The Journal of craniofacial surgery
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A maxillary nerve block using external anatomic landmarks is a safe regional anesthesia for adults. However, the classic approach to the nerve may be difficult in infants. To use this block in infants, we describe the anatomical landmarks needed to reach the foramen rotundum area using the suprazygomatic route. ⋯ From the skin landmark, the direction of the trajectory was oriented 19.3 +/- 5.3 and 8.7 +/- 2.9 degrees forward. These distances and angles must be slightly adapted for infants younger than 6 months, although none of these parameters were correlated with age during the period studied. This anatomic study based on computed tomographic scan information may be useful for clinical application of the truncal maxillary nerve block in infants using the suprazygomatic route.
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A subperiostal abscess of the frontal bone as a complication of osteomyelitis, appearing as a puffy, indolent tumor of the forehead, was first described by Pott. This less-common complication of is known as Pott's Puffy tumor. The complications of Pott's Puffy tumor are preseptal and orbital cellulites by downward spread to the orbit and intracranial infection by posterior extension. We present a case of Pott's Puffy tumor complicated by intracranial infection imaged by means of multidetector computed tomography.
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Pott's Puffy tumor is a rare clinical entity characterized by subperiosteal abscess associated with osteomyelitis. It is usually seen as a complication of frontal sinusitis or trauma predominantly in the adolescent age group. ⋯ An apparently healthy 7-year-old girl presented to the emergency service of otolaryngology with complaints of swelling of forehead and periorbital zone, headache, chills, fever, and rhinorrhea. The patient described in this case report had 2 important complications of paranasal sinus disease: the relatively common complication of postseptal cellulites and the less common complication of Pott's Puffy tumor.
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The objective was to study the relationships among the optic nerve, posterior paranasal sinuses, and ophthalmic artery. The identification of reliable anatomic landmarks would provide an endoscopic anatomic basis for optic nerve localization and effective prevention of ophthalmic artery injury during transsphenoidal optic nerve decompression surgery. The Messerklinger technique was performed to open the posterior ethmoid sinus and sphenoid sinus in 8 adult-head specimens. ⋯ It can be used as the anatomic landmark of choice in endoscopic optic nerve decompression. The origin of the ophthalmic artery is inferomedial to the optic nerve, and thereafter, it courses inferolaterally. An intersecting relationship exists along its course, a factor that must be taken into account during surgery to avoid injuring the ophthalmic artery.
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Squamous cell carcinoma accounts for approximately 90% of oral malignancies. This study was performed to determine the prevalence of oral squamous cell carcinoma (OSCC) in southern Iran in relation to sex, age, subsite distribution, and histologic differentiation of the tumor. Pathologic records of patients with a histologic diagnosis of OSCC at Fars Cancer Registry of Nemazee Hospital affiliated to Shiraz University of Medical Sciences during the period of April 1992 through March 2007 were reviewed. ⋯ The tongue was the most commonly affected site (53%), followed by the buccal mucosa (9.5%) and maxillary gingiva (9%). The well-differentiated type (55.5%) was the most common, with the poorly differentiated OSCC being the least common (7.5%). The present study showed that OSCC was the most common malignancy in the tongue and buccal mucosa being more common in older age and male sex.