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PubMed1992

Osteosarcoma of the facial bones.

Maxillo-facial osteosarcoma is a rare primary tumor in adults. Between 1980 and 1990, 11 patients were considered; 6 had primary tumors in mandible and 5 in the maxillo-paranasal region. All cases were treated with surgery as the primary modality. Resection was radical in 8 patients and palliative in the other 3. Adjuvant postoperative chemotherapy with adriamycin was administered for 6 months in the 8 patients treated with complete resection. After a median follow-up of 3 years, 7 patients are still alive and 4 died of progressive disease. In the group of patients treated with radical surgery and adjuvant chemotherapy only one died for distant metastases, and 7 are living free of disease. With complete surgical resection long term local tumor control was achieved in all patients. No patient treated with incomplete resection achieved local tumor control with subsequent radiotherapy. The possibility of performing a complete surgical resection of the primary appears to be an essential step to obtain long term local control and survival in maxillo-facial osteosarcoma. Our series is, however, too limited to evaluate the therapeutic benefit of adjuvant chemotherapy.

Adolescent↗
PubMed1991

[Benign pathology of the facial bones].

Benign pathology of the facial bones is divided into three groups: congenital, infectious and neoplastic. The knowledge of segmentation of the face into meridians is important for understanding malformations. Panoramic X-rays remain their diagnostic value. CT is able to define the exact location and contents of the tumor. Nowadays, MRI, sometimes gives information concerning the exact contents of tumors. The face is divided into meridians numbered from 0 to 7 and from 8 to 14 counting from the middle part to the external auditory neatus. Infection from dental caries may spread to the maxilla and the mandible and sometimes into masticator spaces. It can be responsible for maxillary fungal sinusitis in tumor. The main problem is not exact diagnosis but the exact location and extent of the disease in order to allow large surgical removal.

Facial Bones↗
PubMed2001

Osseous tissue engineering with gene therapy for facial bone reconstruction.

OBJECTIVE: Facial osseous defects remain a major functional and esthetic challenge for the head and neck surgeon. Tissue engineering may provide advantageous alternatives to conventional therapies. The objective of the study was to evaluate the efficacy of gene therapy in the repair of osseous facial defects. STUDY DESIGN: Blinded, controlled, prospective animal experiment. METHODS: Thirty adult athymic nude rats were divided into five groups of six animals. Three groups were used as control subjects. Two groups were treated with 3.75 x 10(8) viral particles containing recombinant type 5 adenoviral vectors. One group received viruses that coded for beta-galactosidase production, another received viruses that coded for bone morphogenetic protein (BMP-2) production. After 120 days rats were examined at necropsy with precise planimetry, histological analysis of new bone growth, and radio-densitometric analysis of bone thickness. RESULTS: Radio-densitometric measurements showed that BMP-2-treated nude athymic rats had significantly enhanced osseous repair compared with control subjects when evaluated by both radio-densitometry and histological examination. CONCLUSION: Gene therapy-treated, immunosuppressed rodents had an enhanced osteoinductive repair of a dorsal osseous nasal defect.

Adenoviridae↗
PubMed1990

Facial bone fracture associated with carotid-cavernous sinus fistula.

Out of 989 cases of facial bone fracture, ten patients had carotid-cavernous sinus fistulas (1.01%). Their ages ranged from 25 to 48 years. Seven were male and three female. Two of the ten patients had lower third, three patients had middle third, three patients had upper third, and two patients had combined middle and lower third facial bone fractures. The signs and symptoms of a fistula appeared from the first postinjury day up to 50 days after the injury (mean, 21 days). Four patients had symptoms after operation for facial bone fracture. Most fistulae were identified by arteriography before treatment. Followup ranged from 1 year, 8 months, to 5 years, 9 months (mean, 2 years, 9 months). One patient had a malocclusion. Nine patients had complete resolution of their bruits. Complications included unilateral complete visual loss (two), CSF rhinorrhea (two), and stroke in one of the two CSF rhinorrhea patients. One patient expired due to a severe head injury, and there was one death from an unrelated cause.

Adult↗
PubMed2006

Intraosseous hemangiomas of the facial bone.

BACKGROUND: Hemangiomas arising in the soft tissue are common in the head and neck region, but intraosseous hemangiomas of the facial bone are rare. METHODS: The authors conducted a retrospective study investigating the clinical features, management, and outcomes for seven patients with facial bone hemangiomas. RESULTS: Three of the hemangiomas arose in the orbital bones, two arose in the mandible, one arose in the frontal bone, and one arose in the zygoma. The mean follow-up was 3 years 9 months. During the first operation, total tumor resection was performed for two symptomatic patients, and partial resection with superficial osteotomy was performed for the remaining five individuals with facial contour deformity. Three patients who underwent partial resection achieved long-term aesthetically satisfactory results without recurrence; the other two developed recurrent tumors and underwent subsequent en bloc resection. No evidence of recurrence was observed in cases where primary or secondary complete tumor resections were performed. CONCLUSIONS: Although complete tumor resection represents a definitive treatment for facial bone hemangiomas, conservative partial resection offers a simple method of restoring facial contour with minimal side effects. Although it appears that recurrence cannot be avoided entirely, partial resection should be considered for patients who seek surgery for cosmetic reasons.

Adolescent↗
PubMed1984

[Morphological observations on the cranial and facial bones of the crab-eating monkey].

Forty seven skulls of the crab-eating monkey (Macaca fascicularis) were investigated for their morphological characteristics. Five of them were disintegrated into component bones by the use of the papain. Each cranial and facial bone of this species resembled that of the rhesus monkey (M. mulatta) in its general morphology. Some obvious differences, however, were noticed in the detailed structure of the skulls between these two species. The uncinate process of the ethmoid bone was found in the rhesus monkey but was not found in the crab-eating monkey. The intrajugular process of the temporal and occipital bones was present in the crab-eating monkey but absent in the rhesus monkey. The nasal process of the incisor bone was sutured with frontal bone in the rhesus monkey but was not sutured with that bone in the crab-eating monkey.

Animals↗
PubMed1990

[Fibrous dysplasia of the facial bones. A CT study].

The authors report 7 cases of fibrous dysplasia of the facial bones which were evaluated with CT. The involvement of the facial bones by fibrous dysplasia is an uncommon event, which causes different syndromes according to the extent of bone invasion. In all the cases occurred to our observation CT allowed an exact spatial evaluation of the dysplasia, and therefore a correct surgical planning. Moreover, CT densitometric values and CT appearance of fibrous dysplasia often suggested the correct diagnosis.

Adolescent↗
PubMed1979

Facial bone changes with vascular tumors in children.

Deformities of the adjacent facial bones are common with large vascular tumors. Most hemangiomas will resolve spontaneously, but the incidence of resolution appears to be quite low when the adjacent bones are affected. In these, we have used high dosage corticosteroid therapy in the early cases, particularly those involving the orbit. Surgical excision has been used in most of the other cases, with reasonable improvement.

Adolescent↗
PubMed1977

Facial bone scanning by emission tomography.

A single-photon emission tomographic system was used to study the normal anatomy of the facial bones and the usefulness of emission computed tomography in evaluating diseases of the bones of the face. The examination was performed following routine bone scintigraphy and took an additional 20-30 min. The anatomy of the facial bones was well defined, with clear separation of deep and superficial structures. Early experience with tumor, infection, bone grafts, and postirradiation osteonecrosis indicates that useful added diagnositc information can be obtained by this method.

Bone Diseases↗
PubMed2001

Facial translocation approach to the skull base: the viability of translocated facial bone graft.

OBJECTIVES: A retrospective review of 56 patients who were operated through a facial translocation approach was carried out to assess the viability of the translocated facial bone segment. METHODS: Eleven patients had preoperative radiotherapy, and 26 had postoperative radiotherapy. In 14 patients the translocated bone segment was kept attached to the anterior cheek, and in 42 patients the bone segment was detached and then implanted. A vascularized flap was used to obliterate the defect in the paranasal sinuses in 15 patients. RESULTS: Twelve (21.4%) patients had devitalized bone segment and required sequestrectomy. The incidence of devitalized bone segment was higher in the patients who received postoperative radiotherapy (P = 0.04) and lower in the patients in whom the defect in the paranasal sinuses was reconstructed with a vascularized flap (P = 0.006). CONCLUSIONS: The translocated facial bone segment should be kept attached to the cheek soft tissue when possible, or the defect in the paranasal sinuses should be reconstructed with a vascularized flap.

Adolescent↗
PubMed2006

Guillain-Barré syndrome following facial bone fracture.

Guillain-Barré syndrome (GBS) is an inflammatory disorder of the peripheral nerves and nerve roots characterised by lymphocytes and macrophage infiltration and myelin destruction. Two-thirds of cases of GBS emerge from viral or bacterial infection. GBS following facial bone fracture is rare. This article discusses a case of classical GBS following facial bone fracture and its correlative mechanism. The association of GBS with head injury per se is not well recognised. This case highlights the possibility of GBS following facial bone fracture and indicates that medical staff should be alerted to the association.

Adult↗
PubMed2000

Facial bone grafts: Contemporary science and thought.

BACKGROUND AND OBJECTIVES: The use of bone grafts is a vital component of a surgeon's armamentarium in the reconstruction of congenital and acquired deformities of the craniofacial region. A thorough understanding of bone graft physiology and the factors thought to affect graft behavior is essential in order to develop a more intelligent use of the grafts in clinical applications. METHODS AND MATERIALS: This article presents a brief review of the basic physiology of bone grafts along with a survey of pertinent concepts and research currently available. Mechanical stress, rigid fixation, graft orientation, and the recipient sites are reviewed. RESULTS AND/OR CONCLUSION: In an attempt to bring together various issues that exist in current bone graft science, the authors propose new concepts. They suggest that the mechanical environment in which a bone graft is placed, revascularization of the graft, and the interaction between those two factors are the major predictors of clinical results.

Animals↗