The rare phenomenon of vascular pedicle ossification of free fibular flap in mandibular reconstruction.

Ossification of the vascular pedicle in the vascularized free fibular flap (VFFF) has been only previously described twice for jaw reconstruction. A case of severe trismus secondary to periosteal osteogenesis following VFFF for maxillary reconstruction, and four cases of ossification of the vascular pedicle in VFFF for maxillary and mandibular reconstruction have been respectively described. Etiology remains unclear, although presence of periosteum in continuity with bone seems to play a major role. Hormonal stimuli, stress over the bone, and corticosteroid therapy have been proposed as determinant factors, although no clear correlation has been already established. No histologic studies concerning the generation of new bone around the vascular pedicle in VFFF are nowadays present. We report a new case of vascular pedicle ossification of VFFF following mandibular reconstruction, this being the third report in the literature, and focus on histologic examination of the specimen.

Myositis ossificans of the temporalis muscle. Case report.

The authors report an unusual case of myositis ossificans in the temporal muscle manifesting as grave opening limitation of the mouth and a hard firm mass in the right temporal fossa. CT scan examination revealed a bone density mass located in the region of the right temporal fossa, that fussed the right temporal bone with the right coronoid process and a joint-like image in the middle portion of this mass. Traumatic myositis ossificans is a pseudotumor-like benign disease most frequently found in extremities of young population. Cases in the craniofacial skeleton are rare. The masseter and sternocleidomastoid muscles are most commonly affected in this location. The clinicopathological features of scalp myositis ossificans may mimic other soft tissue tumors, requiring care for the differential diagnosis. Histologically, osteoblastic activity is sometimes observed, similar to an osteosarcoma. Then differential diagnosis between both entities must be established.