phenylephrine-hydrochloride and Mandibular-Diseases

The incidence of deformational posterior plagiocephaly has increased dramatically since 1992. We tested the hypothesis that mandibular asymmetry, associated with this condition, is secondary to anterior displacement of the ipsilateral temporomandibular joint. The response to molding helmet therapy was also evaluated.. A caliper was used to measure mandibular dimensions in 27 infants (16 boys and 11 girls) with deformational posterior plagiocephaly; the mean age was 6.2 months (range, 3 to 12 months). Anthropometric measures included ramal height (condylion-gonion), body length (gonion-gnathion), and condylion-gnathion. Gonial angle was calculated from the law of cosines: C(2) = A(2) + B(2) - 2AB cos c. The position of the temporomandibular joint was accepted as corresponding to auricular position and measured from tragion to subnasal. Cranial asymmetry was measured, in the horizontal plane, from orbitale superius to the contralateral parieto-occipital point at the level of inion. Ten of 27 patients were remeasured 5 months after beginning helmet therapy to evaluate change in mandibular dimensions.. Two thirds of infants (67%) had right-sided and one third (33%) had left-sided deformational posterior plagiocephaly. The mean auricular anterior displacement was 79.7 mm on the affected side and 83.4 mm on the unaffected side. The mean difference of 3.8 mm between the sides was statistically significant (P <.001). Transverse cranial dimension averaged 136.0 mm on the affected side and 146.8 mm on the unaffected side; this was also significant (P <.001). There was a significant positive correlation between auricular displacement and cranial asymmetry [R(23) =.59, P <.01). Auricular (temporomandibular joint) displacement also resulted in an apparent mandibular asymmetry with rotation of the jaw to the affected side. Mean mandibular measurements on the affected and unaffected sides were ramus height of 35.2 and 36.4 mm, body length of 59.0 and 60.3 mm, and gonial angle of 127.1 degrees and 126.8 degrees, respectively. Comparison of the affected with the unaffected sides, using a paired-samples t test, was not statistically significant. Improvement in cranial asymmetry occurred with helmet therapy, but there was no correction of auricular and temporomandibular joint position.. This study supports the clinical observation that the mandibular asymmetry in deformational posterior plagiocephaly is secondary to rotation of the cranial base and anterior displacement of the temporomandibular joint (quantified by anterior auricular position) and not the result of primary mandibular deformity.

Topics: Anthropometry; Cephalometry; Craniosynostoses; Ear, External; Facial Asymmetry; Female; Follow-Up Studies; Head Protective Devices; Humans; Infant; Male; Mandibular Condyle; Mandibular Diseases; Matched-Pair Analysis; Nose; Occipital Bone; Orbit; Orthopedic Procedures; Parietal Bone; Rotation; Statistics as Topic; Temporomandibular Joint

A 24-year-old Chinese woman who has undergone staged surgery for craniofacial deformity secondary to beta-thalassemia major is presented. Local clusters of Gaucher-like cells were found in the periosteum of the mandible. The histologic and ultrastructural features of these cells are described and the pathogenesis and differential diagnoses discussed. To the best of our knowledge, this is the first reported case of Gaucher-like cells occurring outside the lymphohematopoietic system in thalassemic patients.

Topics: Adult; beta-Thalassemia; Bone Marrow; Cell Nucleus; Cytoplasm; Female; Gaucher Disease; Histiocytes; Humans; Mandibular Diseases; Maxillary Diseases; Nose; Periosteum

The challenging restoration of form and function in radical surgery of the head and neck demands sound concepts and proper execution in reconstruction. Flaps are most frequently employed in reconstruction, following major surgery because of their rich blood supply and cosmetic superiority. Of the many types of flaps known, the midline forhead flap, temporoforehead flap, mastoid-occipital flap, tongue flap, and deltopectoral flap have enjoyed most popularity. The design and application of these flaps are discussed. Our techniques in reconstruction of the oral cavity, hypopharynx, esophagus, nose, Andy-Gump deformities (anterior jaw complex resection), pharyngo-orocutaneous fistulas, and radionecrosis of the mandible are presented.

Topics: Esophagus; Fistula; Head; Humans; Mandible; Mandibular Diseases; Mouth; Mouth Diseases; Neck Dissection; Nose; Osteoradionecrosis; Pharyngeal Diseases; Pharynx; Skin Diseases; Skin Transplantation; Surgery, Plastic; Transplantation, Autologous

Topics: Cysts; Humans; Mandibular Diseases; Maxillary Diseases; Nose; Odontogenic Cysts

Topics: Adolescent; Anesthesia, General; Ankylosis; Child; Female; Humans; Intubation; Jaw Diseases; Mandibular Diseases; Nigeria; Nose; Tracheotomy; Tropical Climate; Tropical Medicine

Topics: Animals; Bone Development; Cartilage; Ethmoid Bone; Mandibular Diseases; Nasal Septum; Nose; Nose Deformities, Acquired; Prognathism; Rabbits