Frontal Sinus Pneumatization Affects Height of the Lateral Lamella and Position of Anterior Ethmoidal Artery

Abstract: Preoperative evaluation of the frontal sinus (FS) and associated anatomical structures may reduce the risk of intraoperative complications and facilitate the management of potential complications. In this study, the authors aimed to evaluate relationship between FS pneumatization and critical anatomical structures. Paranasal sinus computerized tomography scans of 350 sides of 175 patients were evaluated. The pneumatization pattern of the FS, FS dimensions (on the axial, coronal, and sagittal slices), anterior ethmoidal artery, and depth of the of olfactory fossa were evaluated for every patient on both sides. There were 111 (63.4%) male and 64 (36.6%) female patients. The authors found a statistically significant correlation between the depth of olfactory fossa and the anterior ethmoidal artery position (P 

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Corrugator: Muscle of Empathy and Determination

No abstract available

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Application of Dexamethasone in the Masseter Muscle During the Surgical Removal of Lower Third Molars

Purpose: The aim of the present study was to analyze the effect of the application of dexamethasone in the masseter muscle during third molar surgery. Methods: This randomized, clinical trial used dependent samples and the split-mouth method. A sample of 30 patients, with impacted or semi-impacted third molars, as well as vertical and mesioangular positions of a similar surgical difficulty (on both sides), was subjected to 2 operations: an experimental operation and a control procedure, with a 30-day wash-out. The choice of which group would be experimental or control was random. The experimental group received 8 mg of dexamethasone, which was applied directly to the masseter muscle immediately after surgery. The control group did not receive corticosteroids. Seven and 15 days after the surgery, the patients were assessed in relation to their levels of pain, trismus, and edema. Results: Concerning edema and trismus, there was a significant difference (P 

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Conjoined Twin Separation: Integration of Three-Dimensional Modeling for Optimization of Surgical Planning

Abstract: Conjoined twinning is a rare anomaly, with an incidence of approximately 1 in 100,000 live births. There is a high perinatal mortality rate, but twins who survive pose reconstructive challenges that require meticulous preoperative planning. The authors describe the senior surgeon's career experience with conjoined twin separation, and the evolution of medical modeling and 3-dimensional imaging as a critical component in presurgical planning. The authors performed a retrospective review of all consecutive patients of conjoined twin separation at a single institution from January 2004 to December 2013. Data were collected related to patient demographics, comorbidities, operative technique, perioperative complications, survival, long-term outcomes, and the type of medical modeling system used for preoperative planning. Five sets of conjoined twins underwent separation during the 10-year study period. There were 3 sets of thoraco-omphalopagus twins, 1 set of pyopagus twins, and 1 set of ischiopagus tetrapus twins. The mean age at separation was 70 days, with a mean of 3.5 surgical procedures performed per patient during the first year of life. One set of twins experienced postseparation complications that warranted immediate return to the operating room. The overall survival rate after separation was 70%. The imaging methods used were computed tomography scan with 3-dimensional reconstruction, plaster molds, medical modeling with composite printing, and virtual surgical planning. The use of imaging and medical modeling in presurgical planning has proven to be an important element in optimizing the outcomes for patients with this rare anomaly.

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Modified Heavy Wire Twister as an Efficient Screw Holder and Screw Driver in Maxillofacial Surgery

No abstract available

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A Rare Patient with Facial Duplication

Abstract: Facial duplication, in whole or in part, is a very rare malformation. It may be symmetrical or asymmetric. Those cases that have been reported in the literature constitute a spectrum extending from simple nasal duplication to complete separation of 2 faces. Up to now there are some reports of eye, nose, mandible, or maxilla duplication separately. But there is no report of oral orifice or lips duplication. The present article reports a case of a newborn girl who presented with 2 mouths and also duplication of zygoma and maxilla. Then, we describe her stages of treatment from birth through now that she has 20 years.

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Effect of Submucosal Mesna Application on Mucoperichondrial Elevation in Septoplasty

Objective: It was revealed that the thiol compound named mesna chemically softens the connective tissue with submucosal injection, and facilitates the endoscopic submucosal dissection. The authors aimed to investigate the effect of mesna injection on mucoperichondrial elevation during septoplasty operation. Methods: This study was planned as a patient-control study and performed. Fifty-six patients who had septoplasty operation were divided into 2 groups that are submucosal mesna (group 1) and submucosal saline (group 2) applied ones. In both groups, the measurement was initiated by a timer during the start of septal incision and elevation processes. After bilateral subperichondrial and subperiostal elevation were finished, timer was stopped and time was recorded. After that, mucosal integrity was reviewed and mucosal damage status was recorded. The difficulty of mucoperichondrial elevation for the surgeon was recorded for each patient. Results: Twenty-five (44.7%) of the patients who participated in our study were females while 31 (55.3%) were males. The average elevation periods were 201.4 ± 74.3 seconds in group 1 and 260.2 ± 84.1 seconds in group 2. In mesna applied patients, elevation period was statistically and significantly shorter (P = 0.009). Impairment in mucosal integrity was observed as 33.3% in group 1 and 58.8% in group 2. In mesna applied patients, significantly less impairment in mucosal integrity was observed (P = 0.031). The average mucoperichondrial elevation difficulty for the surgeon is observed as 4.83 ± 2.47 in group 1 and 6.5 ± 1.9 in group 2. Mesna applied patients were defined as significantly easier patients for the surgeon (P = 0.006). Conclusion: Submucosal mesna application is an approach that provides a convenient, fast, and effective mucoperichondrial elevation in septoplasty and protects the mucosal integrity.

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