Multiply comminuted fragmented fracturesof the maxillofacial area are difficult to fix with titanium plates because of the small size of fragments, complex 3D anatomy, thin bone which is unable to hold screws and multidirectional pull of muscles.This study intend to present a case series of extremely comminuted maxilla fractures involving orbital floor both of which rereconstructed with Titanium mesh, cut to shape and used to mold the small fragmented segments in to the shape of the facial bones. Severe fragmentation of maxillary wall leads to facial hollowing, tissue prolapse and asymmetry even after major facial buttresses are reconstructed. Simple Titanium mesh can be used to reconstruct these severe fragmentations of thin bones of the maxillary wall as shown in the series and avoid late and unsightly complications.
Retrosternal extension of goiter is one of the most common types of masses in the superior mediastinum. These types of goiters classically present with compressive symptoms such as dyspnoea, dysphonia, dysphagia, or sleep apnea. Surgical treatment with a total thyroidectomy and complete removal of the intrathoracic portion of thyroid is the gold standard treatment. These cervico-mediastinal lesions at times may not be continuous, and a sternotomy may be required for complete and safe excision of the mediastinal mass to achieve decompression of the surrounding structures and preventing the hemorrhagic complications if attempted from cervical incision.
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