Dental occlusion was restored in all the cases, and good anatomical reduction was achieved. The mean operating time was higher 63.53 (mean) ± 18.12 minutes standard deviation (SD) in the preauricular approach compared to 45.22 (mean) ± 18.86 minutes SD in the mini retromandibular approach. Scar formation was satisfactory in almost all the cases.
Diagnosis of midline neck swellings may give a myriad of options, ranging from ranula, thyroglossal duct cyst, cystic hygroma, cystic lymphangioma, epidermoid, dermoid and teratoid cysts to benign or malignant neoplasms of the mucosa or salivary glands and also rare skin appendage tumours like pilomatricoma or pilomatrix carcinoma. Various pitfalls are encountered in diagnosing these midline swellings as most of the features are overlapping. Careful history and examination have to be complemented with other diagnostic aids such as conventional radiography, ultrasonography, aspiration cytology and computed tomography to arrive at a correct diagnosis. Dermoid cysts in the head and neck are relatively uncommon, present in the midline either above or below the mylohyoid muscle thus differentiating it into sublingual and submental dermoids and can grow to a massive size before presenting symptoms if it breaches the mylohyoid muscle. Pilomatricoma is a skin appendage tumour which presents as midline swelling and is usually diagnosed with careful history and certain pathagnomonic features on fine needle aspiration cytology and ultrasonography. Hereby we are presenting a case of a submental swelling which was diagnosed as a dermoid cyst upon excision but which initially posed a diagnostic challenge because of features of pilomatricoma seen on FNAC.
Abstract:Odontogenic fibroma is a rare tumour of odontogenic mesenchymal origin, which accounts for only 0.1% of all odontogenic tumours and can be seen either in maxilla or mandible. Though it is seen in second and third decade of life, cases have been reported in the age range of 5-80 years. Trismus is a rare clinical presentation of this tumour. As there is seldom any malignant change or recurrence, the treatment of choice is surgical enucleation. Here, we present a case of odontogenic fibroma in a 6-year old child, who presented with trismus as a chief complaint.
Abstract:The aim of the study was to record the etiology, pattern and management of zygomatico-maxillary complex (ZMC) fractures seen in two centres in Mysore and to compare the findings with other studies in literature. A fifteen year retrospective study involving 123 patients with ZMC fractures were selected from a pool of 219 patients who sustained maxillofacial fractures during the period under study. The age distribution, gender distribution, etiology, associated injuries, associated maxillofacial fractures, clinical features, distribution of radiographic investigation, radiographic findings associated with ZMC Fractures, pattern of fractures and various modalities of management and surgery were recorded. In this study, 86.17% were males and 13.83% females. Most (39.02%) patients were aged 21-30 years. There was highly significant association between road traffic accidents and ZMC fractures. (Chi square value 291.512, P < 0.001). The most frequently associated maxillofacial fracture was nasal bone fracture (28.45%). Circumorbital edema was the commonest clinical feature (88.61%); Keene's approach was the commonest method of zygoma elevation (78%). Two point internal fixation was commonly used (46.83%). Among two point fixation, frontozygomatic suture and zygomatico-maxillary suture were commonly plated (64.86%). Among one point internal fixation, zygomatico-maxillary suture was most commonly plated (40.74%). This study has shown that road traffic accidents have been responsible for most of the ZMC fractures in our geographical area and two point fixation at zygomatico-maxillary suture and fronto-zygomatic suture has been the commonest method of fixation and Keene's approach has been the choicest method for elevation of zygoma.
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