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At least 1,225 records · Page 68Linked to original sources
PubMed1997

Recurrent bacterial meningitis: a 6-year experience in adult patients.

Ten adult patients with recurrent bacterial meningitis (RBM) of 22 episodes were diagnosed and treated at the Dicle University Hospital from January 1990 to December 1995. Apart from 22 episodes of RBM these patients had an additional 25 episodes treated at other hospitals. The RBM attacks developed after closed head trauma in four patients, asplenia and chronic otitis media in one patient, chronic otitis media and oto-mastoiditis in one patient, chronic maxillary sinusitis in one patient, chronic mastoiditis in one patients, and suppurative foci of facial bones caused by shrapnel pieces and no predisposing condition in one patient. In 10 RBM episodes, Streptococcus pneumoniae was isolated from cerebrospinal fluid (CSF) and/or blood culture, and in one episode Proteus vulgaris was isolated from CSF and otitis media suppuration. In the four episodes both cultures were negative, but direct microscopy showed Gram-positive diplococci on Gram-staining. Three of the patients died from meningitis-related complications.

Adolescent↗
PubMed2003

Sporadic Burkitt's lymphoma of the head and neck in the pediatric population.

Burkitt's lymphoma (BL) is one of the fastest growing malignancies in the pediatric population in the United States. BL is a high-grade B-cell Non-Hodgkin's lymphoma (NHL) which exists in endemic, sporadic, and human immunodeficiency-associated subtypes. The African, or endemic, variant usually involves the maxilla and other facial bones while head and neck manifestations in non-endemic BL are rare. We present three unusual present ations of sporadic BL stemming from Waldeyer's ring and the orbit. The clinical and pathologic features of BL are reviewed.

Adolescent↗
PubMed1998

Endoscopically guided midfacial degloving in infants for removal of congenital and acquired midfacial masses.

Midface degloving allows excellent exposure for a variety of congenital and acquired pediatric facial masses. The petite facial skeleton of the infant and child, however, can limit the utility of this dissection, thereby necessitating external approaches and altered cosmesis. Endoscopic assistance can aid in safe and complete removal of these masses without the need for external surgical approaches. In this series, five infants underwent midfacial degloving for midface lesions. Those masses that could not be adequately visualized underwent midfacial degloving with endoscopic assistance. Successful surgical removal was accomplished without complications, with follow-up ranging from 1 to 5 years. No surgical nasal deformity, vestibular stenosis, or decrease in midfacial growth was noted. Midfacial degloving with endoscopic guidance in selected cases is a cosmetically appealing option for lesions not otherwise resectable by standard midface degloving.

Endoscopy↗
PubMed2006

[Tumor of the maxilla presenting as primary hyperparathyroidism].

Brown tumors are classic bony lesions of hyperparathyroidism. They usually occur in severe forms with osteolytic subperiosteal lesions. Facial bones are a rare localization: 2% of all cases. The aim of this study was to report a case of multiple craniofacial location of brown tumors and to discuss, within a review of the literature, the role of imagery in the diagnosis of this disease.

Adenoma↗
PubMed1985

An analysis of 2,067 cases of zygomatico-orbital fracture.

A ten-year review of 2,067 cases of zygomatico-orbital fractures is presented. The age and sex distribution, anatomical types of fractures, associated maxillofacial and nonmaxillofacial trauma, and causes of the injuries are described. The majority of fractures were sustained by males and resulted from trauma inflicted in altercations. The most common associated facial fractures were mandibular; the most common associated nonmaxillofacial trauma was extremity fractures. Motorcycle accidents caused the most significant amount of associated trauma, followed by motor vehicle accidents in which no seat restraint was used by the victim. Treatment, when indicated, consisted of elevation via a temporal approach followed by fixation where necessary. The fixation methods used are presented and discussed.

Accidents↗
PubMed1999

Three-dimensional computed tomography landmark measurement in craniofacial surgical planning: experimental validation in vitro.

PURPOSE: This study evaluated the measurement accuracy of three-dimensional (3D) volumetric images from spiral computed tomography (CT) in vitro. MATERIALS AND METHODS: The study sample consisted of nine cadaver heads that were submitted to an impact force by a special device to promote blunt traumatic craniofacial fractures. The heads were subsequently scanned by a spiral CT scanner (Toshiba Xpress S/X). The archived CT data were transferred to networked computer workstations (Sun Microsystems with Cemax VIP version 1.4 software) to generate 3D volumetric images. The visualization software was used to make interactive linear measurements on the 3D images. Measurements were made on the images twice by two observers, based on conventional craniofacial anatomic landmarks. The soft tissues were subsequently removed, and the same measurements were repeated on the cadaver heads with an electromagnetic digitizer (3 Space, Polhemus, Colchester, VT). RESULTS: The results showed no statistically significant differences between the 3D-CT and the physical measurements, with P>.05 for all measurements. The mean difference between the image and real measurements was less than 2 mm in all instances. CONCLUSIONS: It is concluded that measurement of the skull and facial bone landmarks by 3D reconstruction is quantitatively accurate for surgical planning and treatment evaluation of craniofacial fractures.

Aged↗
PubMed1978

Some missile injuries due to civil unrest in Northern Ireland.

Some missile injuries are reviewed after nearly 8 years of continuous warfare. A feature of many of these injuries is the early admission to hospital which has had a profound effect on the survival rate and the recovery period. Some examples are given of injuries inflicted by rubber bullets. The effects of wounding by low and high velocity missiles are described and examples given. An injury caused by a missile incorporated in a bomb is also shown.

Adolescent↗
PubMed1984

Civilian maxillo-facial gunshot injuries.

Recently, in many parts of the world, there has been an increase in the number of civilian crimes involving guns and nowadays any oral surgeon in hospital may be confronted with this type of injury. This paper reviews the mechanism of wounding by different firearms to allow an appreciation of their effect on living tissues, and then outlines the clinical management of these injuries.

Facial Bones↗
PubMed1986

Correction of jaw deformities subsequent to treatment of acromegaly.

In acromegaly, growth of facial bones and changes of oral and laryngeal mucosa are well accepted facts. Orthognathic surgical procedures should in these cases be postponed until the acromegalic process is well controlled. 2 cases of mandibular osteotomies (patients aged 61 and 38 years) are reported. The surgical procedures and the postoperative course of these patients were uneventful and did not deviate from those of otherwise healthy patients.

Acromegaly↗
PubMed1975

Topographical anatomy of the total osteotomy of the midface.

In this study, the operating conditions for total osteotomy of the middle part of the face have been simulated in a cadaver and the topography of the organs at risk has been examined. The area of the maxillary tuberosity is the region which is mainly exposed to considerable injury to vessels; here an uncontrolled fracture as compared with a systematic osteotomy is the safer method under the given anatomical conditions.

Face↗
PubMed1984

A cephalometric analysis of the Le Fort II osteotomy in the adult cleft patient.

A variety of procedures are available for the correction of the secondary cleft deformity. In this study of the use of the Le Fort II osteotomy, hard and soft tissue changes are documented using 40 discrete hard and soft tissue points on each lateral cephalogram. These were compared in the pre-operative, immediate post-operative and follow-up cephalograms. Some of the possible causes for relapse were identified.

Adolescent↗
PubMed1997

Concomitant infusion cisplatin and hyperfractionated radiotherapy for locally advanced nasopharyngeal and paranasal sinus tumors.

PURPOSE: This is a prospective study to improve the therapeutic ratio in the treatment of patients with locally advanced nasopharyngeal and paranasal sinus tumors by using split-course concomitant infusion cisplatin chemotherapy and hyperfractionated radiotherapy. METHODS AND MATERIALS: From 1983 to 1993, 21 patients with locally advanced nasopharyngeal and paranasal sinus tumors (T3 and T4, or recurrent tumors involving the facial bones and/or the base of the skull) were treated with a regimen of split-course hyperfractioned radiotherapy (1.2 Gy/fraction/bid) and concomitant infusion cisplatin (5-10 mg/m2/24 h). The therapy was given in three separate 2-week sessions with 1 to 2 week breaks between sessions. Seventeen of 21 patients were treated with curative intent with cumulative radiation doses ranging from 64.8 to 70.8 Gy. Four patients were treated with palliative intent to a total dose of less than 60 Gy or to a limited field due to previous irradiation. RESULTS: Sixteen of 17 patients (94%) treated curatively achieved a complete response. Of the 16 patients who achieved complete response, 7 patients (50%) were alive at the time of analysis (36 to 126 months). One patient was alive at 4 years with no evidence of disease, and died in 10 years at the age of 80 of unknown cause. Two patients died of local recurrence at 21 and 45 months and one patient died of a cerebrovascular accident at 12 months with disease status unknown. Five patients died of distant metastases. The one patient who had a partial response died in 25 months with local disease and metastases to the bone and lung. Four patients that were previously irradiated received a reduced total dose or treated to a limited irradiation field. All had near complete responses, but died within a year of treatment, with the exception of one patient who died at 23 months. Acute reactions included intense erythema of the mucosa in all patients. Five of 21 (23%) developed punctate mucositis and 3 of 21 (14%) developed confluent mucositis. Hematologically, one patient developed neutropenia (1800 WBC/mm3) and one developed thrombocytopenia (38,000/mm3). A rising creatinine was observed in three patients (2.0, 1.7, 1.7) all of whom were treated with the higher 10 mg/m2/day dose of infusional cisplatin. In all three of these cases, the creatinine slowly returned to normal over a 6-month period. Hormonal evaluations were performed in three patients and all were within normal ranges. There was no evidence of neck fibrosis or trismus. One patient with gross recurrent disease of the orbit developed blindness of the involved eye due to corneal opacification. The orbital area had been reirradiated in this patient. CONCLUSIONS: Concomitant infusion cisplatinum with hyperfractionated radiation improved tumor control, but did not increase normal tissue injury. Acute reactions were minimized by splitting the treatment with a 1- to 2-week break after each 2 weeks of radiation treatment. Late complications were not increased by using a hyperfractionated radiation regimen. The local failure rate was only 18% (3 of 17 patients), but the distant failure rate was 35% (6 patients). Further investigation is needed to prove if adjuvant chemotherapy after concomitant chemoradiation improves survival by decreasing the distant failure in such advanced cases.

Antineoplastic Agents↗
PubMed1978

Zygomatic fractures in the emergency department: evaluation and treatment.

Diagnosis of zygomatic fractures in the emergency department is possible by history and clinical signs together with a routine series of facial bone x-ray films. Three case reports are submitted to illustrate this approach, one case with obvious clinical signs and x-ray findings and two "unclear" cases where either the physical findings or the x-ray findings were equivocal. There may be pain, tenderness, cheekbone displacement subconjuctive hemorrhage and numbness, enophthalmos, and blurred vision. A Water's view is recommended for x-ray films. Zygomatic fractures are best treated in five to seven days; eye signs indicate earlier treatment. To treat, expose the probable fracture site and reduce under direct vision. The zygoma can be immobilized by passing a Kirschner wire through the body of the zygoma medially towards and through the lateral wall of the nose and into the bony nasal septum.

Emergency Service, Hospital↗
PubMed1985

Giant cell reparative granuloma in the hand: report of three cases and review of the literature.

Occurrence of giant cell reparative granuloma (GCRG) outside the jaw, skull, or facial bones is unusual. Three recent cases of GCRG occurring in the hand are presented. This lesion appears on radiographs as a lucent, expansile defect in bone, similar in appearance to enchondroma, giant cell tumor of bone, aneurysmal bone cyst, or brown tumor of hyperparathyroidism. Histologically, GCRG is characterized by spindle-shaped, fibroblastic stoma with scattered, small, angulated giant cells and areas of osteoid formation around foci of hemorrhage. Establishing the pathologic diagnosis is frequently difficult. Misdiagnosis occurred in approximately half of the reported cases and in one of our cases. The typical clinical presentation is that of localized pain and swelling. GCRG is not a neoplastic disorder; however, it recurred locally in a third of the reported cases. Recommended treatment for GCRG is thorough removal of the diseased tissues and grafting of autologous bone.

Adolescent↗
PubMed2003

First experiences with multidetector CT in traumatized children.

INTRODUCTION: The aim of this study was to describe and discuss first experiences with multidetector CT (MDCT) in the assessment of traumatized children. MATERIAL AND METHODS: Since the implementation of a MDCT scanner in April 2002, 85 children (31 girls, 54 boys with a mean age of 9.2 years) consecutively underwent MDCT (Siemens, Erlangen, Germany) with different protocols depending on age, weight, trauma mechanism and clinical presentation. In all patients in whom pathology was suspected, multiplanar reformations (MPR) in coronal and or sagittal orientation was performed. Examinations were evaluated by two radiologists retrospectively and in consensus. RESULTS: In 55 (65%) children, a MDCT solely of the head was performed, in 46 there was no pathology found. In six (7%), head and facial bones were scanned. Head and abdomen was examined in two (2%), in two (2%) the abdomen only and in one (1%) the pelvis solely. Scans of the spine were obtained in seven (8%) children. A thorax and abdomen examination only was obtained in one (1%) child each. In 11 (13%) children, a polytrauma protocol was performed. In all patients, the time of examination did not exceed 17 min, including setup time. All children survived at the writing of this report. CONCLUSION: MDCT was promising in the management of traumatized children and seems to shorten the necessary time to reach diagnosis and to initiate life-saving treatment.

Child↗
PubMed2000

Magnetic resonance imaging appearance of metastatic Merkel cell carcinoma to the sacrum and epidural space.

Merkel cell carcinoma (MCC) is a rare malignant tumor of the skin and often is diagnosed histologically as lymphoma, melanoma and even metastatic small cell carcinoma of the lung (SCCL). Classified as a neuroendocrine tumor, clinically it originates in the head and neck region and may present with metastatic disease at the time of presentation [1]. Osseous involvement in the past has been described to involve regional facial bones only. We present the first reported MRI findings of distant osseous metastasis from a Merkel cell carcinoma to the lumbosacral spine with associated soft tissue and epidural involvement. Appropriate treatment and patient survival depend on prompt diagnostic imaging for establishment of metastatic disease. Previous reports have advocated CT for diagnosis and staging of distant metastases [2,3]. When spinal involvement is suspected, MRI may be a more suitable modality for assessment of the epidural space and appropriate staging and follow-up in such cases.

Aged↗