FACE RECONSTRUCTION THROUGH LIPOSTRUCTURE

Grafting adipose tissue to correct the soft parts in the maxillo-facial area was first used and described over 100 years ago by Neuber, in his search for an ideal natural material [1]. By sampling some block of adipose tissue from the abdomen, the author carried out a fine correction of volume flaws at the level of the cephalic extremity. In 1912, Hollander underlines and reports the facial modifications that appear after fat infiltration in the case of patients with facial lipoatrophy [2]. A step forward is taken in 1926 by Miller, who published data based on his own experience regarding fat injection, using his own cannulas [3]. This technique represented a huge step forward compared to the sampling of blocks of fat tissue, being somehow similar to the technique of lipostructure, the essential difference being that the sampled material was not centrifuge

DENTAL AND PERIODONTAL HEALTH IN END STAGE RENAL DISEASE PATIENTS

In end stage renal disease, a whole range of changes occur in the oral cavity concerning the teeth, oral mucosa, bone, periodontium, salivary glands or temporomandibular joint. Adults with chronic renal failure have more severe oral disease than the general population Material and methods 39 patients undergoing dialysis and requiring oral surgery procedures were evaluated in terms of age, gender, aetiology of renal failure, duration of dialysis, reason for admission, local status and treatment. Results 32 patients presented for complications of carious disease, from which 29 had non-restorable teeth. Severe periodontitis (attachment loss greater than 5mm) was recorded in 17,94 % of cases, while moderate periodontitis (attachment loss 3-5mm) in 54.4% cases. 61.5% of patients presented maxillary or mandibular terminal edentatulism. Conclusions Poor oral health is common among ESRD patients and regular dental consultation should be integrated into care of chronic kidney disease

ECTROPION AS A COMPLICATION OF CRANIO–MAXILLO-FACIAL SURGERY

Ectropion is an outward turning of the eyelid margin. Patients may experience symptoms due to ocular exposure and inadequate lubrication. The causes of retraction of the lower lid are multifactorial and may include scarring retraction, horizontal lid laxity, middle lamellar inflammation, or facial palsy. Ectropion is classified as congenital or acquired. In maxillofacial surgery, may appear following procedures related to subcilliary incisions, the management of skin cancer and, nevertheless, post parotidectomy. The aim of the treatment is to restore anatomy, function and aesthetics of the patients

THE IMPACT OF DENTAL ANXIETY ON PERIODONTAL DISEASE

Aim of the study. Dental anxiety has an important role in the development of the periodontal disease. The aim of the current study is to investigate the relationship between dental anxiety and periodontal disease. Material and methods: Data was collected between 2022 and 2023 using a self-reporting questionnaire created with the Google Forms platform. Results: High dental anxiety is correlated both with poor periodontal health (p=2.11E-86) and with strong psychosocial impact that dental aesthetics has on the quality of life (p=4.46E-56). These directly influence the frequency of visits to the dentist (P values: 4.89E-07, 9.53E-17 and 5.29E-07), as well as the time elapsed since the last professional dental hygienization (P values: 0.0008, 1.57E-17 and 5.62E-10). These three are also interconnected with general health (P values: 0.015, 3.73E-09 and 1.95E-05) and stress (P values: 5.09E-10, 1.64E-08 and 9.87E-07). In addition, BMI shows a direct relationship with dental anxiety (p=0.020), as well as with periodontal health, along with the quality of eating habits (p=0.017 and p=0.001). Conclusion: the results indicated that the severity of the periodontal disease is a result of dental anxiety, and vice versa. Therapy should be personalized for each individual following a comprehensive evaluation and should be based on the experience and expertise of the dentist, the intellectual capacity of the patient, age, cooperation, and clinical situation of the patient

Balancing orbital volume reduction and redistribution for a tailored surgical treatment in Graves’ ophthalmopathy

Aim!#!The purpose of this study is to share our experience on the use of different orbital decompression techniques, as well as the principles followed for deciding the most case-appropriate procedure that ensured the most favorable outcomes.!##!Methods!#!We reviewed the Graves' ophthalmopathy cases operated over the course of 14 years, regarding the presenting signs, the imaging evaluation, the degree of exophthalmos, the type of surgical orbital decompression performed, and the postoperative outcomes.!##!Results!#!All 42 patients identified presented with proptosis, with 92.8% cases of bilateral proptosis. The main addressing concern was functional in 54.8% cases and aesthetic in 45.2% patients. CT was used for the preoperative evaluation in all cases. In total, 81 orbits were operated. The orbital decompression surgery involved only the orbital fat in 7.4% of orbits and associated fat and bone decompression in the other 92.6% of orbits. The postoperative results were favorable in all cases regarding both appearance and function, with minimal postoperative complications.!##!Conclusion!#!The adequate selection of the most suitable procedure based on the characteristics of each case is the prerequisite for a successful surgery. We found that the association of fat and bone decompression of various extents is most permissive in tailoring the degree of decompression to the existing requirements

Cerebellar Abscess Secondary to Cholesteatomatous Otomastoiditis—An Old Enemy in New Times

Chronic otitis with cholesteatoma is a potentially dangerous disease that can lead to the development of intracranial abscesses. Although cerebellar abscess is half as common as cerebral abscess, it is known for its particularly difficult diagnosis, which requires the visualization of the pathological process continuity from the mastoid to the posterior fossa. In this article, we present an extremely rare case from the literature of cholesteatomatous otomastoiditis complicated with meningitis and cerebellar abscess, along with the description of technical surgical details for the plugging of the bony defect between the mastoid and posterior fossa with muscle and surgical glue. The particularity of this case lies in the late presentation to the doctor of an immunocompetent patient, through a dramatic symptomatology of life-threatening complications. We emphasize the importance of responsibly treating any episode of middle ear infection and considering the existence of underlying pathologies. In such cases, we recommend additional neuroimaging explorations, which can prevent potentially lethal complications. The treatment of such intracranial complications must be carried out promptly and requires collaboration between a neurosurgeon and an ENT surgeon