后溃疡性血管瘤的手术切除

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2025-02-12 DOI: 10.1016/j.omsc.2025.100389

Rami Ezzibdeh , Mohamed Diop , Taseer Din , Brooke M. Su-Velez , Tulio Valdez

Infantile hemangiomas are the most common childhood tumor and most frequently appear in the head and neck. Beta-blockers like propranolol have become the standard therapy for hemangiomas and consequently surgical management is becoming increasingly rare. In this report we present the case of an ulcerating post-auricular hemangioma resulting in acute blood loss and requiring urgent surgery for hemorrhage control. This case highlights the importance of early diagnosis and treatment of infantile hemangiomas as progression to ulceration can lead to refractory bleeding needing urgent intervention.

婴儿血管瘤是最常见的儿童肿瘤，最常出现在头颈部。像心得安这样的受体阻滞剂已经成为血管瘤的标准治疗方法，因此手术治疗变得越来越罕见。在这个报告中，我们提出的情况下溃疡耳后血管瘤导致急性失血和出血控制需要紧急手术。这个病例强调了早期诊断和治疗婴儿血管瘤的重要性，因为进展到溃疡可能导致难治性出血，需要紧急干预。

引用次数: 0

Mandibular osteomyelitis and Lemierre's syndrome following third molar extraction in a young adult – A case report 青年第三磨牙拔除后的下颌骨髓炎和Lemierre综合征1例报告

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2025-02-12 DOI: 10.1016/j.omsc.2025.100391

George Ho , Eden Marco , Manuel Carcao , Pierre-Philippe Piche-Renaud , Dale Podolsky

Lemierre's syndrome is a rare condition that involves septic thrombophlebitis of the internal jugular vein (IJV) most commonly as a complication of oropharyngeal bacterial infections. It is even more rare in association with infection following third molar extraction. A 17-year-old male developed septic osteomyelitis with Moraxella osloensis bacteremia and Lemierre's syndrome resulting in complete occlusion of the IJV following routine third molar extraction. The patient required urgent operative debridement of the mandible as well as long-term antibiotics to treat the osteomyelitis and anticoagulant therapy to treat the IJV occlusion. The patient made a complete recovery. Clinicians should be aware that Lemierre's syndrome can complicate mandibular osteomyelitis.

Lemierre综合征是一种罕见的疾病，涉及颈内静脉脓毒性血栓性静脉炎（IJV），最常见的是口咽细菌感染的并发症。与第三磨牙拔牙后感染有关的情况更为罕见。一名17岁男性患者在常规第三磨牙拔除后出现脓毒性骨髓炎并伴有奥氏莫拉菌菌血症和Lemierre综合征，导致IJV完全闭塞。患者需要紧急下颌骨手术清创，长期使用抗生素治疗骨髓炎，并对IJV闭塞进行抗凝治疗。病人完全康复了。临床医生应该意识到Lemierre综合征可使下颌骨髓炎复杂化。

引用次数: 0

Multilobulated congenital epulis protruding from the maxillary anterior alveolar ridge in a four-day-old newborn: A case report 4天大新生儿上颌前牙槽嵴突出的先天性多分叶状上唇：1例报告

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2025-02-12 DOI: 10.1016/j.omsc.2025.100390

Khalid Almutairi , Rana Alshagroud , Fares Alrawashedah , Tariq Wahass

Congenital epulis is an exceedingly uncommon neoplasm that manifests in the oral cavity of neonates. The advancement in prenatal diagnostic techniques such as ultrasound and magnetic resonance imaging (MRI) allows for detection prior to birth. The most frequent site of manifestation is the anterior alveolar ridge of the maxilla, succeeded by the alveolar ridge of the mandible, and in rare cases, the tongue. There exist several theoretical proposals studying its histogenesis and potential causes, but they remain elusive. The case under discussion is a four-day-old female patient exhibiting a multilobulated, firm, pedunculated, mucosal-colored mass originating from the right anterior maxillary ridge and extending out from the mouth. The lesion posed an obstacle to normal feeding, although it fortunately did not impede the airway or respiration. The lesion was excised under general anesthesia and the specimen was forwarded to the histopathology laboratory where the diagnosis was confirmed. Seven weeks post-operation, the patient returned to our clinic exhibiting a fully healed wound. The prognosis for such a lesion is highly favorable, with no instances of recurrence documented in the literature. A multidisciplinary approach is required for the effective management of congenital epulis.

摘要先天性脓包是一种非常罕见的肿瘤，主要表现在新生儿的口腔。产前诊断技术的进步，如超声和磁共振成像（MRI）允许在出生前进行检测。最常见的表现部位是上颌骨的前牙槽嵴，其次是下颌骨的牙槽嵴，在极少数情况下，舌头也会出现。有几种理论建议研究其组织发生和潜在原因，但它们仍然难以捉摸。本文所讨论的病例是一名4天大的女性患者，表现为一多发、坚硬、带梗、黏膜色的肿块，起源于右上颌前脊，并从口腔向外延伸。病变对正常进食构成障碍，但幸运的是，它没有妨碍气道或呼吸。在全身麻醉下切除病变，标本被送到组织病理学实验室确诊。术后7周，患者回到我们的诊所，伤口完全愈合。这种病变的预后是非常有利的，文献中没有复发的记录。先天性膝外肌的有效治疗需要多学科的方法。

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引用次数: 0

A case report of classical presentation of rare melanotic neuroectodermal tumor of infancy 罕见的婴儿期黑色神经外胚层肿瘤的典型表现报告1例

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2025-01-30 DOI: 10.1016/j.omsc.2025.100386

Anumesh Dahal , K.C. Krishna , Sarala Khadka , Dewan Karki

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare neoplasm in infants, often mimicking aggressive malignancies or odontogenic lesions, particularly on maxillary or mandibular alveolar ridges. We report a 4-month-old male presenting with a one-month history of swelling in the right upper mouth, rapidly increasing over 15 days. Clinical examination showed a firm, bluish swelling on the right maxillary alveolus. Provisional diagnosis included rhabdomyosarcoma, with differential diagnoses of peripheral giant cell granuloma and small round cell tumor. Imaging revealed an expansile soft tissue mass in the right maxilla without systemic involvement. Surgical excision under general anesthesia was performed. Histopathology confirmed MNTI, supported by immunohistochemistry markers such as CK and HMB45 positivity. The patient showed no recurrence or complications over eight months of follow-up, with normal growth and healing in the affected region. This case underscores the importance of differentiating MNTI from malignancies in infants. Early diagnosis and surgical intervention are essential. A timely treatment and close follow-up ensures favorable outcomes in MNTI cases.

婴儿期黑色素神经外胚层肿瘤（MNTI）是一种罕见的婴儿肿瘤，通常模仿侵袭性恶性肿瘤或牙源性病变，特别是在上颌或下颌牙槽嵴。我们报告一个4个月大的男性表现为一个月的历史肿胀在右上口，迅速增加超过15天。临床检查显示右侧上颌牙槽有一坚硬的蓝色肿胀。初步诊断为横纹肌肉瘤，鉴别诊断为外周巨细胞肉芽肿及小圆细胞瘤。影像学显示右侧上颌骨有一个可扩张的软组织肿块，但未累及全身。全麻下行手术切除。组织病理学证实为MNTI，免疫组织化学标记如CK和HMB45阳性支持。随访8个月，患者无复发或并发症，受累部位生长愈合正常。这个病例强调了在婴儿中区分MNTI与恶性肿瘤的重要性。早期诊断和手术干预至关重要。及时治疗和密切随访可确保MNTI病例的良好结果。

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引用次数: 0

Masson's tumor of the parotid gland: A case report and literature review 腮腺马森瘤：1例报告并文献复习

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2025-01-30 DOI: 10.1016/j.omsc.2025.100387

Fawaz Alotaibi , Abdulrahman Hesham , Marwa Hatem , Yousef Alshamrani , Areil Cuevas Ocampo , Chinedum Okafor

Masson's tumor, also known as intravascular papillary endothelial hyperplasia (IPEH), is a rare benign vascular lesion characterized by an abnormal proliferation of endothelial cells within blood vessels, forming papillary structures that can occur in various parts of the body, including the parotid gland. Masson's etiology and risk factors remain unclear, but trauma and vascular pathological conditions may contribute to tumor progression. Despite its benign nature, Masson's tumor can present diagnostic challenges due to its variable clinical presentation and the need to differentiate it from other vascular lesions and malignancies. This case report presents a rare occurrence of Masson's tumor in the parotid gland of a 39-year-old female patient, along with a comprehensive review of the existing literature of this unusual presentation.

马松瘤，也称为血管内乳头状内皮增生（IPEH），是一种罕见的良性血管病变，其特征是血管内内皮细胞异常增殖，形成乳头状结构，可发生在身体的各个部位，包括腮腺。马松的病因和危险因素尚不清楚，但创伤和血管病理条件可能有助于肿瘤的进展。尽管它是良性的，但由于其多变的临床表现和需要将其与其他血管病变和恶性肿瘤区分开来，Masson肿瘤的诊断存在挑战。本病例报告一例39岁女性患者罕见的腮腺马森肿瘤，并对现有文献进行全面回顾。

引用次数: 0

Hydatid cyst of the mandibular condyle extending to the orbit–An unusual presentation 下颌骨髁棘包虫囊肿延伸至眼眶-一种不寻常的表现

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2025-01-23 DOI: 10.1016/j.omsc.2025.100388

Zaid R. Alzoubi , Fahad S. Al Qooz , Abdelrahman A. Alzboun , Mohammad F. Aljariri , Yasmeen Soboh

Hydatidosis is one of the most well-known zoonotic infections affecting the liver or brain, prevalent worldwide. Dogs are the most well-known intermediate hosts that affect humans. Humans can also contract the disease and become accidental intermediate hosts. While it is rare in the head and neck region, hydatidosis can manifest as either multiloculated or uniloculated lesions. The management of these cases presents significant challenges in maxillofacial surgery. Understanding the diagnosis, treatment options, and prognosis of head and neck hydatidosis is crucial. Even with advancements in medical technology, diagnosis and treating these infections continues to be a complex as these conditions can arise unexpectedly during a clinicians practice. This case report highlights the significance of clinical presentation, thorough history taking, histopathologic examination, and management plans. We present a case of a 17-year-old male who presented to our clinic with orbital proptosis and vertical orbital dystopia and was diagnosed with a hydatid cyst with an aim to help practitioners better understand and diagnose head and neck zoonotic diseases while promoting careful management practices.

包虫病是影响肝脏或大脑的最著名的人畜共患传染病之一，在世界范围内流行。狗是最著名的影响人类的中间宿主。人类也可能感染这种疾病，并成为意外的中间宿主。虽然它是罕见的在头颈部区域，包虫病可以表现为多房或单房病变。这些病例的处理在颌面外科中提出了重大挑战。了解头颈部包虫病的诊断、治疗方案和预后是至关重要的。即使随着医疗技术的进步，诊断和治疗这些感染仍然是一个复杂的问题，因为这些情况可能在临床医生的实践中意外出现。本病例报告强调临床表现、彻底的病史、组织病理检查和治疗计划的重要性。我们报告一个17岁的男性病例，他因眼眶突出和垂直眼眶异位被诊断为包虫囊肿，目的是帮助医生更好地理解和诊断头颈部人畜共患疾病，同时促进谨慎的管理实践。

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引用次数: 0

Orthognathic surgery in a patient with sickle cell disease: A case report and review of literature 镰状细胞病患者正颌手术一例报告及文献复习

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-12-26 DOI: 10.1016/j.omsc.2024.100382

Hussain Albannai , Abdulla Hanfesh , Yousif Al Nasrallah

Sickle cell disease is a genetic hemoglobinopathy that has the potential to affect any organ of the body. Patients with sickle disease have high morbidity and mortality creating safety concerns among patients and physicians about surgery in this subset of population. Factors that predispose SCD patient to complications are divided into patient-related and surgery-related factors. Patient factors associated with increased complication rate include the type and severity of SCD.

Orthognathic surgery involves osteotomies, major movement of upper or lower jaw that, although safe, have the potential of list of complications in healthy individuals. Therefore, complications are expected to be higher in SCD population. This complicates the decision of surgery and mandates careful perioperative management.

镰状细胞病是一种遗传性血红蛋白病，有可能影响身体的任何器官。镰状病患者的高发病率和死亡率引起了患者和医生对该人群手术安全性的担忧。SCD患者易发生并发症的因素分为患者相关因素和手术相关因素。与并发症发生率增加相关的患者因素包括SCD的类型和严重程度。正颌手术包括截骨术，上颌或下颌的大运动，虽然安全，但在健康个体中有潜在的并发症。因此，SCD人群的并发症预计会更高。这使得手术的决定变得复杂，需要谨慎的围手术期管理。

引用次数: 0

Innominate artery injury during percutaneous tracheostomy; a case report and literature review 经皮气管切开术中无名动脉损伤的研究病例报告及文献复习

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-12-25 DOI: 10.1016/j.omsc.2024.100380

Fawaz H. Alotaibi , Marwa Hatem , Indrajit Sehbi

Percutaneous tracheostomy is a common procedure that can be performed bedside by intensivists. The widespread adoption of bronchoscopy and ultrasound have also been utilized in the Intensive Care Unit (ICU), leading to the decline of conventional surgical tracheotomy. Percutaneous tracheotomy is thought to have several advantages over conventional tracheotomy. These include a smaller skin incision, less dissection and tissue trauma, and fewer wound complications. Long term complications have also been reported less frequently. One of the possible complications of performing these procedures is innominate artery injury, considered a rare but lethal injury. Injury to the innominate artery occurs in multiple different manners, including blunt, penetrating, or iatrogenic trauma.

We report a case of percutaneous tracheostomy complicated by injury to the innominate artery, requiring a conversion to an emergent open surgical tracheostomy. This case report illustrates the potentially fatal complication from performing a percutaneous tracheostomy, highlights the causes and management of innominate artery injury, and provides review of the literature this rare and uncommon complication.

经皮气管造口术是一种常见的手术，可以由重症医师在床边进行。在重症监护室（ICU）广泛采用支气管镜检查和超声检查，导致传统手术气管切开术的减少。经皮气管切开术被认为比传统的气管切开术有几个优点。这些包括更小的皮肤切口，更少的剥离和组织创伤，以及更少的伤口并发症。长期并发症的报道也较少。进行这些手术的一个可能的并发症是无名动脉损伤，这被认为是一种罕见但致命的损伤。无名动脉的损伤有多种不同的方式，包括钝性、穿透性或医源性创伤。我们报告一例经皮气管切开术并发无名动脉损伤，需要转换为紧急开放手术气管切开术。本病例报告阐述了经皮气管切开术的潜在致命并发症，强调了无名动脉损伤的原因和处理，并回顾了这一罕见和不常见并发症的文献。

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引用次数: 0

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