RESUMO
BACKGROUND: Diffuse sclerosing osteomyelitis of the mandible (DSOM) and SAPHO (synovitis, acne, palmo-plantar pustulosis and psoriasis, hyperosteosis, osteitis) syndrome are not commonly associated. SAPHO has not been described to date in the stomatology and maxillo-facial surgery literature in French. Were report here a homogeneous series of 12 patients with DSOM. MATERIAL AND METHODS: All patients had mandibular osteitis. RESULTS: Five patients with multifocal osteitis wre considered to present SAPHO syndrome because of the associated skin lesions. One patient with a unique focus of mandibular osteitis and palmo-plantar pustulosis probably had early-stage SAPHO syndrome. The diagnosis in the other cases was diffuse sclerosis osteitis of the mandible. DISCUSSION: We compared our series with those reported in the literature, emphasizing diagnostic and therapeutic difficulties. Diffuse sclerosing osteomyelitis of the mandible should be distinguished from microbial osteitis. Early diagnosis is required to avoid successive and unnecessary dental avulsions. There is a possible link between DSOM and SAPHO and all patients should have a complete work-up including whole-body scintigraphy to search for other foci. A biopsy is indicated to rule out malignancy. Nonsteroidal antiinflammatory drugs can improve patient comfort in this particularly long syndrome. Although the efficacy is demonstrated, surgery and antibiotics can only delay relapse for a few months.
Assuntos
Síndrome de Hiperostose Adquirida/complicações , Doenças Mandibulares/complicações , Osteomielite/complicações , Síndrome de Hiperostose Adquirida/terapia , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Criança , Terapia Combinada , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Doenças Mandibulares/terapia , Pessoa de Meia-Idade , Osteíte/complicações , Osteíte/terapia , Osteomielite/terapia , Osteotomia , Recidiva , EscleroseRESUMO
SUMMARY: Calcifying epithelial odontogenic tumors and calcifying odontogenic cysts are rare, benign odontogenic tumors. We report two cases of an exceptional combination of these tumors with either an ameloblastic fibroodontoma or an odontoma.
Assuntos
Calcinose/diagnóstico , Neoplasias Maxilomandibulares/diagnóstico , Imageamento por Ressonância Magnética , Tumores Odontogênicos/diagnóstico , Odontoma/diagnóstico , Tomografia Computadorizada por Raios X , Adolescente , Calcinose/complicações , Criança , Feminino , Humanos , Neoplasias Maxilomandibulares/complicações , Masculino , Cisto Odontogênico Calcificante/complicações , Cisto Odontogênico Calcificante/diagnóstico , Tumores Odontogênicos/complicações , Odontoma/complicaçõesRESUMO
Myositis ossificans progressiva is an unusual autosomal-dominant inherited disease characterized by congenital malformations and osseous metaplasia of the fascia of the muscles and connective tissue leading to ossification of the relevant area. The case report is remarkable in that eight members of the same family over five generations manifested the exclusive localization of the disease in the maxillofacial region.
Assuntos
Miosite Ossificante/genética , Músculos Pterigoides/patologia , Adulto , Tecido Conjuntivo/patologia , Progressão da Doença , Fáscia/patologia , Feminino , Genes Dominantes , Humanos , Músculo Masseter/patologia , Miosite Ossificante/patologia , Miosite Ossificante/fisiopatologia , Ossificação Heterotópica/patologia , Linhagem , Músculos Pterigoides/fisiopatologia , Músculo Temporal/patologiaRESUMO
We report the use of an island infrahyoid myocutaneous flap, pedicled on the superior thyroid vessels, in a group of 21 patients. This flap allows reconstruction of intraoral defects or defects of the lower portion of the face, as large as 10 x 4 cm. We used it in 15 cases to repair parts of the oral cavity, after tumour resection, in 2 patients with mandibular osteoradionecrosis and in 4 patients with gunshot injuries. Among the 21 flaps, no muscular necrosis was observed; however, 4 total necrosis and 4 partial necrosis (< or = 25% of the skin area) of the skin paddle were recorded. Loss of the skin paddle was primarily attributable to the anatomical variations of the veins draining this flap.
Assuntos
Traumatismos Maxilofaciais/cirurgia , Soalho Bucal/cirurgia , Neoplasias Bucais/cirurgia , Músculos do Pescoço/transplante , Retalhos Cirúrgicos , Adulto , Idoso , Carcinoma de Células Escamosas/cirurgia , Irradiação Craniana/efeitos adversos , Feminino , Humanos , Masculino , Doenças Mandibulares/cirurgia , Pessoa de Meia-Idade , Soalho Bucal/lesões , Músculos do Pescoço/irrigação sanguínea , Osteorradionecrose/cirurgia , Retalhos Cirúrgicos/irrigação sanguínea , Glândula Tireoide/irrigação sanguínea , Resultado do Tratamento , Ferimentos por Arma de Fogo/cirurgiaRESUMO
A homogeneous series of 15 cases of diffuse cervical cellulitis originating in the oropharyngeal area were collected from December 1990 to April 1995. Despite early management, diffusion of the infectious processus was rapid with extension and development of severe mediastinal or pulmonary complications. When diffuse cervical cellulitis is suspected, early and adapted aggressive treatment must be initiated immediately: suppression of the causal factor, surgical exploration with repeated drainage depending on the clinical course assessed on CT scans, antibiotics effective against the aero-anaerobic flora. This aggressive attitude is required to avoid potentially severe morbidity. Anti-inflammatory drugs, taken alone or with unadapted antibiotics was implicated in 11 cases as a favoring factor.
Assuntos
Infecções Bacterianas , Celulite (Flegmão)/microbiologia , Doenças da Boca/microbiologia , Pescoço , Doenças Faríngeas/microbiologia , Adulto , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Anti-Inflamatórios/efeitos adversos , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/fisiopatologia , Celulite (Flegmão)/tratamento farmacológico , Celulite (Flegmão)/fisiopatologia , Progressão da Doença , Drenagem , Feminino , Humanos , Pneumopatias/fisiopatologia , Masculino , Doenças do Mediastino/fisiopatologia , Doenças da Boca/tratamento farmacológico , Doenças da Boca/fisiopatologia , Doenças Faríngeas/tratamento farmacológico , Doenças Faríngeas/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
The paradental cyst is an odontogenic inflammatory cyst (WHO classification, 1992). It has been rarely described in the french literature and includes: The inflammatory paradental cyst which occurs on the buccal or distal aspects of an erupted third mandibular molar or of a canine (first description by Main in 1970); the mandibular infected buccal cyst which occurs on the buccal surface of the mandibular second or first molar in children around 6-8 years of age with an associated history of inflammatory signs (Stoneman and North, 1993). The histological features are the same as those of the radicular cyst. Prognosis is excellent after enucleation. This paper present an additional case report of a paradental cyst located on a second mandibular molar.
Assuntos
Doenças Mandibulares , Cisto Periodontal , Adolescente , Diagnóstico Diferencial , Humanos , Masculino , Doenças Mandibulares/diagnóstico , Doenças Mandibulares/cirurgia , Cisto Periodontal/diagnóstico , Cisto Periodontal/cirurgia , Prognóstico , Radiografia PanorâmicaAssuntos
Diagnóstico por Imagem , Neoplasias Parotídeas/patologia , Neoplasias da Glândula Submandibular/patologia , Adenolinfoma/diagnóstico por imagem , Adenolinfoma/patologia , Adenoma Pleomorfo/diagnóstico por imagem , Adenoma Pleomorfo/patologia , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Parotídeas/diagnóstico por imagem , Sialografia , Neoplasias da Glândula Submandibular/diagnóstico por imagem , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Ankylosis of the temporomandibular joint has severe consequences due to its effect on eating, speaking, buccal hygiene and growth of the lower third of the face in children. Two therapeutic problems must be addressed: functional capacity (joint mobility) and morphological (correction of the facial deformation). The appropriate surgical techniques are still subject to debate. Each operator has a technique which gives satisfactory results. In our unit, we used two techniques with similar results. Early and prolonged rehabilitation still remains the only guarantee of success.
Assuntos
Anquilose/cirurgia , Transtornos da Articulação Temporomandibular/cirurgia , Anquilose/terapia , Humanos , Prótese Articular , Modalidades de Fisioterapia , Desenho de Prótese , Estudos Retrospectivos , Transtornos da Articulação Temporomandibular/terapiaAssuntos
Neoplasias Faciais/patologia , Neoplasias de Cabeça e Pescoço/patologia , Rabdomiossarcoma/patologia , Adolescente , Criança , Pré-Escolar , Neoplasias Faciais/terapia , Feminino , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Lactente , Masculino , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Rabdomiossarcoma/secundário , Rabdomiossarcoma/terapia , Taxa de SobrevidaRESUMO
Stones occur in the accessory salivary glands more often than is generally thought due to insufficient diagnosis. Certain factors commonly favour stone formation in the salivary glands in general and others are more specific for the accessory glands. Most often, the consultation is motivated by a painful submucosal nodule. The physical examination may include a probe exploration. Calcifications are found on low penetration radiography. The stone is removed after incision under local anaesthesia.
Assuntos
Cálculos das Glândulas Salivares/patologia , Glândulas Salivares Menores/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cálculos das Glândulas Salivares/química , Cálculos das Glândulas Salivares/etiologia , Cálculos das Glândulas Salivares/cirurgiaRESUMO
Heterologous bone grafting has increased considerably due to improved preservation and the development of bone banks. We analyzed the forensic aspects of organ procurement, transformation, processing and preservation specifically related to bone grafts. Topics considered included the organization of the responsible authorities and their activities in the context of ethical medical considerations. The surgeon is often faced with a complex heterogeneous situation without clear legal requirements.
Assuntos
Transplante Ósseo/legislação & jurisprudência , Bancos de Tecidos/legislação & jurisprudência , Transplante Ósseo/métodos , Transplante Ósseo/patologia , Morte Encefálica , Cadáver , Criopreservação , França , Humanos , Preservação de Órgãos , Esterilização/métodos , Doadores de Tecidos/legislação & jurisprudência , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Transplante Heterólogo , Transplante HomólogoRESUMO
Although ameloblastoma is one of the benign odontogenic tumors, the maxillary localisations often grow more infiltratively and show higher recurrency than the mandibular localisations. The authors report a case of ameloblastoma in maxillary sinus and sketch out the operative methods with a literature review.
Assuntos
Ameloblastoma/patologia , Neoplasias do Seio Maxilar/patologia , Adulto , Seguimentos , Humanos , Masculino , Neoplasias Maxilares/patologia , Invasividade Neoplásica , Recidiva Local de Neoplasia/patologiaRESUMO
Preservation of buccal cavity relations raises problems when treating extensive defects of lower lip. After a review of anatomical features, several case reports are presented to illustrate the advantages and inconveniences of three interventions for labial reconstruction.
Assuntos
Doenças Labiais/cirurgia , Lábio/cirurgia , Retalhos Cirúrgicos/métodos , Idoso , Traumatismos Faciais/cirurgia , Músculos Faciais/anatomia & histologia , Músculos Faciais/irrigação sanguínea , Músculos Faciais/inervação , Músculos Faciais/cirurgia , Nervo Facial/anatomia & histologia , Nervo Facial/fisiologia , Humanos , Lábio/anatomia & histologia , Lábio/irrigação sanguínea , Lábio/lesões , Lábio/inervação , Neoplasias Labiais/cirurgia , Masculino , Pessoa de Meia-Idade , Planejamento de Assistência ao Paciente , Úlcera/cirurgia , Ferimentos por Arma de Fogo/cirurgiaRESUMO
Despite a thorough examination it is not always possible to detect the primary cancer responsible for malignant cervical adenopathy. In the vast majority of cases the metastases arise from an epidermoid carcinoma of the upper respiratory or digestive tract. A possible diagnostic, but also therapeutic procedure is exploratory cervicotomy with extemporaneous examination. The prognosis is poor, both locally (glandular involvement) and generally (metastatic spread).