Traumatic Pseudoaneurysm of the Internal Maxillary Artery: A Rare Life-Threatening Hemorrhage as a Complication of Maxillofacial Fractures

Pseudoaneurysm of the internal maxillary artery due to a traumatic event is a rare condition. Pseudoaneurysms are usually directly produced by arteries break with extravasation of blood. The compressed perivascular tissue forms the wall of aneurysmal sac. Then, this sac gradually expands and can be damaged. It is rare to see pseudoaneurysms of IMA. They are usually associated with fracture of the neck of the mandible. To the best of our knowledge the pseudoaneurysm of the internal maxillary artery related to maxillofacial trauma is an event extremely rare in the literature and if not quickly managed can lead to the patient’s death. This case underlines how the close cooperation between surgeons and radiologists results in a quick diagnosis and management of such pathological events

Palatal fistula resulting from cocaine abuse: A case report

Cocaine blocks the reuptake of norepinephrine and dopamine of the sympathetic nervous system. It has a psychomotor stimulating effect that provokes euphoria, motor activity and an amplification of a well being sensation similar to the effect of amphetamines. Well known are the systemic effects of cocaine abuse (acute myocardial infarction, cardiac arrhythmias, aortic ruptures, cerebrovascular accidents). Several local effects are also documented involving above all palatal mucosa and central midface structures. The most common palatal lesions are fistulae resulting from ischemia caused by the constricting effect of cocaine on small vessels, mucosal breakdown, loss of palatal bone, and loss of nasal mucosa. IF cocaine use becomes chronic and compulsive, wider lesions may cause extensive destruction of the osteocartilagineous structures of the nose, sinus and palate, a syndrome called CIMDL (cocaine-induced midline destructive lesion). Many techniques have been described to treat these defects depending on the size and the involved structures of the face. These techniques range from local flaps to complex free flaps. The Authors describe a case of a median hard and soft palatal fistula resulting from cocaine abuse treated with local bilateral palatal flaps, and analyze the most common therapeutic options described in literature

Trigeminal and facial schwannoma: a case load and review of the literature

Schwannoma or neurilemmoma are benign tumours originating from Schwann cells of the nerve sheath. They can arise from any peripheral, cranial, or autonomic nerve The treatment of extracranial head and neck schwannomas is surgical and the approach depends on the location and extent of the tumor and the nerve involved. The Authors report the case load of surgical managements of three different extracranial nerve schwannomas involved facial and trigeminal nerves, and a review of the literature

Trigeminal and facial schwannoma: a case load and review of the literature

Schwannoma or neurilemmoma are benign tumours originating from Schwann cells of the nerve sheath. They can arise from any peripheral, cranial, or autonomic nerve The treatment of extracranial head and neck schwannomas is surgical and the approach depends on the location and extent of the tumor and the nerve involved. The Authors report the case load of surgical managements of three different extracranial nerve schwannomas involved facial and trigeminal nerves, and a review of the literature

Osteonecrosis of the jaws in patients assuming bisphosphonates and sunitinib: Two case reports

Osteonecrosis of the jaw (ONJ) is an unremitting adverse outcome associated with bisphosphonate therapy, primarily intravenously administered, in patients with bone metastases from solid tumors, multiple myeloma and osteometabolic diseases. From 2003 many cases of bisphosphonates related osteonecrosis of the jaw (BRONJ) have been reported in literature. Sunititnib is a novel anticancer agent used in gastrointestinal cancers and renal cancers resistant to imatinib. Recent reports describe the onset of ONJ in patients treated with both sunitinib and bisphosponates. A case of osteonecrosis of the jaw related to sunitinib, without association of bisphosphonate (BP) medications has been recently reported. A recent hypothesis suggests that antiangiogenic drugs such as sunitinib could cause ONJ even without the association with BPs. We describe a case of two patients affected by renal carcinoma under BP and sunitinib medication who developed stage III bisphosphonates- related osteonecrosis of the jaw (BRONJ)

Proposal for a new self-compiled questionnaire in patients affected by temporo-mandibular joint disorders (TMD).

in this work, we propose a self-compiled questionnaire, for those patients showing dysfunctions of the temporomandibular joint. The questionnaire, composed by 33 closed multiple-choice questions, represents one of the steps in the diagnostic procedure, together with the clinical notes compiled by the medical specialist and with the other necessary diagnostic researches. It also has the purpose to make easier anamnesis and clinic procedure and gathering of all informations useful for a right clinical diagnosis, and so for an appropriate therapy

Ethiology of tinnitus. Discomalleolar ligament in fresh human cadavers. Anatomical and clinical aspect: a surgical proposal

Background: Several anatomic relationships between the ear and the TMJ have been proposed to account for the presence of tinnitus during TMD. Most important otomandibular structures are tympanomandibular ligament and discomalleolar ligament. The latter connects the malleus bone of the middle ear and the postero-medial region of the temporomandibular joint. Objectives: For this reason, the aim of the present paper is to study, on fresh adult cadavers, the frequency of discomalleolar ligaments, its correlation with the middle ear and its role in the ethiology of tinnitus. Methods: The study was conducted on 5 fresh adult cadavers through two dissection approaches bilaterally: lateral and superior approach. Findings: The discomalleolar ligament was present in all 10 examined cases. Conclusion: In regard to the relationship between tinnitus and temporomandibular disorders, some authors demonstrated that there is a slight movement of the malleus and the tympanic membrane during the application of tension to the ligament; other authors have shown no movement of the malleus in the same condition. In this study, we have detected an evident movement only in one cadaver; imperceptible movement in the remaining 4. In our opinion, in vivo, microscopic movements to generate tinnitus are sufficient. For this reason, we have carried out a surgical resection of extratympanic portion of discomalleolar ligament in a patient with tinnitus and TMD. One month after surgery the tinnitus had disappeared in the patient