Oral and Maxillofacial Surgery Cases最新文献

Lipomas are a type of mesenchymal neoplasm most commonly occurring in the subcutaneous compartment and can be distributed throughout the body. These tumors are most commonly found in the upper part of the body. Their growth is slow and are usually small, weighing only a few grams. A link has been established between soft tissue trauma and the development of lipomas, which have been dubbed, posttraumatic lipomas. We hereby present a case of a solitary slowly evolving fronto-parietal scalp lipoma following a local blunt trauma.

Background/Aim: Squamous cell carcinoma (SCC) is the most frequent carcinoma when dealing with malignant tumors of the oral cavity. SCC of the head and neck show cervical lymphatic metastasis, which is the most important prognostic factor for the long-term outcome of these patients. Hematogenous spread of this entity is rare, especially distant osseous metastasis. Therefore, the therapy for SCC typically consists of surgical tumor resection, neck dissection and plastic reconstruction. Most recurrences occur within the first two years postoperatively. This results in the need for close tumor follow-up.

Case report

The present case report describes a 79-year-old female suffering from a recurrent SCC of the oral cavity 19 years postoperatively firstly noticed through symptomatic osseous metastasis of the right femur. Trial excision of the right femur revealed the finding of a metastatic squamous cell carcinoma. The patient received palliative radiation therapy.

Conclusion

Osseous metastasis of SCC to the femur is rare. What is remarkable about this case report is the time span of 19 years between primary curative treatment, unremarkable follow up and the presence of metastatic late recurrence. Therefore long-term close follow-up in the treatment of oral cavity SCC in an interdisciplinary context is crucial.

A 26-year-old female patient presented for extraction of her mandibular impacted third molars, teeth #17 and #32. The patient was consented with the understanding of potential complications of inferior alveolar nerve (IAN) and lingual nerve (LN) injury. A panoramic radiograph was the initial imaging used to determine the risk associated with the extraction of tooth #17 and tooth #32. Cone-beam computed tomography (CBCT) was also utilized and interpreted before the extraction surgery. During the removal of #32, there was a fracture of the thin lingual plate and a portion of the #32 root was displaced lingually out of the alveolus. This case presentation illustrates the use of a piezoelectric device (Mectron S·P.A., Carasco, Genoa, Italy) (PD) to create osteotomies of the lingual socket's cortical plate and allow for the retrieval of the root through the lingual plate perforation, avoiding further displacement into the sublingual space. This is a unique modification to a procedure published by Huang et al., in 2007 [1]. The procedure along with an account of the post-operative course is discussed in detail.

Lymphangiomas are rare neck swellings usually benign in nature. It is almost always present in childhood. They can present at any site in the human body being the head and neck the most common region. Treatment is always directed in the surgical excision pathway. We present a 24-year-old female with a rare presentation at a late stage of left supraclavicular cavernous type lymphangioma.

Xanthogranuloma is a granulomatous lesion associated with histiocytic proliferation and lipid accumulation. It occurs as solitary or multiple smooth-surfaced papules or nodules. It generally appears on the skin in infancy and childhood, in which case it is known as juvenile xanthogranuloma, although a few adult-onset cases have also been reported. Adult-onset cases are known as adult-onset xanthogranuloma, and adult-onset xanthogranuloma of the tongue is extremely rare. The disease is difficult to diagnose clinically; it is instead diagnosed histopathologically in most cases. We herein report a case of adult-onset xanthogranuloma of the tongue.

Pseudoaneurysm rarely develops after orthognathic surgery, and can cause symptoms such as facial swelling, delayed bleeding, and development of a pulsatile soft mass. The aim of this report is to highlight a case of a masseteric artery pseudoaneurysm following orthognatic surgery, describing the possible while rare occurrence and its treatment. At the ninth postoperative day, persistent facial swelling and bleeding from the intraoral surgical wounds and nose occurred, followed by a syncope. Support therapy was administered, and an Angio-CT was requested. The results of the scans raised suspicion of the presence of a pseudoaneurysm. After the stabilization of the clinical picture a therapeutic angiography was performed. A pseudoaneurysmatic dilatation was documented in the distal portion of the left masseteric artery and was promptly excluded from the main circle. This artery derived, as an anatomical variant, from a common branch originating from the internal maxillary artery. While this complication is more commonly reported in traumatology, in cases of suspicious intraoperative bleeding, persistent facial swelling, and late-onset nasal-oral hemorrhage, pseudoaneurysms of the maxillofacial district should be considered as a possible complication of orthognatic surgery.

This study aimed to evaluate the feasibility, effectiveness, and reliability of using conventional miniplates to provide stable maxillomandibular fixation (MMF) for the management of condylar fracture(s) in complete/partial edentulous mandible. Eleven displaced condylar fractures (37.5% bilateral) in eight completely/partially edentulous adult males (mean age: 43.37) were immobilized with 2–3 conventional miniplates (across two jaws) and followed for three months. All cases showed stable mandibular immobilization during the MMF period. MMF-miniplates were removed after six weeks under local anesthesia. Satisfactory mouth opening was observed after MMF-miniplate removal. No cases of MMF-miniplate failure, significant postoperative complications, and emergency MMF-miniplate release were observed. Only one case showed local soft tissue inflammation at the MMF-miniplate entry site, which resolved after removal. In conclusion, MMF-miniplate is a feasible, effective, and reliable technique with satisfactory clinical outcomes. This technique can be easily and quickly used as an alternative treatment for open reduction of condylar fractures or as a temporary MMF in complete/partial edentulous mandible to reduce difficult, complex, and time-consuming perioperative procedures.

Two cases of peripheral odontogenic keratocyst (POKC) of the gingiva presenting as asymptomatic nodules are described. The exceptional finding of cystic radiolucency in POKCs was observed on dental radiography in one case, which had a diameter of 10 mm. Conservative surgical excision was performed on both cases, and histopathological examination showed features consistent with keratocysts. POKC may recur and should thus be followed up like intraosseous keracysts. No recurrences were observed after 10-years in our two cases. POKC is managed by conservative treatment. Recurrences should be excised more radically. Adjunct treatment with modified Carnoy's solution or topical 5Fluorouracil should be considered. POKC should be included in the differential diagnosis of asymptomatic gingival nodules.

Introduction

Understanding the pathophysiology, clinical characteristics, and postoperative complications of parotid tumors is crucial in light of the growing emphasis on the occurrence and development of parotid tumor disease.

Materials and methods

The study population consisted of 387 cases of primary parotid tumors treated surgically at our institution between July 2015 and November 2020. We statistically analyzed the gender, age, and pathological findings of patients, 307 of whom underwent postoperative return visits and were included in the study of postoperative complications.

Results

The ratio of male to female parotid tumor patients was 1.39:1, and the best possible age range was between 51 and 60 years. The percentage of benign to malignant tumors (342/45) was 7.6:1. Pleomorphic adenoma constituted the majority of benign tumors. Adenoid cystic carcinoma constituted the majority of malignant tumors.The sensory deficit of the auricle, salivary fistula, facial nerve paralysis, and Frey's syndrome were the most prevalent postoperative complications of parotid tumors.

Conclusions

Our efforts should focus on active prevention and treating parotid tumor postoperative complications.