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A 4-year-old girl presented to a medical clinic with a painless right facial swelling. The treating physician ordered a radiograph of the sinuses and received a report of “maxillary sinusitis.” After appropriate antibiotic treatment, the facial swelling increased, and the mother took the child to her community pediatrician. After a period of observation and additional imaging, the diagnosis of dentigerous cyst was made. After appropriate surgical intervention, the cyst was removed, and over the ensuing 6 weeks the facial swelling gradually diminished. Dentigerous cysts, although uncommon, need to be considered in the differential diagnosis of children with painless 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.

A 31-year-old woman was admitted to this hospital because of rash, fever, and facial swelling that developed after the administration of modafinil for the treatment of fatigue associated with multiple sclerosis. Several hours after admission, chest discomfort and hypotension developed, ST-segment elevation was present on the electrocardiogram, and biomarkers of cardiac necrosis were elevated. Echocardiography disclosed a pericardial effusion and left ventricular dysfunction. A diagnostic procedure was performed.

Background: Advances in three-dimensional technology have enabled applications for the clinical setting to be created and used in routine diagnosis, treatment planning, and patient education. The objectives of this prospective clinical trial were to determine the volume changes associated with facial swelling following orthognathic surgery. Methods: Twelve subjects requiring orthognathic surgery were recruited for the study. Laser scanned images of the subjects were obtained under a reproducible, controlled environment with two laser-scanning devices assembled as a stereo pair. Three-dimensional laser scans were recorded over six time periods, as follows: T1, presurgical scan; T2, 1 day postoperatively; T3, 1 week postoperatively; T4, 1 month postoperatively; T5, 3 months postoperatively; and T6, 6 months postoperatively. Results: The results showed a clinical difference in the mean shell deviations between bimaxillary and single-jaw orthognathic surgery. Furthermore, the results suggest that the mean volume of swelling was reduced by approximately 60 percent within the first month after surgery. Finally, the amounts of swelling following surgery were greater in bimaxillary cases. The recovery in the swelling was also faster in this group of patients. Conclusions: Three-dimensional imaging has opened up new avenues of patient care and treatment evaluation. The results have shown that the laser scanning device and the method described are a reliable and accurate measure of facial swelling following surgery.

Computed tomography was used to evaluate a 7-year-old English bulldog with a history of facial swelling and to aid in the diagnosis of parotid duct sialolithiasis. Removal of the sialolith with repair of the duct was not possible because of ductal fibrosis. Histological evaluation revealed glandular atrophy and fibrosis with lymphoplasmacytic inflammation. The parotid duct was ulcerated and fibrotic, with a mixed inflammatory infiltrate. Surgical excision of the parotid duct and salivary gland was curative.

Endoscopic intranasal dacryocystorhinostomy (DCR) has the following advantages over external surgery: pain and hemorrhage are minimal; postoperative facial swelling and scarring are absent; and symptoms resolve rapidly after surgery. Furthermore, as no significant differences in postoperative results were apparent between external and endoscopic intranasal DCR, and because no facial skin incision is required, the clinical usefulness of endoscopic intranasal DCR is high.In the treatment of nasolacrimal duct obstruction or chronic dacryocystitis in which epiphora or ocular discharge are chief complaints, endoscopic intranasal DCR is a safe, easy, minimally invasive, and reliable approach. In the present study, we describe the surgical procedures, techniques, and results of endoscopic intranasal DCR, and investigate its clinical usefulness.The subjects were 21 patients with nasolacrimal duct obstruction who underwent a total of 24 endoscopic intranasal DCR procedures. Etiologies of the obstruction were, respectively, cryptogenic (62.5%), secondary to partial maxillectomy (16.7%), complication of sinus surgery (12.5%), and due to underlying disease--Wegener's granulomatosis (4.2%) or nasal T-cell lymphoma (4.2%). To assess the clinical usefulness of this procedure, postoperative courses were assessed by reviewing medical records and conducting telephone interviews. In addition, to assess the therapeutic effects, postoperative results were statistically compared to those of external DCR.Closure of the surgical opening was seen in two cases (8.3%). In both cases, after the closed region was opened using an endoscopic procedure, symptoms resolved. Finally, lacrimal passage obstruction was not observed by lacrimal irrigation in any patient. None of the patients in the present study experienced major complications during or after surgery, and since their symptoms improved, the degree of satisfaction was high. When compared to external DCR, endoscopic intranasal DCR showed no statistically significant difference in postoperative results, thus confirming that similar therapeutic effects could be obtained for the two procedures.

Hypothyroidism is known to be associated with muscle pain, weakness, stiffness and mildly elevated muscle enzymes. However, rhabdomyolysis due to hypothyroidism is very rare, especially in the absence of any precipitating factors, such as heavy exercise, alcohol or medication. We report a case of rhabdomyolysis associated with hypothyroidism in a 24-year-old man who presented with choking sensation, generalized lethargy, low backache and facial swelling with markedly raised muscle enzymes which normalized after thyroxine replacement.

It was aimed to investigate the effects of three different local haemostatic agents (oxidized regenerated cellulose, gelatin sponge and collagen sponge) on the facial swelling after surgical removal of impacted the third mandibular molar teeth, in this study. Sixty-six healthy patients (mean age, 21.21±3.14 years) requiring bilateral impacted third molar extractions were included in this double-blind, randomized, controlled clinical study. All teeth were removed bilaterally in the same operation by one surgeon. The left side of the mandible served as the test side for local haemostasis and the right side as the control side in all patients. After removal, the primary closure of surgical wound was provided with silk sutures, in the control side. One of the absorbable haemostatic agents, oxidized regenerated cellulose (ORC), gelatin sponge (GS) and collagen sponge (CS) was placed in the extraction cavities following gauze packing for 5 minutes to prevent bleeding and after that the wound was sutured. Data was collected regarding the operating time, mouth opening, and facial swelling. Facial swelling was measured by "point counting technique" on standard posteroanterior skull radiographs. The comparisons of differences belonging to ORC, GS and CS applications on preoperative and postoperative edema showed that the differences were not statistically significant according to analysis of variance (ANOVA) (p>0.05). This study has shown that the haemostatic local agents do not have any significant effect in the facial edema. © 2015 OMU.

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.

We report an unusual case of Melkersson-Rosenthal syndrome presenting as diffuse facial swelling with facial, glossopharyngeal and vagus nerve palsies. A skin biopsy revealed non-caseating epithelioid cell granulomas throughout the dermis. The disease responded poorly to systemic steroids, antihistamines, antibiotics and potassium iodide.

Subcutaneous cervicofacial emphysema is an entity with the presence of air within the fascial planes of the head and neck, which results from various causes. A case of severe subcutaneous cervicofacial emphysema associated with Munchausen's syndrome is presented. Detailed diagnostic investigations to find out the organic cause of the condition were failed. Episodes of facial swelling were prevented by psychiatric support. Munchausen's syndrome should be kept in mind among the etiological factors of subcutaneous cervicofacial emphysema cases, in whom no organic causes can be found out.

A 57-year-old man presented with a 16-month history of right parotid swelling since undergoing a transoral sialolithotomy of the parotid duct. An ultrasound and a computed tomography scan showed a 6 cm-long dilated parotid duct without evidence of sialolithiasis or tumor mass. The complete Stensen's duct stenosis that was found was managed by a surgeon-performed ultrasound-guided transfacial needle catheterization of the dilated parotid duct, anterograde sialoendoscopy, recanalization of the duct, and stent placement. At 15 month follow-up, the patient reported no recurrent facial swelling or discomfort. Surgeon-performed ultrasound, combined with sialoendoscopy, can provide unique advantages for managing parotid duct stenosis and obstructive sialadenitis.

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.

A case is presented of a 14-year-old female undergoing orthodontic fixed appliance treatment who presented with right facial swelling in the parotid region. An initial diagnosis of acute infective parotitis was made by her primary care clinician. However, after clinical examination and ultrasonographic imaging, a diagnosis of salivary stasis secondary to inflammatory occlusion of Stensen's ductal orifice was made. The ductal orifice had been traumatized by the adjacent orthodontic appliance. This has not been described before in the literature. The differential diagnosis of parotid enlargement in children is discussed.

Alcoholic drinks are capable of triggering a wide range of allergic and allergic-like responses, including rhinitis, itching, facial swelling, headache, cough and asthma. Limited epidemiological data suggests that many individuals are affected and that sensitivities occur to a variety of drinks, including wine, beer and spirits. In surveys of asthmatics, over 40% reported the triggering of allergic or allergic-like symptoms following alcoholic drink consumption and 30 - 35% reported worsening of their asthma. Sensitivity to ethanol itself can play a role in triggering adverse responses, particularly in Asians, which is due mainly to a reduced capacity to metabolize acetaldehyde. In Caucasians, specific non-alcohol components are the main cause of sensitivities to alcoholic drinks. Allergic sensitivities to specific components of beer, spirits and distilled liquors have been described. Wine is clearly the most commonly reported trigger for adverse responses. Sensitivities to wine appear to be due mainly to pharmacological intolerances to specific components, such as biogenic amines and the sulphite additives. Histamine in wine has been associated with the triggering of a wide spectrum of adverse symptoms, including sneezing, rhinitis, itching, flushing, headache and asthma. The sulphite additives in wine have been associated with triggering asthmatic responses. Clinical studies have confirmed sensitivities to the sulphites in wine in limited numbers of individuals, but the extent to which the sulphites contribute to wine sensitivity overall is not clear. The aetiology of wine-induced asthmatic responses may be complex and may involve several co-factors.

We report the case of a 35-year-old male who presented with left facial swelling and pain on deep inspiration following an isolated zygomatic complex fracture. Clinical examination and computer tomography confirmed cervicofacial emphysema and pneumomediastinum secondary to zygomatic fracture. This was subsequently managed conservatively with analgesia and antibiotics. Cervicofacial emphysema following maxillofacial trauma is not uncommon, but pneumomediastinum must be considered where chest pain develops and diagnosed early to minimise potentially life-threatening conditions.

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.

A 47 year old woman developed facial swelling and an itchy maculopapular rash over her whole body one month after commencing sulfasalazine for rheumatoid arthritis. On examination, she was pyrexial and had generalised lymphadenopathy. Her alkaline phosphatase …

A 50-year-old fit and well man presented to the Accident and Emergency Department in a tertiary centre following lower molar extraction, complaining of voice hoarseness with neck and facial swelling. Clinical examination along with plain film radiography revealed pneumomediastinum and extensive cervical surgical emphysema. He was subsequently admitted for observation and managed conservatively under the ENT team with input from the maxillofacial and anaesthetic teams. With supportive treatment only, the emphysema resolved and he remained well up until discharge.

Objectives: Sinonasal malignancies in children are rare, histologically diverse tumors that present diagnostic and management challenges. The purpose of this study is to review the experience of a single cancer center in the management of pediatric sinonasal malignancies. Study Design: Retrospective review. Methods: Retrospective chart review. Results: Forty-four patients were identified. The median age was 12 years (range: 2–17), 54% were female, and the maxillary sinus was the most common primary site. Facial swelling and pain were the most common presenting complaints. Thirty-four patients (76%) in this series had paranasal sinus sarcomas, three patients had esthesioneuroblastomas, and eight patients had carcinomas. The 5-year overall survival, disease-specific survival, and recurrence rate for the entire group was 71%, 81%, and 43%, respectively. Conclusions: Pediatric sinonasal malignancies are rare, locally aggressive tumors associated with nonspecific signs and symptoms. Multimodality treatment can result in 5-year overall and disease-specific survival rates of over 70%. A multidisciplinary team approach is essential to optimize outcomes and limit the morbidity of treatment.

Intermittent facial swelling is an unusual presentation in the emergency department. The differential diagnosis may range from a variety of causes. Most common differential diagnosis is angio-oedema. However, more serious presentations such as superior venacaval obstruction must not be ignored. This case report presents a patient who was investigated in the hospital for 2 weeks (2 admissions) with intermittent facial swelling. He presented to the emergency department (3rd admission) and was diagnosed to have superior venacaval obstruction secondary to metastatic bronchogenic carcinoma. He underwent emergency endovascular stenting; however, he died within a few weeks.

A 25-year-old black man presented with left-sided chest pain and cough for 3 days. His pain was pressure-like and nonradiating and was aggravated with movement and relieved when the patient lay at a 45° angle. The patient denied fevers, chills, night sweats, and swelling but reported gaining 4 to 6 kg (10 to 15 lbs) in the past few months. His cough had started 2 weeks prior with yellow mucus production but he denied facial swelling or tenderness. He had no chronic medical conditions and was not taking medications. He had no known exposure to chemicals, fumes, or dust and no history of tobacco or alcohol abuse.

A 26-year-old man reported with the chief complaints of dry mouth, facial swelling and difficulty opening his mouth. His medical records indicated that he had been treated for nasopharyngeal squamous cell carcinoma when he was 10 years old. He had undergone two cycles of chemotherapy (cisplatin, 5-fluorouracil and vincristine) followed by 60 Gray of cobalt-60 beam therapy to the nasopharynx and bilateral cervical lymph nodes. After defaulting on follow-up for nearly 14 years, he presented with the following dental and maxillofacial features that …

Histamine is produced by the decarboxylation of histidine in fish muscle tissue. When histamine is ingested in excessive amount, Scombroid poisoning occurs. Scombroid poisoning is a type of allergy with symptom such as headache, nausea, vomiting, diarrhea, facial swelling and low blood pressure. Existing methods to detect histamine include HPLC and TLC. However, they are expensive; in need of well trained technician and are laborious and time consuming. In contrast, ISFET is robust, cheap, miniaturization enabling and simple. This is the first attempt to apply ISFET technology on detection of histamine. Our previous work has shown histamine can be detected by depositing a PVC-based liquid membrane, plasticized with DOP added with ionophore Mn(TPP)Cl and polyHEMA layer on the insulator gate of ISFET. In order to increase the sensitivity of ISFET towards histamine, the effect from duration to condition the ISFET in 0.05 molar of histamine, is examined here. It is found that ISFET A and C, which show good sensitivity near Nernstian response towards pH, are showing good sensitivity towards histamine also. It is also observed that the longer the conditioning time, the lower the sensitivity. ISFET A is found to display a more stable and repeatable performance, at a sensitivity of about 7mV/dec. The sensitivity is found higher with 1 hour conditioning in 0.05 molar of histamine.

Postoperative morbidity is a major disadvantage after oral and maxillofacial (OMF) surgery, often caused by pain, trismus and swelling affecting patients' quality of life. The goal of this study was to examine the effect of kinesiologic taping (KT) on swelling, pain, trismus and patients' satisfaction after OMF surgery.Performing a pooled analysis of 96 patients that were assigned for maxillofacial treatment (midface fractures n = 30, mandibular fractures n = 26, wisdom tooth removal n = 40) divided into treatment either with or without kinesiologic tape application. Tape was applied directly after surgery and maintained for at least 5 d postoperatively. Facial swelling was quantified at six specific points in time using a five-line measurement. Pain and degree of mouth opening was measured. Patients' objective feeling and satisfaction was queried.Application of KT after OMF surgery has a significant influence on the reduction of swelling decreasing the turgidity for 60% during the first 2 d after surgery. Evaluating all patients swelling was significantly lower in the KT treatment group (T2: 63.5 cm ± 4.3; T3: 62.5 cm ± 4.2; T4: 61.6 cm ± 4.2) than in the no-KT group (T2: 67.6 cm ± 5.0; T3: 67.0 cm ± 5.0; T4: 64.8 cm ± 4.8) at T2 (p0.001), T3 (p0.001), and T4 (p = 0.001). VAS Pain values were scored significantly lower for the KT group (T1: 2.5 ± 2.0 (p = 0.006); T2: 1.7 ± 2.0 (p0.001); T3: 1.5 ± 2.3 (p = 0.004); T4: 0.6 ± 1.1 (p = 0.001) compared to the no-KT group (T1: 3.8 ± 2.5; T2: 3.5 ± 2.7; T3: 2.9 ± 2.2; T4: 1.6 ± 1.7). A statistically significant amelioration in mean mouth opening ability was observed in the KT group (T1-BL: -0.08 cm ± 0.49 (p = 0.025); T2-BL: 0.07 cm ± 0.59 (p = 0.012); T3-BL: 0.20 ± 0.63 (p = 0.013); T4-BL: 0.42 ± 0.59 (p = 0.003)) compared to the no-KT group (T1-BL: -0.47 cm ± 0.86; T2-BL: -0.39 cm ± 0.84; T3-BL: -0.24 ± 0.89; T4-BL: -0.13 ± 1.02).KT after OMF surgery is a promising, simple, less traumatic, economical approach free from systemic adverse reaction upgrading patients' quality of life.

Volume changes in facial morphology can be assessed using the 3dMD DSP400 stereo-optical 3-dimensional scanner, which uses visible light and has a short scanning time. Its reliability and validity have not to our knowledge been investigated for the assessment of facial swelling. Our aim therefore was to assess them for measuring changes in facial contour, in vivo and in vitro. Twenty-four healthy volunteers with and without an artificial swelling of the cheek were scanned, twice in the morning and twice in the afternoon (in vivo measurements). A mannequin head was scanned 4 times with and without various externally applied artificial swellings (in vitro measurements). The changes in facial contour caused by the artificial swelling were measured as the change in volume of the cheek (with and without artificial swelling in place) using 3dMD Vultus software. In vivo and in vitro reliability expressed in intraclass correlations were 0.89 and 0.99, respectively. In vivo and in vitro repeatability coefficients were 5.9 and 1.3 ml, respectively. The scanner underestimated the volume by 1.2 ml (95% CI -0.9 to 3.4) in vivo and 0.2 ml (95% CI 0.02 to 0.4) in vitro. The 3dMD stereophotogrammetry scanner is a valid and reliable tool to measure volumetric changes in facial contour of more than 5.9 ml and for the assessment of facial swelling.

Background/Purpose Impacted third molars can be extracted by regular surgery or piezosurgery. The aim of this study was to compare clinical parameters and device-produced noise levels between regular surgery and piezosurgery for the extraction of impacted third molars. Methods Twenty patients (18 women and 2 men, 17–29 years of age) with bilateral symmetrical impacted mandibular or maxillary third molars of the same level were included in this randomized crossover clinical trial. The 40 impacted third molars were divided into a control group ( n = 20), in which the third molar was extracted by regular surgery using a high-speed handpiece and an elevator, and an experimental group ( n = 20), in which the third molar was extracted by piezosurgery using a high-speed handpiece and a piezotome. The clinical parameters were evaluated by a self-reported questionnaire. The noise levels produced by the high-speed handpiece and piezotome were measured and compared between the experimental and control groups. Results Patients in the experimental group had a better feeling about tooth extraction and force delivery during extraction and less facial swelling than patients in the control group. However, there were no significant differences in noise-related disturbance, extraction period, degree of facial swelling, pain score, pain duration, any noise levels produced by the devices under different circumstances during tooth extraction between the control and experimental groups. Conclusion The piezosurgery device produced noise levels similar to or lower than those of the high-speed drilling device. However, piezosurgery provides advantages of increased patient comfort during extraction of impacted third molars.

Location of ectopic tooth in a nondentate area like the maxillary antrum is rare. A 17-year-old boy, with one year history of recurrent right facial swelling and radiographic finding of a maxillary third molar tooth located at the posterior wall of the maxillary antrum, is presented. Under endotracheal intubation, the tooth was extracted through a Caldwell-Luc antrostomy approach and patient had an uneventful recovery and has been symptom free for eight months. Ectopic tooth in the maxillary antrum is rare and is commonest with maxillary third molar. It may be symptomless but is more commonly associated with inflammatory symptoms. The treatment of choice is surgical excision which is mostly carried out with Caldwell-Luc approach, even though endoscopic approach is being reported.

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.

A 7 month-old, male domestic shorthaired cat was referred because of facial swelling, an operculated cystic oral mass, and impaction of the associated maxillary left canine tooth. Surgical exposure and realignment failed to result in eruption. Surgical re-exposure and orthodontic extrusion resulted in a functional alignment of the tooth within the dental arch. Follow up evaluations over the 5 ensuing years indicated persistence of the facial deformation, no evidence of ameloblastic biotransformation, and a healthy tooth.

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.

Das hereditare angioneurotische Odem wird durch einen Mangel oder Dysfunktion des C1-Esterase-Inhibitors hervorgerufen. Dabei kommt es u. a. durch unkontrollierte Aktivierung des Komplementweges zu erhohten Bradykininspiegeln und Odembildung. Wir berichten uber eine Patientin mit massiven Schwellungen im Gesicht und akuten gastrointestinalen Symptomen. Therapie der Wahl ist bei Beteiligung der oberen Luftwege die Sicherung der Atemwege und Substitution von C1-Esterase-Inhibitor-Konzentrat. Behandlungen mit Glukokortikoiden, Antihistaminika und Adrenalin sind unwirksam.

Sinonasal lymphoma, a rare nonepithelial malignant tumor often originates from the nose and paranasal sinuses. Typically, these lymphomas present with symptoms of nasal obstruction, discharge, epistaxis and facial swelling. Orbital extension results in ocular symptoms like proptosis, blurred vision and diplopia. In this case report, we describe persistent blepharoconjunctivitis, an unusual ocular presentation of sinonasal lymphoma. The tumor was positively identified with immunoreactivity of biopsy specimen; Appropriate chemotherapy lead to successful remission of the disease.

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.

Subcutaneous emphysema is characterized by the presence of air or other gases in the subcutis after a spontaenous or traumatic interruption in a air-carrying structure. We describe a patient who developed unilateral facial swelling after dental treatment. Considering the history, differential diagnostic possibilities and the physical examination, we diagnosed cervicofacial emphysema.

Oro-facial swellings are frequently encountered in clinical practice. The aim of this report is to unveil the uncommon manifestation of a common clinical problem and the help of ultrasonographic imaging in the diagnosis.