Actinomycotic sinus of the buccal mucosa: a rare complication of cheek dimple creation

Analysis of the clinical and aesthetic results of facial dimple creation surgery

Background

Dimples on the cheeks can make the smile look more cheerful and attractive. Therefore, some people who do not have dimples may choose to undergo dimple creation surgery. Although dimple surgery is quite common, those desiring this procedure often lack information about it. Therefore, we conducted the present study to share our surgical tips and clinical experiences regarding safe dimple creation surgery.

Methods

This study included 2,048 patients who underwent dimple creation surgery at our plastic surgery clinic between April 2010 and June 2014. These patients were selected from those who displayed no scarring from injury or tumor removal in the central face during the presurgical evaluation. Medical records were used to identify the age and sex of each patient, the location of dimple creation, any postoperative complications, reoperation, and the reason for reoperation.

Results

Of the 2,048 patients, 159 (7.7%) underwent reoperation. The reason for reoperation was undercorrection in 78 cases (49.0%), disappearance of the dimple in 62 cases (38.9%), and overcorrection in nine cases (5.6%). Five patients (3.1%) had their stitches removed to eliminate the created dimple because they changed their minds, and five patients (3.1%) had their stitches removed because of infection. No patients reported complications after reoperation, and no other complications, such as hyperpigmentation or foreign body reaction, were observed.

Conclusions

Safe surgery with minimal complications and satisfying cosmetic results can be achieved via accurate knowledge of the relevant anatomy and its relationship with dimples, as well as appropriate surgical methodology.

Challenge dilemma of actinomycosis in the tongue: Review and case report

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Rare presentation of actinomycosis of the tongue makes it challenge.

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Actinomycosis should be kept as a differential diagnosis in bewildering cases.

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Histopathology consider as important diagnostic aids in challenged cases.

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Varied clinical manifestations of the disease.

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Treatment should implement in harmony according to each diseases solely.

Introduction

Rare presentation of tongue actinomycosis makes it challenge, less than 3% of all recorded cases of actinomycosis can be proved in the English literature. In this study we clarify the unexpected presence of actinomycosis wishing that it assist our practitioner colleagues in diagnosing such lesions perfectly.

Case presentation

Sixty five years old female was complaining from mass in the tongue submucosally since 1 year last with no history of fever, pain and trauma. It’s situated in the anterior third of the tongue, mild discomfort with percussion. Benign neoplasm was the clinical diagnosis. Decision was excisional biopsy. So patient underwent surgery under local anesthesia. Complete excision was done. Specimen sends for histopathological examination. Good healing process. Patient advice to keep on tetracycline capsule 250 mg for 1 month precautionary. Histopathological examination of the biopsy specimen diagnosis was mycetoma, with no malignancy.

Discussion

Clinically actinomycosis can be challenge too when it be silent not manifest as infection more over similarity to other pathological conditions at that time detailed patient history will be invaluable to exclude neoplastic pathology. Surgeons should pay attention to that prolonged antibiotic therapy is usually required is mandatory in some cases, and excellent prognosis confirmed. With better oral hygiene, availability of antibiotics, and advanced surgical techniques, the outcome, and mortality have improved.

Conclusion

Varied clinical manifestations of the disease are make achievement of clinical diagnosis of actinomycosis is difficult. Treatment should implement in harmony according to each diseases solely.