Pearls of plastics in ENT practice that Conceals & Camouflages the Camber, Contour & Cosmesis in Facial Trauma

Facial trauma can involve soft tissue injuries such as burns, lacerations, bruises and even fractures of the facial bones such as nasal fractures and fractures of the jaw as well as injury to the eye. Symptoms are specific to the type of injury that can be either signs of inflammation or changes in facial definition. Facial injuries have the potential to cause temporary deviations in facial delineation to permanent disfigurement of facial structures.

Tolerance of Normal Rabbit Facial Bones and Teeth to Synchrotron X-Ray Microbeam Irradiation

Microbeam radiation therapy, an alternative radiosurgical treatment under preclinical investigation, aims to safely treat muzzle tumors in pet animals. This will require data on the largely unknown radiation toxicity of microbeam arrays for bones and teeth. To this end, the muzzle of six young adult New Zealand rabbits was irradiated by a lateral array of microplanar beamlets with peak entrance doses of 200, 330 or 500 Gy. The muzzles were examined 431 days postirradiation by computed microtomographic imaging (micro-CT) ex vivo, and extensive histopathology. The boundaries of the radiation field were identified histologically by microbeam tracks in cartilage and other tissues. There was no radionecrosis of facial bones in any rabbit. Conversely, normal incisor teeth exposed to peak entrance doses of 330 Gy or 500 Gy developed marked caries-like damage, whereas the incisors of the two rabbits exposed to 200 Gy remained unscathed. A single, unidirectional array of microbeams with a peak entrance dose ≤200 Gy (valley dose14 Gy) did not damage normal bone, teeth and soft tissues of the muzzle of normal rabbits longer than one year after irradiation. Because of that, Microbeam radiation therapy of muzzle tumors in pet animals is unlikely to cause sizeable damage to normal teeth, bone and soft tissues, if a single array as used here delivers a limited entrance dose of 200 Gy and a valley dose of ≤14 Gy.

ORO-FASCIAL SYSTEM PECULIARITIES AND AN OSTEOPATHIC APPROACH TO THE CORRECTION OF SPEECH DISORDERS IN CHILDREN WITH DOWN SYNDROME

The key parameters of anatomical deformations of the facial bones and the cranium, which cause speech disorders in children with Down syndrome, are discussed in the review article.

The mandible

The mandible is the largest of the facial bones, occupying a prominent position upon and providing the foundation for the lower third of the face. Despite holding the honour of being the strongest bone in the face, its protrusive location makes it vulnerable to injury – particularly in relation to aggressively placed fists, steering wheels and concrete. Anatomically, the mandible consists of a symmetrical, horseshoe shaped body continuous with paired broad rami posteriorly. The former houses the lower teeth within the alveolus whilst the latter provides attachment for the four principle muscles of mastication from the its medial and lateral surfaces and coronoid and condylar processes. In addition to the aforementioned muscles of mastication, the mandible provides origin to the muscles of the tongue, the floor of mouth and some muscles of facial expression.

A RARE CASE OF MAXILLARY BROWN TUMOUR AS PRIMARY PRESENTATION OF THE PARATHYROID CARCINOMA.

Background: Brown tumours are expansile osteolytic lesions of bone, occurring in Hyperparathyroidism. Brown tumours occur most commonly in ribs, clavicle, long bones and pelvis and are uncommon in other facial bones except mandible. Other facial bones are rarely affected. Brown tumors are due to the direct effect of the parathyroid hormone. Brown tumors occur more with primary hyperparathyroidism than secondary. However, they are reported more in secondary hyperparathyroidism. In primary hyperparathyroidism, a parathyroid adenoma is a cause in 81% while other causes include hyperplasia in 15% and parathyroid carcinoma only in 4%. We present a case report of maxillary Brown tumor due to parathyroid carcinoma in an elderly male patient. Case Report: A 67-year-old male presented with right maxillary swelling increasing in size for the last few months associated with ipsilateral nasal block and right eye epiphora. The contrast CT scan of paranasal sinuses and neck revealed a large expansile right maxillary tumor aggressively eroding maxillary wall with extension into the orbital oor, ethmoid, sphenoid sinuses, nasal cavity, and oral cavity with the erosion of hard palate and soft tissue extension to subcutaneous Plane. A three cm sized soft tissue density lesion was also noted posterior to the right thyroid lobe in CT sections of the neck. Blood prole was normal except extremely high serum parathormone and calcium as well as mildly elevated serum creatinine (S. PTH 3437 pg./ml. S. Ca. 19 mg%. S. Creatinine 1.77mg%.) Ultrasonography of the abdomen also revealed calcication in the renal medulla. Right lower parathyroidectomy was done with the frozen section as well as the Intraoperative Rapid PTH assay. The PTH level was reduced by 90 percent of the original value. The nal histopathology was suggestive of parathyroid carcinoma. Summary: The patient was under regular surveillance, as the maxillary tumor was under remittance after the resection of parathyroid carcinoma. Parathyroid carcinoma is a very rare tumor and involvement of maxillary bone due to primary hyperparathyroidism due to parathyroid carcinoma is also uncommon.

DEVELOPMENT OF OCCLUSION

There are several reasons why pediatric dentist should understand the development of dental occlusion. One of the major objectives of orthodontic treatment is to correct occlusal problems. Much of the need for this treatment could be avoided if children received the proper dental care at earlier ages. Development of occlusion is a genetically and environmentally conditioned process, which shows a great deal of individual variations, and consequently, for the development of an acceptable occlusion, quite a remarkable co-ordination of different events is necessary. The development of occlusion depends on a number of conditions, like muscular pressure, habits, availability of space, etc. This development is coincident with the growth of all tissues associated with the dental apparatus, including the nose, maxillary sinuses, facial bones and muscles. Failure in one part of the development process may lead to anomalies, or else may be compensated for by other developmental processes. Thus Proper care of the developing deciduous and permanent teeth, both at the dental office and at home, is important for the appropriate development of occlusion. and timely diagnosis followed by appropriate interception can prevent any developing malocclusion. This article is an overview which depicts (1) periods of development of occlusion, (2) outline the development of normal occlusion in the pediatric patient and (3) explain what occlusion of the teeth is and why it is important.

POST COVID ORAL MUCORMYCOSIS AN EARLY LESION ON THE PALATE: A CASE REPORT

Covid-19 is an infection caused by severe acute respiratory syndrome coronavirus-2. During second wave in India a serious fungal infection known as black fungus, mucormycosis has been increasingly found in covid -19 recovered patients. It causes necrosis in the head and neck region including nose, paransal sinuses, orbits and facial bones and intracranial spread. If not diagnosed early this disease progresses rapidly causing high mortality and high morbidity. A case of 60 year old female patient of post covid home isolation with very mild symptoms only of red lesion on the palate. We are presenting this rare case for its clinical ndings and awareness.

Erdheim-Chester disease: a rare non-Langerhans histiocytosis

A 3-year-old girl was admitted to our hospital with diabetes insipidus and a left eye proptosis. During investigation of diabetes insipidus, an extensive osteolytic mass, involving skull base and maxillo-facial bones, was revealed. Biopsy exhibited dense infiltrate of foamy histiocytes, which were positive for CD68 and CD163 and negative for CD1a and S100 confirming histopathological diagnosis of Erdheim-Chester disease. Treatment with dabrafenib was initiated, with good response and no side effects.

MORPHOLOGICAL RESEARCH USAGE OF BIOPLAST - DENT IN EXPERIMENT

The work represents experimental and morphological studies of regeneration of damaged areas of maxillo-facial bones. Time course of healing of induced defects in the low jaw bone filled with bioplast - dent and was studied in experimental rabbits. On days 7, 14, 21 and 28 four rabbits from each group were killed and the defect investigated by X-ray and histological methods. We stained the micropreparations ith hematoxilineeosine. Bioplast - dent granulate exerted the best effect on bone repair. In experiments with bioplast - dent, bone regenerate replaced up to one half of the area of defect by day 28.