Arachnoid cyst with intracystic haemorrhage and subdural haematoma: case report and literature review

Arachnoid cysts (AC) are usually asymptomatic. However, very rarely they can become symptomatic due to cyst enlargement or haemorrhage, often after head trauma. In such cases bleeding is often confined to the subdural space, but intracystic haemorrhage has rarely been observed. We report a case of a child who had intracranial hypertension syndrome due to a right middle cranial fossa AC with intracystic bleeding and subdural haematoma

Endoscopic approach for paranasal sinuses osteomas: Our experience and review of literature

Osteomas are common benign bone tumors of the skull and facial structures involving primarily the cranial vault, mandible, external auditory canal, paranasal sinuses, nasal cavity, and orbit.1,2 These neoplasms are usually asymptomatic and account for 0.43% of tumor in population with an incidental finding on 1% of radiographs and on 3% of computed tomography (CT) scans. [1] These solid nodular sclerotic lesions usually arise from the outer table and are usually < 10 mm; lesions larger than 30 mm in diameter are considered giant tumors.3,4,7 Most of patients with such a diagnosis have few or no symptoms, in general only 10% is symptomatic, in the second to fifth decades of life 5,6. In literature, endoscopic endonasal approaches are mainly indicated for small ethmoidal osteomas without significant orbital or frontal extension7, while large osteomas require Caldwell-Luc surgery8 or other more aggressive approaches25. We report our experience about the treatment of paranasal sinuses osteomas treated endoscopically or by endoscope-assisted Caldwell-Luc approach, achieving total removal of the neoplasms with all the advantages deriving by endoscopic technique such as closer visualization of the anatomy, no damage to the surrounding structures, better cosmetic results, less morbidity and shorter hospitalization17

L’utilizzo del lembo di SMAS per ricostruzioni della loggia parotidea

Lo scopo dello studio è stato quello di valutare i benefici della ricostruzione con lembo di SMAS nei pazienti affetti da neoplasie benigne della parotide e sottoposti a parotidectomia superficiale. Abbiamo condotto uno studio retrospettivo su 123 pazienti affetti da neoplasie benigne della ghiandola parotide ricoverati presso il Nostro istituto tra il Marzo 1997 e Marzo 2010. Tutti i pazienti arruolati sono stati sottoposti a parotidectomia superficiale. Il Nostro campione è stato diviso in due gruppi in base alla esecuzione (Gruppo 2) o no (Gruppo 1) di ricostruzione con lembo di SMAS dopo la parotidectomia superficiale. La ricostruzione con lembo di SMAS è stata eseguita in 64 pazienti. Un test chi quadro è stato utilizzato per valutare le differenze statistiche tra i due gruppi. Il livello di significatività statistica scelto è stato di p 0,05] , 8,47% vs 4,68% [P > 0,05, 5,08% vs 0,00%). La paralisi transitoria del facciale, la fistola, la depressione della cute e la sindrome di Frey sono significativamente più frequenti nei pazienti non ricostruiti con lembo di SMAS (10,16% vs 3,125% [P < 0,05], 13,55% vs 3,125% [P < 0,05] , 13,55% vs 3,125% [P < 0,05], 20,33% vs 0% [P < 0,05], rispettivamente). Il lembo di SMAS è capace di ridurre le complicanze funzionali ed estetiche che si verificano dopo la rimozione di un tumore benigno della parotide mediante parotidectomia superficiale, tra queste, riduce il verificarsi della sindrome di Frey

Postoperative Management of Zygomatic Arch Fractures: In-House Rapid Prototyping System for the Manufacture of Protective Facial Shields

Zygomatic fractures account for 10% to 15% of all facial fractures. The surgical management of isolated zygomatic arch fractures usually requires open reduction treatment without fixation through an intraoral access. Therefore, the main problem in the non-fixed treatment of zygomatic arch fractures is related to the difficulty in obtaining a stable reduction for a period long enough to guarantee the physiological bone healing process. We propose an innovative "in-house" rapid prototyping (RP) protocol for the 3D-zygoma mask manufacture of a patient-specific protective device to apply after zygomatic arch fracture reduction. Our study includes 16 consecutive patients who underwent surgical open reduction for an isolated zygoma fracture without fixation between January 2017 and February 2018. The patients received regular postoperative checks at weeks 1 and 2. Before the device was removed, a multiple choice questionnaire was administered to measure the degree of wearability of the mask. The estimated cost of the production is around &OV0556;5 per case and the construction time is around 90 minutes. Based on the encouraging results, obtained in our experience, we hope that other studies can be conducted to confirm our procedure and improve its functionality in the field of facial trauma

Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports

<p>Abstract</p> <p>Introduction</p> <p>Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature.</p> <p>Case presentation</p> <p>We report two cases of people (a 23-year-old man and a 41-year-old man) with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma.</p> <p>Conclusion</p> <p>It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.</p