Zygomatic Bone Research Articles

Three-dimensional analysis of facial asymmetry after zygomaticomaxillary complex fracture reduction: a retrospective analysis of 101 East Asian patients.

BackgroundThe zygomaticomaxillary complex (ZMC) has a protruded, convex shape and plays a vital role in determining the contour by affecting the width of the middle face. This study aimed to evaluate the efficiency of ZMC fracture reduction and explore detailed directions for outcome improvement.MethodsWe conducted a retrospective study of patients diagnosed with unilateral ZMC fracture who underwent ZMC reduction surgery at a single hospital between January 2015 and May 2020. The primary outcome variable was facial asymmetry using the difference in the bilateral malar eminence (ME) position measured by computed tomography scan. The 3-dimensional distance (IA, asymmetry index) and the distance in each dimension, Dx (anteroposterior distance), Dy (mediolateral distance), and Dz (superoinferior distance) were compared.ResultsA total of 101 patients with ZMC fractures and 54 non-fracture patients were enrolled in the study. The mean age of the study sample was 43.49 years (control sample, 43.35 years), and the male-to-female ratio was 66.3:33.7 (control sample, 64.8:35.2). There were 53 and 48 patients with right and left ZMC fractures, respectively. The IA was not statistically different between the two groups. In terms of position in each dimension, only Dx was significantly different between the two groups.ConclusionThe results show that overall facial asymmetry was recovered after ZMC reduction, but in certain dimension significant difference in ME position has still remained. For further improvement, treatment should be performed to relieve malar depression in the anteroposterior dimension.

A Zygomatic Bone Study Using Virtual Dental Implant Planning Software.

This study evaluated the anatomical factors that influence the virtual planning of zygomatic implants by using cone-beam computerized tomography (CBCT) scans. CBCT scans of 268 edentulous patients were transferred to specialized implant planning software for the following measurements: maxillo-sinus concavity size (small, medium, and large), zygoma width, implant insertion angle, implant length, and implant apical anchorage. Concavity sizes found were as follows: 34.95% small, 52.30% medium, and 7.35% large. The mean insertion angle was 43.2 degrees, and the average implant apical anchorage was 9.1 mm. The most frequent implant length was 40 mm. Significant differences were found when the different types of concavities in relation to the installation angle, the distance of the apical portion of the implant in contact with the zygomatic bone, and the lateral-lateral thickness of the zygomatic bone were compared (P < .001). Medium-sized maxillary sinus concavity presented greater apical anchorage of the implant (9.7 mm) and was the most frequent type (52.30%). The zygomatic bone is a viable site for zygomatic fixtures, and the use of specialized implant planning software is an important tool to achieve predictable outcomes for zygomatic implants and allows good visualization of the relation between implants and anatomical structures.

Extra Articular False Ankylosis Following Fusion of Mandible to Zygomatic Bone and Maxilla Due to Ossifying Fibroma-A Rare Case Report

Trismus is a disturbing condition with varied etiology, one of them is Extra articular ankylosis. The extra articular ankylosis has been reported in the literature as a fusion of the coronoid process to the zygomatic bone or to the skull base. However, there are a very few cases reported in the literature that highlights a pathologic tumor of mandible leading to extra-articular ankylosis and subsequently resulting in trismus. We hereby present a unique case of young adult having restricted mouth opening due to the bony fusion of the mandibular ramus to the zygomatic bone and zygomaticomaxillary buttress region due to a pathologic tumor diagnosed as Ossifying Fibroma.

Diagnostic accuracy of physical examination findings for midfacial and mandibular fractures

ObjectivesTo assess the diagnostic accuracy of physical examination findings used to identify patients at risk for midfacial or mandibular fractures. Materials and MethodsA five-year retrospective cohort was constructed from all emergency department patients with a midfacial or mandibular trauma. The sensitivity, specificity, pre-test probability, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio data was calculated for 19 and 14 physical examination findings for midfacial and mandibular fractures respectively. Computed Tomography and panoramic radiography were used as index tests. ResultsA total of 1484 patients were identified among whom 40.4% midfacial and 33.4% mandibular fractures were diagnosed. Overall, specificity was found to be higher than sensitivity. Regarding midfacial fractures, high specificity was found for raccoon eyes, malar eminence flattening and all the findings that are related to palpation, the nasal, ocular and intra-oral assessment. Malar eminence flattening, external nasal deformity, nasal septum hematoma, change of globe position and palpable step-off had ad high positive predictive value and positive likelihood ratio. Regarding mandibular fractures high specificity was found for mouth opening restriction, auditory canal bleeding, intra-oral assessment related findings, palpable step-off, inferior alveolar nerve paresthesia, the angular compression test and chin axial pressure test. ConclusionsThe diagnostic accuracy of relevant physical examination findings were identified for the prediction of midfacial and mandibular fractures.

A review of post-operative imaging of zygomaticomaxillary complex fractures without orbital floor reconstruction in University Hospital Galway

The zygomaticomaxillary complex (ZMC) is used to describe the zygomatic bone and related structures. When ZMC fractures occur treatment ranges from conservative management to open reduction with internal fixation. It is recommended that radiographs are used to assess the outcome of surgical treatment. Additionally, it is advised that these radiographs are taken, and the images viewed prior to patient discharge.This study analysed the post-operative images used for ZMC reduction without orbital floor reconstruction over a five-year period in the Oral and Maxillofacial Surgery (OMFS) Department in University Hospital Galway (UHG).

Long-term results of treatment for patients with locally advanced external ear skin cancer

The study objective is to assess long-term results of treatment for patients with locally advanced external ear skin cancer.Materials and methods. This research work based on a retrospective and prospective analysis case history for patients with locally advanced external ear skin cancer. These are 45 patients, who received treatment in surgical department of head and neck tumors in Blokhin National Medical Research Center of Oncology between 1994 and 2020. Patient observation time averaged 30.0 ± 32.3 months (from 0.7 to 117.4 months, median 12.0 months). We divided patients into 3 groups depending on treatment methods. Group 1 consisted of patients who received combined or complex treatment (33.3 %, n = 15). Treatment for first group patients involved subtotal, lateral temporal bone resection or incomplete lateral resection and postoperative radiation therapy on the area of primary tumor and regional metastasis zone (total focal dose from 60 Gy). In the case of complex treatment, radiation therapy had carried out against background cisplatin introduction. The second group consisted of patients who received only surgical treatment (40.0 %, n = 18). Temporal bone resections were not performed for patients of the third group (26.7 %, n = 12). Treatment for patients of the third group involved one of the treatment methods: cryodestruction, laser destruction, photodynamic therapy, radiotherapy or chemoradiation treatment.Results. Five-year survival without signs of progression in a group of patients with locally advanced of the ear skin cancer, who received combined or complex treatment was 73.8 ± 13.1. Median progression-free survival not achieved. In the surgical treatment group 5 year progression-free survival was 40.4 ± 13.0, median was 34.1 months. In a group of patients who did not undergo temporal bone resection (3rd group) median progression-free survival was 4.5 months. Group differences are statistically significant (p &lt;0.05). The most significant adverse prognosis factors that reduce overall survival for patients with locally advanced external ear skin cancer are positive histological margin (p = 0.0001, hazard ratio (HR) = 10.611, 95 % confidence interval (CI) 3.058-36.820), signs of destruction branch of the lower jaw/ zygomatic bone (p = 0.027, HR = 4.65, 95 % CI 1.193-18.116). Facial paralysis is the most unfavorable prognosis factor, reducing tumor-specific survival in patients with locally advanced outer ear skin cancer (p = 0.0001, HR = 19.146, 95 % CI 4.056-90.388).Conclusion. Combined/complex treatment of patients with locally advanced ear skin cancer (surgery with postoperative radiotherapy/chemoradiotherapy) provides better long-term results compared to other treatment options.

The difference in the location of the malar summit between genders in Southeast Asians with appropriate references.

BackgroundFacial feminization surgery and malarplasty require information concerning facial features in the malar area. Such information varies as a function of sex and race. The objectives of this study aimed to quantitatively evaluate the location of malar prominence across sexes in the Southeast Asian population, and identify sex-specific differences in malar prominence using a combination of two-dimensional (2D) computed tomography (CT) and three-dimensional (3D) CT.MethodsThe location of malar prominence was evaluated in 101 Thai adults, consisting of 52 men and 49 women. This study used both 2D CT and 3D CT to achieve greater accuracy, in which 2D CT was used to measure malar distance, malar summit width, facial width, and malar summit-to-facial width ratio whereas 3D CT was used to evaluate the positional relationship between the zygomatic summit and four reference points of the zygoma.ResultsThe malar summit was positioned more laterally in males (p<0.01) and was more projected in females (p=0.01). The other 2D-parameters were wider in males. The ratio between the malar summit width and facial width showed similar results for both sexes. The vertical dimension did not show any statistically significant differences; however, a higher summit position was observed in males.ConclusionThe zygomatic summit is positioned more laterally in males and is more projected in females. However, the ratio was similar, which indicates that the male cranium is larger in size. Based on the results in this study, when facial feminization surgery or malarplasty is performed on a Southeast Asian patient, the malar bone should be reduced horizontally and moved forward for better outcomes.

Objective evaluation of orbito-zygomatic reconstruction with scapular tip free flaps to restore facial projection and orbital volume

BackgroundRestoring anatomical contour and position of the malar eminence and orbital rim following ablative mid-face procedures is critical in maintaining facial contour and orbit position. ObjectiveTo report our reconstructive approach using the scapular tip free-flap (STFF) for orbito-zygomatic defects, evaluating contour and overall shape restoration. MethodsThe study included 2 series: a clinical cohort of 15 consecutive patients who underwent an orbito-zygomatic reconstruction with a STFF and a cohort of 10 patients who had CT scan imaging but did not have orbito-zygomatic surgical resection or reconstruction. Using a 3D software, overall conformance (OC) and contour conformance (CC) with respect to the mirrored contralateral (clinical cohort) or native zygoma (preclinical cohort) were analyzed. Postoperative orbital volumes were also measured in the clinical cohort. Mean, median, root-mean-square (RMS), minimum and maximum measurements were obtained both for OC and CC. Conformance values of clinical and preclinical cohort were compared to objectively evaluate the quality of reconstruction in terms of orbito-zygomatic framework restoration (Mann-Whitney test). ResultsAll measurements for OC and CC between scapular tip and the zygoma showed no differences, both on the clinical (RMS: OC 3.29 mm vs CC 3.32 mm -p = NS-) and preclinical (RMS: OC 2.03 mm and CC 2.31 mm -p = NS-) cohorts. Moreover, there were no differences in post-operative orbital volumes in the clinical cohort. Clinical outcomes of the case-series are also reported. ConclusionThe STFF is highly effective in restoring facial projection and orbital volume in orbito-zygomatic reconstruction.

Topology and FEA modeling and optimization of a patient-specific zygoma implant

Additive manufacturing has proven to be a very beneficial production technology in the medical and healthcare industries. While existing for over four decades, recent work has seen great improvements in the quality of products; particularly in medical devices such as implants. Improved customization reduced operating time and increased cost-effectiveness associated with Metal AM for these products offers a new value proposition. This paper investigates and evaluates modelling methods for the zygoma bone (human jawbone) and explores the most suitable material and optimum design for this critical biomedical implant. This paper proposes an innovative and efficient pre-process methodology that includes modelling, design validation, topological optimization, and numerical analysis. The method includes the generation of the model using reverse engineering of CT scan data and a topology optimization technique which makes the implant lightweight without causing excessive stress concentration. Static structural Finite Element Analysis was conducted to test three different biocompatible materials (Ti6Al4V, stainless steel 316L and CoCr alloys) which are commonly available for metal additive manufacturing. The stresses and conditions in the analysis were that of the human mastication process and all the implant design were tested with the three material types. The Taguchi method was used to determine the optimum design which was found to result in the highest mass reduction of 25% with Ti6Al4V as the implant material.

"Digital Simulation of Osteotomy Reduction of a Prominent Zygomatic Arch".

To analyze the value of simulated surgery in predicting the outcome of individualized surgical reduction of a prominent zygomatic arch. Computed tomography data were obtained from the electronic records of 15 patients who underwent surgery at Tianjin Stomatological Hospital for prominent zygoma. The data were imported into Mimics 23.0. Left and right three-dimensional (3D) zygoma models were created through standard procedures. In the 3D models, a wedge-shaped cut of the zygomatic bone was pushed inward, and the osteotomy position of the zygomatic arch was taken as a variable to simulate the reduction malarplasty. The reduction effect was calculated from the simulated movement of the fracture end of the zygomatic arch from internal pushing forces. Stable versus high-efficiency internal pushing areas were defined based on the amount of movement. Mean values with 95% confidence intervals (CI) were calculated for the areas data. The anterior edge of the stable internal pushing osteotomy area was located in front of the articular tubercle point (95% CI: 10.64-11.89 mm). The posterior edge of the stable internal pushing area was located in front of the articular tubercle point (95% CI: 7.8-9.13 mm). The posterior edge of the high-efficiency internal pushing area was located in front of the articular tubercle point (95% CI: 4.7-5.73 mm). Stable and high-efficiency internal pushing areas were detected above the zygomatic arch. The simulation showed that osteotomy in these areas can provide different degrees of zygomatic arch reduction.

The sphenozygomatic fissure

The lateral (temporal) wall of the orbit separates it from the temporal fossa and the anterior part of the temporal muscle. Within this wall, the sphenozygomatic suture joins the greater wing of the sphenoid bone and the zygomatic bone. We retrospectively documented in cone-beam computed tomography the anatomy of the orbit in a 56-year-old female and we found a previously unreported anatomic variant. The greater wing of the sphenoid bone and the zygomatic bone were separated, bilaterally, by a large unossified space which we termed the sphenozygomatic fissure. This was merged inferiorly with the inferior orbital fissure. A possible imbalanced mechanism of membranous ossification of both the zygomatic bone and the orbital surface of the greater wing could be speculated as a possible cause for such sphenozygomatic fissure. This previously undocumented anatomic variant is of high clinical relevance, since it may allow orbital fat to herniate (or bulge) toward the temporal fossa, it may be easily damaged during minor trauma and it should be carefully approached during the surgery of the orbit through the lateral wall.

Taxonomic diversity of Cebuella in the western Amazon: Molecular, morphological and pelage diversity of museum and free-ranging specimens.

We investigated the diversity of the pygmy marmoset, Cebuella pygmaea, by comparing genetic, morphological and pelage traits of animals from Peru and Ecuador. We extracted DNA from museum specimen osteocrusts and from fecal samples collected from free-ranging individuals. We sequenced the mtDNA cytochrome b gene and the control region from samples collected at 13 different sites and used Bayesian inference and Maximum Likelihood to identify distinct clades. We took measurements of the crania of a subset of these specimens (n = 26) and ran a logistic regression to determine if any of the cranial measurements (n = 22) could predict a specimen's clade. In addition, we examined the pelage patterns of the museum specimens and photographs taken of free-ranging individuals and divided them into pelage types based on coloration of the underbelly. We identified two divergent clades, and two distinct groups with clear geographic boundaries within one of those clades. Two measurements of the zygomatic bone perfectly predicted a given individual's mtDNA clade. We found four distinct pelage patterns in our samples, but these patterns are variable within clades and among individuals within the same population. These analyses indicate that the two recognized subspecies of pygmy marmoset should be elevated to the species level (C. pygmaea and C. niveiventris) based on molecular and cranial differences but not on pelage patterns. We provide evidence on the geographic limits of the two clades and identify regions where additional sampling is required to better define the geographic distribution of the two clades.

Maxillary dentoskeletal outcomes of the expander with differential opening and the fan-type expander: a randomized controlled trial.

The aim of this study was to compare the maxillary dentoskeletal outcomes of the expander with differential opening (EDO) and the fan-type expander (FE). Forty-eight patients with maxillary arch constriction in the mixed dentition were randomly allocated into EDO and FE groups. Cone-beam computed tomography scans were acquired before and after expansion. Linear and angular three-dimensional changes were assessed after cranial base superimposition using the ITK-SNAP and the 3D Slicer software. T or Mann-Whitney U tests were used for intergroup comparisons (P<0.05). The EDO group comprised 24 patients treated with the EDO (13 female, 11 male; 7.6 years). The FE group comprised 24 patients treated with the FE (14 female, 10 male; 7.8 years). Skeletal lateral displacements were greater in the EDO group with greater expansion in the orbital, nasal cavity, zygomatic bone, and palate regions (mean intergroup differences of 0.4, 0.8, 0.9, and 1.1 mm, respectively). Intercanine expansion and canine buccal inclination were greater in the FE group, while intermolar distance changes and molar buccal inclination were greater in the EDO group. Similar changes were observed for vertical and anteroposterior displacements and palatal plane rotation. The EDO produced greater transverse skeletal expansion compared to the FE, with similar vertical and anteroposterior effects. Dental changes were greater in the molar region for patients treated with the EDO and in the canine region for patients treated with the FE. The EDO and the FE are capable of producing skeletal changes in the mixed dentition. The decision between both expanders will depend on the amount of expansion required in the molar region and in the nasomaxillary complex. The trial was registered at ClinicalTrials.gov , under the identifier NCT03705871.

Complications related to zygomatic implants placement: A retrospective evaluation with 5 years follow-up

This retrospective study assessed zygoma implants in patients treated for upper maxilla extreme atrophy, trauma, cleft palate, or failed reconstruction.The implants were placed using Quad (4 zygoma implants) or mixed (zygoma and conventional implants in premaxilla) surgical technique, with intra-sinus or extra-sinus approach, followed by immediate or deferred loading. Clinical and radiographic evaluations were carried out at 5-year follow-up from loading. Implant survival, symptoms and signs of sinusitis, radiological alterations in terms of mucosal thickening or obliteration of the maxillary sinuses, oroantral communications, and peri-implant soft tissues were examined.A total of 42 patients, with 116 zygoma implants, were included in the study. The cumulative survival rate was 97.41%. One zygomatic bone fracture was assessed. Eight patients reported sinusitis, and two showed oro-antral communications. A comparison between mean pre- and post-operative Lund–Mackay scores showed a statistically significant increase of sino-nasal disease in the post-operative scores (p = 0.0019). Mucositis and gingival recession was observed in 21 and 8 implants respectively. Average recession was 2.52 ± 2.35 mm.According to our results, placement of zygoma implants has proved to be a predictable procedure, with a lower rate of severe complications compared to other treatment options in extreme upper jaw atrophy.

Pen Touch Test for Detecting Exophthalmos

Graves’ ophthalmopathy (GO) is an autoimmune disease of the retroocular tissue occurring in patients with Grave’s disease leading to exophthalmos. Exophthalmos is usually detected by inspection using Nafziger’s method and objectively measured with Hertel’s exophthalmometry. Here we have described a novel technique “Pen touch test” to clinically diagnose exophthalmos. This cross-sectional study was conducted on patients with suspicious hyperthyroid ophthalmopathy/Grave’s ophthalmopathy (GO) who underwent eye examination by Nafziger’s method and our proposed new method “Pen Touch Test (PTT)”. In this test, a clean ruler or pen is held straight over the middle of orbital ridge touching the superior orbital margin and ipsilateral malar eminence. In normal persons, the ruler or pen touches both the superior orbital margin and ipsilateral malar eminence with or without touching eyelids. In patients with GO, there is true bulging forward of the eyeball. Hence, the ruler or pen cannot be made to touch both upper orbital margin and malar eminence simultanously. The presence and degree of exophthalmos was measured objectively on Hertel’s exophthalmometry, which was considered the “gold standard”. Pen touch test was found to have 100% sensitivity, 100% specificity and 100% Positive Predictive value. Whereas Nafziger’s method had a sensitivity of only 75% compared to Hertel’s exophthalmometry as gold standard test. “Pen touch test” is simple and sensitive method that can be used to screen for exophthalmos in suspected cases of Grave’s ophthalmopathy.

Malar augmentation with zygomatic osteotomy in orthognatic surgery: Bone and soft tissue changes threedimensional evaluation

BackgroundThe aim of this prospective study is to objectively assess 3D soft tissue and bone changes of the malar region by using the malar valgization osteotomy in concomitant association with orthognatic surgery. Materials and methodsFrom January 2015 to January 2018, 10 patients who underwent single stage bilateral malar valgization osteotomy in conjunction with maxillo-mandibular orthognatic procedures for aesthetic and functional correction were evaluated. Clinical and surgical reports were collected and patient satisfaction was evaluated with a VAS score.For each patient, maxillofacial CT-scans were collected 1 month preoperatively (T0) and 6 months after the operation (T1). DICOM data were imported and elaborated in the software MatLab, which creates a 3D soft tissue model of the face. 3D Bone changes were assessed importing DICOM data into iPlan (BrainLAB 3.0) software and the superimposition process was achieved using autofusion. Descriptive statistical analyses were obtained for soft tissue and bone changes. ResultsConsidering bone assessment the comparison by superimposition between T0 and T1 showed an increase of the distance between bilateral malar prominence (Pr – Pl) and a slight forward movement (87,65 ± 1,55 to 97,60 ± 5,91); p-value 0.007. All of the patients had improvement of α angle, ranging from 36,30 ± 1,70 to 38,45 ± 0,55, p-value 0,04 (αr) and 36,75 ± 1,58 to 38,45 ± 0,35; p-value 0,04 (αl). The distance S increased from 78,05 ± 2,48 to 84,2 ± 1,20; p-value 0,04 (Sr) and 78,65 ± 2,16 to 82,60 ± 0,90 (Sl); p-value 0,03.Considering the soft tissue, the comparison by superimposition between T0 and T1 showed an antero-lateral movement (p-value 0.008 NVL; p-value 0.001 NVR) of the malar bone projection together with an increase in width measurements (p-value 0,05 VL; p-value 0,01 VR). Angular measurement confirmed the pattern of the bony changes (p-value 0.034 αL; p-value 0,05 αR). ConclusionThe malar valgization osteotomy in conjunction with orthognatic surgery is effective in improving zygomatic projection contributing to a balanced facial correction in midface hypoplasia.3D geometrical based volume and surface analysis demonstrate an increase in transversal and forward direction. The osteotomy can be safely performed in conjunction with orthognatic procedures.

Sinonazal Tümörlerden Düşük Dereceli Tübülopapiller Adenokarsinomu: Tanı ve Takip

Low grade tubulopapillary adenocarcinoma is one of the rare sinonasal tumors. A 65-year-old male patient was admitted to our clinic with painless intraoral and extraoral swelling and speech disorder. Radiological examination of the patient revealed a lesion suggesting malignancy. The area of the lesion spread from the left maxillary area to the maxillary sinus, nasal cavity, zygomatic bone and the base of the eye, causing resorption of the bones in the regions. As a result of biopsy, the lesion was diagnosed as well-differentiated low-grade tubulopapillary adenocarcinoma. The patient was referred to the oncology department of the medical faculty and the radiotherapy was started by the medical faculty board, indicating that it was not suitable for surgical treatment. After 1.5-year follow-up, the patient was re-biopsied and diagnosed as poorly differentiated tubulopapillary adenocarcinoma. We think that the aggressive lesion may show heterogeneous differentiation as a possible reason for the differentiation between the two biopsies.

Three-dimensional measurement of radiographic bone–implant contact lengths of zygomatic implants in zygomatic bone: a retrospective study of 66 implants in 28 patients

Zygomatic implant treatment is widely applied for severe maxillary atrophy to help rehabilitate the maxillary dentition. This retrospective study was performed to evaluate the actual radiographic bone–implant contact (rBIC) lengths of zygomatic implants. The records of 28 patients who underwent zygomatic implant surgery and subsequent follow-up examinations between August 2013 and September 2018 in the Department of Oral and Maxillofacial Surgery, Taipei Tzu Chi Hospital were reviewed. The surgeries were performed by a single surgeon using the same treatment protocol. All patients had a computed tomography scan at 1year after the surgery. Using three-dimensional imaging software, an investigator measured the rBIC lengths of 66 implants and documented their clinical status. The implant survival rate was 100%. The mean rBIC length was significantly longer in male patients than in female patients (20.80±5.88mm versus 17.79±6.34mm; P=0.028). The mean rBIC length of double zygomatic implants was significantly longer when compared to that of single implants (21.11±6.23mm versus 17.75±5.85mm; P=0.027). This article is novel in reporting the exact rBIC lengths of zygomatic implants in a clinical setting. The results showed that zygomatic implants are a viable treatment modality for full-mouth rehabilitation.

Central hemangioma of Zygoma - A rare case report with CT and MRI features

Intraosseous hemangiomas are uncommon, constituting less than 1% of all osseous tumors. The most frequent sites are the calvaria and the vertebral column. The involvement of the facial bones is rare, and if occurs, it can involve maxilla, mandible, nasal bones and zygomatic bone. Zygomatic hemangioma is a benign, slow-growing tumor occurring mostly in adult women. The radiographic findings are diagnostic. Total excision of the tumor with the primary reconstruction of the defect is the preferred treatment modality. Here, we are reporting a case of a 37-year-old woman who presented with a painless hard swelling in the right zygomatic prominence, which was diagnosed as intraosseous hemangioma after the radiological examination because of its characteristic radiological picture. An Excisional biopsy also proved the swelling to be a cavernous hemangioma.

A 6-Year Epidemiological Study of Mandibular Fractures in Traumatic Patients in North of Iran: Review of 463 Patients.

BACKGROUNDMandibular fracture is considered the second most common facial fracture worldwide. We aimed to evaluate the epidemiology of mandibular fractures in traumatic patients hospitalized at Velayat Teaching Hospital in Rasht, Iran for 6-year.METHODSIn this retrospective study, all traumatic patients with mandibular fractures admitted to Velayat Teaching Hospital, Rasht, northern Iran for 6-year (2013-18) were enrolled. The data collection tool was a checklist consisting of two parts: demographic information, and injury data. All data were collected through the Hospital Information System (HIS), and analyzed using SPSS software and descriptive and analytical statistics tests.RESULTSOverall, 463 hospitalized patients were reviewed. Males had higher frequency than females. The most common accident place was rural roads. The most frequent mechanism of fractures was road accidents. The most common injuries occurred in motorcyclists, followed by car passengers, pedestrians, and cyclists. The highest and lowest frequency of injury occurred in September, and February, respectively. The most common site of fracture was condyle, followed by trunk. In concurrent fractures, the most frequently affected site was maxillary bone, followed by zygomatic bones, orbital, nasal, and frontal bones. CONCLUSIONThe majority of patients with mandibular fractures were young men of working age following motor vehicle accidents. Consequently, the most effective strategy for reducing accidents leading to mandibular fractures is considering all three components of human, environment, and vehicle.