Purpose The aim of the study is to compare subciliary incision and 'sutureless' transconjunctival incision in the treatment of infraorbital rim fractures. Materials and method In this prospective study, 40 patients with fractures of the infraorbital rim were selected and divided into 2 groups using random sampling technique. Group A patients were treated using 'sutureless' transconjunctival technique and group B patients were treated using subciliary approach. The following parameters were compared a) time taken, intraoperative ease of access, exposure achieved; b) clinical outcome and postoperative complications; c) Aesthetic outcome at intervals of 15 days, 1 month and 3 months. Results Total time taken for completion of surgery was lesser in group A patients. The presence of subconjunctival ecchymosis (at 1 month interval) and neurological deficit was found to be statistically significant (P\0.05) in the 'subciliary' group of patients. The transconjunctival approach showed better esthetic results and fewer postoperative complications. Conclusion The subciliary approach gives good exposure of the infra-orbital rim and is better suited to reduce extensively displaced fractures of the infra-orbital rim. The transconjunctival approach is comparatively faster, gives better esthetic results and fewer post-operative complications but is technique sensitive and requires an additional lateral canthotomy in cases where more exposure is needed.
Maxillofacial trauma particularly that associated with Lefort II, Lefort III and Zygomatico maxillary complex fracture may lead to opthalmic injuries and even blindness. A thorough opthalmic examination should be carried out for every patient with maxillofacial trauma and suspected cases should be placed under closed observation so that immediate and active treatment can be taken if necessary.
Hereditary sensory and autonomic neuropathy (HSAN) IV is a rare autosomal recessive disorder which is characterized by a decrease in the number of myelinated and non-myelinated nerve fibers of peripheral nerves which causes diminished or absent pain sensation leading to increase in self-mutilative habits. A retrospective study of eight cases ranging from age group of 4 to 17 years for oral and digital signs and symptoms is presented. All the patients showed congenital insensitivity to pain and anhidrosis. Oral self-mutilations, such as autoextraction of teeth and severe bite injuries (with resultant scarring) of the finger tips and oral soft tissues (tongue, lip, and buccal mucosa) were found in most patients. Our study suggests that early diagnosis and specific treatment plan are important for prevention of characteristic of the oral as well as digital trauma associated with this disorder.
A detailed history, clinical and functional examination, radiographic examination facilitating correct diagnosis followed by immediate surgical intervention, and physiotherapy can help us to restore physical, psychological, and emotional health of the child patient.
Introduction Trigeminal neuralgia (TN) often called as ''Tic douloureux'' is a syndrome characterized by paroxysmal facial pain, is one of the most painful and debilitating craniofacial pain disorders. The controversy regarding the etiology and treatment of TN still exists. Objective To evaluate the effectiveness of percutaneous radiofrequency rhizotomy (PRR) for TN, after failure of pharmacological management. Method A nonrandomized, non comparative, descriptive, in vivo study of 15 patients with TN of maxillary and mandibular divisions of trigeminal nerve and patients with pain refractory to pharmacological management were done. It was performed as an O.P.D procedure. A routine follow up was done in all cases for 1 year. Results In a total of 15 patients, 8 female and 7 male patients were enrolled for the study. Early pain relief (immediately, postoperatively to 6 month) classified as excellent or good (successful), occurred in 12 of 15 patients (80 %). Fair or poor pain relief (unsuccessful) occurred in three patients (20 %).There was no mortalities and no major morbidity. Summary It was found that surgical treatment with PRR is a safe and effective way to manage patients with TN in whom pharmacologic therapy is either ineffective or not tolerated, with low side effects which are well tolerated.
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