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1.
Artículo en Inglés | MEDLINE | ID: mdl-39266433

RESUMEN

Pleomorphic adenoma (PA) is the most prevalent benign salivary gland tumor. Although rare, among the minor salivary glands, palatal PA exhibits the highest incidence. Unlike other benign tumors, PA infiltrates the surrounding tissues, posing challenges for complete removal through conservative measures. Surgeons often resort to aggressive surgical procedures involving resection of adjacent tissue to ensure clear margins and prevent recurrence. This study aims to analyze diverse histological characteristics of palatal PA, seeking statistical correlations for early prediction of tumor aggressiveness. The goal is to facilitate the preservation of the periosteum during surgical resection and attain conservative surgical margins. A retrospective histopathological investigation encompassed 18 patients diagnosed with palatal PA who underwent surgical treatment at Hadassah Medical Centre, Jerusalem, Israel. Evaluated parameters included tumor size, pseudocapsule thickness, tumor-periosteum distance, and the presence of pseudopodia and satellite nodules indicating tumor penetration. Statistical significance was set at P < 0.05. Tumors of varying sizes, whether large or small, lack consistent features. Neither tumor size, pseudocapsule thickness, nor tumor-periosteum distance displayed correlations with tumor penetration features. Palatal PA exhibits varied histological attributes impacting surgical technique. The absence of correlations among these attributes impedes early prediction of tumor aggressiveness, casting doubt on periosteum preservation. The periosteum is sufficiently robust to contain the tumor and should be excised. There is no data to support either ostectomy or a through-and-through surgical resection as part of the treatment.

2.
Sci Rep ; 13(1): 19192, 2023 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-37932515

RESUMEN

Critical maxillofacial bone fractures do not heal spontaneously, thus, often there is a need to facilitate repair via surgical intervention. Gold standard approaches, include the use of autologous bone graft, or devices supplemented with osteogenic growth factors and bone substitutes. This research aimed to employ a critical size calvaria defect model, to determine if the addition of chondrocytes to collagen-containing bone graft substitute, may expedite bone repair. As such, using a critical size rat calvaria defect, we implanted a collagen scaffold containing bone graft substitute (i.e., Bone graft scaffold, BG) or BG supplemented with costal chondrocytes (cBG). The rats were subjected to live CT imaging at 1, 6, 9, and 12 weeks following the surgical procedure and sacrificed for microCT imaging of the defect site. Moreover, serum markers and histological evaluation were assessed to determine osseous tissue regeneration and turnover. Live CT and microCT indicated cBG implants displayed expedited bone repair vs, BG alone, already at 6 weeks post defect induction. cBG also displayed a shorter distance between the defect edges and greater mineral apposition distance compared to BG. Summerizing, the data support the addition of chondrocytes to bone substitute, accelerates the formation of new bone within a critical size defect.


Asunto(s)
Sustitutos de Huesos , Condrocitos , Ratas , Animales , Andamios del Tejido , Cráneo , Colágeno , Osteogénesis , Regeneración Ósea
3.
BMC Infect Dis ; 22(1): 212, 2022 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-35241005

RESUMEN

BACKGROUND: We report a clinically challenging and unusual case of L. donovani oral mucosal leishmaniasis. CASE PRESENTATION: Israeli resident with a former travel to central and North Africa, with no documented or prior cutaneous lesions presented with oral lesions of the maxillary gingiva and the upper lip. A delay in diagnosis and treatment have led to progression of the maxillary gingival lesions towards the hard palatal and the soft palate that could have potentially compromised the upper airway. CONCLUSIONS: This case highlights the importance of early diagnosis of leishmaniasis in patients with oral lesions and the laboratory workup necessary to appropriately characterize and treat the disease.


Asunto(s)
Leishmaniasis Cutánea , Leishmaniasis Mucocutánea , Leishmaniasis , Úlceras Bucales , Humanos , Leishmaniasis Cutánea/diagnóstico , Leishmaniasis Cutánea/tratamiento farmacológico , Leishmaniasis Cutánea/patología , Leishmaniasis Mucocutánea/diagnóstico , Leishmaniasis Mucocutánea/tratamiento farmacológico , Labio/patología , Mucosa Bucal
4.
J Craniofac Surg ; 30(4): 1113-1117, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31166255

RESUMEN

OBJECTIVES: To study the trigeminal nerve neuropathy prevalence after mandibular fractures and follow nerve recovery and to examine associations with clinical features. SUBJECTS: The files of 304 patients treated for 424 mandibular fractures in Hadassah Medical Center between 2001 and 2008 were analyzed. Twenty-five patients with paresthesia were examined by electro-diagnostic conduction test (quantitative sensory testing). RESULTS: The most common fracture sites were the symphysis (28.5%) and condyle (21.4%). A strong correlation between fracture severity and treatment modality was found. Nerve damage occurred in 13.4% of nondisplaced fractures and in 65.3% of >5 mm displaced fractures. Patients who were treated by open reduction internal fixation demonstrated the biggest difference in quantitative sensory testing values between the affected and nonaffected sides. C nerve fibers were the most damaged and least regenerated. There was correlation between damage perception and objective test results. CONCLUSIONS: There is a correlation between fracture type and displacement severity on neurologic deficit and prognosis. The objective neurosensory damage was manifested by higher nerve excitation threshold on the injured side. Patients should be informed on the prognosis of neurologic deficit according to fracture type.


Asunto(s)
Fracturas Mandibulares/complicaciones , Enfermedades del Nervio Trigémino/etiología , Traumatismos del Nervio Trigémino/etiología , Adulto , Electrodiagnóstico , Femenino , Fijación Interna de Fracturas , Humanos , Puntaje de Gravedad del Traumatismo , Israel/epidemiología , Masculino , Fracturas Mandibulares/cirugía , Persona de Mediana Edad , Reducción Abierta , Enfermedades del Nervio Trigémino/diagnóstico , Enfermedades del Nervio Trigémino/epidemiología , Traumatismos del Nervio Trigémino/diagnóstico , Traumatismos del Nervio Trigémino/epidemiología , Escala Visual Analógica
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