Fernando Antonini

Analysis of Incision Effects on Upper Lip Height and Thickness After Maxillary Surgically Assisted Expansion: A Randomized Clinical Trial

PURPOSE To evaluate changes from maxillary circumvestibular incision performed with a #15 scalpel blade versus electrocautery on the height and thickness of the upper lip (UL) after surgically assisted maxillary expansion. MATERIALS AND METHODS Twenty-three patients who underwent surgically assisted maxillary expansion for transverse maxillary deficiency from April 2011 through April 2012 were included in the study. In group 1 (n = 11), the incision was performed with a Bard-Parker #15 scalpel blade. In group 2 (n = 12), the incision was performed with monopolar electrocautery (blend function, 1; power, 20 Watts; frequency, 480 kHz). Clinical measurements for UL height and radiographic measurements for UL height and thickness were performed preoperatively and postoperatively (mean, 6 months). The collected data were subjected to statistical analysis to test the hypotheses of the study. RESULTS After excluding 2 patients, 21 patients were included in the sample. For UL height, clinical and radiographic measurements showed shortening of the UL, and the differences between pre- and postoperative values were statistically significant (P < .05) in the 2 groups. However, there was no statistically significant difference between groups 1 and 2 for UL height (P > .05) by clinical or radiographic measurements. For UL thickness, the 2 groups showed slight UL thickening in the lower portion, with no statistical difference between pre- and postoperative values (P > .05). Moreover, these results were not statistically different between the 2 groups (P = .754). In the uppermost portion of the UL, there was significant thinning in group 2 (P = .001), but not in group 1 (P = .076), and no statistical difference between groups (P = .535). CONCLUSIONS Maxillary circumvestibular incision causes significant shortening of the UL and thinning of the uppermost portion when using a #15 scalpel blade or electrocautery. However, there is no difference in UL dimensional changes when using either technique for maxillary circumvestibular incision.

Cicatricial Ectropion Correction in the Inferior Eyelid with Cartilaginous Tissue Graft: Case Report

Transcutaneous approaches of the lower eyelid are commonly used to provide adequate exposure of the orbital floor and zygomaticomaxillary suture during treatment of facial fractures. Cicatricial ectropion is a rare complication that results in a shortened eyelid. This condition can be temporary in some cases but when it is permanent it must be surgically corrected, aiming to restore function, improve the aesthetical outcomes and to prevent ophthalmological disorders such as epiphora and corneal ulceration. The present study describes a novel surgical approach, associated with a concomitant cartilaginous graft, to treat severe lower eyelid ectropion resultant from a previously performed subtarsal incision.

Misdiagnosed maxillary sinusitis: the case for further investigation

Rhinocerebral mucormycosis is a rare life threatening fungal infection, affecting almost exclusively patients with known predisposing conditions such as diabetes mellitus, immunocompromised status, haemochromatosis or major trauma. The purpose of this paper is to report a case of orbit-zygomatic bone mucormycosis involvement in a diabetic patient, previously diagnosed and treated as recurrent maxillary sinusitis. Treatment of the condition required extensive surgical intervention and medical management for a life saving outcome.