The Journal of craniofacial surgery
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Case Reports
Treatment of acute temporomandibular joint dislocation using manipulation technique for disk displacement.
Temporomandibular joint dislocation is not frequently encountered, but it is often difficult to reduce the dislocation with conventional methods described in textbooks. The key points to success of reduction depend on the patient's position, route of approach, and timing of reducing each side. ⋯ Using our method, temporomandibular joint dislocation can be easily reduced, without using sedative or analgesics. This method is simple, convenient, and worth trying in place of the conventional method.
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Cervical and facial subcutaneous emphysema is mainly caused by maxillofacial trauma or head and neck surgery. There are only 2 cases of subcutaneous emphysema after septorhinoplasty in the English literature. We report a case of subcutaneous emphysema and pneumomediastinum after a septorhinoplasty. ⋯ On the fifth day after the hospitalization, follow-up CT scans were performed. Subcutaneous emphysema and pneumomediastinum were markedly decreased. The patient was discharged on the fifth day.
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Case Reports
Endoscopic endonasal treatment of a large clival giant cell tumor invading the cavernous sinus and temporal lobe.
Giant cell tumors (GCTs) are extremely rare lesions, representing less than 5% of all bone tumors. They primarily occur in the long bones. ⋯ Nowadays, GCT and other skull base lesions can be treated using the extended endoscopic endonasal approach. We present a case report of a GCT located in the skull base, originating from the clivus and sphenoid bone, invading through the cavernous sinus, and treated using the fully endoscopic endonasal approach.
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The objective of this study was to retrospectively study the outcomes of large vestibular schwannoma resection through the suboccipital retrosigmoid keyhole approach and emphasize technical details and advantages of surgical resection of large vestibular schwannomas via this approach. ⋯ The suboccipital retrosigmoid keyhole approach is a valid choice for removing large vestibular schwannomas. Through this approach, cerebellopontine angle can be effectively exposed. Skills to protect facial nerve and extensive experience in microsurgical techniques can significantly improve the total resection rate and postoperative facial nerve function. The authors recommend this approach for patients with vestibular schwannomas larger than 3 to 4 cm.
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Cerebrospinal fluid leakage into the orbit (CSF orbitorrhea) or through the orbit to the exterior (CSF oculorrhea) occurs when there is a communication between orbit and subarachnoid space. It has rarely been described. We report a case of CSF oculorrhea following surgery for recurrent sphenoid wing meningioma. ⋯ With wide retraction of eyelids, a 1-cm longitudinal full-thickness laceration through the conjunctiva toward the lateral orbital rim was visualized in the area of the lateral canthal tendon. Steady leakage of pink-tinged serous fluid through the forniceal laceration was observed. With a presumed diagnosis of iatrogenic CSF oculorrhea, the patient was treated conservatively with resolution by postoperative day 6.