Zygomatic Area Research Articles

Eazygoma technique: a new approach for zygomatic implant placement aligned with maxillomalar anatomy

This study focused on evaluating the novel Eazygoma method for zygomatic implant placement. This approach focuses on biomechanical principles, offering direct visualization that facilitates enhanced control during implant insertion. It helps prevent malpositioning, ensuring that the apical portion remains within the zygomatic body and achieves emergence in the alveolar crest through an inverted drilling sequence. The Eazygoma system enables improved control during drilling, starting in the zygomatic area and eliminating the need for osteotomies in the maxillary sinus. This not only simplifies the procedure but also significantly reduces the operative time, allowing it to be performed under local anesthesia and sedation in approximately one hour, according to the author’s experience. The study included 34 zygomatic implants placed in 11 patients with severe maxillary atrophy, treated between 2021 and 2023 at the Maxillofacial surgery Department of the private clinic “Clínica Colsanitas” in Bogotá, Colombia. To evaluate outcomes, intraoperative torque, surgical time, and whether alveolar emergence was achieved were measured for the implants. Patients were followed up at 12 months to assess implant survival. Results showed that the Eazygoma approach eliminated postoperative sinus injuries and implant malposition, ensuring alveolar emergence and achieving a torque greater than 50 Newtons in all cases, allowing for immediate implant loading.

Profhilo® Structura, Current Status and Future Perspectives: A Practical Review.

Hyaluronic acid (HA)-based injectables continue to grow in popularity and are used worldwide to improve facial changes associated with aging. Profhilo® Structura (IBSA Farmaceutici Italia, Lodi, Italy) is a novel HA-based product that uses nano hybrid complex of hyaluronic acid (NAHYCO)® technology to create hybrid cooperative complexes consisting of high and low molecular weight HA. Profhilo® Structura's high concentration (45 mg of total HA) and rheological properties (ie, viscosity [resistance to flow] and elasticity [stickiness]) have been specially formulated to restore facial adipose tissue. Because of their early involvement in the facial aging process, the superficial medial and lateral-temporal cheek fat compartments are good candidates for treatment. However, recommendations and guidelines are necessary to ensure that treatment is safe and effective. Three experts were invited to IBSA Farmaceutici Italia Srl to discuss clinical rationale, optimal injection techniques, and clinical outcomes for treating the superficial medial and lateral-temporal cheek fat compartments with Profhilo® Structura. These techniques were developed using patients presenting with either initial hypotrophy of fat compartments within the preauricular area (ie, sinkers) or jowl sagging due to hypotrophy within the preauricular and zygomatic areas (ie, saggers). Targeting these areas using the optimal injection site can maximize product diffusion and minimize the risk for vascular compromise. Targeting these areas also leads to lateral tightening and lipolifting effects due to adipose tissue restoration. The experts agreed that Profhilo® Structura is currently the first and only HA-based injectable treatment that can integrate and restore the adipose tissue in these affected fat compartments.

Histological analysis of the dermal and hypodermal layers of the face and correlation with high-frequency 24 MHz ultrasonography and elastosonography.

Knowledge of the structure of the face is of fundamental importance. In fact, the face is treated in many areas of medicine, from dermatology, to maxillofacial surgery, to otorhinolaryngology, to ophthalmology, etc. and anti-aging aesthetic treatments, and those for the resolution of blemishes are on the increase. For ethical reasons it is not possible to take biopsy samples for facial analysis in the aesthetic field. The main aim of this study was to demonstrate that a high-resolution bimodal ultrasound examination, combined with elastosonography, could be a valid tool for pre-treatment morphological evaluation. To achieve this goal, skin samples were taken from the forehead, zygomatic area, nasolabial fold, upper and lower lip from cadavers to histologically characterize their structure. Subsequently, these same areas were evaluated in vivo using conventional B-mode ultrasound with a 24 MHz high-frequency probe, and elastosonography. The data obtained with the different techniques were compared, in order to state that modern ultrasound techniques can provide similar histological information. The analysis showed that the superficial hypodermis presented a different shape and structure in the different areas, with the exception of the areas of the upper and lower lip, which appeared similar. With aging, the forehead and zygomatic area showed a volumetric increase in the superficial hypodermic layer, while the lip showed non-structural changes. The morphology of the nasolabial fold remained unchanged. When it is not possible to perform histological investigations on the face, to understand its characteristics and dynamics, ultrasound with a 24 MHz probe would seem to be the most suitable method, while elastosonography could be a valid method for evaluating the stiffness of the structural components.

Peculiarities of the clinical picture and diagnosis of dirofilariasis in the maxillofacial area: a series of cases from practice

Dirofilariasis is a helminthiasis that occurs in carnivorous animals (dogs, cats, foxes, wolves, etc.) and less often in humans, although according to some authors it is believed that the number of infected animals approximately corresponds to the number of infected people. Dirofilariasis of the maxillofacial area is not a widespread condition, its cases are described in short series, therefore, the aim of this work is to share our own experience of managing patients with this rare condition.The work presents our own experience in the management of 14 dirofilariasis patients with lesions of the maxillofacial area, of them there are 3 men and 11 women aged 29 to 54. Most patients sought help in the late autumn, winter and spring periods and only 2 people in the summer period. All patients were examined by a dentist, and an ultrasound examination of the area with a formation was performed. According to the clinical manifestations, the disease began acutely in nine patients and had a picture of inflamed atheroma (2 – in the zygomatic area, 1 – in the parotid, 2 – in the infraorbital area, 2 – in the temporal area, and 2 – in the area of the nasal bridge). All patients were operated on and tumor-like formations in dense membranes were removed, inside which one live nematode 11-18 cm long was found. In 3 observations, fragments of dead, partially lysed nematodes were removed from the oral cavity, the capsules of which imitated a migrating granuloma. According to the location – 5 capsules with dirofilaria were located in the subcutaneous fatty tissue, 3 – in the submucosal layer of the gums fused to the periosteum of the upper jaw, 1 – in the submucous layer of the lower jaw, 2 – in the fibers of the temporalis muscle and 1 – in the fibers of the buccal muscle. In each case, the localization of the nematode was close to the places of accumulation of adipose tissue or large blood vessels. In the postoperative period complex therapy was prescribed, including symptomatic anti-inflammatory and desensitizing agents, and consultation with infectionist was recommended. Thus, according to our observations, dirofilariasis most often affects areas of the face in which there are large vessels and accumulation of fatty tissue. In connection with the prevalence of dirofilariosis in humans and the predominant localization of parasitic infection in the face area, dentists, ophthalmologists and otolaryngologists need to be familiar with this pathology and show definite vigilance. Treatment dirofilariosis patients should be carried out comprehensively, together with parasitologists, with surgical excision of the lesion and appropriate drug therapy.

Intraosseous cavernous hemangioma of parietal bone: A case report and literature review

Introduction and background: Intraosseous Hemangiomas or Primary Intraosseous Hemangiomas (PIH) are slowgrowing innocuous blood vessel tumors that make up less than 1% of all bone malignancies [1-4]. These lesions are estimated to account for 0.2 percent of all benign skull tumors [4-8], with a clear female predisposition (3:1) [2]. Prior trauma to the region is thought to be the most prevalent cause of intraosseous hemangiomas. They bleed profusely when removed or biopsied; therefore, preoperative diagnosis of the lesion’s vascular character is critical [8]. They are most frequently seen in the vertebral skeleton, although they can also be found in the calvarium and facial bones. The temporal bone is the most prevalent place in the head after the vertebral skeleton, followed by the parietal, mandible, malar, and zygomatic areas [8]. In this case report, we discuss the case of a 9-year-old male who presented with a large soft mass in his right parietal region.

Intraosseous cavernous hemangioma of parietal bone: A case report and literature review

Introduction and background: Intraosseous Hemangiomas or Primary Intraosseous Hemangiomas (PIH) are slow-growing innocuous blood vessel tumors that make up less than 1% of all bone malignancies [1]. These lesions are estimated to account for 0.2 percent of all benign skull tumors [4], with a clear female predisposition (3:1) [2]. Prior trauma to the region is thought to be the most prevalent cause of intraosseous hemangiomas. They bleed profusely when removed or biopsied; therefore, preoperative diagnosis of the lesion’s vascular character is critical [8]. They are most frequently seen in the vertebral skeleton, although they can also be found in the calvarium and facial bones. The temporal bone is the most prevalent place in the head after the vertebral skeleton, followed by the parietal, mandible, malar, and zygomatic areas [8]. In this case report, we discuss the case of a 9-year-old male who presented with a large soft mass in his right parietal region.

Ayurveda intervention in Riehl’s melanosis- A case report

Abstract Riehl’s melanosis (RM) is frequently identified as a kind of facial melanosis known as pigmented contact dermatitis (PCD). It results from cosmetic fragrances and their other products. The pigmentation on the forehead, temporal, and zygomatic areas of the face ranges from dark brown to grayish-brown. Satisfactory treatments are presently lacking leading to the psychological suffering of the patient. This study aims to find a promising solution for the RM WSR Dushi Visha. In the present case study, a 45-year-old female patient suffered from RM with blackish discoloration over the periorbital region, cheeks, and in the middle of the eyebrows with severe itching and dryness for the past 22 days. The patient was managed effectively with classical Ayurveda medications. In Ayurveda, this condition can be correlated with the symptoms of Mukhalepajanya Dushi Visha (artificial poison in the form of facial cosmetics), characterized by Mukhashyavata (blackish discoloration of the face), Kotha (round patches and rashes on the skin), intense Rukshata (dryness), and Kandu (itching sensation) followed by Daha (burning sensation). The principle of treatment is Raktamokshana (bloodletting) and drugs having Kushthaghna (antidermatosis), Kandughna (antipruritic), Raktashodhaka (blood purifier), Twak Prasadana (skin quality enhancer), and Varnyakara (promotes complexion) properties. The outcome of the assessment was based on the changes in the symptoms after 15 days of treatment. Recurrence of itching and burning was not observed during the follow-up period. The case sheds on the excellent management of RM by Ayurveda modalities.

Preauricular Incision Approach as a Management of Zygomaticomaxillary Complex Fracture Reduction: A Case Report

Introduction: A zygomatico maxillary complex fracture is a facial bone fracture that commonly occurs as a centrally and laterally protruding zygomatic area. The effective surgical approach and exact reduction of the displaced fracture is the most important task in the treatment of a zygomatic fracture, from the aesthetic point of view. Determination of surgical approach and the fixation point of zygomatic arch fracture is one of the most challenging procedure. The purpose of this case report is to find out that the preauricular incison approach is one of the effective methods for reduction of zygomaticomaxillary complex fracture. Case Report: A 53 years old male patient presented with right zygomatico maxillary complex fractures. Diagnosis of right side tetrapod zygomatico maxillary complex fracture deformity was done by clinical examination and confirmed by computed tomography which included 3-D reconstruction view. The authors performed 4-point fixation using the preauricular approach to counter the disadvantages of the coronal approach. The results and usefulness of preauricular approach with 4-point fixation are reported in this study. Conclusion: Preauricular incision is an effective surgical approach for the reduction of zygomatic arch fracture. 4-point fixation using the easier-to-manipulate preauricular approach would be more useful than the conventional method that uses the coronal approach. Satisfactory reduction that showed exact correction was observed. In an outpatient follow-up, no complication such as nonunion or malunion was found, and facial symmetry was also shown. In addition, the preauricular scar was hardly observed. Keywords: zygomaticomaxillary complex fracture, preauricular incision, reduction, fixation

Conjunctival tumour as an acute myeloblastic lymphoma presentation in a paediatric patient

AbstractPurpose: The most frequent ocular tumours are those that affect the conjunctiva which have a wide spectrum of presentation and can arise from any cell lineage that forms the conjunctiva, being the most representatives those that origins from epithelial and melanocytic cells. A case of a 10‐month‐old female patient who was diagnosed with acute myeloblastic leukaemia after studying a conjunctival tumour is presented.Methods: The case of a 10‐month‐old female with a conjunctival lesion located in the right eye who was also being studied for two masses, one on the right preauricular zone and the other on the left zygomatic area is described. About her medical history, she had an aplastic crisis due to parvovirus infection when she was 8 months old. No ophthalmological background was reported. On the clinical exam of the right eye, a pink conjunctival lesion located in the outer corner of the superior conjunctival fornix was found. The ocular motility was normal and the eyeball position was normal.Results: A biopsy of the conjunctival mass was performed immediately. The histopathology report showed infiltration with leukaemic cells. After this finding, a bone marrow biopsy, lumbar puncture, full‐body CT scan and an orbit MRI were performed, concluding the patient was suffering from an acute myeloblastic leukaemia with extramedullary involvement (face, orbit, ovaries) and central nervous system affection. After two cycles of chemotherapy, complete remission is achieved, including the conjunctival and orbital lesions.Conclusions: Haematology‐Oncology systemic diseases can imply the eye and the orbit. The manifestations most commonly found in children with leukaemia are proptosis, retinal and choroidal affection, optic nerve damage, and sixth nerve palsy. In the conjunctiva, it usually manifests as a subconjunctival salmon‐pink flesh coloured mass. Excision‐biopsy study is essential in the differential diagnosis of conjunctival neoplasms.

Distribution of problematic localized facial infantile haemangiomas and their response to propranolol: a retrospective cohort study

The distribution and response to propranolol of problematic facial infantile haemangiomas (IHs) has rarely been described in the literature. To map problematic facial IHs and observe their response to propranolol. Eligible patients were categorized according to focal location and cohorts corresponding to these (buccal, medial, zygomatic, lateral and multiregional) were created. The primary efficacy variable was regression score ranging from 1 to 4, calculated using results of colour Doppler ultrasonography. In total, 104 patients met the inclusion criteria. There were 32 (30·8%) IHs located in the buccal area, 12 (11·5%) in the medial area, 49 (47·1%) in the lateral area and 1 (1·0%) in the zygomatic area, with 10 (9·6%) IH cases having multiregional lesions. We found that the distribution pattern of most IHs matched the surface projection of the trunk of the external carotid and the facial arteries. Further analysis showed that the median regression score in the buccal and medial groups were significantly lower than those in the lateral and multiregional groups. Treatment of buccal and medial haemangiomas tends to be more challenging and their distribution pattern mainly reflects the direction of the facial vessels.

Facial Defects With Infraorbital and Zygomatic Area Reconstruction Using an Expanded Flap Based on the Orbicularis Oculi Muscle: A Long-Term Follow-up.

Reconstruction of facial soft-tissue defects may pose a dilemma for plastic surgeons, as the flaps must be reliable to obtain a natural appearance while minimizing donor site morbidities. This clinical study describes a reconstructive method for infraorbital and zygomatic defects using a pre-expanded rotation flap based on the orbicularis oculi muscle (OOM). The surgeries were subdivided into 2 stages. In the first stage of the operation, a 100 to 200mL expander was placed underneath the temporal area through a hairline incision. In the second stage, after adequate inflation of the expander, the pre-expanded rotation flap based on the OOM of the lower eyelid was raised from lateral to medial to cover the facial defects. In this single-center study from February 2010 to February 2017, 16 patients underwent facial defect reconstruction using the pre-expanded flap based on the OOM. All of the defects were located at the infraorbital and zygomatic regions, and their sizes ranged from 3.0 4.0 to 7.0 14.0cm. The causes of these defects included postburn scars (37.5%), melanocytic nevus (50%), and hemangiomas (12.5%). In all cases, good coverage was provided for the defects that were in the medial cheek or lower eyelids. There were no flap losses of any kind. There were no major complications, and all minor incidences were treated by minimal procedures. The patients were followed up after surgery, with the follow up ranging from 6 months to 108 months. The follow-up data included postoperative consultations, the defect size, the need for further procedures and the degree of satisfaction. The pre-expanded rotation flaps in the lateral facial area based on the OOM can ideally and safely be applied for facial defect reconstruction owing to their reliable blood supply and excellent texture match.

Surgical treatment of glaucoma with filtration bleb activation of a patient with Sturge — Weber syndrome: a clinical case

Purpose:to describe surgical treatment of glaucoma of a patient with Sturge — Weber — Krabbe syndrome. We present a clinical case of a patient with Sturge — Weber — Krabbe syndrome who sought assistance with us due to secondary stage III glaucoma with moderately elevated intraocular pressure. The examination revealed a cutaneous hemangioma of the frontal, and zygomatic area of the left half of the face, the upper and the lower eyelids, and conjunctival and episcleral hemangioma of the left eye. Since local hypotensive drug therapy produced no effect, the patient was offered a surgical treatment: sinus trabeculectomy. A pronounced hemorrhage from the conjunctival vessels, the episclera and choroidal vessels that occurred during the operation increased its duration, but severe complications could be avoided. A hyphema that appeared during the operation was almost completely washed out and dissolved within 5 days. Since scarring processes of the filtration zone were activated in the postoperative period, we resorted to an active tactics of the patient’s management, namely the needling of the filtration zone with the use of antimetabolites and corticosteroids.Conclusion. Sinus trabeculectomy is an effective method of IOP normalization in glaucoma patients with Sturge — Weber — Krabbe syndrome. Active management of the patient in the postoperative period of the case described allowed us to avoid severe intra- and postoperative complications and to achieve stable clinical and functional results.

Algorithm of reconstruction combined midface defects after resection malignant tumors

Introduction. Surgical treatment of malignant tumors of maxilla and midface results to a combined defects of the soft tissues of the face (upper lip, buccal, zygomatic regions), upper jaw, hard and soft palate, retromolar region, orbit, nasoethmoidal complex. This is one of the most difficult localizations in terms of both the possibility of performing radical surgery and reconstruction. The purpose of reconstruction is not only the elimination of cosmetic deformity, but also the restoration of such vital functions as breathing, swallowing, speech and binocular vision. Till that time, no algorithm has been developed for choosing a method for the reconstruction and there is no comparative analysis of the available methods.The study objective is to improve the functional and aesthetic results of treatment patients with malignant tumors of the upper jaw and midface.Materials and methods. For the period from 2014 to 2020 in the Department of Head and Neck Tumors of the N.N. Blokhin National Medical Research Center of Oncology, ministry of Health of Russia microsurgical reconstruction after resections of the upper jaw and midface was performed in 80 patients. most often (25 (31 %) patients) the primary tumor was localized in the maxillary sinus, then hard palate (16 (20 %) patients), soft palate (11 (14 %) patients), retromolar trigone (13 (16 %) patients). primary location at alveolar process of the upper jaw was in 3 (3 %) cases, nasal cavity and cells of the ethmoid labyrinth - in 4 (5 %), frontal sinus - in 5 (6 %), the skin of the cheek and lower eyelid - in 3 (3 %) patients. we defined 4 main types of resection. Type I - combined lower resections of the maxilla and mucosa of the retromolar region, soft palate, lateral wall of the oropharynx (47 (60 %) patients). Type II - total radical maxillectomy (resection of all walls of the upper jaw, including orbital wall) (12 (15 %) patients). In 5 (42 %) cases, the resection was combined and included, in addition to the upper jaw, the skin of the buccal and zygomatic regions. Type III - combined partial resections of the upper jaw (13 (17 %) cases). In 9 (69 %) cases, the block of tissues to be removed included a fragment of the skin of the buccal region, part of the external nose, and lower eyelid. Type Iv - orbitomaxillary resection with orbital exenteration (6 (8 %) patients), including exenteration of the orbit, cells of the ethmoid labyrinth, resection of the frontal bone, medial wall of the orbit, a fragment of the dura mater (4 (67 %) cases), skin of frontal, buccal, zygomatic areas, upper and lower eyelids. for reconstruction of defects in 80 patients we used 82 free flaps. In 76 (93 %) cases, simultaneous resections of the primary lesion and reconstructions were performed, in 6 (7 %) cases, delayed reconstruction after previously performed combined or complex treatment were performed.Results. In type I resection with limited defects excellent functional and aesthetic results were obtained in all cases of using a radialis fasciocutaneous free flap. In case of subtotal and total defects of the hard palate and the alveolar margin of the upper jaw, the best aesthetic (excellent in 5-46 % of patients, satisfactory in 3-27 %) and functional (excellent speech quality in 8 patients) results were obtained with use free scapula tip flap. In type II resections excellent aesthetic results were obtained in 6 (55 %) patients. In all cases, a chimeric free flap consists of tip of the scapula, fragment of serratus muscle and skin of parascapular region was used. In type III resections in patients with limited defects, 5 (71 %) had excellent aesthetic results, and 2 (29 %) had satisfactory aesthetic results. In all cases a radial free flap was used. In case of half defects of the upper jaw anterior-lateral thigh flap and thoracodorsal free flap was used. In all cases satisfactory aesthetic result was obtained. In type IV resections satisfactory aesthetic results were obtained in all patients.Conclusion. Preoperative computer 3D modeling is necessary in planning of reconstruction. This allows to determining the type and volume of the defect, plan optimal method of reconstruction, model the required flap geometry, making a template for harvesting flap, calculating the position and number of titanium plates for fixation, and, if necessary, print an individual mesh of the infraorbital wall.

Profiles of facial soft tissue changes during and after orthodontic treatment in female adults

BackgroundSome female adults who received orthodontic treatment often complain about thinner faces, protruding cheekbones and sunken temples, even at the beginning of treatment. The present research aimed to explore facial soft tissue changes during and after orthodontic treatment, as well as the related factors affecting facial soft tissue changes.MethodsThis study used 3dMD stereo photography technology to compare facial soft tissue changes among adult females who received orthodontics. A total of 52 adult females (24 teeth extraction, 28 non-teeth extraction cases) were included and potential correlations between related factors (facial morphology features, the change of occlusal height and dental arch width) were evaluated during different treatment periods.ResultsOverall, 3D-negative soft tissue changes of the buccal region moderately correlated with distances of nasion-menton and subnasale-menton (both rs = 0.30, P < 0.05) as well as the ratio of subnasale-menton/right gonion-left gonion (rs = 0.33, P < 0.05) and nasion-menton/right zygomatic point-left zygomatic point (rs = 0.30, P < 0.05). Among the 3D angle measurements, the right chelion-median upper lip point-left chelion angle was found to have a moderate correlation with 3D negative changes of the upper cheilion region (rs = 0.31, P < 0.01). Analysis of occlusal height changes revealed that an increase in the posterior facial height (nasion-gonial distance) may be a risk factor for negative changes in the zygomatic arch area. In addition, a moderate positive correlation between the maxillary first molar width changes and 3D-negative changes of the lower cheek region was found (rs = 0.41, P < 0.05).ConclusionsAfter orthodontic treatment, adult females with wide and short faces may be prone to negative soft tissue changes. Changes of posterior facial height and arch width between the first molars were also risk factors for negative changes of facial soft tissues. Extraction is not a major factor producing facial soft tissue changes.

Volumetric Effect and Patient Satisfaction after Facial Fat Grafting

Facial fat grafts decrease in volume after transplantation. This observation is based on overall facial three-dimensional analyses, because there is sparse information on volume changes in well-defined aesthetic areas. The authors aimed to assess the overall and, more specifically, the local volumetric effects of facial fat grafting and relate these effects to patient satisfaction up to 1 year after treatment. All consecutive adult female patients who were scheduled for facial fat grafting without additional surgical procedures were asked to participate. All patients underwent the same fat grafting method. An algorithm-based personalized aesthetic template was applied to define specific aesthetic areas on the preoperative three-dimensional image. Objective outcome parameters [i.e., three-dimensional volume differences, patient satisfaction (FACE-Q questionnaire)] were measured at baseline and at 6 weeks, 6 months, and 12 months after fat grafting. Of 33 female patients who underwent a facial fat graft procedure, 23 patients had complete three-dimensional data and were eligible for analysis. The highest volume gain was observed 6 weeks after grafting and was followed by a gradual loss thereafter. Overall and in the zygomatic area, a substantial gain in volume was still present 1 year after grafting, whereas this effect was lost in the lip area. FACE-Q scales Satisfaction with Facial Appearance Overall and Satisfaction with Cheeks improved too, whereas scores for Lines: Lips returned to baseline levels. The improvement in FACE-Q scales was in agreement with the objective change in volume. Gain in overall and local volumetric effects is accompanied by comparable changes in patient satisfaction. Therapeutic, IV.

Minimizing sampling error using a unique ink-stained reflectance confocal microscopy-guided biopsy technique to diagnose a large lentigo maligna

An 88-year-old man with a history of melanoma presented with a 5.0-cm × 5.5-cm patch with variegated pigmentation (Fig 1, A) involving the right zygomatic area. An 8-mm scar from a previous biopsy was present near the lateral aspect of the lower portion of the right eyelid. On dermatoscopy, perifollicular hyperpigmentation with globules was noted adjacent to the scar, near the lateral border (Fig 1, B).

Head and neck cutaneous basal cell carcinoma: A challenging entity of ENT surgeons

Otorhinolaryngology head and neck (ENT) surgeons are often challenged in their daily practice with patients presenting cutaneous cancer. Cutaneous basal cell carcinoma (cBCC) is the most common cancer diagnosed in human population, with 80% occurring in the head and the neck. We present the case of a 56-year-old male patient with an extensive lesion on the right zygomatic area that examined in the outpatient ENT Department of our hospital. A surgical excision of the lesion was performed, under local anesthesia and then we used a superficial based neck flap to reconstruct the defect. The final postoperative result was satisfactory. The histological examination revealed a basal cell carcinoma.

Unusual extension of a dental abscess through the pterygomandibular space in subcutaneous maxillofacial tissue.

Infections of maxillary teeth commonly spread to the buccal space, whereas infections originating in the mandible usually spread to the submandibular, pterygomandibular, and buccal spaces. The pterygomandibular space may serve as a path for spread to zygomatic areas and thus must always be a part of imaging evaluations.

The epidemiology of facial trauma in a city in Northern Brazil

The aim of the present work is to carry out an epidemiological study with patients with facial fractures who were operated on in the city of Belém do Pará. In the Years 2015 to 2020, in addition to a literature search on the topic, data was collected on the system of a health insurance company in the city of Belém. It was approved by the Research Ethics Committee of the Dental Research Center and São Leopoldo Mandic Dental School. Facial fractures in Belém do Pará had a 3.5 times higher incidence in men than women. One of the explanations lies in the increased number of men involved in interpersonal aggression, violent sports and traffic accidents. Mostly there were fractures in the zygomatic area and in the nose. The vast majority were treated with open reduction. Facial fractures are multifactorial, but traffic awareness campaigns and alcohol abuse should be incorporated into government projects in each national area.

English

Maxillary sinus squamous cell carcinoma is an invasive tumour that is usually diagnosed at an advanced stage, where the majority of patients have a very low prognosis and survival rate. We present a case of maxillary sinus carcinoma that affected the entire orbit, resulting in proptosis of the eye and nasal cavity. The patient was recommended for palliative treatment due to the high degree of its involvement and proximity to vital structures. It manifests with very mild to no signs, resulting in a late diagnosis. As a result, physicians must be mindful of maxillary sinus pathologies to make an early diagnosis. Paranasal sinuses are air-filled spaces located close to vital structures such as visual organs and the face. Maxillary, ethmoidal, frontal, and sphenoidal are the 4 paranasal sinuses that are named according to the bones in which they are situated. Nasal cavity and paranasal air sinus malignancies are uncommon. According to the literature, paranasal sinus malignancies account for less than 1 % of all human malignancies and 3 % of the total malignancies of the head and neck region. However, the maxillary sinus is the most frequent site of origin of primary malignant tumours amongst the paranasal sinuses.1 we need to raise general awareness among the oral stomatologists as Asian countries report a very high incidence of maxillary sinus carcinoma.2 The incidence of malignancies in maxillary sinus is high (60 % - 70 %) and less in the nasal cavity (12 % - 25 %), the Ethmoid (10 % - 15 %) and very rare in sphenoid / frontal sinuses (1 %).3 Further, not only the malignancies of maxillary sinuses are common, but they also incur the worst prognosis. Maxillary sinus carcinomas have very few symptoms and are similar to those of chronic paranasal sinusitis. They usually present themselves as locally advanced diseases. 4,5 Paranasal sinus malignancies are difficult to diagnose in the early stages and 90 % of cases are reported in T3 / T4 advanced stage.6 Environmental factors such as industrial pollutants, dust, smoke, and adhesives are the leading causes for the development of disease.7 Thus, sinonasal malignant tumours are rare and pose a challenge in diagnosis as well as treatment. Therefore, maxillofacial specialists should be aware of the signs and symptoms of this rarely occurring disease. This article presents a rare case of a 45-year-old female who reported to our OPD with a complaint of swelling in the right zygomatic area and proptosis of the right eye.