A Novel Approach to the Treatment of Le Fort Fractures Using Internal Fixation to Achieve Mandibulomaxillary Fixation

Background:

We aimed to determine the minimum effective period of mandibulomaxillary fixation after the inadequate internal fixation of Le Fort I or Le Fort II fracture.

Objective:

The aim of this study was to investigate the stability of the skeleton after the treatment of Le Fort I or Le Fort II fractures by measuring bite forces and to determine the minimum time required for effective mandibulomaxillary fixation following treatment with internal fixation and mandibulomaxillary fixation.

Method:

A prospective study was performed to examine the treatment of Le Fort I or Le Fort II fracture in the Department of Maxillofacial Surgery at the National Hospital of Odonto-Stomatology in Ho Chi Minh City, Vietnam. A total of 31 patients were included, with up to 1 month of follow-up after discharge from the hospital. Midface bone stability and the mandibulomaxillary fixation time were evaluated using bite force criteria after 1, 2, and 4 weeks.

Results:

Midface bone stability values 1, 2, and 4 weeks after treatment were 87.1%, 100%, and 100%, respectively. After 1 week, 87.1% of patients achieved intermaxillary fixation, and 96.3% of these patients were treated with at least three rigid plates. The remaining 12.9% of patients achieved fixation after 2 weeks, and all of these patients were fixed only at zygomaticomaxillary sutures (p < 0.05). Bite forces increased significantly at 2 weeks compared with 1 week and at 4 weeks compared with 2 weeks (p < 0.05).

Conclusion:

When treated using only rigid fixation, through the placement of plates and screws at zygomaticomaxillary buttresses, patients with Le Fort I and Le Fort II fractures can achieve mandibulomaxillary fixation after 2 weeks. For Le Fort I fractures, rigid fixation using plates and screws at zygomaticomaxillary buttresses and canine buttress at three positions can achieve mandibulomaxillary fixation after only 1 week (p = 0.0001).

Evaluation of Bite Force After Treatment of Le Fort Fractures by Internal Fixation and Mandibulomaxillary Fixation

Objectives:

Evaluation of bite force one, two, and four weeks after discharge following treatment of Le Fort I and/or Le Fort II fracture by rigid fixation and mandibulomaxillary fixation.

Objective:

The aim of this study was to evaluate bite force following treatment of Le Fort I and/or Le Fort II fractures by rigid fixation and mandibulomaxillary fixation at one, two, and four weeks after discharge. This provides valuable results to guide the development of a treatment protocol for Le Fort fractures.

Method:

This was a prospective study including 31 patients who underwent followup examination three times after being discharged from hospital. The examination evaluated bite force using a bite force meter in the right molar, left molar, and incisor regions.

Results:

One week after discharge, bite forces in the right molar, left molar, and incisor regions were 94.29 ± 58.80 N, 95.42 ± 57.34 N, and 39,94 ± 30,29 N, respectively. Two weeks after discharge, bite forces in the right molar, left molar, and incisor regions were 153.84 ± 89.14 N, 153.00 ± 78.55 N, and 65,9 ± 43.89 N, respectively. Four weeks after discharge, bite forces in the right molar, left molar, and incisor regions were 279.77 ± 95.46 N, 285.00 ± 90,47 N, and 123.42 ± 54.04 N, respectively.

Conclusions:

Bite forces in the right molar, left molar, and incisor regions were significantly increased one week, two weeks, and four weeks after discharge. Bite force may be a helpful parameter to confirm the stability of the midface bone after treatment of Le Fort fractures.

Miliary brain tuberculosis in an infant

Tuberculosis remains prevalent in developing countries. Central nervous system tuberculosis often occurs secondary to pulmonary tuberculosis, transmitted through the bloodstream, and has a high mortality rate. Meningitis is the most common presentation of central nervous system tuberculosis, followed by tuberculoma, tuberculous brain abscess, and miliary tuberculosis. In this report, we present a case of miliary tuberculosis in a 3 month-old boy. The patient had a fever and was breathless for 1 month. The patient appeared cyanotic, experienced a seizure, and became comatose. Chest computed tomography scan suggested a pulmonary miliary tuberculosis abscess in the right lung and mediastinal lymph node tuberculosis. Brain magnetic resonance imaging showed the lesions were homogeneously enhancing tiny 2-3 mm nodules characteristic of miliary TB. Polymerase chain reaction of the cerebrospinal fluid and sputum samples confirmed tuberculosis. The patient died 1 month after diagnosis.

Pleuropulmonary blastoma (type III) in a two-year-old: A case report

Pleuropulmonary blastoma is a rare, aggressive, malignant tumor of the lungs or pleura that primarily affects children. Pleuropulmonary blastoma is classified into 3 types based on morphology, including cystic (type I), mixed (type II), or solid (type III). These morphological types correlate with prognosis. In this article, we present a case of type III pleuropulmonary blastoma in a 2-year-old girl. The patient was treated with tumoral resection and chemotherapy; however, she experienced local recurrence and spinal metastasis after 5 months of treatment.

A case report of congenital temporal bone encephalocele presenting as a tumor in a child

An encephalocele may be congenital or acquired and is characterized by the herniation of cranial contents through a skull bone defect. Most congenital encephaloceles occur in the occipital area, and temporal bone encephaloceles in children are rare. Congenital encephaloceles can be diagnosed either prenatally or after birth. We describe the case of a congenital temporal bone encephalocele in a 2-month-old boy that was diagnosed after birth. The patient presented with seizures and a bulging mass in the right neck that was detected by his mother during the second month after birth. The combined results from brain magnetic resonance imaging, computed tomography, and histological analysis confirmed the diagnosis of encephalocele. Although the surgical repair was offered, the family declined.