The fixation of malar fractures with the transnasal Kirschner wire.

Our experience with a rapid and reliable method for the repair of selected unstable malar fractures using external pin fixation is reported. Following reduction through a Gillies temporal incision, a Kirschner wire is introduced on the contralateral side, advanced through the nasal vault and septum and the reduced malar bone is engaged. This method of immobilization can be used in isolated malar fractures or in conjunction with the repair of other facial injuries. In 38 patients where this procedure was utilized, there was low morbidity as well as excellent cosmetic and functional results. The advantages of this technique as well as a comparison with other available methods of malar fixation are discussed.

The transoral treatment of mandibular fractures using noncompression miniplates: a prospective study.

A prospective study was performed to evaluate the efficacy of noncompression miniplates in the repair of mandible fractures treated at a large regional trauma center. The study included 54 cases of all types of adult mandible fractures with the exception of fractures of the condylar neck and ascending ramus. Cases were excluded in which preexisting infection was present. The technique consisted of a transoral approach followed by monocortical juxtaalveolar and subapical osteosynthesis without long-term intermaxillary fixation. Overall, there were 7 complications associated with this technique (13%): 4 infections (7.4%), 1 malunion (1.9%), and 2 mental nerve paresthesias (3.7%). These results compare favorably with those reported in the literature and suggest that mandibular osteosynthesis using miniature malleable plates is a useful and effective method for the repair of selected mandible fractures.

Long-term evaluation of human teeth after Le Fort I osteotomy: a histologic and developmental study.

Transient pulpal vascular ischemia and direct injury to the apices of the teeth have been implicated as the causes of degenerative and atrophic pulpal changes in experimental animals after Le Fort I osteotomy despite the presence of collateral circulation. The long-term clinical effect of these pathologic changes in human teeth has not been studied. Seventeen maxillary third molar teeth from 10 patients whose postsurgical follow-up ranged from 6 months to 78 months (mean, 40 months) were extracted. The long-term biologic effects of Le Fort I osteotomy on the pulp and on the development of teeth were retrospectively evaluated with clinical and standard histologic techniques. Normal teeth from patients who were not operated on were used as controls. Histologic examination revealed an intact pulpal circulation and minimal pathologic changes in the pulpal tissue. Clinical and radiographic studies showed that the growing teeth developed normally after surgery. The Le Fort I downfracture procedure had little discernible long-term effect on the pulp and on the development of human third molar teeth.

Juvenile nasopharyngeal angiofibroma presenting as a facial swelling. A case report.

Juvenile nasopharyngeal angiofibroma is a rare benign neoplasm occurring almost exclusively in adolescent males. When it is confined to the nasopharynx, surgery is often curative. In 20% of cases, there is intracranial extension, and radiotherapy may be used to avoid the risk of life-threatening haemorrhage. The authors report an unusual case which presented with a swelling of the cheek and an abducens nerve palsy. The lesion extended from the nasopharynx across the pterygomaxillary fissure, as well as intracranially. Radiotherapy was given, and the patient remains disease-free after one year.

Histologic evaluation of purified bovine tendon collagen sponge in tooth extraction sites in dogs.

This study presents a histologic evaluation of the healing process of dental extraction sites in dogs with and without the use of collagen sponge as an extraction site dressing. The healing process was evaluated at 3 days, 1 week, and 6 months after tooth extraction and appears comparable in both collagen-filled and nonfilled extraction sites.