Primary Myiasis in Surgical Wound of Mandible Symphisis Fracture.

A 42 year old patient was referred to the Department of Oral and Maxillofacial Surgery of the Federal University of Uberlândia, for treatment of mandibular fractures (condyles and symphysis), a victim of a run over. The symphysis was surgically approached, using as surgical access the pre-existing laceration in the submental region. Five days after discharge, the patient returned with dehiscence of the wound and physical examination showed infestation by larvae in the symphysis. Mechanical removal and debridement were performed under local anesthesia, where plate exposure was noted. The patient underwent oral ivermectin therapy, intravenous antibiotic therapy and a thorough debridement was performed under general anesthesia due to the invasion of deep spaces in the supra-hyoid region. After 2 weeks, it presented with purulent drainage at the site. The miniplates were replaced by a 2.4 mm reconstruction plate and antibiotic therapy was maintained. Due to the social risk, the patient remained hospitalized for 45 days, when he was discharged with outpatient return, but did not attend the returns.

Mandibular dislocation after stroke: an uncommon sequelae / Luxação mandibular após acidente vascular cerebral: uma sequela incomum

Temporomandibular joint (TMJ) recurrent dislocation is usually associated with jaw hypermobility or articular eminence anatomy. Patients who have stroke experience (CVA) can present joint and muscle tone changes, as laxity ligamentous and appearance of spastic muscle patterns in different parts of the body such as shoulder, elbow, wrist, hip, knee and face. This study reported two cases of patients with stroke sequelae who developed chronic dislocation of the jaw. It was concluded that these two clinical conditions appear to have some correlation, further studies with more patients needed to confirm this correlation.

A luxação recorrente da articulação temporo-mandibular ocorre quando o côndilo mandibular move-se para fora da cavidade glenóide e permanece travado anteriormente à eminência articular de forma repetitiva. Pacientes com histórico de acidente vascular cerebral podem apresentar alterações articulares e de tonicidade muscular. O presente estudo relatou dois casos clínicos de pacientes com seqüela de AVC, que desenvolveram luxação crônica da mandíbula. Concluiu-se que essas duas condições clinicas parecem apresentar alguma correlação clínica, sendo ainda necessário estudos com mais pacientes para confirmar tal correlação.