Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
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J Craniomaxillofac Surg · Jul 2011
Case ReportsDescending necrotizing mediastinitis following dental extraction. Radiological features and surgical treatment considerations.
Descending necrotizing mediastinitis (DNM) following dental extraction is an extremely serious infection with a high mortality rate. Oral infection may rapidly descend into the mediastinum across the retropharyngeal and retrovisceral spaces. ⋯ After this, prompt control of the upper airway with tracheostomy, aggressive surgical debridement of the deep cervical spaces and mediastinum, and intravenous broad spectrum antibiotic therapy are mandatory. The present paper reports two new cases of DNM following dental extraction, and focuses on radiological features of abscess progression through the cervical spaces down into the mediastinum.
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J Craniomaxillofac Surg · Jul 2011
Panel and patient perceptions of nasal aesthetics after secondary cleft rhinoplasty with versus without columellar grafting.
Cleft-lip nasal deformity alters patient's self-image, as well as posing unique challenges for the rhinoplastic surgeon. ⋯ Our results suggest that caudal septal extension grafting improves the nasal aesthetics of the cleft patients, as judged by the panel. Patient's self-assessment seems unreliable to be used as an outcome measure.
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J Craniomaxillofac Surg · Jul 2011
Case ReportsTwo cases of emergent endovascular treatment for carotid blowout syndrome after free flap reconstruction for neck cancer.
Carotid blowout is a devastating complication in patients with head and neck malignancy, and is associated with high morbidity and mortality. For patients with bleeding originating in the internal or common carotid artery, treatment options are limited. ⋯ They underwent immediate coil embolization and wall stent deployment and, which resulted in the successful control of bleeding. Although these endovascular treatments often result in recurrent carotid blowout syndrome, they can be useful and effective in treating emergent carotid rupture in patients for whom balloon occlusion test is contraindicated.