ABSTRACT
A child with severe Crouzon's disease had a markedly retruded forehead with exorbitism, which was treated by radical forehead advancement. At a subsequent operation, the maxillary hypoplasia was corrected by a Le Fort III osteotomy and face advancement.
Subject(s)
Craniofacial Dysostosis/surgery , Facial Bones/surgery , Child, Preschool , Forehead , Humans , Male , Orbit/surgery , Osteotomy/methodsABSTRACT
Crouzon's disease results in maxillary hypoplasia and a receding forehead, which produce characteristic exorbitism. Total correction of the deformity by Le Fort III osteotomy and face advancement with a simultaneous forehead advancement corrects all the deformities. The advantages and disadvantages of this major craniofacial procedure are discussed after 2 case descriptions.
Subject(s)
Craniofacial Dysostosis/surgery , Skull/surgery , Surgery, Plastic/methods , Child , Child, Preschool , Facial Bones/surgery , Female , Frontal Bone/surgery , Humans , Male , Methods , OsteotomyABSTRACT
Trauma to the orbital region may result in fractures of the bony orbit, displacement of which gives rise to malposition of the eye and diplopia. If initial treatment is not feasible or is unsuccessful, later correction may be achieved by osteotomy or reduction and stabilisation of the bony fragments, often with bone grafts. Displaced medial or lateral canthi may need to be repositioned, where feasible in an overcorrected position. Where bone grafts are necessary, the skull is now favoured as the best donor site.
Subject(s)
Orbital Fractures/surgery , Skull Fractures/surgery , Surgery, Plastic/methods , Adult , Child , Female , Humans , Male , Time FactorsABSTRACT
The Pietermaritzburg Craniofacial Unit was established in 1976, and since its inception 150 patients with major skull and facial deformities have been referred there from centres throughout South Africa. Fifty craniofacial operations have been performed by the surgeons of the Unit, who form only a part of a team of 16 members from many branches of the medical, dental and allied professions. Craniofacial surgery is defined and reasons are presented for limiting the number of such highly specialized units.
Subject(s)
Face/surgery , Hospital Units , Patient Care Team/organization & administration , Skull/surgery , Specialties, Surgical , Surgery, Plastic , Humans , South AfricaABSTRACT
A prospective study of 79 fit young adults who underwent oral dental surgery was undertaken with five different anaesthetic techniques. Anaesthesia was commenced with methohexitone or flunitrazepam, muscle relaxants, and cuffed nasal intubation, and anaesthesia was maintained with 50% nitrous oxide, 50% oxygen, halothane or fentanyl with or without intermittent positive pressure ventilation (IPPV). Six of the 33 patients who received methohexitone and halothane developed dangerous dysrhythmias. Flunitrazepam, IPPV, adequate analgesia and anaesthesia provide maximum cardiovascular stability.
Subject(s)
Anesthesia, Dental , Anesthesia, General , Arrhythmias, Cardiac/chemically induced , Heart Rate/drug effects , Adult , Anesthesia, Dental/methods , Anesthesia, General/methods , Blood Pressure/drug effects , Carbon Dioxide , Female , Fentanyl/pharmacology , Flunitrazepam/pharmacology , Halothane/pharmacology , Humans , Intermittent Positive-Pressure Ventilation , Male , Methohexital/pharmacology , Pancuronium/pharmacology , Stimulation, Chemical , Succinylcholine/pharmacology , Tooth Extraction/methodsABSTRACT
A new case of primary oral Kaposi's sarcoma associated with immunosuppressive therapy is presented. The literature related to oral Kaposi's sarcoma is reviewed, and the pathogenesis of this condition is briefly discussed. There is a possiblity that early lesions of Kaposi's sarcoma may be misadiagnosed clinically and histopathologically as simple pyogenic granulomas.
