Milene Castilhos Oliveira

Retrospective analysis of 73 orbital floor fractures

Methods: After confirmation of a zygomatic complex fracture the patients were divided into groups of surgically and non-surgically treated fractures, with and without fracture displacement. The groups were compared according to age, gender, degree of fracture displacement and clinical signs. Results: 283 patients were included, with a mean age of 43 years and a domination of male patients. All type C-fractures and themajority of type B-fractures were treated surgically. Except for facial swelling, the symptoms frequently found in the surgically treated patients, were found less common in the non-surgically treated patient group. Extraoral steps, intraoral steps, and malar depression were significantly related to surgical treatment. Conclusions: The clinical characteristics extraoral steps, intraoral steps, and malar depression, in contrast to paraesthesia of the infraorbital nerve, were significantly related to surgical treatment of zygomatic complex fractures. Knowledge of the differences between the surgically and non-surgically treated patients may help physicians to develop future methods in clinical decision making.

Facial artery haemangioma diagnosed by facial pain

Background and objectives: Necrotizing fasciitis of the neck is a rare, progressive and lifethreatening bacterial infection, usually polymicrobial, which spreads with frightening speed along the fascial planes and subcutaneous tissue, resulting in extensive tissue necrosis and often death. Rapidly spreading necrosis can cause systemic sepsis, toxic shock syndrome and multiorgan failure. Methods: We report 2 cases following odontogenic neck cellulites, complicated with abscess formation in the anterior region of the neck. The first case is a 59 years old men, with no relevant precedent medic conditions, the second case is a 67 years old men with rheumatoid arthritis medicated with prednisolone, both with poor oral health. Early recognition of the symptoms followed by aggressive debridement of all necrotic tissue was conducted, medical support in an intensive medical care unit and broad spectrum antibiotics were also immediately started. Results: In the first case, the smaller myocutaneous defect of the anterior region of the neck, was reconstructed with skin grafts, the second patient larger defect is reconstructed with a latissimus dorsi free flap. Conclusions: Early diagnosis, appropriate antibiotics and surgical debridement can lead to successful outcomes in a disease with a high mortality rate.