PMC6955112_01
Axial section of computed tomography revealing fracture of mandibular symphysis.
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During the clinical examination, signs suggestive of mandibular fractures were observed, which were confirmed by imaging examinations, closing the diagnosis of symphysis and mandibular condyles fracture (Figure 1).
Rigid internal fixation of mandibular symphysis fracture with 2.0 system miniplates.
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Surgery was performed without complications and the patient was discharged after 24 hours, referred home with oral antibiotic therapy (amoxicillin 500 mg, 8/8 hours for 7 days) and scheduled outpatient return (Figure 2).
Clinical view from the primary surgery, showing larval infestation.
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After five days, he returned with dehiscence in the surgical wound and the clinical examination revealed the presence of larvae in the symphisis (Figure 3).
Iodorform compound used topically to facilitate the larval removal.
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During the procedure, approximately 250 larvae were removed and topical iodoform was applied (Figure 4).
Sagital section of computed tomography contrast enhanced, revealing extensive damage to the suprahyoid soft tissues.
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A computed tomography was performed for suprahyoid space examination, due to the extensive tissue destruction and the impossibility of evaluation of deeper larvae (Figure 5).
Ortopantomogram radiography showing internal rigid fixation with 2.4 mm reconstruction plate.
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The miniplates were replaced by a 2.4 mm reconstruction plate and again the patient underwent antibiotic therapy (IV) (Figure 6).
Final clinical aspect, with complete wound healing.
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Despite this, there was remission of the condition and complete closure of the wound in 15 days, after the last surgical intervention, without significant sequelae (Figure 7).