Necrotizing fasciitis (NF) is defined as rapidly progressive necrosis of subcutaneous fat and fascia. Although NF of the face is rare, its mortality rate is nearly 30%. It usually originates from dental infection and can lead to involvement of the neck, mediastinum, and chest wall. Complications resulting from pre-existing systemic diseases can increase the mortality rate. Known complication factors for NF include diabetes, malnutrition, advanced age, peripheral vascular disease, renal failure, and obesity. Here, we report a case of NF originating from dental infection in an 88-year-old woman already diagnosed with hypertension, thoracic aortic aneurysm, and renal diseases. Such conditions limited adequate surgical and antibiotic treatment. However, interdisciplinary treatment involving multiple departments was implemented with good results.
The proper management of mandibular fractures involves reduction, rigid fixation, and immobilization to allow bone healing. Nonunion or malunion at the fractured sites is a well-known complication of fracture when the treatments are inappropriate. We present a case of left mandibular fracture due to shrapnel during the Korean War. The patients did not receive appropriate treatment at that time, so nonunion and malunion developed. Sixty years after the accident, mandibular osteomyelitis on the fracture site developed due to dental-origin inflammation. The treatment was based on relatively conservative care, such as saucerization and administration of antibiotics. There was no complication during the short-term follow-up. We present the case with literature review.
Angioedema is defined as self-limited, localized swelling. The swelling is asymmetric, non-pitting, and non-tender. Common locations of swelling include periorbital area, lips, tongue, extremities, and bowel wall. A 54-year-old woman visited our hospital with the clinical complaint of left maxillary swelling. Swelling of the left maxillary area was diffuse and temperature of the involved area was normal. No infectious source was found on panoramic radiography and cone-beam computed tomography. After considering the patient's medical history and assessing clinical examination, we suspected angioedema and administered corticosteroid only. In the oral and maxillofacial area, proper diagnosis and prompt treatment of angioedema is important because angioedema of the tongue or larynx may lead to airway obstruction or a life-threatening condition.
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