Surgical Treatment of Posttraumatic Ophthalmoplegia Through the Reconstruction of the Lateral Orbital Wall.

Orbital fractures are injuries frequently related to traumas of the midface. These fractures can be associated with ocular lesions, ranging from small abrasions on the cornea to serious complications such as hyphema and ocular globe rupture. Diplopia and ophthalmoplegia are common findings in orbital fractures. They can be caused by mechanical factors as bone fragments or muscle imprisonment. The aim of this study was to report a case of a 40-year patient, male showing diplopia and ophthalmoplegia due to the orbital fracture. The patient was treated by general anesthesia. It was performed a supra orbital approach and the fragments were removed. A titanium mesh to restore the orbital anatomy was installed. After 40 days of follow-up, the patient has no aesthetic or functional complaints. In orbital traumas, the ophthalmological evaluation should be performed carefully aiming to avoid ocular sequelaes. In surgical patients, the surgery should be done as early as the clinical conditions permit, to restore the ocular function.

Queiloplastia primária unilateral através da técnica de Fisher / Unilateral primary lip repair by Fisher technique

Introdução: As fissuras labiais são alterações congênitas que decorrem da não fusão dos processos nasais medianos com os processos nasais laterais, sendo sua ocorrência em aproximadamente 1:550 nascidos vivos. Essas fissuras podem apresentar-se bilaterais ou unilaterais nos lábios e acompanhadas ou não de fenda palatina. A cirurgia primária para reparação do lábio fissurado unilateral vem sendo descrita por diversas técnicas na literatura e geralmente envolve rotações de retalho e deixam cicatrizes visíveis bem como encurtamento do vermelhão do lábio. A técnica de Fisher foi proposta para resultar em uma cicatriz menos visível, em linha reta na região do filtro labial, colocando-a em uma região mais anatômica e simplificando a cirurgia. O objetivo deste artigo é mostrar um caso clínico de queiloplastia primária unilateral, utilizando a técnica de Fisher. Relado de Caso: Paciente CDSS, 8 meses de idade, portador de fissura lábio-palatina unilateral do lado esquerdo. A cirurgia do lábio foi realizada em ambiente hospitalar sob anestesia geral e a técnica utilizada foi a de Fisher. No acompanhamento de 30 dias o paciente apresentou-se com uma cicatriz bastante discreta, posicionada simetricamente em relação ao filtro labial do lado oposto. Conclusão: A técnica de Fisher mostrase como ótima opção para o tratamento de fissuras labiais unilaterais, pois proporciona uma excelente estética, a técnica cirúrgica é relativamente simples e acompanhada de bons resultados funcionais

Introduction: Cleft lip is a congenital abnormality arising from no merger of the median nasal processes with the lateral nasal processes, and their occurrence is approximately 1 in 550 live births. These clefts may present bilateral or unilateral lips and with or without cleft palate. The primary surgery for repair of unilateral cleft lip has been described by several techniques in literature and usually involves retail rotations and leave visible scars and lip vermilion shortening. Fisher technique has been proposed to result in a less visible scar, straight in the philtrum region placing it in a more anatomical region and simplifying the surgery. The purpose of this article is to show a case of unilateral primary lip repair using the Fisher technique. Case Report: Patient CDSS 8 months old has an unilateral cleft lip and palate on the left side. The lip surgery was performed in a hospital under general anesthesia and the technique used was Fisher. In the following 30 days, the patient is presented with a very slight scar, positioned symmetrically in relation to the philtrum of the opposite side. Conclusion: Fisher technique is shown as great option for the treatment of unilateral cleft lip, it provides an excellent aesthetic, the surgery technique is relatively simple and accompanied by good functional results

Tratamento cirúrgico de macrostomia / Surgical Treatment of Macrostomia

A macrostomia é uma rara anomalia congênita, definida como alargamento da boca na região das comissuras orais. Pode-se apresentar na forma bilateral ou unilateral, e ocorre principalmente por uma falha na fusão dos processos maxilar e mandibular do primeiro arco branquial. Pode ocorrer isoladamente ou associada a diversas síndromes. Os principais problemas associados à macrostomia são alterações estéticas e dificuldades na deglutição e fonação. Relato de Caso: O objetivo deste trabalho é mostrar um caso clínico de um paciente de 3 anos de idade com macrostomia bilateral. Foi instituído tratamento cirúrgico sob anestesia geral em ambiente hospitalar. Foram realizadas incisões cutâneas e na mucosa oral, e realizado o fechamento em linha reta. O paciente evolui bem com cicatriz facial satisfatória e funções do esfincter oral reestabelecidas. Conclusão: A macrostomia é uma anomalia congênita que necessita de tratamento cirúrgico. O fechamento em linha reta apresentou bons resultados estéticos e funcionais... (AU)

Macrostomia is a rare congenital anomaly, defined as extending from the mouth in the region of the oral commissure. Can be present in bilateral or unilateral, and occurs mainly by a failure of fusion of the mandibular jaw processes of the first arch. Can occur alone or associated with several syndromes. The main problems associated with macrostomia are cosmetic changes and difficulties in swallowing and speech. Case Report: The objective of this study is to present a clinical case of a 3-year-old patient with bilateral macrostomia. Surgical treatment was instituted under general anesthesia in a hospital setting. They were carried out skin and oral mucosa incisions, and performed the closing straight line. The patient progressed well and satisfactory facial scar and functions of the re-established oral sphincter. Conclusion: Macrostomia is a congenital anomaly that requires surgical treatment. The closing straight line presented good cosmetic and functional results. had experienced some form of UME during their professional practice, of these, 86.2% have felt prepared to intervene when it occurred and 84.2% said they did not have equipment and drugs for emergencies in clinics. Therefore, professionals are not adequately trained and equipped to work in the event of an UME in his office... (AU)