1/18. Really painful double vision.A 67-year-old woman with a history of chronic headache and recent removal of two squamous cell lesions from her forehead presented with left facial pain and diplopia. A diagnosis of tolosa-hunt syndrome was made based on clinical presentation and imaging studies. When the patient did not respond to steroids, further studies were done, including biopsy, which revealed perineural spread of squamous cell carcinoma.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
2/18. Sympathetic activity-mediated neuropathic facial pain following simple tooth extraction: a case report.This is a report of a case of sympathetic activity-mediated neuropathic facial pain induced by a traumatic trigeminal nerve injury and by varicella zoster virus infection, following a simple tooth extraction. The patient had undergone extraction of the right lower third molar at a local dental clinic, and soon after the tooth extraction, she became aware of spontaneous pain in the right ear, right temporal region, and in the tooth socket. At our initial examination 30 days after the tooth extraction, the healing of the tooth socket was normal; however, the patient had a tingling and burning sensation (dysesthesia) and spontaneous pain of the right lower lip and the right temporal region, both of which were exacerbated by non-noxious stimuli (allodynia). The patient also showed paralysis of the marginal mandibular branch of the facial nerve, taste dysfunction, and increased varicella zoster serum titers. A diagnostic stellate ganglion block (SGB) 45 days after the tooth extraction using one percent lidocaine markedly alleviated the dysesthesia and allodynia. These symptoms are characteristic of neuropathic pain with sympathetic interaction. The patient was successfully treated with SGB and a tricyclic antidepressant.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
3/18. facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature.facial pain can, on rare occasions, be the presenting symptom of lung cancer. This report describes a patient with non-metastatic lung cancer, which was associated with attacks of debilitating facial pain, presenting as cluster headache. Moreover, 32 reported cases of lung cancer-related facial pain (including the present one) are reviewed, and their clinical features are summarized. The facial pain is almost always unilateral, and is most commonly localized to the ear, the jaws, and the temporal region. The pain is frequently described as severe and aching, and may be continuous or intermittent. Aggravation and expansion of the pain, digital clubbing, increased erythrocyte sedimentation rate, and hypertrophic osteopathy, may contribute to the diagnosis. Referred pain, due to invasion or compression of the vagus nerve, as well as paraneoplastic syndrome secondary to the production of circulating humoral factors by the malignant tumor cells, is implicated in the pathophysiology of facial pain associated with non-metastatic lung cancer. radiotherapy and tumor resection with vagotomy are very effective in aborting the facial pain. Thus, lung cancer should be included in the differential diagnosis of facial pain that is atypical and/or refractory to treatment.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
4/18. Use of advanced imaging modalities for the differential diagnosis of pathoses mimicking temporomandibular disorders.The medical records of 3 patients who visited our hospital with preauricular pain and limited jaw movement were retrospectively reviewed. All were clinically evaluated, diagnosed through the use of conventional radiographs, and initially treated as having temporomandibular disorders (TMD). However, their symptoms did not improve and even increased or facial swelling occurred, so advanced imaging modalities were used to make a differential diagnosis. The final diagnoses of the patients were cellulitis, an inflammatory pseudotumor, and pigmented villonodular synovitis. In addition to these 3 patients, 50 others who were initially misdiagnosed during a clinical examination as having TMD on conventional radiographs were reviewed in the English-language literature. When diagnosing patients with TMD symptoms, we must consider the possibility of unusual causes, including tumors and infections or inflammations. Furthermore, in addition to usual TMD treatment procedures, an advanced radiologic examination should be performed to aid in the differential diagnosis of all patients with unceasing pain and mouth-opening limitation.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
5/18. Manifestations of fungal cellulitis of the orbit in children with neutropenia and fever.PURPOSE: To delineate clinical manifestations of fungal orbital cellulitis in immunocompromized patients. methods: The charts of 7 pediatric patients with fungal orbital cellulitis treated at a tertiary children's cancer hospital were reviewed retrospectively for histologically confirmed fungal sinusitis with associated orbital cellulitis. patients underwent CT and/or MRI of the orbits, sinuses, and brain; surgery; and therapy with antifungal medications. Main outcome measures were presenting signs and patient survival. RESULTS: Twenty-four patients with fungal sinusitis were identified, 7 of whom (4 months to 15 years of age) had documented orbital fungal cellulitis. All 7 patients presented with neutropenia and fever. Presenting symptoms included edema of the upper eyelid (n=4), headache (n=1), and facial pain (n=1). One patient was asymptomatic. Although antifungal therapy was initiated within 24 hours of presentation, disease progressed, and 5 patients eventually died of their infections. CONCLUSIONS: Because fungal orbital cellulitis can be fatal even if detected early in patients who are immunocompromised, ophthalmologists and otolaryngologists should be alert to the disease's subtle clinical manifestations.- - - - - - - - - - ranking = 4.5keywords = cell (Clic here for more details about this article) |
6/18. Sickle-cell anemia: a case report and literature review.Sickle-cell disease is characterized by the pathophysiological features of chronic hemolytic anemia, vaso-occlusion resulting in ischemic tissue injury and painful episodes. The organs at greatest risk are the spleen, kidney and bone marrow, where oxygen tension is low and blood flow is diminished. However, disease may also present in the mandible. The oral manifestations and radiographic findings of a sickle cell patient with a left mandibular neuropathy, along with dental management guidelines are presented in the context of interdisciplinary care.- - - - - - - - - - ranking = 3keywords = cell (Clic here for more details about this article) |
7/18. Surgery and treatment with high-dose liposomal amphotericin b for eradication of craniofacial zygomycosis in a patient with Hodgkin's disease who had undergone allogeneic hematopoietic stem cell transplantation.This case report describes craniofacial zygomycosis in a 24-year-old male with Hodgkin's disease who underwent chemotherapy and autologous hematopoietic stem cell transplantation, followed by a nonmyeloablative allogeneic transplant. Empirical therapy with itraconazole and amoxicillin-clavulanate failed to resolve the infection. Postdiagnosis, surgery and treatment with high-dose liposomal amphotericin b eradicated the disease.- - - - - - - - - - ranking = 2.5keywords = cell (Clic here for more details about this article) |
8/18. Chronic inflammation and pain inside the mandibular jaw and a 10-year forgotten amalgam filling in an alveolar cavity of an extracted molar tooth.A 55-year-old woman, suffered from severe pain in her mandibular jaw for several years. A metallic artifact of about 2(3) mm was detected by a panorama radiography in an edentulous region with a surrounding inflammation in close contact to the canal of the mandibular nerve. Inflammated tissue with the central metallic inclusion was removed from the bone under local anesthesia and operation. Postoperatively, pain and missensitivity disappeared within 1 week. Although the patient had no macroscopically visible so-called amalgam tattoo, the metallic cube was identified as amalgam by the detection of mercury, silver, tin, copper, and zinc using energy dispersive X-ray analysis (EDX) in a scanning electron microscope (SEM). Nevertheless, brown to black pigments in the connective tissue matrix and inside histiocytes, fibroblasts, and multinucleated foreign giant cells of the surrounding inflammatory tissue were observed by light and electron microscopy. However, the elemental analysis by EDX in SEM or by electron energy loss spectroscopy in transmission electron microscope detected only silver, tin, and sulfur but no mercury in these precipitates and in the residual bodies of phagocytes. The presented case demonstrates a seldom complication of amalgam deposition in the tissue. The authors assume that the chronic pain results from a forgotten amalgam filling inside an alveole after extraction of a molar tooth, causing a chronic inflammation by resolving mercury and other toxic elements out of the metallic artifact.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
9/18. maxillary sinus lymphoma: a consideration in the diagnosis of odontogenic pain.A patient with a known history of diffuse large cell histiocytic non-Hodgkin's lymphoma in the neck and left parotid gland presented with acute right maxillary odontogenic pain and swelling. Following endodontic treatment of the nonvital maxillary right second molar, minor masticatory discomfort persisted in the sextant but a dental etiology could not be established. Two months after the onset of symptoms, the right maxilla expanded uncontrollably and biopsy confirmed an antral lymphoma. The patient succumbed to the lymphoma and secondary complications 2 months later.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
10/18. Complications following enucleation and implantation of multiple glass spheres in the orbit.The technique of subperiosteal implantation of multiple, small glass beads for correction of enophthalmos associated with anophthalmos was first described in 1967. Reported complications of this procedure include ptosis, anesthesia of the distribution of the supraorbital or infraorbital nerve, and migration of the implants into the orbit or sinuses. A case of orbital cellulitis has been reported. We now report a case in which the extremely serious complication of intracranial migration of glass bead implants, with subsequent cerebrospinal fluid leak, occurred 17 years postimplantation.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
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