The etiology and histogenesis of granular cell tumor are still debated. Granular cell tumor of the newborn is considered to be a different entity than the adult form of this lesion with different immunohistochemical features. We present a case of a rare gingival granular cell tumor in a newborn and review the literature. Gingival granular cell tumor must be clinically differentiated from teratoma, congenital dermoid cyst, congenital fibrosarcoma, hemangioma, lymphangioma, leiomyoma, rhabdomyoma, heterotopic gastrointestinal cyst, congenital cystic choristoma and congenital lipoma. Surface ulceration or pseudoepitheliomatous hyperplasia may lead to confusion with malignancy.
The reconstruction of acquired mandibular defects due to ablative tumor surgery or traumatic injuries is still challenging. The gold standard in such treatment is application of reconstructive titanium plates, which should be contoured and adapted to the defect as much as possible because of their influence on postoperative functional and esthetic results. Traditionally, plate bending is achieved by trial and error intraoperatively. Use of stereolitography (STL) models potentially could reduce the risk of incorrect contouring as well as operating time. On the other hand, fabrication of STL is time-consuming and costly. However, we found only one experimental study dedicating to virtual plate bending in the literature. The aim of this article was to demonstrate clinical application of a method of virtual bending of reconstructive plate for mandibular defect bridging. No significant complications occurred, and satisfactory functional and esthetic results were achieved in all cases. We found this technique precise and applicable in cases of reconstruction of mandibular defects.
Crouzon syndrome is one of the frequent pathologies within craniosynostosis syndrome. Current progress in computers and biotechnologies allows improving surgical approach and forecasting final result of reconstruction as well. We present a case of successful surgical treatment of Crouzon syndrome, done by application of virtual planning allowing determining “monobloc” features, type of reconstruction and distraction protocol as well. A 20-year-old female had presented with craniofacial deformity. Clinical and radiological investigation revealed Crouzon syndrome. The “monobloc” creation, cranioplasty and internal distractors positioning, direction and schedule of advancement were done according to preoperative virtual planning data achieved by Materialise Mimics Research software. Nine months postoperative functional and esthetic result and radiological findings showed to be reasonable. That application of virtual simulation significantly allows to determine best direction of distraction and improves postoperative outcomes of surgical treatment of Crouzon syndrome.
Introduction: Orbital floor fractures are common among mid-face fractures. The general aim of treatment is to restore orbital volume and anatomy with grafts or reconstructive materials. Malpositioning of the implants and inadequate volume restorations are common complications of these procedures. The aim of our study is to present the surgical outcomes of orbital reconstruction aided by our algorithm of patient-specific virtual planning. Materials and Methods: The current study was performed on 77 patients with orbital wall fractures who were categorized into two groups: Group A – 42 patients (virtual planning) and Group B – 35 patients (traditional approach). Criteria of analysis included the presence of diplopia postoperatively and duration of surgical procedures. Results: Diplopia was recorded right after surgery in 16 cases (38.1%) of Group A and in 12 cases (34.3%) of Group B. However, 6 months postreconstruction, residual diplopia was recorded in 4 cases (9.5%) of Group A and in 12 cases (34.3%) of Group B. Mean operation time in Group A for the patients with isolated zygoma fracture was 2.23 h; for isolated orbital wall fracture was 1.98 h; and for combined zygoma, orbital wall, and facial bone fracture was 3.07 h. In Group B, these indexes were 3.47, 2.05, and 3.31 h, respectively. Conclusions: Application of virtual planning could significantly improve postoperative outcomes in orbital reconstruction. However, application of this technology could be limited by complicated defects of the orbital walls, which would require complex shape of the implant that might be difficult to be prevent virtually.
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