No data in the literature report the specific invasion of the orbit from ethmoidal tumors, although such a pattern of involvement of the orbit frequently occurs because of the thin lamina papyracea separating the two structures. From January 1986 to January 2003, 38 patients with untreated primary ethmoidal malignancies were observed at the Unit of Maxillo-Facial Surgery of the University "La Sapienza" in Rome. Personal data were obtained from review of the personal clinical file of each. Orbital invasion was present in 24 patients with ethmoidal malignancy. Three stages of orbital invasion were identified. The average overall survival, with the Kaplan-Meyer method, was 61.4% after 1 year and 51.1% at 5 and 10 years. Intracranial involvement is the main element for short-term negative prognosis. Orbital exenteration is fundamental if grade III orbital invasion occurs because it ensures an improvement of the disease-free survival.
SUMMARYWarthin's tumor is the second most common benign neoplasm of the parotid. Most of cases are represented by a single localization, while only a small percentage of patients presents bilateral lesions or unilateral multifocal pattern. Warthin's tumor has an excellent prognosis due to the low rate of recurrence after surgical treatment. Malignant transformation occurs in less than 1% of cases. The aim of this article is to present two unusual cases of Warthin's tumor and an updated review of the latest scientific literature.
Bilateral orbital roof fractures are rare events usually associated with high-energy impact trauma. The clinical picture is often multiple because of involvement of cranial, cerebral, and facial injuries. The primary diagnostic and therapeutic approaches aim to safeguard the cerebral state and to intercept the consequences of severe orbital trauma. The latter may present dramatic events and determine permanent ocular bulb or optic nerve damage, even vision impairment and blindness. Immediate intraorbital decompression decreases the pressure exerting directly or indirectly on the optic nerve. Surgical decompression of the orbit was performed in a young man showing almost complete blindness after bilateral orbital roof fracture. The final result showed good recovery of vision and functional motility of the bulbs.
SUMMARYA complication following tooth extraction: a case report of chronic suppurative osteomyelitis. Objective. This article presents a case report about the surgery treatment of chronic suppurative osteomyelitis following a tooth extraction. Methods. Cone beam computed tomography revealed a sequestrum bone formation that required the sequestrectomy and the debridement of the involved area. The prescription of oral penicillin and metronidazole were necessary after and before the surgery. Also 20 sessions of hyperbaric oxygen therapy were important for the healing of the marrow space.Results. The histologic test confirmed the diagnosis of "Chronic suppurative osteomyelitis". Clinically the post-operative course showed no complications but a good healing of the bone tissue. Culture reports revealed two microorganisms, streptococcus viridans and staphylococcus, that are sensitive to penicillin. Conclusions. Clinical results confirmed the validity of the sequestrectomy and the debridement of the involved area for the treatment of chronic suppurative osteomyelitis. Such approach has always to be preferred because it guarantees the healing of bone tissue.
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