ephalohematoma of infancy is a subperiosteal blood collection of the infant cranium, occurring in up to 2.5 percent of all live births. 1 This ensues after sudden blunt trauma or shear forces tear the delicate blood vessels traversing the pericranium. 2 The most common causes of birth trauma leading to cephalohematoma are vacuum extraction, forceps-assisted delivery, intrauterine scalp electrode use for fetal heart rate monitoring, skull fracture, and fetal calvarial impact against the laboring mother's pelvis. [2][3][4][5][6] Although the majority of cephalohematomas resolve within 1 to 4 weeks of life without intervention, a small proportion will persist and can become calcified through subperiosteal osteogenesis. 2,7-10 Because of the subperiosteal location, calcified cephalohematoma of infancy is a distinct entity from subgaleal hematoma and has the capacity to form a permanent cranial deformity.Although the pathophysiology behind the calcification process is not definitive, we postulate that calcified cephalohematoma growth recapitulates normal development of the inner and outer cranial tables, as described by Melvin
Treatment of bilateral subcondylar fractures is a challenging clinical problem, and optimal management of these fractures remains controversial. Similar to unilateral subcondylar fractures, bilateral injuries present with significant malocclusion due to fracture segment displacement; however, the loss of vertical stops on both sides of the mandible mandate a more concerted approach to surgical management. Closed reduction and maxillomandibular fixation (MMF) alone in bilateral subcondylar fractures carry a higher risk of recurrent anterior open bite postoperatively secondary to the absence of a vertical stop with fracture segment displacement and persistent shortening of the posterior facial height. Therefore, some surgeons consider bilateral subcondylar fractures an indication for open reduction and internal fixation (ORIF). Unfortunately, open approaches involving the proximal subcondylar fracture segment are riddled with potential risks including facial nerve damage, parotid gland injury, and temporomandibular joint (TMJ) damage. Given that neither approach is optimal, investigation of new approaches for the treatment of bilateral subcondylar fractures is warranted. The objective of this paper is to present our novel technique for the treatment of bilateral subcondylar fractures, which utilizes a combination of traditional closed reduction and MMF with a custom “wedge” occlusal splint to overcorrect the traumatic shortening of the posterior mandibular height.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.