Endosurgical repair of an iatrogenic facial arteriovenous fistula due to percutaneous trigeminal balloon rhizotomy.
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A 56-year-old woman with right-sided trigeminal neuralgia (TN), who underwent technically uneventful percutaneous balloon rhizotomy, developed significant bilateral pulsatile tinnitus on the first post-operative day. Although the patient reported significantly improved neuralgia, auscultation revealed a right facial bruit. Magnetic resonance angiography (MRA) of the face and brain demonstrated prominent right facial and jugular venous vascularity. Catheter angiography confirmed the suspected facial arteriovenous fistula (AVF). A transarterial approach was used to explore the AVF which arose from a laceration of the right internal maxillary artery and which fistulized directly with the pterygoid venous plexus. Endosurgical repair utilizing three non-fibered platinum coils was done under conscious sedation at the same setting as the diagnostic angiogram. Angiographically, the fistula was obliterated, and the patient's bruit and tinnitus immediately resolved. Follow-up MRA at 3.5 months was normal, and, the patient had no clinical symptoms of recurrent AVF. In conclusion facial AVF can complicate percutaneous trigeminal rhizotomy. Iatrogenic facial AVF can be repaired via an endovascular approach. (+info)
A weighted logistic regression analysis for predicting the odds of head/face and neck injuries during rollover crashes.
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A weighted logistic regression with careful selection of crash, vehicle, occupant and injury data and sequentially adjusting the covariants, was used to investigate the predictors of the odds of head/face and neck (HFN) injuries during rollovers. The results show that unbelted occupants have statistically significant higher HFN injury risks than belted occupants. Age, number of quarter-turns, rollover initiation type, maximum lateral deformation adjacent to the occupant, A-pillar and B-pillar deformation are significant predictors of HFN injury odds for belted occupants. Age, rollover leading side and windshield header deformation are significant predictors of HFN injury odds for unbelted occupants. The results also show that the significant predictors are different between head/face (HF) and neck injury odds, indicating the injury mechanisms of HF and neck injuries are different. (+info)
Penetrating facial injury from angle grinder use: management and prevention.
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Sudoriferous cyst of the orbit of adult origin after trauma.
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A rare case of sudoriferous cyst of the orbit occurring in an adult, who had facial trauma, is reported. Several factors suggest its adult onset. The only other case reported in an adult is of presumed childhood origin. Very few congenital cases have been reported. A 65-year-old lady presented with recent onset of left-sided ptosis and a painless mass below the left supraorbital margin. The patient had traumatic ptosis after a road traffic accident 13 years ago. The ptosis was surgically repaired, which resulted in symmetrical palpebral apertures. Computed tomographic scan revealed a well-defined cystic mass in the anterior orbit. The mass was removed in toto by anterior orbitotomy. Histopathological examination revealed a single cyst lined by double-layered cuboidal epithelium in some areas and transitional epithelium at others. A periodic acid Schiff (PAS) positive, diastase-resistant glycocalyx lined the inner epithelium. Apical snouting suggested an apocrine nature. This confirmed a diagnosis of sudoriferous cyst. (+info)
Dynamic commissural splint.
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Microstomia, an abnormally small oral orifice, can manifest as a sequela of burns involving the oral and perioral tissues due to contraction of the tissues and hypotonia of the circumoral musculature. Regardless of the etiology, scar contracture results in deformities that produce esthetic and functional impairment. Changes in the circumoral anatomy prevent optimal dental care and maintenance of good oral hygiene. The anatomic changes may detrimentally alter eating, speech, and mandibular motion. Prosthetic treatment involves providing physical resistance to scar contracture by maintaining the oral commissures in their normal relationship by means of a splint. This article describes a method to fabricate a dynamic commissural splint and describes its use in two cases. (+info)
Barriers to seeking mental health care after treatment for orofacial injury at a large, urban medical center: concordance of patient and provider perspectives.
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Agriculture-related severe craniofacial injuries in rural children and adolescents.
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The severe craniofacial injuries connected with agricultural work in rural children and adolescents were analysed. The analysis took into account the causes for injuries, their types and treatment. The studied group were hospitalized and constituted 18.6% of the patients of the specialized surgery department. The most severe injuries of the face and the bone structure occurred during operating or assisting in operating farming equipment, wood processing, as a result of the fall from a height, or were injuries inflicted by an animal. Causes of injuries sustained by rural children are analogous to factors causing injuries in adult agricultural workers. The practice of employing children to perform agricultural work should be prohibited because severe injuries of the facial skeleton and soft tissues may lead to disorders in children's physical and mental development. (+info)