Masseteric/crossfacial nerve grafting is feasible for patients with palsies 20-24 months in duration, affording satisfactory functional and esthetic results and a dramatic improvement in quality of life.
Gorlin-Goltz (GG) syndrome is an inherited autosomal dominant condition. Its diagnosis may be clinically confirmed by checking either major or minor signs that define the diagnostic criteria. It may occur that, although GG syndrome is a well-known condition, only the specific symptom could be observed by different specialists. Therefore, the patient cannot be placed into an always complex clinical panel. We introduce an example in this report. Throughout a 20-year clinical history characterized by the lack of proper diagnosis and missed follow-up operations, a patient with GG syndrome underwent partial amputation of the jaw after severe complications. A 52-year-old man required an implant-prosthetic rehabilitation since becoming edentulous after a partial resection of the jaw due to a keratocyst, which was later reconstructed through a free fibula flap. The observation of a typical phenotype and various symptoms that succeeded for longer than 20 years, with anamnestic evaluation and clinical examination, led us to suspect a complex pathologic condition such as GG syndrome, which was not previously considered, although the patient had undergone several polyspecialistic evaluations. Diagnosis has been eventually confirmed by a genetic study, which was always mandatory. The simultaneous presence of muscular and skeletal malformations, basocellular nevi, and multiple cysts of the jaw can represent signs linking to a condition such as GG syndrome. There are many syndromes involving the head and neck region, and specialists are supposed to be alerted when faced with similar typical expressions associated with a characteristic soma so as to avoid delays in diagnosing the syndrome.
Background. Cemento-ossifying fibroma (COF) is a relatively rare tumor of the maxillary bones, classified among the fibro-osseous lesions Feller et al. (2004). The lesion that develops appears within the bone, although in some cases, it involves the soft tissues Kaufmann et al. (1999), Jung et al. (1999. In literature there is not report of COF in the thickness of the cheek. Methods. A 24-year-old Caucasian woman presented a hard mass of 1.5 cm in the thickness of the right cheek; no signs of damaged tissues were present. Radiographically all the mass appeared radiopaque as bone, and well demarcated with an evident capsule, without invasing the adjacent structures. The lesion was resected en bloc. Result. Pathological examination of the excised mass revealed an encapsulated cemento-ossifying fibroma that did not invade the adjacent tissues. The case was resolved with no complicance and with restitutio ad integrum. Conclusion. Typically, the unusual characterisitcs of a pathology get difficult as for its diagnosis and therapy. This is a case report of a rare cemento-ossifying fibroma of the cheek. Clinical and instrumental examinations exclude a malignant pathology and lead to an appropriate conservative surgical therapy. Only the histological examination confirmed the clinical diagnosis of extraosseous COF.
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