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[On the therapeutic methods of facial bone injuries].

The authors present clinicomorphological characteristics of 2293 patients with benign neoplasms of the vocal cords. Nodules predominated in females, contact granulomas in males. Histological and histochemical evidence indicates that polyp-like new growths of the vocal cords known as fibromas, angiofibromas and nodules are not tumors. They are rather edematous, edematous-fibrous and angiomatous polyps arising as a reaction of vocal cords mucosa to phonatory trauma or chemical irritants.

Adolescent↗

The dynamic Morris biphase appliance for stabilization of flail facial bones.

This report presents our experience with a modification of the Morris biphase appliance. We have modified the device to let the patient open his or her mouth immediately after surgery to allow for intraoral suture line care. The device prevents deviation of the remaining mandible toward the operated side of the face. We believe this has lessened the esthetic, masticatory, and speech difficulties of the two patients in whom we used the device. We conclude the device deserves further testing.

Facial Bones↗

High-density porous polyethylene for facial bone augmentation.

Medpor is a porous polyethylene biomaterial used in plastic and reconstructive surgery in the craniofacial skeleton. Its porous nature allows for substantial vascular and soft-tissue ingrowth. Medpor is available in a variety of implants including block, sheet, and preformed shapes. In vitro and in vivo studies have demonstrated that Medpor has been successfully used in the reconstruction of the orbital floor and external ear, and in augmentation of the chin, mandibular, nasal, and malar regions.

Biocompatible Materials↗

Implants in management of gunshot injuries of teeth, facial bones and jaws.

The use of implants in management of gunshot injuries of teeth, face and jaws presents novelty that is manifested in primary surgical treatment, reduction and fixation of bone fragments and teeth, replacement of lost parts of bone tissues as well as preparation for definitive prosthetic management. At the Clinic for Maxillofacial Surgery of the MMA 173 implants of different types and purposes have been placed in the period 1991-1997, in rehabilitation of the patients injured during the civil war. Although this number of placed implants is significant, the conclusive estimate about benefit of using implants may be obtained only after a longer period of time. Early results are satisfactory.

Adolescent↗

[Rapid compression of maxillary molar region, and its effects on sutures of the cranio-facial bones].

Twenty young hybrid dogs were classified into 5 groups: the control, the group examined immediately after 2 weeks compression (3.52 mm), and those examined at 2, 4 and 8 weeks retention. In those animals undergoing compression 4 times, Dentaurum expansion screws (#602-813) were placed between the left and right fourth dento premolar. when rapid compression was used interruptedly, local synostosis was only seen in the palatine suture, but following retention for 8 weeks, this phenomenon almost completely disappeared. The internal mechanical force of the adjoining sutures had disappeared within 4 weeks of retention. In conclusion, this clinical application causes no permanent damage.

Animals↗

Adenosquamous carcinoma of the facial bones, skull base, and calvaria: CT and MR manifestations.

A 62-year-old woman had proptosis of the right eye, decreased visual acuity of the left eye, and no other focal neurologic deficits. She had a grand mal seizure 1 month before admission. The CT and MR studies showed extensive bone destruction of the margins of the right orbit, the floor of the middle cranial fossa, the right cavernous sinus, and much of the calvaria. There was considerable dural disease and tumor in the right orbit, paranasal sinuses, and scalp, as well as mucoceles of the left ethmoidal sinus with desiccated secretions. The diagnosis was adenosquamous carcinoma, an aggressive tumor related to both squamous cell carcinoma and adenocarcinoma.

Biopsy↗

[547 facial bone fractures: a statistical report of the Neuruppin Clinic for Stomatology and Maxillofacial Surgery for the years 1968 to 1977].

Most of the 574 treated patients were adolescents and young adults from 15 to 25 years of age. 73% of these patients had been injured in traffic accidents or by acts of violence, 28% being under the influence of alcohol. The ratio between the mandibular and the midfacial fractures was 2.4:1.57% of the patients had concurrent injuries. 83% of the mandibular fractures and 53% of the midfacial fractures were managed by conservative-orthodontic splintage. Full recovery was seen in 96% of the injured.

Accidents↗

Use of stainless steel implants in facial bone reconstruction.

Stainless steel has adequate strength, flexibility, ductility, and bio-compatibility for most maxillofacial implant applications. In addition, it is relatively cheap and easy to manufacture. Stainless steel may be effectively used in the maxillofacial region in the form of wires, pins, and plates. This article presents a technique for using a transmalar Steinmann pin to secure a midface prosthesis in cases of bilateral midfacial, bilateral maxillectomy, and total rhinectomy defects. The stainless steel pin may serve as a stable long-term anchoring if used for retention rather than load bearing. This method offers the potential for single-stage reconstruction and allows for prosthesis removal to inspect the surgical defect for early evidence of recurrence.

Face↗

[The role of the genotype in the development of suppurative inflammatory complications in trauma to the facial bones].

The distribution of the genetic markers of leukocytes (HLA I and II), serum proteins (allotypes Gm, transferrin, haptoglobin, group-specific component), red cell enzymes (acid phosphatase--AP, phosphoglucomutase--PGM, esterase D, adenosine deaminase) was found to be universal in patients suffering from various pyoinflammatory diseases. The incidence of HLA A10, Cw4, DR5 antigens, IgG allotype G1m (2) and phenotype G1m (+1+2) and AP (aa) and PGM (2-2) phenotypes was found increased in patients with maxillofacial suppuration and pyoinflammatory complications of maxillofacial injuries as against normal subjects and patients with maxillofacial injuries without such complications. Traumatic osteomyelitis much more often develops in the carriers of the before genetic markers than in those in whom these markers are absent (61.6 and 20.4%, respectively).

Abscess↗

Aesthetics of feminizing the male face by craniofacial contouring of the facial bones.

The "forceful" and macho look of a prototypical man may not be unduly appealing to others whom he meets. This "forceful" look might not even appeal to the individual himself. In order to soften this appearance, a series of operative procedures has been devised for use on the craniofacial skeleton. These surgical steps can be done in a single operation or as a series of multiple operative procedures. Moreover, the needs of some patients may require that only special segments of these procedures be performed. This article presents these operative procedures and describes the feasibility with which they can be performed. Complications and unfavorable outcomes, when they occur, are usually related to unrealistic expectations on the part of the patient. The surgical steps routinely performed are those that contour the forehead, orbits, malar eminence, cheeks, chin, angle of the mandible, and larynx. Three categories of patients are described: the female with a male face; the male with a "forceful look"; and the patient requesting a gender identity change. The psychosocial, psychological, and behavioral problems leading to the decision for surgery will be the basis of final patient selection.

Adult↗

[Effect of breathing mode and nose ventilation on growth of the facial bones].

Correlations between breathing mode and craniofacial morphology were investigated in 47 children at the ages of 6-15 years (average, 9.9 years). Apart from history and clinical examination, nasal endoscopy, rhinomanometry and measurements of cephalometric radiographs were included in the analysis. After separating the patients into a "normal face" group and a "long face" group by measuring the angle between the frontal skull base and the mandibular plane, we analyzed the data in attempting to correlate nasal obstruction with craniofacial development. Findings demonstrated a significant predominance of mouth-breathing compared to nasal breathing in the vertical growth patterns studied. Furthermore, significant differences were found during nasal endoscopy in the growth pattern and were attributed to large adenoids. These findings were confirmed separately in all patients up to the age of 9 years, but differences were clearer. Rhinomanometry and planimetric measurements of the sizes of the adenoids in craniofacial radiographs showed no unambiguous differences between the patient groups. Our present study was not able to establish clear causal correlations between mouth-breathing, craniofacial development and adenoid size, suggesting that existing genetically determined craniofacial growth patterns are modulated by exogenic influences. Nonetheless, our results show a correlation between obstructed nasal breathing, large adenoids and vertical growth patterns.

Adenoids↗

Surgical correction of late sequelae from facial bone fractures.

This study has described the UCLA experience over a 5 year period in the treatment of secondary traumatic deformities utilizing the craniofacial techniques originally proposed by Tessier. Because of scarring, absent parts, and the malposition of segments, correction of long-standing traumatic deformities remains difficult and treatment results remain less than ideal. Primary correction utilizing the principles we have described herein still provides the best functional and aesthetic results. Facial fractures can no longer be considered as an independent and unrelated entity when dealing with the traumatized patient. If primary reconstruction continues to be compromised, correction of residual disfigurement will result in unnecessary patient morbidity and disturbances of facial form and function.

Accidents, Traffic↗

Cranial imaging in autosomal recessive osteopetrosis. Part I. Facial bones and calvarium.

Cranial imaging studies (radiographs, computed tomographic [CT] scans, magnetic resonance [MR] images, and bone marrow scintigrams) in 13 infants and children with autosomally recessive osteopetrosis were reviewed to characterize patterns of facial and calvarial involvement at presentation and with progression of disease. In the mandible, a characteristic triangular opacity representing calcification within the secondary condylar cartilage ossification center was seen in 10 of the 13 patients. Defective dentition with incomplete enamel formation and/or caries was encountered in all patients. The paranasal sinuses were poorly pneumatized in all patients, but the ethmoid sinuses tended to be the least severely affected. Hypertelorism was present in five of the 13 patients, with a characteristic "space-alien" appearance on frontal radiographs. In younger patients, the calvarium demonstrated a high-attenuation inner table, a broad, low-attenuation diploic space, and a less high-attenuation outer table at CT. In three older children, a "hair-on-end" appearance was seen, which, at bone marrow scintigraphy, corresponded to areas of marked hematopoietic activity. Regions of sclerotic bone demonstrated low signal intensity on both T1- and T2-weighted MR images; areas containing marrow had intermediate signal intensity. These many new radiologic features of osteopetrosis are related to its pathophysiologic characteristics.

Child↗

[Fractures of maxillo-facial bones in children. Our experience].

A clinic-statistical study of maxillo-facial fractures in a series of 52 children is reported. This group presents a higher involvement of mandibular body and a low rate M:F than in the literature. Factors responsible for increasing of maxillo-facial traumas in little girls and in school age are analyzed.

Child↗

The treatment of traumatic facial bones and jaw fractures in the period 1972-1996.

During the last twenty-five years, in the period from January 1, 1972 to December 31, 1996, 1006 injured with facial and jaw fractures have been treated at the Clinic for Maxillofacial Surgery of the Military Medical Academy--91.05% of the injured were males and 67.98% belonged to the age group between 11 and 30. The most frequent etiologic factors were traffic accidents (46.42%) and fights (38.07%). Isolated fractures of mandible were found in 51.09% of the injured. In 70.57% of the treated the surgery was used for adequate reduction, osteosynthesis and stabilization of bone fragments, and 29.34% of the injured were treated conservatively, which involved the manual reduction and intermaxillar immobilization. The post-operative complications were observed in 51 (5%) of the injured.

Adolescent↗