RESUMO
Inadequate craniofacial orientation of computed tomography (CT) scans can have significant implications in all three planes of space. The purpose of this study was to present the reproducibility of a 3-dimensional skeletal-based method of craniofacial orientation for virtual surgical planning. The protocol was defined by landmarks commonly used for cephalometry, and required identification of basion, nasion, right porion, and right orbitale, and navigation in all CT views (coronal, sagittal, and axial) for correction of yaw, roll, and pitch. Reproducibility of the method was assessed using eight CT scans that were randomly selected and anonymised. The observer group consisted of six oral and maxillofacial surgeons with varying levels of experience (resident or faculty) who performed craniofacial orientation according to the proposed method. Results were expected to be below 2° of variation, when overall accuracy as well as the influence of the academic level of the observers and symmetry of the evaluated anatomy, were considered as independent variables. Overall accuracy for all cases and for yaw, roll, and pitch were always below 2° of variation, without influence of level of experience and symmetry. Interobserver assessment was categorised as excellent in all instances, and intraobserver evaluation demonstrated consistency in the orientation of all axes. The proposed craniofacial orientation protocol presented in this study is easy to learn, applicable to computer-aided surgical planning, and can be performed by the non-technical clinician, resulting in excellent reproducibility and consistency.
Assuntos
Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Cefalometria/métodos , Humanos , Imageamento Tridimensional/métodos , Reprodutibilidade dos TestesRESUMO
Pleomorphic adenoma is a benign neoplasm of the salivary glands that affects most frequently females in the fourth and sixth decade of life. As it is usually an asymptomatic lesion, it is diagnosed upon routine physical examination. Treatment consists in surgical removal with partial or total involvement of the parotid gland. Conservative enucleation is the least invasive surgical option for this type of lesion. The present work aimed to report a case of pleomorphic adenoma of the parotid gland with eight years of evolution. The tumor was treated conservatively. Patient has been followed for sixth months, and no sensory alterations, fistulae, clinical signs of recurrence, nor any other alteration have been observed so far. Due to the benign nature of the lesion, an evolution with favorable prognosis is expected. (AU)
O Adenoma pleomórfico é uma neoplasia benigna de glândulas salivares, que acomete com maior frequência pessoas do sexo feminino entre a quarta e sexta década de vida. Por se tratar de uma lesão muitas vezes assintomática, geralmente é descoberta através do exame físico de rotina. O seu tratamento consiste em remoção cirúrgica podendo envolver ou não a glândula parótida de maneira parcial ou total. A enucleação conservadora é a modalidade cirúrgica menos invasiva para este tipo de lesão. O presente trabalho tem por objetivo relatar um caso de adenoma pleomórfico em glândula parótida com oito anos de evolução. O tumor foi tratado de maneira conservadora. A paciente está sendo acompanhada há 6 meses e não foram observados até momento alterações sensoriais, fistulas, indícios clínicos de recidiva ou qualquer outra alteração. Devido ao caráter benigno da lesão, espera-se evolução com prognóstico favorável. (AU)
RESUMO
A Hipertrofia do músculo masseter é uma condição rara e pouco descrita na literatura, apresentando-se como um aumento volumétrico excessivo em região posterior de mandíbula. É de etiologia incerta, provocando alterações funcionais, desconforto estético, e prejuízo psicossociais aos pacientes. Por ter seu crescimento assintomático na maioria dos casos, tem grande importância no diagnóstico diferencial de outras patologias que provocam aumento de volume na região da cabeça e pescoço. Os tratamentos são variados, indo desde o uso de substâncias farmacológicas até o tratamento cirúrgico. O presente artigo relata um caso de hipertrofia do músculo masseter, tratado cirurgicamente, através de incisão intraoral, obtendo resultado estético e funcional satisfatório.
The hypertrophy of the masseter muscle is arare and poorly described in the literature, presenting itself as an excessive increase in volume in the posterior mandible, is of uncertain etiology, causing functional changes, aesthetic discomfort, and psychosocial harm to patients. By having your growth asymptomatic in most cases, is of great importance in the differential diagnostic of other masses of the head and neck. The treatments are varied, ranging from the use of pharmacological substances to surgical treatment. This article reports a case of hypertrophy of the masseter muscle, treated surgically, through oral incision, obtaining satisfactory aesthetic and functional result.