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BACKGROUND: The purpose of this retrospective study was to investigate the usefulness of tracheostomy scoring system in the decision of postoperative airway management in oral cancer patients. MATERIALS AND METHODS: A total of 104 patients were reviewed in this retrospective study, who underwent radical resection with or without neck dissection and free flap reconstruction due to oral cancer. The patients were classified into three groups according to the timing of the extubation; extubated groups (n = 51), overnight intubation group (n = 45), and tracheostomy group (n = 8). Cameron's score was used to evaluate the relation between the state of the patient's airway and the type of the operation. RESULTS: Tracheostomy was performed in eight patients (8/104, 7.7 %). A total of 22 patients (21.2 %) had more than 5 points of which 17 patients (77.3 %) did not have a tracheostomy and any postoperative emergency airway problems. The tracheostomy scores were significantly different among the three groups. Hospital stay showed a significant correlation with the tracheostomy score. CONCLUSIONS: The scoring system did not quite agree with the airway management of the authors' clinic; however, it can be one of the clinical factors predicting the degree of the postoperative airway obstruction and surgical aggressiveness for recovery. The further studies are needed for clinically more reliable scoring systems.
الموضوعات
Humans , Airway Management , Airway Obstruction , Emergencies , Free Tissue Flaps , Intubation , Length of Stay , Mouth Neoplasms , Neck Dissection , Retrospective Studies , Tracheostomyالملخص
الموضوعات
Humans , Aneurysm, False , Angiography , Arteries , Curettage , Embolization, Therapeutic , Head , Hemorrhage , Hemostasis , Mandible , Neck , Odontogenic Cysts , Odontogenic Tumors , Petrolatumالملخص
الموضوعات
Female , Humans , Alkalies , Bicuspid , Burns, Chemical , Calcium , Calcium Hydroxide , Cheek , Curettage , Dental Pulp Cavity , Hydroxides , Hypesthesia , Incisor , Lip , Paresthesia , Root Canal Filling Materials , Silicones , Zygomaالملخص
الموضوعات
Female , Humans , Male , Carcinoma, Mucoepidermoid , Carcinoma, Squamous Cell , Fibrosarcoma , Fistula , Free Tissue Flaps , Hematoma , Mouth Neoplasms , Necrosis , Postoperative Complications , Retrospective Studiesالملخص
INTRODUCTION: The location of parotid gland tumors in the superficial or deep lobes can affect the time and difficulty of operations. Therefore, accurate preoperative evaluation of the tumor location is important for surgical outcomes. MATERIALS AND METHODS: A total of 16 patients with parotid gland tumors and who underwent a parotidectomy between April 2003 and March 2011 were retrospectively reviewed in terms of demographic background, tumor location, surgical treatment, and treatment outcomes. Tumor location was estimated by four landmarks on contrast enhanced computerized tomography scans, which were Conn's arc, the facial nerve (FN) line, the Utrecht line, and the retromandibular vein. Tumor location was confirmed by relative position depending on the facial nerve during surgery. It was assumed positive since the tumor lies in the superficial lobe of the parotid gland, the sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of each landmark were evaluated. RESULTS: Our result revealed that the facial nerve line had a sensitivity of 83.3%, specificity of 100%, positive predictive value of 100%, negative predictive value of 71.4%, and efficiency of 87.5%. Some would be more efficient preoperative evaluation methods of the relationship of parotid gland tumors to the facial nerve than others. CONCLUSION: In our study, the FN line was found to be the most reliable analysis method.
الموضوعات
Humans , Facial Nerve , Parotid Diseases , Parotid Gland , Parotid Neoplasms , Retrospective Studies , Sensitivity and Specificity , Veinsالملخص
0.05). First measurement was longer than third measurement (P<0.05). This is the actual placement of the implant site measured on the vertical length than the length of the panorama means that there are a few more free. The first measurement was longer than 114% over the third measurement.
الموضوعات
Female , Humans , Male , Cone-Beam Computed Tomography , Dental Implants , Floors and Floorcoverings , Incisor , Meristem , Radiography, Panoramic , Toothالملخص
الموضوعات
Humans , Bone Resorption , Follow-Up Studies , Mandible , Surgery, Oral , Tissue Donors , Transplantsالملخص
OBJECTIVES: Odontogenic keratocysts (OKCs) have a tendency to recur and possess an aggressive nature. the aim of the present study was to evaluate cytokeratin (CK) expression patterns as a method for the differentiation between dentigerous cysts (DCs) and OKCs, as their histomorphologic appearance are often indistinguishable. MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded tissue sections of 43 OKCs and 38 DCs were immunohistochemically analyzed with i-solution in a quantitative manner in order to evaluate the immunoreactivity of CK 10, 16 and 17. RESULTS: CK 10 expression was evident in 79.1% of OKCs but found in only 18.4% of DCs (P<0.05), and CK 10 expression was observed to occur more frequently in OKCs (mean 25.45%) than in DCs (2.19%) (P<0.05). The expression of CK 16 was evident in 79.1% of OKCs but found in only 7.9% of the DCs (P<0.05) and CK 16 expression was observed to occur more frequently in OKCs (mean 4.33%) than in the DCs (0.61%) (P<0.05). The expression of CK 17 was evident in 88.4% of OKCs but seen in only 15.7% of the DCs (P<0.05) and CK 17 expression was observed to occur more frequently in OKCs (mean 31.11%) than in the DCs (2.37%) (P<0.05). CONCLUSION: The immunohistochemical detection of CK 10, 16 and 17 can be utilized as a valuable biomarker for use in distinguishing between OKCs and DCs, which have clinically significant differential diagnoses.
الموضوعات
Biomarkers , Dentigerous Cyst , Diagnosis, Differential , Imines , Keratins , Odontogenic Cysts , Thiazinesالملخص
OBJECTIVES: This study sought to investigate the positioning of the posterior superior alveolar artery in relation to the performance of the maxillary sinus bone graft procedure in a Korean population. MATERIALS AND METHODS: We identified the position of the posterior superior alveolar artery relative to 93 maxillary sinuses in 58 patients and determined the distance from the inferior border of the artery in the premolar and molar areas to the alveolar ridge and sinus floor. RESULTS: The mean distance from the alveolar ridge to the posterior superior alveolar artery in the dentate group (20.62+/-3.05 mm in the premolar region, 17.50+/-2.84 mm in the molar region) was greater than as compared to the edentulous group (18.83+/-2.79 mm in the premolar region, 15.50+/-1.64 mm in the molar region), and this difference was statistically significant (P0.05) between the mean distance from the sinus floor to the posterior superior alveolar artery in the dentate group (8.21+/-2.79 mm in the premolar region, 7.52+/-2.07 mm in the molar region) or in the edentulous group (7.75+/-3.31 mm in the premolar region, 7.97+/-2.31 mm in the molar region). CONCLUSION: Prior to surgery, it is important to evaluate the position of the posterior superior maxillary artery by using computed tomography scans. The premolar area is safer than the molar area for performing the maxillary sinus bone graft without bleeding.
الموضوعات
Humans , Alveolar Process , Arteries , Bicuspid , Floors and Floorcoverings , Hemorrhage , Maxillary Artery , Maxillary Sinus , Molar , Sinus Floor Augmentation , Transplantsالملخص
Polymorphous low-grade adenocarcinomas (PLGA) are distinctive salivary gland neoplasms with a propensity to arise from the minor salivary glands. The most frequent location of PLGA is the palate, even though other locations have been described. Previously used terms for PLGA include lobular carcinoma and terminal duct carcinoma. Although the frequency of the tumor is unknown, the recognition of PLGA as an individual tumor has increased with the establishment of specific histopathological criteria characterizing the PLGA. The first choice of treatment is a wide surgical excision including the subjacent bone if necessary. The prognosis is generally good and the recurrence rate ranges from 17% and 22%. Distant metastases is unusual (9%) but occur mainly in the regional lymph nodes. This is a case report of a 67 year old female patient with PLGA who was treated with a wide excision by layers (2 stage) of the lesion including the surrounding bone. We present this case with a review of the relevant literature.
الموضوعات
Female , Humans , Adenocarcinoma , Carcinoma, Lobular , Lactic Acid , Neoplasm Metastasis , Palate , Polyglycolic Acid , Prognosis , Recurrence , Salivary Gland Neoplasms , Salivary Glands, Minorالملخص
Myxofibrosarcoma, also known as a myxoid variant of a malignant fibrous histiocytoma (MFH), is one of the most common sarcomas in the extremities of elderly people. The lesion is characterized by a high frequency of local recurrence but is uncommon in the head and neck regions. Low-grade myxofibrosarcoma, which is commonly misinterpreted as being benign, has a tendency for histological and biological progression in local recurrences, highlighting the importance of an accurate diagnosis and wide surgical excision of the primary lesion. We report a rare case of low-grade myxofibrosarcoma of the mandible located in the left mandibular body and angle area. The tumor was first diagnosed as a myxofibroma and was resected initially. After the final biopsy the patient underwent combined chemo-radiotherapy. The progress of the patent was uneventful until the one year follow up.
الموضوعات
Aged , Humans , Biopsy , Extremities , Fibroma , Follow-Up Studies , Head , Histiocytoma, Malignant Fibrous , Mandible , Neck , Recurrence , Sarcomaالملخص
INTRODUCTION: The current study examined the morphological characteristics of maxillary sinus septum by computed tomography (CT). MATERIALS AND METHODS: Two hundred and four patients (408 maxillary sinuses) who visited dental clinic were evaluated. CT were examined. The height of the septum measured from the sinus floor to the apex of the septum more than 3 mm was defined as "sinus septum". RESULTS: The prevalence of sinus septa was 21.3% (87/408), and 31.4% (64/204) of patients had more than 1 sinus septum. Females showed higher and thinner sinus septa than males. The anatomic location of the septa were distributed in the 2nd molar region (43.7%), 1st molar region (31.0%), 2nd premolar region (21.8%) and 1st premolar region (3.5%). In 57 patients with chronic disease, there was no significant difference between sinus disease and the presence of sinus septa. The loss of remaining teeth and teeth adjacent to the sinus septum area was not related to the presence of sinus septa. Older subjects showed a reduced height and length of the septum, and a thicker septum. CONCLUSION: These results show that the maxillary sinus septum undergoes atrophy with age.
الموضوعات
Female , Humans , Male , Atrophy , Bicuspid , Chronic Disease , Dental Clinics , Floors and Floorcoverings , Maxillary Sinus , Molar , Prevalence , Toothالملخص
الموضوعات
Ameloblastoma , Connective Tissue , Crowns , Cuspid , Dental Cementum , Dental Enamel , Dentigerous Cyst , Epithelial Cells , Epithelium , Mandible , Maxilla , Odontogenic Tumors , Phenobarbital , Skin Neoplasms , Strikes, Employee , Tooth, Impacted , Tooth, Uneruptedالملخص
الموضوعات
Humans , Denture, Overlay , Dietary Sucrose , Floors and Floorcoverings , Follow-Up Studies , Inflammation , Maxilla , Maxillary Sinus , Osseointegration , Survival Rate , Transplantsالملخص
INTRODUCTION: Very high aggressiveness and recurrence are important clinical characteristics of ameloblastoma compared to the other benign tumors. Therefore, an accurate diagnosis and treatment plan is important. This study examined the association of the clinical findings and recurrence based on the radiological findings of ameloblastoma. In recurrent cases, these results are expected to help in the diagnosis and treatment of ameloblastoma to examine the relevance with the clinical characteristics and radiological features. MATERIALS AND METHODS: For a clinical (gender, age) and radiological (location, internal pattern, size, perforation, border pattern, impacted tooth, root resorption) evaluation , this study examined 156 cases of 147 patients diagnosed with ameloblastoma, who had been treated and in most cases regularly checked at the department of oral and maxillofacial surgery, Kyungpook National University Hospital, between January 1993 and December 2009. For a recurrent rate evaluation, a more than 3 years follow-up period is needed. Accordingly, 116 patients diagnosed with ameloblastoma between January 1994 and December 2007 were investigated. RESULTS: The recurrence rate in all cases was 6.1% but was 7.8% in cases with follow-up periods more than 3 years. The male-to-female ratio was 3:2, showing a slight male predilection. Ameloblastoma had a peak occurrence in the second decade of life followed by the fourth decade of life. The mandibular angle area is the most frequent site of ameloblastoma (50.8%) in the jaws. Six cases of unilocular (7.8%) and 3 cases of multilocular (7.7%) ameloblastomas recurred. Seven cases of smooth (10%) and 2 cases of irregular (4.3%) ameloblastomas recurred. No cases of ameloblastomas without perforation of the cortical bone (0%) and 9 cases with a perforation of cortical bone (11.1%) recurred. Four cases of the ameloblastomas with impacted teeth (11.4%) and 5 cases of ameloblastomas without impacted tooth (6.2%) recurred. Seven cases of ameloblastomas with root resorption (10.9%) and 2 cases of ameloblastomas without root resorption (3.8%) recurred. CONCLUSION: A multiple smooth margin, unilocular ameloblastoma with an impacted tooth, root resorption tends to recur more easily. Therefore, they need to be treated more carefully and require a a longer follow-up.
الموضوعات
Humans , Male , Ameloblastoma , Follow-Up Studies , Jaw , Recurrence , Root Resorption , Surgery, Oral , Tooth, Impactedالملخص
PURPOSE: The odontogenic keratocysts demonstrated a high recurrence rate and a biologically aggressive nature. This might be due to unknown factors inherent in the epithelium or enzymatic activity in the fibrous wall. Bcl-2 protein is characterized by its ability to inhibit apoptosis. The aim of this study was to evaluate the expression and distribution of bcl-2 in the OKCs, its possible relationship with the tumorous characteristics, such as the aggressive nature and high recurrence rate, and its usefulness to differentiate OKCs from dentigerous cysts. MATERIALS AND METHODS: Formalin fixed paraffin-embedded tissue sections of 53 OKCs, and 44 dentigerous cyst were immunohistochemically analyzed quantitatively for the immunoreactivity of the bcl-2 protein with i-solution. RESULTS: More Bcl-2 expression was observed in the OKCs (mean34.387%) than dentigerous cyst (mean11.144%) with statistical significance (P<0.001). Seventeen and 15 of the 32 OKCs in this study showed positivity in the basal layer and basal/suprabasal layers, respectively. In dentigerous cyst, 2 of 3 showed positivity in the basal cell layer. CONCLUSION: Considering that bcl-2 over expression may lead to the increased survival of epithelial cells, this study demonstrated a possible relationship between the aggressive nature of OKC and the intrinsic growth potential of its lining epithelium. Furthermore, the basal/suprabasal distribution of bcl-2 positive cells was observed in some OKCs, which might have a significant impact on the behavior of cysts. The bcl-2 expression of OKCs can be useful for differentiating OKCs from dentigerous cysts.
الموضوعات
Apoptosis , Dentigerous Cyst , Epithelial Cells , Epithelium , Formaldehyde , Odontogenic Cysts , Recurrenceالملخص
INTRODUCTION: Ameloblastoma is a benign but locally invasive tumor with a high recurrence rate. The aim of this study was to make an easier diagnosis and treatment planning of ameloblastoma. MATERIALS AND METHODS: From January 1993 to October 2009, 139 cases from 123 patients, who had been diagnosed with ameloblastoma through radiologic and biopsy in the department of oral and maxillofacial surgery of Kyunpook National University, were selected as the subjects in this study. According to the medical charts, 9 factors (age, gender, location, chief complaints, duration, radiographic findings, size and recurrence) concerned in deciding the treatment method and the relevance between each factor and the treatment methods were examined.(Conservative treatments were marsupialization, enucleation, curettage and lateral decortication. Radical treatments included block excision, resection and hemisection) RESULTS: In the patients under the age of 20, 77.14% had conservative treatments, whereas 22.86% underwent radical treatments. In the patients over the age of 20, 44.23% were treated conservatively treatments, and 55.77% underwent radical treatments. For unilocular types, 28.57% had conservative treatments, whereas 71.43% had radical treatments. For the multilocular types, 66.67% underwent conservative treatments, and 33.33% had radical treatments. For the primary cases, 58.68% were treated conservatively and 41.32% had radical treatments. For the recurrent cases, 16.67% and 83.33% underwent conservative and radical treatments, respectively. CONCLUSION: There was statistical significance in the factors affecting the treatment methods, such as age, radiographic findings and recurrence.
الموضوعات
Humans , Ameloblastoma , Biopsy , Curettage , Recurrence , Surgery, Oralالملخص
0.05). 2. At the total success rate, osteotome group was 92.4% and Hatch reamer group was 94.9%. There was no statistically significant difference between the two groups (P > 0.05). 3. On the discomfort during the operation by using numerical rating scale, osteotome group was 2.87 +/- 0.83 and Hatch reamer group was 1.12 +/- 0.64. There was statistically significant difference between the two groups (P < 0.05). The Hatch reamer group' clinical results was similar to osteotome group and we thought that Hatch reamer technique can overcome the faults of osteotome technique.
الموضوعات
Humans , Alveolar Bone Loss , Dizziness , Floors and Floorcoverings , Maxilla , Transplantsالملخص