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PubMed2000

Hyperbaric oxygen in the therapeutic management of osteoradionecrosis of the facial bones.

This paper reviews all 17 cases of facial bone osteoradionecrosis (ORN) which were treated in Adelaide, South Australia, in a nine-year period (1987 1996). This was 1.2% of all cases of head and neck cancer treated with radiotherapy (RT). Fourteen cases received treatment following the Marx principles of staging and the protocols of hyperbaric oxygen plus or minus surgery. The three exclusions were two patients who died of recurrent cancer before treatment was complete and one who declined treatment. The eleven cases of mandibular ORN occurred within a few years of the initial RT treatment. All except one occurred after surgical trauma, with dental extractions being the factor in nine cases. All responded to HBO, with or without surgery depending on stage. The three cases of temporal bone ORN were all of late spontaneous onset. All were stage I and all responded to HBO alone. This study shows that the incidence of ORN in Adelaide is low, probably through use of conservative doses of RT and good preventative protocols. The treatment with HBO plus or minus surgery was effective.

Aged↗
PubMed1995

Chondrosarcoma of the jaw and facial bones.

BACKGROUND: Osteosarcomas of the jaw frequently have chondroblastic differentiation, causing confusion with chondrosarcomas. METHOD: Clinicopathologic features and results of treatment were analyzed for a series of 56 patients (27 males and 29 females from 1.5 to 88 years of age) with chondrosarcoma of jaw and facial bones. Twelve patients (21.4%) were younger than 20 years. RESULTS: The major symptom was nasal obstruction or a painless mass; the median interval from the first symptom until initial treatment was 1 year. Of the 56 chondrosarcomas, 25(44.6%) involved the alveolar portion of the maxilla and maxillary sinus; 23 (41.1%) involved the nasal septum, ethmoid, and sphenoid; 6 (10.7%) involved the mandible; and 2 (3.6%) involved the nasal tip. Of the 19 patients with radiographic studies, 15 (78.9%) had an expanding soft tissue mass with varied matrix calcification and destruction of bone and 2 had a purely lytic lesion. The lesion was difficult to assess in the two others. Most tumors had a lobulated growth pattern of hyaline cartilage. Hypercellularity, nuclear pleomorphism, and binucleation were common features. Forty-three tumors were grade 1, 13 were grade 2, and none were grade 3. Modalities of treatment were known for 51 of the 56 patients. Forty-six patients (90.2%) had surgical treatment, 2 (3.9%) had combination radiation therapy and chemotherapy, 1 (2%) had radiation therapy alone, and 2 (3.9%) had biopsy only. Follow-up adequate for analysis was obtained for 42 patients. Of these, 14 (33.3%) had local recurrence; uncontrolled recurrence developed in 9 (21.4%) patients. No distant metastases were documented. Overall actuarial survival at 5, 10, and 15 years was 80.7%, 65.3%, and 56%, respectively. Survival was analyzed for location, size, and histologic grade of tumor. No statistically significant differences were found. CONCLUSIONS: Chondrosarcomas of the jaw and facial bones are extremely rare, locally aggressive tumors.

Adolescent↗
PubMed1980

[Effects of trauma to the facial bones on the anterior shelf of the base of the skull (author's transl)].

The different types of fractures of the upper jaw and facial bones and their extension to the anterior wall of the frontal sinus are discussed. Possible effects on the bony floor of the anterior shelf of the base of the skull and subjacent meninges are outlined. These injuries are then reviewed as part of the larger picture of lesions of the middle third of the craniofacial region. Several types can be distinguished:I.--Lesions in the anterior wall of the frontal sinus only, II.--Lesions affecting the base of the facial bones, III.--Lesions in the frontal vault radiating to the base, IV.--Direct lesions of the middle third, V.--Isolated lesions from back-lash or distortion, VI.--External fronto-orbital impactions. Only types 2, 3, 4, and 5 affect the middle third of the endocranial region. As far as the risk of fistula formation is concerned, facial lesions (type 2) have a good prognosis, while frontal lesions (type 3, 4, and 5) have a poor prognosis. This criterium can assist in making decisions, after superficial examination of the lesions, whether to employ major surgery or not in a deep, difficult region.

Brain Injuries↗
PubMedDate not supplied

[Tumors of the nose, paranasal sinuses and facial bones: the role of computerized tomography and MRI in the assessment of the damage].

The authors examine the use of CT and MR comparatively in tumours of nose, paranasal sinuses and facial bones. Both CT and MR are much more useful to assess the real extent of the pathology than to give specific diagnose. The resolution of the images and the possibility of examining them on many different planes give evident advantage to MR as regards the evaluation of tumors in this region. Nevertheless, CT with bone algoritme gives better details about bone structure.

Facial Bones↗
PubMed1989

[Fibro-osseous lesions of the jaw and facial bones: a clinico-histologic-radiologic study of 138 cases].

A clinical-histologic-radiologic study of 138 cases of fibro-osseous lesions of the jaw and facial bones is presented. In this series, all were monostotic lesions except 8 polyostotic fibrous dysplasia. In the 130 monostotic lesions, 59 occurred in maxilla, 66 in mandible, 4 in zygoma and one in ethmoid bone. Clinically, a painless enlargement of the involved bone was the main sign. Histologically, these lesions were composed of proliferating fibrous connective tissues and various amounts of calcified tissues, but different lesion has different feature. Radiologically, fibrous dysplasia was characterized by lesions with diffuse blending. The other three tumors including ossifying fibroma, cementifying fibroma and fibro-osteoma were all represented by lesions with well delineated borders. In this article, Diagnosis of the fibro-osseous lesions and some questions about fibro-osteoma of the jaw and facial bones and osteofibrous dysplasia of long bones are discussed.

Adolescent↗
PubMed2002

[Rehabilitation possibilities of the post-resection defects of facial bones and surrounding soft tissues in cancer patients (review of the literature)].

The review of the scientific literature, concerning contemporary treatment methods and materials of the post-resection defects of facial bones and surrounding soft tissues in cancer patients is presented in this article. The aloplastic endoprostheses, removable post-resection intraoral prostheses, fixed on implants and ectoprostheses, which are reconstructing the defects of soft facial tissues, are analysed more broadly. The advantages and leaks of these treatment methods are discussed, taking into account the problems, which are faced by the patients after the surgical and radiological treatment of malignant tumours of face and jaws. According to the data of Institute of Oncology, Vilnius University and Kaunas Medical University Clinics, from the beginning of the 1999 till the end of the 2000, 63 patients needed the rehabilitation after the treatment of the malignant tumours of face and jaws.

Ceramics↗
PubMed1988

Osteosynthesis in facial bone fractures using miniplates: clinical and experimental studies.

Miniplates were used in the treatment of 66 patients with facial bone fractures. Follow-up (mean, 12 months) disclosed that complications occurred only in cases of mandibular fracture: there were five instances of wound dehiscence, two of infection, and two of occlusal disharmony. Loading tests on the mandibles of dogs which had undergone segmental resection showed that a dynamic compression plate gives rigid fixation, although this appeared to be due to the rigidity of the thick plate itself, rather than the compressive force. When mandibular continuity was restored with a graft, the miniplates provided considerable rigidity.

Adolescent↗
PubMed1988

Biomaterials for facial bone augmentation: comparative studies.

Presently no material is available which is entirely satisfactory for facial bone augmentation. These studies examine several of those already in clinical use, made from various polymers in solid, porous, and woven forms. Homograft bone has also been studied, as an implant material. All materials were used in situations for which they are currently recommended clinically. Bioglass (Bioglass is a trademark of the University of Florida) implants, which are suggested for clinical use, have been studied in the same model and results show that their surface activity provides a more satisfactory immobilization, both in the short and long term, than does the tissue ingrowth on which most of the other materials depend. Results show that in this model as well as in clinical practice, porous and woven materials provoke in tissues a continuing cellular response which will always compromise long-term clinical success. Autograft bone has associated morbidity and is unpredictable with respect to its incorporation into host tissue and persistence at the site. Bioglass, however, was immobilized successfully at both hard and soft tissue interfaces without the need for porosity, could be satisfactorily shaped in the operating room, and, in addition, had the bonelike hardness which is not provided by any other available material.

Animals↗
PubMed1989

[Facial bone fracture--statistical analysis and clinical aspects].

We experienced 102 cases of facial bone fracture during 16 months of 1986 to 1987. These cases were analyzed statistically concerning causes, age and locations of the fracture. These fractures have increased rapidly in number. The causes were classified into three types; occurrence during sport, traffic accident and fighting, which were equal in number. There were 85% males and 15% females in the patient cohort, which were concentrated at the ages of 10-20 years. A large part of the fractures was mostly consisted of maxillo-facial components (95%). These trends were similar to the previous report of our clinic (1972-1979). On the other hand, not only severe dysfunctioning cases but also complicated cases increased in number, so that the several clinical aspects were reported. Case 1: 17-year-old male presented with retraction of left cheek caused by Rugby foot ball, whose malar bone was dislocated backward and anticlockwise, was treated with oroantral reduction and with the intermaxillary packing of silicon blocks. Case 2: 10-year-old boy with complaint of double vision occurred by head blow to right eye. Pure type blowout fracture of the orbital floor was presented, which was reconstructed by silicon plate from the incision of the lower eyelid. Case 3: 59-year-old male presented with 6 month history of diplopia and retraction of left eye ball, had been under the conservative care by an eye doctor. X-ray examination showed the intraorbital soft tissue was blown out into the ethmoidal sinus. However the transethmoidal reduction was performed, the result was not satisfactory.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1964

FRACTURES OF FACIAL BONES.

A detailed review was made of 1025 consecutive patients with "face-bone" fractures admitted to four Montreal hospitals over the five-year period 1958-1962, inclusive. In addition a survey was carried out of the other general hospitals in Greater Montreal in order to obtain admission figures for facial-bone fractures and for total hospital cases. In the study group the common causes of face-bone fractures were found to be fights, traffic accidents, falls, and athletic pursuits. Very few of these injuries occurred in industrial settings. A distinctly vulnerable group is made up of males between ages 16 and 35 years. In order of frequency of occurrence these injuries involve the nose, lower jaw, cheekbone, upper jaw, and zygomatic arch. The experience throughout metropolitan Montreal indicated that more persons with face-bone fractures require hospital treatment each year, but the increase is approximately parallel to the upward trend of total hospital admissions.

Accidents↗
PubMed1997

[Distraction osteogenesis for hypoplastic facial bones].

Distraction osteogenesis is a well-known method for bone lengthening which stretches callus to generate new bone in the distracted area. The method was developed by Ilizarov for the lengthening of long enchondral bones. In recent years the method has also been applied to the facial bones and to the jaw.

Adolescent↗
PubMed1980

[Computed tomography for individual treatment planning in tumors of the facial bones (author's transl)].

Moving-field irradiation of malignant tumors in the region of the facial bones makes possible the application of high focal doses along with optimal sparing of radiosensitive organs and is yielding very good cosmetic results. An indispensable condition, however, is a correctly scaled, exact representation of bone structures in the medium plane of pendulum irradiation. Standardized transversal sections of the skull or radiometric techniques mostly do not satisfy, being deficient in precision and demanding too much time. Every pendulum plane desired can be represented in the picture obtained by addition from the series of transversal sections with the help of appropriate programming of the computer for tomography. By means of an objective representation of the osseous skeleton, of cavities, soft tissues, and of the tumor contours, individually optimized irradiation planning is possible.

Aged↗