Oral and Maxillofacial Surgery Cases最新文献

英文中文

Effects of botulinum toxin type A on the masseter muscles of a patient with a temporomandibular joint disorder of muscular origin: A case report A型肉毒毒素对肌肉源性颞下颌关节紊乱患者咬肌的影响：1例报告

Q3 Dentistry

Oral and Maxillofacial Surgery Cases

Pub Date : 2024-12-21 DOI: 10.1016/j.omsc.2024.100385

Mohammad Nasoh Alzaeem , Bassel Brad , Ibrahim Haddad , Mohammad Y. Hajeer

Temporomandibular joint disorders (TMDs) typically manifest with symptoms and signs such as pain, mandibular movement, dysfunction, or joint sounds. Botulinum toxin type A (BTX/A) is a biological toxin that inhibits the release of the neurotransmitter acetylcholine at the neuromuscular junction. This toxin is used to treat hyperactivity of masseter muscles and TMD symptoms. This case report aimed to investigate the effects of BTX/A injection in the masseter and lateral pterygoid muscles of a patient with painful symptoms of TMDs via electromyography (EMG), with a follow-up of six months post-treatment. During each visit, the clinical effects, which were evaluated based on pain intensity (NPRS), the bruxism questionnaire, and maximum mouth opening, were evaluated at five-time points, pre-injection and 2, 6, 12, and 24 weeks after the injection. Based on this case report, there was a clear improvement in the studied parameters, with a significant decrease in the electromagnetic activity of the injected muscles as shown by EMG; thus, BTX/A can be considered an effective treatment to relieve symptoms and improve the quality of life in patients with TMDs of muscular origin, relying on EMG as an effective diagnostic tool and for subsequent evaluation of treatment results.

颞下颌关节紊乱（TMDs）通常表现为疼痛、下颌运动、功能障碍或关节声音等症状和体征。A型肉毒毒素（BTX/A）是一种抑制神经递质乙酰胆碱在神经肌肉交界处释放的生物毒素。这种毒素用于治疗咬肌过度活跃和TMD症状。本病例报告旨在通过肌电图（EMG）研究BTX/A注射对有疼痛症状的颞下颌关节痛患者咬肌和翼状外侧肌的影响，治疗后随访6个月。每次就诊时，分别在注射前、注射后2周、6周、12周和24周的5个时间点对临床效果进行评估，评估依据疼痛强度（NPRS）、磨牙问卷和最大开口度。根据本病例报告，研究参数有明显改善，肌电图显示注射肌肉的电磁活动明显减少；因此，BTX/A可被认为是缓解肌肉源性tmd患者症状和改善生活质量的有效治疗方法，依托肌电图作为有效的诊断工具和对治疗结果的后续评价。

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引用次数: 0

Impressive regression of aggressive central giant cell granuloma with the use of intralesional corticosteroid injections 病灶内皮质类固醇注射后侵袭性中央巨细胞肉芽肿显著消退

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.

巨细胞肉芽肿（GCG）是一种常见于下颌骨或上颌骨的初发性肿瘤。临床表现可以从小的外周性GCG到侵袭性的中央性GCG，其中手术可能会损害功能结构并导致不良的美学结果。在这些病例中，作为单模治疗方式或作为新辅助治疗，替代疗法是至关重要的。病例介绍：我们在此报告一例侵袭性中央GCG在11岁的婴儿与疑为结节性骨裂症治疗新辅助病灶内注射皮质类固醇。观察到病灶明显缩小，患者接受手术切除剩余肿块。术后7个月GCG复发，患者受益于相同的治疗方案。29个月后无复发迹象。(1)临床讨论：由于颌面区域与重要和功能结构的解剖关系以及相关的畸形风险，ongcgs通常发生在年轻人群中，使得颌面区域的病情管理具有挑战性。不同的医学疗法，如皮质类固醇注射、双膦酸盐、α干扰素和降钙素，都取得了不同程度的成功。结论手术是治疗gcg的金标准，但对于广泛病变的治疗应探讨替代疗法。

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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 1例5岁结节性硬化症（TSC）患者的上颌骨纤维组织增生瘤：病例报告及文献复习

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.

以下病例报告详细介绍了一名5岁女性左上颌无痛性扩张性病变，经证实为上颌粘连增生纤维瘤（DF），并通过保守切除治疗。鉴于颌面文献中DF病例的缺乏，没有正式商定的DF治疗指南，特别是在上颌窦。我们对文献进行了全面的回顾和讨论，强调了DF与结节性硬化症（TSC）的相关性，以及儿科患者在上颌窦遇到时的治疗建议。

引用次数: 0

Recurrent clear cell odontogenic carcinoma initially diagnosed as ameloblastoma: A case report and review of literature 最初诊断为成釉细胞瘤的复发性透明细胞性牙源性癌1例报告及文献复习

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.

透明细胞牙源性癌（CCOC）是一种罕见的恶性肿瘤，主要影响中年妇女的下颌骨，已知是术后高度复发。一名56岁女性，最初诊断为成膜细胞瘤，基于影像学表现，在根特大学医院进行组织病理学分析和EWSR1::CREB1基因融合确认后，诊断修改为CCOC。尽管接受了Brown-Shah ii型上颌切除术、根治性颈部清扫术和腓骨瓣重建，她在一年内面临复发，并伴有烟曲霉感染，需要抗真菌治疗和清创。诊断依赖免疫组织化学标志物p40、p63、CK5、SMA、钙钙蛋白和S-100。此外，超过80%的CCOC病例显示EWSR1基因重排。治疗包括手术切除和腓骨游离皮瓣重建。对于边缘受损或淋巴结阳性的病例，辅助放疗可能是有益的。建议高危患者进行预防性抗真菌治疗。CCOC的复杂性需要彻底的随访和潜在的辅助治疗。

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引用次数: 0

Case report: Chopstick penetrating into the left orbit and maxillary sinus without patient’s perception 病例报告：筷子在患者未察觉的情况下刺入左眼眶和上颌窦

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.

筷子在亚洲人的日常饮食中使用得很普遍。在使用过程中，如果不注意，可能会造成轻微的创伤。但是头部和颈部结构的严重创伤是非常罕见的。因此，我们报告一例非常罕见的病例，一名24岁的男性患者在入院前3周发生意外后，因筷子刺入左眼眶破坏眶底及上颌窦外侧壁，采用Caldwell-Luc手术联合鼻窦内窥镜手术治疗，以确保异物及骨碎片完全清除。

引用次数: 0

Odontogenic myxoma of the maxillary sinus associated with an ectopic tooth 伴有异位牙的上颌窦牙源性黏液瘤

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.

牙源性黏液瘤是一种罕见的良性肿瘤，由于其局部侵袭或被困在骨小梁中，容易复发。它被认为是由与牙齿和牙周组织相关的间质组织产生的，因为它生长在颌骨的含牙区域，通常靠近未长出的牙齿。有时它会取代牙齿。发生在上颌骨的常侵犯上颌窦。我们在此报告一例罕见的牙源性黏液瘤的上颌窦与异位的牙齿，这是冲击鼻黏膜，并因此被提取通过鼻子。

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

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