Hemophilic arthropathy of the temporomandibular joint: review of the literature, a case report, and discussion.

Hemarthrosis of extremity joints in patients with hemophilia has been well documented. However, hemarthrosis of the temporomandibular joint in patients with coagulopathies appears to be rare. Consequently, management of a temporomandibular joint hemarthrosis is difficult because of the lack of treatment guidelines. The purpose of this article is to review the pathophysiology of hemophilic arthropathy and its management. A case of temporomandibular joint hemophilic arthropathy in a patient with a factor XI deficiency will be presented. A brief review of factor XI deficiency and a hypothetical pathophysiological mechanism for internal derangement induced by myofascial pain dysfunction are included.

Endotracheal tube obstruction due to impaction of the inferior turbinate.

A case of inferior turbinate impaction in a nasoendotracheal tube is presented. This is an additional potentially lethal complication associated with general anesthesia.

Tympanometric changes after total maxillary osteotomy.

With the frequency of orthognathic surgery increasing each year, more is being learned about this surgical art. Although techniques are improving, more acute and chronic complications are being reported after orthognathic surgery. In our institution, it has been noticed that approximately 25% to 30% of our patients experience unilateral or bilateral otalgia after total (Le Fort I) maxillary osteotomy. Recently, two patients with maxillary osteotomies. In both patients acute otitis media developed postoperatively and myringotomies for relief of symptoms were required. This paper reports changes observed in preoperative and postoperative tympanograms of patients who undergo total maxillary osteotomy and offers a possible explanation for these middle ear changes, which are accompanied by otalgia.

Incontinentia pigmenti: report of case.

A case of incontinentia pigmenti in a 14-year-old girl has been presented. The patient showed classic signs including dermatologic, ophthalmologic, central nervous system, and dental changes. This case also presented a previously unreported occurrence of hemorrhagic bone cyst in the mandible along with ectodermal-mesodermal disorder.

The keratinizing and calcifying odontogenic cyst (Gorlin cyst).

A 61-year-old white woman had a radiolucent lesion in the anterior portion of the mandible which was diagnosed as a keratinizing and calcifying odontogenic cyst. As it has a radiographic appearance similar to other pathologic processes, it should be considered in the differential diagnosis when a radiolucent-radiopaque lesion is encountered.

Unilateral mydriasis during general anesthesia.

A healthy 24-year-old woman was taken to the operating room for surgical removal of impacted third molars while under general anesthesia. During surgery, a local anesthetic was administered, resulting in mydriasis, which was initially mistaken for a central nervous system deficit secondary to a complication from general anesthetic.

Frontal lobe abscess of dental origin. Report of a case.

A 52-year-old white man came to our hospital with obscure signs of disease. Multiple laboratory tests, radiographs, and examinations ruled out aseptic meningitis, bacterial endocarditis, cerebral artery aneurysm, and other possibilities. A brain abscess was finally diagnosed. The teeth and their surrounding tissues were implicated as the etiologic factors. The importance of odontogenic sources as potential foci of infection is emphasized. This sequel to odontogenic infection is quite rare, but it can be prevented by removal of chronically carious teeth and periapical pathosis.

Malignant lymphomas of the oral soft tissues.

Two cases have been presented in which a malignant lymphocytic tumor was found in the oral soft tissues. The first was a "histiocytic lymphoma" that appeared as a rapidly growing, ulcerative lesion. This tumor was the initial presentation of disease and may be considered a primary lesion. The second was a "poorly differentiated lymphocytic lymphoma" which formed a mass in the mental area. In that case, the tumor was associated with widespread disease. Both of these lesions had previously been diagnosed by physicians as inflammatory processes.

Eagle's syndrome. Report of a case.

This case report demonstrates an uncommon, symptomatic elongated styloid process that did not conform to the usual clinical features. The patient was under 30 years of age when the symptoms appeared. He experienced the classic symptoms without prior tonsillectomy; he also experienced carotid artery syndrome symptoms. However, the patient did receive the common diagnosis seen in many cases of unexplained chronic head and neck pain. He was simply labeled a psychotic with no just cause for pain.

Osteochondromas associated with facial asymmetry and masticatory dysfunction: report of two cases.

Two cases of solitary osteochondromas interfering with mandibular motion are presented along with a brief review of the literature. A single incidence of an osteochondroma developing from the mandibular condyle is added to the growing number of case reports. In addition, an osteochondroma developing from the zygomatic arch is reported. Our review of the literature has shown no previous report of occurrence at this site.

Mandibular retrognathia: a review of the literature and selected cases.

Many techniques have been developed since the first osteotomy for correction of retrognathism was performed in 1905. These techniques have been in two groups--those that are performed in the mandibular body and those that are performed in the mandibular ramus. Ramus procedures are more favored because there is less morbidity in comparison to body procedures. Regardless of the procedure used, an adequate preoperative evaluation based on oral and radiographic examinations, study models, cephalometric analysis, and photographs is mandatory to achieve satisfactory results. A more satisfactory result can almost always be attained if a cooperative effort is made by the oral surgeon and orthodontist in the treatment of retrognathism.

Eminectomy for the treatment of recurrent temporomandibular joint dislocation.

Several techniques have been used to treat chronic dislocation of the mandible. Most of these techniques represent attempts at reducing the mobility of the TMJ. The eminectomy procedure is an attempt at restoring normal joint function without reducing mobility of the joint. We have presented two cases of chronic dislocation of the mandible that were treated successfully by removal of the articular tubercle and the lateral portion of the temporal bone. Although surgery of the TMJ area may be hazardous if approached without caution, we feel that the complications associated with this procedure are minimized if adequate care is taken in flap design and tissue dissection. On the basis of the excellent results of the eminectomy procedures reported in the literature and of our own experience with this procedure, we feel that this is the preferred treatment for chronic dislocation of the mandible.

The diagnostic significance of the microhematocrit as an office screening test.

The microhematocrit provides accurate and reproducible test results. This laboratory procedure is useful not only in determining the hematocrit value, but also in the identification of conditions that may be of primary interest to the clinician. The information it provides is valuable in treatment planning, in choosing an anesthetic technique, and in helping to avoid operative and postoperative complications. This test can be easily and inexpensively performed and can be incorporated into the normal office routine with little difficulty.