Transconjunctival Surgical Access With Modified Aesthetic Lateral Canthotomy.

ABSTRACT: Displaced fractures of the zygomatic bone that require surgical treatment are accessed transcutaneously but these accesses to the skin can cause a hypertrophy scar in patients with this predisposition. This paper indicates a modification in the lateral canthotomy that aim to minimize the hypertrophic scar in the treatment of zygomatic fracture.

Positioning of the knot in the steel wire in relation to the tooth and the Erich bars: technical note

Erich bar is a basic techniquefor restoring occlusal alignment in patients with facial fractures.Although this method is used worldwide, there is no description of what is the best way to stabilize the bar that should be anchored tooth to tooth with steel wire. We describe the method of stabilizing the bar of current use in our Service. We indicate the use of this technique because it stabilizes the bar and, in our opinion, it reduces the need to twist the knots during the patient's return(AU)

Oral focal mucinosis of the hard palate and gingiva

Oral focal mucinosis (OFM) is an uncommon, asymptomatic, submucosal, slow-growing nodule representing a counterpart of the cutaneous focal mucinosis (CFM). OFM has a female predilection with the highest prevalence in the fifth decade of life. About 68% of OFMs occur in the gingiva and 14% in the palate. We present the case of a 41-year-old woman presenting a progressively growing mass on the palate, since the last 8 months. The diagnostic workup led to the diagnosis of an unusual OFM with the clinical presentation involving the gingiva and hard palate. This case report discusses the clinical and histopathological differential diagnosis.

Windshield glass fragment mimicking a nasal fracture / Fragmento de parabrisas mimetizando fratura nasal / Fragmento de vidrio del parabrisas que imita una fractura nasal

A male patient with facial trauma by road traffic accident arrived in the emergency room and he was assisted by the Trauma and Neurosurgery team. After clinical evaluation a frontal sinus anterior wall fracture plus a nasal fracture were diagnosed. On the primary OMS examination was checked multiple facial lacerations and gross nasal dorsum deviation with pain, nasal airway obstruction and crepitus with clinical diagnosis of a nasal fracture. After radiologic exam a piece of windshield glass that was superimposed on the nasal bones simulating a nasal fracture was visualized. This paper presents clinical data and literature review of foreign body mimicking facial fractures(AU)

Paciente do sexo masculino com trauma facial por acidente de trânsito foi avaliado na sala de emergência e foi atendido pelas equipes de Trauma e Neurocirurgia. Após avaliação clínica, foi diagnosticada fratura da parede anterior do seio frontal e fratura nasal. No exame facial foram verificadas múltiplas lacerações faciais e desvio do dorso nasal com dor, obstrução das vias aéreas e crepitação com diagnóstico clínico de fratura nasal. Após o exame radiográfico visualizou-se fragmento de vidro do pára-brisa que estava sobreposto nos ossos nasais simulando fratura. Este artigo apresenta dados clínicos e revisão de literatura de corpo estranho, mimetizando fraturas faciais(AU)

Un paciente masculino con trauma facial por accidente de tráfico llegó a la sala de emergencia y fue asistido por el equipo de Trauma and Neurocirurgia. Después de la evaluación clínica, se diagnosticaron fracturas de la pared anterior del seno frontal más una fractura nasal. En el examen primario de OMS se verificaron múltiples laceraciones faciales y desviación neta del dorso nasal con dolor, obstrucción nasal de las vías aéreas y crepitación con diagnóstico clínico de fractura nasal. Después del examen radiológico, se visualizó un trozo de vidrio del parabrisas superpuesto a los huesos nasales que simulaba una fractura nasal. Este artículo presenta datos clínicos y revisión de la literatura de cuerpos extraños que imitan fracturas faciales(AU)

Fratura zigomática tratada com fixação em ponto único (single point) / Zigomatic fracture treated with single point

Objetivo: Relatar um caso de fixação de zigoma em ponto único "single point". Relato do caso: Paciente do gênero masculino, 58 anos, saudável, pardo, foi encaminhado ao Pronto Socorro Municipal do município de Osasco/SP relatando ter sido assaltado, sofrendo trauma facial. Ao exame físico específico observou-se perda de projeção zigomática direita, degrau palpável na sutura fronto zigomática, degrau mínimo no rebordo infra orbital e movimentação ocular normal, sem perda de sensibilidade na porção infra orbital. O paciente foi informado do diagnóstico e necessidade de tratamento cirúrgico. Após exames laboratoriais e consentimento, foi submetido a procedimento composto por: acesso supratarsal, exposição da fratura, redução, checagem da projeção e fixação utilizando miniplaca 2.0 mm. Procedeu-se a nova checagem da posição do zigoma onde verificou-se a resolução do degrau na margem infraorbital. No controle pós-operatório, observou-se abertura bucal normal e restauração da projeção zigomática. Conclusão: Quando corretamente indicadas, as fixações em ponto único trazem benefícios como menores custos, menor morbidade, melhora da estética facial e redução do risco de ocorrer lesões sensoriais e o incômodo quando são utilizadas as miniplacas e parafusos.

Aim: To report a case of single-point zygoma fixation. Case report: A 58-year-old male, healthy, brown patient was referred to the Municipal Emergency Room in the city of Osasco / SP, reporting that he had been assaulted, suffering facial trauma. At the specific physical examination, there was loss of right zygomatic projection, palpable step in the zygomatic frontal suture, minimal step in the infraorbital border and normal ocular movement, without loss of sensitivity in the infra-orbital portion. The patient was informed of the diagnosis and the need for surgical treatment. After laboratory tests and consent, the patient was submitted to a procedure consisting of: supratarsal access, fracture exposure, reduction, check of the projection and fixation using mini-plate 2.0 mm. A new check of the zygoma position was performed, where the resolution of the step in the infraorbital margin was verified. Postoperative control revealed a normal oral opening and restoration of the zygomatic projection. Conclusion: When correctly indicated, single-point fixations bring benefits such as lower costs, lower morbidity, improved facial aesthetics and reduced risk of sensory lesions, and discomfort when using miniplates and screws.

Oral focal mucinosis of the hard palate and gingiva.

Oral focal mucinosis (OFM) is an uncommon, asymptomatic, submucosal, slow-growing nodule representing a counterpart of the cutaneous focal mucinosis (CFM). OFM has a female predilection with the highest prevalence in the fifth decade of life. About 68% of OFMs occur in the gingiva and 14% in the palate. We present the case of a 41-year-old woman presenting a progressively growing mass on the palate, since the last 8 months. The diagnostic workup led to the diagnosis of an unusual OFM with the clinical presentation involving the gingiva and hard palate. This case report discusses the clinical and histopathological differential diagnosis.

The use of a bite fork to help mobilize the maxilla after downfracture during the Le Fort I osteotomy. A technical note.

INTRODUCTION: The Le Fort I osteotomy is indicated to reposition the maxilla in the surgical correction of dentofacial deformities. Although it is a known surgical step, like any surgical procedure, it can have complications and difficulties; among these, the initial mobility of the jaw is very common after completing all corticotomies. METHODS: The authors present a technique in which the bite fork is used as an auxiliary tool in maxilla downfracture, especially in cases of maxillary impaction where vertical space is created on the walls of the corticotomy. FINDINGS: As the bite fork acts as a scraper with a long leverage arm, an advantage would be the better distribution of forces along the corticotomy, minimizing the risk of bad fracture and facilitating maxillary downfracture movement.

Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note.

In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy.

Single puncture for TMJ arthrocentesis: An effective technique for hydraulic distention of the superior joint space.

Temporomandibular joint arthrocentesis is a method of flushing out the synovial fluid that is currently performed by providing a double puncture to the upper joint space. The traditional 2-needle technique has some restrictions, such as the difficulty in performing it in the presence of intra-articular adherences and in the female patients, because the space is very small. The adoption of a single-needle for fluid injection might have some advantages with respect to the traditional 2-needle approach in terms of easily, time of execution and tolerability. We describe a single needle technique and we recommend the use.

Peripheral osteoma of the maxillofacial region: a study of 10 cases.

UNLABELLED: Peripheral osteoma is a benign neoplasm, with low recurrence rate. Its incidence is rare in the jaws and the mandible is more affected than the maxilla. In most cases it is discovered during routine radiographic examinations. OBJECTIVE: The aim of this study is to show the author's experience regarding the treatment of this neoplasm. METHODS: A retrospective study from January 2002 to December 2007 including ten cases of peripheral osteoma in the maxillofacial region which were treated surgically by removal of the lesion followed by histological confirmation. None of the cases were correlated with Gardner's syndrome. RESULTS: In this series the incidence of this neoplasm was higher in females (1.5:1) with a mean age of 39, without age preference. One of the patients had lesion recurrence two years after the first surgery, having been submitted to another intervention, with no signs of relapse after three years and six months of follow-up. CONCLUSION: Surgical treatment is effective for peripheral osteoma with a low recurrence rate.

Osteoma periférico da região maxilofacial: um estudo de 10 casos / Peripheral osteoma of the maxillofacial region: a study of 10 cases

Osteoma periférico é uma neoplasia benigna, com baixa taxa de recorrência. Sua incidência é rara nos maxilares e a mandíbula é mais afetada do que a maxila. Na maioria dos casos, é descoberto durante exames radiográficos de rotina. OBJETIVO: O objetivo deste trabalho é mostrar a experiência dos autores no tratamento desta neoplasia. MÉTODO: Em um estudo retrospectivo de janeiro de 2002 a dezembro de 2007 foram avaliados dez casos de osteoma periférico na região maxilofacial, tratados cirurgicamente por remoção completa da lesão, seguido de confirmação histológica. Nenhum dos casos estava correlacionado com a síndrome de Gardner. RESULTADOS: Nesta série avaliada, a incidência desta neoplasia foi maior no gênero feminino (1,5:1), com média de idade de 39 anos, sem predileção por faixa etária. Um dos pacientes apresentou recidiva da lesão após dois anos da primeira cirurgia, tendo sido submetido à nova intervenção, sem sinais de recidiva após três anos e seis meses de acompanhamento. CONCLUSÃO: O tratamento cirúrgico para o osteoma periférico é efetivo, com baixa taxa de recidiva.

Peripheral osteoma is a benign neoplasm, with low recurrence rate. Its incidence is rare in the jaws and the mandible is more affected than the maxilla. In most cases it is discovered during routine radiographic examinations. OBJECTIVE: The aim of this study is to show the author's experience regarding the treatment of this neoplasm. METHODS: A retrospective study from January 2002 to December 2007 including ten cases of peripheral osteoma in the maxillofacial region which were treated surgically by removal of the lesion followed by histological confirmation. None of the cases were correlated with Gardner's syndrome. RESULTS: In this series the incidence of this neoplasm was higher in females (1.5:1) with a mean age of 39, without age preference. One of the patients had lesion recurrence two years after the first surgery, having been submitted to another intervention, with no signs of relapse after three years and six months of follow-up. CONCLUSION: Surgical treatment is effective for peripheral osteoma with a low recurrence rate.

Tongue piercing: case report of a local complication.

Historically, wearing adornments on pierced body parts has been associated with many cultures as manifestations of religious or cultural identities. Currently, its use has a broad acceptance among young people. The most common sites for piercings are the tongue and lower lip in the oral cavity. Several complications may be associated with this practice with the most frequently observed being halitosis, periodontitis, tooth fracture, glossitis, and the formation of abscesses. This paper is a case report of a patient who had a complication from a piercing on the tongue located under the overlying mucosa. It also suggests a local habit was a possible initiator of this complication.

Mandibular fracture reduction without intraoperative intermaxillary fixation: a technique using two modified reduction forceps.

This case report demonstrates a technique that is useful for precompressing mandibular fractures and obtaining anatomical reduction of the fracture edges without the use of peroperative intermaxillary fixation (IMF) in a mandibular fracture by using two modified reduction forceps. The first forcep is positioned at the inferior mandibular border and the other in the neutral zone where it is an ideal location to place a fixation plate in mandibular fractures. This technique is indicated for the anatomic reduction in mandibular fractures of the partial dentate patient.