[Exostoses and the surgical procedure].
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PURPOSE OF THE STUDY: The authors report 2 cases of internal costal exostosis in children. OBSERVATIONS: Case 1: A 15-year-old boy with hereditary multiple exostosis presented for chest pain. Radiograph and CT scan showed an internal rib exostosis. It was removed by thoracotomy. Eighteen months later, the child was painfree. Case 2: An-11-year old boy presented with fever and a headache. A chest radiograph showed an image of pulmonary opacity interpreted as a pneumonia. The child was admitted for antibiotic therapy. Two months later, X-ray lesion persisted and a CT-scan was obtained. It showed a solitary costal internal exostosis which was removed by thoracotomy. At 12 months follow-up, he was asymptomatic. DISCUSSION: Internal costal exostosis can induce some complications such as hemothorax, diaphragmatic or pericardic wounds. In case of symptomatic exostosis, the authors recommend a surgical removal to avoid severe complications. If the exostosis is asymptomatic, abstention can be recommend. As a matter of fact, hemothorax, for instance, can occur even due to a round and smooth exostosis without any history of trauma.
Ever slowly, plastic surgery has adopted minimally invasive procedures in order to avoid extensive incisions, large scars, and to obtain better results. Endoscopy was introduced into cosmetic surgery of the face in 1992 and it is getting more and more widespread as are its indications, often replacing open surgical approach. Sometimes, a patient seeking a solution to the stigma attached to the aging face may present other problems that are surgically treatable. The authors describe a case of surgical endoscopic resection of a frontal osteoma during endoscopically assisted brow-lift rhytidoplasty.
Although cartilaginous exostosis is considered to be the most common tumor of the skeleton, it is relatively uncommon in the jaws. The pathogenesis of the lesion is unclear. Three cases are presented and the development of the tumors from embryonic cartilage is discussed.
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