Complications associated with submental liposuction:a scoping review

Liposuction is one of the most commonly performed cosmetic procedures worldwide. Complications associated with submental liposuction are rare. However, when they occur they are significant and can cause disFiguring consequences. The objective of this study was evaluated complications from submentual liposuction in literature and description of clinical experience of complication after submentual liposuction. At first, a scoping review was carried out online search with no time restrictions for complications after submental liposuction was performed in the databases Medline / PubMed, Embase, and Web of Science. The variables analyzed were: age, sex, type of esthetic procedure, anesthesia, complications, time after Procedure, treatment, follow-up care, and sequelae. Then, a case of a patient with submental hematoma after an aesthetic procedure for submental liposuction was described. Firstly, 539 articles were selected, after application of the inclusion criteria, 4 studies were included. Most cases were female (8:1), with a mean age of 55.77 years. Postoperative complications were found, such as submental depression, submental edema, hypertrophic scar formation, scar contracture, cervical necrotizing fasciitis, Cervico-facial dystonia and transient facial nerve paralysis. The follow-up period for cases ranged from 3 to 12 months. The clinical case presented there was no sequelae. Submental liposuction requires the surgeon's attention. Anatomical knowledge, correct clinical and surgical management, diagnosis, and immediate approach to adverse situations are points that must be respected in this type of esthetic procedure to avoid more serious complications

Sinusectomia maxilar via endoscópica como tratamento da rinossinusite crônica oriunda de fístula oroantral / Maxillary sinusectomy via endoscopy as treatment of chronic rhinosinusitis from oroantral fistula

O seio maxilar define-se por um espaço pneumático na maxila bilateralmente que possui volume e proximidade com os ápices de 2º pré-molares e molares superiores, possibilitando que intervenções nestes afetem sua integridade, levando a inflamação e podendo resultar em Rinossinusite Crônica (RSC).  Este estudo visa elucidar a atribuição da cirurgia endoscópica para tratamento da RSC através de um relato de caso clínico. Paciente sexo masculino, 50 anos, compareceu ao serviço de CTBMF do Hospital da Restauração – PE, com algesia em região zigomático-maxilar direita e comunicação oroantral, há sete meses, por exodontia traumática do elemento 15, já submetido à terapêuticas clínicas, sem sucesso. Diagnosticou-se ao exame físico e de imagem, RSC secundária, optando pela sinusectomia via endoscópica ântero-posterior acessando o seio maxilar direito por antrostomia maxilar na parede nasal lateral, removendo a mucosa doente e instalando um dreno de manutenção. Concomitantemente, fechou-se a comunicação bucossinusal por um retalho na mucosa vestibular maxilar recobrindo toda falha, sob anestesia geral. No pós-operatório imediato, iniciou-se antibioticoterapia, analgesia e irrigação com soro fisiológico 0,9%, pelo dreno, removido após 72 horas. A cirurgia endoscópica como tratamento da RSC mostra-se uma alternativa quando há falha terapêutica clínica, apresentando melhora da sintomatologia e qualidade de vida dos pacientes.

Conservative Treatment of Comminuted Mandibular Fracture Involving Maxillomandibular Fixation With Miniplates

Bars and steel wires are the most commonly used methods to achieve maxillomandibular fixation, although there are numerous alternatives described for this same purpose. In cases of edentulous candidates for the conservative treatment of facial fractures, none of the conventional methods can be instituted for maxillomandibular fixation. Fixation in such cases is achieved with the aid of the total dentures of the patient or the confection of splints, but these methods lead to eating and oral hygiene problems. This article reports the case of an edentulous patient with a comminuted mandible fracture treated with a rarely described technique in which intermaxillary fixation was achieved with titanium miniplates

Transmaxillary approach to the cranial base: an evaluation of 11 cases

Summary: Surgical access to the skull base is always difficult, especially because of the noble anatomic structures present there. Maxillary osteotomy provides direct view to the clivus region and the neck spine, and it also bears less morbidity when compared to the many other accesses described in the literature. Aim: to assess 11 patients submitted to transmaxillary osteotomy, describing the surgical technique and postoperative results and complications. Materials and Methods: A retrospective study involving eleven patients submitted to transmaxillary approach to the brainstem. We studied dental occlusion, trans and postoperative bleeding, bone necrosis and soft tissue alterations. All followed the same surgical protocol and were followed up for two years. Results: after treatment, all the patients improved in their clinical status and had no neurological complication, trans and postoperative hemorrhage or major complications were seen. Among the complications, two patients had incomplete maxilla fracture, two had laceration of their nasal mucosa and one had, as late complication, an oral-sinusal fistula. Conclusion: Transmaxillary osteotomy provided proper access to the clivus for brainstem decompression with low rate of complications in this series. Keywords: maxilla, osteotom

Nos caminhos da história urbana, a presença das figueiras-bravas

RESUMO Este texto trata das chamadas figueiras-bravas, espécies nativas em florestas tropicais e subtropicais que, plantadas ou nascendo espontaneamente em certos locais, propiciaram, sob suas imensas copas, espaços de sociabilidade em muitos núcleos urbanos oitocentistas. As figueiras-bravas foram também importantes marcos paisagísticos, influindo muitas vezes na configuração de espaços urbanos de várias cidades brasileiras. Neste artigo, três casos relativos ao estado de São Paulo são apresentados: o caso de Lorena, no Vale do Paraíba, onde ao menos quatro logradouros importantes foram formados a partir da existência de figueiras-bravas e outros dois casos relativos à capital paulista, a saber, a figueira-brava da chácara da Marquesa de Santos, na várzea do Carmo, atual Parque D. Pedro II, e a figueira conhecida como Árvore das Lágrimas, ainda existente no Ipiranga