Use of a Questionnaire for Evaluation of Surgical Treatment of Masseter Muscle Hypertrophy: A Case Report.

Masseter hypertrophy (MH) is an uncommon natural condition that affects the facial contour. The etiology is debatable, and complaints are usually cosmetic in nature. The diagnosis is essentially clinical and aided by imaging tests. Treatment is still controversial. The literature is relatively scarce in relation to information on MH, particularly in the evaluation of outcomes. Through questionnaires, the progress was observed in the evaluation of the outcomes of aesthetic procedures. Thus, the purpose of this paper is to apply a Facelift Outcome Evaluation (FOE) questionnaire to evaluate the outcomes of surgical treatment in a case of MH. A 23-year-old male presented to the clinic complaining of bullying due to his facial aesthetics. Clinical and imaging evaluation was performed, with the creation of surgical guides. The patient answered the FOE questionnaire pre- and postoperatively, with results of 12.5 and 100.00 respectively. This subjectively shows the success of the treatment. We suggest that a questionnaire applied exclusively to masseter hypertrophy should be developed, as well as studies for the development of muscle volume measurement protocols, aiming at a more specific evaluation of the surgical outcomes.

Epidermoid cyst of the tonge: two new cases of an extremely uncommon entity / Quiste epidermoide de la lengua: dos nuevos casos de una entidad extremadamente infrecuente

El quiste epidermoide (QE) es una lesión benigna que emerge como un aumento indoloro y fluctuante del volumen. Es una lesión rara en la cavidad oral y su diagnóstico a través de exámenes clínicos y radiografía convencional proporciona resultados limitados. Por lo tanto, el propósito del presente trabajo es reportar dos casos de lesiones raras de la lengua diagnosticadas como QE en dos pacientes adultos tratados quirúrgicamente. Un hombre de 65 años y una mujer de 40 años se quejaban de una “bolita” en la lengua. Los pacientes presentaron lesiones en la lengua en sitios anatómicos con distintas presentaciones clínicas. El tratamiento adoptado fue una resección de la lesión y, tras un análisis histopatológico, el diagnóstico final apuntó a un quiste epidermoide. En los casos actuales, la lesión ocurrió en el vientre y el dorso de la lengua, y ambos fueron tratados quirúrgicamente. Así, se convirtieron en los casos 14 y 15 de QE en lenguas encontradas en la literatura, confirmando así la relevancia del trabajo actual. (AU)

Epidermoid cyst (EC) is a benign lesion that emerges as a painless and fluctuating increase of volume. EC is a rare injury in the oral cavity and its diagnostic through clinical exams and conventional radiography provides limited results. Thus, the purpose of the current work is to report two cases of rare tongue lesions diagnosed as EC in two adult patients treated surgically. A 65-year old man and a 40-year old woman were complaining of a “little ball” in their tongue. The patients presented tongue lesions in anatomical sites with distinct clinical presentations. The adopted treatment was a resection of the lesion and, after a histopathological analysis, the final diagnostic pointed to an epidermoid cyst. In the current cases, the lesion occurred in the belly and dorsum of the tongue, and both were treated surgically. And so they became the 14th and 15th cases of EC in tongues found in the literature, thus confirming the relevance of the current work. (AU)

Ranula in children: Retrospective study of 25 years and literature review of the plunging variable.

OBJECTIVE: The aim of this article was to conduct a 25-year retrospective study within an oral surgery department, on the incidence of the ranula in children and its ideal treatment, associated with a literature review on the plunging ranula in pediatrics. METHODS: A retrospective review of the medical records of pediatric patients (0-12 years) from 1995 to 2020 was performed in an oral surgery department in Maringá/Brazil. The examined data included age of the patients, sex, clinical signs, time of evolution and follow-up, complementary exams, type of ranula, diagnostic hypothesis, surgical procedures and accesses, complications and recurrence. In addition, a literature review was carried out on the plunging ranula in children, using the MEDLINE database, from 1995 to 2020, with the search terms: "PLUNGING RANULA" OR "CERVICAL RANULA. A PICOS was established and PRISMA standards were followed. RESULTS: In the retrospective study, of the 11 patients found, 10 were with simple ranulas and only 1 with plunging ranula. All patients were approached by intraoral access, and conservative treatments had higher recurrence rates. The case of plunging ranula was treated by intraoral resection of the sublingual gland and saliva drainage, and obtained good results with 15 years of follow-up. In the literature review, 372 articles were found, which 10 were qualitatively selected after inclusion and exclusion criteria. Excision of the sublingual gland was the most prevalent procedure, and intraoral and extraoral accesses had the same incidence, despite the fact that the last one had higher percentages of complications. CONCLUSION: The treatment of ranulas is variable; however, it is proven that conservative methods have higher rates of recurrence. As for the plunging ranula, resection of the sublingual gland through intraoral access, associated with mucus leakage, is considered a safe and effective treatment.

Clinical Approach to External Cervical Resorption in the Anterior Teeth: A Case Report Study.

External cervical resorption (ECR) is a pathology that is difficult to diagnose early, and because it is often confused with root decay, it can be treated inadequately and even result in tooth loss. Currently, treatment does not have a defined protocol, being widely varied in the literature. This article proposes that cases of ECR should be treated individually, following different criteria, based on aspects related to the patient and the tooth involved. Furthermore, this work illustrates, through a case report, how a patient can present unique characteristics that require treatment to be case-dependent and should be discussed among a multidisciplinary team.

How does bimaxillary orthognathic surgery change dimensions of maxillary sinuses and pharyngeal airway space?

OBJECTIVES: To assess changes in the maxillary sinus (MS) and pharyngeal airway space (PAS) after bimaxillary orthognathic surgery using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The CBCT scans of 48 patients were divided into two groups: group 1: maxillary advancement and mandibular setback (n = 24); group 2: maxillomandibular advancement (n = 24). The CBCTs were acquired 1 to 2 months preoperatively and 6 to 8 months postoperatively. A kappa test was used to determine intra- and interexaminer agreement. Area, volume, and linear measurements of MSs and PASs obtained before and after surgery were compared using a mixed model (P < .05). RESULTS: All variables of the MS showed significant postsurgical reductions in both groups, except the MS length, which showed a significant increase in group 2. Volume and minimum axial area of PAS showed statistically significant postsurgical increases in both groups (P < .05). CONCLUSIONS: Despite the reduction in the MS and the increase in the PAS, results indicated that the airway was not negatively affected after maxillomandibular advancement and maxillary advancement with mandibular setback.

Temporal Muscle Flap as a Treatment of an Extensive Cleft Palate in an Adult Patient.

For the management of cleft palate, the surgical approach has been suggested at an early stage even in childhood, varying in the number of interventions. Once the interventions are not performed at appropriate times, such as sequences that may accompany specific psychological, functional, and aesthetic effects. Since it has been indicated, temporal muscle flap is a technique with satisfactory results for a resolution of extensive clef palate in adult patients. The purpose of this paper is reporting a case of temporal muscle flap in the soft and hard palate of an adult with a reconstruction of the donor area with a titanium mesh. A 37 year old male patient with cleft lip/palate, complained of difficulty in speech, chewing, swallowing, and breathing. Clinically, it was observed oroantral communication in the region of the hard and soft palate, with a previous cheiloplasty. A temporal rotation was planned to close the fissure for the treatment. The modified coronal approach was used. Temporal muscle traction and its interposition in the palate region were performed through the tunneling technique, and mass suturing was performed. After 3 years, he presented satisfactory results, with the improvement of the quality of life, as well as the area of exposure. In conclusion, since it has been indicated, temporal muscle flap is a technique with satisfactory results for a resolution of extensive cleft palate in adult patients.

The Role of Computed Tomography in Zygomatic Bone Fracture - A Case Report.

INTRODUCTION: The zygomatic complex is integral to the facial contour, protection of the eye and other facial structures, and dental occlusion. Its importance in facial function and aesthetics requires high quality outcomes of the treatment. CASE PRESENTATION: This paper reports the case of a 46-year-old man who had an occupational accident resulting in extensive facial trauma and zygomatic fractures. The patient presented with hyposphagma, palpable step in the area of the infraorbital rim, paresthesia of the right infraorbital nerve, flattening of zygomatic prominence, abrasion of the chin and nose, a 7-cm laceration in the midface region, ecchymosis in the palate, and alteration in the dental occlusion without limitation of mouth opening. Computed tomography (CT) confirmed the zygomatic complex fractures. The treatment was reduction and fixation with plates and screws. CT was used throughout the treatment period as an essential diagnostic tool for accurate fracture assessment and classification, formulation of the surgical plan, and postoperative evaluation. CONCLUSION: This case study illustrated the correct use of CT for improved and efficient treatment of traumatic injury of the zygoma, an anatomical area where restoration of function and aesthetics is challenging. The patient signed a written informed consent statement for publication.