Fibro-osseous lesions associated with simple bone cysts: three case reports and review of the literature.

An uncommon association between simple bone cyst and fibro-osseous lesions has been reported in the Literature. Here we report three additional cases, including two related to florid cemento-osseous dysplasia and one with fibrous dysplasia. All patients were African-American women, with a mean age of 39.7 years. The treatment of choice for the simple bone cyst was curettage to cause bleeding into the empty cavity. After 18 months, there was a recurrence of the cyst associated with fibrous dysplasia and a second intervention was necessary. One patient has been lost to follow-up and the other patients are currently asymptomatic. In conclusion, we describe a rare association between simple bone cyst and fibro-osseous lesions. Knowledge of this association is important for correct diagnosis and patient approach.

Kirschner wire as a guide to secondary reconstruction of the deformities of the zygoma. A technical note.

Mistreated fractures of the zygomatic complex may result in facial enlargement, loss of zygomatic projection, increase of orbitary volume, diplopy, enophthalmy, neuropraxy of the infraorbitary nerve and limited mouth opening. Hence, the treatment of sequelae demands accurate planning, through approaches that evaluate the degree of the existing displacement, bone repositioning and the need of grafts. Surgery is difficult due to lack of anatomical references as guides for bone repositioning. Some techniques have been described in the literature as alternatives for evaluating the degree of bone displacement and necessary correction. We believe that a greater number of anatomical references may contribute to a better final result. The aim of this paper is to present a simple technique using three Kirschner wires as spacial parameters-guides that aid secondary reconstructions of fractures of the zygomatic complex. After osteotomy, it becomes possible to compare and transfer the measures of the non-affected bone for re-establishing an adequate anatomical position for the affected side. This approach is proposed as a useful tool for obtaining 3-D references, helping to obtain a better bone positioning.

Facial nerve paralysis following mandibular trauma: a case report.

A strong posteriorly directed force applied to the mandible resulting in fracture, can also displace the mandibular condyle towards the external auditory canal or superiorly against the mandibular fossa, causing its penetration into the middle cranial fossa or even the fracture of the temporal bone. We report the case of a 30-year-old male patient victim of a bicycle accident that developed facial expression muscles paralysis on the left side soon after the trauma. On physical examination he presented left side postauricular ecchymosis, diminished muscular tonus of the left mouth angle and difficulty to close the left eye, he did not present clinical signs of facial fractures. The neurological and CT scan examination revealed fracture of the left temporal bone with total facial expression muscles paralysis. The patient was referred to the neurosurgical team for evaluation and they opted for a conservative treatment. After 3 months the patient showed a marked improvement with almost normal facial expression muscle movements. The trauma dynamics and treatment details are discussed.