1/5. Adverse granulomatous reaction after cosmetic dermal silicone injection.BACKGROUND: Various alloplastic injectable implants have been developed for soft tissue augmentation without surgery, but different local or systemic adverse reactions have limited their use for cosmetic purposes. OBJECTIVE: To examine the problems associated with silicone injection. methods: Case report and literature review. RESULTS: We describe an adverse granulomatous reaction after the injection of liquid silicone for lip augmentation, causing facial disfigurement. Although the initial response to steroids was poor, after 3 years of follow-up the nodules have almost disappeared spontaneously. CONCLUSION: We advise that silicone injection be performed solely by trained physicians using medical-grade silicone or consider other injectable materials.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. Vertebral body granuloma of the cervical region after pencil injury.OBJECTIVE AND IMPORTANCE: granuloma formation has been reported as a rare complication of pencil lead injury. Insufficient data exist regarding pencil lead injuries of the cervical spine. We present the findings in an 18-year-old male patient with secondary granuloma formation after a penetrating transoral pencil injury. We suggest that imaging characteristics and a detailed history will assist with the diagnosis of such lesions. CLINICAL PRESENTATION AND INTERVENTION: The patient was an 18-year-old man who presented with cervical pain. His history included falling as a child while having a pencil in his mouth. T2-weighted imaging studies documented a 1- x 1-cm enhancing lesion posterior to the vertebral body at the C3 level. The patient underwent a C3 vertebrectomy, and specimens were notable for infection, pencil lead, and granuloma formation. CONCLUSION: In the evaluation of a potential granuloma or mass lesion of the cervical spine in a child or adolescent, the differential diagnosis may include a neoplasm. Although computed tomography is an ideal tool to detect foreign objects, including pencil leads, only awareness of the potential for pencil lead injuries and that pencil lead fragments may remain unrecognized on computed tomographic scans will assist the physician in diagnosing such injuries.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/5. Paraffinoma and ulcer of the external genitalia after self-injection of vaseline.We present a 42-year-old circumcised man with a 10-cm firm, irregular penile mass associated with multiple penile ulcers, voiding difficulty, and erectile dysfunction. He reluctantly admitted that 8 months previously, he had multiple mineral-oil (vaseline) self-injections to the penis, for penile enlargement purposes. Histopathological examination revealed the condition was consistent with mineral-oil granuloma (paraffinoma). The patient did not accept surgical intervention; therefore, we performed local therapy (intralesional triamcinolone) and hot-water baths. Paraffinoma results from mineral-oil injections. Such injections are rare; however, they are still being performed in some countries in Eastern europe and the far east such as korea. Increased physician and public awareness are needed for prevention and treatment of complications of this physically and psychologically debilitating and destructive problem.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/5. Sclerosing lipogranulomatosis: a case report of scrotal injection of automobile transmission fluid and literature review of subcutaneous injection of oils.For nearly a century, physicians and laypersons have attempted to repair, reconstruct, and embellish the human body in numerous ways by injecting various oils beneath the skin. Soon after Gersuny's first reported subcutaneous injection of oil, the local and systemic complications became apparent. Despite this, the practice of oil injections continues. "Medical grade" silicone injection was investigated in the 1960s to 1980s with varied success and complications. While few physicians practice oil injection therapy, some laypersons continue to subject themselves or their clients to the risk of the disfiguring complications of sclerosing lipogranulomata. Accidental high-pressure injection injury of liquids, so-called grease gun injuries, continues to provide a therapeutic challenge for the hand surgeon. Our case of a man who injected automobile transmission fluid into his scrotum illustrates the classical course and proper management of sclerosing lipogranulomata. A subcutaneous inflammatory and fibrosing reaction occurred with regional lymphadenopathy. The need for complete excision of all involved tissue to treat the condition successfully is illustrated. This case also illustrates the tendency of patients to conceal from their doctors the history of self-injection of foreign bodies. In cases of self-injection, psychological counseling might certainly be appropriate.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
5/5. Tympanostomy tubes: experience with removal.Whereas the clinical indications for tympanostomy tube placement are well-established, the indications for operative tympanostomy tube removal remain unspecified. A 1-year retrospective review done at the massachusetts eye and ear Infirmary revealed 131 tympanostomy tubes to have been removed under general anesthesia. Chronic otorrhea, granuloma formation, tube nonfunction due to blockage, and migration of the tube into the middle ear constituted the surgical indications in 75 cases. The remaining 56 tubes were removed on the physicians' judgment that artificial ventilation was no longer required. Selected cases are presented. While the vast majority of tubes spontaneously extrude uneventfully, a comparatively small number of patients do require operative tube removal. Practice guidelines for surgical tube removal are suggested.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |