1/4. Recurrent ectopic calcification involving the maxillofacial skeleton: A potential harbinger of Albright's osteodystrophy.We present a case of osteoma cutis as the initial presenting sign of Albright's osteodystrophy. Albright's osteodystrophy represents a challenge in both diagnosis and treatment because the phenotype manifests as a broad spectrum of biochemical and physical findings. The syndrome may be overlooked, particularly in the early phases when serum calcium and phosphorous levels may be normal. Although surgery is the treatment of osteoma cutis, recurrence is common, creating frustration for the patient's family and the surgeon. In the present case, a girl 4 months and 2 years of age presented with refractory ectopic calcification emanating from the maxilla and demonstrated repeated recurrence after surgical resection. This ectopic calcification was not adequately controlled until Albright's osteodystrophy was properly diagnosed and treated. A differential diagnosis and surgical approach to deal with recurrent ectopic calcification of the facial skeleton is outlined.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/4. Familial malignant osteopetrosis in children: a case report.The clinical, radiological, pathological and laboratory findings of two brothers with autosomal recessive malignant osteopetrosis are presented. Our findings are similar to characteristics previously reported in the literature about patients with osteopetrosis. The 6-year-old male patient was pale and had petechiae on his arms and legs. He also had macrocephalia, splenomegaly, severe pancytopenia, genu valgus, hypocalcemia, amaurosis, cessation of physical development, generalized bone sclerosis and recurrent infections with a history of multiple incidences of acute otitis media. Generalized bone sclerosis and irregular sclerosis of the maxilla and mandible were seen on radiographs. The oral mucosa was apparently normal but permanent tooth eruption was delayed although there was early loss of deciduous teeth. The recommended treatment was blood transfusion and therapy with antibiotics when necessary; a bone marrow transplant was not possible due to lack of a compatible donor.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/4. osteoradionecrosis of the maxilla and skull base.osteoradionecrosis of the maxilla and base of skull are rare phenomena, usually seen after combined therapy for malignancies of the maxillary sinus. While the mandible is most commonly affected by osteoradionecrosis, the maxilla and skull base may also be affected when preoperative or postoperative radiotherapy is combined with surgery. Contributing factors may be: high radiation dosage delivered to the treatment volume (greater than 6000 rads), loss of tissue protective effects due to surgery, decreased vascularity caused by surgery and radiation, and proximity of a contaminated field. Onset of symptoms may vary. One patient presented 25 years after postoperative radiotherapy. Major symptoms were pain, trismus, and purulent discharge. The best diagnostic modality remains the history and physical exam, as the area is readily accessible. CT scans may be helpful in diagnosis and treatment planning. Therapy should follow time honored principles of local wound care. Home irrigations and hyperbaric therapy have been helpful in encouraging early sequestration and rapid healing.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/4. Alveolar bone necrosis and tooth loss. a rare complication associated with herpes zoster infection of the fifth cranial nerve.Eleven case reports involving herpes zoster infection associated with alveolar bone necrosis and tooth loss were reviewed in order to develop a patient profile for this rare combination of physical findings. The clinical course of a 56-year-old white woman with herpes zoster infection of the fifth cranial nerve and related alveolar bone necrosis, tooth loss, and oroantral fistula development is reported. The etiology and management of herpes zoster infection associated with destructive oral sequelae are discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |