ABSTRACT
Cherubism, a rare autosomal dominant disorder, presents with symmetrical, painless jaw extension due to fibrous tissue ossification, often referred to as hereditary fibrous dysplasia of the jaw. It typically manifests with progressive mandibular and maxillary swelling from childhood to adolescence, with exacerbation over time. A 20-year-old male presented with facial and jaw swelling, causing restricted jaw movements. Computed tomography confirmed the cherubism diagnosis. Subsequently, the patient underwent oral surgery for bone shaving and shaping. Post-surgery, a five-week physiotherapy regimen was initiated, emphasizing joint mobility preservation through active range-of-motion exercises and proprioceptive neuromuscular facilitation for facial expression and dyspnea alleviation. Following physiotherapy, significant improvements were observed, including enhanced respiratory function, increased cervical muscle strength, improved respiratory clearance, and reduced anxiety and depression levels. This case highlights the importance of physiotherapy in cherubism rehabilitation, a novel approach deserving further exploration.
ABSTRACT
Hirschsprung disease (HD) is characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the hindgut. Here, we report a case of an eight-year-old male child who had abdominal distension with a history of repetitive gas passage and a complaint of stool passage. In February 2023, the patient was diagnosed with Hirshsprung disease, for which a left-side colostomy was done. In November 2023, he underwent Hirshsprung stage 2 repair. He was operated on the 17th of December 2023 under general anaesthesia colostomy mobilization. Physiotherapy commencement and evaluation were started on the 18th of December 2023. After the colostomy procedure, the incision weakened the abdominal and lower limb muscles, while bowel obstruction and discomfort further impeded the patient's ability to perform daily activities. Physical examination revealed increased work of breathing, reduced range of motion of the bilateral hip joint, reduced muscle strength of lower limb musculature, reduced abdominal muscle strength, difficulty in walking and waddling type of gait. Physiotherapy goals were set based on the problem list. The patient showed improvement in the two weeks of physiotherapy commencement, followed by improvement in functional ability. The comprehensive care provided during the rehabilitation phase aimed at addressing the specific needs arising from the surgical intervention, promoting optimal bowel function, improving ranges and strength and ensuring overall well-being.
