phenylephrine-hydrochloride and Maxillary-Neoplasms

To describe a naso-facial reconstruction technique following bilateral rostral maxillectomy and its functional and cosmetic outcomes.. Two dogs.. Clinical case series.. Two dogs were presented with a right rostral maxillary mass. Preoperative biopsy and staging revealed a biologically high-grade and histologically low-grade fibrosarcoma (Hi-Lo FSA). A combined nasal planectomy and radical bilateral rostral maxillectomy was performed sparing the labial/buccal mucocutaneous flaps bilaterally. Surgery resulted in asymmetry of the width of the flaps; the narrower flap was rotated medially to reconstruct the lip and create an oral vestibule. The wider flap was rotated medially to cover the remaining dorsolateral opening of the nasal conchae. The flaps overlapped in a parallel manner, discretely concealing the nasal passages, and separating them from the oral cavity. Hemorrhage occurred in both dogs, with one dog requiring a blood transfusion postoperatively.. Oral Hi-Lo FSA with tumor-free margins was confirmed in both dogs. Both dogs recovered uneventfully within 4 weeks. Owners reported being very satisfied with the functional (return to normal exercise/activities and uncompromised respiration) and cosmetic outcomes. Based on the owners' telephone follow up, no tumor recurrence was noted at 15 (Dog 1) and 6 (Dog 2) months postoperatively.. The full-thickness bilateral labial/buccal rotational flaps were used successfully to reconstruct the rostral maxilla, external nose and facial defects involving the nasal cavity. The technique resulted in acceptable functional and cosmetic outcomes and can be considered for naso-facial reconstruction in selected cases.

Topics: Animals; Dog Diseases; Dogs; Maxillary Neoplasms; Neoplasm Recurrence, Local; Nose; Plastic Surgery Procedures; Surgical Flaps

Hemangiopericytoma (HPC) is a rare vascular tumour and difficult to diagnose clinically. Incidence is reported in fourth to fifth decade of life.With female predominance, 3%-5% cases affect the oral cavity, sinus lining and meninges. The patient presented with 8×6 cm swelling on her face, evaluation reported it to be HPC. Bilateral maxillary artery embolisation, wide local excision of the lesion, preserving the left eye and its function, was done. No recurrence is reported at 1-year follow-up. Response of such lesions to radiotherapy is questionable; with no lymphadenopathy and adequate encapsulation, embolisation of feeder vessel followed by a wide local excision of the lesion seems to be a fairly good option of treatment.

Topics: Adult; Diagnosis, Differential; Female; Hemangiopericytoma; Humans; Maxilla; Maxillary Neoplasms; Neurosurgical Procedures; Nose; Nose Neoplasms; Orbit; Orbital Neoplasms; Tomography, X-Ray Computed; Ultrasonography

Surgical and prosthodontic restoration of the midfacial region following tumor resection has always posed a considerable challenge, as this area serves crucial functional and esthetic roles. Being diagnosed and subsequently treated for facial tumors can have an immense psychosocial impact on a patient, as the resulting defects are often disfiguring, and lead to an inability to masticate, swallow, and speak clearly. Provision of an immediate facial and dental prosthesis at the time of surgery can limit these side effects and help reduce mental duress on these patients and their families, as well as aid in the process of rehabilitation. Rapid prototyping (RP) and 3D printing, as this paper shows, assists presurgical planning of the tumor resection, as well as the manufacture of maxillofacial and dental prostheses. Often these defects are extensive, so prosthesis retention is aided by zygomatic implants placed at the time of surgical resection. When placed at this time, and prior to radiation therapy, these craniofacial implants have improved survival rates. Thus, this treatment modality can improve postoperative recovery considerably, while at the same time allowing for cleaning and monitoring of the resected site for tumor recurrence.

Topics: Adult; Aged; Dental Implants; Dental Prosthesis, Implant-Supported; Female; Humans; Immediate Dental Implant Loading; Male; Maxillary Neoplasms; Neoplasm Recurrence, Local; Nose; Treatment Outcome; Zygoma

Total nasal reconstruction is a challenging surgical procedure which usually involves a free flap, forehead flap, and cartilage grafts. In certain failure situations where patients do not accept the idea of anaplastology, possibilities become very limited. We report the case of a patient who underwent several reconstruction steps with multiple failures including free and local flaps and cartilage harvests which showed recurrent episodes of necrosis and infection leading to melting and collapse of reconstructed structures. Furthermore, the patient did not want any anaplastological rehabilitation. We proposed to the patient an innovative method that consists to print a three-dimensional custom-made porous titanium prosthesis, based on the original shape of his nose, to replace the cartilage support. This implant was first inserted in a thoracodorsal artery perforator flap for primary integration before the free transfer of the complete structure, two months later. The free transfer was successful without any complication. A stable reconstruction and satisfying result was obtained. The patient did not want additional surgical improvement 24 months post-operatively, and resumed his professional activities. The possibility of using three-dimensional custom titanium prostheses to replace the bone and cartilage support seems to be an interesting alternative for patients in the failure situation of nasal reconstruction.

Topics: Amputation, Surgical; Anastomosis, Surgical; Carcinoma, Squamous Cell; Echocardiography, Doppler, Color; Follow-Up Studies; Humans; Length of Stay; Male; Mandibular Reconstruction; Maxillary Neoplasms; Middle Aged; Nose; Perforator Flap; Prostheses and Implants; Rhinoplasty; Surgical Mesh; Thoracic Arteries; Titanium; Transplant Donor Site; Treatment Outcome

This clinical report describes the fabrication of an implant-supported and magnet-retained combination oral-nasal prosthesis for a patient with a midline midfacial defect. The patient had undergone a total rhinectomy and partial maxillectomy as part of his cancer treatment. The nasal prosthesis was retained on the face by a magnet attached to the implant-supported maxillary denture, resulting in improved appearance and the recovery of speech, mastication, and swallowing functions.

Topics: Dental Prosthesis, Implant-Supported; Humans; Magnets; Male; Maxilla; Maxillary Neoplasms; Maxillofacial Prosthesis; Middle Aged; Nose; Nose Neoplasms; Prosthesis Design

The maxillary strut is the bone that separates the foramen rotundum and superior orbital fissure. Tumors involving the lateral wall of the sphenoid sinus, posterior ethmoid, or posterior maxillary sinus may invade this region. The authors detail the anatomy of the strut and present a case series that emphasizes the importance and utility of this useful landmark during an endoscopic endonasal approach to lesions in this region.. Cadaveric dissections and retrospective case series.. Endoscopic endonasal dissections were performed on six formalin-fixed cadaver heads. Morphometric analyses of 100 skulls were conducted using CT scans and BrainLab. Four patients underwent procedures that exposed the maxillary strut.. The maxillary strut was trapezoidal shaped with an average cross-sectional area of 15.25 ± 0.48 mm(2) and average thickness of 4.43 ± 0.10 mm. The maxillary strut was present bilaterally in all skulls examined. Anteroposterior length averaged 4.18 ± 0.15 mm on the right and 3.90 ± 0.14 mm on the left. Our patient series illustrated the clinical utility of the maxillary strut as a landmark during endoscopic approaches to the skull base.. An endoscopic endonasal approach can be used to expose the maxillary strut. Improved understanding of this anatomy is important to achieving success when using this approach for the biopsy or resection of lesions in the lateral sellar compartment, pterygopalatine fossa, and aspects of the middle cranial fossa.

Topics: Adult; Aged, 80 and over; Cadaver; Endoscopy; Female; Humans; Male; Maxilla; Maxillary Neoplasms; Middle Aged; Nose; Retrospective Studies

Calcifying cystic odontogenic tumor (CCOT) is a rare histologic subtype of odontogenic tumor. Treatment requires complete enucleation. We report what we believe is the first case of CCOT to be removed via a transnasal endoscopic approach. A 16-year-old boy was referred to our department by his dentist for evaluation of an expansile mass of the left maxillary sinus. The dentist had noted an area of hyperlucency of the left palate during a routine examination. Computed tomography confirmed the presence of a large tumor. Complete resection of the tumor was achieved via a transnasal endoscopic surgical approach. Resection of odontogenic tumors is necessary because of their tendency to expand and produce a mass effect on surrounding structures. We believe resection via an entirely transnasal endoscopic approach is a valuable and important technique in the treatment of odontogenic tumors that leaves the patient with a more cosmetically acceptable postoperative appearance.

Topics: Adolescent; Humans; Male; Maxillary Neoplasms; Natural Orifice Endoscopic Surgery; Nose; Odontogenic Cyst, Calcifying; Radiography

The iliac crest free flap is one of the most reliable flaps for maxillary reconstruction because of the large amount of bone provided and the chance to harvest both muscle and skin. However, reconstruction of maxillary through-and-through defects requires special skills to be managed. Simultaneous replacement of oral lining and external tissue with the same features as the resected skin is difficult to achieve with conventional techniques and the use of flaps association is often necessary to ensure acceptable cosmetic and functional results. In the case presented the submental island flap was a good choice to overcome these difficulties.

Topics: Aged; Alveolar Process; Anastomosis, Surgical; Carcinoma, Squamous Cell; Female; Humans; Ilium; Maxillary Neoplasms; Microsurgery; Muscle, Skeletal; Nose; Palate, Hard; Perforator Flap; Surgical Flaps

The common anterior paralateronasal approach for malignant maxillo-mandibular tumors extending to the infratemporal fossa is usually difficult, insufficient, or even dangerous.. We report a new approach for tumors extending to the infratemporal fossa. It combines a paralateronasal and a cervical approach indicated for tumors extending to the infratemporal fossa, requiring a total monoblock excision of the tumor with as little esthetic sequel as possible.. The main interest of this technique is to offer a large exposure of the facial skeleton and the tumor, and to spare cervical vascular structures.

Topics: Carcinoma, Squamous Cell; Humans; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Neck; Neoplasm Invasiveness; Nose; Oral Surgical Procedures; Temporal Bone

Chondrosarcoma is a malignant tumor in which the tumor cells produce cartilage but not bone. The recommended management is wide local or radical excision, followed by surgical and prosthetic reconstruction. This article explains postsurgical prosthetic rehabilitation of a chondrosarcoma patient by means of intraoral acrylic, and extraoral silicone prosthesis for restoration of normal orofacial function and appearance.

Topics: Chondrosarcoma; Dental Prosthesis Design; Denture Design; Denture, Complete, Upper; Face; Follow-Up Studies; Humans; Male; Maxilla; Maxillary Neoplasms; Maxillofacial Prosthesis; Middle Aged; Neoplasm Recurrence, Local; Nose; Palatal Obturators; Plastic Surgery Procedures; Prostheses and Implants; Prosthesis Design

Few published reports have addressed the issues related to upper lip reconstruction. The present clinical report describes the maxillofacial rehabilitation of an edentulous patient who had been diagnosed with squamous cell carcinoma of the nasal septum and contiguous structures. The patient underwent total rhinectomy, anterior maxillectomy, and maxillary lip resection. Her maxillary lip was reconstructed with a bilateral cheek advancement flap, which allowed primary closure of the lip and aided in maintaining function of the orbicularis oris muscle. Microstomia was anticipated and was a consequence of this procedure. During primary resection, and before chemoradiotherapy, dental implants were successfully placed in the maxilla. These implants helped to retain a maxillary obturator prosthesis, which, in turn, helped to retain a silicone nasal prosthesis that restored the nasal defect. An intranasal acrylic resin framework with magnets aided in connecting the extraoral prosthesis with the intraoral prosthesis. The surgical and prosthodontic advantages of a cheek advancement flap and the treatment challenges in a microstomic patient are discussed.

Topics: Aged; Carcinoma, Squamous Cell; Cheek; Dental Implants; Female; Humans; Lip; Magnetics; Maxilla; Maxillary Neoplasms; Maxillofacial Prosthesis; Maxillofacial Prosthesis Implantation; Microstomia; Mouth, Edentulous; Nasal Septum; Nose; Nose Neoplasms; Oral Surgical Procedures; Palatal Obturators; Plastic Surgery Procedures; Prosthesis Design; Surgical Flaps

Chondrosarcoma of the maxillofacial region is a rare tumor. The classification of this tumor is based on histologic grades (1, 2, or 3) or variant including clear cell, differentiated, myxoid, and mesenchymal chondrosarcomas. However, histologic differentiation between this tumor and other relevant bone tumors is fairly difficult. Recently, molecular and genomic studies thought to be useful tools in a more definite diagnosis, accurate treatment, and quality of life of patients. The most acceptable choice of treatment of the chondrosarcoma is wide resection. Radiotherapy and chemotherapy as an adjunctive or palliative treatment remain controversial. The prognosis is different by histologic appearance and clinical behavior bases. However, lifelong follow-up is essential because chondrosarcoma shows a high incidence of local recurrence as well as regional and distant metastasis more than 2 decades later. This study presents 2 cases of chondrosarcoma with a long-term follow-up.

Topics: Adult; Chondrosarcoma; Fatal Outcome; Female; Humans; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Nose; Orbital Implants; Prostheses and Implants; Skull Base Neoplasms

To describe a novel reconstructive technique after nasal planum and premaxilla resection.. Case report.. Dogs (n=2) with squamous cell carcinoma (SCC) of the nasal planum.. A 9-year-old neutered female Labrador retriever (dog 1) and an 11-year-old neutered male Golden retriever (dog 2) had resection of the nasal planum and premaxilla for treatment of locally invasive SCC. Reconstruction of a nasal planum facsimile was based on use of the nonhaired pigmented margins of bilateral labial mucocutaneous rotation-advancement flaps.. Reconstruction of the premaxilla by construction of a nasal planum facsimile resulted in uncomplicated wound healing and improved cosmesis. There was no tumor recurrence at 1290 (dog 1) and 210 (dog 2) days after surgery.. Reconstruction of a nasal planum facsimile was successfully performed without complications in 2 dogs with high owner satisfaction with cosmetic appearance.. This technique represents a significant advancement in surgical cosmetic outcome, may potentially reduce postoperative complications, and should be considered for dogs requiring nasal reconstruction after nasal planum resection with premaxillectomy.

Topics: Animals; Carcinoma, Squamous Cell; Cosmetic Techniques; Dog Diseases; Dogs; Female; Male; Maxilla; Maxillary Neoplasms; Nose; Nose Neoplasms; Plastic Surgery Procedures; Treatment Outcome

Topics: Acrylic Resins; Adhesives; Aged; Carcinoma, Squamous Cell; Denture Design; Denture Retention; Denture, Complete, Upper; Female; Humans; Maxillary Neoplasms; Maxillary Sinus Neoplasms; Nose; Oroantral Fistula; Palatal Obturators; Prosthesis Design; Prosthesis Fitting; Surface Properties

Severe limitation in the oral opening, though an uncommon clinical presentation, makes gaining access to the oral cavity difficult for any dental procedure. This article describes the maxillofacial prosthetic management of a patient with a midfacial defect complicated by postsurgical microstomia. Intraoral and extraoral prostheses restored the patient's speech, dental articulation, mastication, lip support, esthetics, and anterior oral seal.

Topics: Aged; Dental Impression Technique; Dental Prosthesis Design; Humans; Lip; Male; Maxillary Neoplasms; Maxillofacial Prosthesis; Microstomia; Nose; Oral Surgical Procedures; Palatal Obturators; Prostheses and Implants

Superiorly based nasolabial flap is an interesting solution for reconstruction of moderate size maxillary defects. The operative technique and its results are described. Advantages (reliability in flap vascularity, versatility, easiness of elevation) and limits of this procedure for closure maxillary defects are mentioned. Then they are compared to the other reconstructive maxillary techniques.

Topics: Aged; Aged, 80 and over; Ameloblastoma; Carcinoma, Squamous Cell; Cheek; Facial Muscles; Female; Humans; Male; Maxilla; Maxillary Neoplasms; Middle Aged; Mouth Mucosa; Nose; Palate, Soft; Regional Blood Flow; Reproducibility of Results; Retrospective Studies; Surgical Flaps

In the group of 42 patients after maxillectomy face deformation and function defects were assessed. The best cosmetic and functional result was observed after maxillectomy without orbital exenteration, with preservation of lateral part of the zygomatic bone and at least a half of nasal skeleton. Severe face deformation developed after orbital exenteration, resection of the palpebrae, cheek and external nose.

Topics: Adolescent; Adult; Aged; Cheek; Face; Female; Humans; Male; Maxillary Neoplasms; Middle Aged; Nose; Orbit; Otorhinolaryngologic Surgical Procedures; Treatment Outcome

The nasolabial flap has been used for intraoral reconstruction since last century. In this paper, a modification is proposed in order to increase the amount of skin available in male patients. Simple closure of the donor area is not possible and a cheek rotation flap is suggested for closure.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Humans; Lip; Male; Maxillary Neoplasms; Mouth; Mouth Neoplasms; Nose; Skin Transplantation; Surgical Flaps

Surgery for maxillofacial cancer often creates a defect, which may affect speech, swallowing, mastication and facial appearance. The provision of a prosthesis is one method to help restore these physiologic and psychologic functions. Prosthodontic planning and rehabilitation should be an integral part of the team management to provide not just the preservation, but a quality of life for the patient. Various types of appliances are illustrated and the role of the dental surgeon is emphasised.

Topics: Aged; Facial Neoplasms; Humans; Male; Maxillary Neoplasms; Maxillofacial Prosthesis; Middle Aged; Nose; Prostheses and Implants

Topics: Aged; Airway Obstruction; Ameloblastoma; Female; Humans; Male; Maxillary Neoplasms; Middle Aged; Nose

Topics: Humans; Male; Maxilla; Maxillary Neoplasms; Maxillofacial Injuries; Maxillofacial Prosthesis; Middle Aged; Nose; Palatal Obturators; Prostheses and Implants

High energy photon beams traversing large iatrogenic air cavities can lead to surface underdosage and overdosage because of high exit dose. A water bag bolus in such external cavities is a remarkably simple and reproducible means of producing dosage homogeneity.

Topics: Adolescent; Eye Neoplasms; Female; Humans; Maxilla; Maxillary Neoplasms; Neoplasm Recurrence, Local; Nose; Orbit; Radiotherapy; Retinoblastoma

Patients with extensive surgical defects of the palate, orbit, or nose are difficult to rehabilitate. Prosthetic rehabilitation in these areas often shortens hospitalization, speeds recovery, and reduces medical expenses. Specific factors in planning treatment are directed toward successful prosthetic rehabilitation, using a team approach, careful patient selection, and specific surgical principles keyed to each facial region.

Topics: Female; Humans; Male; Maxillary Neoplasms; Maxillofacial Prosthesis; Nose; Orbit; Palate; Patient Compliance; Prostheses and Implants

In a study of non-epithelial tumors involving the nasal cavity, paranasal sinuses and nasopharynx, 256 lesions, 156 benign and 100 malignant, were identified. Of these, six were classified as myxoma. Myxomas of facial bones, neoplasms of uncertain histogenesis, infiltrate adjacent tissues and if not completely excised will recur locally. In this series, three patients at one time were treated with limited local excisions. Tumor persisted or recurred in all three. Five patients were treated with en bloc resection (following recurrences in two patients). None of these patients subsequently developed recurrent tumor. We believe that myxomas should be widely resected to prevent recurrence. The extent of the surgical resection should depend on the size, extent and location of the lesion.

Topics: Adolescent; Adult; Child; Diagnosis, Differential; Female; Humans; In Vitro Techniques; Liposarcoma; Maxillary Neoplasms; Maxillary Sinus; Middle Aged; Myxoma; Nasal Cavity; Nasopharyngeal Neoplasms; Neoplasm Recurrence, Local; Neurilemmoma; Nose; Nose Neoplasms; Paranasal Sinus Neoplasms; Rhabdomyosarcoma

A clinical study was made of three cases of Ameloblastoma (Adamantinoma) of the maxilla. One case presented with oro-antral fistula following extraction of a molar tooth. Extensive bone destruction and involvement of ethmoidal air sinuses and nasal cavity was seen in one of the patients. At times histological diagnosis can be difficult; therefore, accurate diagnosis should be obtained by an experienced histopathologist. Partial maxillectomy with a wide margin of healthy bone should be the choice of treatment in the majority of cases. There tumours are sensitive to deep-X-ray to a varying degree. One should consider radiotherapy post-operatively if growth has been excised inadequately. Radiotherapy may be helpful when surgery is contraindicated.

Topics: Adult; Aged; Ameloblastoma; Ethmoid Sinus; Humans; Male; Maxillary Neoplasms; Middle Aged; Nose; Radiography; Radiotherapy Dosage

Topics: Alveolar Process; Carcinoma, Squamous Cell; Female; Humans; Maxillary Neoplasms; Methods; Middle Aged; Mouth Mucosa; Nose; Palate; Periosteum; Surgery, Plastic

Topics: Adult; Child; Child, Preschool; Ethmoid Sinus; Female; Head and Neck Neoplasms; Humans; Infant; Lymph Nodes; Male; Maxillary Neoplasms; Mesenchymoma; Neoplasm Metastasis; Nose; Palatal Neoplasms; Pregnancy; Pregnancy Complications; Respiratory Tract Neoplasms; Rhabdomyosarcoma

Topics: Barium Sulfate; Carcinogens; Hydrocarbons; Maxillary Neoplasms; Nicotiana; Nose; Plants, Toxic; Sneezing

Topics: Antineoplastic Agents; Blood Cell Count; Bone Marrow Examination; Cobalt Isotopes; Humans; Male; Maxillary Neoplasms; Maxillary Sinus; Middle Aged; Nose; Plasmacytoma

Topics: Dentigerous Cyst; Humans; Jaw Cysts; Maxillary Neoplasms; Nose

Topics: Anesthesia; Anesthesia, Endotracheal; Ankylosis; Contracture; Humans; Intubation, Intratracheal; Laryngoscopy; Lymphatic Metastasis; Mandibular Neoplasms; Maxillary Neoplasms; Muscle Relaxants, Central; Nose; Osteotomy; Parotid Neoplasms; Preanesthetic Medication; Salivary Gland Neoplasms; Surgical Procedures, Operative; Tracheotomy