Management of Ludwig's Angina in Pregnancy: A Review of 10 Cases.

BACKGROUND: Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. AIM: The present paper reviews the management of Ludwig's angina in the third trimester of pregnancy. The inherent dangers to the mother and her unborn child are highlighted. MATERIALS AND METHODS: The case files of pregnant patients who had emergent incision and drainage for life-threatening facial cellulitis at the maxillofacial unit of the Murtala Mohammed Specialist Hospital in Kano, Nigeria, over a 2 year period were retrieved and demographic and clinical characteristics were retrospectively obtained and analyzed descriptively using the statistical package for social sciences (SPSS version 13.0, for Windows, September 2004, Chicago, Illinois). Comparative statistics were determined using Pearson's Chi-square, Fisher's exact tests and independent t tests as appropriate. A P value of less than 0.05 was considered significant. RESULTS: A total of 10 patients were seen within the study period, age ranges from 23 to 40 years, mean 29.5 (5.3) years. Majority of the women were in their third decade [60% (6/10)] while the remaining 40% (4/10) were in their fourth decade of life. Two of the patients presented within the period of less than 1 week of onset of symptoms while those who presented within the periods of 1-2 weeks and periods of over 2 weeks accounted for 50% (5/10) and 30% (3/10) respectively. All the patients presented during the third trimester of their pregnancy and odontogenic infections were responsible for 80% (8/10) of the Ludwig's angina. There were 20% mortality among the patients and this was significant for those with underlying systemic conditions (P = 0.02). The time of presentation was not significant for the survival rate of the gravid patient (P = 0.36) but was significant for survival of the fetus (P = 0.01). CONCLUSION: During a life-threatening infectious situation such as Ludwig's angina, risks of maternal and fetal morbidity include both septicemia and asphyxia. Attending clinicians must consider the risks that the condition and the possible treatments may cause the mother and her unborn child.

Augmentation of craniofacial defects using alloplastic material / Técnica de aumento para la reparación de defectos craneofaciales usando materiales aloplásticos

BACKGROUND: Alloplastic materials are increasingly being used in augmentation of craniofacial defects because of its ready availability, good aesthetic outcome and absence of donor site morbidity. This paper highlights experience in the use of heat-cured acrylic in augmentation cranioplasty. SUBJECTS AND METHOD: The management of three patients with anterior skull defect who presented at the Dental and Maxillofacial Surgery Clinic of the Aminu Kano Teaching Hospital over a five-year period is presented. RESULTS: There was good aesthetic outcome in all the patients and no complications were recorded. CONCLUSION: Augmentation of craniofacial defects using customized prefabricated heat-cured acrylic provides patients with a durable, stable and structural repair ofcraniofacial defects with good aesthetic outcome.

ANTECEDENTES: Los materiales aloplásticos son usados cada vez más en la técnica de aumento para la reparación de defectos craneofaciales, debido a su disponibilidad inmediata, buen resultado estético y ausencia de morbosidad del sitio donante. Este trabajo destaca nuestra experiencia en el uso de acrílico curado por calor en las técnicas de aumento en la craneoplastia. SUJETOS Y MÉTODOS: Se describe el tratamiento de tres pacientes con defectos del cráneo anterior, que asistieron a la Clínica de Cirugía Maxilofacial y Dental del Hospital Docente Aminu Kano por un período de más de cinco años. RESULTADOS: Hubo un buen resultado estético en todos los pacientes y no se reportaron complicaciones. CONCLUSIÓN: La técnica de aumentación para los defectos craneofaciales, utilizando acrílico prefabricado curado con calor, proporciona a los pacientes una reparación duradera, estable y estructural de los defectos craneofaciales con buen resultado estético.

Pediatric maxillofacial injuries at a Nigerian teaching hospital: a three-year review.

AIM: To determine the nature of pediatric maxillofacial injuries, according to etiology and characteristics of patients. MATERIALS AND METHODS: The records of patients aged 15 years and below who presented with maxillofacial trauma to the Maxillofacial Clinic of Aminu Kano Teaching Hospital, Kano, Nigeria over a 3-year period were retrospectively examined. Patients' demographic and etiologic factors were obtained and analyzed. A P value of <0.05 was considered significant. RESULTS: A total of 160 patients comprising males, 102 (63.8%) and females 58 (36.2%), were seen over the period of study. The age of patients range from 4 months to 15 years, mean 7.07 ± 4.52 years. There was no gender difference in terms of age (P < 0.05). Road traffic accident (RTA) was the most common etiologic factor accounting for 45.0% of cases. This was followed by fall (40.6%). Animal related injury and violence accounted equally for 3.8%. Soft tissue injuries in the form of abrasion, laceration and avulsion accounted for 70.0% of cases. Other anatomical sites included the mandible (16.3%), dento-alveolar fractures(12.5%), and midface (1.3%). CONCLUSION: Road traffic accident and falls still remains the leading cause of maxillofacial injuries in children in this part of the globe. There is a need to reinforce existing traffic laws that aimed at minimizing the menace of RTA-related accidents.

Augmentation of craniofacial defects using alloplastic material.

BACKGROUND: Alloplastic materials are increasingly being used in augmentation of craniofacial defects because of its ready availability, good aesthetic outcome and absence of donor site morbidity. This paper highlights experience in the use of heat-cured acrylic in augmentation cranioplasty. SUBJECTS AND METHODS: The management of three patients with anterior skull defect who presented at the Dental and Maxillofacial Surgery Clinic of the Aminu Kano Teaching Hospital over a five-year period is presented. RESULTS: There was good aesthetic outcome in all the patients and no complications were recorded. CONCLUSION: Augmentation of craniofacial defects using customized prefabricated heat-cured acrylic provides patients with a durable, stable and structural repair of craniofacial defects with good aesthetic outcome.