No abstract available.
Congenital Abnormalities* ; Humans ; Jaw*

This 24-year-old woman presented to ENT outpatients with an enlarging swelling in the right external auditory canal. A radical mastoidectomy for chronic suppurative otitis media with cholesteatoma had previously been undertaken at another institution. On clinical examination there was an otologic mass that was tender on probing. High resolution imaging of the temporal bones and a subsequent MRI brain confirmed the mass was a temporal lobe encephalocele. A temporal lobe encephalocele is where a segment of the temporal lobe invaginates through a defect in the tegmen tympani. The brain is separated from the middle ear and mastoid process by an exceptionally thin layer of bone – the tegmen tympani. Damage to the tegmen compromises the barrier with the brain and may occur for a number of reasons. This includes congenital, traumatic, post-infectious, malignant invasion, post-radiation therapy and post-surgical causes.1 When this occurs the brain may extrude through the defect resulting in a temporal lobe encephalocele. A bony defect alone, whatever the cause, is insufficient to always result in an encephalocele. Even with dehiscence of the tegmen the dura is capable of supporting the brain issue without herniation. Only when the integrity of the dura is compromised does an encephalocele occur.2 This may be due to the underlying disease process (such as cholesteatoma causing an intracranial abscess) or both purposeful (opening dura to drain an adjacent intracranial abscess) /non-purposeful surgical intervention. Mainstream microsurgical techniques however have lowered the incidence of dural violation.3 Historically, infection was a major cause, but with the ready availability of antibiotics and prompt management, the key contemporary cause is iatrogenic, following mastoid surgery. However, the overall incidence is uncommon following otologic surgery. In a review of 25 years of middle ear/mastoid encephalocele cases 77% were identified to be iatrogenic in origin.4 This patient presented with the finding of a mass observed in the external auditory canal. Less common findings at attendance include tympanic perforation, cholesteatoma, otorrhoea and meningitis.4 The key to diagnosis hinges on cross-sectional imaging: combined imaging with CT to assess the osseous structures and MRI for soft tissue review. The high-resolution CT (HRCT) of the temporal bones illustrates a large defect in the right tegmen tympani with a large soft tissue lesion occupying the post-surgical mastoid cavity abutting the tympanic membrane. (Figures 1A, B) The defect of 15mm in the tegmen was more than double the average of 7.2mm reported elsewhere.4 The MRI confirms the defect in the tegmen with the protrusion of a knuckle of the right temporal lobe and its overlying meninges through the defect into the mastoid cavity. The dumb-bell appearance is typical with the narrower neck at the site of the tegmental dehiscence. The extruded brain occupies the post-operative middle ear cavity. (Figures 2 A, B and C) The defect size and volume of herniated brain can be accurately assessed, both of which may be key determinates of the type of surgical procedure. Revision mastoidectomy with repair of the tegmen defect and dural integrity using a combined intracranial-mastoid approach is planned as a joint case with neurosurgical colleagues.
Encephalocele ; Jaw Abnormalities ; Facial Bones

The treatment of intraosseous ateriovenous malformation in the jaw is difficult because of life threatening frequent bleeding tendency. The surgical resection of AVM may be mortal due to massive blood loss .In the growing pediatric patient, surgery may cause facial deformity and growth disturbance. So currently, the treatment of AVM is only embolization using various material through endovascular access, direct-puncture or embolization in conjunction with surgical resection. We report a case of combined techniques.
Congenital Abnormalities ; Hemorrhage ; Humans ; Jaw ; Mandible*

Ameloblastoma is a benign neoplasm originating from odontogenic epithelium. It is the most common neoplasm in the jaws and is characterized by aggressive behavior and local invasion. Unicystic ameloblastoma (UA) has a unilocular feature in radiologic examination and a cystic feature histologically. Decompression and marsupialization are conservative method of treatment of large UA. The purpose of decompression and marsupialization are size reduction of the mass, which makes it easy to handle at total enucleation with protection of nerve damage and facial deformity. Here we report successful conservative treatment of extensive UA using decompression and marsupialization with a review of literatures.
Ameloblastoma ; Congenital Abnormalities ; Decompression ; Epithelium ; Jaw ; Methods

jaw. ossifying fibroma has been designated as a demarcated,occasionally encapsulated lesion consisting of fibrous tissue that contains variable amounts of mineralized material resembling abnormal bone or cementum-like tissue. most of them are solitary and show slow, often expansile growth centrally within the jaws and characteristrically behave in a benign fashion. But, rarely they occur as a multiple and in a gigantic form exhibiting an aggressive nature. We has a case of multiple ossifying fibroma showing rapid-growing behavior and sequential occurrence in all four jaw quadrants resulting in severe facial deformity and orbital compression. therefore such a rare case is reported here.]]>
Congenital Abnormalities ; Fibroma, Ossifying ; Jaw ; Orbit

The posttraumatic complications of jaw fractures related to jaw function and facial deformity include nonunion, malunion, malocclusion, temporomandibular joint dysfunction and facial asymmetry. This report presents cases referred to our department for revision of malunion and malocclusion following inadequate reduction of jaw fractures. Three patients with posttraumatic malocclusions caused by malunion were treated with a LeFort I osteotomy in one case and re-fracture in two cases. All of the patients exhibited stable results without further complications (e.g., malunion or malocclusion). Accurate preoperative diagnosis and proper anatomical reduction of the fracture segments are essential to preventing post-surgical malunion and malocclusion.
Congenital Abnormalities ; Diagnosis ; Facial Asymmetry ; Humans ; Jaw ; Jaw Fractures ; Malocclusion* ; Osteotomy ; Temporomandibular Joint

Management of infants born with cleft lip and palate entails an interdisciplinary team effort that begins from infancy to adulthood. The goal of pre-surgical infant orthopedics is to reduce the severity of the cleft deformity before surgery. However, traditional methods do not address the deformity of the nasal cartilages and alveolar ridges simultaneously. The Nasoalveolar Molding (NAM) technique takes advantage of the malleability of immature nasal cartilage and its ability to maintain a permanent correction of its form. The NAM device is used to actively mold the alar dome, nasal cartilages, premaxilla, and alveolar ridges into a more normal anatomic form and position. It permits non-surgical elongation of the columella through application of tissue expansion principles. This results in better facial aesthetics and may help reduce the extent, number and cost of surgeries. The three cases presented illustrate the application of the NAM device for the pre-surgical infant orthopedics in unilateral and bilateral cleft lip and palate patients treated at the Philippine Children's Medical Center-Pediatric Dentistry Division (PCMC-PDD).
Human ; Male ; Infant Newborn ; CLEFT LIP ; CLEFT PALATE ; MUSCULOSKELETAL DISEASES ; JAW DISEASES ; JAW ABNORMALITIES

There have been few reports on fibrous dyplasia associated with secondary hyperparathyroidism. We report a case of a hemodialysis patient with secondary hyperparathyroidism concomitant with fibrous dysplasia of the jaws causing an abnormal facial deformity.
Congenital Abnormalities ; Humans ; Hyperparathyroidism, Secondary* ; Jaw* ; Renal Dialysis

Objective: To present the case of a midline Tessier 30 cleft in a baby boy who initially underwent a glossoplasty, cheiloplasty and mentoplasty. Methods: Design: Case Report. Setting: Tertiary Government Training Hospital. Patient: One. Result: A 4-month-old boy with a complete midline cleft of the lower lip, alveolus and mandible, and bifid distal tongue that was fused with the floor of the mouth, underwent glossoplasty, cheiloplasty and mentoplasty with subsequent excellent aesthetic outcome and normal oral competency. Conclusion Tessier 30 is a rare congenital midline mandibular cleft. Prompt glossoplasty, cheiloplasty and mentoplasty can correct the gross deformity, restore oral competency, and address functional needs such as feeding, swallowing and early speech development. Future bony repair will hopefully complete the reconstruction.
Mandible ; Cleft Lip ; Tongue Diseases ; Jaw Abnormalities ; Plastic Surgery Procedures

jaw abnormalities as well as malocclusion and speech problems. In particular, unilateral cleft lip and palate is characterized by midface deformity resulting in maxillary anterior nasal septal deviation and nasal deformity. The aim of this study is to analyze the facial deformity of untreated unilateral cleft lip patients for contribution to primary cheiloplasty.METHODS: Thirty-three patients with unilateral cleft lip and palate were impressioned before operation and facial casts were made. The casts were classified into complete cleft lip and incomplete cleft lip groups and each group were classified into affected side and normal side. Anthropometric reference points and lines were setted up and analysis between points and lines were made.RESULTS AND CONCLUSION: The obtained results were as follows:1.The intercanthal width had no significant difference between the incomplete and complete cleft lip groups.2.Cleft width and alar base width were greater in the complete group, and nasal tip protrusion was greater in the incomplete group.3.Involved alar width and nostril width were greater in the complete group and in both complete and incomplete groups, involved alar width and nostril width were greater than the non-involved side.4.The lateral deviation of the subnasale was greater in the complete group in both involved and non-involved sides.5.The nasal laterale was placed inferiorly in both cleft groups.6.The subnasale was deviated to the non-involved side in both cleft groups.7.The nose tip was deviated to the non-involved side in both cleft groups and had greater lateral deviation in the complete cleft group.8.The midpoint of cupid's bow had no vertical difference between complete and incomplete groups, but had a greater lateral deviation in the complete group.9.In the complete cleft group, correlation between differences in cleft width and nostril width and columella height difference were obtained.]]>
Cleft Lip ; Congenital Abnormalities ; Humans ; Jaw Abnormalities ; Malocclusion ; Nose ; Palate ; Rhinoplasty ; Succinates