Evaluation of oral and maxillofacial swellings using ultrasonographic features

PURPOSE: The aim of this study was to evaluate the characteristic features of oral and maxillofacial swellings that could be seen on ultrasonographic examinations. MATERIALS AND METHODS: Fifty patients with oral and/or maxillofacial swellings were randomly selected, thorough case histories and clinical examinations were done, ultrasonographic examinations with Doppler imaging were performed, and the features of every group were studied. Finally, histopathological evaluations were performed to identify the final diagnosis, according to which patients were classified into 5 groups; group I: inflammatory/space infection and abscess swellings, group II: cystic swellings, group III: lymph node swellings, group IV: benign swellings, and group V: malignant neoplastic swellings. RESULTS: A significant association (P<0.05), with a contingency coefficient of 0.88, was found between the histopathological and ultrasonographic diagnoses, with ultrasonography having a diagnostic accuracy of 89% in diagnosing maxillofacial swellings. The diagnostic accuracy of ultrasonography was 100% for lymph node and malignant swellings, followed by 98% for inflammatory and cystic swellings and 92% for benign swellings. The sensitivity of the ultrasonographic diagnosis was 100% for cystic, lymph node, and malignant swellings, followed by 91% for inflammatory swellings and 86% for benign swellings. CONCLUSION: Ultrasonographic features with Doppler imaging greatly aid in obtaining accurate diagnoses of oral and maxillofacial swellings. Ultrasonography is a recommended imaging tool for differentiating maxillofacial swellings and classifying them accurately.

Improvement of Domperidone Solubility and Dissolution Rate by Dispersion in Various Hydrophilic Carriers.

The aim of this work was to improve the solubility and dissolution rate of poorly-soluble, weakly-basic, anti-emetic drug; domperidone (DMP) using solid dispersion technique. Solubility studies of DMP with various hydrophilic carriers including sorbitol, mannitol, PEG 4000, PEG 6000, pluronic F-68 and pluronic F-127 were performed. Pluronic F-68 and pluronic F-127 showed the highest solubilizing effect on DMP and therefore; they were selected for the preparation of solid dispersions in different weight ratios by the fusion method. The solid dispersions were characterized using Fourier-transform infrared spectroscopy (FT-IR), Differential Scanning Calorimetry (DSC), Powder X-ray Diffractometry (P-XRD), solubility determination and in-vitro dissolution rate studies. FT-IR and DSC studies confirmed the absence of incompatibilities between DMP and the used carriers. DSC and P-XRD studies proved the transformation of drug from crystalline to amorphous state in the prepared solid dispersions. The results showed marked improvement of DMP solubility and dissolution rate from the solid dispersions compared with the pure drug and indicated the superiority of solid dispersions prepared with pluronic F-68 over those prepared with pluronic F-127. It can be concluded that solid dispersion technique was an effective tool in the enhancement of DMP dissolution.

Ultrasonography and computed tomography in patients with crystal induced arthropathy

To assess the different ultrasonography [US] and computed tomography [CT] findings in patients with crystal induced arthropathy. A total of 45 patients; 27 male and 18 female with joint effusion are enrolled in the study in the period between May 2008 to November 2012 by the cooperation of the Radiology and Rheumatology and Rehabilitation Departments, Sohag University Hospital All patients subjected to physical examination, ultrasonography; computed tomography; joint aspiration and analysis of aspirated fluid. Ages of the patients were between 40-73 years. Thirty sixth patients were proven to have crystals fluid analysis. About 90% of them diagnosed by CT and 86% diagnosed by US. Different types of calcification were found In 88% f patients. US show double contour sign in about14% of patients with MSU. Synovial hypertrophy was observed in about 28% of patients. Erosion was diagnosed better by CT than US and found in 80%." of patients. Uneven joint space was seen in 22% of patients. US and CT are very important in assessment of patients with crystal induced arthropathy

Cranioplasty: successful use of rib grafts

Background: numerous materials are available for use in Cranioplasty including bone, ceramics and metals. Rib graft as a construct for cranial reconstruction offers several advantages including autologous bone source, a formable platform, low infection rate, regeneration at the donor site and high fusion rates

Aim of the work: the present series aims to clinical evaluation of the use of rib grafts in Cranioplasty

Patients and methods: rib autograft Cranioplasty was performed in 15 patients. 12of them were males and 3 were females. The mean age was 18 years. When single rib needed, it has been harvested from the 5th rib and when two ribs needed, they were f harvested from the 4th and 6th ribs. 20 ribs were totally harvested

Results: the reasons for cranial reconstruction were: post traumatic calvarial defects [73.6%]. Previous craniotomy [13.2%], congenital defect [6.6%] and fibrous dysplasia resection [6.6%]. The size of the defects ranged between 15 and 84cm2. The mean follow up period was 16 months post-operatively. Normal cranial contour was achieved in all patients. One patient developed CSF leak that resolved spontaneously No donor site complications were noted [Pneumothorax, haemothorax post-operative pain no post-operative infections were encountered and graft resorption was not noticed in all patients

Conclusion: the use of autologous rib graft for cranioplasty,particularly in young age group was found to have low cost effectiveness, easily harvested, easily moulded to the skull shape, osteointegrated adequately with the surrounding bone thus offers good brain protection and is associated with low complication rate

Open rhinoplasty: versatility of the technique

Aim: to study the advantages of application of external technique in the different rhinoplasty procedures

Methods: 200 Patients were subjected to open rhinoplasty technique. The indications were; combined nasal and septal deformity, broad nasal tip, low nasal tip, saddle nose deformity, bifid nasal tip and cleft lip nose deformity. The different procedures performed in this study were; sept rhinoplasty, narrowing of the nasal tip, augmentation rhinoplasty, lengthening of the columella and insertion of columellar strut

Results: the good exposure allowed in open approach made the surgical procedures performed under direct vision. None of the patients developed wound dehiscence or tip necrosis. No patient developed hypertrophic scar or need scar revision. There were no considerable reported complications related to this external approach and the results were satisfactory

Conclusion: the open rhinoplasty technique is a versatile approach for variety of rhino plastic procedures as: severely deformed nasal bones, severe septal deviation saddle nose deformity, deformed nasal tip and congenital nasal tip deformity. Also, it is a simple, reliable and rapid technique for gaining access to both nasal architecture and soft tissue of the nose without significate cosmetic or surgical risk

Brown tumors of hyperparathyroidism [BTHPT]. Experience with fifteen patients

Brown tumors of hyperparathyroidism [BTHPT] are non neoplastic lesions. They may be associated with primary, secondary or tertiary hyperparathyroidism. However it occurs far more common with the primary one. The maximum reported cases in the literature were three cases, but we have encountered 15 patients in the last 8 years. All these cases were associated with primary hyperparathyroidism due to parathyroid adenomas in 14 cases and parathyroid carcinoma in one case. All the adenomas were excised after proper pre-operative localization. Ten were found in the neck and live were found in the superior mediastinum. The intraoral tumor like lesions were not touched and regressed in size till completely disappeared within 6 -18 months post operatively. One patient underwent surgical excision of the disfiguring upper jaw swelling that was also interfering with mouth opening, chewing and swallowing. The clinical presentations of the cases, the preoperative methods of localization, the surgery done and the follow up [i.e. the change in tumor size and the blood chemistry] are presented and discussed

Antegrade intramedullary interlocking nailing versus plating for the treatment of humeral shaft fractures

This prospective r and omized study included 46 humeral shaft fractures managed by antegrade intramedullary interlocking nail [Group I] and compression plate [Group II] with 23 patients in each group. The mean age was 35.6 years in group I and 33.8 years in group II [p>0.05]. The mean blood loss was 145 ml in group I while it was 437 ml in group II [p<0.05]. The mean operative time was 66.7 minutes for group I and 88.2 minutes for group II [p<0.05]. the average time of union was 14.9 weeks for group I and 15.2 weeks for group II [p>0.05]. The UCLA shoulder rating scale was used for assessment of the shoulder function. In group I four patients had excellent results, 13 patients had good results and six patients had fair results, while in group II, 18 patients had excellent results and five patients had good results. The modified rating system of Morrey et al. was used for assessment of the elbow function. All patients in group I had excellent results while in group II 17 patients had excellent results and seven patients had good results