Ramazan Köymen

Anatomic evaluation of maxillary sinus septa: surgery and radiology.

The anatomical structure of the maxillary sinus is fundamental to maxillofacial surgery. The presence of septa, located at the inner surface of the maxillary sinus, increases the risk of sinus membrane perforation during sinus elevation for dental implant surgery. The aim of this study was to evaluate the anatomy of maxillary sinus septa.Data in this study was obtained from a total of 205 cases. One hundred and seventy‐seven patients were partially edentulous (PE) whereas 28 patients had no teeth. Dental computerized tomography (dental CT) was used in the assessment of 410 sinus segments (205 left and 205 right segments). The prevalence of sinus segments with septa was found to be 145/410. Septa were detected in 91 of the 177 PE cases. There were a total of 26 septa in 18 of the 28 completely edentulous (CE) cases. A total of 165 septa were detected in these segments. The prevalence of septa was 46.4% (26/56) in the CE, and 39.2% (139/354) in the PE segments. Thirty septa were found in the anterior, 110 in the middle and 25 in the posterior region. All detected septa were located mediolateral direction. Their relative position: lateral, middle or medial were also noted. The height measurements of the septa varied amongst the different positions. In view of the fact that septa of various heights and courses can develop in all parts of the maxillary sinus, timely and adequate assessment of the inner aspect of the maxillary sinus is essential to avoid complications during sinus augmentation procedures. Clin. Anat. 22:563–570, 2009.

Treatment of microstomia with commissuroplasties and semidynamic acrylic splints

Microstomia is defined as an abnormal small oral orifice. Burns and injuries of perioral tissues, perioral surgeries, and genetic disorders can lead to perioral scar formations and restrict mouth opening. Treatment of microstomia requires surgical or conservative approaches. The aim of this report is to assess the effects of surgical commissuroplasty techniques combined with the application of semidynamic mouth splints on 4 microstomia patients with different etiologies. The combination of surgical and conservative techniques proves to be the best method of treating compromised perioral tissues in microstomia patients.

Ocular and periocular injuries associated with an isolated orbital fracture depending on a blunt cranial trauma: Anatomical and surgical aspects☆

The anatomical location of fractures following blunt cranio-orbital trauma is important for neurosurgeons and maxillofacial surgeons. In this study, 588 cranio-orbital fractures following blunt trauma were evaluated retrospectively with regard to the anatomical site and surgical treatment. Orbital cranial nerve injuries and the outcomes of the medical and/or surgical treatment are described. Distribution of the zygomatic complex and orbital fractures were as follows: zygomatic complex fractures (n:304), isolated orbital fractures (n:58), complex comminuted fractures (n:226). In 58 cases, 69 orbit fractures were found (11 bilateral and 47 unilateral fractures). The lateral wall was the most frequent fracture (n:63). The least frequent fracture was the roof of the orbit (n:11). The accompanying lesions were as follows: 89.65% of cases were associated with periorbital haematoma (n:52), 13.79% of cases with retrobulbar haemorrhage (n:8), 96.55% cases with periorbital soft tissue oedema (n:56), 53.45% cases with pneumocephalus (n:31), 8.62% cases with intra-parenchymal contusion (n:5), 6.89% cases with enophthalmia (n:4), 5.17% of cases with rhinorrhoea (n: 3), 5.17% cases with optic bulb injury and adnexial trauma (n:3), 32.76% cases with intra-orbital emphysema (n:19), and 20.69% with vision dysfunctions (n:12), of whom 2 had no optic nerve injury.

Clinical and stereologic evaluation of osteochondroma

Osteochondroma is a benign tumor that is unusual in the maxillofacial region. Anatomy of the region, especially the mandible, is important for surgical intervention for the condylar osteochondroma. The present case report describes evaluation of condylar hyperplasia with emphasis on the advantages and disadvantages of sterolithographic solid model and stereologic techniques for preoperative surgical planning, operation time, and prognosis. Condylar osteochondoma was diagnosed by panoramic radiograph and 3-dimensional computerized tomography (3DCT) as well as histopathologic analysis in a male patient. Before surgery, a stereolithographic model was created and stereologic method was used based upon 3DCT.