Etiology, pattern, and treatment of nose fractures: A 10-year cross-sectional cohort retrospective study.

BACKGROUND: Determining the etiology, epidemiology, pattern, and treatment of nasal bone fractures and the associated soft tissue injuries in a population will be beneficial for the prevention, rapid and correct diagnosis, and adequate management of this pathology in order to minimize postoperative complications. PATIENTS AND METHODS: This study retrospectively evaluated the patients admitted and treated for nasal bone fractures in a university clinic of oral and maxillofacial surgery in Romania over a 10-year period. Following statistical analysis, evaluation and correlation of the monitored variables, a P value < 0.05 was considered statistically significant. RESULTS: Nasal bone fractures had the highest incidence among men (88.30%), aged 20-29 years (33.33%), with no education (33.33%), interpersonal violence being the main cause in this category of patients (P = 0.004; P = 0.005; P = 0.005). In urban environment (55.9%), nasal bone fractures through aggression and road traffic accidents were predominant, while in rural areas (44.10%), those caused by domestic accidents and animal attacks prevailed (P = 0.551). Nondisplaced (81.10%), closed (85.60%) and involving the nasal septum fractures (51.35%) were preponderant. Hematoma was the most frequent associated soft tissue injury (86.49%), its incidence being increased in the case of displaced (P = 1.000) and open fractures (P = 0.692). The most frequent treatment method was close nasal reduction (CNR) + closed septoplasty (51.35%). The most frequent complication was malunion (7.2%), secondary to CNR without septoplasty (P = 0.037). CONCLUSIONS: The main etiology of nasal bone fractures was interpersonal violence, which mainly affected men, aged 20-39 years, with a low level of education, living in urban areas. Implementing laws to fight interpersonal aggression and increase the education level of the population would lead to a considerable reduction in the incidence of this pathology. Patients treated by CNR + closed septoplasty and ORIF had the best postoperative evolution. Immediate septoplasty in the case of associated septal fractures significantly decreased the rate of postoperative complications.

Giant maxillary cyst with intrasinusal evolution.

Giant maxillary cysts deserve one's attention, mainly because of all the complication they can originate, such as facial aesthetic changes, jaw fractures, infections and occasional but the most severe one the neoplasia of its epithelium. Here we present the case of a 51-year-old man who was sent to the Clinic of Oral and Maxillofacial Surgery of Timisoara, Romania, because of a facial asymmetry due to the hyper-dimension of the right superior genian and labial region, consecutive to the volume growth of the subjacent alveolar process. The clinical and paraclinical investigations, especially the fine-needle aspiration and the 3D imagistic investigation, most likely lead to the diagnosis of maxillary cyst with intrasinusal evolution, the lesion being caused by the untreated teeth of the superior right hemiarcade. The surgery was performed in general anesthesia and consisted of a cystectomy and the curettage of the right maxillary sinus, followed by the restoration of alveolar process with the help of bone graft materials. The histopathological examination of the lesion confirmed the diagnosis of maxillary radicular cyst. This case shows the frequently asimptomatic and long-term evolution of maxillary cysts, their growing volume causing massive bone destructions and affections of the neighboring anatomic structures.

The MRI fine evaluation of cervical lymphadenopathies and associated oral cavity pathological conditions.

The aim of this paper is to point out the value of MRI in diagnostic assessment of cervical lymphadenopathies and associated oral cavity pathological conditions. We used a statistic retrospective method to evaluate the results obtained after MRI examinations of 64 patients diagnosed with oral cavity pathology and cervical lymphadenopathies. In all cases the MRI exams detected the presence of cervical lymphadenopathies, their topoanatomic sites and oral cavity pathological entities that produced them. Due to fine characterization abilities by internal signal variation. MRI is the method of choice in daily practice for diagnosing, evaluation and staging of oral cavity pathology and cervical lymphadenopathies. Due to fine capacities of detecting internal signal variations in soft tissues or visceral parenchyma, MRI has high abilities in diagnostic assessment of oral cavity pathologies being a daily method of choice for diagnosing, evaluation and staging, with great value in any morbid entity.