Osteomyelitis involving the maxillofacial skeleton is a rare entity today. In maxillofacial region mandible is more commonly involved as compared to maxilla. It continues to remain one of the most difficult to treat infections with considerable morbidity and costs to the healthcare system. Hallmark of osteomyelitis are progressive bony destruction and formation of sequestrum. When present, the possibility of underlying malignancy or granulomatous diseases should be kept in mind and ruled out. We present a rare case of osteomyelitis involving the maxilla in a 64 year old male diabetic. The patient was managed with sequestrectomy and debridement by infrastructure maxillectomy via a midfacial degloving approach, appropriate parentral antibiotic therapy and glycemic control. The patient had an uneventful recovery. <p> </p>
<p class="abstract"><strong>Background:</strong> Deviated nasal septum is one of the most common disorders in human beings, which may lead to symptoms of nasal obstruction, headache, epistaxis, hyposmia, and post nasal drip. DNS correction may also be required to gain access during intranasal procedures like endoscopic sinus surgery, endoscopic dacryocystor-hinostomy and skull base surgery. The technique of septoplasty has evolved over the decades with a tendency towards more conservative and precise surgery. Over the last few decades endoscopic septoplasty has become increasingly popular.</p><p class="abstract"><strong>Methods:</strong> It was a cross-sectional comparative study done to compare the efficacy of endoscopic septoplasty with conventional septoplasty, conducted at a tertiary care centre over a period of 3 years. Records of 100 patients of nose and PNS disorders with DNS who were operated either by conventional or by endoscopic technique were studied. The patients were studied for the improvement in their symptoms, anatomical correction and intra-operative/post-operative complications. </p><p class="abstract"><strong>Results:</strong> Endoscopic septoplasty group patients showed better symptomatic relief, lesser incidence of residual anterior /posterior deviation and persistent spur and less complications as compared to the conventional septoplasty group.</p><p><strong>Conclusions:</strong> In our study we found more clientele satisfaction and lesser rate of complications in endoscopic septoplasty group. We recommend all ENT specialists to be trained in nasal endoscopic septoplasty technique as it offers many advantages such as more precision in post nasal spurs with less flap tears, it can be tailor made according to the disease and can be combined with various endoscopic surgeries.</p>
Sinonasal mucormycosis is uncommon entity and it rarely infects a healthy host. When it does occur; it becomes very difficult to treat because of the speed of progress of disease and can have fatal outcomes. The mainstays of therapy are treatment of immunocompromised status, systemic high dose Amphotericin B, and surgical debridement of necrosed or nonviable tissue. The following six cases, managed at our centre from July 2016 to October 2016, outline nuances in the diagnosis of invasive sinonasal mucormycosis and highlight the importance of timely surgical debridement and importance of endoscopic approach in complete clearance of disease in order to facilitate medical management to work. All cases included in this study were found to be immunocompromised and had unilateral severe diminution of vision due to periorbital extension of disease. Diagnostic nasal endoscopy revealed black-brown crust and tenacious pus filling up nasal cavity, erosion of turbinates and nasal septal perforation. One patient showed erosion of hard palate and eschar formation. CECT/MRI of PNS showed evidence of bony erosion and orbital involvement. Biopsy taken during nasal endoscopy confirmed the presence of mucormycosis. All patients were started on Liposomal Amphotericin B and broad spectrum antibiotics in renal corrected dosages and taken up for urgent endonasal endoscopic debridement. All paranasal sinuses were cleared and orbital decompression was done. Postoperatively all patients were continued on Liposomal Amphotericin B in renal corrected dosages for two-three weeks and being followed up monthly. One patient could not survive due to several co morbidities and severe immunocompromised status. Only one patient showed recurrence of disease on one month postoperative follow up. Five patients showed improvement in visual acuity. Sinonasal mucormycosis if inappropriately diagnosed and treated can be a fatal condition. Energetic diagnostic workup, combined with equally energetic management, surgical and management leads to favourable outcome.<p> </p>
Superficial parotidectomy is the biopsy procedure of choice for all parotid neoplasm's as well as therapeutic choice for small low-grade malignancies. The key to successful parotid surgery is identification of the facial nerve. It is usually done under general anesthesia (GA).The main focus in this procedure is to remove entire superficial parotid gland along with a disease and at the same time preventing any iatrogenic injury to facial nerve and its peripheral branches which supplies over the face. We present three cases of superficial parotidectomies done under local anesthesia technique. The objectives of these reports are to discuss the clinical presentation, diagnosis and management of these growths surgically under local as an alternative method or when it is desired under some special circumstances and the merits. This technique may avoid the use of facial nerve monitor.
Mucor is a saprophytic fungus. Although it commonly invades the nose and the paranasal sinuses, cutaneous, pulmonary or gastrointestinal lesions may also be seen and haematogenous spread to other sites can also occur. The predisposing factors include Diabetes Mellitus and other conditions causing immunocompromised state. However, rare cases without any underlying disorder have been also reported. This case is described to demonstrate rarer neurological presentation of Oto-cerebral Mucormycosis rather than the well recognized rhino-orbito-cerebral form. Early diagnosis and institution of treatment is the mainstay to successful therapy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.