Rare Facial Clefts

2015 ◽  
Vol 87 (8) ◽  
Author(s):  
Marta Fijałkowska ◽  
Bogusław Antoszewski
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Clinical Presentation ◽  
Treatment Plan ◽  
General Rule ◽  
Common Type ◽  
Facilitated Communication ◽  
Facial Clefts ◽  
Therapeutic Problem ◽  
Variable Clinical Presentation

AbstractIn 1976 Dr. Paul Tessier described numeric classification for rare craniofacial clefts. He first emphasized that a fissure of the soft tissue corresponds, as a general rule, to a cleft of the bony structure. The classification, easy to understand, became widely accepted because the recording of the malformations was simple and facilitated communication between observers.was to present our own experience with treatment of patients with rare facial clefts.Our Department has 11 patients with rare craniofacial clefts under its care. This group includes 8 boys and 3 girls. The patients aged from 2 months to 18 years at the time of the first consultation.In two patients the cleft was median, in seven patients it was one-sided and in two – bilateral. The most common type of cleft was number 6, and the rarest were 2, 3, and 7. All patients underwent surgical treatment.Atypical facial clefts are rare congenital anomalies, however because of functional and aesthetic disturbances they constitute a serious medical and therapeutic problem. Facial clefts are characterized by variable clinical presentation and require individualized treatment plan.

scholarly journals Paediatric flatfoot

2020 ◽  
Vol 16 (4) ◽  
pp. 368-372
Author(s):  
Ryszard Tomaszewski ◽  
◽  
Barbara Czasławska ◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Conservative Treatment ◽  
Radiological Evaluation ◽  
Foot Deformity ◽  
Flat Foot ◽  
Small Children ◽  
Flat Feet ◽  
Inflammatory Drugs ◽  
Therapeutic Problem

Paediatric flat feet are a serious therapeutic problem. During the child’s development, the foot is subject to the processes of anatomical and physiological modifications. In small children, the flat foot is a physiological variant. The assessment of the flat foot deformity is based on clinical examination, a podoscope examination and possibly radiological evaluation. Only from the age of about 3 years is it possible to consider the implementation of treatment, initially conservative with rehabilitation and possibly orthotics. Some patients require treatment with analgesics, anti-inflammatory drugs or physiotherapy due to the pain they experience, especially in the hindfoot. The lack of progress in conservative treatment requires consideration of surgical treatment, which must be individually adjusted. Arthroereisis, possibly combined with the elongation of the Achilles tendon, is the most commonly used treatment. In fixed deformities or congenital flat feet, corrective bone procedures are also performed, usually combined with soft tissue procedures.

Orthognathic Surgery and Aesthetics: Planning Treatment to Achieve Functional and Aesthetic Goals

1993 ◽  
Vol 20 (2) ◽  
pp. 93-100 ◽  
Author(s):  
David M. Sarver ◽  
Mark W. Johnston
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Orthognathic Surgery ◽  
Imaging Techniques ◽  
Treatment Plan ◽  
Video Imaging ◽  
Aesthetic Result ◽  
Valuable Addition ◽  
Valuable Adjunct ◽  
Planning Treatment

Computerized video imaging is a valuable adjunct for communication with patients and planning orthognathic surgical treatment. The incorporation of adjunctive soft tissue procedures to enhance the final aesthetic result of orthognathic surgery is a valuable addition to the orthodontic and orthognathic treatment plan. This paper presents the use of video imaging techniques in the planning and execution of comprehensive functional and aesthetically orientated orthodontic and surgical treatment.

scholarly journals Melioidosis of the Musculoskeletal System

2019 ◽  
Vol 29 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Rajamani Perumal ◽  
Abel Livingston ◽  
Sumant Samuel ◽  
Santhosh Kumar Govindaraju
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Septic Arthritis ◽  
Musculoskeletal System ◽  
Medical Management ◽  
Clinical Presentation ◽  
Treatment Modalities ◽  
Soft Tissue Abscess ◽  
Musculoskeletal Involvement

Objective: Recent studies indicate that India is an endemic region for Burkholderia pseudomallei infection. We aimed to describe the clinical presentation of B. pseudomallei infection of the musculoskeletal system and summarise the various treatment modalities used in our clinical practice. Subjects and Methods: Patients with confirmed microbiological diagnosis of B. pseudomallei infection involving the musculoskeletal system treated from January 2007 to December 2016 with a minimum follow-up of 1 year were included. A retrospective review of medical records was carried out and patients’ demographic data, co-morbidities, clinical presentation, and details of medical and surgical treatment were documented. Results: Of 342 patients diagnosed with B. pseudomallei infection, 37 (9.2%) had musculoskeletal involvement; 26 patients (23 males) followed up for at least a year were included in the study. Four patients (15%) had multisystem involvement and 10 (37%) had multiple musculoskeletal foci of infection; 15 patients (58%) had osteomyelitis, 10 (38%) had septic arthritis with or without osteomyelitis, and 1 patient (4%) presented with only soft tissue abscess. All patients required surgical intervention in addition to medical management. Surgical treatment varied from soft tissue abscess drainage, arthrotomy for septic arthritis, decompression and curettage for osteomyelitis, and/or use of antibiotic (meropenem or ceftazidime)-loaded polymethylmethacrylate bone cement for local drug delivery. At final follow-up (average: 37 months, range: 12–120), all patients were disease free. Conclusion: We found the rate of musculoskeletal involvement in B. pseudomallei infection to be 9.2%. Appropriate surgical treatment in addition to medical management resulted in resolution of disease in all our patients.

scholarly journals Postmenopausal Infiltrating Desmoid Tumor: A Rare Postoperative Complication

2011 ◽  
Vol 3 (2) ◽  
pp. 100-102
Author(s):  
Neelamma Patil ◽  
GR Sajjan ◽  
Tejaswini Vallabh ◽  
Jyoti Korbu ◽  
Shilpi Aggarwal
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Soft Tissue ◽  
Desmoid Tumor ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Rare Condition ◽  
Benign Tumors ◽  
Desmoid Tumors ◽  
Unusual Condition

ABSTRACT Postoperative desmoid tumors in postmenopausal women is a rare condition. Desmoid tumors are unusual soft tissue benign tumors that arise from musculoaponeurotic tissues. They also have ingrowing tendencies to intestines causing unusual clinical presentation. Recent surgical intervention is known in such cases. FNAC is not contributory due to hypocellularity. CT pelvis, abdomen is helpful. Surgical treatment is usually required. Case report is of this unusual condition in our practice.

Early Maxillary Orthopedics in a Child with an Oblique Facial Cleft

1997 ◽  
Vol 34 (2) ◽  
pp. 147-150 ◽  
Author(s):  
Angelika Stellzig ◽  
Efthimia K. Basdra ◽  
Jochen Mühling ◽  
Gerda Komposch
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Soft Tissue Defect ◽  
Alveolar Cleft ◽  
Facial Cleft ◽  
Tissue Defect ◽  
Plastic Reconstruction ◽  
Facial Clefts ◽  
Newborn Child

Objective Oblique facial clefts are extremely rare. In view of their variabilty, surgical treatment cannot be standardized. To date, early maxillary orthopedics in the treatment of oblique facial clefts have not been reported. The case described here presents a newborn child with a Tessier 3 cleft. Because of the enormous width of the alveolar cleft, a narrowing of the segments was regarded as prerequisite for definitive lip closure. To bring the segments together, an actively working plate with a forward pull was designed. Conclusion After a period of 4 weeks, proper alignment and proximity of the segments were achieved, so that definitive lip closure and plastic reconstruction of the remaining soft tissue defect could be easier performed.

scholarly journals Rosai-Dorfman Disease of Bone and Soft Tissue

2021 ◽  
Vol 146 (1) ◽  
pp. 40-46
Author(s):  
Roberto A. Garcia ◽  
Edward F. DiCarlo
Keyword(s):  
Differential Diagnosis ◽  
Soft Tissue ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Imaging Findings ◽  
Imaging Characteristics ◽  
Rosai Dorfman Disease ◽  
S 100 ◽  
Systemic Manifestations ◽  
Variable Clinical Presentation

Context.— Rosai-Dorfman disease is a rare histiocytic proliferative disorder of unknown pathogenesis that may be diagnostically difficult in extranodal sites. It is commonly an unsuspected diagnosis when arising in bone and soft tissue, especially when it presents without associated lymphadenopathy. Its variable clinical presentation and nonspecific imaging findings make the diagnosis quite challenging, particularly in small biopsies. The problem is compounded by its less-characteristic histomorphologic features in comparison with nodal disease. Awareness of the potential diagnostic pitfalls in Rosai-Dorfman disease of bone and soft tissue should raise the degree of diagnostic accuracy. Objective.— To review the clinical manifestations, imaging characteristics, and histomorphologic features of Rosai-Dorfman disease of bone and soft tissue along with a brief discussion of its differential diagnosis, pathogenesis, and current management. Data Sources.— Thorough review of the literature with focus on clinical manifestations, imaging findings, key histomorphologic features, pathogenesis, and treatment. Conclusions.— The diagnosis of Rosai-Dorfman disease of bone and soft tissue may be quite challenging because of its variable clinical presentation and nonspecific imaging findings. It may be asymptomatic without systemic manifestations or associated lymphadenopathy. The definitive diagnosis relies on histopathologic identification of the characteristic S-100–positive histiocytes demonstrating emperipolesis. Bone and soft tissue lesions tend to have lower numbers of characteristic histiocytes and less conspicuous emperipolesis and often demonstrate areas of fibrosis or storiform spindle cell areas resembling fibrohistiocytic lesions. Awareness of these unusual features is necessary in order to consider Rosai-Dorfman disease in the differential diagnosis when confronting these rare and often misleading lesions.

Malignant melanoma of nasal mucosa, ethmoid and frontal sinuses endoscopically resected in the combined transnasal and trans-paralateronasal approach

ORL ro ◽  
2016 ◽  
Vol 3 (1) ◽  
pp. 44-49
Author(s):  
Bogdan Mocanu ◽  
Daniel Mirea ◽  
Silviu Oprescu ◽  
Anca Vișan ◽  
Mihai Tușaliu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Malignant Melanoma ◽  
Nasal Obstruction ◽  
Nasal Mucosa ◽  
Treatment Plan ◽  
Subtotal Resection ◽  
External Nose ◽  
Frontal Process ◽  
Advanced Stages ◽  
Frontal Sinuses

Introduction. The primitive malignant melanoma of nasal mucosa and paranasal sinus is a rare tumor of uncertain etiology, with unpredictable biologic behavior and bad prognosis. Unlike skin melanomas, there are no risk factors and the disease is frequently manifested in older patients, whose clinical otorhinolaryngology complaints are normally non-specific and ranges from nasal obstruction to rhinorrhea and epistaxis. Unfortunately, this disease is diagnosed basically in advanced stages which makes the surgery difficult. Objective. To report a case of primitive malignant melanoma of nasal mucosa, ethmoid and frontal sinuses, that was diagnosed in 2015. It was performed a subtotal resection in another hospital in 24.08.2015, with a large local reccurence. Report. Our patient was a 78-year-old woman with bilateral nasal obstruction, light epistaxis and unilateral rhinorrhea. The ENT, CT and  MRI exams showed a tumour with important, invasion of the nasal cavity structures (billateral nasal bones, left frontal process of the maxilla, the superior midpoint of the nasal septum, bilateral middle and superior turbinates, left ethmoid and bilateral frontal sinuses). The patient was submited for surgery: total macroscopic resection in the combined endoscopic approach; transnasal and modified lateral rhinotomy with titaniul plates reconstruction of the external nose architecture. Conclusions. Malignant melanomas of nasal mucosa are, in general, diagnosed in advanced stages. Their histological characteristics in the mucosa makes difficult the surgical treatment, which is one of the most efficient options, because they are resistant to chemo and radiotherapy. The early diagnosis and a good surgical treatment plan are the best option for this tumor nowadays.  

scholarly journals No implant, no solution, lost cases to surgery: orthopedic trauma triage for surgery in an NGO hospital in Sierra Leone

2021 ◽  
Author(s):  
F. Wichlas ◽  
V. Hofmann ◽  
M. Moursy ◽  
G. Strada ◽  
C. Deininger
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Sierra Leone ◽  
Low Income ◽  
Soft Tissue Defect ◽  
Low Income Countries ◽  
Pelvic Surgery ◽  
Closed Fractures ◽  
Trauma Triage ◽  
Tissue Defects

Abstract Introduction In low-income countries (LIC), international surgeons face the fact that there are patients they cannot treat. The goal of this study was to identify and analyze patients lost to treatment. Material and methods We analyzed retrospectively the data of 282 trauma victims from a non-governmental organizational (NGO) hospital in Sierra Leone, Africa. During a 3-month period (10.10.2015–08.01.2016), these patients had 367 injuries and underwent 263 orthopedic surgeries. Despite a clear indication, some patients did not receive surgical treatment. We identified these injuries and the reason why they could not be operated. The anatomic region of the injury was evaluated and if they had a bone or soft tissue defect or were infected. Results We identified 95 (25.89%) injuries in 70 patients (47 males; 23 females) that were not be operated. The reasons were lack of specific implants (no implant group; N = 33), no treatment strategy for the injury (no solution group; N = 29), and patients that were lost (lost patient group; N = 33), almost equally distributed by 1/3. In the no implant group were mainly closed fractures and fractures of the pelvis and the proximal femur. The implants needed were locking plates (N = 19), proximal femoral nails (N = 8), and implants for pelvic surgery (N = 6). In the no solution group were nearly all bone (P < 0.0000), soft tissue defects (P < 0.00001) and infections (P = 0.00003) compared to the rest and more open fractures (P < 0.00001). In the lost patients group, most fractures were closed (24 out of 33, P = 0.033). These fractures were mostly not urgent and were postponed repeatedly. Conclusion One quarter of the patients did not receive the surgical treatment needed. Besides acquisition of implants, surgical skills and expertise could be a solution for this issue. Nevertheless, these skills must be passed to local surgeons.

scholarly journals Case series on variable presentations of tuberculosis of the breast

2020 ◽  
Vol 13 (12) ◽  
pp. e236019
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Jeyakumar Sundaraj ◽  
Pradeep Joshua Christopher ◽  
Ramyasree Paladugu
Keyword(s):  
Clinical Presentation ◽  
Case Series ◽  
Common Type ◽  
Breast Abscess ◽  
Breast Lump ◽  
Clinical Presentations ◽  
Malignant Lesions

Tuberculosis (TB) of the breast is extremely rare and is often mistaken for benign or malignant lesions of the breast. They are rare even in countries which are endemic for TB, like India. The most common type of clinical presentation is a vague lump in the breast, but there are even other types of presentations which are documented. In olden days, there was a lot of dilemma and challenge in diagnosing TB of the breast, but thanks to improved pathological knowledge and the advent of investigations such as QuantiFERON-TB gold and GeneXpert, TB can be diagnosed early nowadays and treated accordingly. In this study series, we report 10 cases of TB of the breast with variable clinical presentations as fibroadenosis, breast abscess, duct ectasia and breast lump on evaluation, and the challenges encountered in establishing the diagnosis.

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