A. Rachmiel

The management of mandibular body fractures in young children

This article reviews the management of mandibular body fractures in young children. Treatment principles of this fracture type differ from that of adults due to concerns regarding mandibular growth processes and dentition development. The goal of this fracture treatment is to restore the underlying bony architecture to its preinjury position in a stable fashion as non-invasively as possible and with minimal residual esthetic and functional impairment. The management of mandibular body fractures in children depends on the fracture type and the stage of skeletal and dental development; treatment modalities range from conservative non-invasive, through closed reduction and immobilization methods to open reduction with internal fixation. Disruption of the periosteal envelope of the mandibular body may have an unpredictable effect on growth. Thus, if intervention is required closed reduction is favored.

Lemierre's syndrome from odontogenic infection: Review of the literature and case description.

Lemierres syndrome (LS) is a rare potentially fatal sequel of head and neck infection, classically described as thrombophlebitis of the internal jugular vein (IJV) with cervical space infection extending into the thorax. Our objective was to answer the clinical question: “Does Lemierre syndrome (LS) from odontogenic infection differ from nonodontogenic LS in regard to clinical sequence, treatment, and survival.” We reviewed the literature on the management of LS over the last two decades, with a focus on LS from odontogenic infection. Such a case is presented in order to portray the clinical sequence. Only 10 cases met the inclusion criteria (including the case presented). The recorded data were analyzed in comparison to large case series reviewing LS. Our data reflect the moderate differences in regard to IJV thrombosis and bacteriogram. There is an overall rise in published LS cases in the last 20 years. Odontogenic infection leading to LS is scarce, yet with survival rates similar to nonodontogenic LS. Repeated surgical interventions and aggressive wide spectrum antibiotic therapy remain the treatment of choice.

Reconstruction of complex mandibular defects using integrated dental custom-made titanium implants

i g t G i t econstruction of the craniofacial complex is challengng because of the unique anatomy, the presence of vital tructures, and the diversity of defects. In craniofacial recontruction, restoration of appearance and function is the rimary goal. Autografts are the gold standard treatment,1 but hey have several disadvantages, which has led to research nto alloplastic materials. The development of CADCAM ystems allows for precise preoperative planning and design f patient-specific implants.2,3 The workflow of customade implants is shown in Fig. 1. Two-dimensional DICOM les were converted into 3-dimensional stereolithography STL) files and the custom-made implant was designed sing AB Guided 3-dimensional software (A.B. Dental, Ashod, Israel). The skull and the implant were printed as n STL model in resin for compatibility tests using a 3imensional Objet260 Dental Selection printer (Stratasys©, ehovot, Israel). The titanium implant was then printed sing a laser sintering 3-dimensional printer (EOS, Novi, MI,

Goldenhar syndrome and medulloblastoma: A coincidental association? The first case report

BACKGROUND Features of Goldenhar syndrome include several craniofacial anomalies of structures derived from the first and second pharyngeal arches, as well as vertebral, cardiac and renal systems abnormalities. In addition, Goldenhar patients were reported to manifest a variety of central nervous system anomalies and several types of neoplasias. CASE HISTORY AND DISCUSSION The first case of medulloblastoma in a patient with Goldenhar syndrome is presented here. There is no clear association between these two pathologies. We speculate that aberrant events during the migration of neural crest cells in early stages of development could be the basis of an association between medulloblastoma and Goldenhar syndrome. The case history suggests other possible etiological contributing factors to the development of medulloblastoma, such as patients history of trauma and/or early childhood exposure to ionizing radiation.

Subcutaneous Emphysema following Emergent Surgical Conventional Tracheostomy

In maxillofacial surgery, tracheostomy is indicated in congenital, inflammatory, oncologic, or traumatic respiratory obstruction. In traumatic cases, however, it is sometimes hard to implement. We describe subcutaneous emphysema following emergent surgical conventional tracheostomy performed after stab injury to the floor of the mouth. We analyze the course that led to this complication and discuss suggestions on how to avoid it. In addition, we review the literature to improve our knowledge and practice regarding this entity. Massive subcutaneous neck emphysema occurred because ventilation started at the time when the hemorrhage was not completely managed and the tracheal tube was not fully secured. In traumatic cases with profound bleeding, hemorrhage management must be performed carefully. The recommendation not to ventilate until the hemorrhage is completely managed should be observed.