RESUMEN
Orthognathic surgery is the surgical procedure that makes correcting deformities of the bones in the region of the maxilla and mandible a reality in the Brazilian dentistry. However, this type of surgery usually involves paresthesia in the postoperative period, concerning the surgeons who perform them and generating discomfort to patients. This study aimed at evaluating the effect of infrared laser (830 nm) in the prevention and treatment of paresthesias after orthognathic surgery. Six patients underwent orthognathic surgery: the experimental group composed of 4 patients and the control group that did not receive laser therapy composed of 2 patients. The experimental group received laser applications during the transoperative and 12 postoperative sessions. Tests for mechanical (deep and shallow) and thermal (cold) sensitivity were performed in the preoperative and postoperative period (during 12 sessions) in the lip and chin areas by the same operator. The paresthesia was classified into 1, strong; 2, moderate; 3, mild; and 4, absent, through the patient's response to stimuli. The results showed that all patients had no disturbance of sensitivity in the preoperative period, but paresthesia was presented at various levels in the postoperative period. Both groups showed recovery of deep mechanical sensitivity within a shorter time interval compared with the superficial mechanical and thermal sensitivity. However, at the 12th assessment, patients who underwent the laser therapy showed better reduction in the level of paresthesia or even complete regression of this. The laser, therefore, brought benefits to the treatment of paresthesia, accelerating the return of neurosensorial sensitivity.
Asunto(s)
Láseres de Semiconductores/uso terapéutico , Terapia por Luz de Baja Intensidad/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Parestesia/prevención & control , Complicaciones Posoperatorias/prevención & control , Adulto , Mentón/patología , Femenino , Mentoplastia/métodos , Humanos , Enfermedades de los Labios/prevención & control , Enfermedades de los Labios/terapia , Masculino , Mandíbula/cirugía , Maxilar/cirugía , Osteotomía/métodos , Osteotomía Le Fort/métodos , Osteotomía Sagital de Rama Mandibular/métodos , Parestesia/terapia , Complicaciones Posoperatorias/terapia , Sensación Térmica/fisiología , Tacto/fisiología , Resultado del Tratamiento , Adulto JovenRESUMEN
A rare case of fracture of the coronoid and the pterygoid process caused by firearms is described. A 28-year-old male was hit by a bullet in the face, resulting in restricted mouth opening, difficulty in chewing and pain when opening the mouth. Clinical examination revealed a perforating wound in the right parotid region and a similar wound on the left side of the same region. A CT scan showed comminuted fracture of the left coronoid process and bilateral comminuted fracture of the pterygoid processes. Treatment was conservative, speech therapy was conducted and it was successful. Details of the clinical signs, radiology (3D-CT scan), treatment and follow-up are presented.
Asunto(s)
Fracturas Conminutas/etiología , Fracturas Mandibulares/etiología , Fracturas Craneales/etiología , Hueso Esfenoides/lesiones , Heridas por Arma de Fuego/complicaciones , Adulto , Terapia por Ejercicio , Dolor Facial/etiología , Armas de Fuego , Estudios de Seguimiento , Humanos , Masculino , Masticación/fisiología , Manipulaciones Musculoesqueléticas , Glándula Parótida/lesiones , Logopedia , Trismo/etiologíaRESUMEN
A rare case of fracture of the coronoid and the pterygoid process caused by firearms is described. A 28-year-old male was hit by a bullet in the face, resulting in restricted mouth opening, difficulty in chewing and pain when opening the mouth. Clinical examination revealed a perforating wound in the right parotid region and a similar wound on the left side of the same region. A CT scan showed comminuted fracture of the left coronoid process and bilateral comminuted fracture of the pterygoid processes. Treatment was conservative, speech therapy was conducted and it was successful. Details of the clinical signs, radiology (3D-CT scan), treatment and follow-up are presented.
Um caso raro de fratura dos processos coronóide e pterigóide por arma de fogo é descrito. Paciente do sexo masculino, 28 anos de idade, foi atingido por projétil de arma de fogo na face, resultando em limitação na abertura da boca, dificuldade para mastigar e dor ao abrir a boca. Exame clínico revelou ferimento perfurante em região parotídea direita e ferida similar do lado esquerdo na mesma região. Tomografia computadorizada (TC) mostrou fratura cominutiva do processo coronóide esquerdo e fratura cominutiva bilateral dos processo pterigóides. O tratamento foi conservador, através de fonoterapia, obtendo-se sucesso. Uma descrição detalhada das características clínicas, radiológicas (TC com reconstrução 3D), tratamento e proservação do caso é apresentada.