Facial Swelling Research Articles

A CHILD CASE OF EGOMA (PERILLA FRUTESCENS) ALLERGY DUE TO SCHOOL LUNCH, PROBABLY CAUSED BY PERCUTANEOUS SENSITIZATION

Herein, we report the case of a 7-year-old girl with a history of atopic dermatitis because of infancy. Her grandfather grew Egoma (Perilla frutescens), and her family frequently consumed food items prepared using Egoma; however, she never consumed them because she did not enjoy these food items; she experienced vomiting, facial swelling, and oral discomfort upon ingesting Egoma during school lunch for the first time. Her food oral challenge test was positive, as well as a skin-prick test with sesame powder. Egoma antigen protein was extracted and reacted with patient serum by immunoblotting, which detected a positive band of approximately 26kDa. She was brought up in an environment with high exposure to Egoma; hence, she most likely developed an allergy to Egoma because of percutaneous sensitization. This is the first time an Egoma allergen analysis has been conducted in Japan, and we consider it to be a valuable case.

Early Diagnosis of Upper Extremity Deep Venous Thrombosis Using Emergency Department Point-of-Care Ultrasound: A Case Report

Introduction: Upper extremity deep vein thrombosis (UEDVT) is a serious condition associated with fatal complications. It necessitates careful consideration and prompt intervention. Despite the proven effectiveness of point-of-care ultrasonography (POCUS) in detecting UEDVT, it is rarely utilized in the Emergency Department (ED). Purpose: To highlight the role of POCUS in the early diagnosis of UEDVT in the ED. Case Summary: A 65-year-old female, actively undergoing chemotherapy via a right subcutaneous port for known left breast cancer, presented to the ED exhibiting throat irritation, facial swelling, and itchiness. These symptoms surfaced the day after her latest chemotherapy session. She typically experienced similar reactions post-chemotherapy, managed by routine oral antihistamines and steroids, yet this instance persisted despite medication. On examination, she appeared flushed, with a plethoric and erythematous face, accompanied by swelling extending from her neck to the left arm, along with tender left axillary lymph nodes. A POCUS of the left upper arm revealed soft tissue edema, a non-compressible brachial vein, and a hypoechoic floating luminal lesion (Figure 1). Subsequent computed tomography (CT) confirmed upper limb deep venous thrombosis extending into the left subclavian and internal jugular vein, partially non-occlusive in the proximal superior vena cava (Figure 2. A & B). Notably, she had a known contrast allergy, requiring pre-treatment with steroid and diphenhydramine before contrast injection. Based on CT findings, therapeutic enoxaparin was initiated in the ED and patient was admitted under oncology care, subsequently discharged on rivaroxaban. Discussion: Based on previous studies, the reliance on radiologists' availability for vascular imaging to diagnose UEDVT within the ED led to significant delays, extending up to two hours. Notably, the utilization of POCUS by Emergency Physicians resulted in a marked reduction in both diagnosis and intervention times. Furthermore, insights from six prospective studies confirm the accuracy of color-Doppler sonographic imaging in diagnosing UEDVT, showcasing sensitivity ranging between 78% to 100% and specificity from 82% to 100%. This compelling evidence strongly advocates for the broader integration of POCUS in EDs, emphasizing its credibility in enhancing diagnostic accuracy and expediting timely intervention for UEDVT. Applying these findings to this specific patient case, reliance on POCUS could have avoided the risks associated with radiation and contrast exposure Conclusion: Integrating POCUS into the ED's diagnostic protocol for UEDVT enables early detection and intervention, and mitigates risks associated with contrast agents and excessive radiation exposure.

Symptoms: Abdominal Distension, Facial Swelling

Symptoms: Abdominal Distension, Facial Swelling

Subcutaneous Panniculitis-like T-cell Lymphoma: A Case Report of A Solved Conundrum

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare primary cutaneous lymphoma which often be very complexed to be diagnosed. Here we reported a case of a 38-year-old lady with wax and wane course of left facial swelling associated with prolonged pyrexia of unknown origin, lethargy and prominent weight loss. Multiple investigations were conducted to reach to the conclusive diagnosis. Histopathological showed infiltration of neoplastic lymphoid cells within the adipocyte clusters with hyperchromatic nuclei, small nucleoli and scant cytoplasm. Immunohistochemical analysis were immunoreactive to CD3, CD8 & TIA and negative to CD20, CD4 & CD56. Based on clinical findings, histopathology report and immunohistochemical analysis, the patient diagnosed with SPTCL. Hence, any suspicious maxillofacial swelling without obvious sign of infection and trauma shall be investigated until a final diagnosis is reached.

HIMS-Net: Horizontal-vertical interaction and multiple side-outputs network for cyst segmentation in jaw images.

Jaw cysts are mainly caused by abnormal tooth development, chronic oral inflammation, or jaw damage, which may lead to facial swelling, deformity, tooth loss, and other symptoms. Due to the diversity and complexity of cyst images, deep-learning algorithms still face many difficulties and challenges. In response to these problems, we present a horizontal-vertical interaction and multiple side-outputs network for cyst segmentation in jaw images. First, the horizontal-vertical interaction mechanism facilitates complex communication paths in the vertical and horizontal dimensions, and it has the ability to capture a wide range of context dependencies. Second, the feature-fused unit is introduced to adjust the network's receptive field, which enhances the ability of acquiring multi-scale context information. Third, the multiple side-outputs strategy intelligently combines feature maps to generate more accurate and detailed change maps. Finally, experiments were carried out on the self-established jaw cyst dataset and compared with different specialist physicians to evaluate its clinical usability. The research results indicate that the Matthews correlation coefficient (Mcc), Dice, and Jaccard of HIMS-Net were 93.61, 93.66 and 88.10% respectively, which may contribute to rapid and accurate diagnosis in clinical practice.

Non-granulomatous Morbihan disease: a case report

Background: Morbihan disease (MD) is a rare dermatological condition, which is characterized by rosaceous lymphedema or erythematous edema of the middle and upper thirds of the face. To date, the underlying pathogenetic mechanisms of MD remains unclear. Although MD is considered a late-stage manifestation of rosacea, it has been reported to exist as an initial presentation, in the absence of other features of rosacea. Case Presentation: A 27-year-old female with a history of hypothyroidism, presented with a chronic solid, persistent, facial swelling for 4 years without rosacea symptoms. The patient wore a face cover for religious and social reasons, and therefore her face was not exposed to direct sunlight. Based on the clinical findings, a preemptive diagnosis of MD was established, and the patient was started on oral Isotretinoin with significant improvement. Histopathology of the left cheek revealed perifollicular lymphocyte and histocyte infiltration and mild dermal fibrosis; no granuloma or malignancy was found. After 36 months of treatment, there was an overall 65%-70% improvement since the initial visit and the patient was pleased with her results. Conclusion: In contrast to published reports, the formation of epithelioid cell granuloma as well as mast cell infiltration were not observed in presented case. The diverse histopathological features of MD are most likely attributed to its varying underlying inflammatory triggers. The presence of MD without rosacea features supports the argument that MD represents a separate disease process.

Eficiencia del gel de ozono tópico como complemento de antibióticos y analgésicos en las secuelas tras la extracción del tercer molar mandibular impactado

Introduction: Extraction of the impacted mandibular third molar is a common procedure in dentistry. Many complications may arise after this operation, the most common being pain, trismus, and swelling. Systemic medications have been used in an attempt to manage these problems, but because of their side effects, the need for non-medication treatment arises to treat these complications without side effects, such as cryotherapy, ice packs, low-level laser therapy, and ozone. Ozone is one of the most effective antimicrobials used in the dentistry field, and it also has a positive effect on soft tissue healing, activates cellular metabolism, and can react with blood components; for these reasons ozone is used to manage trismus, swelling, and pain after removal of the mandibular third molar. Aim: The purpose of the study was to assess the effects of topical ozone gel on complications from the extraction of the impacted mandibular third molar. Materials and Methods: Thirty patients were enrolled in the current study and were randomly divided into two equal groups. Preoperatively clinical examination included measurement of facial swelling measurements and maximum mouth opening. The position and configuration of the impacted lower third molar, the surrounding bone, the mandibular canal, and the neighboring tooth were all assessed using a panoramic X-ray. On days 2 and 7, after surgery, the facial swelling dimensions and maximum mouth opening were again assessed. Statistics were used to analyze results. Results: Findings indicate statistical significance for pain, but not for swelling or mouth opening. Conclusions: After lower third molar surgery, topical ozone gel helps reduce postoperative pain. Keywords: Molar, third; Tooth, impacted; Ozone; Pain; Trismus; Edema.

Effect of At-home Beauty Device Equipped with Microcurrent and Electrical Muscle Sitmulation Functions on the Elasticity and Lifting of Facial Skin

At-home beauty devices used in facial skin are developed by combining various technologies such as electromagnetic waves, microcurrents, and lasers according to the main purpose of consumers. This study aimed to assess the effects of increasing of facial elasticity, improvement of eye wrinkles, and facial lifting in healthy Korean women to objectively prove the efficacy of an at-home beauty device equipped with microcurrent (MC) and medium-frequency electrical muscle stimulation (EMS). A total of 44 participants used the at-home beauty device and cosmetics together on the left side of the face (test area), and applied only cosmetics to the right side (control area). The results of the assessment, the improvement in the dermal density and eye wrinkles was clearly observed in the MC mode use group. In the EMS mode use group, the lifting effect of the cheek and decreasing facial swelling were clearly observed, and the lifting effect of the sagging double chin was also confirmed. Especially, EMS group had derived reproducible results like previous studies, and the skin improvement effects were proved again. MC and EMS, which are mainly used for therapeutic purposes, were developed into at-home beauty device, and this study confirmed that they are effective in facial elasticity, eye wrinkles, and facial lifting. Based on the research, we hope that various research for at-home beauty devices equipped with various functions are actively conducted.

An overview of juvenile ossifying fibroma

Juvenile ossifying fibroma (JOF) is a cancerous bone condition that mainly affects the facial bones, particularly the jaw and upper jaw. This review article provides an overview of JOF, covering its signs, difficulties in diagnosis, radiographic characteristics, histopathological features, and current treatment strategies. The exact cause of JOF is still uncertain, leading to debates about whether it originates from a tumor growth, abnormal development, or reactive response. The way JOF presents clinically can vary greatly, emphasizing the importance of an approach when evaluating patients with facial swellings. Radiographically, JOF appears as a defined area of bone with varying degrees of mineralization. Clinical and histopathological findings must be combined with the results to diagnose this condition accurately. Histopathologically, JOF is characterized by increased tissue and mineralized components that create a two-phase pattern. Surgical treatment options range from removing the affected area to complete resection; however, achieving surgical margins can be challenging and may lead to recurrence due to its ability to infiltrate surrounding tissues. Reconstruction using either bone grafts or artificial materials is necessary for lesions caused by JOF. Long-term follow-up that includes imaging techniques is crucial due to the likelihood of recurrence in JOF cases. Various factors, such as the extent of removal and the aggressiveness of the lesion, influence recurrence rates. Highlight the complexity involved in managing JOF—emerging developments in procedures and understanding at the level offer promising possibilities for focused treatments. A comprehensive approach to managing JOF includes collaboration between healthcare experts, educating patients, and providing support. It is essential to continue research endeavors and promote data sharing to unravel the complexities surrounding JOF, improve precision and treatment approaches, and enhance well-being.

Therapeutic management of osteodystrophia fibrosa in early weaned Malabari male goat kids.

Osteodystrophia fibrosa is a metabolic disease of goats resulting from the insufficient mineralization of bones, excessive bone resorption, and improper bone development, leading to subsequent accumulation of the fibrous connective tissue. This report describes the successful therapeutic management of acute osteodystrophia fibrosa in early-weaned goat kids by following a medical protocol. Three Malabari male goat kids of forty days old from two different litters of the same farm were presented with spontaneous, bilaterally symmetrical, non-inflammatory facial swelling, protruded tongue, prominent eyeballs, frothy drooling saliva, diarrhoea, and inanition due to the inability in mastication or suckling for the last two weeks. As per the history, these kids were weaned and started feeding pelleted concentrate feed and jackfruit leaves along with the milk sucking three weeks back only. On clinical examination, the vital parameters were normal and the key phenotypic abnormalities noted were the abnormally developed maxilla/mandible, manifested as a swelling that was hard to touch, and the loosely attached teeth. In biochemical evaluation, the reduction in Ca:P ratio was evident and the serum creatinine level was within normal ranges. A therapeutic protocol was devised for three weeks by including calcium (calcium gluconate), phosphate-binder (Kaolin), vitamins (Vit. ADEH), and anabolic steroid (Nandrolone; a well-established drug promoting formation and mineralization of bone in mammals). Considerable improvement was observed after three weeks of therapy and the animals were having apparently normal facial appearance on the review after three months. The kids showed normal healthy growth and were slaughtered later for meat purpose after gaining adult body weight. This report accentuates the possibility of acute hypocalcemia-induced osteodystrophia fibrosa, rather than hyperphosphatemia-induced, and its management using anabolic steroids for better clinical recovery in growing goat kids.

Comparison of the Effectiveness of Four Different Irrigation Solutions on Postoperative Sequelae in Patients Undergoing Lower Third Molar Surgery: A Prospective Study.

Introduction Oral and maxillofacial surgeons frequently perform the removal of impacted mandibular third molars. The success of this surgical intervention depends on meticulous surgical technique and the use of appropriate irrigants to minimize complications in the postoperative period. Aim The aim of this study was to evaluate the efficacy of four different irrigation solutions (povidone-iodine, metronidazole, chlorhexidine gluconate (CHX), and normal saline)on postoperative sequelae like pain, trismus, swelling, and alveolar osteitisfollowing surgical extraction of the impacted mandibular third molars. Materials and methods The current research was a randomized study carried out at Saveetha Dental College and Hospital in Chennai, India, from December 2022 to March 2023.The study population consisted of 112 participants who were referred to the Oral and Maxillofacial Surgery for the surgical removal of impacted mandibular third molars. The population was divided into four groups, with 28in each group. They were categorized as A, B, C, and D based on the final irrigation solution used after surgical removal of the impacted teeth. In group A, patients received 0.5% povidone-iodine as the final irrigation solution; group B received 1% metronidazole; group C received 0.12% chlorhexidine gluconate (CHX); and group D received 0.9% normal saline.Patients were examined on the first and seventh postoperative days to assess pain, swelling, trismus, and alveolar osteitis. The results were analyzed with SPSSStatistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States) software for Windows (MicrosoftCorporation, Redmond, Washington, United States). A p-value less than 0.05 was considered statistically significant. Results Group B experienced significantly less pain than groups A, C, and D on the first and seventh postoperative days (p<0.05). The facial swelling was significantly less on the first and seventh postoperative day in groupB compared to groups A, B, and D (p<0.05). There was no statistically significant variation observed in trismus (mouth opening) across the groups on both the first postoperative and seventh postoperative days. The presence of alveolar osteitis was seen in groups A, C, and D, but no instances were reported in group B. Conclusion It can be concluded that among the four irrigation solutions used in the lower third molar surgery,metronidazole irrigation solution yielded the best results in terms of less pain, swelling, and alveolar osteitis followed by chlorhexidine.There was no difference between povidone-iodine irrigation and normal saline irrigation on the postoperative sequelae. Postoperative trismus does not depend on the irrigation solutionused in the third molar surgery.

Bronchiectasis with Trans Mediastinal Herniation of Left Upper Lobe in 3-Year-Old Child: A Case Report

BACKGROUND: Bronchiectasis is a disorder characterized by destruction of smooth muscle and elastic tissue due to inflammation which leads to permanent dilation of bronchi and bronchioles. It may develop in association with Cystic Fibrosis, a single severe episode or recurrent episodes of pneumonia and exposure to tuberculosis. The principal conditions associated with bronchiectasis are obstruction and infection. Infections primarily originate from issues with airway clearance, which cause bronchi and bronchioles to enlarge irreversibly. Vertical airways are notably affected, while distal bronchi and bronchioles are more severely affected. The degree of disease activity and chronicity may affect the histological findings. Childhood bronchiectasis can proceed to severe consequences including persistent bacterial bronchitis, in developing nations like India due to a lack of effective diagnosis and treatment as a result of poor health care infrastructure in the rural areas as well as limited awareness on the part of general public and health care professionals. THE CASE: A 3.5-year-old Indian boy presented with productive cough and cold for 8 days associated with low grade fever. Patient was admitted through Out Patient Department (OPD) due to respiratory distress and facial swelling. Clinical exam revealed presence of crepitation, wheeze and pectus carinatum. Patient has history of multiple hospital admissions due to pneumonia and respiratory distress. There is history of exposure to tuberculosis. His mother had been diagnosed with tuberculosis when the child was 3 months old. She received anti-tubercular drugs and is now cured. HRCT thorax reveals collapse of basal segment of right lung, trans-mediastinal space shift of left upper lobe and bi-lateral bronchiectatic changes which include unusually thickened enlarged airways exhibiting the characteristic tram-track appearance. Echocardiogram findings show thickened pericardium, mild pericardial collection and trace tricuspid valve regurgitation. The case is unique since it is quite rare for a young child to have such a severe form of bronchiectasis. CONCLUSION: Diagnosis can be done with the help of radiological and clinical examination. However, High Resolution Computed Tomography (HRCT) scan is the investigation of choice. Early management is a key factor in minimizing more serious complication like severe hemoptysis and cor pulmonale. Current treatment modalities include antibiotics, bronchodilators, anti-inflammatory drugs and chest physical therapy. Severe cases may require injectable antibiotics. Bronchiectasis was thought to be an orphan disease that seldom progressed to severe consequences, especially after the introduction of newer antimicrobials. There exist guidelines that advocate treatments for bronchiectasis, and reports of therapy have been shown to be linked with clinical success. However, such guidelines do not exist in India at present. This case is noteworthy as it portrays bronchiectasis in an Indian child that has proceeded to the severe complication of transmediastinal herniation, demonstrating that it is relatively common albeit under-diagnosed in developing countries. Though is an irreversible disease in adults, in children if detected early there is almost complete restoration of pulmonary function and adequate exercise tolerance. Early diagnosis with suitable pharmacological and non-pharmacological management is critical for a positive outcome and prevention of sequelae like persistent bacterial bronchitis.

A reliable and reproducible method for repositioning 3D images to calculate changes in facial volume after orthognathic surgery

PurposeAn accurate, reproducible method to calculate post-operative facial swelling in patients who have undergone orthognathic surgery is important to evaluate the effects of different therapies and surgical techniques on edema. The purpose of this study was to describe such a method and assess its reliability. Materials and methodsA prospective study of patients undergoing orthognathic surgery was conducted. 3D facial photographs were taken on these patients immediately postoperatively, and again at least 21 days later using the 3DMD face system (3DMD LLC., Atlanta, GA, USA). These were cropped using specific anatomic points and the difference in facial volume between the photographs was calculated. Intra-rater reliability and inter-rater reliability were assessed using the Intraclass Correlation Coefficient (ICC). Results30 patients were included in the study for analysis. When the difference in facial swelling was calculated twice by the same rater, the mean difference between the two measurements was 4.0 ± 4.2 mL. When calculated by two separate raters, the mean difference was found to be 5.0 ± 3.8 mL. The ICCs for intra-rater and inter-rater reliability were excellent at 0.979 and 0.981 respectively. ConclusionThis method allows for reproducible calculation of post-operative facial swelling and could be useful to evaluate the effects of different therapies used to limit swelling and to track the resolution of swelling. It can also potentially be used as a visual aid for patient counseling during the pre-surgical visits.

РЕАКЦИЯ ЛЕКАРСТВЕННОЙ ГИПЕРЧУВСТВИТЕЛЬНОСТИ С ЭОЗИНОФИЛИЕЙ И СИСТЕМНЫМИ СИМПТОМАМИ (DRESS-СИНДРОМ) НА КАРБАМАЗЕПИН. Клинический случай и обзор литературы

Abstract. Introduction. A drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, potentially life- threatening T-cell mediated reaction characterized by heterogeneous clinical manifestations and by a variable and unpredictable course. It is difficult to diagnose this reaction due to the long latent period between the start of therapy with a new drug and onset of symptoms, as well as due to no pathognomonic manifestations. Aim. Providing physicians with an algorithm for the diagnosis and treatment of DRESS syndrome exemplified by our own clinical observation. Materials and Methods. A 70-year-old female patient was hospitalized in the Department of Allergology and Immunology, complaining of generalized itchy rash on the face, body, and extremities, swelling of face and hands, and temperature rise to 37.5-38 °C. She was examined using general clinical, laboratory and instrumental methods. Results and Discussion. On examination, we found generalized maculopapular rash, increased levels of hepatic transaminases, reaching the criteria for mild drug-induced liver damage, and peripheral blood eosinophilia 25% (4,260 cells in 1 μl). Using the RegiSCAR scoring system helped to diagnose drug hypersensitivity reaction with eosinophilia and systemic symptoms, while utilizing the algorithm for assessing the causal relationship between the drug and the development of symptoms allowed considering carbamazepine as a possible cause of this reaction. The patient was treated with systemic and topical glucocorticosteroids with positive changes. Conclusions. Using the RegiSCAR scoring system developed by a team of international experts facilitates diagnosing the DRESS syndrome. Identifying and withdrawing the culprit drug is an essential condition of successfully managing patients. Systemic and topical glucocorticosteroids are the drugs of choice for the treatment of drug reactions with eosinophilia and systemic symptoms.

P133 Differential diagnosis of facial swelling: case report of Juvenile recurrent parotitis

P133 Differential diagnosis of facial swelling: case report of Juvenile recurrent parotitis

AngioJetTM rheolytic thrombectomy with covered balloon-expandable stent deployment in a superior vena cava syndrome: a case report

The Superior Vena Cava Syndrome (SVCS) is a rare mediastinal syndrome, frequently due to compression by a mediastinal malignant leading to venous flow obstruction through the Superior Vena Cava (SVC) towards the heart. The symptoms may consist of edema of the upper body and distended veins, dyspnea up to a life-threatening condition. Restoring the SVC flow by endovascular means can be beneficial in order to achieve a rapid relief of the clinical symptoms. A 51-year-old male with a recent diagnosis of squamous cell lung tumor diagnosis presented to the emergency department with persistent cough, neck and face swelling, and distended jugular veins on clinical examination. No dyspnea and normal vital parameters were reported. Computed Tomography angiography (CT) examination demonstrated thrombosis of subclavian veins and SVC due to compression by malignancy. Compression also involved the right upper lobar bronchus. Through a percutaneous transvenous right humeral access, phlebography confirmed total occlusion of the right subclavian vein, brachiocephalic venous trunk, and superior vena cava. We performed AngioJetTM (Boston Scientific, Marlborough, MA, USA) rheolytic endovascular thrombectomy. The phlebography demonstrated the unlying hemodynamic stenosis due to the ab-extrinsic compression and underwent stenting with a covered balloon-expandable stent. The final phlebography confirmed the patency of the stent and restoration of venous flow. Although there was a complete recovery of the symptoms, the patient died from respiratory complications caused by malignancy involvement. AngioJetTM mechanical thrombectomy and covered balloon-expandable stent deployment is a useful solution for SVCS to quickly achieve relief of the clinical symptoms. There are few case series where thrombectomy and primary stent placement are studied. Further follow-up studies are needed to understand the patency of treated vessels better.

Repair of Oroantral Fistulas Using Free Bone and Mucoperiosteal Flaps After Endoscopic Removal of the Medial Wall of the Maxillary Sinus.

Oroantral fistula (OAF) refers to a pathological connection between the oral cavity and maxillary sinus. It may lead to symptoms that include purulent mucus, nasal congestion, facial swelling, bad breath, and nasal regurgitation of food, all of which negatively impact patients' quality of life. This study presents a novel approach for OAF repair using a 2-layered structure composed of free bone and a mucoperiosteal flap obtained from the medial wall of maxillary sinus. Ten OAF patients who underwent repair using this method were retrospectively reviewed between August 2015 and June 2022. The extraction of maxillary molars was the most common cause of OAF. The size of the fistulas ranged from 1×2mm to 5×8mm. Nine of the 10 patients achieved successful OAF closure following the initial operation using the 2-layer structure composed of free bone and mucoperiosteal flag. One patient was lost to follow-up. The 9 patients were observed for 6 months to 1 year, and they exhibited no obvious complications or recurrence. The use of free bone and mucoperiosteal flag from the medial wall of maxillary sinus through an endoscope was effective for OAF repair.

Orbital floor defect caused by invasive aspergillosis: a case report and literature review.

Fungal sinusitis is relatively rare, but it has become more common in recent years. When fungal sinusitis invades the orbit, it can cause proptosis, chemosis, ophthalmoplegia, retroorbital pain, and vision impairment. We present a case of an extensive orbital floor defect due to invasive fungal sinusitis. A 62-year-old man with hypertension and a history of lung adenocarcinoma, presented with right-side facial pain and swelling. On admission, the serum glucose level was 347 mg/dL, and hemoglobin A1c was 11.4%. A computed tomography scan and a Waters' view X-ray showed right maxillary sinusitis with an orbital floor defect. On hospital day 3, functional endoscopic sinus surgery was performed by the otorhinolaryngology team, and an aspergilloma in necrotic inflammatory exudate obtained during exploration. On hospital day 7, orbital floor reconstruction with a Medpor Titan surgical implant was done. In principle, the management of invasive sino- orbital fungal infection often begins with surgical debridement and local irrigation with an antifungal agent. Exceptionally, in this case, debridement and immediate orbital floor reconstruction were performed to prevent enophthalmos caused by the extensive orbital floor defect. The patient underwent orbital floor reconstruction and received intravenous and oral voriconazole. Despite orbital invasion, there were no ophthalmic symptoms or sequelae.

Clinical findings, surgical treatment and outcome in dogs with parotid duct ectasia: 14 cases (2010-2023).

To describe the clinical presentation, diagnostic findings, surgical treatment and outcome of dogs diagnosed with parotid duct ectasia. Medical records of dogs diagnosed with parotid duct ectasia between 2010 and 2023 at six small animal referral hospitals were retrospectively reviewed. Outcome was assessed by contacting the owners or referring veterinarians. Fourteen dogs were included. Lateral facial swelling was the most common clinical presentation. CT revealed a tortuous cavitary tubular fluid-filled structure consistent with a dilated parotid duct in all dogs. Surgical treatment included marsupialisation of the parotid duct papilla, surgical exploration of the duct alone, parotid duct marsupialisation with surgical exploration of the duct, parotidectomy or en-bloc parotid duct resection. The aetiology of parotid duct ectasia was not established in 13 of 14 dogs. In one case, a foreign body was retrieved from the duct. No recurrence of clinical signs was noted during the follow-up period (range 21 to 2900 days). Parotid duct ectasia should be considered for dogs with a lateralised fluctuant non-painful tubular facial swelling. Surgical management was associated with a favourable prognosis without evidence of recurrence in all cases reported in the case series.

The Effect of Platelet-Rich Fibrin on Post-Operative Inflammatory Sequelae after Mandibular Third Molar Surgery: A Randomized Controlled Trial

Background: Surgical extraction of impacted mandibular third molars is commonly associated with post-operative inflammatory sequelae, causing distress to patients and affecting their quality of life. This study aimed to investigate the effect of using autologous platelet-rich fibrin (PRF) on post-operative pain, facial swelling, and trismus following mandibular third molar surgery.&#x0D; Methods: In this single-blinded prospective randomized controlled trial, 90 participants aged 18-35 years were enrolled. Eligible patients underwent surgical extraction of impacted mandibular third molars under local anesthesia between October 2017 and June 2018 at the Oral and Maxillofacial Surgery clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Participants were randomly assigned to either the PRF group or the non-PRF group. PRF was placed in the extraction socket of the PRF group, while the non-PRF group received a blood clot. Post-operative pain, facial swelling, and trismus were measured as outcomes. Longitudinal data analysis using generalized estimating equations was employed, adjusting for confounding factors, with statistical significance set at p &lt; 0.05.&#x0D; Results: The PRF group exhibited significantly lower pain scores (3.02 mm; p &lt; 0.001), reduced facial swelling (0.55%; p = 0.01), and decreased trismus (4.52%; p = 0.05) compared to the non-PRF group.&#x0D; Conclusion: Placement of PRF in the extraction socket following mandibular third molar surgery resulted in decreased post-operative pain, facial swelling, and trismus. These findings suggest that PRF may have a beneficial impact on the inflammatory outcomes of third molar surgeries.&#x0D; &#x0D;