The infraorbital nerve is a branch of the trigeminal nerve. Injury to the infraorbital nerve can be caused by trauma, including various facial fractures. Due to this nerve injury, patients complain of numbness and pain in the entire cheek, the ala of nose, and upper lip. In general, spontaneous sensory recovery is expected after decompressive surgery. If nerve transection is confirmed, however, neurorrhaphy is typically performed. Here, we present a case in which microsurgery was not performed in a patient with Sunderland grade V avulsion injury of the infraorbital nerve due to a facial bone fracture. Gradual nerve function recovery was confirmed to be possible with conservative treatment and rehabilitation alone. These findings suggest that the nerve function recovery can be expected with conservative treatment, even for severe nerve injury for which microsurgery cannot be considered.

Background: Orbital fractures are the most common pediatric facial fractures. Treatment is conservative due to the anatomical differences that make children more resilient to severe displacement or orbital volume change than adults. Although rarely, extensive fractures may result in enophthalmos, causing cosmetic problems. We aimed to establish criteria for extensive fractures that may result in enophthalmos. Methods: We retrospectively reviewed the charts of patients aged 0-15 years diagnosed with orbital fractures in our hospital from January 2010 to February 2019. Computed tomography images were used to classify the fractures into linear, trapdoor, and open-door types, and to estimate the defect size. Data on enophthalmos severity (Hertel exophthalmometry results) and fracture pattern and size at the time of injury were obtained from patients who did not undergo surgery during the follow-up and were used to identify the surgical indications for pediatric orbital fractures. Results: A total of 305 pediatric patients with pure orbital fractures were included-257 males (84.3%), 48 females (15.7%); mean age, 12.01 ± 2.99 years. The defect size (p = 0.002) and fracture type (p = 0.017) were identified as the variables affecting the enophthalmometric difference between the eyes of non-operated patients. In the linear regression analysis, the variable affecting the fracture size was open-door type fracture (p < 0.001). Pearson's correlation analysis demonstrated a positive correlation between the enophthalmometric difference and the bony defect size (p = 0.003). Using receiver operating characteristic curve analysis, a cutoff value of 1.81 cm 2 was obtained (sensitivity, 0.543; specificity, 0.724; p = 0.002). Conclusion: The incidence of enophthalmos in pediatric pure orbital fractures was found to increase with fracture size, with an even higher incidence when open-door type fracture was a cofactor. In clinical settings, pediatric orbital fractures larger than 1.81 cm 2 may be considered as extensive fractures that can result in enophthalmos and consequent cosmetic problems.

Mucinous cystadenoma, one of the subtypes of cystadenomas, is a rare benign salivary gland tumor. Most of the cases reported tumors presenting as asymptomatic, slow growing, single masses, primarily occurring in the parotid glands, buccal mucosa, and hard palate. This report describes a case of multiple mucinous cystadenomas that presented as subcutaneous swellings in both cheeks, which were mistaken for a benign subcutaneous tumor. A complete surgical excision was performed through an intraoral incision. There were no recurrences or complications. A diagnosis of mucinous cystadenoma was made by histopathological examination. Mucinous cystadenomas are differentiated from other salivary gland tumors based on the pathological findings. A malignant transformation is also possible. Preoperative imaging cannot identify mucinous cystadenomas because of their small size and atypical features, and needle biopsy has its limitations in such salivary gland tumors. Therefore, accurate diagnosis and treatment through surgical excision become important.

Background/Objectives: Spontaneous chest wall hematomas are rare but potentially life-threatening complications, particularly in patients with multiple comorbidities such as those undergoing hemodialysis. This case report aims to highlight the significance of early diagnosis and appropriate management in preventing complications associated with this condition. Methods: We report the case of a 79-year-old man with end-stage renal disease on hemodialysis, presenting with a large spontaneous hematoma (18.7 × 13.1 × 9.6 cm) in the right upper chest wall. Initial interventions, including diagnostic imaging and transarterial angiography, did not detect active bleeding. Surgical exploration revealed bleeding from a branch of the lateral thoracic artery, which was managed through vessel ligation and hematoma drainage. Results: The hematoma was successfully managed through surgical intervention, with no postoperative complications such as infection, recurrent bleeding, or wound issues. The patient’s recovery was uneventful, and he was discharged in stable condition. This case underscores the role of microvascular fragility and uremic coagulopathy in the development of spontaneous bleeding in hemodialysis patients. Conclusions: This case emphasizes the importance of timely recognition and individualized management of spontaneous soft tissue bleeding in hemodialysis patients. Surgical intervention is necessary for large hematomas or cases of hemodynamic instability to ensure hemostasis and mitigate complications.

Background: Infraorbital nerve dysfunction frequently occurs after maxillary fractures. This study aimed to determine whether maxillary fractures involving the infraorbital foramen affect the recovery of infraorbital nerve function.Methods: In this prospective study, 60 patients who received treatment for unilateral maxillary fractures between January 2020 and December 2022 were analyzed, with a follow-up period of over 1 year. Computed tomography scans were employed to categorize the fractures into three types according to the location of the fracture line relative to the infraorbital foramen. Sensory changes in four predetermined areas, supplied by the infraorbital nerve, were evaluated preoperatively and at 1 week, 1 month, 3 months, 6 months and 1 year postoperatively using the two-point discrimination test and the monofilament test.Results: Paresthesia was observed in all patients with maxillary fractures. In the majority of instances, sensory deficits resolved spontaneously within 1 year. However, in patients whose fracture lines encroached upon the infraorbital foramen, the severity of paralysis was greater, and the rates of recovery were slower.Conclusion: The degree of infraorbital nerve function after a maxillary fracture was influenced by the involvement of the infraorbital foramen. Therefore, in the management of patients with maxillary fractures, computed tomography scans can serve as a predictive tool for the potential severity of paresthesia and the anticipated recovery rate.

Background: Acute compartment syndrome is a surgical emergency that is most often associated with trauma. Rarely, however, it can develop without major trauma in patients receiving anticoagulation therapy. Methods: A 53-year-old woman receiving warfarin therapy presented with progressive swelling and pain in the left forearm after physical therapy. Computed tomography angiography showed preserved arterial flow. On clinical examination, pain and paralysis were present, whereas pallor and paresthesia were absent. Direct compartment pressure measurements demonstrated markedly elevated pressures in the dorsal and deep volar compartments, measuring 88 mmHg and 110 mmHg, respectively. Emergency fasciotomy was performed approximately 9 h after symptom onset. Results: Intraoperative findings showed hematoma formation and partial muscle necrosis in the deep volar compartment. After surgery, persistent bleeding required repeated hemostatic interventions and blood-product transfusion. Negative-pressure wound therapy was applied, and delayed primary closure was subsequently performed. Anticoagulation therapy was temporarily discontinued and later resumed. The patient recovered without further bleeding, wound complications, or functional impairment and was discharged in stable condition. No complications, including hematoma recurrence or infection, were observed during 6 months of follow-up. Conclusions: This case highlights a temporal association between physical therapy and acute forearm compartment syndrome in a patient receiving anticoagulation therapy. It also emphasizes that preserved peripheral pulses and intact arterial flow do not exclude the diagnosis. Early recognition and prompt surgical intervention remain essential to prevent irreversible tissue damage and optimize outcomes.