Surgical Treatment of Anterior Sinus Wall Fracture Due to Sports Accident.

Frontal bone fractures represent a low percentage of craniofacial fractures. However, a systematic approach and a correct diagnosis are essential for successful treatment and maintenance of physiology of the frontal sinus and late complications. The purpose of this study was to report a clinical patient with anterior wall fracture of the frontal due to sports accident sinus that was surgically treated.

Simplified Access for Reduction and Fixation of a Frontal Bone Fracture.

The frontal bone fractures occur very often in service units in oral and maxillofacial surgery. Bicoronal access is the most common for the surgical treatment of frontal bone fractures. However, patients are surprised when they receive notice that such invasive access will be made. This approach allows adequate visualization of the fracture site, but may be associated with complications, which can be avoided by the use of less invasive techniques. We describe an alternative approach that aims to minimize the complications of a coronal incision.

Respiratory Obstruction Due to Richards Type 4 Fracture.

Facial fractures can be potentially fatal in polytraumatized patients due to retropositioning tissues to upper airway obstruction. In the first aids, this situation can be reversed using a tracheostomy procedure to break out the airways. However, fractures leading to airway obstruction are rare and according to Richards Classification can be classified into 5 types. The purpose of this article is to report a clinical patient with a bilateral condylar and mandibular symphysis fractures that resulted in airway obstruction and severe mandibular rear projection.

Survival Without Neurological Impairment of a Patient With Rhino-Orbito-Cerebral Zygomycosis.

Rhinocerebral zygomycosis is a rare condition characterized by infection initially in the nose and paranasal sinuses with atypical symptoms consistent with sinusitis. Once established in the nasal sinuses, the infection can easily spread to the orbital region and brain. In the localized form of the infection, the mortality rate is approximately 10%, which increases in the occurrence of orbital involvement and survival in patients of cerebral dissemination is extremely rare. The present paper reports a patient of nasal zygomycosis with orbital and cerebral dissemination in an otherwise healthy patient who survived after 14 months of hospitalization with no neurological impairment. A review of the literature addressing aspects related to diagnosis, treatment, and complications of this fungal infection is also presented.

Failure of Maxillary Reconstruction With Freeze-Dried Bone Allograft.

Bone reconstruction to reestablish bone width and height is required in case of bone atrophy. A 45-year-old white woman was referred to the oral clinical surgery of Aracatuba Dental School, University Estadual Paulista-UNESP, in 2013 with the main complain of bone exposure at the superior right site of the maxilla after 1-year reconstruction with bone block allograft. Bone block was removed besides the dental implant next to the bone allograft. Complication of bone allograft could jeopardize treatment planning.

The primary closure approach of dog bite injuries of the nose.

The nose holds an outstanding position on the face, acquiring great importance within the context of facial aesthetics. Because of the functional, psychological, and social aspects of trauma in a society increasingly demanding about aesthetics, treatment institution must reduce, as accurate as possible, the sequelae that hinder social integration. This clinical report relates an immediate nasal reconstruction of a complex animal bite wound. A 7-year-old patient was victim of a dog bite with avulsion of the left nasal ala and part of the ipsilateral nasal tip. The treatment was immediate nasal reconstruction with auricular composite graft. After 1 year of follow-up, the shape of nasal ala was stable, and the color was consistent with the surrounding tissue. The 2 nasal sides exhibited satisfactory symmetry when evaluated. It can be concluded that the composite graft derived from the auricular helix is a safe option for reconstruction of nasal ala defects with compromised margins in pediatric patients when conditions of reimplantation do not exist.

Failure of miniplate osteosynthesis for the management of atrophic mandibular fracture.

Fractures of the severely atrophic (<10 mm) edentulous mandible are not common, and these fractures with a vertical height of 10 mm or less have long been recognized as being particularly problematic. Although there are advances in the treatment of the atrophic mandibular fracture, the treatment remains controversial. There are some options for treatment planning because of using small miniplates to large reconstruction plates. However, when the fixation method fails, it causes malunion, nonunion, and/or infection, and sometimes it has been associated with large bone defects. The authors describe a clinical report of a failed miniplate fixation for atrophic mandibular fracture management. The authors used a load-bearing reconstruction plate combined with autogenous bone graft from iliac crest for this retreatment. The authors show a follow-up of 6 months, with union of the fracture line and no complication postoperatively.