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Introduction: This report investigates late-stage internal derangement (ID) of the temporomandibular joint (TMJ) with the aim of establishing a more effective and personalized treatment protocol to improve patients' quality of life (QoL). Material and methods: A consensus was reached among maxillofacial surgeons specializing in LSID, based on a literature research and collective expert experience following the Delphi method. Consensus was considered to be achieved when a response received at least 80% of votes. Results: Four expert groups were established, respectively, focusing on diagnosis, minimally invasive surgery (MIS), open surgery and joint replacement. A comprehensive approach to late-stage ID of the TMJ requires a consensus report. This underscores the need for a personalized treatment plan, considering the variability in clinical presentations and progression of this pathology. Our recommendations aim to optimize clinical outcomes and enhance patient QoL.
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PURPOSE: Total or subtotal glossectomy following the resection of intraoral tumors causes significant morbidity. However, which reconstructive technique is the most successful remains controversial. PATIENTS AND METHODS: After approval by the Ethics Committee, charts were reviewed retrospectively for patients treated at the Oral and Maxillofacial Surgery Department, University Hospital La Paz (Madrid, Spain), during a 3-year period (2005-2008). All were reconstructed with a deep inferior epigastric artery perforator (DIEAP) flap after total glossectomy. Data collected included affiliation data, extent of extirpation, type of reconstruction, and surgical outcome, including donor-site morbidity, complications, and functional results. RESULTS: Seven patients (5 men, 71.4%; 2 women, 28.6%) with primary squamous cell carcinoma of the tongue underwent total glossectomy and simultaneous microsurgical reconstruction with a DIEAP flap. In all cases, the flap was harvested with a fusiform shape oriented craniocaudally and limited to zone 1. The average size of the flap was 16.7 × 7.2 cm. Functional outcome related to swallowing was poor; 57.1% of the patients required a permanent gastrostomy. Speech was considered intelligible in 85.7% of cases by 2 independent observers. The surgical outcome was uneventful in most of the cases, with only 1 case of local dehiscence at the mouth floor. None of the cases developed abdominal wall dehiscence or an abdominal hernia at mid- or long-term follow-up. CONCLUSIONS: The DIEAP flap is a reliable alternative for tongue reconstruction. It provides a large volume of soft tissue for transfer and is predictable and stable over time with low donor-site morbidity.
Asunto(s)
Carcinoma Adenoide Quístico/cirugía , Carcinoma de Células Escamosas/cirugía , Colgajos Tisulares Libres , Glosectomía/rehabilitación , Procedimientos de Cirugía Plástica/métodos , Neoplasias de la Lengua/cirugía , Anciano , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/rehabilitación , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/rehabilitación , Deglución , Femenino , Colgajos Tisulares Libres/irrigación sanguínea , Glosectomía/métodos , Supervivencia de Injerto , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Inteligibilidad del Habla , Neoplasias de la Lengua/patología , Neoplasias de la Lengua/rehabilitaciónAsunto(s)
Huesos Faciales/cirugía , Fibroma Osificante/cirugía , Procedimientos de Cirugía Plástica/métodos , Neoplasias Craneales/cirugía , Alveolectomía , Trasplante Óseo/métodos , Niño , Femenino , Humanos , Neoplasias del Seno Maxilar/cirugía , Microcirugia , Músculo Esquelético/trasplante , Cavidad Nasal/cirugía , Neoplasias Nasales/cirugía , Neoplasias Orbitales/cirugía , Neoplasias Palatinas/cirugía , Planificación de Atención al Paciente , Trasplante de Piel/métodos , Hueso Esfenoides/cirugíaAsunto(s)
Maloclusión de Angle Clase III/cirugía , Ortodoncia Correctiva , Osteogénesis Imperfecta/complicaciones , Adolescente , Femenino , Humanos , Maloclusión de Angle Clase III/complicaciones , Maloclusión de Angle Clase III/diagnóstico por imagen , Procedimientos Quirúrgicos Orales/métodos , Radiografía , Anomalías Dentarias/complicaciones , Anomalías Dentarias/terapiaRESUMEN
Conformation of the fibula flap to passively adapt to the remaining mandible may be indeed challenging. A review of the 'axial splitting' technique for fibula free flaps is presented with a novel method of osteosynthesis. Adequate mandibular angle shape is achieved by performing this type of osteotomy with a minimal use of titanium hardware for flap insetting.
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El término displasia fibrosa hace referencia a un conjunto de lesiones óseas benignas que se caracterizan por la sustitución del tejido óseo normal por tejido conectivo. Se presenta el caso de una paciente afectada de displasia fibrosa poliostótica de predominio maxilar tratada de forma conservadora con bisfosfonatos(AU)
The term fibrous dysplasia refers to a variety of bony diseases characterized by the substituion of the bone by abnormal connective tissue. A case report of patient affected by a polyostotic form of fibrous dysplasia with an uneven evolution of its disease after being treated with pamidronate is presented(AU)