The paper presents a brown tumor case related to secondary hyperparathyroidism in an end stage kidney disease patient undergoing dialysis treatment. The interesting feature of the case is that the primary clinical presentation of the condition was a mild swelling in the attached gingiva of a mandibular molar tooth. Medical practitioners should be alert to the fact that some pathological conditions may have an initial presentation in the oral cavity. Thus, a thorough and careful examination of the oral mucosa with the accompanying dental radiographs of patients, should be noted and studied in all cases, where available.
Aim: The term “branchial cleft cyst” refers to the lesions that can be considered synonymous with cervical lymphoepithelial cysts. Although relatively rare, they constitute the second major cause of head and neck pathologies in childhood. This study aimed to report the clinical presentations, diagnosis, and management of pediatric patients with the pathological diagnosis of branchial cleft cyst. Material and methods: This study was a retrospective analysis of the records of 33 patients with the diagnosis of branchial cyst, in two different university hospitals, in two different populations. Results: Thirty-three cases of branchial cleft cysts were seen in 33 patients: 17 females and 16 males. The majority (16 patients) were 2nd branchial cleft cysts. Accurate diagnosis of branchial cleft malformation was made via imaging in 20 of the 21 (95%) patients that underwent preoperative surgical ultrasonographic imaging. Conclusion: Branchial cleft cysts are frequently incorrectly diagnosed and ignored in the differential diagnosis. Thus, the diagnosis is often delayed, resulting in the mismanagement of affected patients. A branchial cyst should be suspected in any patient with a swelling in the lateral aspect of the neck, regardless of whether the swelling is solid or cystic, painful or painless. The use of ultrasonography can dramatically help clinicians with distinguishing branchial cleft cysts from other similar lesions of the head and neck.
Proximal humerus fractures are the most common upper extremity fractures and account for approximately 4 to 5% of all fractures. [1] Proximal humerus fractures can be treated conservatively, particularly in the elderly. [2,3] Surgical options come to the forefront in comminuted and unstable fractures. Transosseous suture fixation, closed reduction and percutaneous fixation, open reduction with conventional or locking plate fixation, locking intramedullary nail, hemi, and total shoulder arthroplasty is among the different surgical options for surgically planned proximal humerus fractures. [4] The use of plating systems in the treatment of proximal humerus fractures has become more common owing to the effectiveness of locked plate applications. [5,6] The axillary nerve arises from the posterior cord of the brachial plexus. The nerve passes the quadrilateral space posterolaterally at the lower Objectives: This study aims to examine the reliability of the old and new parameters in determining the axillary nerve safe area for surgical interventions in the proximal humerus by measuring the distances between the top of the humeral head, the top of the greater tuberosity, the base of the greater tuberosity, and the acromion and axillary nerve. Materials and methods:Between 2020 and 2022, a total of 52 shoulders of 26 fresh frozen male human cadavers (mean age: 46±25.5 years; range, 28 to 64 years), 26 right and 26 left were included. The deltopectoral approach was used. The intersection distances of the anterolateral end of the acromion, the top of the humeral head, the top of the tuberculum majus, and the base of the tuberculum majus with the N. axillaries were determined. All measurements were performed using the Microscribe ® G2X. Results:The mean distance from the top of the tuberculum majus to the axillary nerve (shown as "A") was measured as 4.36±0.17 cm and 4±0.21 cm on the right and left, respectively. The mean distance from the center of the base of the tuberculum majus to the axillary nerve (shown as "B") was measured as 1.27±0.18 cm and 1.24±0.11 cm on the right and left, respectively. The mean distance from the apex of the humeral head to the axillary nerve (shown as "C") was measured as 6.15±0.39 cm and 5.89±0.34 cm on the right and left, respectively. The mean distance between the anterolateral end of the acromion (shown as "D") was measured as 6.15±0.39 cm and 5.89±0.34 cm on the right and left, respectively. There was a moderate positive correlation between distances A and B measured on the right and left side, respectively (r=0,484; p=0,012) (r=0,454; p=0,020). Conclusion:A strong positive correlation was found between the distances A and B. The A, B, and C parameters had a weak correlation with parameter D. The anatomical parameters A and B was found to be less variable and more reliable than parameter D.
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