Transcultural adaptation and validation of the Spanish language version of the questionnaire OQLQ for the assessment of quality of life in orthognathic patients.

BACKGROUND: Orthognathic surgery is the cornerstone of the treatment of dentofacial deformities, which have a great psychological and social impact on the life of the patient. Patient satisfaction and the impact on quality of life have recently become clinical parameters of growing importance. The aim of this study was to undertake a transcultural adaptation, translation to Spanish and validation of this version of the questionnaire OQLQ, used to measure quality of life in the context of Spanish culture. MATERIAL AND METHODS: Validation of the OQLQ questionnaire to the Spanish language was carried out through the methodology of translation and back translation, conceptual equivalence and piloting. The Spanish version was applied through a cross-sectional study to a total of 50 patients undergoing orthognathic surgery. RESULTS: The adapted and validated version showed adequate metric properties of reliability, change sensitivity and validity. In this study, a positive impact of orthognathic surgery on the specific quality of life was evident in 96% of patients, with an average improvement of 58% with respect to the initial score. CONCLUSIONS: Dentofacial deformities have a marked negative impact on the lives of patients, with orthognathic surgery being a therapeutic tool of great value in improving the quality of life in social, functional and aesthetic terms. The pilot test of this Spanish language version of the OQLQ proved valid for the assessment of quality of life in Spanish-speaking orthognathic patients or those with a Spanish culture. Key words:Orthognathic surgery, quality of life, validation studies, dentofacial deformities, patient satisfaction, treatment outcome.

Facial nerve reconstruction following radical parotidectomy and subtotal petrosectomy for advanced malignant parotid neoplasms.

INTRODUCTION: To describe the oncological management and functional outcome of patients with advanced parotid malignant tumors undergoing facial nerve reconstruction after radical parotidectomy and subtotal petrosectomy. MATERIALS AND METHODS: A combined approach was used to treat advanced stage parotid malignancies with intrapetrous involvement of the facial nerve main trunk or abutment on the stylomastoid foramen. Patients underwent facial nerve rehabilitation with cable graft reconstruction or with static techniques. RESULTS: Six patients were included. All patients had Stage IV disease and underwent surgical treatment using a combined approach. Three patients underwent facial-nerve cable graft technique and three patients underwent static techniques to rehabilitate facial nerve function. Five patients received adjuvant treatment with radiotherapy and/or chemotherapy. The mean follow-up was 27.5 months, with a minimum of 7 months and a maximum of 8 years. Four patients remain disease-free, with an overall survival rate of 66%. Among the patients undergoing dynamic reconstruction, first signs of recovery were established at 6 months of follow-up. All patients achieved a House-Brackmann score of III-IV within the first two postoperative years. CONCLUSIONS: When possible, facial nerve grafting is the preferred method of facial nerve rehabilitation in an advanced stage parotid tumors. A multidisciplinary approach allows better functional and oncological outcomes.

Osteochondroma of coronoid process: a rare etiology of jacob disease.

Jacob disease is a rare entity consisting of the formation of a pseudojoint between the inner surface of the zygoma and the coronoid process. This requires constant contact between the two implicated surfaces. It can be achieved by two mechanisms: one by an enlarged coronoid process and two by an anterior displacement of the coronoid process caused by a temporomandibular joint (TMJ) disorder. Although von Langenbeck described coronoid process hyperplasia in 1853, Oscar Jacob was the first author to describe the pathology in 1899. Since then, only a few cases have been published in the literature. The authors report a rare case of Jacob disease caused by an osteochondroma of the coronoid process, which is even less common, and review the literature.

Clinical, radiological and therapeutic features of keratocystic odontogenic tumours: a study over a decade.

Factors associated with the potential for recurrence of keratocystic odontogenic tumours (KCOT) still remain to be clearly determined and no consensus exists concerning the management of KCOT. The purpose of this study was to evaluate different clinical factors associated with KCOT and its treatment methods. A retrospective review was performed of 55 cases treated from 2001 to 2010. Of the 55 cases, 27% were associated with an impacted or semi-impacted tooth. The majority of the lesions (82%) were located in tooth-bearing areas, and the overall mandibular to maxilla ratio of tumour occurrence was 5:1. The treatment options included enucleation, marsupialisation, or peripheral ostectomy, with or without the use of Carnoy´s solution. Recurrence was found in 14 cases (25%). No significant association was seen between recurrence and age, symptomatic cases, location of the lesion, or unilocular or multilocular appearance. The recurrence rate was higher in the group with tooth involvement, more marked in cases with third molar involvement. Statistical analysis showed a significant relation between recurrence and the type of treatment, with higher rates in cases treated with enucleation associated with tooth extraction. In our series, those cases with a closer relation with dental tissues showed a higher risk of recurrence, suggesting the need for a distinct classification for peripheral variants of KCOT. Key words:Keratocystic odontogenic tumour, Odontogenic keratocyst, Odontogenic cysts, Keratocyst, Carnoy's solution.

Bronchial impaction of an implant screwdriver after accidental aspiration: report of a case and revision of the literature.

BACKGROUND: Adverse outcomes resulting from aspiration or ingestion of instruments and materials can occur in any dental procedure. Clinical manifestation depends on the location, the obstructive potential of the foreign body, and the temporal factor since the accidental incident. Accidental inhalation of dental appliances can be an even more serious event than ingestion and must always be treated as an emergency situation. CASE REPORT: A 62-year-old woman was admitted to our hospital with the suspicion of ingestion of a screwdriver implants. In spite of the clinically asymptomatic presentation, chest radiography in posteroanterior and lateral projections showed a radiopaque dental instrument impacted on the right main inferior bronchus. Rigid bronchoscope was successful to remove the dental instrument under general anesthesia, and the patient was discharged 24 h later. CONCLUSION: Aspiration and ingestion of dental foreign objects are infrequent, but they can occur at large multidisciplinary dental procedures. These episodes have the potential to result in acute medical and life-threatening emergencies since the beginning of the event or at a late stage in proceeding in the underdiagnosed patient. Prevention of such incidents is, therefore, the best approach via the mandatory use of precautions during all dental procedures, and in case of suspicion with no retrievable material, patient must always be submitted to a radiographic study.