Sigmoid and transverse sinus thrombosis caused by mastoid implant – case report

Lobe of sound: prosthetic rehabilitation of partial auriculectomy defect

Loss of facial organs in an individual may be due to congenital anomalies or acquired causes. The missing parts of the face like ear, eyes and nose are considered as maxillofacial defects that can be rehabilitated by a prosthesis and/or cosmetic surgeries. This frontier of science has developed into a more reliable and predictable process due to the ever-increasing development of materials and equipments used in this procedure. The fabrication of an ear prosthesis is considered by many prosthetists to be one of the most difficult replacements in maxillofacial reconstruction. The severe undercuts and pronounced convolutions of the ear present a challenge in simulating a naturally proportioned prosthesis. Proper assessment of the disfigured facial organs and a feasible approach to rehabilitating them has for long been the target of clinical maxillofacial prosthodontics. This report describes a simple and engrossing technique to rehabilitate a patient with a partial auricular defect in the most aesthetic and economical manner using medical-grade room temperature vulcanising silicone.

Cerebral Venous Sinus Thrombosis in a Patient with Appendicular Abscess

BACKGROUND

Acute appendicitis is a common abdominal emergency, while cerebral venous sinus thrombosis (CVST) is a rare cerebral vascular disease. Cases of CVST in patients with appendicitis have not been reported in the literature. We present a case of CVST in a patient with appendicular abscess.

CASE DESCRIPTION

A 56-year old man presented to our department with a headache for 6 days; he had a history of abdominal pain 15 days before admission. Abdominal contrast-enhanced computed tomography revealed appendicular abscess. Head magnetic resonance venography and contrast-enhanced magnetic resonance imaging showed thrombosis in the left transverse and sigmoid sinus. Antithrombotic treatments were administered, and antibiotic treatments and puncture and drainage were used to treat the appendicular abscess. The patient's headache disappeared after 10 days of treatment, and he had recovered well clinically at 3-month follow-up.

CONCLUSIONS

CVST after acute appendicitis is rare, and clinicians should be aware of this complication when suspicious symptoms occur. The underlying mechanisms require further investigation.

Using Osseointegrated Implants Concomitant With Onlay Bone Grafting for Auricular Reconstruction

Conventional dental implants have been reported for nasal and orbital regions but due to limited thickness of calvarium they are not used in mastoid region. Onlay bone grafting in skull concomitant with implants is a predictable method and experimental animal studies confirm it. Parietal bone and lateral mandibular ramus are suggested source of bone grafts and dental implants with 7 mm length can be used safely. Increased fixture length may lead to increase survival in long term.

Subdural hematoma--a rare complication of removal of osseointegrated auricular prosthesis retention system

Periauricular osseointegrated prosthesis retention systems have been proven safe and effective in the management of microtia. Intracranial hemorrhage has been previously reported with implantation but is rare. We report a case of subdural hemorrhage following removal of an auricular prosthesis implant system. This case highlights the role of imaging, surgical technique, and neurosurgical support in prevention and management of intracranial hemorrhage associated with osseointegrated device removal.