History Of Facial Trauma Research Articles

Clinicial-pathologic correlations of non-trauma related Odontodysplasia in 28 dogs: 2013-2023.

Odontodysplasia is an uncommon dental developmental disorder associated with enamel, dentin, pulp abnormalities, and overall tooth morphology. The affected tooth is grossly abnormal in size and contour and is commonly associated with swelling of the affected area and failure of eruption. Histologically, the enamel and dentin are hypoplastic and hypomineralized. Odontodyplasia occurs most commonly in response to direct trauma to the developing tooth bud (enamel organ and dental follicle). Data on the prevalence and features of non-traumatic odontodysplasia are lacking. Medical records of dogs diagnosed with odontodysplasia were reviewed at the William R. Pritchard Veterinary Medical Teaching Hospital (VMTH), University of California, Davis, for 10 years (from 2013 to 2023). Dogs with a known history of facial trauma, persistent deciduous tooth or teeth over the region of odontodysplastic tooth or teeth, and endodontic disease of the persistent deciduous tooth or teeth were excluded from the study. Twenty-eight dogs were included in this retrospective study, representing an incidence of 1.4 per 100 dogs presenting over 10 years. Regional odontodysplasia (RO) was identified in twenty-two dogs, and generalized odontodysplasia (GO) was found in six dogs. Both comprehensive oral examination and diagnostic imaging were essential in diagnosing and assessing the presence of odontodysplasia. Awake oral examination failed to identify odontodysplasia in almost 70% of the RO cases. Secondary diseases or lesions in odontodysplastic teeth, such as periodontal disease, endodontal disease, and perio-endo lesions, were commonly seen and were particularly more frequently identified in strategic teeth (canine and carnassial teeth) than non-strategic ones. Similarities, such as female predilection, maxilla more commonly affected, and clinical signs, were observed between RO in dogs and those reported in people. The exact etiology of non-traumatic odontodysplasia remains elusive, and the condition may be of multifactorial causality.

A Case of Atraumatic Pseudoaneurysm of Superficial Temporal Artery

Pseudoaneurysm of the superficial temporal artery (STA) is a rare vascular lesion that typically presents after traumatic head injury. Most of them occur mainly in the anterior branch of the STA, and their occurrence in the preauricular region without any history of trauma is very uncommon. In this article, we describe a 78-year-old female patient presenting a painless preauricular, pulsatile mass without any history of facial trauma. The mass was completely removed following ligation and division of STA both proximally and distally. In most case reports, the diagnosis was performed with thoughtful history taking and physical examination. Diagnostic imaging is especially useful in cases of STA aneurysm without any history of trauma. Herein, we present a rare case of preauricular pseudoaneurysm of STA with a literature review.

AN UNUSUAL CASE OF ORAL FOCAL MUCINOSIS

Focal oral mucinosis (OFM) is a rare lesion of unknown etiology that exhibits tumor growth. OFM has a predilection for keratinized tissues, such as the gingiva or hard palate. The occurrence of OFM in nonadherent oral mucosa is rare. Here we present the case of a 47-year-old woman, nonsmoker, nonalcoholic, with no history of facial trauma. On extrabuccal examination, no changes were observed. On intraoral examination, a 10 × 10 mm yellow submucosal rounded nodule was observed in the lower midline fornix region, fibrous on palpation, covered by thin and normal mucosa. On occlusal radiography, no bone destruction was observed. Excisional biopsy was performed. Histomorphologic analysis showed myxoid connective tissue with abundant mucinous material with delicate collagen fibrils. The diagnosis of OFM was established by staining with Alcian blue, period acid-Schiff stain, and immunohistochemistry for protein S-100. In 1 year of follow-up, there was no recurrence.

Age-related changes of the periocular morphology: a two- and three-dimensional anthropometry study in Caucasians

PurposeTo determine age-and sex-related changes in periocular morphology in Caucasians using a standardized protocol.MethodsHealthy Caucasian volunteers aged 18–35 and 60–90 years old were recruited from the Department of Ophthalmology, Faculty of Medicine and University Hospital, Cologne, between October 2018 and May 2020. Volunteers with facial asymmetry, facial deformities, history of facial trauma, facial surgery, botox injection, eyelid ptosis, strabismus, or nystagmus, were excluded. Standardized three-dimensional facial photos of 68 young volunteers and 73 old volunteers were taken in this clinical practice. Position changes of endocanthion, pupil center, and exocanthion were analyzed in different age and gender groups, including palpebral fissure width (PFW): distance between endocanthions (En-En), pupil centers (Pu–Pu), exocanthions (Ex-Ex), endocanthion and nasion (En-Na), pupil center and nasion (Pu-Na), exocanthion and nasion (Ex-Na), endocanthion and pupil center (Pu-En), exocanthion and pupil center (Pu-Ex), and palpebral fissure inclination (PFI); angle of endocanthions to nasion (En-Na-En), pupils to nasion (Pu-Na-Pu), exocanthions to nasion (Ex-Na-Ex); endocanthion inclination (EnI), and exocanthion inclination (ExI).ResultsPFW, En-En, Ex-Na, Pu-Ex, PFI, ExI, and Ex-Na-Ex were significantly different between the young and old groups (p ≤ 0.004). There were sex-related differences in PFW, Ex-Ex, En-Na, Pu-Na, Ex-Na, Pu-En, PFI, and EnI between both groups (p ≤ 0.041).ConclusionThe position change of the pupil is minimal relative to age; it is preferred to establish the reference plane to describe periocular changes. The endocanthion tends to move temporally and inferiorly, while the exocanthion tends to shift nasally and inferiorly with age.

Silent sinus syndrome: systematic review and proposal of definition, diagnosis and management.

SUMMARYSilent sinus syndrome (SSS) is a rare disease consisting of a collapse of maxillary sinus walls with concomitant orbital floor descent. Due to its rareness, the literature highlights some confusion on its definition, diagnosis and management. A PRISMA-compliant systematic review was performed on SSS with focus on definition, diagnosis and therapeutic management. Twenty-eight studies were selected, with 276 patients evaluated. The analysis revealed that the leading definition of SSS includes evidence of both enophtalmos and maxillary atelectasia. Although the definition of SSS accepts only spontaneous sinus collapse, the presence of sinonasal diseases and history of facial trauma are starting to be included in the criteria. Most studies (n = 21) considered CT scans satisfactory for diagnosis of SSS, while 7 also performed MR. The majority of SSS were successfully treated with isolated functional endoscopic sinus surgery (n = 17), sparing orbital reconstruction as a rescue procedure in case of non-satisfactory long-term resolution of signs. Although the literature is starting to coordinate on diagnosis of SSS, our review revealed the necessity of consensus on its definition and management.

Step-technique genioplasty: A case report

Genioplasty is the gold standard technique to modify natural chin anatomy based on an inferior border osteotomy of the mandible enabling 3D-repositioning of the chin. Our “step-technique genioplasty” is a modified and improved surgical technique for advancement genioplasty in patients with elusive chin and vertical excess of the lower third. We performed this technique on a 23-year-old female patient with a history of facial trauma that affected the morphology and aesthetics of the lower third. The surgery consisted of two osteotomy lines. The first osteotomy line was a monocortical osteotomy allowing to preserve the integrity of the lingual cortex. About 3 mm below, the second and complete bicortical osteotomy was performed to mobilize the chin segment. A bone fragment containing the vestibular cortex and medullary portion of the mandible was removed preserving the integrity of the lingual cortex and creating a bony step in mandibular symphysis. The osteotomized chin was advanced in the front of the bony step. Compared with known techniques, step-technique genioplasty allowed addressing the vertical chin excess not only at the level of the symphysis but also posteriorly with no over-projection of the chin and no deepening of the labiomental crease, common downsides in other approaches. The aesthetic outcome reflected the preoperative planning: we obtained a smoother transition between symphysis and horizontal branch of the mandible, just the right amount of anterior projection of the chin, greater stability, and predictability of the outcome with satisfying aesthetical results and no complications.

\u201cMultidisciplinary management of post- infective osteoarthritis and secondary condylar resorption of temporomandibular joint: a case report in a 9\u2009years-old female patient and a review of literature\u201d

BackgroundOsteoarthritis and condylar resorption of temporomandibular joint (TMJ) has rarely been reported in children as consequence of otologic disease. We describe the management of a case in a 9-year-old female as long-term complication of an otomastoiditis and review the literature currently available on this topic.Case presentationA nine-years-old female patient referred to Emergency Room of Bambino Gesù Children’s Research Hospital, IRCCS (Rome,Italy) for an acute pain in the left preauricular area and reduced mandibular movements. In the medical history an otomastoiditis and periorbital cellulitis was reported at the age of six with complete remission of symptoms after antibiotic treatment. No recent history of facial trauma and no previous orthodontic treatment were reported. She was referred to a pediatric dentist that conducted a clinical examination according to the Diagnostic Criteria of Temporomandibular Disorders (DC/TMD) and was diagnosed with bilateral myalgia of the masticatory muscles and arthralgia at the level of the left TMJ. Then, a complete diagnostic path was performed that included multidisciplinary examinations by a rheumatologist, infectious disease specialist, ear nose and throat (ENT) doctor, a maxillofacial surgeon and a medical imaging specialist. Differential diagnosis included juvenile idiopathic arthritis, idiopathic condylar resorption, trauma, degenerative joint disease, neurological disease. Finally, unilateral post-infective osteoarthritis of the left TMJ with resorption of mandibular condyle was diagnosed. The patient went through a pharmacological therapy with paracetamol associated to counselling, jaw exercises and occlusal bite plate. After 1 month, the patient showed significant reduction of orofacial pain and functional recovery that was confirmed also one-year post-treatment. The novelty of this clinical case lies in the accurate description of the multidisciplinary approach with clinical examination, the differential diagnosis process and the management of TMD with conservative treatment in a growing patient.ConclusionsSeptic arthritis of temporomandibular joint and condylar resorption were described as complications of acute otitis media and/or otomastoiditis in children. We evidenced the importance of long-term follow-up in children with acute media otitis or otomastoiditis due to the onset of TMJ diseases. Furthermore, in the multidisciplinary management of orofacial pain the role of pediatric dentist is crucial for the diagnostic and therapeutic pathway to avoid serious impairment of mandibular function.

A Quantitative Analysis of Facial Asymmetry in Torticollis Using 3-Dimensional Photogrammetry.

To assess whether children with torticollis have quantifiably greater facial asymmetry than their age-matched controls using 3-dimensional (3D) photogrammetry. We retrospectively analyzed patients diagnosed with torticollis and age-matched volunteers who underwent 3D photogrammetry of their faces. We calculated the root mean square deviation (RMSD) between native and reflected facial images, as a measure of asymmetry. Two observers independently measured RMSD values for all study participants. The Spearman correlation coefficient evaluated interobserver reliability. The Wilcoxon rank-sum test with Bonferroni adjusted P values for multiple comparisons. Institutional. Twenty patients diagnosed with torticollis and 12 age-matched volunteers. Patients were analyzed on a computer database and volunteers were selected and consented in the hospital. We excluded patients with a history of facial trauma, facial operations, or other craniofacial diagnoses. Facial surface scans were obtained using the Canfield Vectra stereophotogrammetry system. The technology captures surface anatomy without radiation. RMSD comparisons between patients with torticollis and age-matched controls. Compared to controls, patients with torticollis had statistically significant greater full face, upper third, and middle third facial asymmetry. There was a trend toward greater asymmetry of the lower facial third. We used 3D photogrammetry to quantitate facial asymmetry from torticollis. We found greater asymmetry in patients with torticollis than in their unaffected peers. All areas of the face appeared to be affected, though the asymmetry in the lower facial third just failed to reach significance.

Cephalometric for Orthognathic Surgery (COGS) Analysis for Saudi Population

Objective: T o establish the cephalometric (Ceph.) norm by Ceph. for orthognathic surgery (COGS) analysis for Saudi population . Material and Methods: 500 adult Saudi samples (250 males and 250 females) with the age range of 18-30 years old were selected for this study. The selections of samples were based on a normal occlusal relationship, no history of facial trauma and no previous orthodontic treatment. Lateral Ceph. radiographs were tracing by CASSOS software and analyzed by SPSS software according to COGS analysis. Results: Signi fi cant differences were showed between the Saudi males and females on most of the Ceph. parameters. The Saudi males had a convex facial profile with chin prominent and more bimaxillary protrusion, upper and lower lip protrusion than the Saudi females . Conclusion: This study evaluated the craniofacial morphological difference between the male and the female population in Saudi Arabia by using COGS analysis. The finding of this study will help for better diagnosis of orthodontic and orthognathic surgical treatment planning and identify the morphological facial characteristics of Saudi patients.

Craniofacial Anthropometry of Healthy Turkish Young Adults: Analysis of Head and Face.

The aim of this study was to evaluate the craniofacial anthropometric measurements of Turkish young adults between the ages of 18 and 25. Anterior view and side profile photographs were taken of 100 females and 100 males who volunteered to participate in the study and had no craniofacial anomalies, history of facial trauma, or history of orofacial surgery. Thirteen landmarks on the face and head were chosen, and these landmarks were identified on the photographs. Then, using these landmarks, a total of 19 distance measurements were made, 16 from the anterior view, and 3 from the side profile. There were statistically significant differences between the sexes in 13 parameters: 2 parameters (t-n and ft-ft) being higher in females and 11 parameters (v-n, v-t, t-gn, sn-gn, n-gn, st-gn, sl-gn, fz-fz, z-z, tr-tr and go-go) being higher in males. Also, 7 facial anthropometric ratios were calculated. There were statistically significant differences between the genders in all ratios. The literature reveals that craniofacial anthropometric measurements have been performed on many different populations and that there are numerous differences between the results of the studies conducted. We are of the opinion that the results obtained in this present study will contribute to the literature by helping to determine the standard values for the Turkish population between the ages of 18 and 25, which can be used in diagnosis, treatment and postoperative evaluation in areas such as forensic science, orthodontics, clinical genetics, maxillofacial surgery, and plastic surgery.

Incidence of Odontogenic Disease in Patients With Pott's Puffy Tumor

Osteomyelitis with subperiosteal abscess of the frontal bone, or Pott's puffy tumor (PPT), is a rare but life-threatening condition. The relationship of concurrent dental disease to PPT has not been well described. This study sought to delineate the incidence of odontogenic disease in PPT, especially in cases where there is no history of facial trauma or prior frontal sinus surgery. A retrospective chart review of patients diagnosed with PPT between 2010 and 2019 was carried out. Demographics, pertinent medical history, surgical procedures performed, and microbial cultures and antibiotics used were extracted for analysis. Maxillofacial computed tomography scans were reviewed for presence of odontogenic disease. A total of 17 patients were identified. Four had documented history of frontal bone trauma; 3 had previous frontal sinus surgery. Seven (41%) had documented odontogenic disease on initial radiology reports; however, upon dentist review, 16 (94%) had various pathology visible on their computed tomography scans. Twelve of these 16 patients had no previous frontal sinus trauma or surgery. Eight patients (47%) had only ipsilateral maxillary or ethmoid inflammation respective to PPT on computed tomography. Seventy-six percent of patients underwent endoscopic sinus surgery. Of 14 patients with cultures collected at the time of surgery, 7 (50%) had polymicrobial growth and 6 (43%) had anaerobic growth. The incidence of odontogenic disease in this population of PPT was 94%. In the absence of a history of frontal bone trauma or frontal sinus surgery, underlying dental origin should be suspected in cases of PPT. Initial radiology reports may not document all identifiable dental pathology. Therefore, patients presenting with PPT should undergo comprehensive evaluation, including an oral cavity and dental examination, and potential referral to dental colleagues.

Comparative and retrospective evaluation of the predictive performance of optic nerve sheath thickness and optic nerve sheath diameter for traumatic brain injury using facial computed tomography.

ObjectiveTo evaluate the predictive performance of optic nerve sheath thickness (ONST) on the outcomes of traumatic brain injury (TBI) and to compare the inter-observer agreement To evaluate the predictive performance of optic nerve sheath thickness (ONST) for traumatic brain injury (TBI) and to compare the predictive performance and inter-observer agreement between ONST and optic nerve sheath diameter (ONSD) on facial computed tomography (CT).MethodsWe retrospectively enrolled patients with a history of facial trauma and who underwent both facial CT and brain CT. Two reviewers independently measured ONST and ONSD of each patient using facial CT images. Final brain CT with clinical outcome was used as the reference standard for TBI. Multivariate logistic regression analyses, receiver operating characteristic (ROC) curves, and intraclass correlation coefficients were used for statistical analyses.ResultsBoth ONST (P=0.002) and ONSD (P=0.001) on facial CT were significantly independent factors to distinguish between TBI and healthy brains; an increase in ONST and ONSD values corresponded with an increase in the risk of TBI by 8.9- and 7.6-fold, respectively. The predictive performances of the ONST (sensitivity, 96.2%; specificity, 94.3%; area under the ROC curve, 0.968) and ONSD (sensitivity, 92.6%; specificity, 90.2%; area under the ROC curve, 0.955) were excellent and exhibited similar sensitivity, specificity, and area under the curve (P=0.18–0.99). Interobserver and intraobserver intraclass correlation coefficients for ONST were significantly higher than those for ONSD (all P<0.001).ConclusionONST on facial CT is a feasible predictor of TBI and demonstrates similar performance and superior observer agreement than ONSD. We recommend using ONST measurements to assess the need for additional brain CT scans in TBI-suspected cases.

Differences in dental arch characteristics between genders in patients with suspected condylar hyperplasia in a North Sumatra subpopulation: a cross-sectional study

Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress in conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to analysis the difference of dental arch characteristics based on genders in orthodontic patients with suspected CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient’s clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior crossbite and midline deviation), the positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, the distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p&lt;0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form were mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these suspected CH patients. Conclusion: Indeed skeletal asymmetry, the evaluation of the dental arch characteristic symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with suspected CH in the North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.

Differences in dental arch characteristics between genders in patients with suspected condylar hyperplasia in a North Sumatra subpopulation: a cross-sectional study

Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress in conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to analysis the difference of dental arch characteristics based on genders in orthodontic patients with suspected CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient’s clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior crossbite and midline deviation), the positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, the distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p<0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form were mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these suspected CH patients. Conclusion: Indeed skeletal asymmetry, the evaluation of the dental arch characteristic symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with suspected CH in the North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.

Evaluation of dental arches in orthodontic patients with condylar hyperplasia in a North Sumatra subpopulation: a cross-sectional study

Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to evaluate dental arches by analyzing dental arch asymmetry and form in orthodontic patients with CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient’s clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior cross bite and midline deviation), positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p&lt;0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form was mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these CH patients. Conclusion: The evaluation of dental arch symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with CH in North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.

Evaluation of dental arches in orthodontic patients with condylar hyperplasia in a North Sumatra subpopulation: a cross-sectional study.

Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to evaluate dental arches by analyzing dental arch asymmetry and form in orthodontic patients with CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient's clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior cross bite and midline deviation), positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p<0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form was mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these CH patients. Conclusion: The evaluation of dental arch symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with CH in North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.

FOREIGN-BODY REACTION IN THE UPPER LIP: CASE REPORT

Foreign-body reaction is an inflammatory process caused by the presence of immunologically inert exogenous materials in the organism. A 47-year-old female patient, who was hairdresser, presented with an exophytic lesion in the upper lip, whose coloration was similar to that of the mucosa, which evolved over the course of 20 years. The patient reported no history of systemic diseases, submission to aesthetic procedures, or history of facial trauma. Thus, the clinical diagnosis was fibrous hyperplasia. After excisional biopsy, the histopathologic analysis revealed the presence of vacuoles and cells with clear cytoplasm compatible with macrophages in connective tissue. The immunohistochemical reaction for CD68 demonstrated strong diffuse immunoexpression in a large number of cells, confirming the presence of macrophages. The final diagnosis was foreign body type reaction. The patient is still under follow-up, and after 6 months there were no signs of recurrence. Foreign-body reaction is an inflammatory process caused by the presence of immunologically inert exogenous materials in the organism. A 47-year-old female patient, who was hairdresser, presented with an exophytic lesion in the upper lip, whose coloration was similar to that of the mucosa, which evolved over the course of 20 years. The patient reported no history of systemic diseases, submission to aesthetic procedures, or history of facial trauma. Thus, the clinical diagnosis was fibrous hyperplasia. After excisional biopsy, the histopathologic analysis revealed the presence of vacuoles and cells with clear cytoplasm compatible with macrophages in connective tissue. The immunohistochemical reaction for CD68 demonstrated strong diffuse immunoexpression in a large number of cells, confirming the presence of macrophages. The final diagnosis was foreign body type reaction. The patient is still under follow-up, and after 6 months there were no signs of recurrence.

Substance Use and Maxillofacial Trauma: A Comprehensive Patient Profile

Maxillofacial trauma confers an increased risk of long-term clinical sequelae with a substantial economic burden on the health care system.Substance use has long been correlated with an increased risk of trauma, yet to date, a comprehensive profile of substance users incurring facial fractures has not been established. We aimed to establish patterns and trends of substance use and specific substances in the setting of maxillofacial trauma. A retrospective chart review was conducted at our institution examining patients with maxillofacial fractures from 2016 to 2017. Information on age, gender, race, urine drug screen status, setting of presentation, mechanism of injury, trauma history, and injury severity was collected and examined for associations with particular substances. We included 388 patients for analysis. Patients with positive urine drug screen results were significantly more likely to be men, present in an urban setting, incur poly-facial trauma, and have a history of facial trauma. In addition, alcohol use correlated significantly with injury severity in the context of polytrauma. Living in an urban setting and using phencyclidine were both significantly associated with a history of maxillofacial trauma. Patients with comorbid maxillofacial trauma and substance use exhibit particular patterns in presentation and history. Establishing a profile for these patients allows for the development of prevention and rehabilitation programs.

Eyelid Spontaneous Blink Analysis and Age-Related Changes Through High-Speed Imaging.

To analyze the spontaneous eyelid blink and sphincter closure activity of the orbicularis oculi by measuring the horizontal eyelid movement. Individuals 18+ years of age, any ethnicity, and gender were recruited. Participants completed a questionnaire to determine eligibility. Exclusion criteria included the following: history of facial trauma, nerve palsy, surgery, use of periorbital neuromodulators or filler within the past year, thyroid eye disease, and eyelid or ocular surface disease. Data were collected from participants by decade. Eyelid blinks were recorded using the FPS 1000HD. The motions of 3 spontaneous blinks in primary gaze were recorded. All blinks were reviewed and one chosen for most accurate analysis. Horizontal palpebral fissure width and its changes of open and closed eye measurements were taken using National Institute of Health ImageJ software version 2.0. The data were subjected to SAS version 9.4 analysis using paired t test, t test, and linear models. One hundred thirty-six patients were recruited. Fourteen patients were excluded; 122 patients were used in analysis. Ages ranged from 22 to 90 years. Participants were divided into 6 groups according to age (20-29, 30-39, 40-49, 50-59, 60-69, and 70+ years of age). The average horizontal fissure length across all ages was 24.23 mm. Average change in horizontal fissure length decreased 1.42 mm among all ages. There was a statistically significant difference comparing age 20-29 decade to age 70+ decade. Horizontal fissure length changes with eyelid blink and defines 1 component of the eyelid sphincter.

Olfactory Dysfunction in β Thalassemia Major Patients Treated With Iron-Chelating Agents.

Ocular and ophthalmological adverse effects may be seen in β-thalassemia major (BTM) patients treated with regular blood transfusions and iron-chelating agents. We hypothesized that olfactory dysfunction may be present in this population. In this study, we aimed to investigate olfactory dysfunction in patients with BTM and determine the etiological factors. A total of 43 patients with BTM were included in the study. Forty-three patients without any nasal complaints, history of facial trauma, or nasal surgery were included as the controls. All participants had nasal endoscopy. The iron-chelating agents used, their duration of use, as well as hemoglobin and ferritin levels of the BTM patients were recorded. Sniffin' Sticks test (SST) was used to assess olfactory functions, and BTM and control groups were compared for the results. The correlations of SST scores with the other study parameters were analyzed. Eight (18.6%) of 43 patients in the BTM group had hyposmia while none of the patients in the control group had hyposmia (P < .001). Older age, low-hemoglobin level, and longer use of deferoxamine were found to be correlated with olfactory dysfunction. Olfactory dysfunction may be seen in BTM patients treated with iron-chelating agents. The results of this study suggest that screening for olfactory function may be needed in routine follow-up of BTM patients.