Management of facial asymmetry.

Asymmetries of the craniofacial region encompass a multitude of diverse and potentially complex abnormalities that may be the result of numerous causes. The expression and degree of asymmetry for a given condition, although a highly variable process, is the ultimate determinant of the nature of its treatment. This article highlights some of the key features and treatment strategies for various common facial asymmetries.

Primary intraosseous meningioma of the calvaria: analysis of the literature and case report.

Meningiomas are the most common of the benign intracranial neoplasms. They are uncommon as primary or secondary extracranial entities. Of these, the primary intraosseous variant may represent the rarest form. We report the case of a rare primary intraosseous meningioma presenting as a localized, symptom-free supraorbital bony expansion in an 81-year-old female patient and tabulate the previously reported cases of primary intraosseous meningiomas of the craniomaxillofacial region for analysis.

Cranioplasty for midline metopic suture defects in adults with cleidocranial dysplasia.

OBJECTIVE: Patients with cleidocranial dysplasia often express concerns related to their perception of an undesirable esthetic appearance of their forehead and skull because of a combination of the persistence of metopic suture defects and frontal bossing. This case series reviews the use of a cranioplasty technique that has been developed to address such concerns. STUDY DESIGN: A series of 7 adult patients with cleidocranial dysplasia were treated using a cranioplasty technique to correct visible metopic suture defects in the forehead region. The patients were 4 males and 3 females with a mean age of 29.0 years. All 7 patients underwent identical cranioplasty procedures. RESULTS: The metopic suture cranial defects were found to range in size from 0.6 to 2.4 cm in diameter and were present as full-thickness osseous defects in 4 of the 7 patients. All postoperative complications resolved spontaneously. Inpatient admission times ranged from 1 to 3 days. Follow-up ranged from 9 to 48 months with satisfactory subjective esthetic outcomes. The patients were content in all cases. CONCLUSION: This cranioplasty procedure successfully addresses the specific esthetic concerns of a rare and unique group of individuals. The procedure can be offered to cleidocranial dysplasia patients as part of their overall comprehensive craniomaxillofacial management.

Unilateral facial swelling caused by Ramsay Hunt syndrome resembles odontogenic infection.

Facial cellulitis and swellings of the head and neck are worrisome signs of odontogenic infection, which can be life threatening. Most head and neck infections are caused by bacterial pathogens. When treating such infections, dentists must also be aware of possible viral or fungal causes and their associated presentations. This report documents a case of viral infection that initially resembled a bacterial odontogenic infection. It is intended to familiarize dentists with the Ramsay Hunt syndrome and the need for prompt recognition and early definitive treatment.

Congenital epulis: a surprise in the neonate.

A newborn infant with congenital epulis can be a striking sight for both parents and health care professionals involved in neonatal care. These tumours of the infant mouth can be remarkably large, occupying much of the oral cavity and posing a risk of airway obstruction or interfering with feeding. Dentists should be able to recognize these swellings as they may be asked to consult and provide information to parents and other practitioners regarding treatment of these lesions.

Fractures of the supraorbital rim: principles and management.

Dentists may be asked to provide consultations for patients who have sustained trauma to their facial structures. Supraorbital rim fractures, although uncommon, must be recognized and promptly referred to an oral and maxillofacial surgeon or other specialist skilled in the management of facial bone fractures. Supraorbital rim fractures commonly coexist with other craniomaxillofacial injuries, especially with fractures of the anterior table of the frontal sinus. In this article, we review the frequency, management and complications associated with the treatment of supraorbital rim fractures in adults. A series of 5 cases was reviewed; 4 of the 5 patients were male, with a mean age of 21.6 years (range 17-28 years). All injuries involved the supraorbital rim and the anterior table of the frontal sinus and occurred concurrently with other facial injuries. Treatment ranged from conservative observation to open reduction and internal fixation of the fractures. No associated perioperative or postoperative complications occurred. The follow-up ranged from 6 months to 26 years, with satisfactory subjective esthetic outcomes in all cases.