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A 37-year-old man with no known comorbidities presented to our department with complaints of left eye proptosis and diminution of vision for 1 month and left facial swelling for the past 2 years. He underwent left-sided nasal surgery thrice—functional endoscopic sinus surgery (FESS) in 2018

A 53-year-old man presented to the accident and emergency department with sudden onset left-sided facial nerve palsy and a 4-day history of progressive bilateral facial swelling. There is no history of any previous medical conditions, trauma or recent travel. What is the most likely Diagnosis seen in figures 1 and 2? 1. Bell’s Palsy. 2. Stroke. 3. Vasculitis. 4. Parotid abscess. For question see page 02 Figure 1 Patient presentation with bilateral facial swellings and facial nerve palsy. Figure 2 Clinical findings when …

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.

Background:\ud \ud Oral swellings can be attributed to various causes, both odontogenic and non‐odontogenic in nature. This paper will discuss a buccal swelling caused by a haematoma.\ud \ud Case presentation:\ud \ud A 76‐year‐old edentulous male patient presented to a dental student outreach clinic with a three‐day history of a right‐sided facial swelling. No dental cause could be confirmed and so the patient was referred to the local secondary oral surgery department. The patient was examined, and an ultrasound of the swelling was arranged on the same day. The swelling was aspirated, and a haematoma was deemed the likely cause. After aspiration and a course of antibiotics, the swelling reduced rapidly. Blood tests were undertaken, and no underlying cause could be identified.\ud \ud Conclusions:\ud \ud Although uncommon, haematoma should be considered within differential diagnoses when dental pathology has been ruled out. A course of antibiotics is indicated where symptoms appear consistent with a systemic infection and timely referral to local dental hospital services is recommended. Blood tests should be requested to identify any undiagnosed coagulopathies or platelet abnormalities and liaison with local haematology services if resolution is not achieved would be appropriate.

COVID-19 became a pandemic with a worldwide impact leading to stay-at-home orders, death, economic difficulties, and a significant influence on daily lives. Dental services became limited at this time, causing increased concerns for patients requiring urgent dental care. We report the case of a 5-year-old previously healthy male who presented to our hospital’s emergency department (ED) with facial swelling secondary to infected maxillary left molars. Extractions were performed in the ED with moderate sedation. He was later found to be COVID-19 positive before admission for intravenous antibiotics. The use of universal precautions during the pandemic in treating patients with possible COVID-19 symptoms and in aerosol-generating procedures is recommended. Evaluating and providing treatment to our patients with urgent dental care should not be delayed to prevent further complications and decrease the burden placed on the ED, which may be limited in its ability to provide definitive care.

Carcinomas of the maxillary antrum are rare and tend to present late, leading to poor survival rates. Two-thirds of cases will present with oral symptoms or facial swelling. Dentists should be aware of suspicious clinical and radiographic signs, which may help in early detection and treatment. We present the case of a 48-year-old female complaining of facial swelling. In preceding months, she had visited her GP and dentist numerous times, receiving antibiotics from each for suspected sinusitis and a dental abscess, respectively. Subsequent investigations confirmed an SCC of the right maxillary antrum, which unfortunately, could only be treated palliatively. CPD/Clinical Relevance: The reader should understand the classic findings for a maxillary antrum carcinoma. They should also increase their confidence and awareness in identifying red flag signs and symptoms.

The following is a case report of a 17-day-old female baby, born at 35 weeks' gestation, weighing 2.6 kg. She was brought to us with reluctance to feed, swelling over the left side of her face and a fever documented at 102oF, along with an erythematous, tender, localised swelling over the left pre-auricular region that measured 2 x 1.5 cm in size. Diagnostic workup and ultrasound findings were consistent with parotitis; however, her blood culture was negative. The patient was managed on antibiotics but subsequently, developed a nosocomial infection while she was admitted in the hospital, which prolonged her hospital stay to a total of 16 days. Nevertheless, she had complete resolution of the signs and symptoms on her follow-up visit. Acute parotitis should be considered in the differential diagnosis of a neonate presenting with facial swelling, reluctance to feed or incessant crying. Timely and appropriate management can result in good recovery and minimising the potential for complications.

INTRODUCTION: Adverse events associated with vaccine administration can manifest in the oral cavity and orofacial region. Hence, the aim of this study was to compare the orofacial adverse effects of two recently authorised COVID-19 vaccines, namely BNT162b2 and mRNA-1273. METHODS: Publicly available data on BNT162b2 and mRNA-1273 vaccines were accessed from the relevant regulatory authorities in the United States, Canada, European Union and United Kingdom. Both patient/recipient information and healthcare professional fact sheets for each of these drugs were manually searched to find their orofacial adverse effects. RESULTS: Adverse events affecting the orofacial region were reported for both vaccines. These were rare and included acute peripheral facial paralysis (Bell's palsy), facial swelling, and swelling of the lips, face or tongue associated with anaphylaxis. There was heterogeneity in the acknowledgement of vaccine-related adverse events in North America compared with Europe. CONCLUSION: Globally, there are inconsistencies in the description of adverse effects presenting in the orofacial region of the COVID-19 vaccines BNT162b2 and mRNA-1273. We believe that awareness of these orofacial manifestations will improve recognition, management and reporting of vaccine-related adverse effects.

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.

Background Rhinofacial entomophthoramycosis is a specific fungal infection of the skin and subcutaneous tissue. It is considered as a rare and neglected disease in tropical and subtropical areas. We would like to present our cases to aid other physicians in the improved recognition of typical cases. Materials and methods A retrospective review was performed on patients with the diagnosis of Conidiobolomycosis or Entomophthoramycosis in Chiang Mai University Hospital, Thailand, from January 2009 to May 2019. There were seven cases with a definite pathologic report or culture in this review. Results All seven patients were men and were referred to the university hospital for diagnosis. The mean age was 53 ± 15.7, ranging from 27 to 71 years. Most of the patients (85.7%) presented first with nasal or rhinofacial swelling and nasal obstruction. The definite diagnosis came from clinical presentation and investigation with a tissue biopsy, culture and communication among physicians. Patients responded well with a combination of medical treatment, including potassium iodide (KI), co-trimoxazole, or itraconazole. Conclusion Rhinofacial entomophthoromycosis or Conidiobolomycosis typically can be diagnosed under a suspicious clinical presentation. The obvious clinical response can be seen within several weeks after medication., Highlights • Rhinofacial entomophthoramycosis or Conidiobolomycosis is uncommon disease, but commonly presented with facial swelling. • Typical clinical presentations were demonstrated to help other physicians in the improved recognition and diagnosis. • This is a disease that once known, will not be forgotten.

Background The purpose of this publication is to report on the six-month clinical results and patient reported outcomes (PROs) comparing the surgical use of the Er,Cr:YSGG laser (ERL) and minimally invasive surgical technique (MIST) for the treatment of intrabony defects in subjects with generalized periodontitis stage III, grade B. Methods Fifty-three adult subjects (29 females and 24 males; 19 to 73 years) with 79 intrabony defects were randomized following scaling and root planing (SRP) to receive ERL monotherapy (n = 27) or MIST (n = 26). Recession (REC), probing depth (PD), clinical attachment level (CAL), treatment time, and PROs were assessed and compared for each treatment group. Clinical measurements were recorded at baseline, 4-6 weeks following SRP, and six months following surgical therapy. Results The following primary and secondary outcome variables were non-inferior with the following margins: CAL with a non-inferiority margin of 0.6 millimeters (mm). (p = 0.05), PD with a non-inferiority margin of 0.5 mm. (p = 0.05), Recession with a non-inferiority margin of 0.4 mm (p = 0.05). Faster procedure times were found for ERL (16.39 ± 6.21 minutes) vs MIST (20.17 ± 5.62 minutes), p = 0.0002. In the first two to three days of post therapeutic diary outcomes, subjects reported less bruising, facial swelling, and use of Ice pack for the ERL group. Conclusions This is the first multicenter, randomized, blinded, and controlled study demonstrating the Er,Cr:YSGG laser is not inferior to MIST in terms of clinical outcomes but is superior in PROs for the surgical treatment of intrabony defects. This article is protected by copyright. All rights reserved.

There are a wide variety of inflammatory, infectious, and cystic lesions which may lead patients to seek acute care for facial swelling. Computed tomography (CT) has become the mainstay for imaging in the urgent/emergent setting. However, magnetic resonance imaging (MRI) can also serve as a powerful problem solving tool in the modern era. As volume continues to increase, a wide variety of facial pathology will be encountered by the emergency radiologist. Recognition of both common and uncommon pathology will assist in diagnosis and value-based care. This article serves as an image-rich review of the many causes of facial swelling with an emphasis on key imaging findings and possible complications.

A 35-year-old female with pulmonary arterial hypertension (PAH) who presented with complaints of progressively worsening dysphagia, facial swelling, and shortness of breath, was found to have a large goiter. In patients treated with epoprostenol for long periods of time, thyroid disease is common. Most cases of thyroid disease describe thyrotoxicosis and hyperthyroid statues, but our case was a patient on long term IV epoprostenol presenting with a superior vena cava-syndrome (SVC) like appearance and airway compromise found to have a goiter incidentally during workup.

Aim The report is about diagnosis, therapy, and follow-up of a 15-year old boy, who experienced facial swelling and impaired mouth opening after a sport accident. Case report Diagnosis of mandibular damage was delayed due to inadequate clinical investigation and radiography after trauma and only became clear after a parotid swelling occurred sometime later resulting from the dissolution of the upper part of the articular process. Follow-up control over a period of three years showed a partial restoration of the articular process but some inhibition of mouth opening combined with slight deviation of the mandible to the affected side remained over the years. Conclusion This report reminds us that parotid swelling can be the result of mandibular trauma without a recent history of physical injury to this region. Therefore, the basic standards of radiologic diagnosis should be maintained and the limited restoring capacity of the condylar process in adolescence should be acknowledged.

Placing objects in the mouth by children get accidentally implanted in the oral cavity, ingested, or aspirated. The incidence of foreign bodies is usually higher in the zone of head and neck than other regions of the human body. Usually, foreign bodies are symptomatic and signs of inflammation pain and purulent discharge are shown. This paper describes an unusual case of traumatic foreign body (pen cover) accidently moved in the retromolar area causing recurrent facial swelling, purulent discharge, and reduced mouth opening. How to cite this article Gupta G, Gupta DK, Bhat M, et al. Traumatic Impaction of Unusual Foreign Body in a 10-year-old Boy's Mouth: A Case Report. Int J Clin Pediatr Dent 2020;13(4):433-436.

A 7-year-old Thoroughbred gelding presented with a history of mild unilateral right-sided epistaxis and facial swelling over the right caudal maxillary sinus and zygomatic arch. Eleven months previously a progressive ethmoid hematoma had been surgically removed from the right caudal maxillary and conchofrontal sinus. Computed tomography identified a large expansile soft-tissue attenuating mass in the right caudal maxillary sinus, with protrusion into the conchofrontal sinus, that extended into the zygomatic arch. Lytic expansion and thinning of the cortex with pneumatization of the zygomatic arch was present. The mass was surgically excised after a biopsy had confirmed the recurring progressive ethmoid hematoma.

Osteomas are an uncommon benign neoplasia in horses, which most frequently affect the paranasal sinuses. There are only 25 reported cases in the literature. Clinical signs typically associated with paranasal osteoma formation include nasal discharge, ocular and/or facial swelling and distortion. Historically, surgical excision under general anaesthesia has been the standard approach for the treatment of large osteomas with standing surgery reserved for small masses. This case report describes standing removal of an extensive paranasal osteoma through a maxillary bone flap, without recurrence. Long-term follow up at 2 years confirmed a good cosmetic appearance and successful return to racing.

The differential diagnosis for facial swelling is broad and can be a diagnostic challenge in the pediatric emergency department. We describe the first pediatric case of acute parotitis with sialolithiasis where the diagnosis was facilitated by point-of-care ultrasound.

Introduction: The surgical removal of impacted lower third molars involves trauma to soft and bony tissue and can result in pain, swelling and trismus. The purpose of this study was to evaluate the efficacy of dexamethasone, as a single 4 mg dose injected into the masseter muscle prior to extraction of impacted lower third molars on theses postoperative sequelae. Materials & Methods: This prospective, randomized clinical research consisted of 43 healthy patients. The study group received 4 mg dexamethasone into the masseter muscle via intrabuccal approach immediately before starting the procedure while the control group received no corticoid. 7 days after surgery. Data were analyzed using t-test (α = 0.05). Results: The patients administered dexamethasone showed superior results after surgery in terms of oral aperture, pain and all the facial swelling parameters, with statistically significant differences versus the controls (p value

Background: The aim of this study was to compare the anti-inflammatory effects of prednisolone andetoricoxib after third molar extraction.Method: A prospective, controlled study was conducted on 39 volunteers were allocated in three differentgroups, to receive either 120 mg etoricoxib or 10mg prednisolone 30 minutes prior to the procedure, and alsoa controlled group who didn’t receive any medication pre-operatively.Baseline measurements were obtainedpreoperatively, and subsequent assessments were made on immediate postoperative, at 48 hours and 7 daysafter surgery to measure postoperative facial swelling by use of linear measurements, interincisal mouthopening width and visual analog scale score for pain. The amount of analgesics consumed was recorded.Descriptive statistics were used to compare the two groups at P < 0.05.Conclusion: Considering the results that were obtained upon the efficacy of different pre-emptive medication,Etoricoxib showed statistically significant values in terms of pain reduction and restriction in mouth opening,in the other hand prednisolone showed significance results in terms of edema reduction.

ObjectiveThis paper reports a rare case of a 61-year-old man with sialodochitis fibrinosa.MethodsClinical case report and review of current literature.ResultsSialodochitis fibrinosa is a diagnosis of exclusion and in many cases can be managed conservatively. Conservative management failed for this patient and he was managed successfully with staged bilateral total parotidectomy.ConclusionSialodochitis fibrinosa should be considered as a differential diagnosis of painful bilateral facial swelling. While conservative management is successful for many patients, staged bilateral total parotidectomy may be necessary for full remission of symptoms; the timing of this is crucial to reduce the risk of facial nerve palsy.

Administration of hyaluronic acid (HA) filler for aesthetic lip augmentation is a routine and common procedure with a low rate of adverse reactions. This case report documents an extremely rare complication of lip augmentation with HA leading to the development of lymphangiomas. Lymphangiomas are uncommon hamartomas of the lymphatic system. Although usually congenital, they can be acquired due to trauma, inflammation, or lymphatic blockage. They may be in the deep or superficial tissues, with superficial forms being either lymphangioma circumscriptum or acquired lymphangioma, also referred to as lymphangiectasia. Acquired lymphangiomas are typically formed by blockage of lymphatic drainage leading to dilation of the lymphatic channels. The diagnosis in our case report is acquired lymphangioma. A 27-year-old female presented with a two-year history of linear swellings in her upper lip. These lumps followed the line where HA filler had been injected four years earlier. Hyaluronidase had previously been used unsuccessfully to remove these lumps. The patient was treated with surgery to excise the lesions. Five masses were excised, and histopathological analysis displayed the presence of variably ectatic lacunae, lined by cells with CD34 expression, a lymph-vascular-endothelial marker. There were also scattered macrophages with CD68 expression in the interstices. These are typical features of a lymphangioma. The patient was satisfied with the excellent aesthetic and functional outcome. To our knowledge this is the first case of a lymphangioma following HA lip augmentation. Although rare, this complication can have aesthetic implications for the patient which may require further treatment or surgery to correct.

Any facial swelling is associated with stress for the patient due to cosmesis. Especially when one has bilateral symmetrical enlarged parotids, having exhausted all available conservative management, surgery becomes the last resort; which in such cases pose specific challenges. A 29-year-old man presented with problems of bilateral symmetrical enlarged parotid lesion for 5 years, which did not have an adequate response to medical line of management. He underwent proposed surgery and was diagnosed to have chronic sclerosing parotitis (CSS). The challenges faced during surgery of this non-neoplastic inflammatory lesion, with significant fibrosis, is being described. He recovered completely without any complications related to surgery. CSS rarely affects bilateral parotid glands. Surgery, results of which are outstanding, must be considered in cases where these lesions do not respond to medical line of management. Bilateral total conservative parotidectomy with sternocleidomastoid flap reconstruction provides excellent aesthesis and improves quality of life.

Malignant pericardial sarcomatoid mesothelioma is a massively rare tumor accounting for 0.8% of all cases of mesothelioma. Superior vena cava syndrome (SVCS) occurs due to a partial obstruction or compression to the superior vena cava, which hinders the blood outflow to the upper body. It can be caused by an intrinsic factor such as thrombosis, or by an extrinsic factor such as tumors. Clinical presentation includes edema of the face and upper limbs, plethora, dyspnea, dysphagia, stridor and cough. we are reporting a case of a 56-year-old female, who is a known case of hypertension on angiotensin-converting enzyme inhibitors (ACEIs). Presented to the emergency department with intermittent facial swelling and dyspnea. Imaging and pathology reports confirmed the diagnosis of intermittent SVCS secondary to pericardial sarcomatoid mesothelioma with pericardial effusion. What makes our case unique is that both the etiology and the presenting complaint are rare entities, as most SVCS cases are continuously symptomatic throughout the disease course, and are usually caused by a lung cancer or lymphoma.

Introduction Adverse events associated with vaccine administration can manifest in the oral cavity and orofacial region. Hence, the aim of this study was to compare the orofacial adverse effects of two recently authorised COVID‐19 vaccines, namely BNT162b2 and mRNA‐1273. Methods Publicly available data on BNT162b2 and mRNA‐1273 vaccines were accessed from the relevant regulatory authorities in the United States, Canada, European Union and United Kingdom. Both patient/recipient information and healthcare professional fact sheets for each of these drugs were manually searched to find their orofacial adverse effects. Results Adverse events affecting the orofacial region were reported for both vaccines. These were rare and included acute peripheral facial paralysis (Bell's palsy), facial swelling, and swelling of the lips, face or tongue associated with anaphylaxis. There was heterogeneity in the acknowledgement of vaccine‐related adverse events in North America compared with Europe. Conclusion Globally, there are inconsistencies in the description of adverse effects presenting in the orofacial region of the COVID‐19 vaccines BNT162b2 and mRNA‐1273. We believe that awareness of these orofacial manifestations will improve recognition, management and reporting of vaccine‐related adverse effects.

Postoperative facial swelling after mandibular angle ostectomy is a concern for patients as it affects their quality of life. This study aimed to evaluate the effect of hyperbaric CO2 cryotherapy in relieving postoperative swelling. Thirty-seven patients (mean age: 22.95 ± 3.49 years) who underwent bilateral mandibular angle ostectomy from April to October 2019, were included in this study. A split-mouth design was adopted and through a random sequence, either side of the face was designated as the experimental side. Both received routine nursing care, while the experimental side underwent an additional hyperbaric CO2 cryotherapy treatment. The facial structure was recorded by a 3-dimensional laser scanner pre- and postoperatively. Geomagic Studio was used for alignment, visualization, and quantification of the swelling. The largest deviation value on each side was adopted to assess the overall swelling. Parameters were compared using the paired t-test, and P

Facial swelling has several etiologies. In patients with head and neck malignancies, this can include primary disease progression or iatrogenic causes. A 66-year-old man presented with increased facial swelling and erythema for 18 months. He had a history of baseline postoperative facial lymphedema following head and neck surgery and radiotherapy for desmoplastic melanoma approximately 20 years ago. However, his facial edema acutely worsened 18 months prior to presentation. A medication review revealed that he was regularly taking melatonin for the past two years. Approximately two weeks after cessation of melatonin therapy, the patient's facial appearance returned to baseline. In conclusion, it is important for clinicians to perform a thorough medication review for patients with facial swelling and erythema.

Background We investigated the efficacy of a maxillary Jackson-Pratt (J-P) suction drain for preventing maxillary sinus hematoma and facial swelling after maxillary Le Fort I osteotomy (LF1). Methods We retrospectively evaluated 66 patients who underwent LF1 at a single institution. Of these, 41 had a J-P suction tube inserted in the mandible and maxilla (maxillary insertion), and 25 had a J-P drain inserted in the mandible only (no maxillary insertion). Facial CT was obtained before and 4 days after surgery. We compared mean midfacial swelling and maxillary sinus haziness by t test and examined correlations between bleeding amount and body mass index (BMI). Results For the maxillary-insertion group, the ratio of total maxillary sinus volume to haziness (57.5 ± 24.2%) was significantly lower than in the group without maxillary drain insertion (65.5% ± 20.3; P = .043). This latter group, however, did not have a significantly greater midfacial soft tissue volume (7575 mm3) than the maxillary-insertion group (7250 mm3; P = .728). BMI did not correlate significantly with bleeding amount or facial swelling. Conclusions Suction drainage in the maxilla reduced maxillary sinus haziness after orthognathic surgery but did not significantly reduce midfacial swelling.

This 79-year-old woman with sarcoidosis presented to the ENT (ear, nose and throat) outpatient service with increasing unilateral right-sided facial swelling and nasal obstruction, as shown in [figure 1][1]. Four years previously she had been treated for unilateral sinus disease on the right, and

Angioedema resulting in oral and facial swelling with possible airway compromise can be either hereditary or acquired. Hereditary angioedema is an autosomal dominant disease and results from an inh...

Immunoglobulin G4-related disease (IgG4-RD) is a new disease entity of rare and complex immune-mediated fibroinflammatory conditions that can affect any organ. The concomitance of IgG4 sclerosing sialadenitis and dacryoadenitis with rhinosinusitis is extremely rare. We report a case of IgG4 sclerosing sialadenitis and dacryoadenitis (Mikulicz’s disease) diagnosed in a middle-aged African American man with a long-standing history of chronic rhinosinusitis who presented with progressively worsening bilateral salivary and lacrimal glands swelling. Imaging revealed pansinusitis, symmetric enlargement of the lacrimal glands, parotid glands, and submandibular glands. Serological IgG4 level was significantly elevated and the diagnosis of IgG4 sclerosing sialadenitis was confirmed by histopathology. A robust clinical response in the facial swelling and nasal manifestations was noted after the initiation of immunotherapy with corticosteroids.

Central venous stenosis is a well-recognized complication of central venous catheter use in hemodialysis patients, which may present with significant swelling of the upper limbs, neck, and face. Here, we describe a renal transplant recipient previously on hemodialysis, who underwent endovascular intervention for central venous stenosis after presenting with facial swelling and exertional dyspnoea. His symptoms continued to progress, however, until the underlying thyroid pathology was recognized. Ruling out the possible mimics of central venous stenosis is important in preventing unnecessary intervention. This case highlights the role of specialty bias in the process of diagnosis.

Background Previous studies have investigated the effects of dexamethasone injections into the pterygomandibular space and compared them to those of controls; however, the effects of dexamethasone injections before and after lower third molar surgery on postoperative complications have not been studied. This research investigated the postoperative sequelae of dexamethasone injections before and after surgery into the pterygomandibular space. The aim of this study was to evaluate the effects of preoperative and postoperative injections of 4 mg of dexamethasone into the pterygomandibular space on postoperative pain, facial swelling, and the restriction of mouth opening following lower third molar surgical removal. Methods Twenty-seven participants with bilateral symmetrical lower impacted third molars were included in this study. Each participant was randomly allocated to one of two groups. Group A received injections of 1 ml dexamethasone (4 mg/mL) and 1 mL placebo into the pterygomandibular space before and after surgery, respectively. Group B received the same doses of placebo before surgery and dexamethasone after surgery. Results A significant restriction of mouth opening on the second postoperative day was observed in both groups. Nonetheless, the postoperative restriction of mouth opening, facial swelling, postoperative pain, and analgesic consumption after lower third molar surgical removal were not significantly different in the two groups. Conclusions Regardless of the time of administration, dexamethasone injections into the pterygomandibular space resulted in satisfactory control of the postoperative sequelae of the mandibular third molar surgical removal.

A 54-year-old female with facial swelling for one month who had repeatedly been treated for allergic reaction during multiple emergency department (ED) visits, presented to the ED for the same complaint of facial swelling. Maintaining a broad differential diagnosis was of critical importance to appropriately evaluating the patient and arriving at the correct conclusion for the etiology of the patient’s symptoms. Upon establishing the correct diagnosis, a multidisciplinary approach was used to intervene to provide early treatment without delay.

Inflammatory pseudotumor (IP) is a clinically aggressive but histologically benign condition of unknown cause. It rarely appears in the nasal cavity and sinuses. Here, we describe a 24-year-old female with the main symptom of right nasal obstruction. Examinations showed dilation in the right maxillary sinus and a pale neoplasm in the nasal cavity. The neoplasm was completely excised under endoscope. Postoperative pathology showed significant proliferation of plasma cells and lymphocytes, indicating the presence of IP. No recurrence was found during 20 months of follow-up. Only 28 cases (10 males and 18 females, average 41.04 years) have been reported on Pubmed. The main clinical manifestations were nasal obstruction, epistaxis, facial swelling and pain, eyeball protrusion, diplopia, and other ocular symptoms. Inflammatory pseudotumor always erodes the surrounding bone and requires active treatments. Surgery is the optimal option with a good prognosis.

A five-year-old male presenting with progressive right facial swelling underwent multiple biopsies before being diagnosed with a polyostotic frontal-zygomatic primary intraosseous hemangioma. Intraosseous hemangiomas are rare, more frequently afflict adult females, and very rarely involve the orbit. Our case with bony destruction and surrounding soft tissue mass measured 5.3 cm in a child mimicked a more ominous malignancy. This case is unique with its rapid progression and largest reported size, leading to additional challenges such as difficulty in achieving an adequate tissue sample and in the surgical management with respect to significant blood loss in a small child.

We present a 32-year old woman with a 9-year history of upper facial swelling. A workup by the ophthalmology department led to the diagnosis of Melkersson-Rosenthal syndrome. Re-evaluation in our dermatology clinic confirmed a diagnosis of Morbihan disease. Herein, we review case reports and case series of upper facial swelling in the dermatologic and ophthalmologic literature. Although the two entities share histopathological changes, they tend to have different clinical presentations. Melkersson-Rosenthal syndrome appears to be more likely diagnosed in the ophthalmologic literature when the clinical presentation and histopathology may be more consistent with Morbihan disease. In a patient with upper facial swelling, an absence of orolabial swelling, and lack of facial neuropathy, we argue for a diagnosis of Morbihan disease over Melkersson-Rosenthal syndrome, especially if the patient has a history of rosacea.

A 31-year-old pregnant woman at term, G2P1, is sent from clinic to Labor & Delivery (L&D) because of preeclampsia, with a blood pressure of 180/100, proteinuria, sudden weight gain, a severe frontal headache, and facial swelling. In clinic the week before, her BP had been 118/72 and her earlier blood pressures during pregnancy had all been normal. In the clinic they gave her acetaminophen for her headache, but on arrival in L&D she says that there has been no improvement in her pain.

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.