Direct access to a frontal sinus osteoma and reconstruction of the orbital roof displaced by the lesion by titanium mesh

Osteomas are the most common benign tumors of the paranasal sinuses. They are usually localized in the frontal sinus and less often in the other paranasal sinuses. In this article, we report the surgical treatment of an unknown frontal sinus osteoma discovered after an acute exophthalmos. We have chosen an external approach to obtain a radical excision of the tumor, but we prefer a direct frontal incision following a horizontal wrinkle to the classic bicoronal flap to avoid an unsightly scar because of patient's hair loss. We discuss the surgical approach, the reconstruction of the roof of the orbit involved, and patient's satisfaction.     

Diagnosis and treatment of orbit posttraumatic subperiosteal hemorrhage in a child, associated with a subdural intracranial hemorrhage

We describe a rare case of traumatic subperiosteal orbital hematoma in a child, with intracranial hemorrhagic complication. Subperiosteal hematoma are the more infrequent occurrences among intraorbital hemorrhagic lesions and can be also associated with intracranial extradural hematoma in patients with orbital roof fracture. Here, we describe a case without roof fracture but with a never-before described intracranial subdural hematoma. The patient underwent computed tomography and magnetic resonance imaging, in an acute state, and later, a radiologic diagnosis of percutaneous drainage of the hematoma was mad. MRI was more sensitive and specific in the evaluation of the intracranial and intraorbital complication.     

Plasma rich in growth factors (PRGF) for the promotion of bone cell proliferation and tissue regeneration

Objectives

Over the past few years, studies about growth factors have been increasingly developed and the knowledge of their role in stimulating cell proliferation and differentiation used for therapeutic purposes. This study aims to compare a platelets concentrate, the plasma rich in growth factors (PRGF) to a control, consisting of cellulose membranes, to evaluate in vitro the cellular adhesion and migration of human osteoblasts (hOb) and understand if the use of platelets concentrates could be an advantage in view of bone tissue regeneration.

Study design

Twenty-seven human donors provided 27 blood samples used to make 54 samples: 27 for PRGF and 27 for the control group. PRGFs and controls were incubated for 48 h in sterility in 1 ml of culture with 10⁵ hOb and hOb in the scaffolds were then quantified.

Results

In PRGF samples, hObs were more numerous than in controls. (T?=?6.6964, p?<?0.0001).

Conclusions

Human osteoblasts are driven to colonize PRGFs with a greater efficacy than negative controls, probably due to the presence of chemokines and growth factors in PRGFs.

     

Non-familial hemiplegic migraine responsive to naloxone

Two cases of non-familial hemiplegic migraine are described. Naloxone reversed the neurological deficits accompanying attacks, whereas the pain was uninfluenced. The possibility that the opiate-antagonist naloxone facilitates regression of neurological symptoms associated with migraine attacks in general is voiced.     

Gardner syndrome: presurgical planning and surgical management of craniomaxillofacial osteomas

Gardner syndrome, a variant of familial adenomatous polyposis, is an autosomal dominant genetic disease characterized by the combined presence of multiple intestinal polyps and extraintestinal manifestations. The extraintestinal manifestations include multiple osteomas, connective tissue tumors, thyroid carcinomas, and hypertrophy of the pigmented epithelium of the retina. Osteoma is a benign neoplasm of bone tissue characterized by slow continuous growth that usually affects the long bones and cranial bones and is a major symptom for Gardner syndrome. The authors report the extraintestinal lesions affecting the maxillofacial regions in 2 male patients (father and son) with Gardner syndrome. The presurgical planning and surgical management of these lesions are described.     

Hemangiopericytoma of the infratemporal fossa: progression toward malignancy in a 30-year history

Hemangiopericytoma is a rare vascular tumor first described by Stout and Murray in 1942 and characterized by a proliferation of Zimmermann's pericytes, smooth muscle cells arranged around blood vessels. This tumor presents as a slowly enlarging painless mass. Diagnosis with certainty is often a difficult one because of the close likeness with other spindle cell tumors; it requires the help of immunohistochemical techniques and sometimes ultrastructural techniques. Only 15% of hemangiopericytomas are localized in the cervicofacial region; in particular, occurrence in the infratemporal fossa is an exceptional occurrence. In this article, we report an unusual case of recidivate hemangiopericytoma of the infratemporal fossa that has progressively assumed features of malignancy over 30 years. The hemangiopericytoma relapse potentiality is elevated, even when the histologic characteristics of the tumor indicate a low aggressivity, and therefore every hemangiopericytoma must be considered to have malignant potential. In conclusion, the unpredictable behavior of hemangiopericytoma requires a radical primary treatment to avoid the risk of relapses that always are frequent and aggressive.     

The “European zygomatic fracture” research project: The epidemiological results from a multicenter European collaboration

Purpose

Fractures of the zygomaticomaxillary complex (ZMC) are common injuries that may lead to loss of an aesthetically pleasing appearance and functional impairment. The aim of this study was to analyze the demographics, causes, characteristics, and outcomes of zygomatic fractures managed at several European departments of oral and maxillofacial surgery.