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Treatment of nasofrontal ethmoidal complex fractures.

Successful reduction of severely telescoped nasofrontal ethmoidal fractures is difficult to achieve. In an effort to improve the results, a technique involving open reduction and external fixation was performed on three patients. These cases, along with ten other nasofrontal ethmoidal fractures treated between 1971 and 1980, are presented, with special emphasis in methods of reduction, stabilization, and results. The method of open reduction using an osteoplastic frontal sinus flap with external fixation gave the best overall results.

Adolescent↗

PubMedDate not supplied

Radiographic management of juvenile angiofibromas.

Juvenile angiofibromas are benign, vascular, locally aggressive neoplasms that are preferably treated by surgical resection, or irradiation if surgery is not possible. Adequate surgery in the past has been limited by incomplete knowledge of the anatomy of the tumor and technical difficulties related to the vascularity. To better define the tumor, 12 patients with juvenile angiofibroma have been studied by axial and coronal high resolution computed tomography (CT). The extent of the neoplasm was better demonstrated by CT than by other techniques. Based on the CT findings, we propose an anatomic classification that is helpful in determining treatment methods. Nine patients were considered operable, and eight of these underwent preoperative embolization with Silastic spheres and Gelfoam. The preoperative embolization significantly reduced operative difficulty and the necessity for blood transfusions. Based on these cases, we believe the current radiographic management of juvenile angiofibromas should consist of plain films, CT, angiography and, in surgical cases, preoperative embolization.

Adolescent↗