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1.
Eur. j. psychiatry ; 38(1): [100230], Jan.-Mar. 2024.
Artigo em Inglês | IBECS | ID: ibc-229232

RESUMO

Background and Objectives Supporting the neurodevelopmental model of schizophrenia, minor physical anomalies (MPAs) are markers of abnormalities in early fetal development. The mouth seems to be a common region for the occurrence of MPAs in patients with schizophrenia. This study aimed to compare the palatal rugae patterns, according to their length, shape, and orientation, between patients with schizophrenia and controls in a blinded fashion. The palatal rugae patterns were also evaluated by sex, as its effect on neurodevelopment was relevant. Methods Dental stone models were fabricated from maxilla impressions of patients with schizophrenia (N = 105) and controls (N = 105). Based on their lengths, three types of palatal rugae were classified; primary, secondary, and fragmentary. Primary rugae were further categorized according to their shape and direction. Results The most detected palatal rugae were the primary ones in both groups. The primary, secondary, and fragmentary rugae numbers in both groups were no different. There were significant differences in the shape and orientation of the primary rugae between the two groups. Curved (OR:1.76, p = 0.006), island (OR:2.97, p = 0.001) and nonspecific (OR:5.44, p = 0.004) primary rugae shape were found to be significant predictive variables for schizophrenia. Randomly oriented rugae numbers were higher in schizophrenics than controls (p = 0.018). The two sexes had different preferences in primary rugae shapes and directions compared to same-sex controls in patients with schizophrenia. Conclusion Identifying subtle changes in the primary rugae pattern, which appear to be sex-specific, is consistent with impaired neurodevelopment in schizophrenia. (AU)


Assuntos
Humanos , Morfogênese , Esquizofrenia , Palato Duro , Palato Mole
3.
Cir. pediátr ; 33(3): 137-142, jul. 2020. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-193556

RESUMO

INTRODUCCIÓN: La fístula palatina es la complicación más frecuente tras una palatoplastia. Los objetivos de este estudio fueron: describir las técnicas de reparación más frecuentemente empleadas, estudiar los resultados y la tasa de recidiva, analizar posibles variables predictivas de recidiva y valorar la posible superioridad de una determinada técnica según el tamaño y la localización de la fístula. MATERIAL Y MÉTODO: Estudio retrospectivo de pacientes operados de fístulas palatinas desde 2008 hasta 2018 en 7 centros. Todos operaban al menos 20 casos nuevos de fisuras labiopalatinas al año (rango 20-80) con una incidencia de fístulas de 14% (rango: 1,5-20%). El seguimiento mínimo fue de 1 año. Se recogieron 8 variables para el análisis estadístico. RESULTADOS: Se operaron 234 pacientes con fístulas. La mayoría ocurrieron en fisuras labiopalatinas bilaterales completas (tipo IV de Veau). La localización más frecuente fue el paladar duro (tipos IV y V de Pittsburgh) (63,2%) y la mayoría fueron grandes (42,1%) y medianas (39,5%). La técnica de reparación más frecuente fue la repalatoplastia (34,2%). La tasa de recidiva fue del 22%. El análisis multivariante mostró más recidivas en fístulas tipo III reparadas con repalatoplastia en mayores de 3 años. CONCLUSIÓN: Se observó una tendencia a utilizar más reparación con colgajo en fístulas grandes del paladar duro, repalatoplastia en fístulas medianas de paladar duro y de la unión y colgajos locales o repalatoplastia en fístulas pequeñas en cualquier localización, pero no se pudo demostrar estadísticamente la superioridad de una técnica reparadora concreta en diferentes situaciones clínicas


INTRODUCTION: Palate fistula is the most frequent complication following palatoplasty. The objectives of this study were: to describe the most widely used repair techniques; to study results and recurrence rate; to analyze potentially predictive recurrence variables; and to assess whether a specific technique is superior according to fistula size and location. MATERIALS AND METHODS: Retrospective study of patients undergoing palate fistula repair in 7 healthcare facilities from 2008 to 2018. All facilities had at least 20 new cases of cleft lift and palate annually (range: 20-80), with a fistula incidence of 14% (range: 1.5-20%). Minimum follow-up was 1 year. 8 variables were collected for statistical analysis purposes. RESULTS: 234 fistula patients underwent surgery. Most fistulas occurred in complete bilateral cleft lift and palate (Veau type IV). The most frequent location was the hard palate (Pittsburgh types IV and V (63.2%)), and fistulas were mostly large (42.1%) and medium (39.5%). The most frequent repair technique was re-palatoplasty (34.2%). Recurrence rate was 22%. The multivariate analysis demonstrated more recurrences in re-palatoplasty repaired type III fistulas in patients over 3 years old. CONCLUSION: A tendency towards using flap repair in large hard palate fistulas, repalatoplasty in medium hard palate and soft and hard palate junction fistulas, and local flaps or re-palatoplasty in small fistulas at any location was observed. However, it could not be statistically demonstrated whether a specific repair technique was superior in different clinical situations


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Fístula Bucal/cirurgia , Fístula Bucal/complicações , Palato Mole/cirurgia , Resultado do Tratamento , Recidiva , Estudos Retrospectivos , 28599 , Retalhos Cirúrgicos/cirurgia , Procedimentos Cirúrgicos Bucais/métodos
4.
Av. odontoestomatol ; 32(5): 251-258, sept.-oct. 2016. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-156981

RESUMO

Las fisuras labio palatinas se generan por la falta de fusión de los tejidos del labio o del paladar durante las primeras etapas del desarrollo fetal, estas se encuentran entre los defectos congénitos más comunes causados por el desarrollo facial anormal durante la gestación; su etiología no se encuentra totalmente aclarada, sin embargo se intenta explicar por medio del modelo de umbral multifactorial, planteándose que es producto de la interacción de factores endógenos y exógenos, entre los endógenos se han reportado alteraciones en la señalización del TGF-ß, el cual está involucrado en el desarrollo embrionario, diferenciación celular y en la regulación del desarrollo del paladar. En esta revisión se muestran los recientes avances sobre las implicaciones moleculares de la vía de señalización TGF-ß en el desarrollo de las fisuras labio palatinas (AU)


Cleft lip and palate are generated by the lack of fusion of the tissues of the lip or palate during early fetal development, these are among the most common birth defects caused by abnormal facial development during gestation. The etiology of these cracks is not fully elucidated, however attempts to explain by means of multifactorial threshold model, considering that is the product of the interaction of endogenous and exogenous factors, endogenous alterations have been reported in TGF-ß signaling, which is involved in embryonic development, cell differentiation and in the regulation of development of the palate. In this review, the recent advances implications of the molecular signaling pathway TGF-ß in the development of cleft lip and palate shown (AU)


Assuntos
Humanos , Fator de Crescimento Transformador beta/genética , Fissura Palatina/genética , Fenda Labial/genética , Palato Mole/embriologia , Fissura Palatina/embriologia , Transdução de Sinais/genética , Proteína Smad2/genética , Proteína Smad3/genética
5.
Med. oral patol. oral cir. bucal (Internet) ; 21(1): e48-e52, ene. 2016. tab
Artigo em Inglês | IBECS | ID: ibc-149424

RESUMO

BACKGROUND: Individuals with nonsyndromic cleft lip with or without cleft palate (NSCL±P) present high frequency of dental anomalies, which may represent complicating factors for dental treatment. The aim of this study was to investigate the prevalence of dental anomalies inside cleft area in a group of Brazilians with NSCL±P. MATERIAL AND METHODS: Retrospective analysis of 178 panoramic radiographs of patients aged from 12 to 45 years old and without history of tooth extraction or orthodontic treatment was performed. Association between cleft type and the prevalence of dental anomalies was assessed by chi-square test with a significance level set at pless than or equal to 0.05. RESULTS: Dental anomalies were found in 88.2% (n = 157) of the patients. Tooth agenesis (47.1%), giroversion (20%) and microdontia (15.5%) were the most common anomalies. Individuals with unilateral complete cleft lip and palate (CLP, p< 0.0001) were more affected by tooth agenesis than individuals with other cleft types. The maxillary lateral incisors were the most affected teeth (p < 0.0001). CONCLUSIONS: The present study revealed a high frequency of dental anomalies inside cleft region in NSCL±P patients, and further demonstrated that patients with unilateral complete CLP and bilateral incomplete CLP were frequently more affected by dental anomalies. Moreover, our results demonstrate that dental anomalies should be considered during dental treatment planning of individuals affected by NSCL±P


Assuntos
Humanos , Anormalidades da Boca/diagnóstico , Anormalidades Dentárias/diagnóstico , Fissura Palatina/complicações , Fenda Labial/complicações , Anodontia/epidemiologia , Palato Mole/anormalidades , Estudos Retrospectivos
6.
Neurocir.-Soc. Luso-Esp. Neurocir ; 26(5): 217-223, sept.-oct. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-142307

RESUMO

Introducción: El papel de la cirugía robótica está claramente establecido en diversas especialidades como Urología o Cirugía General, pero no así en otras como Neurocirugía u Otorrinolaringología, y en el caso concreto de la Cirugía de base de cráneo, apenas ha pasado de una fase experimental. Objetivo: Investigar las posibilidades de la aplicación del robot quirúrgico da Vinci en cirugía transoral de base de cráneo comparándola con la experiencia de los autores en cirugía endoscópica transnasal convencional de la misma región. Métodos: se llevó a cabo un abordaje transoral transpalatino a la rinofaringe y la base del cráneo medial en 4 cabezas de cadáver criopreservadas. Se empleó el robot da Vinci, con endoscopio de 30° y 12mm de grosor, con doble cámara e iluminación doble, pinza de Maryland en el terminal izquierdo y tijera curva en el derecho, ambos de 8mm de grosor. El fresado óseo se realizó manualmente. Para el estudio anatómico de la región a abordar se emplearon cortes axiales de 0,5cm de grosor de una cabeza de cadáver plastinada. Resultados: Con los terminales del robot se alcanzaron con relativa facilidad diversas estructuras de la base del cráneo a distintos niveles de profundidad. Conclusiones: La cirugía robótica transoral con el sistema da Vinci aporta posibles ventajas sobre la cirugía endoscópica transnasal convencional en el abordaje quirúrgico de esta región


Introduction: The role of robotic surgery is well established in various specialties such as urology and general surgery, but not in others such as neurosurgery and otolaryngology. In the case of surgery of the skull base, it has just emerged from an experimental phase. Objective: To investigate possible applications of the da Vinci surgical robot in transoral skull base surgery, comparing it with the authors’ experience using conventional endoscopic transnasal surgery in the same region. Methods: A transoral transpalatal approach to the nasopharynx and medial skull base was performed on 4 cryopreserved cadaver heads. We used the da Vinci robot, a 30° standard endoscope 12mm thick, dual camera and dual illumination, Maryland forceps on the left terminal and curved scissors on the right, both 8mm thick. Bone drilling was performed manually. For the anatomical study of this region, we used 0.5cm axial slices from a plastinated cadaver head. Results: Various skull base structures at different depths were reached with relative ease with the robot terminals Conclusions: Transoral robotic surgery with the da Vinci system provides potential advantages over conventional endoscopic transnasal surgery in the surgical approach to this region


Assuntos
Humanos , Base do Crânio/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Cadáver , Procedimentos Neurocirúrgicos/métodos , Nasofaringe/cirurgia , Palato Mole/cirurgia
7.
Acta otorrinolaringol. esp ; 66(2): 74-82, mar.-abr. 2015. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-134150

RESUMO

Introducción y objetivos: Los carcinomas de orofaringe son neoplasias agresivas habitualmente diagnosticadas en estadios avanzados. El objetivo de este estudio es exponer los resultados oncológicos y funcionales del tratamiento de estos tumores mediante resección quirúrgica transoral (RTO). Métodos: Se realizó un estudio retrospectivo en 43 pacientes con carcinoma epidermoide de orofaringe tratados mediante RTO. En el 52% de los casos el tumor se originaba en la región amigdalina, en el 23% en el paladar blando, en el 21% en la base de la lengua y en el 4% en la pared posterior. Ocho casos se clasificaron como estadio I, 9 como estadio II, 7 como estadio III, 16 como estadio IVA y 3 como estadio IVB. Dieciocho pacientes recibieron radioterapia postoperatoria. Se revisaron las historias de estos pacientes para obtener información en cuanto a control local y regional, supervivencia total y específica de la enfermedad, y función fonatoria y deglutoria. Resultados: La tasa global de recidivas fue del 44%, siendo la tasa de recidivas locales del 18%. La supervivencia global y específica a los 5 años fue del 55% y 66%, respectivamente. Las tasas de supervivencia específica a los 5 años según la localización tumoral fueron del 100%, 85%, 44%, y 30% para la pared posterior, amígdala, paladar blando y base de la lengua. El control local a los 5 años fue del 100%, 90%, y 0% para el paladar, amígdala y base de la lengua, respectivamente. En todos los casos se preservó la laringe, y los pacientes no requirieron traqueotomía definitiva y reanudaron la alimentación oral. Conclusiones: La RTO es una alternativa terapéutica eficaz para el tratamiento primario de los carcinomas de orofaringe, en la era de la quimio-radioterapia, obteniendo unos buenos resultados oncológicos y funcionales (AU)


Introduction and objectives: The aim of our study was to evaluate outcomes of a minimally invasive approach, using transoral surgery (TOS) as the primary treatment for oropharyngeal carcinoma. Methods: We reviewed 43 previously untreated patients with oropharyngeal carcinoma, who were treated with TOS. Distribution of the primary tumor site was: tonsil (52%), soft palate (23%), base of the tongue (21%) and posterior wall (4%). Eight patients had a stage I disease, 9 had a stage II disease, 7 had a stage III disease, 16 had a stage IVA, and 3 had stage IVB disease. Eighteen patients underwent postoperative radiotherapy. Records of these patients were reviewed to obtain measures such as local and regional control, overall and disease-specific survival, and speech and swallowing function. Results: The overall recurrence rate was 44%, and the local recurrence rate was 18%. The 5-year overall survival and disease-specific survival rates were 55% and 66%, respectively. Five-year disease-specific survival rates by site were as follows: 100%, 85%, 44%, and 30% for posterior wall, tonsil, soft palate and base of the tongue, respectively. Five-year estimates for local control were 100%, 90%, and 0% for palate, tonsil and for base of the tongue tumors, respectively. All of the patients preserved the larynx and live without tracheotomy and oral alimentation was successfully without feeding tube. Conclusions: TOS as the primary treatment approach offers a surgical alternative for treatment of the primary oropharyngeal tumor, in the era of chemoradiation therapy. This approach confers a good local control and functional outcomes (AU)


Assuntos
Humanos , Masculino , Feminino , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/metabolismo , Tonsila Faríngea/anormalidades , Palato Mole/patologia , Neoplasias de Cabeça e Pescoço/metabolismo , Carcinoma de Células Escamosas/induzido quimicamente , Carcinoma de Células Escamosas/prevenção & controle , Tonsila Faríngea/lesões , Palato Mole/anatomia & histologia , Neoplasias de Cabeça e Pescoço/complicações
9.
Av. odontoestomatol ; 30(2): 63-67, mar.-abr. 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-123209

RESUMO

Los autores realizan una revisión bibliográfica de las perforaciones palatinas asociadas a lesiones necrotizantes de la línea media por inhalación de cocaína y, aportan un caso clínico propio con fístula oronasal. La frecuencia de las perforaciones palatinas asociadas a las lesiones necrotizantes de la línea media por inhalación de cocaína es muy superior a las encontradas en la granulomatosis de Wegener. La presencia de una perforación palatina es también un dato sugestivo de linfoma extranodal. La clave diagnóstica de todas las lesiones necrotizantes de la línea media es histopatológica pero obtener un diagnóstico inequívoco es más difícil de obtener de lo que podría suponerse (AU)


The authors perform a literature review of palatal fistulas present in midline necrotizing nasal lesions due to inhalation of cocaine and present a case report. The frequency of palatal fistulas associated with midline necrotizing lesions by inhalation of cocaine is superior to tose found in Wegener's granulomatosis. The presence of a palatal fistula is also suggestive of a extranodal lymphoma. Histopathology is the key to the differential diagnosis but getting an unequivocal diagnosis is more difficult to obtain than might be supposed (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Cocaína/diagnóstico , Fístula Bucal/induzido quimicamente , Granuloma Letal da Linha Média/induzido quimicamente , Cocaína/efeitos adversos , Necrose/induzido quimicamente , Palato Mole/lesões , Diagnóstico Diferencial
10.
Av. periodoncia implantol. oral ; 26(1): 11-17, abr. 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-124826

RESUMO

En el presente trabajo hemos realizado una revisión bibliográfica de la literatura con el objetivo de esclarecer las consideraciones anatómicas que deben tenerse en cuenta a la hora de realizar cirugía periodontal, que posibles estructuras anatómicas podemos encontrarnos al elevar un colgajo y cómo podemos evitar la lesión de las mismas. También aportamos un breve repaso sobre conceptos y referencias anatómicas que los especialistas debemos tener presentes durante el manejo de los tejidos blandos y duros


For the present work, we have made a revision through the literature with the objective to clarify the anatomic considerations that should be considered during periodontal surgery, which anatomic structures we could find when raising a flap and how could we avoid injury. Also we have made a short review of the concepts and anatomic references that the specialists should take into consideration during the management of soft and hard tissues


Assuntos
Humanos , Doenças Periodontais/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Desbridamento Periodontal/métodos , Boca/anatomia & histologia , Tela Subcutânea/anatomia & histologia , Mucosa/anatomia & histologia , Arcada Osseodentária/anatomia & histologia , Palato Mole/anatomia & histologia , Palato Duro/anatomia & histologia
11.
Av. odontoestomatol ; 29(6): 309-314, nov.-dic. 2013. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-118295

RESUMO

Existen diversos factores que pueden inducir pigmentaciones en la mucosa bucal, entre ellos algunos fármacos tienen la capacidad de estimular la producción de melanina en el epitelio oral. Recientemente se ha demostrado que el mesilato de imatinib (Glivec®) usado como droga antineoplásica es capaz de producir como efecto adverso pigmentación de la mucosa bucal muy especialmente la del paladar. Se reporta el caso de una paciente de 56 años de edad bajo terapia con imatinib desde hace 8 años por padecer de leucemia mieloide crónica. Al examen clínico se observó una hiperpigmentación color azul grisácea en la totalidad del paladar óseo que al estudio histopatológico mostró acúmulo de melanina principalmente en el corion. La paciente se ha mantenido con la lesión en paladar bajo observación, sin cambios clínicos ni histopatológicos. Para establecer la asociación de este fármaco con la pigmentación en la mucosa bucal es necesario descartar otros factores inductores de melanosis además de considerar las características clínicas como coloración y ubicación de la lesión (AU)


There are several factors related to oral mucosa pigmentations, among them; some drugs may be able to induce melanin production in oral epithelia. Recently, it has been demonstrated that imatinib metylate (Glivec®), used to stop tumor growth, may cause oral pigmentation especially on the hard palate. A case is reported regarding a 56 year old female under imatinib treated since 8 years for chronic myeloid leukemia. Oral evaluation showed a diffuse blue/grey hyperpigmentation covering completely hard palate. Histopathologycal analysis revealed melanin accumulation in corion. Patient is under clinical surveillance, with no clinical changes. In order to establish the association between imatinib and oral pigmentation is necessary to discard other factors that may induce melanin production (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Transtornos da Pigmentação/induzido quimicamente , Palato Mole , Proteínas Tirosina Quinases/antagonistas & inibidores , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico
12.
J. physiol. biochem ; 69(4): 855-863, dic. 2013.
Artigo em Inglês | IBECS | ID: ibc-121643

RESUMO

Cleft palate is one of the most common birth defects. Both environmental and genetic factors are involved in this disorder. Here, we investigated the function of Wnt10a in proliferation and apoptosis of mouse embryonic palatal mesenchymal (MEPM) cells. Expression of Wnt10a was down-regulated at both the mRNA and protein levels in transfected MEPM cells containing Wnt10a-specific small hairpin RNA (shRNA) plasmid. Down-regulation of Wnt10a inhibited cell proliferation and induced cell cycle arrest in the S phase in MEPM cells. Moreover, apoptosis was significantly increased in MEPM cells of Wnt10a gene silencing. Finally, the expression of β-catenin was markedly reduced in MEPM cells transfected with shRNA plasmid, indicating that the canonical Wnt/β-catenin signaling pathway was involved in the alterations of cell proliferation and apoptosis induced by Wnt10a knockdown. Thus, our findings reveal that Wnt10a regulates proliferation and apoptosis of MEPM cells at least partially through the canonical Wnt/β-catenin signaling pathway


Assuntos
Animais , Ratos , Desenvolvimento Embrionário , Palato Mole/embriologia , Fissura Palatina/embriologia , Proteínas Wnt/análise , Modelos Animais de Doenças , Substâncias Protetoras/farmacocinética , Interferência de RNA
14.
Cient. dent. (Ed. impr.) ; 10(2): 147-150, mayo-ago. 2013. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-114732

RESUMO

El síndrome del Hamulus Pterigoideo se produce por una bursitis en el tendón del músculo tensor del velo del paladar. Presenta una patología dolorosa y muy variada dada la complejidad de la región y muchas veces este dolor puede enmascarar diferentes patologías que hay que diagnosticar y diferenciar. El tratamiento es multidisciplinario en muchos de los casos (AU)


The Pterygoid Hamulus Syndrome is produced by bursitis in the tendon of the tensormuscle of the soft palate. It presents a painful and varied pathology given the complexity of the region and many times this pain can mask different pathologies that must be diagnosed and differentiated. The treatment is multidisciplinary in many of the cases (AU)


Assuntos
Humanos , Bursite/complicações , Palato Mole/fisiopatologia , Músculos Pterigoides/fisiopatologia , Diagnóstico Diferencial
15.
Med. oral patol. oral cir. bucal (Internet) ; 18(3): 445-448, mayo 2013. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-112706

RESUMO

Background: Management and preservation of the soft palate is dependent on clinical stage and tumor histology. However, available literature is scarce regarding the palate preservation with the use of laser CO2.Objectives: We report the results obtained after management with laser surgery and soft palate preservation in three patients with salivary gland neoplasms. Method: Three patients with minor salivary gland tumors were treated by means of transoral laser microsurgery. All tumors were assessed using magnetic resonance imaging. All tumors were >3 cm. Soft palate function was preserved and reconstruction was performed with primary closure. Patients began oral feeding the same day and were discharged after 24 h. Conclusions: Transoral laser microsurgery is recommended for treatment of soft palate tumors. This treatment can be considered a better option when compared with other modalities such as radio- or chemo radiotherapy which require a longer time of treatment, are more expensive and tend to produce significant toxicity (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Neoplasias Palatinas/cirurgia , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Microcirurgia/métodos , Palato Mole/cirurgia
16.
Acta otorrinolaringol. esp ; 63(4): 321-323, jul.-ago. 2012. ilus
Artigo em Espanhol | IBECS | ID: ibc-102774

RESUMO

Los cordomas intracraneales son tumores relativamente raros localmente agresivos, que probablemente se originan de remanentes embrionarios de la notocorda. La localización primaria más frecuente es el sacro, seguida en orden de frecuencia por el clivus. Cuando los cordomas de base de cráneo tienen una localización extraósea (sin destrucción lítica del hueso) mimetizan cualquier otra lesión de nasofaringe. Presentamos el caso de un cordoma extraóseo primario en edad pediátrica que se origina en la nasofaringe, con la intención de mejorar el diagnóstico y tratamiento postoperatorio de este raro tumor(AU)


Intracranial chordomas are relatively rare locally aggressive tumours that probably originate from embryonic remnants of the notochord. They typically arise from the sacrum and secondly in the skull base/clivus region. When skull base chordomas occur at an extraosseous location (without lytic bone destruction), they may mimic other lesions of the nasopharynx. We present a case of primarily extraosseous chordoma in paediatric age, involving the nasopharynx, to improve preoperative diagnosis and postoperative management of this rare tumour(AU)


Assuntos
Humanos , Feminino , Criança , Cordoma/complicações , Cordoma/diagnóstico , Nasofaringe/patologia , Nasofaringe , Neoplasias Nasofaríngeas/complicações , Neoplasias Nasofaríngeas/diagnóstico , Palato Mole/patologia , Palato Mole/cirurgia , Otoscopia/métodos , Otoscopia , Cordoma/fisiopatologia , Cordoma , /métodos , Imageamento por Ressonância Magnética
17.
Cir. mayor ambul ; 17(2): 35-43, abr.-jun. 2012. ilus
Artigo em Espanhol | IBECS | ID: ibc-103942

RESUMO

El manejo de la vía aérea, la correcta ventilación y oxigenación es un tema de constante preocupación para los anestesiólogos. Su manejo, gracias a la variedad de dispositivos disponibles en el mercado, ha cambiado mucho en los últimos años. Todas las técnicas que empleamos requieren amplios conocimientos anatómicos. Algunas, como la anestesia de la vía aérea para la intubación con el paciente despierto, precisan del reconocimiento de la vascularización e inervación de las estructuras anatómicas. Finalmente, dedicamos unas líneas a la ecografía de la vía aérea, cuya aplicación es novedosa y su eficacia real está aún por demostrar. Con este artículo iniciamos una serie de capítulos dedicados a la anatomía y exploración de la vía aérea, la realización de una valoración adecuada de la vía aérea y la prediccción de una vía aérea difícil (AU)


The difficult airway and its management have always been studied by anaesthetist with great interest but also with fear and concern. This situation has changed considerably in the last few years due to the great variety of machinery and artefacts available. Despite this, all of the techniques that are used today require the knowledge and clear understanding of the local anatomy. Some of the more recent techniques, like the nasal intubation in awake patients, need a very accurate knowledge of the vascularization and precisely, the innervation of certain structures. We will also use some of our final words discussing ultrasound assessment of the airway, as a new application to difficult intubation, but of course, its real efficiency will need to be tested in further studies. With this paper we start a series of chapters devoted to the anatomy and examination of the airway and the different methods to predict a difficult airway (AU)


Assuntos
Humanos , Manuseio das Vias Aéreas/métodos , Sistema Respiratório/anatomia & histologia , Anestesia/métodos , Respiração Artificial/métodos , Faringe/anatomia & histologia , Boca/anatomia & histologia , Laringe/anatomia & histologia , Língua/anatomia & histologia , Palato Mole/anatomia & histologia , Articulação Temporomandibular/anatomia & histologia , Traqueia/anatomia & histologia
19.
Rev. esp. cir. oral maxilofac ; 34(1): 31-34, ene.-mar. 2012.
Artigo em Espanhol | IBECS | ID: ibc-97701

RESUMO

La fístula oronasal es la complicación más común posterior a una palatoplastía y frecuentemente requiere de una reparación secundaria. Se ha desarrollado una gran cantidad de técnicas quirúrgicas para su manejo, siendo una de las más populares el colgajo lingual. A pesar de la excelente vascularidad de la lengua, para asegurar la viabilidad del colgajo, éste debe ser manejado con extremo cuidado durante el procedimiento. Con este propósito sugerimos el uso de una platina acrílica en forma de herradura que aporta estabilidad e inmoviliza la lengua durante la cirugía, lo que facilita el procedimiento y ayuda a evitar errores durante el diseño y el levantamiento del colgajo(AU)


The oronasal fistula is the most common complication after a palatoplasty and it frequently needs a secondary repair. A great number of surgical techniques have been developed for the management of this condition. The lingual flap is one of the most popular treatments. In spite of the excellent vascularity of the tongue, it must be handled carefully during the procedure to assure the viability of the flap. For this reason we suggest the use of an acrylic slide in the shape of horse-shoe that improves the stability and immobilises the tongue during the surgery. This makes the procedure easier and helps to avoid mistakes during the design and the raising of the flap(AU)


Assuntos
Humanos , Feminino , Pré-Escolar , Retalhos Cirúrgicos/tendências , Retalhos Cirúrgicos , Fístula/diagnóstico , Fístula/cirurgia , Deiscência da Ferida Operatória/complicações , Deiscência da Ferida Operatória/diagnóstico , Fístula Dentária/terapia , Palato Mole/patologia , Palato Mole/cirurgia , Palato Mole , Mucosa Nasal/patologia , Mucosa Nasal/cirurgia
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