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soft tissue mass extending along the medial orbit region in the m.rect. medialis and m. obliquus sup. and partly also m. rect. inf. space as a lesion of size 23 × 30 mm with a slight postcontrast homogeneous saturation and this lesion tightly fitted to the eyeball. Exenteration with lid sparing technique was performed. In 2019 after healing process patient got an individual epithesis. CONCLUSIONS Basal cell carcinoma is the most frequent indication of orbital exenteration. Rarely is indicated subtotal exenteration with eyelid sparing technique for non-cancer reason as it was in our 1 case.An indirect anthropometric study was conducted to find out whether neoclassical facial canons could be applied to the population of Brazilian white young adults. The study was based on standardized facial photographs of 689 women and 666 men aged 30 years ± 6 months. The findings were compared to those observed for the North American Caucasian population. The frequency of 5 canons was assessed facial thirds; interorbital width; nose and eye widths; mouth and nose widths; and face and nose widths. The assessed population showed the following ratios tr-n > n-sn (96.01%), n-sn  less then  sn-gn (95.90%), tr-n = sn-gn (42.06%), en-en  less then  al-al (58.08%), en-en  less then  ec-en (59.92%), ch-ch = 1½ al-al (52.61%), and al-al = 1/4 zy-zy (56.67%). When compared to North American Caucasians, only tr-n/n-sn and n-sn/sn-gn were identical. In conclusion, neoclassical facial canons cannot be applied to the Brazilian population, but they could serve as parameters for application in clinical practice and in forensic sciences.INTRODUCTION In this study, the authors aimed to perform a novel and extensive analysis, based on the most applicable correlations between the mandibular and upper airway parameters, using cone beam computed tomography across all malocclusion classes. The authors also focused on gender-dependent differences in an Iranian population. MATERIALS AND METHODS Images were acquired from adult patients using cone beam computed tomography. The patients were classified into three groups of malocclusion classes (class I 13 males and 27 females, class II 13 males and 27 females, and class III 25 males and 15 females). For each patient, 10 parameters for the mandible and 23 parameters for the pharynx, pyriform aperture, and nasal cavity were evaluated in the images. RESULTS Pearson's correlation coefficient showed significant correlations between the mandibular morphology and upper airway dimensions in each malocclusion class. In females, the menton angle had a significant correlation with pharyngeal dimensions in all malocclusion classes. In males, the bigonial width, bicondylar width, and symphyseal height of the mandible were correlated with pharyngeal dimensions in all classes. The greatest correlation between the mandible and upper airways was observed in class III malocclusions, and the lowest correlation was observed in class I malocclusions. In addition, the mandibular parameters had relationships with the nasal cavity and pyriform aperture. CONCLUSION It is important to consider the knowledge of the relationship between some characteristics of the mandible and airways in various clinical approaches.The purpose of this study was to compare the amount of stress on the fracture site via three-dimensional finite element analysis between lag screw and miniplate systems. Solid mathematical models were created from the CT of a patient and a fracture observed in the symphysis area. On the fracture site mini plates and lag screws applied to the bone to fixate segments. The physiologic mastication chewing forces were applied for simulation. These 2 fixation methods were evaluated by their amount of stress values. The maximum Von Misses stress lag screw model was 2727 MPa on the apex of the lag screw and 934 MPa on the fracture site of the screw. At the miniplate model, the maximum Von Misses stress was 571 MPa on the head of the miniplate screw, and it was 202 MPa on the fracture site. Thus, lag screw model causes at least 4 times higher stress values than mini plate model. The stress level of lag screw model is higher than miniplate model. However, when the chewing forces are taken into account, the amount of stress in the lag screw system is also acceptable in clinical applications.Cleidocranial dysplasia (CCD) is a rare autosomal dominant disorder caused by mutations in the Runx2 gene. The CCD is characterized by frontal bossing, a patent anterior fontanelle, presence of Wormian bones, midface hypoplasia, multiple dental abnormalities, clavicular hypoplasia or aplasia, skeletal abnormalities, and short stature. The aims of this study are to report the phenotypic manifestations of all patients who presented with CCD and to review the multidisciplinary management of these patients. The longitudinal data of patients with a diagnosis of CCD treated at The Australian Craniofacial Unit from 1980 to 2019 were reviewed. Fourteen patients were identified for inclusion in this study. The age at referral to the unit ranged from 1 week old to 49 years old (mean 11.2 years old). All patients had clinical features of frontal bossing, a patent anterior fontanelle, multiple Wormian bones, midface hypoplasia, abnormal dentition, clavicular hypoplasia/aplasia, and normal intellect. Eleven patients had o the body should draw clinicians' attention to the need for multidisciplinary management of these patients.A pseudoaneurysm is an uncommon pathology arising from any artery in the human body. It typically presents as a pulsatile swelling in contact with a blood vessel. Of pseudoaneurysms of the head and neck region, the most common site is the superficial temporal artery while that of the dorsal nasal artery is extremely rare. A pseudoaneurysm can be routinely diagnosed by its clinical features and confirmed by radiologic evaluation. The authors report a case of pseudoaneurysm of the dorsal nasal artery, which was misdiagnosed as a hematoma owing to its non-pulsatile nature during initial presentation.Ethmoid sinus osteomas are rare, benign, encapsulated neoplasms of the paranasal region. They can lead to various complications such as sinusitis, orbital cellulitis, proptosis, and diplopia. The treatment protocol of these lesions changed remarkably as powered instrumentation of functional endoscopic sinus surgery evolved and otolaryngologists gained experience. Here, the authors report a 30-year-old female who was diagnosed with a giant right-sided ethmoid sinus osteoma and discuss diagnostic and treatment modalities of these lesions in consonance with the current literature.BACKGROUND The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed. METHODS We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations. RESULTS The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which four are best practice statements, nine are strong recommendations, and 35 are weak recommendations. No recommendation was provided for six questions. The topics were 1) infection control, 2) laboratory diagnosis and specimens, 3) hemodynamic support, 4) ventilatory support, and 5) COVID-19 therapy. CONCLUSION The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new evidence in further releases of these guidelines.Using a representative case, this article discusses prehospital innovations for patients with acute large vessel occlusion ischemic stroke, including mobile stroke unit care supported by advanced field imaging.Stroke is one of the most common conditions neurologists treat in emergency situations. This article examines the issues of surrogate decision makers and the physician's potential legal liability in the context of the administration or nonadministration of recombinant tissue plasminogen activator (rtPA) in a common emergency department scenario.PURPOSE OF REVIEW Unruptured intracranial aneurysms and brain arteriovenous malformations (AVMs) may be detected as incidental findings on cranial imaging. This article provides a practical approach to the management of unruptured intracranial aneurysms and unruptured brain AVMs and reviews the risk of rupture, risk factors for rupture, preventive treatment options with their associated risks, and the approach of treatment versus observation for both types of vascular malformations. RECENT FINDINGS For unruptured intracranial aneurysms, scoring systems on the risk of rupture can help with choosing preventive treatment or observation with follow-up imaging. Although the literature provides detailed information on the complication risks of preventive treatment of unruptured intracranial aneurysms, individualized predictions of these procedural complication risks are not yet available. With observation with imaging, growth of unruptured intracranial aneurysms can be monitored, and prediction scores for growth can help determine the optimal timing of monitoring. The past years have revealed more about the risk of complications of the different treatment modalities for brain AVMs. A randomized clinical trial and prospective follow-up data have shown that preventive interventional therapy in patients with brain AVMs is associated with a higher rate of neurologic morbidity and mortality compared with observation. SUMMARY The risk of hemorrhage from both unruptured intracranial aneurysms and brain AVMs varies depending on the number of risk factors associated with hemorrhage. For both types of vascular malformations, different preventive treatment options are available, and all carry risks of complications. For unruptured intracranial aneurysms, the consideration of preventive treatment versus observation is complex, and several factors should be included in the decision making. Overall, it is recommended that patients with unruptured asymptomatic brain AVMs should be observed.PURPOSE OF REVIEW Surgical vascular intervention is an important tool in reducing the risk of stroke. This article examines the evidence for using the available options. RECENT FINDINGS Carotid endarterectomy is an effective treatment option for reducing the risk of stroke in appropriately selected patients. Patients should be stratified for future stroke risk based on both the degree of stenosis and the presence of symptoms referable to the culprit lesion. Carotid stenting is also useful in reducing stroke risk, again in carefully selected patients. Because of the publication of significant data regarding both carotid endarterectomy and carotid artery stenting in the last several years, selection can be far more personalized and refined for individual patients based on demographics, sex, patient preference, and medical comorbidities. Blasticidin S Routine extracranial-intracranial bypass surgery remains unproven as a therapeutic option for large vessel occlusion in reducing the incidence of ischemic stroke although some carefully screened patient populations remaining at high risk may benefit; procedural risks and pathology related to alterations in blood flow dynamics are challenges to overcome.
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