Bernard D. Gold

Treatment of protracted bilateral mandibular dislocation with Proplast-Vitallium prostheses

A case of bilateral protracted mandibular dislocation complicated by the presence of unusual degenerative changes in the temporomandibular joints is presented. A synopsis of treatment modalities that have been used previously to treat similar conditions is given. Our treatment consisted of bilateral condylectomies, eminectomies, and insertion of Proplast-coated Vitallium condylar prostheses. These procedures resulted in the re-establishment of normal TMJ anatomy, the maintenance of proper posterior mandibular vertical dimension, correction of malocclusion, and relief of the patients symptoms.

Carotid cavernous fistula after minimal facial trauma: Report of a case

The carotid cavernous fistula has historically been associated with extensive facial trauma as a result of direct or indirect forces. Most fistulas of traumatic origin develop as a result of a fracture through the base of the skull, which produces a force causing laceration of the internal carotid artery in the region where it approximates the cavernous sinus. We report a case in which apparently minimal head trauma resulted in the development of a carotid cavernous fistula. The rather innocuous presentation of this complication requires particular attention by the caregiver in assessing the patient sustaining maxillofacial trauma.

Use of the electrosurgical knife and topical thrombin for hemostasis in split-thickness skin graft vestibuloplasty

The use of electrocautery and topical thrombin at the donor and recipient sites has decreased most of the oozing normally present in skin graft vestibuloplasty procedures. It has effectively reduced operating room time, has significantly reduced post-operative morbidity, and has shortened both hospital stay and recovery time for the patient.

Septicemia secondary to administration of a contaminated intravenous fluid

The clinical entities of bacterial contamination, septicemia, and septic shock have been discussed, and an unusual case of septic shock has been presented. The associated risks of intravenous delivery of drugs or fluids are stressed.

Dislodgement of a submandibular gland sialolith during nasal intubation: A case report

A case of dislodgement of a submandibular sialolith into the oropharynx during nasal intubation is presented. The deleterious effect of the patient aspirating the stone into the lungs was averted by the taking of a lateral skull radiograph and localization and removal of the sialolith.

The syndrome of inappropriate secretion of antidiuretic hormone in the maxillofacial trauma patient

The maxillofacial trauma patient whose neurologic status undergoes a rapid and serious deterioration may have a severe hyponatremia secondary to the inappropriate secretion of antidiuretic hormone (SIADH). Other causes of hyponatremia must be ruled out, especially posttraumatic cerebral salt wasting, which necessitates a different mode of therapy. A case of SIADH is reported, and the work-up and differential diagnosis of posttraumatic hyponatremia are discussed.

Cheiloplasty using Michel clips

C heiloplasty for the correction of enlarged lips is a well-known and straightforward surgical procedure. Techniques have been described in various texts’ and by Turvey and Epker2 as an adjunct to orthognathic surgery to improve soft-tissue facial balance. Enlarged or redundant lip tissue may be of congenital origin, a result of hyperplastic or hypertrophic labial salivary gland or muscle, or secondary to scar tissue formation resulting from trauma to the lips. Regardless of cause, the result is an imbalance in facial soft-tissue contour and compromise in facial esthetics. A simplified technique for cheiloplasty using Michel clips has been used for the correction of enlarged lips, regardless of etiology, with satisfactory results. This variation of the classic cheiloplasty procedure offers several advantages: (1) The amount of tissue to be removed is clearly outlined; (2) a reversible preview of results is achieved prior to performance of surgery; (3) an area-by-area determination of the amount of tissue to be removed is possible; (4) the potential removal of an excessive amount of tissue, with creation of a “fish mouth” appearance, is minimized.