RESUMO
We describe the removal of a lower second molar tooth in which preoperative cone-beam computed tomography (CBCT) showed that the inferior alveolar nerve (IAN) was encased in the distal apex of the root of the tooth. During operation the nerve was found to be entirely separate from the apex of the root and not involved. With the wider use of CBCT in the treatment planning of dentoalveolar surgery, this case represents a cautionary tale to the clinician on reliance on clinical imaging and software in guiding the decision making process.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Nervo Mandibular/diagnóstico por imagem , Erros Médicos , Dente Serotino/diagnóstico por imagem , Adolescente , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Masculino , Dente Serotino/inervação , Dente Serotino/cirurgia , Radiografia Panorâmica , Ápice Dentário/diagnóstico por imagem , Ápice Dentário/inervação , Ápice Dentário/cirurgia , Extração Dentária/efeitos adversos , Extração Dentária/métodos , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Traumatismos do Nervo Trigêmeo/etiologiaRESUMO
The combined use of three-dimensional reformatted images, stereolithographic models, and rapid prototyping allows the construction of an accurate, individually made titanium implant for the reconstruction of orbital floor defects. Despite the perfect fit of the custom-made plate to the model, there might be several locations on the bone where the plate may reside intraoperatively. Most titanium orbital plates therefore contain extensions over the inferior orbital rim to help locate and stabilize the plate in its position on the bone. Such over-the-rim extensions may be palpable and can cause discomfort postoperatively. We describe the use of two small detachable flanges that help to accurately locate the orbital plate in place and allow its fixation. The locating flanges are then detached and discarded, leaving a smooth implant surface within the confines of the bony orbit.
Assuntos
Imageamento Tridimensional/métodos , Órbita/cirurgia , Cirurgia Assistida por Computador , Interface Usuário-Computador , Humanos , Seio Maxilar/anatomia & histologia , Seio Maxilar/diagnóstico por imagem , Modelos Anatômicos , Órbita/anatomia & histologia , Implantes Orbitários , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: Orbital emphysema is a recognised complication of fractures of the orbit and only rarely poses a threat to vision. PATIENTS AND METHODS: We present three patients with threatened vision secondary to orbital emphysema that required an immediate surgical decompression. RESULTS: Visual function was preserved in all three patients. CONCLUSION: Clinical awareness of pneumo-orbitism is vital as immediate orbital decompression may be necessary to preserve visual function.
Assuntos
Descompressão Cirúrgica , Enfisema/cirurgia , Doenças Orbitárias/cirurgia , Fraturas Orbitárias/complicações , Adulto , Idoso , Enfisema/etiologia , Exoftalmia/etiologia , Exoftalmia/cirurgia , Humanos , Masculino , Doenças Orbitárias/etiologia , Fraturas Orbitárias/cirurgia , Resultado do TratamentoRESUMO
Giant orf is a zoonotic infection that is endemic in sheep and goats. It may be transmitted to humans by direct contact with infected animals or contaminated objects and is typically found on the hands. We report the case of a sheep farmer with facial orf that proliferated dramatically with the formation of satellite lesions after curettage.
Assuntos
Doenças dos Trabalhadores Agrícolas/cirurgia , Ectima Contagioso/cirurgia , Dermatoses Faciais/cirurgia , Dermatopatias Virais/cirurgia , Dermatopatias Virais/terapia , Adulto , Doenças dos Trabalhadores Agrícolas/patologia , Doenças dos Trabalhadores Agrícolas/virologia , Animais , Desbridamento/métodos , Ectima Contagioso/patologia , Ectima Contagioso/transmissão , Dermatoses Faciais/patologia , Dermatoses Faciais/virologia , Humanos , Lasers de Corante/uso terapêutico , Masculino , Recidiva , Ovinos , Dermatopatias Virais/transmissãoRESUMO
INTRODUCTION: Langerhans' cell histiocytosis is a collective term used to describe a group of enigmatic proliferative disorders. The natural history of the disease varies from a slow, benign, localized symptomatic bony or soft tissue lesion, to a rapidly progressive widespread multiple organ disorder which is often fatal. Eosinophilic granuloma accounts for 60-70% of all cases of Langerhans' cell histiocytosis and can present as solitary (50-75%) or multifocal defects in bone. It occasionally presents as a localized soft tissue lesion. There are multiple treatment options but the response is unpredictable. AIMS: We present three separate cases, of the maxillofacial skeleton where the lesions of eosinophilic granuloma resolved following incisional biopsy only. PATIENTS AND RESULTS: Three patients presented with solitary lesions of the maxillofacial skeleton. All were diagnosed as Langerhans' cell histiocytosis following open curettage, which also resulted in resolution of the lesions. Follow-up has thus far been disease free. CONCLUSION: For some solitary Langerhans' cell histiocytosis lesions, simple curettage is the only treatment required. The paper discusses the need to confirm the solitary nature of the disease and the need for follow-up. Reviewing the literature on the disease, the authors suggest that perhaps cellular immaturity holds the cells of the lesion in a disease state until pushed to maturity by the trauma of open curettage surgery, resulting in a complete resolution of the disease.
