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A 72-year-old man had presented with a 4-day history of progressive left-sided facial swelling associated with pain. The physical examination revealed left facial fullness over the parotid gland without tenderness to palpation. His vital signs and laboratory test findings were within normal limits. A computed tomography scan demonstrated a left facial varix measuring 3.4 cm × 2.8 cm within an unremarkable-appearing parotid gland. Parotidectomy vs close observation were discussed, and the patient decided to pursue nonoperative management. Ultimately, his symptoms were self-limited, and the swelling had resolved within 6 months after the diagnosis. Interval computed tomography demonstrated a thrombosed left facial varix measuring 1.3 cm × 1.1 cm.

Chronic non-bacterial osteomyelitis (CNO) is a rare and difficult-to-diagnose disease, especially when limited to the jaws. We report the case of a 5-year-old girl with spontaneous jaw pain and a large pre-auricular facial swelling overlying the angle of the mandible that was non-responsive to previous antibiotic and non-steroidal anti-inflammatory treatment. The diagnosis was confirmed as CNO following evaluation and workup by a multidisciplinary team. The patient exhibited a favourable response to oral alendronate sodium plus vitamin D3 combination treatment. We believe that alendronate sodium is an effective second-line drug for CNO.

This case study describes a 24-year-old woman who presents to her primary care provider with marked unilateral facial swelling that has been present for 6 months. Facial swelling is a frequently observed symptom associated with various odontogenic and nonodontogenic conditions. Appropriate diagnosis and referral are critical when patients seek care for a suspected oral pathology.

Acute otitis media is a localized infection. Advanced cases demonstrate local spread and abscess formation in the mastoid, temporomandibular joint, and zygomatic root if anatomy allows. We present a case of acute otitis media complicated by an abscess of a pneumatized zygomatic root extending into the temporomandibular joint treated by incision and drainage.

Background Immunoglobulin E–mediated food allergy (FA) affects children and adults with variable age of onset. Phenotype and quality of life (QoL) differences between childhood-onset FA (COFA) and adult-onset FA (AOFA) are not known. Objective To identify phenotypic and QoL differences between AOFA and COFA. Methods A cross-sectional study of adults (≥18 years old) seen at Northwestern Memorial HealthCare clinics between 2002 and 2017 with an International Classification of Diseases ninth and tenth revision diagnosis of FA. Subjects completed a FA history survey and a FA QoL questionnaire. FA characteristics and QoL scores were compared between groups. Results Among 294 consented subjects, 202 had a clinical history consistent with labeled immunoglobulin E–mediated FA. The onset of FA symptoms occurred before age 18 years (COFA) in 80 subjects and after age 18 years in 122 (AOFA) subjects. Shellfish reactions were most common in AOFA-labeled subjects (28%), whereas tree nut reactions were the most common in COFA-labeled subjects (55%) compared with other triggers. Hives (68% vs 52%, P = .03), facial swelling (69% vs 50%, P = .009), wheezing (56% vs 29%, P Conclusion There are differences in specific food triggers and symptoms in adult-onset and childhood-onset labeled FA. Adults labeled with childhood-onset FA have reduced QoL.

Pediatric head and neck lymphedema is rare and there have not been any reported cases in children. Here we discuss severe, diffuse head and neck lymphedema in a child caused by compression of the internal jugular veins by lymphadenopathy from Kawasaki's disease. With steroid and intravenous immunoglobulin treatment, the lymphadenopathy improved and facial edema slowly resolved. In review of the literature, complications of head and neck lymphedema including airway obstruction and blindness are discussed. This case highlights the importance of the pediatric otolaryngologist considering lymphedema as a cause for facial swelling and monitoring for complications of lymphedema.

Nodular fasciitis (NF) is a benign reactive fibroblastic process which belongs to pseudosarcomatous proliferative lesions of soft tissues. Its occurrence is uncommon in the pediatrics with only a handful of cases reported in the sino-nasal area. We report a 14-month old boy, presented with right facial swelling caused by a 5 cm tumor involving the sino-nasal area with erosion of the floor of the orbit and extension into the pterygopalatine fossa. The lesion was completely excised through a midfacial degloving approach. Histological examination revealed the diganosis of NF. The postoperative period was uneventful with no evidence of recurrence 24-months postoperatively.

Surgical treatment of zygomatico-orbital (ZO) fractures is a common procedure in maxillofacial surgery. Often accompanied by pain, trismus and swelling, postoperative morbidity is a major disadvantage, affecting patients' quality of life. The appliance of kinesiologic tape (KT) improves the blood and lymph flow, removing congestions of lymphatic fluid and haemorrhages. The aim of this study was to find out if the application of kinesiologic tape prevents or improves swelling, pain and trismus after zygomatico-orbital fracture surgery, improving patients' postoperative quality of life. A total of 30 patients were assigned for treatment of zygomatico-orbital fractures and were randomly divided into treatment either with or without kinesiologic tape. Tape was applied directly after surgery and maintained for at least 5 days postoperatively. Facial swelling was quantified using a five-line measurement at six specific time points. Pain and degree of mouth opening was measured. Patient's subjective feeling and satisfaction was queried. The results of this study show that application of kinesiologic tape after zygomatico-orbital surgery significantly reduced the incidence of swelling with an earlier swelling maximum, and decreased the maximum turgidity for more than 60% during the first 2 days after surgery. Although, kinesiologic tape has no significant influence on pain control and trismus, mouth opening increased earlier after operation in the kinesiologic tape group compared to the no-kinesiologic tape group. Furthermore, patients with kinesiologic tape felt significantly lower morbidity than those without kinesiologic tape. Therefore kinesiologic tape is a promising, simple, less traumatic, economical approach, which is free from adverse reaction and improves patients' quality of life.

Background The aim of this systematic review and meta-analysis was to evaluate the efficacy of cryotherapy in reducing pain, trismus, and facial swelling in patients undergoing third-molar surgery. Types of Studies Reviewed The authors searched for randomized clinical trials in PubMed, Web of Science, SCOPUS, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov , Google Scholar, and OpenThesis. Eligibility criteria were population: patients submitted to removal of impacted third molars; intervention and comparison: postoperative cryotherapy versus no cold therapy; and outcomes: primary outcome was postoperative pain, and secondary outcomes were facial swelling and trismus. Eligible studies must have reported at least 1 of the outcomes of interest. After extracting data and assessing quality, the authors performed the meta-analyses. Results The authors included 6 studies in the quantitative synthesis analysis. Differences in pain intensity were found on postoperative day 2 (weighted mean difference, −0.72; 95% confidence interval, −1.45 to 0.01; P = .05) and postoperative day 3 (weighted mean difference, −0.36; 95% confidence interval, −0.59 to −0.13; P = .002). No evidence was found that cryotherapy was effective in reducing trismus and facial swelling. The quality of evidence was graded as low. Conclusions and Practical Implications Evidence suggests that cryotherapy may have a small benefit in reducing pain after third-molar surgery, but it is not effective on facial swelling and trismus. Owing to the lack of standardization of cold application, effective evidence-based treatment protocols for cryotherapy after third-molar surgery still need to be established.

The aim of this study was to compare the effect of intramuscular (IM) injection and consumption of 8 mg dexamethasone in patients after lower third molar (LTM) surgery. 20 healthy Thai patients, average age 20 years, with bilateral LTM removal were recruited for this study, a double blinded, paired sample clinical trial. The washout period was 1 month after the first operation. Clinical assessment of facial swelling, pain and maximum mouth opening were measured before and after operation for 7 days. No significant difference was found in facial swelling between IM injection and consumption of 8 mg dexamethasone after LTM surgery (paired t test P > 0.05). The visual analogue scale scores for pain assessment showed no significant difference between IM injection and consumption of dexamethasone (paired t test P > 0.05). The results conclude that IM injection or consumption of dexamethasone after LTM surgery can be used to control facial swelling, pain and trismus.

A 50-year-old man with a right-sided pectoral dual chamber defibrillator for cardiac sarcoid and complete heart block developed debilitating superior vena cava (SVC) obstructive symptoms, including facial swelling, arm swelling, headache, and distorted vision despite therapeutic anticoagulation. He

We report a case of an orofacial lesion in Crohn's disease successfully treated with tacrolimus ointment. A 22-year-old woman with Crohn's disease presented with a discharging lesion on the right side of her face. Intraorally, there was a resultant loss of the sulcal depth. She reported a 1-year history of variable right-sided facial swelling for which she had undergone extraoral incision and drainage, resulting in localized paresthesia and nonhealing of the incision site. Following exclusion tests, a treatment of twice-daily extraoral application of tacrolimus 0.1% ointment was commenced. Upon review, the lesion had reduced in size, with minimal discharge. Further improvement over 12 months of tacrolimus use resulted in a satisfactory cosmetic result as well as resolution of the intraoral features and reestablishment of the full sulcal depth. This case illustrates the successful use of topical tacrolimus to treat a cutaneous manifestation of Crohn's disease.

Introduction Irritant contact dermatitis is a localized inflammatory skin response to various chemicals, metals and other physical agents. Irritant contact dermatitis is not immune related, rather it is a direct result from the cytotoxic effects of the agents. The irritation is often described as burning, stinging, or pain. Case Description 11 yo male presents with oral swelling after application of Metal braces. Braces applied and within 5 hours developed pain and discomfort in his mouth. Lip and facial swelling developed the following morning. As the day progressed, gums became white and more painful. No improvement with Benadryl and penicillin. Braces were removed 4 days after application. Plan: Patch test for MET-1000 series Assessment: Patches negative on metal testing. Further evaluation: Patch testing to orthodontic brackets, rubber bands and four different types of adhesives. Assessment: Patch reading positive +++ to # 3 Opal Etch phosphoric acid. Discuss with orthodontist about application with different adhesive. Diagnosis: Irritant contact dermatitis. Discussion Contact dermatitis is a common diagnosis given to patients presenting with rashes and localized swelling. It is important to look beyond the regular testing and have patients bring in their own products as these may be the trigger for their problem.

Extranodal natural killer/T-cell lymphoma (ENKTCL) is a rare form of Epstein-Barr virus (EBV)-associated non-Hodgkin lymphoma (NHL). 1-4 The nose and para-nasal sinuses are the most commonly reported sites of initial involvement. ENKTCL is reported most frequently in East Asian populations and is notably rare in Western populations. The purposes of this case report are to describe an atypical presentation of ENKTCL involving primarily the soft tissues of the midface and to highlight the vigilance required in diagnosing this cause of nonresolving facial swelling.

Rhinoliths are calcified masses formed within the nasal cavity because of the solidification of mucus, debris, or foreign objects by gradual accretion of mineral salts. They are mostly asymptomatic and incidentally diagnosed, although some patients may complain of nasal discharge and obstruction. Ulceration of the nasal mucosa, facial swelling, and bone destruction are less frequently observed but bring about difficulties for differential diagnoses with several pathologic entities. This article presents a case of a 54-year-old woman with a rhinolith causing palatal perforation, focusing on the diagnostic process and histopathologic characteristics.

Summary We report a case of a 12-year-old boy who presented with a 1-year history of left facial swelling. During surgical exploration of the parotid gland, a plexiform schwannoma of the facial nerve was discovered. Subsequently other features of neurofibromatosis type 2 (NF2) were unravelled—bilateral intracanalicular facial schwannomas, and ependymoma of the spine. We detail the course that led to achieving this extremely rare association. This is the eighth case of plexiform schwannoma associated with neurofibromatosis type 2 reported to date, the first ever to involve a cranial nerve, and the third to present in the pediatric population.

Purpose : This paper is intended as an investigation of the relationship between preoperative findings and short-term outcome in third molar surgery. Material and methods : We assessed 153 consecutive surgical extractions of mandibular third molars performed in 140 patients between April 1998 and March 2001. Results : Fifty-four (35%) of the 153 extractions were performed in male subjects and 99 (65%) in female subjects. The median age was 27 years. The amount of facial swelling varied depending on age and sex. Severe pain was associated with depth and preoperative index of difficulty. Average pain was associated with preoperative index of difficulty. Conclusion : In conclusion, we consider that the short-term outcomes of third molar operations (swelling and pain) differ depending on patients’ characteristics (age and sex) and preoperative index of difficulty. Further mega-trial studies of the association between preoperative findings and short-term outcome will help to elucidate the true nature and magnitude of the association.

A new generation lightweight, hand-held, laser surface scanner (FastSCAN™) was validated and clinically evaluated for the assessment of postoperative facial swelling. The potential sources of error—scanner error, registration error, and repositioning and movement error were established for laser scans of a mannequin head and seven volunteers. For the mannequin head the mean (S.D.) volume of the simulated swelling was 12.5 (0.5) cm3. The measurement error was therefore about 4%, and reflected the error in scanned data and in surface registration. Among the volunteers, repositioning of the head introduced additional errors of up to 7.6 cm3 (mean 1.8 cm3), illustrating the additional influence of variable positions. We then scanned 20 patients (9 women and 11 men, age range 18–26) before and 2 days after, third molar removal. The external, facial soft tissue volume changes were calculated for both left and right sides (range 0.2–64.3 cm3). The main source of inaccuracy was again variability of position. Despite this, the FastSCAN™ proved to be a simple, accurate, and non-invasive method of measuring postoperative changes in volume in the external, soft tissues of the face. Minimising variability in position by using more precise positioning techniques will increase the accuracy of this technique and is a focus for future work.

We describe an 8-year-old boy who presented with severe facial swelling. This progressed rapidly and 17 months later he died of gastrointestinal and pulmonary infections. The diagnosis was initially brown tumour associated with hyperparathyroidism, but this was revised in the light of laboratory investigations that were within the reference ranges, and normal appearance of the parathyroids on exploration to that of an extreme case of cherubism that behaved in a locally aggressive manner.

Dentigerous cysts are the most common developmental odontogenic cysts of the jaw, arising from impacted, embedded or unerupted teeth. We report the case of a Thirteen year-old girl with painful anterior left-sided facial swelling, diagnosed with infected dentigerous cyst in relation to impacted canine , who successfully underwent enucleation under G.A.

Cholesteatoma of the paranasal sinuses is a rare condition. The purpose of this paper is to present a child with a congenital maxillary sinus cholesteatoma. An 18-month-old girl presented with a 4-week history of right cheek and intraoral swelling. Examination revealed a smooth swelling of the right hard palate in association with the facial swelling in the maxillary region. An inferior meatal antrostomy revealed pultaceous debris in the right maxillary antrum and biopsy confirmed a maxillary sinus cholesteatoma. The inferior meatal antrostomy was enlarged to allow exteriorisation of the disease. Recurrence of the disease has not presented on follow-up. An exteriorisation procedure as performed, in child of this age, allows normal facial growth. If recurrence develops then further treatment may be instituted in a more mature facial skeleton.

An 8 1/2-year-old with chronic but fluctuating unilateral facial pain, earache, frontal headache and facial swelling is presented. Her journey through the health care system provides an instructional lesson for all who deal with patients with unusual or difficult to recognize conditions.

The insertion of a small surgical tube drain with primary wound closure (drain group) was compared to a simple primary wound closure (no drain group) after removal of impacted third molars. Surgery was performed on 23 patients in a randomized cross-over fashion. The operation time was found to be significantly longer and mouth opening significantly wider in the immediate postoperative period in the drain group subjects as compared to the no drain group (Por = 0.01). There was no significant difference in the severity of pain between the two groups. Facial swelling was found to be significantly less in the drain group subjects (Por = 0.01). The number of patients with wound breakdown, edema, and bleeding was found to be less in the drain group than in the no drain group. Thus, the postoperative problems, in general, were less in the small surgical drain group as compared to the no drain group.

Fibrous dysplasia (FD) in the paranasal sinuses is uncommon, and its management may be difficult. We report the case of a 25-year-old female with FD exhibiting a cystic appearance in the maxillary sinus. The patient had been complaining of facial swelling for few years. Imagery study showed a cystic lesion and dense bone changes in the maxillary bone. Inferior meatal antrostomy with a nasal endoscope failed to confirm a histological diagnosis. After a 3-year follow-up, the degree of facial swelling was unchanged, and the patient underwent middle meatal antrostomy and was diagnosed with FD.

A case is reported in a 15-year-old white girl who had a swollen lower face and lips; a diagnosis of orofacial granulomatosis was made. It was suspected that her condition had an allergic basis because an increase in clinical signs and symptoms was shown to be related to the food additive monosodium glutamate. Treatment with a restricted diet resulted in resolution of the facial swelling.

This paper describes the case of a primary cutaneous T-cell lymphoma (CTCL) which presented on the cheek of a 69-year-old man. Contemporary theories of the pathogenesis and immunologic basis of CTCL are discussed along with recent advances in its diagnosis, classification, and treatment.

A 10-week-old female infant presented with a right-sided facial swelling without any constitutional symptoms. The swelling was nontender, nonfluctuant, with no erythema or induration. On the basis of the clinical picture, magnetic resonance imaging findings and serology, a diagnosis of unilateral mumps parotitis was made. The United Kingdom is currently experiencing a mumps epidemic with a 28-fold rise in the number of cases over the last 10 years. Infants are being increasingly affected. Mumps parotitis, which was previously unreported in infants, needs to be considered as part of the differential diagnosis when a small child presents with swelling of the parotid gland.

without other hypermethabolic alterations. Initial medical management consisted of pain relief medication and corticotherapy with quick symptomatic relieve. At present, the patient is undergoing chemotherapy. Discussion: SVCS is considered an emergency, however, its presentation is rarely an acute life-threatening event. As the effectiveness of therapy depends on underlying disease, considering the definitive diagnosis may be more important than the actual care when making therapeutic decisions. Conclusion: Facial swelling and respiratory complaints are frequent symptoms in Emergency Department patients. They requires quick and complex diagnostic evaluation including differential diagnosis of SVCS. The malignant cause of SVCS should be always considered even in younger patients.

Introduction Patients that are being seen by Oral/Maxillofacial surgeons for treatment of Oro/facial swelling (abscess) with dental origin under local anesthesia, are being seen for 2 or 3 visits. First visit for Incision & drainage and placement of drain, second visit for the eradication of source of infection (extraction of infected tooth), sometime 3rd visit become necessary due to patient discomfort and pain, and percentage of patients even do not return for extraction. Purpose This clinical study fully discussed this new technique for the treatment of Oro/facial abscess, for this purpose, to reducing patient, pain, discomfort, anxiety, time and numbers of visit and decreasing the cost of treatment. Method This procedure is based on clinical experience and was developed and led to completion over the years, will discuss and differentiate the kind of local anesthesia, anesthetic agent, and vasoconstrictors and its relationship to the existing pathologic and anatomic condition of our operative field and nature of our surgical procedure that we want to perform. Result This procedure will allow us to eliminate the source of infection immediately and improve the systemic health of patient as soon as possible, as a result long term antibiotic and analgesic therapy will not be necessary and patient will be able to resume his or her routine daily life. Conclusion Reviewing the history of medicine will manifest this fact, that service to people and helping the suffering patients has been the goal of clinicians and medical experts from ancient days, however these days, the cost of medical care and economy are interconnected and inseparable parts and commodity. This procedure provide us with an opportunity and a tool to help patient and medical establishment and health organizations economically.