Background Orofacial clefts are considered one of the most common birth defects and are frequently associated with other malformations. Congenital heart disease is one of the most prevalent congenital malformation. Objective To investigate the prevalence of congenital heart diseases associated with non-syndromic orofacial clefts in the Saudi population. Methods Electronic files of non-syndromic orofacial cleft patients who visited the Oral and Maxillofacial Surgery Department in King Abdulaziz Medical City of Riyadh, Saudi Arabia from January 2015 to December 2018 were retrospectively reviewed. Data were recorded in an excel sheet and analyzed using SPSS via frequency tests. Results In the cleft children identified, the prevalence of non-syndromic orofacial clefts was (77%). Orofacial clefts showed a male predominance (62%). The most common orofacial phenotype was unilateral cleft lip and palate (34%). The prevalence of associated congenital malformations with orofacial clefts was (41%). The most prevalent congenital malformation was congenital heart disease (35%), mainly found in unilateral cleft lip and palate patients (33%). The prevalence of associated congenital heart disease with orofacial clefts was (19%). The most frequent type of congenital heart disease was atrial septal defect (37%). Conclusion This study highlights the recognition of the associated congenital heart disease with non-syndromic orofacial cleft patients. Global screening protocols designed for newborns with non-syndromic orofacial cleft are needed to eliminate late diagnosis of critical congenital heart diseases which might present operative risks of anesthesia and/or surgical procedures.
Background. Hypothalamic lipomas are benign developmental lesions that tend to be discovered incidentally. This article describes the radiological features, outcome, and the postulated theories behind hypothalamic lipomas development. Methods. The electronic archive of neurosurgery was retrospectively reviewed. All patients with a neuroradiological diagnosis of hypothalamic lipoma, between 2005 and 2020, were included. Results. Out of 246 patients with intracranial lipomas, a total of six patients with hypothalamic lipomas have been identified. On computed tomography images, one of the hypothalamic lipomas demonstrated calcification. On magnetic resonance imaging, peripheral enhancement after contrast administration was noted in one of the lesions. Considering the benign nature of the lesions, neurosurgical intervention was not indicated. Conclusion. The majority of patients with hypothalamic lipomas are asymptomatic and undergo brain imaging for other indications. Although uncommon, such developmental lesions can be identified in the general population, especially with the advancement of neuroimaging techniques.
Oculomotor nerve palsy, due to pituitary apoplexy, has been previously reported in the literature. However, the association with coronary artery bypass graft surgery (CABG) is rarely investigated. This article reports a case of pituitary apoplexy presenting with oculomotor nerve palsy following CABG. A 65-year-old male, known to have ischemic heart disease, diabetes mellitus and hypertension, presented with ptosis, diplopia and anisocoria that developed after 1 day of CABG. Radiological imaging demonstrated a pituitary adenoma with acute/subacute hemorrhage causing mild mass effect on the cavernous sinus. Considering the acute state of bypass surgery and pre-existing cardiac co-morbidities, expectant management was considered. The visual acuity and palsy gradually improved. Pituitary apoplexy, following CABG, is a rare phenomenon in the post-operative period. High index of suspicious is required to promptly identify high-risk patients to avoid further neurological sequelae.
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