Tehran University Medical Journal

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Maxillary sinus atelectasis is a rare and relatively unknown disease. Most patients present with non-sinonasel complaints. Negative intracavitary pressure due to ostial obstruction is suggested as the most probable etiology. Two patients with sinus atelectasis are presented in this paper: Case 1 presented with enophthalmus and maxillary sinus opacity and atelectasis in imaging. Endoscopic uncinectomy and midle antrostomy was done for this patient. Case 2 presented with mid-facial deformity and depression. Caldwel-Luc procedure with inferior meatal antrostomy was done. In 1 year follow up, they were asymptomatic and with no deterioration of facial deformity.

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The genus acinetobacter are intestinal gram negative, encapsulated, non motile, aerobic bacilli, which are rod shaped during rapid growth and cocobacillary in stationary phase. Risk factors associated with nosocomial infections include: length of hospital stay, surgery, wounds, previous infection, fecal colonization, treatment with broad spectrum antibiotics, parenteral nutrition, indwelling central intravenous or urinary catheters, admission to a burn unite or ICU and mechanical ventilation. Acinetobacter meningitis occur infrequently and is generally found after neuro‌surgical procedures.
Here, we are presenting a 19 year-old female patient who developed multi-drug resistant (MDR) acinetobacter meningitis after operation on maxillary bone, but despite good clinical response to imipenem and amikacin succumbed aminoglycoside induced otoxicity.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: The aim of this study was to describe the prevalence of different types of maxillary fractures, concurrent fractures and accompanying signs and symptoms. Trauma is the second cause of mortality in Iran, after cardiovascular diseases. In traumatic patients, head, neck and facial bones fractures are common. The maxillary fractures are seen much less commonly than the fractures of the mandible, zygoma, or nose. Maxillary fractures include: (Le fort I, II, III fractures- alveolar process fracture and Sagittal fracture). The most common cause of maxillary fracture is motor vehicle accidents.
Methods: This descriptive cross sectional study designed on 56 patients with maxillary fractures in a referral educational trauma center of Tehran. Sample size was the patients who referred to this hospital with maxillary fracture during past seven years.
Results: Forty eight (86%) patients were male and 8(14%) were female. Male to female ratio was 6/1. Mean age of patients was 30 years. The most common type of maxillary fracture was infra orbital rim and floor fracture. Among Le fort fracture Le fort type II was the most common. Paresthesia of infra orbital nerve and malocclusion were more common than the other especial signs of maxillary fracture. Concomitant fracture with maxilla include: zygomatic fracture in 62%, mandibular fracture in 25%, nasoethmoidal fracture in 9% and skull base fracture in 4%. Management of maxillary fracture was reduction of displaced bone fragment and fixation for osteosynthesis. The most common way for osteosynthesis was fixation with miniplate and screw.
Conclusions: Face fractures are a piece of all problems in multiple trauma patients as the tip of iceberg. Early diagnosis of maxillary fractures and immediate treatment will prevent the future deformities and complications.

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Background: Osteoblastoma is one of the rarest primary benign bone tumors which accounts for 1% of all bone neoplasms and 3.5% of benign bone tumors, with the potential for local invasion and recurrence. Osteoblastoma is not homogeneous. Differences in histological details have led to the division of these lesions into subtypes. The histologic features in most cases are distinctive, there are various changes that make the diagnosis challenging. Although involvement of this disease is more in the spines or small long bones, but it has been reported involvement of jaws in this disease. Correct diagnosis is very important because it may be misdiagnosed osteosarcoma  with hypercellular cases.

Case presentation: In this case report, it is described patient a 7-year-old girl with a lesion in the posterior maxilla and bone resorption in May 2016, Sari, Mazandaran province, Iran. Differential diagnosis of the radiological and clinical findings suggested an osteosarcoma. In terms of pathology, osteoblastoma was included a well-vascularized connective stroma tissue with plenty of veins which osteoid and primitive woven bone can be seen actively. In microscopy diagnosis, samples were shown cortical bone with a natural appearance, prominent osteoblasts and surrounding granulation tissue containing blood vessels that confirmed maxilla osteoblastoma. The lesion was examined by histopathology method for final recognition and the results revealed osteoblastoma.

Conclusion: Although jaw osteoblastoma is a rare tumor and presents with microscopic features that can mimic a variety of other types of malignant entities. It is important to avoid of other non-specific clinical and radiographic protests that led to the recognition problems. The importance of interdisciplinary cooperation between the surgeon, radiologist and pathologist must be pressured.