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BACKGROUND: Orthodontic purposes, such as the prevention of anterior crowding, are common and controversial indications for surgical removal of the third molar (M3) germ in young patients. A higher tooth bud position and the risk of tooth displacement in the infratemporal fossa when surgery of the maxillary M3 germ is planned makes the success of germectomy unlikely with little benefit. A rare complication of maxillary M3 germ surgery is partial tooth building after germectomy.
METHODS: We report the case of a 14-year-old patient who was referred for germectomy of the maxillary M3 in the early development germ stadium to address space constraints and obstruction to the eruption of the second molar (M2) teeth. Computed tomography (CT) examination was used to verify the position and development of the maxillary M3 germ. The surgical procedure was performed without any complications. Eight years after the surgery, the patient presented with indefinable pain in the right upper jaw in the germectomy area. Cone-beam CT revealed a partial tooth formation in the form of a radix relict in the region of the maxillary M3.
CONCLUSIONS: The ongoing debate surrounding germectomy revolves around its indications and timing, considering factors such as patient age, anatomical appearance, and root formation stage. Complications, like partial tooth formation postgermectomy, highlight the importance of precise timing in treatment.
CONCLUSIONS: This is the first report of partial tooth formation as a complication after germectomy of the M3 germ in a complete crown-formation stadium.

UNASSIGNED: Soft tissue injuries are known complications of orthodontic treatment. Most of the injuries are mild, but severe complications can arise from deeper penetration or dislodgement of brackets and other foreign bodies into the surrounding tissues of the oropharynx and infratemporal fossa.
UNASSIGNED: The patient, accompanied by his parents, presented to the Children\'s Emergency Department with the concern of gradual limitation of mouth opening and eventual trismus, which occurred over a span of 2 weeks.
UNASSIGNED: The patient presented with trismus and slight discomfort at the left cheek region. He reported a history of gradual limitation to his mouth opening 2 weeks prior. He was wearing upper and lower fixed orthodontic appliances and the left distal end of the maxillary archwire was found to have migrated into the left infratemporal fossa.
UNASSIGNED: Left medial pterygoid muscle inflammation, or bleeding and haematoma formation, or infection within the infratemporal region.
UNASSIGNED: The maxillary archwire was removed in the Children\'s Emergency Department and a computed tomography (CT) scan performed subsequently confirmed the diagnosis of left medial pterygoid muscle inflammation. The patient was started on an intravenous (IV) antibiotic and a 2-day course of IV dexamethasone to reduce the muscle inflammation.
UNASSIGNED: By the second day, the patient was able to achieve a mouth opening of 6 mm, and by the second week, the mouth opening had returned to normal.
UNASSIGNED: The potential risk of soft tissue injury and complications from orthodontic treatment is generally mild and limited. Soft tissue injuries can be avoided with careful management by the operator with the proper precautions taken. Clinicians should be familiar with the surrounding soft tissue anatomy and be aware of the potential for more severe complications and provide management or referral to the appropriate specialty accordingly.

Of all the head and neck tumors, salivary gland tumors account to 3%. Pleomorphic adenomas are one of the most common benign tumors arising from major salivary glands, although it could also develop from minor salivary glands situated at accessory sites like nasal cavity, pharynx, parapharyngeal space, lacrimal glands etc. Tumors of infratemporal fossa are quite unusual, mainly because of its hidden location in retromaxillary region. We report an unusual case of 65 years old male presenting with complaint of progressive left cheek swelling for 4 years. FNAC revealed pleomorphic adenoma of minor salivary gland tumor. Intraoperatively a giant lobulated tumor was seen occupying almost whole space of infratemporal fossa, which was removed in-toto via open approach. Patient was kept on regular follow up with no evidence of recurrence reported till date.

Respiratory epithelial adenomatoid hamartoma (REAH) in the head and neck is a rare benign lesion containing glandular tissue covered with ciliated respiratory epithelium. In the head and neck, REAH of the nasal cavity, paranasal sinuses, and nasopharynx have been reported in literature. Due to rareness of REAH and insufficient knowledge of its imaging features, the diagnosis can be challenging when we encounter a non-specific cystic mass at an uncommon site in the head or neck. Here, we report the case of a pathologically confirmed REAH showing a cystic mass centered at the buccal space (retromaxillary fat pad) with CT and MRI findings.
두경부의 호흡상피 선종양 과오종은 섬모호흡상피로 둘러싸인 선조직으로 구성된 드문 양성종양이다. 두경부의 비강, 부비동 또는 비인강의 호흡상피 선종양 과오종이 현재까지 보고되었다. 호흡상피 선종양 과오종은 드물고 특징적인 영상 소견이 잘 알려져 있지 않기 때문에 흔하지 않은 위치에 비특이적인 낭성종물로 발생한 경우 영상의학적 진단을 내리기가 쉽지 않다. 저자들은 볼쪽공간(상악후방 지방층)에서 낭성종물의 형태로 나타난 병리적으로 진단된 호흡상피 선종양 과오종의 CT 및 MRI 영상 소견을 증례 보고하고자 한다.

Neoplasms in the infratemporal fossa (ITF) are rare and insidious lesions that cause various symptoms due to involvement of the temporomandibular joint (TMJ), paranasal sinuses, and orbit. Here, we report a case of metastatic non-small cell lung adenocarcinoma in the ITF. The patient presented with facial pain and limited mouth opening, which did not respond to treatment for TMJ disorder, and a neoplasm was discovered in the ITF through medical imaging. With an open biopsy, the diagnosis was finalized. This report suggested that the physician should consider lesions in the ITF when facial pain and limited mouth opening failed local treatment, and distant metastasis of malignant tumor should be alerted. We also reviewed the literature regarding metastatic cancer to the ITF.

BACKGROUND: A malignant myoepithelioma is a rare tumor, mostly arising from the salivary glands. Myoepitheliomas of the ear have rarely been reported. The manuscript reports myoepithelial carcinoma of the external auditory canal (EAC) spreading to the infratemporal fossa. A clinician must be aware of anatomical variation of the bony EAC wall, such as the foramen of Huschke. This rare defect may be a pathway for spreading pathologies between these two anatomical regions.
METHODS: We present a case of osteoma-like stenosis of the EAC, which turned out to be an extremely rare malignant tumor. The preoperative MRI and PET/CT revealed that two parts of the tumor communicated through a defect in the antero-inferior portion of the bony ear canal. No distant metastases were detected. Subsequently, the tumor was resected from the ear canal and the infratemporal fossa en bloc. Perioperatively the defect in the EAC wall was suspected of the foramen of Huschke. After the surgery, the older scans of the patient from the past showed no presence of a congenital EAC wall defect. Therefore, the authors concluded that the tumor aggressively grew through the bone due to its biological nature.
CONCLUSIONS: Malignant myoepithelioma of the external auditory canal is an extremely rare condition and could be misdiagnosed as other benign lesions. In cases of suspicious lesions, it is advisable to do a probatory biopsy from the EAC. Surgery is the treatment of choice in malignant myoepitheliomas, and regular follow-ups are essential to monitor for recurrence or metastatic disease. Any mass located at the antero-inferior portion of the EAC wall warrants close evaluation due to its potential for expansion from the EAC.

OBJECTIVE: This is a case report of a dermoid cyst located in the infratemporal fossa and its surgical removal using infratemporal fossa type B approach.
METHODS: A 15-year-old male was referred from a local clinic after an incidental finding of a mass lesion in the skull base area on computed tomography (CT). Pre-operative magnetic resonance imaging showed a large cystic mass lesion, expanding to the foramen ovale with fat component in the right infratemporal fossa region. The lesion was completely excised using an infratemporal fossa type B approach.
CONCLUSIONS: An extremely rare case of dermoid cysts of the infratemporal fossa was managed with infratemporal fossa type B approach without severe complication.

Schwannomas are benign nerve tumours arising from the Schwann cells. Approximately 25-45% of schwannomas occurs in the head and neck region. Majority of schwannomas in the head and neck region arise from the vagus nerve. Trigeminal schwannomas account for about 0.2% of all intracranial tumours. Trigeminal schwannomas can originate from any section of the fifth cranial nerve, from the root to the distal extracranial branches, but majority develops from the Gasserian ganglion, usually growing in the middle cranium. Most common presenting symptom is facial pain. MRI is the imaging modality of choice and CT scan usually serves as a supplementary imaging especially for skull base tumours. 47 year old male patient presented to the outpatient department with complains of swelling over the left side of palate. Contrast enhanced CT scan demonstrated a large bilobed heterogeneously enhancing soft tissue lesion in the left infratemporal fossa with widened foramen ovale and extension of lesion into the Meckel\'s cave, larger contiguous component extending into ramus of mandible. MRI scan showed a large lobulated mass in the left masticator space with intracranial extension. Biopsy of the lesion was suggestive of schwannoma. The patient underwent left composite resection with dural repair and free flap reconstruction. Post operatively, on day 5 he developed features of meningitis for which he was treated conservatively and later discharged in stable condition. Trigeminal schwannomas are rare tumours with very low chance of malignant transformation which commonly presents with facial pain. MRI is the imaging modality of choice. Complete surgical excision is the treatment of choice.

Schwann cells are responsible for the production of the myelin sheath around the axons of the peripheral nervous system. Benign neoplasms which originate from Schwann cells are hence termed Schwannomas or Neurilemmomas. They present as slow-growing, solitary, encapsulated, benign masses usually in association with nerve trunks. Schwannomas are relatively rare tumors with 25-45% occurring in the head and neck region. These case reports aim to describe the presentations, work-up, and treatment of two patients with head and neck schwannoma in atypical locations. Both patients had a history of gradually increasing swelling, the first originating from the sino-nasal region and the second from the temporal/ infratemporal region. Complete surgical excision of the tumor was done in both cases with no reported recurrence at 18 months follow-up. The final diagnosis was made based on histopathology and immunohistochemistry findings. Schwannomas often present a diagnostic dilemma and should be considered a possibility in all head and neck tumors. Recurrence is rare.