• Title/Summary/Keyword: Mandibular condylar neck fracture

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Orthognathic surgery with removal of lipoma in the asymmetric mandibular prognathism of a patient with a mandibular bone defect due to intramuscular lipoma on the medial aspect of the ramus: a case report

  • Yoon Ju Nam;Min Seong Kang;Jung Han Lee;Bok Joo Kim;Jung Han Kim;Chul Hoon Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.4
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    • pp.235-240
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    • 2024
  • Lipomas, the most common soft-tissue mesenchymal neoplasms in adults, are characterized by the proliferation of mature white adipocytes without cytologic atypia. Lipomas are rarely observed in the head and neck region. We present a case of resection and orthognathic surgical removal of an intramuscular lipoma of the mandible with involvement of the mandibular ramus and condylar head and neck. An 18-year-old female patient was referred to our hospital for orthognathic surgery for the management of facial asymmetry and mandibular prognathism. The patient did not present with facial swelling, pain, or temporomandibular dysfunction; however, on radiographic examination, including cone-beam computed tomography and magnetic resonance imaging, an infiltrative fatty lesion was observed in the masticator space inside the right mandible, and the adjacent mandible exhibited bone thinning and deformity. Resection of the lipoma was performed along with orthognathic surgery, including a Le Fort I osteotomy for the maxilla and bilateral sagittal split ramus osteotomy (BSSRO). In this case, because the ramus was split using BSSRO, accessing the lipoma intraorally was easy. Consequently, aesthetic scarring was avoided, and no complications, such as unfavorable splitting or pathologic fracture, occurred. Although recurrence has not been observed about 1 year, long-term follow-up should be performed.

REMOVAL OF FOREIGN BODY IN THE LATERAL PHARYNGEAL SPACE VIA TRANSTONSILLAR APPROACH (편도와 접근을 통한 측방인두간극 이물제거의 치험 증례)

  • Kim, Soung-Min;Kim, Han-Seok;Kim, Ji-Hyuck;Kwon, Kwang-Jun;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.567-571
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    • 2007
  • Lateral pharyngeal space is one of potential fascial planes of head and neck, that may become involved by various pathological processes, such as infection, inflammation and neoplasm. The calcified stylohyoid ligament with styloid process is also located in this space, so this space is more acquainted with Eagle's syndrome in oral and maxillofacial field. During the mandibular transbuccal fixation procedures of 29-year old female patient who had right condylar neck and left parasymphysis fracture, we had lost one 10.0 mm miniscrew. After confirming the location of the lost miniscrew from different angled plain skull radiographies, we tried to find it in the lateral pharyngeal space via transtonsillar approach at the time of plate removal operation. This case report is aimed to share our valuable experience of the effective approach way to the lateral pharyngeal space, which has many advantages, such as short operative time, minimal bleeding, fast post-operative recovery, and less morbidity. The related literature is also reviewed.