Tratamento conservador de osteomielite em mandibula: relato de caso / Conservative treatment osteomyelitis in jaw: case report / Tratamiento conservador de osteomielita en mandible: reporte de caso

Introdução: As infecções nos ossos de face podem acometer os maxilares, geralmente a mandíbula, apresentando diversos fatores etiológicos, além de seu potencial multibacteriano. Embora tratamentos mais radicais possam ser uma escolha preferencial, meios conservadores podem surgir como alternativa afim de evitar tratamento mais agressivo aos pacientes. Relato de caso: Paciente do sexo feminino, 17 anos de idade, vítima de acidente náutico foi submetido a tratamento cirúrgico para osteossíntese de fratura complexa de mandíbula e após um período de 30 dias houve evolução de um quadro de osteomielite em região mandibular no qual foi preconizado tratamento conservador com antibioticoterapia e orientações de restrição de dieta líquida e pastosa. No período de proservação de 06 meses observou se melhora e regressão considerável do quadro infeccioso onde houve continuidade do acompanhamento de 01 ano sem sinais sugestivos de recidiva. Considerações Finais: O tratamento conservador deve ser considerado como importante alternativa nos casos de osteomielite nas complicações pós-operatórias de fixação de fraturas do complexo maxilo-mandibular... (AU)

Introduction: Infections is commonly affect in jaws and usually the mandibular bone present several etiological factors and in addition to their multibacterial potential. Although radical treatments may be preferred choices another treatments can be emerge as a new way to prevent treatment from becoming more aggressive to pacients. Case Report: A 17-year-old female patient victim of a nautical accident, underwent surgery treatment for complex fracture osteosynthesis and after a while appear osteomyelitis in mandibular bone in which conservative treatment was recommended with antibiotherapy and guidelines for restricting liquid and pasty diet. During 06 months improvement and considerable regression of the infect condition was observed with 01 year of preservation without signs of reccurrence. Final considerations: Conservative treatment should be considered na important alternative in cases of osteomyelitis in post operative complications of fixation of fractures in jaws... (AU)

Las infecciones en los huesos faciales pueden afectar el maxilar, generalmente la mandíbula, presentando varios factores etiológicos, además de su potencial multibacteriano. Aunque los tratamientos más radicales pueden ser una opción preferida, los medios conservadores pueden surgir como una alternativa para evitar un tratamiento más agresivo para los pacientes Caso clínico: Paciente de sexo femenino de 17 años, víctima de accidente náutico, sometida a tratamiento quirúrgico por osteosíntesis de una fractura compleja de mandíbula y al cabo de 30 días evolucionó una osteomielitis en la región mandibular en la que se Fue un tratamiento conservador con antibioticoterapia y se recomendaron pautas para restringir las dietas líquidas y pastosas. En el período de seguimiento de 06 meses, hubo una mejoría considerable y regresión de la condición infecciosa, donde hubo una continuación del seguimiento de 01 año sin signos sugestivos de recurrencia. Consideraciones finales: El tratamiento conservador debe considerarse como una alternativa importante en casos de osteomielitis en complicaciones postoperatorias de fijación de fracturas del complejo maxilomandibular... (AU)

The Successful Reduction of an Anterior Maxillary Fracture with Foley Catheter and Real-Time Ultrasonography / 대한이비인후과학회지

Maxillary fractures are common traumas in facial lesions, frequently involving the thin bony anterior wall. Minimally invasive operations have been tried in these maxillofacial areas; for example, the Foley balloon inflation technique guided by nasal endoscopy in orbital blow-out fractures have been recently reported with a high success rate. However, in maxillary anterior wall fractures, these minimally invasive surgical procedures have seldom been reported. This report presents the case of a 24-year-old man with an anterior maxillary wall fracture. The fracture was treated with a minimally invasive method that uses an endoscopic approach to the maxillary antrum with a Foley catheter ballooning, which was monitored by real-time ultrasonography. This report presents the imaging studies and a description of the endoscopic procedure.

Effective Reduction of the Frontal Process of the Maxillary Fracture Segment Using Intermaxillary Fixation Screw

PURPOSE: It is relatively unusual that infraorbital rim fracture is accompanied by nasal bone fracture. In order to correct effectively, subciliary approach and intranasal manipulation are applied simultaneously. But if reduction is not successful, intranasal manipulation may become aggressive and this often causes complications. We introduce a method using intermaxillary fixation screws for decreasing such complications and effective reduction of fracture. METHODS: Total seven patients with fracture of frontal process of maxilla were treated with this method. The fracture site was exposed through the subciliary approach, and one or two screws were inserted into the displaced fracture fragment. During the traction of the screws using the wire, the fracture fragment was pushed upward from the intranasal side using an elevator supplementarily and fixed with a plate and the screws. RESULTS: In all patients, the fracture fragment was reduced successfully and no complication occurred during one year's postoperative follow-up. CONCLUSION: When reduction cannot be attained through a bone hook or an elevator alone, reduction of fracture fragment can be done easily using intermaxillary fixation screws. This method is less likely to cause a mucosal injury because intranasal manipulation is not aggressive. Furthermore, as the screw can be inserted and removed easily, this method is considered effective not only for fracture of frontal process of maxilla but also for fractures in other regions.

Maxillary and/or mandible fractures: Retrospective clinical analysis of 39 cases / 医学研究生学报

Objective: Maxillary and mandible fractures are severe intermaxillary injuries,frequently involving other vital organs,and usually difficult to be treated.This study discusses the treatment of maxillary and mandible fractures.Methods: We retrospectively analyzed the clinical data of 39 cases of maxillary fractures and/or mandible fractures.Results: Of the 39 cases,34 males,5 females and 84.64% aged from 20 to 50,87.17% were caused by vehicle accidents,and 94.87% were accompanied by injuries of other parts of the body.After surgical treatment,78.95% gained normal or basically normal ocular esthetic results and 68% achieved good or improved facial esthetic results.Conclusion: The results of treatment are closely related with the type and severity of fracture and the time and plan of treatment.Preoperative CT scanning and facial profile three-dimensional reconstruction are necessitated for a thorough evaluation of the fractures and an analysis of the causes and extent of facial and ocular changes.The best treatment plan for maxillary and/or mandible fractures would include anatomic reduction by surgery,intermaxillary elastic traction and rigid internal fixation with the Ti plate.