The Journal of craniofacial surgery
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The purposes of this study were to locate the constant anatomic landmarks, which are very important and helpful for endoscopic surgery and not well described for the pterygopalatine fossa (PPF) surgery via the middle nasal meatus-sphenopalatine foramen approach to establish a safe surgical mode. ⋯ Endoscopic PPF surgery via the middle nasal meatus-sphenopalatine foramen approach is safe, and the ethmoidal crest, sphenopalatine foramen, and Y structure with the pterygopalatine ganglion in the center are important anatomic landmarks that can be referred to during the surgery.
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Case Reports
Management outline of oral and maxillofacial missile injuries in Iraq: the value of the intermediate phase.
Oral and maxillofacial surgeons in Iraq are practicing in a paradoxical situation where a high number of extensive injuries are accompanied by limited resources. Steps of management should be followed cautiously in attempts to reduce residual deformities that characterize the end results of severe missile injuries. This study elucidate lessons extirpated from surgical experience in the management of diversity of causalities with special emphasis on the intermediate phase of management as well as different modalities of treatment, trying to get best benefit from available resources.
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Comparative Study
Reduction of nasal bone fractures: a comparative study of general, local, and topical anesthesia techniques.
The aim of the current study of nasal bone fracture reduction carried out under topical, local, and general anesthesia was to suggest a proper treatment of patients with nose fractures. ⋯ If the selection of patients is done properly, CNR under TA/LA will have considerable success in comparison with GA. Topical anesthesia is suggested in simple nasal fracture with unilateral depression or minimal displacement.
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Postoperative cerebrospinal fluid (CSF) leak is a common complication in the practice of neurosurgery, and various surgical techniques were described to overcome and manage this problem. Besides not applying watertight closure of the duraplasty, the inviability and the poor vascularization of the graft and/or the dura (eg, reoperations, multiple operations, or cranial radiotherapy) may lead to delayed healing of the suture site and resultant persistent CSF leaks. We present a simple technique that uses on-site muscle flap with pedicle to supply and vascularize the autologous fascia lata, preserving the viability of the graft and reenforcing its healing ability. ⋯ Duraplasty using autologous fascia lata reenforced by on-site pedicled muscle flap is an effective technique to control CSF leak, especially when dura is poorly vascularized and less viable. The unfortunate recurrence of CSF leak and reexploration in the seventh patient helped us to observe the effectively healed dural defect with profound early postoperative vascularization of the graft, supporting our idea about the effectiveness of this technique.
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Aspiration of a tooth in maxillofacial injuries is a known complication necessitating prompt recognition and early treatment to minimize potentially serious and, sometimes, even fatal consequences. Here, we report a rare and unusual case in its presentation, the patient having aspirated 2 permanent teeth after maxillofacial, cervical vertebrae, and thoracic region crush injuries due to a motor vehicle accident. ⋯ The paper also emphasizes that clinicians must be aware of dental injury resulting from maxillofacial injuries and account for all teeth as part of their evaluation, keeping an open mind as to where a missing tooth might be located. A rapid diagnosis depends on high clinical suspicion, clinical signs, and radiologic findings.