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The radiological features of craniofacial neurofibromatosis.

Three cases of neurofibromatosis are reported showing a wide spectrum of roentgen abnormalities affecting the skull and facial bones. One case had macrocrania and multiple calvarial defects; enlargement of the sella turcica and middle cranial fossa was also present. All the three cases had orbital changes either in the form of enlargement, reduced anteroposterior width or loss of bony outlines with an appearance of emptiness. The other two cases showed predominantly facial involvement with hypoplasia of the mandibular body and ramus, abnormal coronoid process, zygomatic arch, hypoplastic maxilla, cystic mandible with abnormal dentition and absence of the osseous external auditory meatus. Intra-orbital calcification was present in one case. The radiological projections required to evaluate such cases are discussed. The 20 degrees occipito-mental view has been found extremely useful and is recommended.

Adolescent↗

Cranial base in craniofacial development: developmental features, influence on facial growth, anomaly, and molecular basis.

The cranial base is of crucial importance in integrated craniofacial development. As distinct from facial bones, it is formed through endochondral ossification. The posterior and anterior cranial bases are derived from distinct embryologic origins and grow independently--the anterior cranial base solely from the neural crest, the posterior cranial base from the paraxial mesoderm. The anterior cranial base has more prolonged and active growth and exerts more influence on facial growth than does the posterior cranial base. Cranial base angulation is a unique feature in modern human beings. Cranial base anomalies have been identified in many genetic and developmental disorders. The molecular basis of cranial base development and growth is being clarified. In this review, these aspects of cranial base are discussed in detail, with a focus on developmental features, roles in craniofacial growth, anomalies, and the genetic basis of development.

Animals↗

Severe facial injury by impalement.

Severe facial trauma is a well recognized hazard of road traffic accidents. We describe severe injuries sustained in an unusual way. A car overturned onto a roadside fencing post, impaling the driver's neck and face. The stake was successfully removed in the operating room, and the fractures were fixed and lacerations sutured.

Accidents, Traffic↗

[Dislocations of the face and skull. Report of 20 cases].

The authors present a serie of 20 cases of craniofacial injuries with or without CSF leakage. They propose a simple classification in 2 groups following the impact: braniofacial injury or orbitofacial injury. For their, craniofacial or orbitofacial injuries are to be operated in one stage by an neurosurgical and maxillofacial team. The best time for operation is approximately around the 10th day following trauma.

Facial Bones↗

Maxillofacial fibrous dysplasia.

Fibrous dysplasia is a non- neoplastic hamartomatous developmental fibro osseous lesion of bone. This paper provides a brief overview of fibrous dysplasia in a historic perspective and highlights the controversies in fibrous dysplasia seen in the cranio- maxillofacial lesions. A case report of a young woman is presented who was diagnosed as having maxillofacial fibrous dysplasia, thereby making an attempt to use this term in cases with relatively limited facial bone disease.

Adult↗

[Effects of different sterilizing techniques on osseous regeneration of grafted lyophilized cartilage].

The suitability of variably sterilized lyocartilage grafts as potential bone substitutes was investigated in animal experiments with special attention to configurational stability. In 3 Beagles corticocancellous implant beds were prepared by box-type ostectomies and lyophilized costal cartilage blocks sterilized with X-rays,ethylene oxide gas and beta-propriolactone solution were placed into them. Implants sterilized with X-rays and beta-propriolactone appeared to be unsuited for recontouring facial bone defects, since they showed complete loss of configuration after a follow-up time of 125 and 230 days, respectively. By contrast, cartilage implants sterilized with ethylene oxide gas retained their configuration after no less than 328 days. In light of these results, methods for sterilizing other biomaterials should be re-considered.

Animals↗

[Chondrosarcoma of the maxilla. A clinical case report].

Chondrosarcoma are malignant tumour originating in cartilaginous cells which tend to preserve their essentially cartilaginous nature throughout their evolution. They are rare at the level of the maxilla and mandibular. When localized in facial bone, chondrosarcoma follow a more aggressive pattern compared to those localized in long bones. They mainly affect individuals aged between 30 and 60 and show no sexual preference. In the majority of cases, chondrosarcoma have a relatively slow rate of growth. The only valid treatment is radical surgical removal. In overall terms, the prognosis in these patients is not good since the 5-year survival rate is less than 40%. During the period 1980-1992 only 5 cases of chondrosarcoma were diagnosed by the Division of Maxillo-Facial Surgery of the University of Turin. The authors considered it worthwhile to report the last case observed in a premaxillary localization given the advanced age of onset and the typical course of the pathology and treatment received. CASE REPORT. A male 83-year-old patient was referred to use due to a slow growing neoformation in the premaxillary region which had appeared approximately 5-6 months earlier. The patient had previously undergone the avulsion of residual upper teeth due to suspected "toothache". The neoformation filled the premaxilla, deforming the anterior middle portion of the palate and spreading towards the floor of the anterior nasal cavity. The gingiva of the upper alveolar crest presented ulceration with irregular edges and sanious bottom. On palpation the consistency was hard-ligneous and swelling, in continuity with the bone, was slightly painful. Incisional biopsy enabled the diagnosis of chondrosarcoma to be confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Chondroblastoma of bone.

Chondroblastomas are unusual benign lesions of bone. They classically occur at the ends of long bones in young persons. The roentgenographic and histologic features are typical. We had an opportunity to study a large number of chondroblastomas. Most of the cases came from the consultation file started by Dr D. C. Dahlin at the Mayo Clinic. This method of ascertainment may tend to load our series with unusual and atypical examples. We found some unusual locations, such as the skull and facial bones and the small tubular bones of the hands and feet. We also found some unusual histologic features, such as mitotic activity, necrosis, and cellular atypia. However, despite the unusual features, the biological behavior of these tumors was that of a benign process with only limited local aggressiveness.

Adolescent↗

Incidence and management of major middle third facial fractures at the Royal Melbourne Hospital. A retrospective study.

In a retrospective study of 240 patients with major fractures of the middle third of the facial skeleton, the incidence, anatomical patterns, and management of these fractures have been reviewed, and an assessment made of the concomitant injuries to other organs. Most of the fractures occurred in the 20-29-year age group (39%), and over 83% of the patients in this study were males. The most common cause of injury was road accidents (80.8% of all cases), and automobile occupants represented most of this group. The Le Fort II fracture was the most commonly sustained, and there were several variations from the classical fracture patterns recorded, combinations of fractures at different levels being frequent. Ninety percent of patients had another concomitant injury, indicating the need for multi-disciplinary care of this type of patient. The most common treatment method involved the use of craniomaxillary and intermaxillary fixation, which was usually maintained for 22-28 days.

Accidents, Occupational↗

[Facial trauma: characteristics and therapy].

This department was established 35 years ago. Since then, many patients with facial trauma, both soldiers and civilians, have been treated and extensive experience has been accumulated. From 1990 to 1995, 487 patients with facial trauma (18.6% of the patients in the department) where hospitalized and treated. 88.5% suffered from injuries which included facial bones, and the others from soft tissue injuries only. We summarize our experience, analyzing both the demographic and clinical characteristics of the injuries and the treatment administered. Based on our experience and the current literature, we present an overview of the issue.

Facial Injuries↗