The authors conduct a review of the etiopathogenesis, the main diagnostic methods and the treatment principles in cervico-facial pain. Pain in otorhinolaryngology is a multifactorial symptom, based on the rich innervation and vascularisation of the cephalic extremity. Pain can be of central or peripheral origin, acute and chronic. With the diversification of methods for exploring pain-generating lesions, different treatment protocols could also be achieved.
BACKGROUND. Fractures of the naso-orbito-ethmoido-maxillary (NOEM) complex are frequently acquired post-traumatic lesions, with both aesthetic and functional consequences, if the diagnosis is not promptly established and the surgical correction is delayed. OBJECTIVES. This study was conducted in order to facilitate the diagnosis of NOEM complex fractures by using anthropometric measures. The aim was to obtain normal mean values of the evaluated parameters from a lot of healthy volunteers. MATERIAL AND METHODS. The measurements were conducted on patient-specific three-dimensional models obtained from processing the CT scan images and building further stereolithographic models. 64 Caucasian patients were enrolled, with ages between 19 and 93 years, both female and male volunteers, without previous surgical history of the middle floor of the face. Measurements were performed between certain craniometric points (Nasion, Dacryon, Infraorbital foramen, Rhinion and Frontomalare orbitale) and a database was created. RESULTS. Although some expected variation arised, we have obtained normal-considered intervals for each of the defined and measured segments between the mentioned craniometric points. We find these measurements useful especially for elaborating a presurgical plan for the best outcome. CONCLUSION. Simple measurements could orient a fast diagnosis, could help establish a surgical plan, an optimal surgical timing by combining clinical and imaging data.
OBJECTIVES. The aim of this study was to reevaluate the implication of early diagnosis of chronic adenoid syndrome and tonsillar hypertrophy in the prophylaxis and control of facial and dental deformities in children. MATERIAL AND METHODS. The authors conducted a prospective study on 42 paediatric patients with chronic adenoid syndrome admitted in the ENT and Orthodontic Departments of “Sf. Spiridon” Emergency Hospital and “Sf. Maria” ENT Paediatric Department, Iasi, treated in collaboration with orthodontic and logopaedic specialists, with follow-up on the improvement of symptomatology and morphofunctional deficiencies. RESULTS. Late diagnosis and treatment of the obstructive adenoid hypertrophy can cause difficulty in managing cases, consequently maintaining the aesthetic deficiencies and morphofunctional disorders within a follow-up period of 2 years. Furthermore, we present the chronic complications due to obstructive adenoid hypertrophy (rhinosinusal and ear-related diseases, obstructive sleep apnea), as well as the progression of these cases after interdisciplinary approach. CONCLUSION. Chronic adenoiditis and tonsillar hypertrophy can increase the incidence of malocclusion in children, as well as causing changes in length and shape of the upper jaw and mandible, resulting in maxillofacial deformities.
Background and Objectives: The internal carotid artery (ICA) is a vascular structure that can be easily injured during sinus endoscopic procedures, and surgeons should be familiar with its anatomic variants. The aim of this study was to describe the anatomical variations in the internal carotid artery in relationship to sphenoidal sinuses, using computed tomography (CT). Materials and Methods: In this retrospective study, we evaluated the variations of the ICA in relationship to sphenoidal sinuses in a cohort of 600 patients who were assessed between January 2020 and December 2022 in ‘Saint Spiridon’ Emergency Hospital, Iasi, Romania. Descriptive statistics were used to characterize our data. Results: The most prevalent anatomical variant was represented by intrasinusal septa with posterior insertion on the ICA (58.6%), followed by procident ICA (58%) and dehiscent ICA (52%). We could not find any statistical significance regarding demographic characteristics among groups. Conclusions: A thorough CT examination should be performed before functional endoscopic sinus surgery, with the identification of anatomical variants of the ICA, in order to prevent its injury with potentially fatal consequences.
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