Right Side Of Face Research Articles

Rare Histologic Imitator Central Mucoepidermoid Carcinoma Arising from Glandular Odontogenic Cyst of the Mandible: Case Report with Updated Review of Literature.

Central mucoepidermoid carcinoma is a relatively rare salivary gland tumour of the jawbone. Glandular odontogenic cyst is another unique odontogenic developmental cyst characterised by glandular differentiation. Both entities share several histological characteristics, and a pre-existing Glandular odontogenic cyst can evolve into Central mucoepidermoid carcinoma. Case 1: A 56-year-old male presented with chief complaint of swelling in lower left facial region since 1 year. Histopathology revealed multicystic compartments resembling mucoepidermoid carcinoma, but strong positive expression of Cytokeratin 13 upon immunohistochemistry helped us in rendering the final diagnosis as Glandular odontogenic cyst Case 2: A 34-year-old female presented with a lesion on right side of face. Histologically, the biopsy specimen revealed both typical findings of a Glandular odontogenic cyst component and a recognizable component of Mucoepidermoid carcinoma. The results from cytokeratin profiling demonstrated that, while both Mucoepidermoid carcinoma and Glandular odontogenic cyst expressed Cyokeratins 7, 18, and 19. Cytokeratin 13 was interestingly exclusively expressed in Glandular odontogenic cyst. Present case findings showed that central mucoepidermoid carcinoma and Glandular odontogenic cyst may be part of the same disease spectrum. However, because the expression profile of Cytokeratin13 in mucoepidermoid carcinoma and Glandular odontogenic cyst was so diverse, it can be used to differentiate both.

A split-face study comparing the efficacy and tolerability of erbium YAG laser and 70% trichloroacetic acid in facial seborrheic keratosis.

Seborrheic keratosis (SK) are benign lesions with cosmetic concerns. Role of TCA and erbium YAG laser has already been described individually in the literature. However, there is a scarcity of data on the comparative evaluation of these two modalities in SK. The aim of this study was to compare the efficacy and safety profile of Erbium YAG laser ablation with 70% TCA for the treatment of facial SK. A total of 50 cases of facial SK were included in the study. Group A included SK lesions on the right side of face treated with Erbium YAG laser ablation while Group B included SK lesions on the left side of face treated with topical 70% trichloroacetic acid. Repeated sessions of laser and TCA application were given at 2-week intervals till cure was achieved or up to a maximum of three sessions. Grading of response to treatment was assessed as complete response (100% clearance), partial response (>50 to 99% improvement), and inadequate or no response (<50% improvement). Complete clearance was observed in 40 (80%) and 29 (58%) cases in Groups A and B, respectively. There was a statistically significant difference in clearance rates between the two groups (P = 0.019). Number of sessions was significantly lesser in laser group (mean ± SD = 1.24 ± 0.43) than in the 70% TCA group (mean ± SD = 1.88 ± 0.79) (P = 0.001). Statistically significant lesser downtime was observed in group A (P = 0.001). Patient satisfaction rate was much higher in group A. Hyperpigmentation was more common in group B (TCA). Although both the treatment modalities achieved good results, erbium YAG laser ablation showed superior results than 70% TCA with better patient satisfaction rates but more downtime. Also, no major adverse effects were observed in the two groups.

Three-Dimensional Morphological Study on the Effectiveness of Expanded Polytetrafluoroethylene Prosthesis in the Paranasal Augmentation.

The paranasal depression is a common facial feature of Oriental populations. One of the most wildly used method to improve it was paranasal augmentation using expanded polytetrafluoroethylene (ePTFE). The effectiveness of it should be tested by three-dimensional morphological measurements. Patients who underwent paranasal augmentation using ePTFE between January 2017 and December 2022 were recruited in the study. The preoperative and postoperative clinical variables and three-dimensional measurement of patients were also collected. The satisfaction outcome were assessed. By establishing a coordinate system based on the Frankfurt plane, 16 landmarks including nasal alar crest, subnasal point, upper lip, pogonion, glabella, sub-cheek, orbitale, tragion in left and right side of faces were marked. Five segments, 4 ratios, and 3 angles were measured based on it. The significant increase of segments, ratios, and angles indicated that paranasal augmentation could increase the protrusion of paranasal area, both in absolute value and relative proportion. The significant decrease of other data indicated that the protrusion difference between paranasal base and upper lip, forehead, and chin, respectively, were shortened after surgery. The average size of implant was 6.54 ± 1.02mm, and the average increase of paranasal height was 4.38 ± 1.04mm postoperatively. This indicates that two-thirds of its height will ultimately be reflected effectively in the sagittal elevation of the paranasal base. Paranasal augmentation using ePTFE could effectively increase paranasal height and improve subunits relationships, and the ePTFE prosthesis should be designed and carve considering the 1/3 loss of height after implantation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Novel incision to debulk eyelids in a case of Orbital Periorbital Plexiform Neurofibroma (OPPN): A case report

: Plexiform neurofibroma with neurofibromatosis 1 is a autosomal dominant condition and a relatively rare condition. It is also termed as Von Recklinghausen disease. PN involving the structures like eyelid, orbit, periorbital and facial structures are labelled as orbital-periorbital PN(OPPN). These are slowly progressing lesions and are present since birth but increase in size during childhood and are locally infiltrating in nature.: To describe a lid incision to simultaneously debulk both upper and lower eyelid, preserving the vascularity in a case of Orbital Periorbital Plexiform Neurofibroma (OPPN).: We report a case of 22 year male who presented with a disfiguring swelling of right side of face since childhood. After thorough clinical and radiological evaluation it was diagnosed to be a OPPN. Staged debulking was planned and after stage 1 debulking, tissue was sent for HPE which revealed overgrowth of peripheral nerve components and connective tissue dermis showing infiltrating tumour composed of oval to spindle cells with pleomorphic nuclei and moderate cytoplasm. Staged debulking with lid reduction surgery was performed.: Neurofibroma is a rare entity with plexiform neurofibroma occurring in 5-15% of patients. OPPN infiltrates locally without respecting the anatomical planes but follows the trigeminal nerve distribution usually. Indications for debulking procedure are usually the disfigurement and optimal timing is also not certain because the extent and rate of growth cannot be predicted.: The facial appearance and outcome in patients with OPPN can be significantly improved through lid reduction surgery.

Thyroid Lesion with Thrombus in Great Veins Points towards Particular Pathology - A Case Report and Review in Literature

Differentiated carcinoma of thyroid is regarded as one of those malignancies which if dealt at the right time lead to good survival and outcome but if the management is delayed then not only it can lead to loss of precious life but poses a surgical challenge in advanced cases. We are presenting an advanced carcinoma thyroid with thrombus extending to right atrium presenting with swelling in front of neck from 2 months, insidious in onset gradually progressive. Swelling was more prominent over right side of face &amp; right upper limb. During evaluation there was a lesion arising from right lobe of thyroid gland 10.6 x 5.7 x 5.2cms. Right internal jugular vein thrombosis and inferiorly thrombosis is extending into right brachiocephalic vein, superior vena cava (SVC) and right atrium. Even in the absence of malignant findings on cytology, the presence of a tumour thrombus in the thyroid vein or internal jugular vein is highly suggestive for malignancy. It is a significant discovery that raises strong suspicions about distant metastases.

Ludwig’s Angina in a Parturient: A Case Report

Introduction: Ludwig’s angina is a rare but life threatening cellulitis of the soft tissue involving the floor of the mouth. Although Ludwig’s angina is a rare condition, it must be kept as a differential in the clinical setup when a patient presents with a neck swelling. Case Report: A 28 year old multigravida with 31 weeks 4 days gestational age presented with a swelling over the right side of the neck since 8 days. Patient also complains of toothache since past 5 days. The swelling was sudden in onset and progressed to attain the present size. It was associated with breathing difficulty since past 1 day. It was also associated with pain over the region. She had difficulty in eating solid food due the restriction in mouth opening due to the swelling. She was on liquid diet since past 7 days. She was diagnosed with hypothyroidism and was on Tab. Thyroxine 50 mcg. On physical examination, she is a moderately built and nourished female, vitals were stable. Examination of the head and neck revealed a diffuse swelling of size 10x10 cm over the right side of face extending from the right mastoid till the right oral commissure. Superiorly it extended up to 1 cm below right eye and inferiorly till the sternocleidomastoid origin. Total leucocyte count of 5.59 thousand/mm3. After admission, antibiotics were started. Incision and drainage was planned for the patient. Intraoperatively, patient was tracheostomized due to restricted mouth opening and difficult intubation. After induction, vertical incision was made and about 100 ml of pus was drained from the swelling on the right side. Post-operative period was uneventful. The patient was discharged on antibiotics and tracheostomy care. Conclusion: Ludwig’s angina should be kept in mind with this type of presentation. It can be life threatening if the treatment is improper, but intervention and subsequent correction can clear the symptoms completely.

"Unusual Presentation of Epitheloid Dermatofibroma- Rare Case Report".

Dermatofibroma is a commonly occurring cutaneous entity usually centered within the skin's dermis. Dermatofibromas are referred to as benign fibrous histiocytomas of the skin, superficial/cutaneous benign fibrous histiocytomas, or common fibrous histiocytoma. These mesenchymal cell lesions of the dermis clinically are firm subcutaneous nodules that occur on the extremities in the vast majority of cases and may or may not be associated with overlying skin changes.A 20years old male presented to ENT OPD, at a private hospital, with complaints of a huge mass over right side of face since 15years, which was slowly growing and not associated with pain. On clinical examination, hard, non tender, lobulated cauliflower like mass located over right side of face extending from right side temporal region to upper border of mandible from superior to inferior. From anterior to posterior it was extending from lateral 1/3rd of forehead and covering lateral canthus of right eye upto right side tragus. We have taken incisional biopsy which was suggestive of dermatofibroma. Then surgery was performed with patient's consent. Excision with 1cm free margin was done. Raw area was covered with full thickness skin grafting and advancement flap. We found no recurrence till date. Dermatofibroma in the head and neck region is less common and often present a difficult differential diagnosis like Dermatofibrosarcoma protuberans, Kaposi Sarcoma, Basal cell carcinomas. The aim of case report is to represent case of dermatofibroma of epitheloid variety which is unusual in size.

A Case Study on Bells Palsy and its Ayurvedic Management

Bell’s palsy is a neurological disorder of seventh cranial nerve which leads to unilateral facial paralysis. A complete interruption of the facial nerve at stylomastoid foramen paralyses all muscles of facial expression. In Ayurveda it can be compared with Ardita, which is Vata Nanatmaja Vyadhi. Different Acharya attributed root cause of Ardita to highly vitiated Vata dosha but some also explained the involvement of other Dosha in disease manifestation. Acharya explained causes of Ardita like transferring heavy wt on head, excessive laughing, loudly talking, sudden fearing, sleeping on uneven bed, eating hard food particles other Vatavardhak ahara vihara leads to vitiation of Vata dosha. This is a case study of a 37-years old female; she came to Kayachikitsa OPD with the complaints of deviation of mouth to left side, numbness in right side of face, feeling of swelling in the lower lip and was unable to completely close her right eye. Diagnosis of the patient was made by typical presentation and with neurological (especially cranial nerve) examination. Lab investigations were not indicative of any underlying pathology. The patient treatment included facial muscle strengthening exercises, eye protection measures and eye drops, Nasya with Anu taila and Ayurvedic formulations. Referrals were made in Panchkarma dept. for regular Nasya and Dhoompan. Patients got discharged after some recovery in symptoms and in few months with regular follow up patient showed marked improvement in symptoms.

Transient Focal Neurologic Episodes in Non-Traumatic Convexity Subarachnoid Hemorrhage (P12-5.028)

<h3>Objective:</h3> To report an interesting case of Transient Focal Neurological Episodes (TFNEs) in a patient presenting with a non-traumatic convexity subarachnoid hemorrhage (cSAH). <h3>Background:</h3> cSAH is a common imaging finding in patients with traumatic brain injury (TBI). However, the management of cSAH can become challenging in cases without any history of informed trauma, especially when they present with Transient Focal Neurological Episodes (TFNEs). Although Cerebral Amyloid Angiopathy (CAA) related TFNEs has been described in literature, it is not well regarded in the patients with sporadic cSAH finding. <h3>Design/Methods:</h3> Case Presentation <h3>Results:</h3> A 67-year-old, right-handed, woman with no significant medical history, presented with recurrent, transient right-sided hemiparesis and hemianesthesia spreading from the right side of face to right upper and lower extremities. Non-contrast CT head showed a left cerebral cSAH. CT angiogram of the head and neck did not show any evidence of aneurysms, vascular malformations or RCVS. UDS came back negative. EEG showed left frontoparietal focal slowing with no epileptiform discharges or seizures. Empiric treatment with levetiracetam was started with partial improvement of symptoms. Furthermore, six vessel angiogram showed a small incidental aneurysm in the left MCA bifurcation, deemed not the cause of the cSAH. MRI brain without contrast showed several foci of hemosiderin deposition and superficial cortical siderosis, cSAH, and lobar cerebral microbleeds in frontal, temporal, and parietal lobes. She met the Modified Boston criteria for probable CAA and the diagnosis of TFNEs related to CAA with cSAH was made. <h3>Conclusions:</h3> It is imperative to consider CAA in the differential diagnosis of non-traumatic cSAH with TFNEs as these patients are at increased risk for symptomatic ICH, especially with antithrombotic therapy. <b>Disclosure:</b> Dr. Lee has nothing to disclose. Dr. Landman has nothing to disclose. Dr. Garcia Ocasio has nothing to disclose. Dr. Veselinovic has nothing to disclose. Adriana Ochoa has nothing to disclose. Dr. Mohamed has nothing to disclose. Dr. Zubairi has nothing to disclose.

An Unusual Presentation of Lichen Striatus.

An Unusual Presentation of Lichen Striatus.

Ocular manifestations in a case of herpes zoster ophthalmicus with human immunodeficiency virus

Abstract This is a case report of human immunodeficiency virus infection whose primary presentation was with herpes zoster ophthalmicus with sterile corneal perforation which is unusual. A 48-year-old female patient presented with redness and painful decrease in vision in the right eye for the past two weeks. Examination revealed skin lesions in right side of face, with complete ptosis in right eye with restricted ocular movements suggestive of third nerve palsy. Slit lamp examination revealed sterile perforated peripheral corneal ulcer in right eye. Screening of viral markers revealed that patient was positive for human immunodeficiency virus. The case was treated conservatively with oral antivirals, topical antibiotics, and lubricants. The patient was started on highly active antiretroviral therapy from nearby antiretroviral therapy centre. We planned to do a corneal patch graft for the patient but the patient was not willing for any surgical intervention.

Case Report on Mucoepidermoid Carcinoma of Salivary Gland

Background: The most prevalent kind of salivary gland cancer is mucoepidermoid carcinoma. The main clinical signs of Salivary gland mucoepidermoid carcinoma region is characterized by a lump in the face, neck, discomfort in the mouth, or trouble swallowing. The initial therapy is the surgical removal of the whole tumor .and in the final stage of chemotherapy, radiation therapy is also used. A 43year old male came to the medicine unit with complaints of edema all over the right-side face below the right ear since from 1 year. loss of appetite and disturbance in sleeping patterns. As per the patient’s verbalization, he was apparently all right before a year, and after that, he started to show swelling over the right side of the face and below the right ear for 1 year, for he took treatment in the primary health care center. But after 4 months it was not relieved so again, he went to the private hospital where he has treated with anti-inflammatory medications but still got no relief. Later this swelling was associated with the loss of appetite and disturbance in sleeping patterns now after a year he came to the tertiary care hospital for management. Salivary gland cancer represents 5% of total head and neck tissue cancers. tumors. Small salivary gland tumors, which make up 10% to Approximately Malignant salivary gland neoplasms make up 15% of all cases. The second most frequent cancer type is mucoepidermoid carcinoma. tiny tumors of the salivary glands are common. (12–40 percent worldwide).

Case Report on Mucoepidermoid Carcinoma of Salivary Gland

Background: The most prevalent kind of salivary gland cancer is mucoepidermoid carcinoma. The main clinical signs of Salivary gland mucoepidermoid carcinoma region is characterized by a lump in the face, neck, discomfort in the mouth, or trouble swallowing. The initial therapy is the surgical removal of the whole tumor .and in the final stage of chemotherapy, radiation therapy is also used. A 43year old male came to the medicine unit with complaints of edema all over the right-side face below the right ear since from 1 year. loss of appetite and disturbance in sleeping patterns. As per the patient’s verbalization, he was apparently all right before a year, and after that, he started to show swelling over the right side of the face and below the right ear for 1 year, for he took treatment in the primary health care center. But after 4 months it was not relieved so again, he went to the private hospital where he has treated with anti-inflammatory medications but still got no relief. Later this swelling was associated with the loss of appetite and disturbance in sleeping patterns now after a year he came to the tertiary care hospital for management. Salivary gland cancer represents 5% of total head and neck tissue cancers. tumors. Small salivary gland tumors, which make up 10% to Approximately Malignant salivary gland neoplasms make up 15% of all cases. The second most frequent cancer type is mucoepidermoid carcinoma. tiny tumors of the salivary glands are common. (12–40 percent worldwide).

Left visual field bias during face perception aligns with individual differences in reading skills and is absent in dyslexia.

When looking at faces, we tend to attend more to the left visual field (corresponding to the right side of the person's face). This phenomenon is called the left visual field bias (LVF) and is presumed to reflect the brain's right-sided dominance for face processing. Whether alterations in hemispheric dominance are present in dyslexia, and are linked with individual differences in word reading development more generally, is still unclear, and no prior research has utilized gaze-based LVF bias to explore these topics. The aim of the study was to examine whether the LVF bias differs in dyslexia and to examine the association with word-reading skills assessed dimensionally. Forty-six 9-13 year-old children with dyslexia and community control children, matched on age and listening comprehension. Participants were presented with a recorded face on a screen while their gaze patterns were collected with an eye tracker. Fixations to the left versus the right side of the face stimuli were compared. Results showed a clear LVF bias in community controls, while no such bias was seen in the dyslexic group. Moreover, the strength of the LVF bias was correlated with better word reading in the controls. Our results suggest a link between weakened hemispheric dominance for face processing in dyslexia and in poor word reading, at least to the extent that the LVF bias actually mirrors underlying physiology. We discuss the implications of these novel findings, highlighting the need for future research to determine the specificity and developmental sources of LVF bias alterations.

A Case of Sclerosing Polycystic Adenoma of the Parotid Gland.

Sclerosing polycystic adenoma (SPA) is a rare salivary gland tumor with about 100 cases reported in the literature. We describe a case of SPA in the parotid gland and review the diagnostic tools used for identifying SPA. A 24-year-old male with a two-year history of right-sided face mass, initially thought to be pleomorphic adenoma of the parotid gland after fine needle aspiration (FNA). Following superficial parotidectomy, histologic features were consistent with SPA. This case illustrates the challenge of pre-operative assessment for SPA. Recent study has suggested SPA is a neoplasm and definitive treatment is surgical excision.

A split face comparative study using a novel triple combination therapy for the treatment of persistent post acne erythema.

Persistent post acne erythema (PAE) is common cosmetically unacceptable and challenging sequelae of acne lesions. Tranexamic acid (TXA) is an antifibrinolytic agent that shows a positive effect on wound healing in several studies, and it showed benefits in treating skin diseases like melasma, rosacea erythema and ultraviolet induced pigmentations. Oxymetazoline (OXZ) is a synthetic, highly selective agonist for alpha 1A-adrenoceptor. It is a potent vasoconstrictor. OXZ hydrochloride 1% cream was approved by the FDA in January 2017 as a topical treatment for persistent facial erythema in rosacea patients. Brimonidine tartrate (BMT) is highly selective α2 adrenergic receptor agonist, results in direct, potent vasoconstriction of small arterioles and veins. In 2013, brimonidine 0.33% gel was the first topical therapy to be FDA approved for the treatment of persistent facial erythema from rosacea. To evaluate the efficacy and safety of topical triple combination (TXA 5% + OXZ 1.5% + BMT 0.33%) in the treatment of PAE planned as split face comparative study. This study was conducted on 40 patients diagnosed with persistent PAE for at least 3months, the right side of the face was treated with topical triple combination in liposomal base and was compared to the left side to which topical lipocream (placebo) was applied as a control. Our treatment plan lasted for 3months. According to the investigator's global assessment of photographs and computerized analysis of erythema using image analysis software, topical triple combination applied on the right side of face was significantly effective in diminishing PAE when compared to topical placebo left side. Topical triple combination is a safe and cost-effective treatment for PAE.

Frequency, Etiology and Presenting Complaints Associated With Zygomatic Complex Fractures

Aim: To investigate the etiology, gender distribution and presenting complaints associated with zygomatic fractures Method: This cross sectional study was done in Oral and Maxillofacial Surgery Department of King Edward Medical University from April to D3ecember 2019. Patient data was collected from OPD and analysed with SPSS. Results: We analyzed the data of 162 patients with zygomatic bone fracture. Out of this 148 were male and 14 were females. There were bilateral cases, more affecting right side of face and affecting left side of face. The most common etiology was road traffic accident followed by interpersonal violence and occupational injuries. When we consider presenting complaints 87 patients came with difficulty in chewing, 45 with limited mouth opening, 23 with depressed malar eminence and only 7 patients with nerve paraesthesia. Conclusion: Considering the geographic and cultural indices of the evaluated population, it can be concluded that the patients gender and trauma causes significantly affect the prevalence of zygomatic bone fracture Keywords: Zygomatic bone, nerve paraesthesia, limited mouth opening

Neonatal Herpes Zoster Ophthalmicus: Two Rare Cases

Two neonates one at age of 15 days and another at age of 20 days were presented with redness, watering, periocular and lid swelling, photophobia and vesicular lesions over forehead on right side of face. Ocular examination revealed ciliary and conjunctival congestion, chemosis, and hazy cornea due to stromal edema. Though herpes zoster is very rare in neonates, the diagnosis of herpes zoster ophthalmicus was made on basis of clinical examination and treated with systemic and topical anti-viral, topical antibiotic and corticosteroid. Both neonates showed dramatic response in seven days treatment and completely cured within four weeks. High clinical suspicion in vesiculo-papular lesion of child of any age can help in early diagnose and early treatment can prevent sequelae of HZO.

Neonatal Herpes Zoster Ophthalmicus: Two Rare Cases

Two neonates one at age of 15 days and another at age of 20 days were presented with redness, watering, periocular and lid swelling, photophobia and vesicular lesions over forehead on right side of face. Ocular examination revealed ciliary and conjunctival congestion, chemosis, and hazy cornea due to stromal edema. Though herpes zoster is very rare in neonates, the diagnosis of herpes zoster ophthalmicus was made on basis of clinical examination and treated with systemic and topical anti-viral, topical antibiotic and corticosteroid. Both neonates showed dramatic response in seven days treatment and completely cured within four weeks. High clinical suspicion in vesiculo-papular lesion of child of any age can help in early diagnose and early treatment can prevent sequelae of HZO.

Efficacy and safety comparison between 1927\xa0nm thulium laser and 2940\xa0nm Er:YAG laser in the treatment of facial atrophic acne scarring: a prospective, simultaneous spilt-face clinical trial

Acne scarring is a common disfiguring complication of acne, and fractional lasers are widely applied in improving it. This study is to compare the efficacy and safety of fractional non-ablative 1927 nm thulium laser (FTL) and fractional ablative 2940 nm Er:YAG laser (FEL) in the treatment of acne scarring. Subjects with moderate or severe atrophic facial acne scarring received 3 sessions of FTL on the left side of face and FEL on the right side of face at an average interval of 4–6 weeks. Major assessments included Goodman&Baron quantitative global scarring grading system (GBS), self-rated improvement and satisfaction score. Twenty-seven subjects completed the study; for FTL side, average GBS decreased from 11.15 ± 5.04 at baseline to 7.07 ± 4.87 with an improvement percent of 36.54%; for FEL side, average GBS decreased from 10.81 ± 4.46 to 7.00 ± 4.07 with an improvement percent of 35.27%. Adverse effects include transient pain, erythema, edema, and increase of acne. No significant difference was found between two lasers. Both FTL and FEL improved atrophic acne scarring and were well-tolerated. Increase of acne during laser treatment may have a negative impact on efficacy. Trial registration number was NCT04813419 and date of registration was 19th, March, 2021, retrospectively registered.