phenylephrine-hydrochloride and Maxillary-Diseases

The nasopalatine duct cyst is the most frequent nonodontogenic cyst of the jaws. The cyst originates from epithelial remanents from the nasopalatine duct. The cells may be activated spontaneously during life, or are eventually stimulated by the irritating action of various agents (infection, etc.). Generally, patients present without clinical signs and symptoms. Therefore, the tentative diagnosis "nasopalatine duct cyst" is often based on a coincidental radiological finding on a routine panoramic view or occlusal radiograph. The definite diagnosis should be based on clinical, radiological and histopathologic findings. The therapy of nasopalatine duct cysts consists of an enucleation of the cystic tissue, only in rare cases a marsupialization needs to be performed. The present review of the literature presents and discusses the epidemiology, etiology, diagnostic work-up, differential diagnostic aspects, histopatholgy, and therapeutic strategies for nasopalatine duct cysts.

Topics: Humans; Maxillary Diseases; Nonodontogenic Cysts; Nose; Palate, Hard

Medial maxillectomy is the standard operation for en bloc resection of the lateral nasal wall with portions of the maxillary and ethmoid sinuses. Although most reports comment on good to excellent cosmetic results, nasal collapse is a possible complication of the procedure and is best explained by the loss of lateral nasal wall support. To overcome this problem, we describe a technique with temporary mobilization of a bone frame around the ipsilateral pyriform aperture, including one nasal bone, and fixing it to its original position at the end of the operation.

Topics: Ethmoid Sinus; Humans; Maxilla; Maxillary Diseases; Maxillary Sinus; Nose; Osteotomy

An unusual case of patent nasopalatine duct appearing in the central region of the hard palate in a young adult is reported. The origin and clinical symptoms of this anomaly are discussed.

Topics: Adult; Fistula; Humans; Male; Maxillary Diseases; Nose; Nose Diseases; Palate

Topics: Endoscopy; Facial Injuries; Humans; Maxillary Diseases; Nasopharyngeal Neoplasms; Nose; Nose Deformities, Acquired; Paranasal Sinus Neoplasms; Penicillins; Rhinoplasty; Sinusitis; Surgery, Plastic

To determine the contribution of the nasal floor and hard palate morphology to nasal obstruction for nonresponders to prior intranasal surgery.. Retrospective case-control study.. Tertiary academic center.. Institutional review board-approved, retrospective institutional database analysis was obtained of a cohort of 575 patients who presented with nasal obstruction over a 21-year period. Of the patients, 89 met inclusion criteria: 52 were placed into the experimental group, defined as having persistent nasal obstruction following endoscopic sinus surgery (ESS), septoplasty, nasal valve repair, and/or turbinoplasty using validated subjective questionnaires, and 37 were placed into the control group, defined as having resolution of subjective nasal obstruction. Computed tomography imaging was presented to 3 blinded experts, who measured numerous nasal airway and hard palate morphology parameters, including anterior nasal floor width, anterior maxillary angle, maxilla width, anterior nasal floor width, and palatal vault height. Standard demographic information, comorbidities, perioperative 22-item Sinonasal Outcome Test (SNOT-22), and follow-up time were also assessed. Wilcox rank sum analysis or. Follow-up ranged from 2 to 36 months following surgical intervention. Several skeletal characteristics within the upper airway were significantly associated with persistent nasal obstruction, including acute maxillary angle (. Persistent nasal obstruction may be seen in patients with narrow, high arched hard palate despite prior nasal surgical intervention and may benefit from additional skeletal remodeling procedures such as maxillary expansion.

Topics: Adult; Case-Control Studies; Female; Humans; Male; Maxillary Diseases; Middle Aged; Nasal Obstruction; Nose; Nose Diseases; Postoperative Complications; Retrospective Studies; Risk Factors

Facial asymmetry is prominent with individuals with unilateral bone resorption and can lead to decreased quality of life.. The purpose of this study was to investigate the influence of maxillary obturator prostheses on facial morphology of individuals with unilateral maxillary defects by using 3-dimensional digital stereophotogrammetry.. The facial data of 8 participants with unilateral maxillary defects were acquired with a noncontact 3-dimensional digitizer, both with and without maxillary prostheses. The mid-facial plane was established by overlapping an original facial image with its mirror image. Displacement at 18 measurement points, including 7 bilateral pairs, was compared between the 2 sides, with and without the prostheses. Asymmetry indices of these 7 pairs also were calculated. Multivariate repeated-measures ANOVA was used to determine differences.. Displacements of the lateral and inferior points at the ala of the nose were significantly greater on the defect side than on the normal side. The distances between the ideal and defect side points at the superior ala, the upper lip, and the angle of the mouth decreased significantly with the prosthesis. No significant differences were found in asymmetry indices, but the angle of the upper lip line to the mid-sagittal plane increased significantly with the prosthesis.. The 3-dimensional analyzing method developed in this study can be useful in evaluating facial reconstruction with maxillary obturator prostheses with individuals with unilateral maxillary defects. The prostheses affect the region of the nasal ala, the upper lip, and the angles of the mouth.

Topics: Aged; Anatomic Landmarks; Cephalometry; Dental Prosthesis Design; Eyelids; Face; Facial Asymmetry; Female; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Lip; Male; Maxillary Diseases; Middle Aged; Mouth; Nasal Cartilages; Nose; Palatal Obturators; Photogrammetry; Tooth Loss

A nasoalveolar cyst is a rare, non-odontogenic soft tissue cyst encountered in the anterior maxillary labial sulcus as an asymptomatic soft tissue swelling. Often, patients with these cysts report them to the dental clinic where they are mistaken for odontogenic lesions by the dental surgeon, especially if concomitant dental problems are present. They cannot be detected by routine conventional dental radiography as they are peripheral, lying within the mucosa thereby posing a diagnostic challenge. We document a case of a 47-year-old woman with a nasoalveolar cyst.

Topics: Cysts; Dentistry; Dentists; Female; Humans; Jaw Cysts; Maxilla; Maxillary Diseases; Middle Aged; Mouth Diseases; Nose; Nose Neoplasms; Odontogenic Cysts; Soft Tissue Neoplasms; Tooth Socket

The aim of this study was to investigate the changes in nasal airways after Le Fort I osteotomy and functional rhinosurgery. 49 patients were included in this study to assess intranasal anatomical and functional changes resulting from a Le Fort I osteotomy. The data were classified according to the three-dimensional positioning of the maxilla: in group I the maxilla was impacted; in group II the maxilla was inferior; and in group III only sagittal maxillary movement was performed. Presurgical and 5 months postsurgical rhinological inspection, anterior rhinomanometry and acoustic rhinometry were carried out. Additional rhinosurgery, such as resection of the inferior concha or septoplastic intervention, was performed to avoid functional problems in nasal breathing, particularly when the maxilla was impacted. Rhinomanometric assessment showed a significant improvement in nasal breathing in the whole group and each single group. Acoustic rhinometry revealed an increase in typical cross-sectional intranasal areas. The authors conclude that concerns about the respiratory consequences of this surgical procedure appear unwarranted when functional rhinosurgery is undertaken concomitantly, particularly in patients with increased preoperative nasal airway resistance.

Topics: Adolescent; Adult; Aged; Airway Resistance; Humans; Maxilla; Maxillary Diseases; Middle Aged; Nasal Cavity; Nasal Obstruction; Nose; Osteotomy, Le Fort; Plastic Surgery Procedures; Prospective Studies; Rhinomanometry; Rhinometry, Acoustic; Rhinoplasty; Treatment Outcome; Young Adult

The purpose of this study was to evaluate nasal airway resistance (NAR) during rapid maxillary expansion (RME) using acoustic rhinometry (AR). The sample comprised 22 children (13 girls and nine boys) with maxillary constriction. The mean age was 12.9 +/- 1.54 years and all patients were found to have normal nasal cavities following anterior rhinoscopic examination. A modified bonded splint type RME appliance was used for expansion. AR was used to measure NAR before (T1), during (T2) and after (T3) expansion, and at the end of retention (T4). Each AR recording was performed, for each patient, with and without the use of a decongestant. Subjective evaluation of reported changes in nasal breathing were also undertaken at T3. The results showed that NAR was significantly reduced with the use of RME, with the main decrease observed during expansion (P < 0.05). The use of a decongestant was not found to have any effect on the results. Subjective evaluation showed that 59 per cent of patients considered that their nasal breathing had improved following RME.

Topics: Adolescent; Airway Resistance; Child; Endoscopy; Female; Follow-Up Studies; Humans; Male; Malocclusion; Maxillary Diseases; Nasal Cavity; Nasal Decongestants; Nose; Orthodontic Appliance Design; Palatal Expansion Technique; Patient Satisfaction; Respiration; Rhinometry, Acoustic

This article describes a simple, new surgical technique to provide a complete two-layer closure of palatal defect resulting from a surgical complication of trans palatal resection of skull base chordoma. The nasal layer was reconstructed with triangular shape oral mucoperiosteal turn over hinge flap based on anterior margin of palatal defect and rectangular shaped lateral nasal mucosal hinge flaps. The oral layer was reconstructed with conventional pushback V-Y advancement 2-flaps palatoplasty. Each layer of the flaps were secured with two key mattress suture for flap coaptation. This technique has some advantages: simple, short operation time, one-stage procedure, no need of osteotomy. It can close small- to medium-sized palatal defect of palate or wide cleft palate and can prevent common complication of oronasal fistula, which could be caused by tension.

Topics: Child, Preschool; Chordoma; Female; Humans; Maxillary Diseases; Mouth Mucosa; Nasal Mucosa; Nose; Palate; Periosteum; Skull Base Neoplasms; Surgical Flaps; Suture Techniques; Velopharyngeal Insufficiency

Topics: Adult; Bone Cysts; Cysts; Diagnosis, Differential; Humans; Male; Maxillary Diseases; Mouth Diseases; Nose; Nose Diseases; Palate; Radicular Cyst; Radiography

The feasibility and possible effects of palatal soft-tissue expansion in palatal repair were studied. A prospective longitudinal animal experiment was performed in 75 growing cats assigned to 5 groups. In 31 cats, a midline defect was made, and bipediced flaps were raised at the age of 8 weeks (stimulated Langenbeck operation) in order to create palatal scars. At the age of 14 weeks, custom-made tissue expanders were inserted palatally in 61 animals. Tissue expansion was performed by weekly inflation in 33 cats (16 without and 17 with scars) for an 8-week period. The remaining 28 cats (14 without and 14 with scars) served as sham groups. A control group was formed by 14 animals (without scars and without tissue expanders). Soft-tissue gain and its effects on maxillofacial growth and development were measured in the midsagittal plane on tracings from standardized lateral radiographs. The effects of the experimental interventions were evaluated for 8 weeks after removal of the tissue expanders. Not all the cats yielded results at all time periods. This study showed that soft-tissue expansion of palatal mucoperiosteum is feasible. The surgically induced scars did not cause significant differences between the different groups in the midsagittal plane, and the data from both expansion and sham groups could be pooled. Significant soft-tissue gain was achieved by the tissue-expansion technique. Iatrogenic side effects were significant anteroposterior growth retardation at the level of the bony palate and an increase in vertical growth of the anterior nasomaxillary height and the posterior skull height during active tissue expansion. After removal of the tissue expanders, some accelerated growth was found in the tissue expansion in the scarred tissue group, with initial correction of the abnormal growth at the cranial base level. It is concluded that palatal soft-tissue expansion is possible in growing cats. This technique, however, impaired maxillofacial growth and development.

Topics: Analysis of Variance; Animals; Cats; Cephalometry; Cicatrix; Feasibility Studies; Growth Disorders; Iatrogenic Disease; Longitudinal Studies; Maxilla; Maxillary Diseases; Maxillofacial Development; Mouth Mucosa; Nose; Palate; Periosteum; Prospective Studies; Radiography; Skull Base; Tissue Expansion; Tissue Expansion Devices; Vertical Dimension

Thirty patients with severely resorbed edentulous maxillae underwent combined treatment of iliac bone onlay graft and titanium implants. The patients were followed for 3 years. They were radiographically examined before surgery to evaluate the bone volume at the intended implant sites. Only 13/156 implant sites were suitable for implant insertion. The bone level at the implant surfaces was evaluated after 6 months and 1, 2, and 3 years, respectively. There was a continuing decrease of the bone level throughout the follow-up period with a mean loss of 4.9 mm after 3 years and with no difference between sexes. Twenty-six implants were radiographically examined before removal, and only three of these implant sites showed radiographic signs of failure. The soft-tissue profile was analyzed cephalometrically by the subtraction technique. The upper lip generally moved inward and the apex of the nose and the columella downward and inward. The anterior facial height increased in most of the patients, resulting in a downward and inward change of the lower lip, the mentolabial sulcus, the soft-tissue pogonion, and the soft-tissue gnathion.

Topics: Adult; Aged; Alveolar Ridge Augmentation; Bone Resorption; Bone Transplantation; Cephalometry; Chin; Dental Implantation, Endosseous; Dental Implants; Dental Restoration Failure; Face; Female; Follow-Up Studies; Humans; Jaw, Edentulous; Lip; Male; Maxilla; Maxillary Diseases; Middle Aged; Nose; Radiography; Sex Factors; Subtraction Technique; Transplantation, Autologous; Vertical Dimension

Topics: Alveolar Process; Bone Transplantation; Cleft Palate; Facial Muscles; Fascia; Hearing Disorders; Humans; Lip; Maxilla; Maxillary Diseases; Mouth Mucosa; Nose; Nose Diseases; Oral Fistula; Speech Disorders; Surgical Flaps; Temporal Muscle; Tongue

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

Three children suffering from facial asymmetry were observed annually using facial stereophotogrammetry before, during, and after their general skeletal adolescent growth spurt. Stereophotogrammetry allows accurate three-dimensional measurements between identifiable facial landmarks. Five pairs of bilateral parameters connecting external canthi and angles of the mouth to alae and tip of nose, and to each other, allowed a positive sign (right-side larger) or a negative (left-side larger) assessment of parameter asymmetry. Their total, taking sign into account, assessed mid-facial asymmetry. Serial observation showed that: (1) in patient no. 1 suffering from post-traumatic condylar hypoplasia, the facial asymmetry resolved; (2) in patient no. 2 suffering from unilateral facial hypoplasia, the asymmetry, which was severe, reduced with adolescence, but did not resolve; (3) in patient no. 3 suffering from fibro-osseous dysplasia of left maxilla, the asymmetry was reduced by surgery, but the full effects of the surgery were not measurable until over 1 year after operation; subsequently, the asymmetry began to increase again.

Topics: Adolescent; Age Factors; Cephalometry; Child; Face; Facial Asymmetry; Female; Fibrous Dysplasia of Bone; Humans; Male; Malocclusion; Mandibular Condyle; Maxillary Diseases; Maxillofacial Development; Mouth; Nose; Photogrammetry

Topics: Drainage; Humans; Maxillary Diseases; Mouth; Nose; Osteomyelitis; Therapeutic Irrigation

To evaluate speech following prosthetic obturation of surgically acquired maxillary defects, the speech intelligibility of eight patients was measured preoperatively and postoperatively, with and without prostheses. Oro-nasal separation and velopharyngeal function were also evaluated by use of a specially designed spirometer and endoscope. Following placement of maxillary obturator prostheses, four patients achieved dramatic improvement in speech intelligibility, while four patients did not. In the latter, insufficient improvement in speech intelligibility was attributed to velopharyngeal incompetence or unstable prosthesis. Two of three patients with velopharyngeal incompetence did achieve adequate improvement in speech following placement of a speech appliance in combination with maxillary obturator prostheses.

Topics: Adult; Aged; Aged, 80 and over; Endoscopy; Female; Humans; Male; Maxilla; Maxillary Diseases; Middle Aged; Mouth; Nose; Palatal Obturators; Palate, Soft; Pharynx; Prosthesis Design; Pulmonary Ventilation; Speech Disorders; Speech Intelligibility; Spirometry

The maxillary cysts are classified on the basis of the recommendations by the World Health Organisation (1971), based on pathogenic criteria, in developmental and inflammatory, odontogenic and nonodontogenic cysts. Only two maxillary cysts lie primarily extraosseous: a non-odontogenic cyst, the nasolabial cyst, and an odontogenic cyst, the gingival cyst. The nasolabial cyst is a rare, developmental, non-odontogenic maxillary cyst, which offers the peculiarity of its constant extraosseous localization. On the basis of our cases from 1966 to 1988 the clinical patterns, histopathology, differential diagnosis, therapy, prognosis and histopathogenesis of the nasolabial cyst are presented.

Topics: Adolescent; Adult; Aged; Diagnosis, Differential; Female; Humans; Male; Maxilla; Maxillary Diseases; Middle Aged; Nonodontogenic Cysts; Nose; Nose Diseases; Odontogenic Cysts

Destructive processes of the midface can occur in a wide variety of diseases. Intrinsic in consideration of these is a cluster of lesions, including Wegener's granulomatosis (WG), idiopathic midline granuloma (IMG), polymorphic reticulosis (PR), and lymphoma. Although there is still confusion as to whether the latter three represent a spectrum of the same malignant process, there is general agreement that WG is a separate entity on the basis of clinical presentation and therapeutic response. It is probable that PR is an emergent lymphoma, with the same prognostic and therapeutic features. Idiopathic midline granuloma is clinically similar to PR and lymphoma, but histologically it appears to be inflammatory in nature with no clearly definable malignant cell type present. At this point in time three diseases are best collectively referred to as midline "nonhealing" granuloma. The cases presented represent the spectrum of this enigmatic process.

Topics: Adult; Connective Tissue; Diagnosis, Differential; Female; Granuloma, Lethal Midline; Histiocytes; Humans; Leukocytes; Male; Maxillary Diseases; Nose

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

Topics: Adult; Cysts; Female; Humans; Male; Maxillary Diseases; Nasal Cavity; Nose; Radiography

A definite relation between ozaena and iron deficiency disease could not be verified. However, the examination of 88 patients with severe iron deficiency disease, mostly of juvenile age, revealed that X-ray pictures of the nose and the paranasal sinuses showed abnormal alterations indicating the existence of a non-inflammatory process. There were few symptoms from the nose and the neighbouring structures as well as insignificant clinical findings by inspection of these structures. The increased opacity of the maxillary sinuses on the roentgenograms and some other changes are considered to be partially due to the insufficient pneumatisation which is related to the retarded development and maturation of juvenile patients with iron deficiency disease. Furthermore, it is caused by the enlargement and thickening of the facial bones resulting from the expansive growth of the hyperplastic and hypertrophic red marrow filling completely the cancelous substance. The space of the maxillary sinuses is narrowed in many cases, the penetration power of the X-ray diminished and the clearing effect of the air containing cavities decreased.

Topics: Adolescent; Adult; Anemia, Hypochromic; Child; Female; Humans; Male; Maxilla; Maxillary Diseases; Nose; Paranasal Sinuses; Radiography; Respiratory Tract Diseases

Topics: Female; Humans; Infant, Newborn; Maxillary Diseases; Nose; Osteomyelitis; Tooth Eruption, Ectopic; Tooth Extraction