Facial Mass Research Articles

Pleomorphic adenoma in an adolescent, about a clinical case

Introduction: salivary gland tumors in children represent a low percentage of pediatric head and neck tumors; most of them are diagnosed in association with the Parotid salivary gland and present a higher proportion of malignancy than in adults. Objective: to present a case with a diagnosis of Pleomorphic Adenoma: clinical symptoms, complementary examinations, treatment and evolution. Case presentation: female patient, 13 years old, from a rural background and white race, attended the Maxillofacial Surgery consultation, in good general condition, accompanied by her parents, due to an increase in volume of a hard consistency, not fixed to deep planes ( mobile), asymptomatic, of 7 months of evolution and 3 cm in length located in the left parotid region. Ultrasound of soft tissues and neck was indicated, as well as contrast-enhanced facial mass tomography, which showed a mass in relation to the left parotid gland that captured contrast. In addition, complementary examinations and a fine needle aspiration biopsy (FNAB) were performed, resulting in a benign parotid gland tumor (Pleomorphic Adenoma). Superficial parotidectomy was performed with preservation of the facial nerve. The patient progressed satisfactorily and continues to be followed up by consultation. Conclusions: pleomorphic adenomas are discovered in practice as slowly growing asymptomatic masses; the size is variable and will always depend on the stage at which it is detected.

Decoding the Implications of Glucagon-like Peptide-1 Receptor Agonists on Accelerated Facial and Skin Aging.

Following the advent of glucagon-like peptide-1 receptor agonists (GLP1RA), subsequent unintended effects such as accelerated facial aging and altered skin health have been noted. This review delves deeper into the causative underlying mechanisms and provides insights into the intricate relationship between GLP-1RA, adipose tissue, and premature facial aging, thereby highlighting the need for a nuanced understanding of their effects on facial alterations and skin health. Studies exploring the potential effects of GLP-1RA on facial alterations and offering insights into the possible underlying mechanisms, causes and clinical implications were included. The accelerated facial aging and altered skin health observed in GLP-1RA patients appears to be multifactorial, involving loss of dermal and subcutaneous white adipose tissue, altered proliferation and differentiation of adipose-derived stem cells (ADSCs), and impacts on the production and secretion of hormonal and metabolic factors. These changes compromise the structural integrity and barrier function of the skin and may lead to diminished facial muscle mass, further exacerbating the appearance of aging. The insights presented call for a paradigm shift in the clinical management of facial changes induced by GLP-1RA, with a focus on treatment strategies aimed at targeting ADSC stimulation. These include autologous fat transfers to reintroduce cells rich in ADSCs for rejuvenation, composite fat grafting combining autologous fat with/without stromal vascular fraction, and the strategic use of soft tissue fillers for volume restoration and biostimulation. This review highlights the potential role of GLP-1RA in modulating adipose tissue dynamics, contributing to accelerated aging through metabolic, structural, and hormonal pathways.

Barbed Pharyngoplasty simulation using a 3D-printed model: design and validation study.

Learning how to use barbed sutures and perform Barbed Pharyngoplasty (BP) is challenging due to limited surgical training opportunities. This work aims to design, develop, and validate a new 3D surgical simulator to train ENT residents and specialists in performing BP. The Barbed Pharyngoplasty Simulator (BPS) was designed using diagnostic images of the facial mass and testing different materials to replicate the mucosal and bony tissues. ENT specialists with experience in BP and ENT residents were included in the validation study and were asked to perform the Alianza BP. After the simulation, they compiled the Face and Content Validity Questionnaires. The BPS consists of a reusable cranial structure that contains the disposable palatopharyngeal structure, replicating the palatal structures and the tongue. Fifteen experienced ENT specialists and nine residents were included in the study. Findings demonstrated that the BPS faithfully replicated the muscular and fibrous-bony palatopharyngeal structures, with only 11% of residents having a negative opinion of the mucosal tissue. All the participants positively rated the sensation of using surgical instruments on the simulator. Also, ENT residents rated all aspects of the content validity test from normal to excellent, while specialists rated the BPS as a general training tool from normal to excellent; for lateral pharyngoplasty, BP, and Alianza, only 6.7% of participants disagreed with its usefulness, and 13.3% disagreed with it for anterior pharyngoplasty. The BPS proposed in this preliminary study can potentially be a valuable tool in BP surgical training for residents and young otolaryngologists.

A Comparison of the Specific Facial Trauma Cases at the Department of Maxillofacial Surgery, Gdansk, Poland, from March 2019 to August 2023.

Background: Accidents involving the maxillofacial area are sudden and unforeseen, such as traffic accidents and physical altercations. The COVID-19 pandemic was a critical threat to the public in aspects not only involving physical health but also those affecting psychological health due to isolation, leading to a higher incidence of stress and depression among the general population and specifically in patients with OMF trauma. This study assessed the relationship between the impact of the COVID-19 pandemic and the quantity and severity of maxillofacial injuries. Methods: Data were retrieved from the Department of Maxillofacial Surgery of the University Clinical Centre in Gdansk from March 2019 to August 2023. Results: There was an increased risk of injury occurrence to the condylar process of the mandible, especially the left side, Le Fort type II/III fractures, injuries of the maxillary alveolar process, and displacement of the upper facial mass. Simultaneously, a decreased occurrence of certain injuries i.e., Le Fort type III fractures and Le Fort type I/II fractures, was recorded. Conclusions: The COVID-19 pandemic led to an increased occurrence of high-energy injuries, including displacement of the upper facial mass (p = 0.010).

Diagnosis and outcome of odontogenic abscesses in client-owned rabbits (Oryctolagus cuniculus): 72 cases (2011-2022).

To characterize the epidemiologic features of rabbits with odontogenic abscesses. 72 client-owned rabbits. The medical record database of a veterinary teaching hospital was searched to identify rabbits with odontogenic abscesses characterized by a palpable facial mass and confirmed via CT scan. Data reviewed included age, breed, presenting complaint, abscess location, bacterial culture results, treatment, and outcome. Lop-eared rabbits were the most common breeds affected (20/72 [28%]), and mini lop rabbits were significantly overrepresented. The mandibular quadrants were more frequently affected (65/92 [71%]), and osteomyelitis was a common comorbidity on CT (53/72 [74%]). The most common aerobic and anaerobic isolates were Streptococcus spp (17/40 [43%]) and Fusobacterium spp (10/22 [45%]), respectively. Systemic antibiotic therapy alone was performed in 35 of 62 (56%) treated cases, with documented resolution in 25%. Abscess packing with antibiotic-soaked gauze in conjunction with systemic antibiotic therapy was performed in 20 of 62 (32%) treated cases. Resolution of the odontogenic abscesses with this treatment protocol was documented in 17 of 20 (85%) cases. The number of packing procedures used to obtain resolution of infection was 4 (IQR, 3 to 5). A combination of the abscess-packing technique, which avoids extensive surgery and extraction of the involved elodont teeth, with systemic antibiotic therapy can be an effective treatment option for rabbits with palpable odontogenic abscesses and can result in a high cure rate comparable to more invasive surgical treatments. Antibiotic treatment alone is not recommended, as it has a low chance of abscess resolution.

Un imprevisto tra capo e collo: la sindrome di Lemierre

A healthy 15-year-old boy was hospitalized due to the persistence of lateral cervical swelling associated with fever and worsening of headache. He underwent a neck and facial mass CT scan showing a thrombophlebitis of the internal jugular vein extended to the intracranial sinuses. The diagnosis of Lemierre syndrome (LS) was formalized with positive blood colture for Fusobacterium necrophorum. Intravenous antibiotic therapy associated with anticoagulant therapy was started with complete clinical recovery after 4 weeks of treatment. A close clinical-instrumental follow-up was set up. Lemierre syndrome is a thrombophlebitis of the internal jugular vein, that in this case was extended to the intracranial sinuses. It is a rare condition, secondary to the extension of an infectious process starting from the oropharynx. The clinical picture is characterized by high fever, persistent pharyngitis followed by sepsis, pneumo-nia or atypical laterocervical pain. Fusobacterium necrophorum, a gram-negative anaerobe bacteriu,, is the responsible pathogen in most of the cases (>90%). The antibiotic treatment is prolonged (at least 4-6 weeks); occasionally a parallel surgical approach is necessary. The start of anticoagulant thera-py for internal venous thrombosis associated with LS is still matter of debate.

A Large Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma of Buccal Mucosa: Report of A Rare Case

Abstract Introduction/Objective Liposarcoma is not common in the head and neck, and extremely rare in the oral cavity: 7% occur in the head and neck and 0.3% in the oral cavity. We report an atypical lipomatous tumor/well-differentiated liposarcoma (ATL/WDL) of the buccal mucosa with recurrence. Methods/Case Report A 66-year-old female presented with a right facial mass that had been present for over 10 years and resected 6 times as lipoma in her home country. The mass had grown since the last resection two years ago. Computerized tomography of neck soft tissue displayed a heterogeneous 11 cm mass with fat density in the right buccal mucosal spaces, and a 4.8 cm connecting solid nodule in the right pharyngeal mucosal space. Complete resection of the mass/nodule was performed. Grossly, the specimen consisted of two nodular masses (separately cut during operation), 13.1 cm and 7 cm, respectively. The cut surfaces of the masses revealed yellow fatty tissue with focal fleshy areas corresponding to the nodule with solid density by imagining. Microscopically, the squamous mucosa had a lipomatous tumor composed of sheets of well-differentiated adipocytes that infiltrated the underlying and surrounding skeletal muscle and connective tissue. Upon extensive sampling, scattered lipoblasts were found in relatively cellular areas. The nonlipogenic stromal cells with nuclear pleomorphism were seen in the fibrous/solid areas. No mitosis or necrosis was identified. MDM2 amplification was detected by fluorescent in situ hybridization (FISH). These findings support the diagnosis of recurrent ATL/WDL. Results (if a Case Study enter NA) NA Conclusion We demonstrate the histological features of a large atypical lipomatous tumor/well-differentiated liposarcoma of buccal mucosa. Extensive sampling of the specimen to identify the lipoblasts and atypical stromal cells, and MDM2 FISH study on suspicious cases are the keys to achieve accurate diagnosis. The high recurrence rate of this entity in the head & neck region exhibited in this case warrants the need of long-term follow-up.

43634 Fungating Facial Mass: Is there a fungus among us?

43634 Fungating Facial Mass: Is there a fungus among us?

Venolymphatic malformation – parotid gland

Abstract: Vascular malformations (VMs) are a rare clinical entity and even rarer are those originating from the salivary glands. Those arising from the parotid gland are the most reported with the most common subtype being venous or arteriovenous malformation. Here, we report a case of a neck mass which was identified as a venolymphatic VM in the parotid gland. A 14-year-old patient presented with a progressive right-sided facial mass without constitutional symptoms. Ultrasonography of the mass showed a well-defined lobulated parotid mass with few cystic areas and minimal vascularity, thus deducing a differential of either a branchial cyst or a pleomorphic adenoma. Excision of the mass was performed and sent for histopathological diagnosis. The grossly hemorrhagic and congested specimen showed many vascular channels lined by flat endothelium on microscopy. These dilated channels of varying sizes had many red blood cells and proteinaceous fluid. The lesion was also seen infiltrating the normal surrounding structures of the salivary gland tissue. With the rare incidence of VMs occurring anywhere in the body, diagnosing a venolymphatic malformation occurring in the parotid gland was an out of common experience. Better imaging of a mass in the salivary gland using not only ultrasonography but also color Doppler and magnetic resonance imaging can help rule out the rare entities that can sometimes be overlooked and help plan better treatment for the patient.

Effects of Adenotonsillectomy on Vocal Function.

Correct breathing is a fundamental condition for adequate vocal production. Respiratory dynamics are able to modify the growth of facial mass and lingual posture, i.e., of the skull, the mandibular one. For this reason, infant mouth breathing can cause hoarseness. We evaluated the actual changes in the characteristics of the voice and articulation of language in a group of subjects affected by adenotonsillar hypertrophy (grade 3-4), with frequent episodes of pharyngo-tonsillitis who underwent adenotonsillectomy. Our study included 20 children-10 boys and 10 girls-aged 4 to 11 years who had adenotonsillar hypertrophy and pharyngotonsillitis episodes exceeding 5-6 per year in the previous 2 years. The control group (Group B) included 20 children-10 boys and 10 girls-aged 4 to 11 years (average age of 6.4 years) who had not undergone surgery and shared the same degree of adenotonsillar hypertrophy as those in Group A but who did not experience recurrent pharyngotonsillitis episodes. The hypertrophy of adenoids and tonsils significantly impacted breathing, vocal function, and speech articulation. All this is responsible for a state of tension in the neck muscles, which at the level of the vocal tract causes hoarseness. The changes objectively observed in our study in the pre- and post-operative phase demonstrate how adenotonsillar hypertrophy is responsible for an increase in resistance to the passage of air at the glottic level. For this reason, adenotonsillectomy has an impact on recurrent infections and can also lead to an improvement in speech, breathing, and posture.

Bimaxillary odonto-ameloblastic fibroma: A case report

Introduction:
 Ameloblastic fibroma is a rare mixed odontogenic tumor, affects the young population, its management is mainly surgical. We report in this work the first observation of a concomitant bimaxillary localization.
 Clinical observation:
 This is a 31-year-old female patient with no pathological history who presented to our department for management of a maxillomandibular tumor. The clinical examination revealed a poor oral condition and a swelling of the alveolar ridges. The CT scan of the facial mass revealed a multilocular cystic lesion encompassing teeth in the maxillary and mandibular bone. The biopsy came back in favor of an odontoameloblastic fibroma. Management consisted of radical resection with reconstruction using local flaps.
 FOA is a tumor distinct from ameloblastoma, it affects the young patients without any predilection to gender. The radiological image is a mono or multilocular cystic image which poses a problem of differential diagnosis with other cystic tumors. The management is surgical, clinical and radiological postoperative surveillance is primordial given the risk of recurrence or sarcomatous transformation.
 Conclusion:
 The FOA was for a long time considered as a form of ameloblastoma, is a rare tumor in the mandibular localization is the most frequent, the bimaxillary localization has never been described and the case we presented is the first in literature.

Anaplastic Large Cell Lymphoma Presenting as Ulcerative Facial Mass:

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Oral Mucosal Melanoma Presenting as a Giant Facial Ulcero-Proliferative Mass.

Oral Mucosal Melanoma Presenting as a Giant Facial Ulcero-Proliferative Mass.

A slowly growing facial tumour in a southern African migrant.

A 35-year-old previously healthy woman, originating from southern Africa, presented with a slowly growing facial mass over a course of ten years. Magnetic resonance imaging showed an intra- and extracranial tumorous mass with extensive bone destruction. Biopsies led to diagnosis of invasive Aspergillus sinusitis which was successfully treated without surgery.

Étude anatomique scanographique du sinus frontal des patients transgenres en vue d’une chirurgie de frontoorbitoplastie de féminisation

Little is known about the anatomical elements that allow safe and predictable performance of fronto orbital surgery for facial feminization. The primary objective of this study was to analyze the characteristics (dimensions, pneumatization rate, and anterior wall thickness) of the frontal sinus in MtF transgender patients. The secondary objective was to establish reproducible criteria for CT measurements that could guide preoperative planning of frontal impaction in feminization frontoplasty (FF). Fifty preoperative facial mass scans of FF surgery patients were included. The mean age of the operated patients was 34 years. The F line represented the ideal forehead tilt in the absence of a frontal hump. The height, width, depth, and thickness of the anterior sinus wall were 26.6mm (±5.7), 49.5mm (±11.3), 10.9mm (±3.3), and 3mm (±0.7), respectively. The mean sinus width to skull width ratio was 0.73 (±0.12). Six percent of patients had bilateral frontal sinus agenesis. An osteotomy of the anterior wall of the frontal sinus was performed in the 64% of patients with frontal sinus projection anterior to the F-line. The emergence of the supraorbital nerves from the frontal bone was through a bony notch in 73.8% of cases. Knowledge of the anatomy of the frontal sinus and preoperative study of the scans of the facial mass is essential for planning the FF. These characteristics guide the surgical technique of bone remodeling as well as the procedure for releasing the supraorbital nerves.

Epidemiology and management of Lefort fractures at the Sylvanus Olympio University Hospital of Lomé (Togo)

IntroductionLefort fractures are lesions of the facial mass following violent trauma. They can be life-threatening and functionally dangerous in the short or long term. This study aimed to report the management of this type of fracture in our context. MethodologyThis was a descriptive cross-sectional study with retrospective data collection from January 1, 2011, to December 31, 2020, in the Department of Otolaryngology and Cervico-Maxillofacial Surgery at the Sylvanus Olympio University Hospital of Lomé. ResultsThe annual frequency was 15.2 cases. The average age of the patients was 34.43 ± 11.98 years with extremes of 15 and 70 years and a sex ratio of 9.13. The majority of patients were workers in the informal sector (44.08%). The etiologies were dominated by road traffic accidents (91.45%) and 28.29% of the patients were emergency cases on admission. Imaging showed 51.06% Lefort II fractures. Treatment was surgical in 99.34%, with screw plates (89.40%). Functional sequelae were reported in 5.92% of patients. ConclusionLefort fractures are common in young adult males after road traffic accidents. Their treatment is delicate and often leaves serious after-effects. Active measures for the prevention of these road traffic accidents are therefore necessary.

Jael’s syndrome: knife blade impacted in the facial skeleton: an illustrated case report and a review of literature

Objective: This article focuses on the penetrating trauma of the facial mass caused by the knife with retention of the blade fractured in the facial skeleton.
 Case report: We describe preoperative, intra-operative and post-operative outcomes of the knife stabbing in the face, and of the surgical removal of the broken 8cm long blade using two dimensional, and tridimensional computed tomography, and clinical iconography
 Conclusions: We provide the readership with a broader perspective on iatrogenic facial trauma caused by blades with examples from history of medicine, with biomechanical focus, as well as a review of literature on the management, and on the surgical treatment outcomes of such infrequent emergency in maxillofacial surgery.

Vascular Tumors in Two Argentine Horned Frogs (Ceratophrys ornata)

Two vascular tumors in two Argentine horned frogs (Ceratophrys ornata) are described. Case 1 involved a 7-year-1-month-old Argentine horned frog that had a splenic mass with a sanguineous coelomic effusion. Histologically, the splenic parenchyma was effaced by a poorly-demarcated, invasive mass, consisting of spindle cells with marked nuclear atypia forming irregular blood vessel channels containing blood. Case 2 involved a pedunculated facial mass located at the upper right lip of an over-8-month-old Argentine horned frog. Histologically, the well-demarcated, poorly cellular mass consisted of sparse proliferation of spindle cells forming irregular slits with prominent edema. Immunohistochemically, the neoplastic cells of both cases were positive for anti-CD31 antibody. The diagnoses were hemangiosarcoma in case 1 and lymphangioma in case 2. To the best of the authors’ knowledge, this is the first description of neoplastic diseases in captive Argentine horned frogs.

Epidemiological and Clinical Aspects of Trauma to the Facial Mass at the National Odonto-Stomatology Center in Bamako

The facial trauma is frequent, severe and of great diversity. The severity of FMD is primarily related to the presence of known or potential respiratory distress, profuse bleeding and / or associated lesions. Moreover, it must also be considered in terms of secondary functional and aesthetic consequences. The objective of this work was to determine the socio-demographic and clinical aspects of facial trauma in our practice. So a retrospective retrospective descriptive cross-sectional study was carried out in the stomatology and maxillofacial surgery department of the national center of odontostomatology of Bamako from June 1st to December 31st. 2012 and concerned all patients admitted for trauma massive facial. There were 58 cases. 84.50% of which were men with a sex ratio of 6.2. The best represented age group was 21-30 years old. The average age was 28.56 years old. School children accounted for 39.90% of cases. Road traffic accidents were the main etiology with 79.30% of cases. Bone lesions accounted for 93.10% of cases versus 20.70% of soft tissue lesions. He main fracture sites were the malar. The maxilla the bones of the nose with 63.80%, 39.70% and 31.00% respectively. Extra-facial lesions accounted for 18.96% of cases. The cranio-facial scanner was performed in 77.60% of patients. The orthopedic treatment method was used in 66.10% of cases. The facial trauma remains frequent. His emphasis must be on the empowerment of road users and on the stricter control of compliance with the Highway Code.

Refining Orthognathic Surgery Results by Synchronous Cheek Fat Compartment Augmentation with Fat Grafting in Adult Females with Class III Skeletal Profiles.

Patients with maxillomandibular disharmony may present with a flat to concave midface. The effects of orthognathic surgery concomitant with midface fat grafting on facial appearance and midface volumetric and positional change have not formally been assessed to date. The authors' approach for synchronous orthognathic surgery and fat grafting is described and evaluated. Adult female patients (n = 20) who underwent synchronous two-jaw orthognathic surgery and cheek-specific fat grafting (1.9 ± 0.6 cm3 per side) for correction of skeletal class III deformity and anteromedial cheek deficiency were prospectively included. Preoperative and postoperative photographs were appraised by 42 blinded raters using facial appearance scales for beauty, attractiveness, and pleasantness parameters. The three-dimensional midface soft-tissue volume change and postoperative cheek mass position were computed. Facial imaging data from gender-, ethnic-, and facial pattern-matched adult patients (n = 20) who underwent isolated two-jaw orthognathic surgery (n = 20) were included for comparison. The three-dimensional facial norms database-derived cheek mass position information (2.19 ± 1.31mm) was also adopted for analysis. Patients treated with the synchronous procedure had significantly (p < 0.001) increased facial appearance-related perception change for beauty (2.9 ± 1.6), attractiveness (2.8 ± 1.8), and pleasantness (3.0 ± 1.5) parameters, three-dimensional midface volume change (1.8 ± 0.5 cm3), and postoperative cheek mass position (2.16 ± 0.47 mm) in comparison with those treated with the isolated procedure (2.0 ± 1.5, 1.9 ± 1.6, 2.3 ± 1.6, 0.6 ± 0.2 cm3, and 1.84 ± 0.43 mm, respectively). Healthy female individuals had similar and larger cheek mass position than patients treated with synchronous (p > 0.05) and isolated (p < 0.001) procedures, respectively. Synchronous orthognathic surgery and check-specific fat grafting resulted in superior enhancement of facial appearance and midface volume and position compared with isolated orthognathic surgery. Therapeutic, III.