The Journal of craniofacial surgery
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We present a case of a maxillary fungus ball caused by retained foreign bodies for 25 years. The patient sustained a stab wound in the left face 25 years ago. ⋯ The fungus ball and foreign bodies were removed via an endoscopic and Caldwell-Luc approach. We suggest the need for careful inspection and radiologic studies to localize occult foreign bodies in the sinonasal cavity or facial soft tissues after facial trauma.
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The lack of certain quotable landmarks and not taking the morphometric variations into consideration for mandibular nerve blockade can cause some complications. The aim of this study was to ensure there are data for more feasible and successful lateral extraoral approach to block the mandibular nerve by proposing reliable and quotable landmarks. ⋯ The determined parameters are suggested to be convenient and quotable to help in successful direct application under three-dimensional computed tomography or computed tomography-fluoroscopy for blocking the mandibular nerve.
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Case Reports
Modified Gillies approach for zygomatic arch fracture reduction in the setting of bicoronal exposure.
Zygomatic arch fractures are common injuries, occurring in isolation in 5% of all patients with facial fractures and in 10% of patients with any fracture to the zygomaticomaxillary complex. Isolated noncomminuted depressed zygomatic arch fractures are easily treated with the minimally invasive Gillies approach, which most often provides long-term stability. However, zygomatic arch fractures often occur in conjunction with zygomaticomaxillary complex, Le Fort, calvarial, and naso-orbitoethmoid fractures. ⋯ This technique exploits the advantages of the traditional Gillies approach, preserving fascial attachments, avoiding neurovascular injury, and obviating the need for rigid fixation. Moreover, this method saves time and money and decreases morbidity. Our modified Gillies approach to zygomatic arch fractures in the setting of a bicoronal incision can be applied to a wide range of cases because of the frequency with which arch fractures occur with concomitant craniomaxillofacial injuries requiring wide exposure.
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Greater palatine nerve block anesthesia (GPNBA) is a local anesthetic procedure used for maxillary and nasal treatment. Investigation of the three-dimensional anatomic location of the greater palatine foramen (GPF) is important for successful local anesthesia. The study aim was to provide standards for anatomic structures in the oral cavity that can be easily referred to in GPNBA. ⋯ In adults, the measured perpendicular distance from the incisive foramen to the GPF in the coronal plane was 32.04 mm, and the perpendicular distance from the median of the line that connects both of the contact points between the maxillary tuberosity and the pterygoid plate to the GPF in the coronal plane was 5.23 mm. Three-dimensional reference values relative to the anatomic structures in the oral cavity may increase the success rate of GPNBA and reduce complications. Although the maxillary growth pattern was analyzed, a limitation of this study is that maxillary anatomic measurements were not analyzed with regard to race or ethnicity.
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Branchial cleft cysts are congenital anomalies that arise from the aberrant embryological development of the branchial apparatus. The location of a branchial cleft cyst is determined by which branchial cleft failed to obliterate during embryological development, with the second branchial cleft cyst being the most commonly recognized lesion. Although the most common location for branchial cleft cysts is between the external auditory canal and the level of the clavicle, the literature does describe unusual locations. ⋯ Upon excision of the lesion and pathologic examination, it was determined to be a branchial cleft cyst. The patient had an uneventful postoperative course, and no recurrence was noted after a 2-year follow-up. Our clinical report demonstrates a lesion on the posterior thorax that proved to be a branchial cleft cyst and should always be part of the differential diagnosis for soft tissue masses of the thorax.