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Capturing three-dimensional (3D) imaging is essential in the broad field of cranio-maxillofacial surgery. Laser scanners and stereophotogrammetry are more and more relevant for capturing (facial) soft tissues. For this purpose, a 3D laser scanning imaging system, using a nonhazardous laser, with a precise texture reproduction and in some models with colour capturing, can replace 3D imaging with radiation in many cases. This chapter gives an overview on the different applications of laser scanning in maxillofacial surgery. The following topics will be pointed out: the method of laser scanning; the laser scanning of plaster models, impressions and skull models; the laser scanning for oral surgical planning and for the assessment of facial swelling after oral surgery; the laser scanning of malformations; the laser scanning in facial aesthetics and epithetic procedures; and the laser scanning in orthodontic treatment and orthognathic surgery. 3D laser scanners are still commonly used, but recently other devices, often based on stereophotogrammetry or 3D camera systems, became often superior. Due to shorter acquisition times, these systems are less vulnerable to motion artefacts and, thereby, more suitable for capturing small children or less cooperative patients.

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.

The aim of this study was to evaluate the effect of phototherapy on bite force, facial swelling, mandibular movements, and pain in patients having undergone surgical treatment for mandibular fractures.These are among the predominant types of facial fractures, and treatment involving surgical fixation with titanium plates is one of the most common procedures in oral-maxillofacial surgery. Phototherapy has been used to accelerate the muscle healing process and significantly improves muscle regeneration by inducing the formation of new muscle fibers.The patients were divided into two groups: Group 1-active phototherapy, and Group 2-sham phototherapy. Both groups underwent the surgical procedure by the same surgeon using the same surgical technique. Dosimetric parameters are wavelength, 660 nm; power, 108 mW; radiant energy, 21.6 J; fluency, 21.6 J/cmThe primary variable was bite force measured with a gnathodynamometer and the secondary variables were facial swelling, mandibular movements (measured with digital calipers), and pain. The Student's t-test was used to determine intergroup differences.The findings suggest improvements in the laser group in comparison with the sham group with regard to mandibular dynamics, a reduction in postoperative facial swelling, a reduction in pain, and an increase in bite force.

Abstract: A 15-month-old male was admitted to hospital with a facial swelling of unknown origin which was of rapid onset over three hours, resulting in airway occlusion and septic shock. Ultimately, the swelling was found to be of odontogenic origin and was managed with high dose intra-venous antibiotics. Cellulitis of the face can be life-threatening and it is important to be aware of the clinical signs and ensure that the patient receives appropriate care to prevent deterioration. CPD/Clinical Relevance: It is essential for dentists in primary and secondary care to recognize and understand how to manage or refer a patient with facial cellulitis, and also for medical teams to seek prompt dental input in cases of facial swelling with a possible dental cause.

Ameloblastoma is a benign odontogenic tumor characterized by slow growth causing painless facial swelling. The tumor can behave locally aggressively, and may have direct destructive effects on the surrounding soft and hard tissues. This paper reports the unique case of a female patient with giant ameloblastoma of the mandible. Computed tomography (CT) revealed an enormous swelling of the left side of the face, resorption of the affected hemi-mandible, left maxilla, and tissues of the temporal, infratemporal, and pterygopalatine fossae. Pressure from the tumor resulted in displacement and destruction of the facial skeleton, upper aero-digestive tract structures, and some structures of the neck. The patient was treated by radical hemimandibulectomy with removal of the tumorous mass. Precise knowledge of the anatomical structures, and their locations and topographical relationships is required in the diagnosis and treatment plan for each surgical procedure in cases of giant ameloblastoma. CT imaging can be used to determine the extent and exact location of the lesion, revealing other important details that may help in selecting appropriate treatment.

Hereby, we report a case of a 75-year-old man who presented with a 3-day history of facial swelling and choking sensation. The only history of note was an insect bite on the left parotid gland area 3 days prior. The patient was later diagnosed with insect-bite-induced Ludwig’s angina. Enterococcus faecalis was detected on blood cultures and was presumed the source of infection. Intravenous antibiotics and corticosteroids were initiated. The patient was intubated and was subsequently made to undergo a tracheostomy insertion to establish a definitive airway. He was admitted to the intensive care unit and when his condition improved, he was transferred to the ward for full recovery. The patient spent a total of 66 days in hospital before being discharged. This case suggests that Ludwig’s angina can be caused by insect bites. However, further similar cases are needed to be documented to explore this theory.

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.

A 4-year-old boy presented with a lifelong history of nasal obstruction, mouth breathing and snoring. His parents denied any associated rhinorrhoea, sneezing, facial pain, facial swelling, epistaxis, epiphora or sinus infections. Skin prick testing was negative for all environmental allergens. On

Dogs have bad breath. But when Montana sheep rancher Katy Harjes noticed her collie, Hoshi, had particularly bad breath and facial swelling, she was concerned that the symptoms might be a sign of something serious. She was right; ten-year-old Hoshi had squamous cell carcinoma, a common type of oral tumor found in dogs. The cancer had not metastasized, but the damage was extensive enough that part of Hoshi's lower jaw needed to be removed. Luckily, Hoshi was a suitable candidate for a stateof-the-art bone regrowth procedure developed by Frank Verstraete, B.V.Sc, Dr.Med.Vet., M.Med.Vet., and Boaz Arzi, D.V.M., oral surgeons at the University of California (UC), Davis, School of Veterinary Medicine. Consequently, Katy and Hoshi embarked on a 15-hour road trip to California.

Dupilumab is a relatively new and quite effective medication for recalcitrant atopic dermatitis in patients over 6 years of age. Here, we present a 12-year-old girl with progressively worsening episodic facial swelling and erythema while treated with dupilumab. This case highlights the possibility of angioedema as an adverse effect of dupilumab treatment.

Introduction/Objective Kaposi’s sarcoma (KS) is the most common malignant vascular tumor in human immunodeficiency virus (HIV) patients caused by human herpesvirus 8. It can affect the vascular endothelium of any part of the body however ocular KS as an initial manifestation has been reported only in 3 cases so far. It affects the vascular endothelium of the lacrimal gland, eyelids, orbit, palpebral and bulbar conjunctiva. It presents as a violaceous fleshy nodular mass. Methods A 23-year-old male with a past medical history of HIV presented with bilateral eye erythema and significant upper and lower lid edema. The patient was initially admitted for facial swelling which led to a conjunctival biopsy and a diagnosis of KS was made and doxorubicin along with chemotherapy was started. Four months later after the initiation of chemotherapy, the patient experienced worsening of facial swelling, and an area on the left side of his face got very firm. His physical examination was positive for a fever, drooling, facial swelling with trouble swallowing, and change of voice along with shortness of breath. Results CT of the orbit revealed symmetric enhancement swelling of the preseptal periorbital soft tissues which was thought to be nonspecific and a differential diagnosis included lymphedema, acute sinusitis, and orbital cellulitis was considered. A chest x-ray revealed bilateral pleural effusions and CT head revealed diffuse scalp and facial cutaneous and subcutaneous edema. Lab findings were significant for a low CD4: CD8 ratio. Cytological examination of the pleural fluid revealed predominantly blood, reactive mesothelial cells, macrophages, neutrophils, and lymphocytes, and appropriately controlled immunostain was positive for ERG and HHV8 with a possibility that Kaposi’s sarcoma cannot be completely excluded. Unfortunately, the patient passed away during the same time of pleural fluid analysis. Autopsy findings revealed multiple metastatic foci in the mediastinal soft tissue, within the right land left lung, scalp soft tissue, retroperitoneal soft tissue, and hilar lymph node which were positive for CD34, CD31, and HHV8 and consistent with metastatic KS. Conclusion Thus, it is important to keep in mind that isolated conjunctival KP with later on systemic metastasis is rare with conjunctiva being an unusual site for the initial presentation, and a possibility of primary conjunctival KS should be considered in HIV positive patients.

Parosteal osteosarcoma is a rare, slow-growing tumor most commonly arising from the surface of long bones. Tissue or histological sections from 5 dogs and 1 cat with zygomatic arch masses were examined. Clinical presentations varied from chronic sneezing to facial swelling. Imaging consistently demonstrated osseous proliferation in the area of the zygomatic arch. Histologically, the masses were characterized by well-differentiated fibro-osseous and chondroid components that radiated outward from the periosteum of the zygomatic bone. Cellular atypia and mitotic figures were uncommon. Parosteal osteosarcomas have previously been reported in the skulls of dogs and cats, but only 1 has been reported on the zygomatic arch. Initially, these tumors are of low histologic low grade, but with time, they can show more aggressive behavior and invade the underlying bone.

Aim The aim of this study is to evaluate the efficacy of sublingual piroxicam as a preemptive analgesic agent in patients undergoing single implant surgery. Materials and methods This was a prospective triple-blind placebo-controlled trial that involved 40 patients presented for the placement of a single endosteal implant in the posterior maxillary arch. Patients were randomly allocated to one of the following groups. Group I (study) who received sublingual piroxicam 40 mg 1 hour prior to the surgical procedure and group II (control) received placebo 1 hour before the surgery, both the groups received sublingual piroxicam 20 mg tablet twice a day on the first and the second postoperative day and once a day on the postoperative day 3. Visual analog scores for measuring pain intensity were assessed at postoperative 1 hour, 6 hours, days 1, 3, and 5. Facial swelling was measured and evaluated during the first, third, and fifth postoperative days using the digital vernier caliper. The Mann-Whitney U test was used to make between-group comparisons. The Wilcoxon-signed rank test was used to make within-group comparisons. Results At all-time intervals, both mean pain and mean swelling scores were higher in controls as compared with those of cases. The difference between the two groups was also statistically significant at all-time intervals for both parameters except for pain at 1 hour. Conclusion Our findings suggest that preoperative sublingual piroxicam is more effective for controlling postoperative pain and swelling after surgical implant placement than only postoperative administration.

A full-term male newborn presents with a large hemifacial swelling extending from the frontal region to the mandibular region, encroaching on the orbit and displacing the pinna. (Figs 1 and 2) Figure 1. Large hemifacial swelling on the right side of the face displacing the pinna. Figure 2. Swelling encroaching on the orbit. ### Prenatal and Birth Histories ### Presentation At birth, the infant was noted to have a hemifacial swelling over the right temporal area. Investigations showed persistent thrombocytopenia, and the lowest platelet count was 51 × 103/μL (51 × 109/L). No platelet transfusion was required before transfer. The infant was referred 9 days after birth to our institution for further management. ### Vital Signs (Day 9) ### Physical Examination (Day 9)

Dermatophilosis has been described in many animals since it was first reported in 1915. In 2010, the genus and species associated with chelonid dermatophilosis was reclassified as Austwickia chelonae. Here we discuss a series of four submissions consisting of eight juvenile African spurred tortoises (Geochelone sulcata) from a large breeding facility. Submissions began in December 2016 and continued to June 2017 and then again in November 2018. Clinical signs were originally noted in December of 2015 and consisted of facial swelling and mandibular necrosis that led to complete disarticulation of the mandibles from the skull. Affected animals were emaciated with minimal gastrointestinal contents and several had soft faeces. The facial and head lesions were caused by A. chelonae. Additionally, co-infection with Cryptosporidium ducismarci was discovered within the small intestine. This report gives information on the pathology and pathogenicity of A. chelonae and characterizes the first reported cases of cryptosporidiosis in African spurred tortoises.

Objective: Local anesthetics are the most effective drugs available for the management of pain while performing operative procedures. This study was performed to compare the clinical efficacy of treatment with local anesthetic articaine (4%) with ketamine and local anesthetic articaine alone (4%) for the relief or prevention of postoperative pain, swelling, and trismus after the surgical extraction of impacted mesioangular third molars. Materials and Methods: Sixty patients undergoing the extraction of impacted mesioangular mandibular third molars were included in the study. The patients were randomly divided into two groups: local anesthetic alone (LAA) and local anesthetic plus ketamine (LAK). Results: Facial swelling following surgery on postoperative days was significantly lower in the LAK group than in the LAA group on 3rd and 7th postoperative days (P < 0.05). Mouth opening on the postoperative days was significantly greater in the LAK group than in the LAA group on 3rd and 7th postoperative days (P < 0.05). The pain scores on the visual analog scale at 30 min and 1 h, 4 h, 12 h, and 24 h after the surgery were significantly higher in the LAA group than in the LAK group and there was no significant difference in heart rate, oxygen saturation, and blood pressure in both the groups. Conclusion: In this present study, the effect of articaine with ketamine in comparison with articaine alone intraoperatively and postoperatively was observed, and it revealed that the combination of articaine with ketamine produced good local anesthesia and provide good postoperative analgesia with less swelling and significantly less trismus.

BackgroundA previously well 15-year-old girl presented with a 2-month history of facial swelling that progressively worsened to involve the neck. There was associated dyspnoea, orthopnoea, headache and throat discomfort. Two weeks before presentation, the patient had an episode of fever for 5 days. On examination, vital signs were within normal limits. Swelling, plethora and venous distension of the face and neck were apparent (figure 1).Figure 1(A) Patient before the onset of symptoms. (B) Patient at presentation.QuestionsWhat is the most likely diagnosis?Superior vena cava syndromeAngioedemaAnasarcaDiphtheriaDescribe the chest X-ray (figure 2).What are the acute concerns?What investigations would you order?Figure 2Chest X-ray of the patient at presentation.Answers can be found on page 02.

There are few reports describing suture periostitis (SP) in horses. This case series outlines the clinical, radiographic and histologic features of SP and compares various types of treatment in 15 horses presented to the Equine Clinic, Vetsuisse-Faculty, University of Zurich. Overall, the incidence of horses with SP presented to our clinic was low, and clinical signs were similar to those previously reported. Radiography was used to diagnose SP, but computed tomography was the imaging modality of choice for determining the extent of the bony changes and the suture lines affected. Horses that underwent surgical stabilization had more rapid resolution of signs than those treated conservatively or not treated at all.

A young lady presented with painful swelling, erythema, and tender nodules at the sites of previously injected filler. The given history, along with the clinical presentation and the distinctive histology of the lesion, confirmed the suspected diagnosis.

Partial hemifacial hyperplasia is a rare congenital malformation characterized by prominent unilateral overdevelopment of some of the hard and soft tissues of the face. This uncommon diagnosis should be considered while examining facial asymmetry. We report a case of slowly enlarging right facial swelling which turned out to be enlarged zygomtic arch. Complete evaluation led us to believe continued condylar hyperactivity as the underlying reason for worsening deformity. We offer an explanation for the same. Minimal surgical intervention led to significant aesthetic improvement which was patients main concern.

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.

Background Cutaneous lymphomas (primary and secondary lymphomas involving the skin) are a heterogeneous group with various clinical manifestations, histological features, and prognoses. Methods We describe eight cases of cutaneous lymphoma presenting with facial swelling. Results Our case series included three cases of primary cutaneous extranodal natural killer/T-cell lymphoma, one case of secondary cutaneous extranodal natural killer/T-cell lymphoma, one case of subcutaneous panniculitis-like T-cell lymphoma, one case of cutaneous CD4+ small/medium pleomorphic T-cell lymphoma, and two cases of peripheral T-cell lymphoma (unspecified). Conclusions This collection of cases and literature review emphasizes the need for clinical suspicion of cutaneous lymphoma in the differential diagnosis of patients with refractory facial swelling.

Frontal sinus fractures (FSF) are relatively uncommon and can be challenging for trauma surgeons to manage. Patients with FSF typically present with facial swelling, pain, and nasofrontal ecchymosis. Here we present a rare case of a patient with FSF and anterior table fracture where the main presenting symptom was bilateral frontal paralysis. We outline our management strategy and review the current literature in regard to management of FSF.