A rare case of maxillary nodular fasciitis: Case report and short literature review.

Nodular fasciitis has to be considered as an option in the presence of a solitary, rapidly growing mass even in older adults. When possible, direct surgery should be preferred to FNAC, particularly in the older adults because of high misdiagnostic risk.

Dermal Regeneration Templates in Maxillo-Facial District: A Multipurpose Aid.

ABSTRACT: Since 1980s, the use of dermal regeneration templates (DRT) for reconstructive purposes has been described in Literature.1 The authors present their experience of 13 patients treated with integra dermal regeneration template and a single-stage surgery for different indications like oncologic reconstruction, trauma injuries, and preprosthetic surgery in the maxillo-facial district.The authors retrospectively reviewed a total of 13 patients treated with DRT at Maxillo-Facial Department of S. Maria Hospital in Terni.Inclusion criteria included the presence of a defect nonapproachable primarily or by secondary intention with an easy locoregional flap reconstruction, a complete clinical record, and a minimum 6 months follow-up.A total of 12 patients underwent surgical reconstruction with DRT at the S. Maria Hospital from June 2018 to February 2020.During follow-up, all patients in which intraoral reconstruction was performed showed first signs of re-mucosization and neovascularization after 10 days.Only in 1 patient (8%) a seroma underneath the silicon sheet was observed. Afterward, the patient healed correctly with no other complications.Dermal regeneration template represents an option that should be considered in the head and neck district reconstruction, especially for intraoral defects where, thanks to its long-term functional results and limited alternatives, should represent a relevant choice.

Chondromatosis of the Temporomandibular Joint as a Consequence of Persistent Long-Lasting Joint Dysfunction: Late Diagnosis of a Rare Occurrence.

The authors present a rare patient of right synovial chondromatosis (SC) of the temporomandibular joint in which diagnosis was late and delay led to SC extension to the cranial base. Synovial chondromatosis is a rare benign disorder characterized by multiple cartilaginous free-floating nodules originated from the synovial membrane of large articular joints of the body. Differential diagnosis is with neoplasm and radical surgical removal is essential. The patient came to the authors' observation complaining about long-lasting temporomandibular joint dysfunction. The patient already underwent either functional or medical therapy in times without any improvement. Clinical examination showed limited mouth opening and swelling of the right preauricolar region with no signs of facial nerve palsy and without paresthesia or hearing loss. No history of recent trauma was recorded. Magnetic resonance imaging showed a mucous-like hyperintense mass with small hypointense spots inside. A preoperative computed tomography scan was performed and showed a mass extending from the superior aspect of the temporomandibular joint to the glenoid fossa, which was partially eroded. The patient underwent either open joint surgery or arthroscopy of the superior joint space and a large number of chondrocytes were removed. No complications were recorded postoperatively and the patient completely recovered after 6 months. Histology confirmed the diagnosis of synovial condromatosys of the right temporomandibular joint.

A rare case of parotid gland lipoma arising from the deep lobe of the parotid gland.

Lipomas are the most commonly encountered benign mesenchymal tumors, but their occurrence in the head and neck is rare, even more at the level of the parotid region where they can be found nearby the parotid capsule, inside the capsule, or within the gland. In addition, lipomas involving the deep parotid lobe are extremely unusual. That is why lipomas are not often considered for differential diagnosis of parotid lumps. Concerning diagnostic tools, magnetic resonance imaging (MRI) is nowadays considered as the main imaging examination for parotid lipomas due to a characteristic signal intensity on T1- and T2-weighted images. Furthermore, even if the cost of MRI is nearly three times that of computed tomography, MRI is accurate, safe, and has few biological costs for the patient. In this reported case, MRI provided all information for either diagnosis or preoperative planning being the best diagnostic tool regarding tumor margin characteristics and surrounding tissues' involvement. Concerning treatment, surgical excision of parotid masses is always mandatory for definitive diagnosis, but it is challenging because of the facial nerve. For this reason, a well-established surgical technique is mandatory for success. The authors present a rare case of parotid gland lipoma arising from the deep lobe and discuss diagnostic tools and surgical technique.