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PubMed2002

Gross dehiscence of the bone covering the facial nerve in the light of otological surgery.

Understanding the relationship between the anatomy of the fallopian canal and a variety of ear diseases is necessary. In this study, our purpose was to identify the incidence of facial nerve dehiscence in patients undergoing surgery for a variety of chronic ear diseases. The operative records of 219 patients were reviewed retrospectively for dehiscence of the facial canal. The diagnoses were cholesteatoma (n = 49), tympanosclerosis (n = 51), adhesive otitis media (n = 38), and chronic otitis media (n = 81). Only 17 of 219 who underwent tympanoplasty without mastoidectomy were excluded from the calculations. Dehiscence of the facial canal was encountered in 18 (8.9 per cent) of 202 patients. The dehiscence rate was highest with cholesteatoma, followed by adhesive otis media, chronic otis media and tympanosclerosis (p < 0.01). The canal dehiscence was mainly seen in the tympanic segment and second genu, and was rare in the mastoid segment. Labyrinthine fistula was the most common pathology that coexisted with the dehiscence. It was encountered in two (11.1 per cent) of 18 patients. In conclusion, the likelihood of dehiscent bone covering the tympanic segment of the fallopian canal is significantly higher in cholesteatoma than the other chronic ear diseases. The surgeon can feel somewhat more confident while performing surgery for tympanosclerosis as far as the dehiscence in the fallopian canal is concerned.

Adolescent↗
PubMed1998

Sickle cell disorder and orofacial pain in Jamaican patients.

AIM: The aim of this study was to investigate the prevalence of orofacial pain in a large group of sickle cell disorder (SCD) sufferers. METHODS: In 1996, 51 Jamaican adults and teenagers with SCD and 51 matched subjects (non-SCD) without any sickle cell problems were questioned about their experience of pain in the maxilla or mandible, and pain in their teeth. The subjects, aged 13 to 45 years, had oral examinations and the state of the teeth was recorded together with the presence or absence of deep periodontal pockets, vertical or horizontal mobility, sepsis, trauma and severe erosion. RESULTS: Mandibular or maxillary pain during the previous 12 months was reported by 49% of those with SCD and only 8% of the non-SCD subjects. Among the SCD group reporting this pain, 68% were found to have no dental problems which could have caused the pain. Dental disease accounted for the facial pain in all non-SCD subjects. Headaches were experienced by 77% of the SCD group and only 47% of the non-SCD group. Experience of toothache during the previous year was reported by 67% of the SCD group and 57% of the non-SCD. In half of these SCD subjects there was no obvious dental pathology to account for the dental pain but none of the controls had dental pain in the absence of dental pathology. CONCLUSION: People who suffer from sickle cell disorders are likely to suffer orofacial and dental pain in the absence of dental pathology and this is probably because of sickling crises within the microcirculation of the facial bones and dental pulps and small areas of necrosis in the bone marrow.

Adolescent↗
PubMed2004

Mouse Zic5 deficiency results in neural tube defects and hypoplasia of cephalic neural crest derivatives.

Zic family genes encode zinc finger proteins, which are homologues of the Drosophila pair-rule gene odd-paired. In the present study, we characterized the fifth member of the mouse Zic family gene, mouse Zic5. Zic5 is located near Zic2, which is responsible for human brain malformation syndrome (holoprosencephaly, or HPE). In embryonic stages, Zic5 was expressed in dorsal part of neural tissues and limbs. Expression of Zic5 overlapped with those of other Zic genes, most closely with Zic2, but was not identical. Targeted disruption of Zic5 resulted in insufficient neural tube closure at the rostral end, similar to that seen in Zic2 mutant mice. In addition, the Zic5-deficient mice exhibited malformation of neural-crest-derived facial bones, especially the mandible, which had not been observed in other Zic family mutants. During the embryonic stages, there were delays in the development of the first branchial arch and extension of the trigeminal and facial nerves. Neural crest marker staining revealed fewer neural crest cells in the dorsal cephalic region of the mutant embryos without significant changes in their migration. When mouse Zic5 was overexpressed in Xenopus embryos, expression of a neural crest marker was enhanced. These findings suggested that Zic5 is involved in the generation of neural crest tissue in mouse development. ZIC5 is also located close to ZIC2 in humans, and deletions of 13q32, where ZIC2 is located, lead to congenital brain and digit malformations known as the "13q32 deletion syndrome". Based on both their similar expression pattern in mouse embryos and the malformations observed in Zic5-deficient mutant mice, human ZIC5 might be involved in the deletion syndrome.

Animals↗
PubMed2003

Malignant lymphoma of the jaw bone.

BACKGROUND: Malignant lymphomas are neoplasms originating from lymphocytes, whose precursor cell or cells are generated during the multipotential differentiation of a stem cell. Extranodal localization most often involves the Waldeyer's ring, nasal cavity, maxillary sinuses, eyeballs, salivary glands, oral cavity, stomach or skin. Localization in the nervous system or facial bones is very rare. CASE REPORT: This article presents a rare case of a patient with B-cell lymphoplasmocytic lymphoma located in the jaw bones. The diagnosis was established after histopathological investigation of periapical lesions. Due to the localized growth of the malignant lymphoma, the patient underwent surgery combined with radiotherapy. The follow-up period amounted to 14 months and the patient now presents without recurrences or lymphadenopathy. CONCLUSIONS: All periapical lesions should be sampled for histopathological examination, possibly revealing a hidden neoplastic process.

Humans↗
PubMed2003

[Fibrous dysplasia of the petrous bone].

Fibrous dysplasia named after Jaffè and Lichtenstein is a benign, self-limiting disorder of the bone structure. The normal bone is replaced by cellular fibrous connective tissue. Fibrous dysplasia can be differentiated into monostotic and polyostotic forms and the McCune-Albright syndrome (combination of polyostotic areas in the bone with hyperpigmentation of the skin and endocrinological disturbances). The rare disease is predominantly found in the 1st to 3rd decade of life in the femur or humerus. In about 15% of all cases it affects the facial bones, and one-third of these is located in the jaw bone. Extremely rare is the invasion of the petrous bone. A 45-year-old female patient was examined because of tinnitus persisting for 1 year. In addition, she was suffering from increased hearing reduction and recurrent vertigo. The CT and MRT showed a milky glass-like tumor, which was limited by an osteolytic process situated in the left petrous bone. The process was removed via the mastoid. Histological examination revealed fibrous dysplasia. A highly differentiated osteosarcoma and an ossifying fibroma as important differential diagnoses have to be excluded because of the different therapeutic consequences.

Cerebellopontine Angle↗
PubMed2003

Osteochondroma of the mandibular condyle.

Osteochondroma is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones. When present, the tumor is most often reported to affect the mandibular coronoid process. Osteochondroma of the mandibular condyle is extremely rare. A case is presented of a massive osteochondroma of the mandibular condyle leading to facial asymmetry and disturbed occlusion. The diagnosis was confirmed by radiological and histological examination.

Adult↗
PubMed1979

Giant cell tumor in Paget's disease of bone: familial and geographic clustering.

Four patients with benign giant cell tumor and one patient with probable benign giant cell tumor associated with Paget's disease of bone are reported. The familial and geographic clustering of these cases is unique in that three patients were related and all patients traced ancestral roots to the same area of southern Italy. Tumors arose from the cranial or facial bones in three patients and from vertebral bodies in two patients. All caused symptoms by local compression, and treatment by curettage or radiotherapy was successful in all patients. Three separate tumors in one patient shrank dramatically in response to treatment with high doses of dexamethasone, and one patient whose tumor caused spinal cord compression showed marked improvement in neurologic function on therapy with dexamathasone.

Bone Neoplasms↗
PubMed2004

Craniomaxillofacial trauma in children: a review of 3,385 cases with 6,060 injuries in 10 years.

PURPOSE: Trauma is the leading cause of diseases and death in children. The goal of this study was to assess the impact of the main causes of accidents among children resulting in pediatric craniomaxillofacial trauma. PATIENTS AND METHODS: Between 1991 and 2000, data for 3,385 patients younger than 15 years of age who sustained a total of 6,060 craniomaxillofacial injuries were recorded for cause of injury, age and gender distribution, frequency and type of injury, injury mechanisms, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, and concomitant injuries. Univariate statistical analyses were followed by logistic regression analyses for the 3 injury types to determine the impact of the main injury causes on the type of injury at different ages in pediatric facial trauma patients. RESULTS: Play (58.2%), sport (31.8%), and traffic accidents (5%), acts of violence (3.9%), and other causes (1.1%) were noted. A total of 389 patients (11.5%) had 615 fractures, 2,582 patients (76.3%) had 3,384 dentoalveolar injuries, and 1,697 patients (50.1%) had 2,061 soft tissue injuries. The girl-to-boy ratio was 3:5, and the mean age was 7 +/- 4.4 years. For children sustaining facial trauma, logistic regression analyses revealed increased risks for fractures (+238%) and soft tissue lesions (+89%) in children involved in traffic accidents. Dental trauma was more frequent (>+38%) in both sport and play accidents (all P <.001). CONCLUSIONS: This study dissected the distinct impact of injury mechanisms in pediatric craniomaxillofacial trauma. Logistic regression analyses revealed statistically highly significant outcome differences in pediatric facial trauma depending on the injury mechanism.

Accidental Falls↗
PubMed2005

[Usage of Cerasorbe in complex treatment of chronic generalized periodontitis (clinical-experimental study)].

The effectiveness of the bioactive osteoplastic composition--Cerasorbe--at a surgical stage of combined treatment of chronic generalized periodontitis was examined. The results obtained in the study and the control groups prove, that Cerasorbe allows reduction of the treatment duration and achieves remission of the disease. From 127 patients with chronic generalized periodontitis 65 were operated by microplasmatic scalpel-irradiator as a part of a complex treatment. The treatment course comprised of 3-5 procedures. The quantity of manipulations was determined by the severity of the pathological process. Before and after the treatment the radiographical investigation was carried out in both groups. At the 18th month after the surgical intervention bone regeneration, confirmed by radiography, was shown in 87,8% cases in the study group and in 60,1% in the control group. The work presents experimental and morphological studies of regeneration of damaged areas of maxillo-facial bones. Time course of healing of defects in the lower jaw bone filled with Cerasorb was studied in experiment on rabbits. On days 7, 14, 21 and 28 four rabbits from each group were killed and the defects were investigation by X-ray and histological methods. We have stained the micropreparations by hematoxilin-eosine. In experiments with Cerasorb, bone regenerations replaced up to one half of the defect area by the day 28. We have shown high efficiency of Cerasorb in experiment and during complex treatment. Cerasorb stimulated reparative osteogenesis and can be recommended for using in the clinical practice.

Animals↗
PubMed1994

[Possibilities for preoperative determination of transplant quality using an osteoporosis index].

Preprosthetic procedures and reconstructive measurements are typically performed in elder patients. In this age group osteoporotic changes of the skeleton are common. The facial bones are persistently envolved within this process. Preoperative assessment of bone height and width are nowadays routine procedures in preprosthetic surgery, little attention is paid towards the bone quality at the recipient site of dental implants and the donor and recipient sites of bone-grafts. This study is performed to investigate the possibility to evaluate the bone quality prior to preprosthetic and reconstructive operations. The amount of the mineralization of the skeleton was determined in 17 patients which were scheduled for preprosthetic and reconstructive surgery with the help of Dual Energy X-Ray Absorptiometry (DEXA). The amount of mineralization of the skeleton and the osteoporosis-index, which were determined with the help of DPX-scans, are representative also for the facial skeleton. In our preliminary study patients with a low skeletal mineralization have a tendency towards increased complications after preprosthetic and bone-graft surgery. In addition the preoperative assessment of bone quality serves the basis for a accompanying osteoporosis therapy.

Adult↗
PubMed1996

A dynamic analysis of changes in the nasolabial fold using magnetic resonance imaging: implications for facial rejuvenation and facial animation surgery.

An anatomic study was performed on living subjects using magnetic resonance imaging (MRI) to distinguish the relative contribution of skin, subcutaneous tissue, and muscle to dynamic changes in the nasolabial fold during facial animation and aging. MRI scans with the face in repose and then holding a full smile were performed in both young and old adult subjects. Anatomic landmarks were identified, and measurements characterizing their position were made on the MRI console. MRI resulted in excellent image resolution of facial tissue planes. Comparison between young and old subjects with the face in repose demonstrated that progressive thickening of the dependent portion of the check fat pad and overlying skin, with no appreciable change in the muscle plane comprising the levators of the upper lip, resulted in a deeper and more acute nasolabial fold in older subjects. In both age groups there was significant shortening of the mimetic muscles with smiling, with the lateral mimetic muscles drawn closer to the underlying facial bones. This was accompanied by redistribution of the cheek fat pad, thereby maintaining projection of surface landmarks within the cheek mass in young subjects with smiling. These findings indicate that in order to diminish the nasolabial fold, surgery for facial rejuvenation should be directed to the skin and subcutaneous tissue planes superficial to the mimetic muscles to the upper lip. In order to recreate a natural nasolabial fold during surgery for facial reanimation, contraction of the levator muscles to the upper lip should result in redistribution of the cheek fat pad without change in surface projection of the cheek mass or upper lip; this can only be accomplished if the reconstructed levator muscle is positioned deep to the cheek fat pad, with its insertion toward the deep (mucosal) surface of the upper lip.

Adipose Tissue↗
PubMed1990

A severe fibrotic reaction after cosmetic liquid silicone injection. A case report.

A case of a severe, locally aggressive fibroblastic reaction to cosmetic silicone injection involving the orbital cone and anterior cranial base is presented. Included is a brief history and description of silicone injection and its complications. Though many facts remain to be discovered, speculation into the possible pathogenesis, with a review of the literature, shows that while silicone continues to be a useful tool for the plastic surgeon, an awareness of the risks, as well as a search for clues to avoid complications, must continue before further liberal use of this material is encouraged.

Facial Bones↗
PubMed1977

Pediatric otolaryngologic crises.

In the second article on pediatric otolaryngology, speed of diagnosis is stressed as vital to prevent permanent aftereffects such as deafness or facial paralysis. Aggressive education of parents in preventing emergencies is recommended.

Acids↗
PubMedDate not supplied

Skeletal and dental disturbances in children after facial burns and pressure garment use: a 4-year follow-up.

Pressure garment use alters facial growth during rehabilitation after a facial burn injury. We previously studied 3 children with full facial burns and 3 children with partial facial burns who wore pressure garments for 1 year, and we found that maxillary horizontal growth and mandibular anterior-inferior growth are inhibited during the time of pressure garment use. The purpose of this follow-up study was to prospectively document skeletal and dental changes after pressure garment use was discontinued. We found that although the growth and development of the facial bones seem to return to normal, lasting changes remain. The use of pressure garments after skin grafting is still recommended. However, it is also recommended that an orthodontist be included in the team of burn care specialists for children with facial burns to monitor facial and dental development. Close attention to facial development during and after pressure garment use is necessary to maintain normal dental and facial relationships.

Burns↗
PubMed1975

Exposure through a coronal incision for initial treatment of facial fractures.

The coronal incision approach to Le Fort III fractures gives excellent exposure for anatomical reduction and internal fixation of the fracture sites. Either an extracranial, or a combined intracranial procedure, is feasible. The exposure obtained not only facilitates the reduction and the fixation but, with the addition of transconjunctival incisions, the patient benefits by not having multiple surgical scars in the face.

Accidents, Traffic↗