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1.
J Pers Med ; 13(12)2023 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-38138929

RESUMEN

BACKGROUND: Genioplasty as an isolated surgical technique is a highly demanded procedure in the maxillofacial surgery area. Advances in facial reconstructive surgery have been associated with less morbidity and more predictable results. In this paper, "conventional" genioplasty and genioplasty by means of virtual surgical planning (VSP), CAD-CAM cutting guides, and patient custom-made plates are compared. METHODS: A descriptive observational study was designed and implemented, and 43 patients were treated, differentiating two groups according to the technique: 18 patients were treated by conventional surgery, and 25 patients were treated through virtual surgical planning (VSP), CAD-CAM cutting guides, STL models, and titanium patient-specific plates. RESULTS: The operation time ranged from 35 to 107 min. The mean operative time in the conventional group was 60.06 + 3.74 min.; in the custom treatment group it was 42.24 + 1.29 min (p < 0.001). The difference between planned and obtained chin changes in cases of advancement or retrusion was not statistically significant (p = 0.125; p = 0.216). In cases of chin rotation due to asymmetry, guided and personalized surgery was superior to conventional surgery (p < 0.01). The mean hospital stay was equal in both groups. A decrease in surgical complications was observed in the group undergoing VSP and customized treatment. CONCLUSIONS: Multi-stage implementation of VSP with CAD-CAM cutting guides, STL models, and patient-specific plates increased the accuracy of the genioplasty surgery, particularly in cases of chin asymmetry, reducing operation time and potential complications.

2.
J Craniofac Surg ; 2023 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-37938104

RESUMEN

Hyperplasia of the coronoid process of the mandible is a rare condition defined as an abnormal and progressive elongation of the coronoid process (unilateral or bilateral). Jacob disease is the name given to a pseudo-joint formation between the coronoid process and the zygomatic bone. The main clinical finding is a progressive, painless difficulty in opening the mouth, due to contact of the coronoid process with the posterior surface of the zygomatic bone or the medial surface of the zygomatic arch. To restore the mouth opening in a stable manner, resection of the elongated coronoid process followed by physiotherapy is the only effective treatment. Surgery (coronoidetomy or coronoidectomy) can be performed through intraoral or extraoral access. Intraoral coronoidectomy is the best surgical choice for most of the cases. However, in some cases, the intraoral surgical field prevents an adequate visualization of the osteotomy line. The authors present 5 consecutive clinical cases of hyperplasia of the coronoid process treated with an endoscopically assisted coronoidectomy using ultrasound bone-cutting instruments.

3.
J Plast Reconstr Aesthet Surg ; 84: 549-555, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37421680

RESUMEN

The introduction of new technologies in the field of facial aesthetic surgery is leading to improvement in surgical intervention quality. In the field of rhinoplasty, the design of customized surgical guides for the patient helps to perform an intervention with greater precision according to the presurgical planning. We present our design and method of fabrication of surgical profile guides for patients undergoing rhinoplasty, with free software and mostly in-house design and fabrication. The entire design process takes less than an hour. We have found that designing the guide enhances the communication process with the patient, and using that guide improves the surgical result.


Asunto(s)
Procedimientos de Cirugía Plástica , Rinoplastia , Cirugía Asistida por Computador , Humanos , Diseño Asistido por Computadora , Impresión Tridimensional , Programas Informáticos
4.
Materials (Basel) ; 14(9)2021 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-34064420

RESUMEN

The aim of this paper is to characterize the mechanical behavior of corrugated cardboard boxes using simple models that allow an approach to the load capacity and the deformation of the boxes. This is very interesting during a box design stage, in which the box does not exist yet. On the one hand, a mathematical model of strength and deformation of boxes with different geometry is obtained from experiments according to the Box Compression Test and Edge Crush Test standards. On the second hand, a finite element simulation is proposed in which only the material elastic modulus in the compression direction is needed. For that, corrugated cardboard sheets are glued to build billets for testing, and an equivalent elastic modulus is obtained. This idea arises from the fact that the collapse of the box is given by the local bucking of the corrugated cardboard panels, due to the slenderness itself, and the properties in the compression direction are predominant. As a result, the numerical models show satisfactory agreement with experiments, concluding that it is an adequate methodology to simulate in a simple and efficient way this type of boxes built with corrugated cardboard.

5.
Ann Maxillofac Surg ; 5(2): 203-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26981471

RESUMEN

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.

6.
J Craniofac Surg ; 24(5): 1507-14, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24036716

RESUMEN

The objective of this study was to valuate 2 substances as potential carriers of fibroblast growth factor 1 (FGF-1) in a rat craniectomy model: gelatin sponge (Spongostan; Ferrosan A/S, Søborg, Denmark) and natural bone mineral (Bio-Oss; Geistlich Biomaterials, Wolhusen, Switzerland).Forty-eight adult male Sprague-Dawley rats were used. A 5-mm-diameter circular craniectomy was performed in the left parietal bone. Animals were divided into 6 experimental groups of 8 rats, each group receiving a different treatment: control (no substance added), Spongostan, Bio-Oss, FGF, FGF + Spongostan, and FGF + Bio-Oss. Animals were killed 12 weeks after surgery.Descriptive histology and stereology were used, the latter to measure the volumes of regenerated bone and Bio-Oss remaining in the defect. Analysis of variance was used to determine differences in bone regeneration between groups, and Mann-Whitney U test was used to compare the volume of remaining Bio-Oss particles.Histologically, the control defects behaved like critical size defects, showing incomplete bone regeneration. Only the FGF + Spongostan group achieved nearly complete bone regeneration. Bio-Oss particles seemed to reduce centripetal bone regeneration. Spongostan by itself did not interfere with spontaneous bone healing.Stereologic measurements of the volume of new bone growth, measured in cubic millimeter, were as follows: control group, 3.86 ± 1.03; Bio-Oss, 2.26 ± 1.06; Spongostan, 3.00 ± 0.81; FGF, 3.99 ± 1.85; FGF + Bio-Oss, 3.02 ± 1.88; and FGF + Spongostan, 8.93 ± 1.28. Analysis of variance showed a statistically significant difference between the FGF + Spongostan group and the other groups (P < 0.001). Comparison among the other groups did not show significant differences.Fibroblast growth factor 1 with a Spongostan carrier has shown great efficacy for bone regeneration in cranial critical size defects in rats. Bio-Oss did not produce a regenerative effect, either alone or with FGF-1.


Asunto(s)
Enfermedades Óseas/cirugía , Regeneración Ósea/efectos de los fármacos , Sustitutos de Huesos/uso terapéutico , Espuma de Fibrina/uso terapéutico , Factor 1 de Crecimiento de Fibroblastos/uso terapéutico , Minerales/uso terapéutico , Hueso Parietal/cirugía , Animales , Materiales Biocompatibles/uso terapéutico , Portadores de Fármacos , Factor 1 de Crecimiento de Fibroblastos/administración & dosificación , Masculino , Osteoclastos/patología , Hueso Parietal/efectos de los fármacos , Hueso Parietal/patología , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Factores de Tiempo , Cicatrización de Heridas/efectos de los fármacos
7.
Craniomaxillofac Trauma Reconstr ; 6(1): 31-6, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24436733

RESUMEN

Objective To study transfusion requirements in patients with cancer undergoing head and neck reconstructive surgery and to discuss surgical and anesthetic strategies to reduce blood loss when the patient is a Jehovah's Witness. Material and Methods A descriptive study to expose the percentage of blood transfusions performed in patients with cancer undergoing microsurgical reconstructions in the department of oral and maxillofacial surgery of the referred hospital in the past 9 years. Results Two hundred thirty-seven microsurgical reconstructions were performed in head and neck tumors between January 2001 and December 2009. Statistical analysis shows a significant decrease (p = 0.035) in the number of patients needing transfusions patients in recent years. Conclusions The treatment of patients who are Jehovah's Witnesses is an ethical and moral dilemma for the clinician and in particular for surgeons.

8.
Craniomaxillofac Trauma Reconstr ; 6(2): 143-6, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24436751

RESUMEN

Background Being edentulous causes progressive bony resorption in maxillae, which can lead to altered maxillomandibular relationships. Discussion should consider Le Fort I osteotomy with inlay grafts for a better success rate. Thus, this article introduces a technical note in improving the success rate. Case Report The presented technical note permits transformation of the surgery in a conventional Le Fort I with a simple fixation not only of the grafts but also of the osteotomy. The surgical steps are explained as well as the follow-up results. Discussion Adding additional wire anchorage around bone grafts greatly improved our success rate and reduced our operative time. Bone grafting concurrently with Le Fort I osteotomy immediately improved the facial skeletal profile. Several in vitro studies have shown that galvanic corrosion does not play a significant role when combining stainless steel and titanium. Our novel technique is relatively simple and can be easily picked up by young surgeons.

9.
Oral Maxillofac Surg ; 14(1): 1-2, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19949826

RESUMEN

Surgical treatment of benign diseases of the neck produces a cervicotomy scar. A modified rhytidectomy incision has been used since 2003 in our department in selected cases of parotid gland tumours. However, there is no mention in bibliography about using facelift approach for treatment of cervical diseases. We have operated on three patients with brachial cysts using this technique. We introduce a clinical case of a 28-year-old woman with a right cervical swelling at the level of the anterior side of the sternocleidomastoid muscle. This technique allows a wide surgical approach. There is no donor-site morbidity, minimum additional operating time, hidden scar and no extra cost, and patients are very satisfied with the results.


Asunto(s)
Branquioma/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Ritidoplastia/métodos , Adulto , Cicatriz/prevención & control , Femenino , Estudios de Seguimiento , Humanos , Satisfacción del Paciente , Complicaciones Posoperatorias/prevención & control , Cicatrización de Heridas/fisiología
10.
Auris Nasus Larynx ; 31(1): 57-63, 2004 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15041055

RESUMEN

OBJECTIVE: Although microsurgical bone transplant is still the gold standard, mandibular reconstruction plates (MRP) were for several years considered a fast and safe way to restore mandibular continuity without using a bone graft. New plate designs with locking screws have been recently introduced, and these may overcome some of the complications related to previous designs. We review the results of mandibular reconstruction plates in our institution from 1991 to 1995. METHODS: The records of nine cancer patients who underwent lateral mandibular resections (with preservation of both condyle and symphysis) followed by reconstruction with a mandibular reconstruction plate, were retrospectively reviewed. Patients were treated between 1991 and 1995 with regular Synthes and Leibinger plates (without locking screws). Immediately after tumour resection, the bone defect was reconstructed with an MRP without bone grafting. Three cases required soft tissue coverage: two flaps and one buccal fat pad flap. RESULTS: There was immediate orocervical fistula in six cases, one of which required surgical closure; and late complications were common. One patient died due to distant metastasis 13 months after surgery without symptoms related to the plate. The remaining eight patients had their plates removed at between 9 and 52 months after reconstruction, due to screw loosening (four cases), plate exposure (one case), or both (three cases). CONCLUSION: Lateral mandibular reconstruction with non-locking screws and regular profile plates is no longer recommended. New plates with improved designs are currently available. Their low profile and locking screws are the usual characteristics of these new plates. More clinical experience is necessary before plate reconstruction can be recommended over microvascular bone transfer.


Asunto(s)
Placas Óseas , Carcinoma de Células Escamosas/cirugía , Implantación de Prótesis Mandibular , Neoplasias de la Boca/cirugía , Procedimientos de Cirugía Plástica , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Falla de Prótesis , Procedimientos de Cirugía Plástica/métodos , Estudios Retrospectivos , Colgajos Quirúrgicos
11.
An Otorrinolaringol Ibero Am ; 29(3): 289-300, 2002.
Artículo en Español | MEDLINE | ID: mdl-12173517

RESUMEN

Epidermoid carcinoma of jugal mucosa is an aggressive tumor. Its treatment is based on broad excision and reconstruction in order to avoid fibrosis and restriction of mouth opening. Neck dissection and radiotherapy are indicated in selected cases. We display our experience with microvascularized flaps with the aim of preventing the flaws. We reconsider 8 patients (representing 10 flaps) handle in our Department. Besides we discuss other therapeutic alternatives after the growth's removal. The conclusion reached is that the mucovascularized forearm flaps give a great quantity of thin tissue and therefore so results to be the best option for the reconstruction of the jugal mucosa.


Asunto(s)
Carcinoma de Células Escamosas/cirugía , Mejilla/cirugía , Fascia/trasplante , Neoplasias de Cabeza y Cuello/cirugía , Procedimientos de Cirugía Plástica/métodos , Trasplante de Piel , Colgajos Quirúrgicos , Carcinoma de Células Escamosas/patología , Mejilla/patología , Fascia/irrigación sanguínea , Antebrazo , Neoplasias de Cabeza y Cuello/patología , Humanos , Microcirugia/métodos , Mucosa Bucal/patología , Mucosa Bucal/cirugía
12.
An Otorrinolaringol Ibero Am ; 29(2): 163-72, 2002.
Artículo en Español | MEDLINE | ID: mdl-12053511

RESUMEN

Lipomas are benign tumors situated preferably on shallow areas of members and trunk, although they can be detected also on head and neck. Infiltrative lipomas subfasciae (intramuscular or intermuscular) are on the contrary rarities. Differential diagnosis with liposarcoma is important because both growths share the preferential those sites. Diagnosis rest upon clinical findings, biopsy with FNA, rounded off with TAC, MRI or ultrasounds, according to the lesion's site. Treatment of choice is surgical exeresis. We report 5 cases of infiltrative lipomas and analyze the diagnostic procedures and the treatment followed.


Asunto(s)
Neoplasias Faciales/diagnóstico por imagen , Lipoma/diagnóstico por imagen , Adulto , Neoplasias Faciales/cirugía , Femenino , Humanos , Lipoma/cirugía , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Tomografía Computarizada por Rayos X , Ultrasonografía
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