RESUMO
We describe a case of glomangiopericytoma located in the pterygo-mandibular space, a rare anatomical region for this neoplasm to develop. The lesion is classified as a separate variant from the classic haemangiopericytoma, which is characterised by more aggressive biological behaviour.
Assuntos
Hemangiopericitoma/diagnóstico , Neoplasias Mandibulares/diagnóstico , Músculo Masseter/patologia , Neoplasias Musculares/diagnóstico , Actinas/análise , Adulto , Antígenos CD34/análise , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Pericitos/patologia , Tomografia Computadorizada por Raios X , Vimentina/análiseRESUMO
Adequate treatment of panfacial injuries often requires tracheostomy or alternating intubation through the nose and the mouth to keep the field free during the operation. Altemir's submental technique is an attractive option in these patients. We used the method with a slight modification in 107 operations in our unit to treat panfacial injuries. We had a low rate of complications and no increased operative time.
Assuntos
Traumatismos Faciais/cirurgia , Intubação Intratraqueal/métodos , Dissecação/métodos , Ossos Faciais/lesões , Ossos Faciais/cirurgia , Humanos , Intubação Intratraqueal/instrumentação , Mandíbula , Fraturas Maxilares/cirurgia , Soalho Bucal/cirurgia , Fraturas Cranianas/cirurgia , Resultado do TratamentoRESUMO
INTRODUCTION: Penetration of the mandibular condyle into the middle cranial fossa is a rare complication usually due to blunt traumas to the chin. Particular anatomical and dynamic conditions can lead to the intracranial dislocation of the condyle in spite of the fracture of the condylar neck that usually prevents this event from dissipating the kinetic force of the impact. DISCUSSION: We report the case of a 10-year-old female patient suffering from symphyseal and bilateral condilar fracture with intrusion of the left condyle into the middle cranial fossa. The diagnosis of intracranial dislocation was initially missed because of the nonspecific symptomatology and insufficient radiologic data provided by conventional investigations (plain X-rays and panoramic views). The persistence of the limitation of the mouth opening and the worsening of the preauricular pain with irradiation to the temporal region led us to perform further radiological investigations (computed tomography scan and magnetic resonance imaging) that revealed the intracranial complication. A successful removal of the displaced condyle was carried out through an extracranial approach, and at a 3-year follow-up temporomandibular joint function is satisfactory. CONCLUSION: The case is reported to emphasize the need for careful radiological investigation in case of condylar fractures and the effectiveness of the extracranial route to surgically treat these rare complications.