Suzana Célia de Aguiar Soares Carneiro

Fracture of the Atrophic Mandible: Case Series and Critical Review

PURPOSE Atrophic mandible fracture is common among elderly patients. Such fractures present management difficulties related to anatomic and physiologic alterations in this population. The purpose of this study was to evaluate the results of this type of fracture treatment and to realize a critical review of literature on the subject. PATIENTS AND METHODS The sample was obtained from records of patients of Restauração Hospital (Recife, Brazil) who underwent surgical treatment of atrophic mandible fracture between 2006 and 2009. Data, such as etiology, location, and degree of displacement of the fractures, as well as access, type of fixation used, and the presence of postoperative complications, were analyzed. RESULTS Successful bone union was achieved in 100% of cases. Complications were related to those patients treated with reconstruction plates (2.4 mm). CONCLUSIONS Open reduction and internal fixation with miniplates seem a feasible option for primary treatment of atrophic mandible fractures without comminution or loss of substance. The level of scientific evidence for the treatment of atrophic mandible fractures is low.

Massive Oral Hemorrhage Due To Mandibular Arteriovenous Malformation Treated With Percutaneous Approach—A Case Report

p a ngiodyplastic lesions of the face are classified as ascular tumors or vascular malformations, each ategory having distinct etiologies and clinical preentations. Hemangiomas are vascular tumors that xhibit endothelial hyperplasia, which increases hrough rapid mitotic cellular proliferation. Vascular malformations (VMs) exhibit a normal umber of endothelial cells and structural abnormalties of arteries, veins, lymphatic vessels, or a combiation of these. VMs can be arteriovenous, veno-capilary, venous, veno-lymphatic, or mixed. Arteriovenous

Adenomatoid odontogenic tumor

The adenomatoid odontogenic tumor (AOT) is usually an asymptomatic slow growth lesion. When grown, one can palpate a hard and large lesion. It is common for the tumor to cause shifting of neighboring teeth because tumor expansion is more common than teeth root resorption. Radiographically, there is a unilocular mass involving an unerupted tooth, sometimes opaque in the center and sclerotic in the periphery. Considering it to be an encapsulated tumor, treatment of choice is enucleation. This paper describes three cases of these tumors and their symptoms, their radiographic characteristics and anatomic findings.

Evaluation of fixation techniques with titanium plates and Kirschner wires for zygoma fractures: preliminary study.

OBJECTIVE The aim of the present study was to assess the quality of treatment using two reduction and fixation techniques for zygoma fractures. PATIENTS AND METHODS A randomized clinical trial was carried out involving a sample of 10 patients with Knight and North type III, IV and V zygoma fractures divided into two groups. One group underwent the closed reduction technique and fixation with Kirschner wire and the other group underwent the open reduction technique and fixation with titanium plates. The groups were submitted to subjective evaluation based on the patients perception of areas of deformity and paresthesia as well as the measurement of range of mouth opening and pain upon mouth opening in the preoperative (T0) and postoperative (T1) periods. The assessment of bone reduction quality was performed using quantifiable points (lateral wall of the orbit, anteroposterior projection of the zygoma and ocular globe projection), measured based on tomographic images. RESULTS Seventy percent of the patients remained with paresthesia and 20% remained with the complaint of deformity at T1. Mouth opening range increased in both groups at T1. In the overall sample, mean total disjunction of the lateral wall of the orbit and the difference in the anteroposterior projection of the zygoma were reduced between T0 and T1 (4.36 mm to 1.25 mm and 6.94 mm to 2.86 mm, respectively). There was also a reduction in ocular globe projection in both groups between T0 and T1. CONCLUSIONS Both techniques achieved adequate reduction of zygoma fractures in the postoperative period.

Post-trauma exophthalmos caused by a carotid-cavernous fistula

Fistulae may be defined as direct connections between arteries and veins. Carotid-cavernous fistulae (CCF) are formed secondarily to abnormal communications between the cavernous portion of the carotid artery and the venous plexus of the cavernous sinus. Traumatic fistulae usually result from injuries to the internal carotid artery in its course to the cavernous sinus. These types of fistula frequently appear a few weeks after trauma with signs and symptoms related to increased venous pressure transmitted through the ophthalmic vein, a valve-free vessel. This paper presents the means to diagnose carotid-cavernous fistulae and a case report.

Exoftalmia pós-traumática causada por fístula carotídeo-cavernosa

Uma fístula pode ser definida como uma conexão direta entre uma artéria e uma veia. As fístulas carotídeo-cavernosas (FCCs) formam secundariamente a comunicações anormais entre a região cavernosa da artéria carótida e o plexo venoso do seio cavernoso. Uma fístula traumática é normalmente causada por uma injúria à artéria carótida interna durante seu curso para dentro do seio cavernoso. Esse tipo de fístula frequentemente aparece após algumas semanas a um trauma com sinais e sintomas relacionados com o aumento da pressão venosa transmitida através da veia oftálmica, a qual não apresenta válvulas. Neste artigo serão discutidas as formas de diagnóstico para esta patologia, assim como será relatado um caso deste tipo de fístula.

Lipomas of the oral cavity

Cases 2 and 3 Cases 2 and 3 are related to smaller lipomas, most commonly found in the oral cavity. In both cases, the patients were females, with ages ranging between 30 and 45 years, respectively. In case 2, the lesion was in the inferior lingual region; and in case 3, it was in the jugal mucosa (Figure 1). Both were treated by surgical excision of the whole lesion and the material was referred to histopathology, with later confirmation of lipoma.

Embolization as the Primary Treatment for Mandibular Arteriovenous Malformations: An Analysis of 50 Literature Reports and of an Illustrative Case

PURPOSE The aim of the present report is to describe 50 cases in the literature of mandibular arteriovenous malformations (AVMs) in which embolization was the primary treatment and to discuss details such as age, gender, materials used, outcome of embolization, time of follow-up, and intra- or postprocedure complications. An illustrative case in which reossification was noticed after embolization also is presented. PATIENTS AND METHODS The study was carried out in 2 steps. In the first, an electronic search without time restriction for embolization as the primary treatment for mandibular AVMs was performed on Medline through PubMed. In the second, the case of a patient with mandibular AVM and massive oral bleeding episodes is described after a long-term follow-up. RESULTS Clinical stability with the cessation of oral bleeding episodes was detected in 25 cases and 2 cases were planned for another embolization session. Clinical stability and reossification were detected in 23 of the 50 cases included. Complications were reported in 50% of cases, but most were minor and transient. CONCLUSION Currently, owing to more sophisticated imaging techniques, the diagnosis of mandibular AVMs is quicker and new, less invasive techniques that avoid surgical resection have proved effective. It should be emphasized that these techniques are not without complications and that long-term monitoring is extremely important.