RESUMEN
Craniofacial defects (CFD) are a significant healthcare problem worldwide. Understanding both the morphogenetic movements which underpin normal facial development, as well as the molecular factors which regulate these processes, forms the cornerstone of future diagnostic, and ultimately, preventative therapies. The soluble morphogen Sonic hedgehog (Shh), a vertebrate orthologue of Drosophila hedgehog, is a key signalling factor in the regulation of craniofacial skeleton development in vertebrates, operating within numerous tissue types in the craniofacial primordia to spatiotemporally regulate the formation of the face and jaws. This review will provide an overview of normal craniofacial skeleton development, and focus specifically on the known roles of Shh in regulating the development and progression of the first pharyngeal arch, which in turn gives rise to both the upper jaw (maxilla) and lower jaw (mandible).
Asunto(s)
Antiinfecciosos Locales , Carcinoma de Células Escamosas/cirugía , Recurrencia Local de Neoplasia/prevención & control , Povidona Yodada , Neoplasias Cutáneas/cirugía , Herida Quirúrgica/terapia , Irrigación Terapéutica , Antiinfecciosos Locales/administración & dosificación , Carcinoma de Células Escamosas/patología , Humanos , Márgenes de Escisión , Povidona Yodada/administración & dosificación , Neoplasias Cutáneas/patología , Cloruro de Sodio/administración & dosificación , Irrigación Terapéutica/métodos , Agua/administración & dosificaciónRESUMEN
Tumours in the mucosa of the retromolar trigone (RMT) are rare, but develop insidiously and spread rapidly into surrounding structures. Resection may require radical dissection beginning usually on the medial side of the mandible. Such surgery can put important structures at risk. The normal anatomy of the RMT and its relations has been studied together with simulated surgical incisions and resections. Tissue removed was processed by histological techniques in order to demonstrate structures excised or damaged by the operation. The simulated incision showed that the lingual nerve, submandibular duct and palatoglossus were at particular risk. This could affect sensation, speech, swallowing and movements of the tongue. The findings pose immediate concerns for surgeons operating in this area. Although cancer surgery often involves sacrificing tissue, care should be taken to preserve structures vital to the patient's oral function without compromising oncological principles.