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Study designCase report.ObjectiveTo present two cases of young children with Hyaline Fibromatosis Syndrome and their oral and maxillofacial manifestations.MethodsThe different oral and maxillofacial manifestations were clinically examined in detail. The patients were treated with surgical excisions of their gingival hyperplasias and soft tissue tumors of the head.ResultsRelief of pain from ears, scalp and intraoral was obtained, resulting in a normal eating and nutritional habits despite absence of teeth. Improved esthetics.ConclusionThis paper underscores the importance of early diagnosis and prompt therapeutic interventions in managing Hyaline Fibromatosis Syndrome. This report contributes to the growing body of knowledge regarding this rare disorder and emphasizes the importance of a multidisciplinary approach in achieving favorable outcomes for patients afflicted with HFS.

Burns are common and devastating injuries, often necessitating intensive care treatment and long-term hospitalisation, making burn patients susceptible to hospital-acquired anaemia and blood transfusion. The purpose of this study was to assess diagnostic blood loss in burn patients at the burn intensive care unit (BICU) at Uppsala University Hospital between 1 September 2016 and 30 June 2019. Medical records were screened; age, gender, mechanism, % total body surface area (TBSA), Baux score, length of stay, days on the respirator, days of continuous renal replacement therapy, number of operations, and number of blood tests per patient were assessed. Volume per blood test was estimated as the volume needed for the specific test tube. A total of 166 patients were included in the study. The mean TBSA was 18.0% +/- 20, and the mean length of stay was 17.0 +/- 41 days. Median diagnostic blood loss was 13.1 mL/day/patient (IQR 7.0, 23.9) and correlated positively with burn extent, Baux score, and mortality. Daily diagnostic blood loss/%TBSA/patient was 1.2 mL (IQR 0.7, 2.3). Transfusion of blood products occurred in 73/166 patients (44%). In conclusion, diagnostic blood loss is greatly influenced by TBSA extent. The diagnostic blood loss can reach significant levels and may affect the transfusion rate.

BACKGROUND: Malplaced implants in orbital reconstruction may lead to serious complications and necessitate re-intervention. The aim of this study was to describe outcomes, complications and scenarios of re-intervention in a historical case series of orbital fractures treated with free-hand orbital wall reconstruction. The main hypothesis was that early re-interventions are mainly because of malplaced implants in the posterior orbit.

METHODS: Retrospective review of 90 patients with facial fractures involving the orbit, reconstructed with radiopaque orbital wall implants, from 2011 to 2016. Data were obtained from medical records and computed tomography images. Recorded parameters were fracture type, ocular injury, ocular motility, diplopia, eye position, complications and re-interventions. Secondary reconstructions because of enophthalmos were volumetrically evaluated.

RESULTS: Early complications requiring re-intervention within 1 month were seen in 12 (13%) patients, where all except two were because of malplaced implants. The implant incongruence was without exception found in the posterior orbit. Late complications consisted of four (4%) cases of ectropion and five (5%) cases of entropion that needed corrective surgery. The majority of the patients with eye-lid complications had undergone repeated surgeries. Secondary orbital surgeries were performed in nine (10%) patients. Five of these patients had secondary reconstruction for enophthalmos and associated diplopia. None of these patients became completely free from either enophthalmos or diplopia after the secondary surgery.

CONCLUSION: Re-intervention after orbital reconstruction is mainly related to malplaced implants in the posterior orbit. Incomplete results in patients requiring secondary surgery for enophthalmos infer the importance of accurate restoration of the orbit at primary surgery.