Sphenoid Wing Dysplasia: Report Of 3 Cases.

Sphenoidal Dysplasia is the absence of complete or a part of sphenoid bone, most commonly the greater wing of sphenoid. It can occur as an isolated deformity or in Neurofibromatosis-1 (NF1). Features of NF1 include café au lait spots, inguinal or axillary freckling, neurofibromas, optic gliomas, scoliosis and tibial deformity. Our study is retrospective case series of 3 cases of Sphenoid wing dysplasia. There was 1 case of isolated bone defect, 1 case of NF-1 and 1 case of operated Craniofacial Fibrous Dysplasia involving the sphenoid wing. There were 2 primary operated cases while 1 was operated secondarily. There was resolution of pulsatile exophthalmos in patient with sphenoid and temporal bone defect. Patient with facial deformity NF1 was debulked to the satisfaction of the patient, the patient however declined surgery to correct the sphenoid bone deformity. The 3rd patient was a re-do surgery patient in which the previous implant material was removed and the CSF rhinorrhoea, the patient did not consent to the correction of vertical orbital dystopia. Sphenoid wing dysplasia is a complex deformity requiring multi speciality care and treatment planning. With meticulous planning and surgery, good results can be achieved as shown in our case series.

Functional Outcomes Of Open Versus Closed Treatment Of Unilateral Mandibular Condylar Fractures.

BACKGROUND: Although mandibular condylar fractures are among the most common fractures of maxillofacial region, the ideal method for treatment of these fractures is still a controversy. The objective of this study was to compare functional outcomes of open vs closed treatment of unilateral mandibular condylar fractures. METHODS: This study was carried out at Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi. All patients, included in our study, were randomly put in open and closed treatment groups. Patients were assessed for maximal mouth opening, deviation of mandible on opening and occlusal status six months postoperatively. Maximal mouth opening was assessed by maximal interincisal distance, deviation of mandible on opening by calculating the midline discrepancy during mouth opening and occlusion was assessed by clinical examination according the modified criteria described by Singh V et al. Independent samples t-test was used to compare means of variables in open and closed treatment groups. RESULTS: After six months of follow up the mean mouth opening was 36.39±4.72 mm in open treatment group while it was 33.74±4.72 mm in closed treatment group and difference was statistically significant. While deviation of mandible on opening was found to be 0.48±0.99 mm in open treatment group and 1.09±1.60 mm in closed treatment group. The mean occlusal disturbance was found to be 1.17±0.38 in closed treatment group while it was 1.10±0.30 in open treatment group.. CONCLUSIONS: Open treatment of unilateral mandibular condylar fractures results in better functional outcomes particularly in terms of mobility of mandible (mouth opening).

Nasolabial and extended nasolabial flaps for reconstruction in oral submucous fibrosis.

OBJECTIVES: The objective of the study was to evaluate the results of nasolabial/extended nasolabial flaps as a modality for treatment of oral submucous fibrosis. MATERIALS AND METHODS: Eleven patients of Stage III or IVa maximum interincisal opening were selected to be operated. Nasolabial/extended nasolabial flaps were done for both the sides. All of the flaps were done in a single stage and were inferiorly based. A similar flap harvest/surgical technique was utilized for all the cases. RESULTS: The preoperative mouth opening ranged from 5 to 16 mm, with a mean of 10.09 mm. At 6 months the mouth opening ranged from 29 to 39 mm. Some of the complications encountered were poor scar, wisdom tooth traumatising the flap, decreased mouth opening due to non compliance and too much bulk. All of theses were managed satisfactorily. CONCLUSION: The nasolabial flap is a very reliable flap to restore the function of oral cavity. Important adjuvant measures are habit cessation, lifestyle changes, and aggressive physiotherapy.

Surgical correction of grade III hypertelorism.

Orbital hypertelorism is an increased distance between the bony orbits and can be caused by frontonasal malformations, craniofacial clefts, frontoethmoidal encephaloceles, glial tumors or dermoid cysts of the root of the nose, and various syndromic or chromosomal disorders. We report a series of 7 cases of hypertelorism that were treated in our hospital. The underlying causes in our series were craniofacial clefts 0 to 14 (4 cases), craniofacial clefts 1 to 12 (1 case), and frontonasal encephalocele (2 cases), all congenital. Surgical techniques used to correct the deformity were box osteotomy and medial wall osteotomy with or without calvarial and rib grafts. A few of our cases were reoperations with specific challenges.