Air Embolism-Induced Ischemic Stroke Following Orthognathic Surgery in a Patient With Goldenhar Syndrome.

Goldenhar syndrome, a rare congenital anomaly, manifests as craniofacial malformations often necessitating intricate surgical interventions. These procedures, though crucial, can expose patients to diverse postoperative complications, including hemorrhage or infection. A noteworthy complication is stroke, potentially linked to air embolism or local surgical trauma. We highlight a case of a male patient, aged 20 years, who experienced a significant postoperative complication of an ischemic stroke, theorized to be due to an air embolism, after undergoing orthognathic procedures for Goldenhar syndrome. The patient was subjected to LeFort I maxillary osteotomy, bilateral sagittal split ramus osteotomy of the mandible, and anterior iliac crest bone grafting to the right maxilla. He suffered an acute ischemic stroke in the left thalamus post-surgery, theorized to stem from an air embolism. Advanced imaging demonstrated air pockets within the cavernous sinus, a rare and concerning finding suggestive of potential air embolism. This case underscores the intricate challenges in treating Goldenhar syndrome patients and the rare but significant risk of stroke due to air embolism or surgical trauma. Limited literature on managing air embolism complications specific to Goldenhar syndrome surgeries exists. Generally, management includes immediate recognition, positional adjustments, air aspiration via central venous catheters, hyperbaric oxygen therapy, hemodynamic support, and high-flow oxygen administration to expedite air resorption. Our patient was conservatively managed post-surgery, and at a 3-month neurology follow-up, he showed significant improvement with only residual right arm weakness. It emphasizes the imperative of a comprehensive, multidisciplinary approach.

Ozone: An Adjunct in Dental Treatment.

Ozone is utilized in dentistry as ozonated oils, ozonated water, and gaseous ozone. The application of ozone in all specialties of dentistry has been demonstrated to be biocompatible. It has been demonstrated to encourage the remineralization of recently carious teeth, and it is utilized in dental caries and intracanal irrigants in endodontic treatment. Herpes virus infection, avascular osteonecrosis of the jaw, and alveolitis have all been treated with it. It can be applied as a supplement in the surgical and ongoing stages of periodontal disease and also hinders plaque formation. The purpose of the present review article is to discuss the numerous application of ozone in dentistry.

Effectiveness of Diode Lasers in the Reduction of Bacteremia Associated with Ultrasonic Scaling: A Clinical and Microbiological Study.

Introduction: As is known, periodontal pathogens and their products as well as inflammatory mediators produced in periodontal tissues might enter the bloodstream, causing systemic effects and/or contributing to systemic diseases. Aim: To evaluate the effect of diode lasers on the incidence of bacteremia associated with ultrasonic scaling and its clinical efficacy as an adjunct to scaling in the treatment of moderate periodontitis. Result: The use of diode laser is more effective in killing or detoxifying periodontopathic bacteria such as P. gingivalis associated with chronic periodontitis as compared to ultrasonic alone with ablate bacteria only when it comes in contact with plaque biofilm directly. Conclusion: The results of study confirm the previously reported findings that bacteremia is caused by ultrasonic scaling and adjunct use of diode laser with scaling has the potential to reduce the bacteremia associated with ultrasonic scaling alone.

Dual substrate strategy to enhance butanol production using high cell inoculum and its efficient recovery by pervaporation.

The present study deals with the development of an efficient ABE fermentation process using mixed substrate strategy for butanol production wherein no acetone was produced. For this, glucose was supplemented in the medium containing glycerol as main substrate which leads to a higher butanol production of 17.75 g/L in 72 h by Clostridium acetobutylicum KF158795. Moreover, the high cell inoculum also resulted in an increased ABE productivity of 0.46 g/L/h. Further, industrial scalability of the process was also successfully validated in a 300 L fermenter. Furthermore, potential of the Polymeric (PolyRMem) and Zeolite (ZeoMem) membranes for separation of butanol from fermentation broth was also studied by testing the pervaporation performance through which the butanol was successfully recovered.