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At least 1,207 records · Page 67Linked to original sources
PubMed2004

Endoscope assisted removal of cementoossifying fibroma in the paranasal sinuses in a five-year-old girl.

We report a five-year-old girl with a sinonasal cementoossifying fibroma with CT findings that reveal the invasion of all paranasal sinuses and the remodeling of facial bones. It was possibly a congenital lesion and caused a slowly progressive nasal obstruction and anosmia. Tumor removal with transnasal endoscopic approach was applied and total removal of the mass was accomplished. It was found out to be the cementoossifying fibroma of the paranasal sinuses when the results of the pathological examinations were obtained.

Child, Preschool↗
PubMed2004

Is primary chronic osteomyelitis a uniform disease? Proposal of a classification based on a retrospective analysis of patients treated in the past 30 years.

INTRODUCTION: Primary chronic osteomyelitis of the jaw is a rare, non-suppurative, chronic inflammatory disease of unknown aetiology. To date, classification is confusing due to a non-uniform terminology. The aim of this study was to establish a simple (clinical) classification based on patient data from our clinic. METHODS: Retrospective analysis revealed 30 cases of which clinical course, radiology, pathology, therapy and outcome were analysed. RESULTS: Both sexes were equally represented. The mean age at onset of disease was 35 years (range 5-76 years). Onset of disease revealed two peaks of incidence, one in adolescence and one after age 50 years. While clinical symptoms were similar in all cases, an increased intensity of these symptoms was noted in younger individuals as well as in the early stages of the disease. Five adults and one adolescent presented with additional non facial bone, joint and skin manifestations consistent with the diagnosis of SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome, or chronic recurrent multifocal osteomyelitis. Radiology demonstrated sclerosis, osteolysis and periosteal reaction in variable stages in all cases. However, findings were more extensive in younger patients. Histology revealed different stages of chronic inflammation in all cases. Microabscess formation was noted in 11 cases, six of which were children/adolescents. Therapy consisted mainly of surgery, antibiotics and hyperbaric oxygen therapy. At the end of the follow up period, 11 patients demonstrated complete remission, while in 14 cases amelioration and in 5 no significant improvement was noted. CONCLUSION: Based on differences in age at presentation, clinical appearance and course, radiology and histology, a subclassification into early and adult onset primary chronic osteomyelitis has been established. Cases with purely mandibular involvement should further be distinguished from cases associated with other syndromes.

Acquired Hyperostosis Syndrome↗
PubMed2004

Effect of restraint systems on maxillofacial injury in frontal motor vehicle collisions.

PURPOSE: Motor vehicle collisions (MVCs) are the leading cause of maxillofacial fractures. Additionally, maxillofacial injuries are the most common injury related to air bag deployment. We sought to characterize the occupant restraint system (seat belt and air bag) and collision characteristics associated with MVC-related maxillofacial injuries. MATERIALS AND METHODS: The 1991-2000 National (United States) Automotive Sampling System Crashworthiness Data System (CDS) data files were used. The CDS is a national probability sample of passenger vehicles involved in police-reported tow-away MVCs. Analysis was limited to front seat occupants involved in frontal collisions of delta-V (estimated change in velocity) of greater than 15 km/hr. The risk of facial injury was calculated according to occupants' restraint use (unrestrained, seat belt only, air bag only, and seat belt and air bag combined) and compared using risk ratios (RRs) and associated 95% confidence intervals (CIs). RESULTS: Occupants restrained with a seat belt only (RR, 0.48; 95% CI, 0.40 to 0.57) or a seat belt and an air bag (RR, 0.83; 95% CI, 0.73 to 0.94) had a significantly reduced risk of any facial injury compared with completely unrestrained occupants. There was no association for those restrained with an air bag only (RR, 1.19; 95% CI, 0.82 to 1.73). A similar pattern of results was observed for moderate to severe facial injuries and for facial fractures. CONCLUSION: Seat belt use significantly reduces the risk of facial injury in frontal MVCs. Air bag use was not associated with the risk of facial injury.

Accidents, Traffic↗
PubMed2004

Modeling facial movement: I. A dynamic analysis of differences based on skeletal characteristics.

PURPOSE: To introduce a novel approach to analyze and model facial movements; and to quantify variations in facial movement caused by the extent of skeletal differences between the maxilla and mandible and the middle to lower facial heights. The hypothesis was that there are differences in facial movement related to the underlying facial skeleton which may be explained by the shape of the face rather than the pattern of movement. PATIENTS AND METHODS: The study sample consisted of 43 subjects (23 men, 20 women) with a mean age of 18.5 years (SD = 11.90). Measures of the facial skeletal differences were made from lateral cephalometric radiographs, and subjects were classified as Class I and Class II, and normal to decreased lower anterior face height, respectively. Facial movements were recorded by a video-based tracking system. Descriptive and inferential statistics were performed on principal component scores generated from the movement data. A linear mixed-effects model was used to test for significant differences in movement among the different skeletal types. RESULTS: A dynamic modeling of facial movements was described that has numerous potential clinical applications. Also, differences in movement were found during the lip purse movement. Specifically, skeletal Class I individuals showed greater forward and upward movement during lip purse compared with individuals with severe skeletal Class II who moved their lips straight forward with less magnitude of movement. CONCLUSION: For most of the movements, apart from the lip purse, differences in motion were explained by static facial shape.

Adolescent↗
PubMed2004

Modeling facial movement: II. A dynamic analysis of differences caused by orthognathic surgery.

PURPOSE: The purpose of this study was to determine the facial movement characteristics of patients who underwent orthognathic surgery. The specific aims were to determine the presurgery versus postsurgery differences in facial movements; to determine whether the presurgery facial movements were similar among patients with different dentofacial deformities; and to determine whether patients have a more similar post- than presurgery dentofacial morphology and soft tissue movement. The hypothesis was that there are differences between the pre- and postsurgery facial movements. PATIENTS AND METHODS: The sample consisted of 19 patients (11 women, 8 men) with a mean age of 20.6 years (SD +/- 8.34). Facial movement and lateral cephalometric data were collected at presurgery, and at 6 and 12 months postsurgery. Measures of the facial skeletal differences were made from lateral cephalometric radiographs and facial movements were recorded by a video-based tracking system. Descriptive and inferential statistics were performed on principal component scores generated from the movement data. A linear mixed-effects model was used to test for significant differences in movement. RESULTS: Differences were found between the presurgery and 12-month postsurgery visits for the instructed smile, lip purse, eye closure, grimace, and mouth opening movements as well as the natural smile. Also, there were significant differences at presurgery among the dentofacial groups for the lip purse movement but no differences were found at postsurgery for any of the movements. CONCLUSION: These findings suggest that facial movements are effected by skeletal malocclusion and orthognathic surgical procedures.

Adult↗
PubMed2005

Facial soft tissue injuries as an aid to ordering a combination head and facial computed tomography in trauma patients.

PURPOSE: While the trauma computed tomography (CT) head scan is frequently ordered during resuscitation of multiply injured patients, determining when also to order facial CT in these situations can be difficult. Consequently, facial fractures are commonly missed on initial imaging evaluation. In acute trauma situations, facial soft tissue injury markers are often used to aid in this decision. A study was undertaken to identify exactly which facial soft tissue injuries correlate with facial fractures and which did not. The aim of our research was to compare the facial soft tissue injury patterns of patients receiving a combination head and facial CT who had facial fractures versus those who had no facial fractures. PATIENTS AND METHODS: A retrospective trauma registry review was performed for a 5-year period at Legacy Emanuel Hospital, a level 1 trauma center. The trauma team saw a total of 9,871 trauma patients and 49.9% required head CT as part of their initial evaluation. A total of 777 (15.7%) patients had a combination head and facial CT in which 477 (61.4%) had a facial fracture and 300 (38.6%) had no facial fracture. Statistical significance was established using Bonferroni corrected P values less than .05. RESULTS: Lacerations occurring in areas of the lips, nose, and intraorally, as well as wounds leading to periorbital contusion and subconjunctival hemorrhage, were significantly prevalent in the fracture group. Conversely, scalp lacerations and scalp contusions were significantly higher in the nonfracture group. Other injuries such as lacerations of the tongue, chin, forehead, cheek, ear, eyelid, and eyebrow were indistinguishable between both groups. CONCLUSIONS: Our data demonstrate that there are certain facial soft tissue injury zones that correlate with facial fractures in trauma patients who obtain head CT. We would like to propose that the acronym LIPS-N (Lip laceration, Intraoral laceration, Periorbital contusion, Subconjunctival hemorrhage, and Nasal laceration) be used in conjunction with a physical examination when assessing if a trauma patient who is getting head CT should also get facial CT.

Abbreviations as Topic↗
PubMed1977

Familial osteosclerosis with abnormalities of the nervous system and meninges.

A mother and daughter with osteosclerotic dysplasia are described. The daughter had generalized osteosclerosis, flattening of the angles of the mandibles, high-arched palate, mandibular and facial bone hypoplasia, a large sella turcica, and spacious foramen magnum, platybasia, basilar impression, widened spinal cord with enlarged intervertebral foramina, and scalloping of the posterior surfaces of the vertebral bodies. Radiographic contrast studies and operative intervention revealed multiple thoracic and lumbar meningoceles and an "empty" sella, as well as evidence of maldevelopment of the spinal cord, cerebellum, and cerebral cortex. Many of these skeletal features were noted to a lesser degree in the asymptomatic mother.

Abnormalities, Multiple↗
PubMed1998

The effect of musculoskeletal facial pain on registration of maxillomandibular relationships and treatment planning: a synthesis of the literature.

STATEMENT OF PROBLEM: A significant number of patients exist who are in need of prosthodontic rehabilitation and who at the same time report musculoskeletal pain in the facial area. PURPOSE: This article, which is based on an assessment of both the past and the most recent basic science and clinical literature, evaluates the effect of musculoskeletal facial pain on two static (physiologic rest position and centric relation) and two dynamic (protrusive border and lateral border movements) maxillomandibular relationships. MATERIAL AND METHODS: To find the relevant studies addressing the association between musculoskeletal facial pain and maxillomandibular relationships, a MEDLINE search was conducted, which was complemented by a hand search in selected journals. RESULTS AND CONCLUSIONS: Musculoskeletal facial pain seems to variably affect the aforementioned positions and movements. Hence, the validity of maxillomandibular registrations in patients with existing facial pain is questioned. In those patients with facial pain who simultaneously are in need of a prosthodontic rehabilitation, clinicians should be cautious with regard to the timing of the restorative procedures.

Centric Relation↗
PubMed2006

[Facial injuries treated in the Grenoble University Hospital. Epidemiological analysis of 961 patients managed in one year].

INTRODUCTION: The purpose of this study was to determine the types of facial injuries treated in a one-year in a maxillo-facial unit operating in a mountainous region. METHODS: All patients admitted to the Grenoble University Hospital maxillo-facial unit for a one year period were studied. We noted cause of trauma, age, sex, type and location of fracture, type of soft tissue injury, time between trauma and surgery. RESULTS: A total of 994 patients presenting maxillo-facial trauma underwent surgery over one year; 30% of the unit's maxillo-facial surgical activity. On average, 80 patients were treated for maxillo-facial trauma per month, with a peak of 97 facial injuries in July; 65.6% were hospitalized in the maxillo-facial unit; 25,4% of the injured were aged between 21 and 30 years. Sex-ratio was 2.7M/1F. The most frequent cause was sports injuries (25.8%) followed, in decreasing order, by traffic injuries (23.1%), home injuries (17.6%), fight injuries (3.4%), work injuries (3.4%) and dog bites (3.2%). 10.5% of the injuries occurred in a mountainous setting and 40.7% were sports injuries, 95% of which during practice of winter's sports. Injuries included facial fractures (65.5%) with or without soft tissue damage, and soft tissue injuries only (34.5%); 33.6% of the patients had other lesions of the body. 67.2% underwent surgery within the first 24 hours and 86.9% before the fifth day. DISCUSSION: Sports accidents are the leading cause of facial trauma in the mountainous regions. Most facial injuries result from ski, surf and other winter sports accidents. Most of the victims were given surgical care within the first 24 hours following the accident.

Accidents, Home↗
PubMed2006

[Total work disability: a national inquiry in France].

Physicians are often asked to draft a descriptive medical certificate for victims of traumatic maxillofacial injuries. Among other requisites, this certificate must mention the subject's total work disability. If the injury results from intentional or unintentional assault and battery, the duration of the work disability will determine the competence of the court that will try and condemn the perpetrator. Thus the total work disability certificate has penal value and should be used only for this purpose. Using the data acquired from a national inquiry in France, we evaluated common practices among a panel of maxillofacial teams concerning the information mentioned on the initial medical certificate and, in particular, the duration of work disability allocated for the most frequent facial fractures. The aim of this study was to establish, based on the observed practices, whether it would be licit to propose a total work disability scale for maxillofacial trauma.

Disability Evaluation↗
PubMed1988

Helmet-induced skull base fracture in a motorcyclist.

Observations after a fatal motorcycle accident suggested that the face bar of a full-face helmet may transmit an impacting force to the skull base via the chin strap and the mandibular rami and condyles, bypassing the energy-absorbing facial bones. If this mechanism is confirmed, the structural properties of these face bars will need to be reassessed.

Accidents, Traffic↗
PubMed1981

Giant cell (reparative) granuloma of the orbit.

Clinically and histologically, there exists considerable controversy as to what constitutes a giant cell tumor. There is an increasing awareness that the term giant cell tumors should not be used indiscriminately in describing lesions of the mandible, maxilla, and facial bones which contain multinucleated giant cells. This paper reports a rare case of giant cell reparative granuloma of the orbit. The differentiation between giant cell reparative granuloma and the true giant cell tumor is discussed and a description of the visual symptomatology associated with these lesions of th sphenoid bone is presented. These tumors must be removed completely to prevent recurrence.

Adolescent↗
PubMed1982

Naso-orbital fractures, complications, and treatment.

Naso-orbital fractures designate a backward displacement of the bones of the nasoskeletal framework into the interorbital space. This anatomical disruption results in deformities, lacrimal dysfunction, medial canthal deformities, ptosis, blow-out fractures, ocular complication, and most severely, penetration of bony fragments into the anterior cranial fossa. Early and late treatment methods are considered. Restoration of the bony contour of the nose and medial canthoplasty procedures are discussed.

Blepharoptosis↗
PubMed1986

Radiation and chemotherapy of parameningeal rhabdomyosarcoma involving the orbit.

Eighteen patients with parameningeal rhabdomyosarcoma (RMS) involving the orbit were treated at Memorial Sloan-Kettering Cancer Center (MSKCC) between July 1971 and October 1983. Fifteen patients were children with a mean age of 6 years and three patients were adults with a mean age of 21 years. In four patients, the primary tumor originated in the orbit, while the remaining 14 had other parameningeal primary sites. The tumors were in a very progressive local stage, with destruction of facial bones in most patients. Six patients were treated with the T2 chemotherapy protocol and 12 received the T6 protocol. The radiation treatment plan for all patients was designed to deliver between 4500 and 7200 rad delivered to the primary tumor over 4 to 16 weeks. Eleven of the 18 patients (61%) are alive and well with a median follow-up time of six years. Two patients died of therapeutic complications and five died of tumor spread with central nervous system involvement. Ocular complications included acute and chronic conjunctival, corneal, lens, and retinal changes, which were less severe than those reported in previous series.

Cataract↗