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Fractures in the pediatric population are less common than in adults. Facial fractures represent only 4%-5% of total trauma in infants. Osteogenesis imperfecta is a group of genetic disorders where multiple fractures can occur even in early years of life. Long-term treatment with bisphosphonates is currently used in these children in order to increase bone strength and to alleviate symptoms. This paper reports a rare case of a traumatic fracture of the mandible in a 4-year-old child with osteogenesis imperfecta type I. This is an unusual complication in children, even in this group of patients. Open reduction and rigid fixation are not often described as the best treatment. As there are controversies about the subject, a literature review and discussion are presented.

RESUMEN Las anomalías del cuarto arco branquial son extremadamente infrecuentes y habitualmente se presentan como tumoraciones cervicales asintomáticas o infecciones recurrentes del cuello. El diagnóstico se establece mediante la realización de una adecuada anamnesis y exploración física, así como con pruebas de imagen complementarias. La exéresis quirúrgica completa constituye el gold standard de tratamiento. Presentamos el caso de una neonata con un quiste de la cuarta hendidura branquial que comenzó como una masa laterocervical izquierda asintomática, que fue diagnosticado mediante ecografía y resonancia magnética nuclear y tratado quirúrgicamente de manera precoz.

Purpose Reconstruction of orbital wall fractures is demanding and has improved dramatically with the implementation of new technologies. True-to-original accuracy of reconstruction has been deemed essential for good clinical outcome, and reasons for unfavorable clinical outcome have been researched extensively. However, no detailed analysis on the influence of plate position and surface contour on clinical outcome has yet been published. Materials and methods Data from a previous study were used for an ad-hoc analysis to identify predictors for unfavorable outcome, defined as diplopia or differences in globe height and/or globe projection of >2 mm. Presumed predictors were implant surface contour, aberrant implant dimension or position, accuracy of reconstructed orbital volume, and anatomical fracture topography according to the current AO classification. Results Neither in univariable nor in multivariable regression models were unfavorable clinical outcomes associated with any of the presumed radiological predictors, and no association of the type of implant, i.e., standard preformed, CAD-based individualized and non−CAD-based individualized with its surface contour could be shown. Conclusion These data suggest that the influence of accurate mechanical reconstruction on clinical outcomes may be less predictable than previously believed, while the role of soft-tissue−related factors may have been underestimated.

espanolRESUMEN La leucemia aguda mieloide (LAM) es una neoplasia maligna con manifestaciones sistemicas, pudiendo presentar lesiones a nivel intraoral. Es el cancer mas frecuente en la infancia y constituye la primera causa de muerte por cancer en la edad pediatrica. El sarcoma mieloide es un tumor maligno extramedular compuesto por celulas precursoras mieloides inmaduras. Este tumor se asocia fundamentalmente con la leucemia mieloide aguda y sindromes mielodisplasicos y, generalmente, debuta despues del diagnostico de la enfermedad primaria. La aparicion del sarcoma mieloide dentro de la cavidad oral como manifestacion inicial de la LAM es extremadamente rara (3-6 % de los casos segun las series). Se presenta el caso de una lactante de 19 meses de edad que llevaron a Urgencias por fiebre y una tumoracion gingival en el cuarto cuadrante refractaria a tratamiento antibiotico. Se solicito un estudio ecografico para valorar la existencia de un absceso, donde se identifico una lesion que, tras realizar una biopsia para estudio anatomopatologico, resulto ser un sarcoma mieloide. La paciente fue diagnosticada de LAM y se inicio tratamiento quimioterapico. Tras tres ciclos, actualmente la paciente se encuentra libre de enfermedad. EnglishABSTRACT Acute myeloid leukemia (AML) is a malignant neoplasm with systemic manifestations, which may present intraoral lesions. It is the most common cancer in childhood and the leading cause of death from cancer in pediatric population. Myeloid sarcoma is a malignant extramedullary tumor composed of immature myeloid precursor cells. This tumor is mainly associated with AML and myelodysplastic syndromes and, generally, shows up after the diagnosis of the primary disease. The appearance of myeloid sarcoma within the oral cavity as an initial manifestation of AMK is extremely rare (3-6% of cases according to the series). We present a case of a 19-month infant who was taken to the Emergency Department due to fever and a gingival lesion that did not respond to antibiotic treatment. An ultrasound study was requested to assess the presence of an abscess. However, a lesion was identified and after performing a biopsy, pathologist found it was a myeloid sarcoma. The patient was diagnosed with AML and chemotherapy treatment was started. After three cycles of treatment, the patient is currently free of disease.