11/27. Necrotizing granulomatous vasculitis associated with cocaine use.cocaine abuse may be associated with a destructive nasal and pharyngeal process felt to be due to ischemia secondary to vasoconstriction. This report is the first to document a necrotizing granulomatous vasculitis associated with nasal destruction and an oronasal fistula in a chronic cocaine user. cocaine is an environmental insult that may play a role in triggering cerebral and non-cerebral vasculitis including a necrotizing granulomatous vasculitis of the respiratory tract.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
12/27. Microsurgical tissue transfer for rehabilitation of the patient with cleft lip and palate.OBJECTIVE: Three case reports of microsurgically revascularized tissue transfer for secondary closure of complex oronasal fistulae in cleft lip and palate patients are reported. One scapular and two radial forearm flaps were used in that respect; the scapular flap was transferred without a skin paddle and was left for secondary epithelialization whereas iliac crest bone was transplanted in the two patients with the forearm flaps in a further surgical step. CONCLUSIONS: These microsurgical flaps represent solutions in selected cases of oronasal fistulae in patients with cleft lip and palate with extensive scarring, large defects, or both. Alternative free flaps of the vast spectrum available today, however, also deserve consideration.- - - - - - - - - - ranking = 2keywords = fistula (Clic here for more details about this article) |
13/27. cocaine-induced oronasal fistulas with external nasal erosion but without palate involvement.The effects of chronic cocaine abuse have been widely described in the literature. Common complications include nasal septal perforation, saddle-nose deformity, and palatal perforation. Erosion of the external structures of the face has not been as extensively described, nor have oronasal fistulas that involve structures other than the hard or soft palate. In this article, we present the first reported case of cocaine-induced external nasal erosion that included multiple oronasal fistulas in the anterior gingival sulcus but did not involve the hard or soft palate. We stress the importance of a thorough history in such patients and consideration of all possible diagnoses, including drug abuse.- - - - - - - - - - ranking = 6keywords = fistula (Clic here for more details about this article) |
14/27. Closure of large oronasal fistulas at the time of secondary bone grafting in patients with cleft lip and palate.Oronasal fistulas often arise after repair of the palate in patients with cleft lip and palate. Those located adjacent to the residual cleft are commonly closed at the time of secondary bone grafting. However, it is not easy to close larger fistulas. We present a method of closing large oronasal fistulas in the anterior palate that are adjacent to the residual cleft at the time of secondary bone grafting, which consists of reducing the size of the inferior nasal turbinate.- - - - - - - - - - ranking = 7keywords = fistula (Clic here for more details about this article) |
15/27. Submental cutaneous sinus tract as a result of progressive peri-implantitis: a case report.BACKGROUND: The aim of the present case report was to define diagnosis and treatment options of a submental cutaneous sinus tract as a result of a progressive peri-implantitis around mandibular dental implants in a patient with a history of oral squamous cell carcinoma. methods: Before the removal of the submental fistula, a panoramic radiograph and a computed tomography of the head and neck were assessed to identify the implants responsible for the cutaneous sinus tract and to exclude the presence of a tumor recurrence and lymph node metastases. The involved implants were removed, as there was a communication along them between the oral cavity and the cutaneous sinus tract resulting from progressive peri-implantitis. A histological examination of the excised fistula was carried out. RESULTS: The histological examination excluded a recurrence of the oral squamous cell carcinoma. The fistula completely consisted of granulation tissue without epithelialization. After affected implants were removed, the wound healing was uneventful. CONCLUSIONS: A panoramic radiograph is mandatory to identify the involved implants. Computed tomography, and excision of the fistula and a histological examination should be performed only in patients with a history of oral squamous cell carcinoma. Since the cutaneous sinus tract showed no epithelialization, it healed spontaneously after the removal of the responsible implants. Because of the large bony defect caused by progressive peri-implantitis leading to a communication of the oral cavity with the cutaneous sinus tract, more conservative treatment options with preservation of the implants could not be adopted in the present case.- - - - - - - - - - ranking = 4keywords = fistula (Clic here for more details about this article) |
16/27. Palatal and nasal necrosis resulting from cocaine misuse.The potential social and economic harm caused by cocaine addiction is well known. The wider health risks and potential nasal complications of septal perforation and nasal collapse are also recognised. We report a case of oro-nasal fistula secondary to cocaine misuse and discuss the aetiology, management and potential methods of repair.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
17/27. Immediate and sustained changes in tongue movement with an experimental palatal "fistula": a case study.OBJECTIVE: To determine the immediate and longer-term effect(s) on tongue movement following the placement of an experimental opening through a palatal obturator (replicate of subject's prosthesis) worn by an adult male with an unrepaired cleft of the hard and soft palate. methods: tongue movements associated with an anterior experimental opening of 20 mm(2) were examined under three conditions: a control condition in which the subject wore the experimental obturator completely occluded, a condition immediately after drilling the experimental openings through the obturator, and a condition after 5 days in which the subject wore the experimental obturator with the experimental opening. An Electromagnetic Articulograph was used for obtaining tongue movements during speech. RESULTS: The findings partly revealed that the immediate introduction of a perturbation to the speech system (experimental fistula) had a temporary effect on tongue movement. After sustained perturbation (for 5 days), the system normalized (going back toward control condition's behavior). Perceptual data were consistent with kinematic tongue movement direction in most of the cases. CONCLUSIONS: Although the immediate response can be interpreted as indicative of the subject's attempts to move the tongue toward the opening to compensate for air loss, the findings following a sustained perturbation indicate that with time, other physiological adjustments (such as respiratory adjustments, for example) may help reestablish the requirements of a pressure-regulating system.- - - - - - - - - - ranking = 5keywords = fistula (Clic here for more details about this article) |
18/27. Hard palate perforation due to invasive aspergillosis in a patient with acute lymphoblastic leukemia.Invasive aspergillosis (IA) is a major cause of morbidity and mortality in immunosuppressed patients. Primary oral invasive aspergillosis is a rare condition. We present an acute lymphoblastic leukemia (ALL) patient with hard palate perforation due to invasive aspergillosis. Two months after the appearance of the fungal lesions, perforation of the hard palate was seen despite amphotericin-b and itracanazole therapy. After debridement of necrotic tissue the patient was followed for spontaneous closure for 6 months but it was seen that the fistula persisted despite the disappearance of the infection. The patient was operated for closure of the palatal fistula and there was no recurrence in 6 months of follow up. Surgical and medical management was performed successfully. Invasive oral aspergillosis is a potentially lethal disease and it should be considered in immunosuppressed patients with oral lesions.- - - - - - - - - - ranking = 2keywords = fistula (Clic here for more details about this article) |
19/27. cleft palate fistula closure with a mucosal prelaminated lateral upper arm flap.BACKGROUND: Recurrent cleft palate fistula is a challenge for maxillofacial surgeons. In severe cases, microvascular tissue transfer is necessary to treat these patients successfully. methods: A 23-year-old man with cleft lip and palate, previously treated elsewhere, presented with a 2-cm defect in the posterior hard palate. A tongue flap had already been performed. It was decided to close the persistent fistula with a lateral upper-arm flap. In a first-step operation, a free graft of buccal mucosa was fixed to the lateral upper arm subcutaneously and covered with an alloplastic sheet. After 11 weeks, the prelaminated flap was harvested and transferred to the palate. RESULTS: Integration of the buccal mucosa to the upper arm was uneventful. On harvesting the flap, we found a smooth, thin, and continuous fasciomucosal flap with a mucosa surface of 4 x 4 cm. Healing of the microvascular flap in its recipient site was regular. The fistula was closed successfully. CONCLUSIONS: To the authors' knowledge, this is the first report of a lateral upper-arm flap prelaminated with autologous mucosa. By prelamination, it is possible to circumvent the disadvantage of extraoral skin within the oral cavity and to cover mucosal defects with mucosa, especially in elective procedures, such as cleft cases.- - - - - - - - - - ranking = 7keywords = fistula (Clic here for more details about this article) |
20/27. Rhinolithiasis as cause of oronasal fistula.Rhinolithiasis is a disease caused by deposition of organic and inorganic compounds in the nasal cavity, leading to unilateral nasal obstruction, fetid rhinorrhea, epistaxis, and it may cause complications. The authors present a case of rhinolithiasis with oronasal fistula and literature review.- - - - - - - - - - ranking = 5keywords = fistula (Clic here for more details about this article) |
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