Reabsorción Condilar como Complicación Postoperatoria en Pacientes Sometidos a Cirugía Ortognática. Revisión Narrativa / Condylar Resorption as a Postoperative Complication in Patients Undergoing Orthognathic Surgery. Narrative Review

RESUMEN: La reabsorción condilar como complicación postoperatoria en cirugía ortognática es una causa frecuente de recidiva de anomalías dentomaxilares, existiendo diversos factores que se relacionan con su aparición. El objetivo de este estudio fue describir mediante una revisión narrativa la reabsorción condilar como complicación postoperatoria en cirugía ortognática. Se realizó una búsqueda electrónica de la literatura en las bases de datos electrónicas PubMed, EBSCO, TripDatabase y Epistemonikos sin límite de años, en idioma inglés y español, incluyendo revisiones sistemáticas, ensayos clínicos y estudios observacionales. Se excluyeron reportes de casos, estudios en animales y aquellos que no relacionaran la complicación con cirugía ortognática. Se evaluaron los estudios según grado de recomendación y calidad de reporte. Veintiún artículos fueron seleccionados según los criterios de selección establecidos en esta revisión. La literatura reportada sugiere que la reabsorción condilar es una patología de frecuencia relativa en pacientes postoperados de cirugía ortognática (1,4-32 % de los casos) y que está asociada a factores de riesgo preoperatorios tales como género, edad, tipo de anomalía dentomaxilar y técnica quirúrgica utilizada. La reabsorción condilar es una complicación postoperatoria a cirugía ortognática que debemos considerar en la planificación del tratamiento e identificar pacientes con factores de riesgo. Luego de la intervención quirúrgica es de vital importancia realizar un seguimiento estricto a este tipo de pacientes e identificar de forma temprana cambios clínicos y radiográficos. Finalmente, es importante seguir investigando sobre esta materia para establecer criterios de prevención y diagnóstico, con mayor claridad.

ABSTRACT: Condylar resorption as a complication following orthognathic surgery is considered to cause dento-facial anomalies, relating to different pre and intra-operative factors. The aim of the research was to describe condylar resorption as a postoperative complication after orthognathic surgery. A review of the literature was made in four databases: PubMed, EBSCO, Trip database and Epistemonikos. The search was carried out without year limiting, articles in English and Spanish, including systematic reviews, observational studies and clinical trials. Exclusion criteria were applied for report cases, animal studies and articles that do not relate condylar resorption with orthognathic surgery. Quality of evidence and strength of the recommendations were assessed for the chosen studies. For this study 21 articles were selected following the inclusion criteria. The literature found reported that condylar resorption is a relatively frequent complication following orthognathic surgery (1.4-32 % of frequency) and that it can be associated with several factors such as genre, age, dento-maxillary anomaly and surgical technique. Condylar resorption is a complication that we must consider in the planning of orthognathic surgery, in order to identify risk factors and patients who are more likely to present this post-surgical complication. Following surgery, strict follow-up is a key factor to determine early clinical and radiographic changes. Finally, further research is needed to establish stronger prevention and diagnostic criteria.

Tratamento cirúrgico da limitação de abertura bucal causada por hiperplasia do processo coronoide: relato de caso / Surgical treatment for mouth opening limitation caused by coronoid process hyperplasia: case report

A hiperplasia do processo coronoide é uma condiçãoincomum de etiologia desconhecida que se apresentaclinicamente por meio da limitação de abertura bucal enão possui sintomatologia dolorosa durante a aberturae o fechamento bucal. Objetivo: relatar e discutir, pormeio de um caso cirúrgico, o tratamento da limitaçãode abertura bucal causada por hiperplasia bilateral doprocesso coronoide. Relato de caso: paciente do sexofeminino, com 11 anos de idade, foi encaminhada paraatendimento devido à dificuldade de mastigação emfunção da limitação de abertura bucal, sem históricode trauma em face ou na região articular. O exame tomográficoevidenciou o alongamento bilateral do processocoronoide, fazendo com que ele colidisse com oarco zigomático durante a abertura bucal e causasse otravamento. O tratamento proposto foi a coronoidectomiabilateral com acesso cirúrgico intraoral, obtendono pós-cirúrgico imediato um ganho na abertura bucal.Considerações finais: a coronoidectomia é uma abordagemcirúrgica de fácil acesso por via intraoral, poucotraumática e eficaz no tratamento de pacientes com hiperplasiado processo coronoide. (AU)

The coronoid process hyperplasia is an unusual condition of unknown etiology that is presented clinically through mouth opening limitation, without painful symptoms during mouth opening and closure. Objective: to report and discuss, through a surgical case, the treatment of mouth opening limitation caused by bilateral coronoid process hyperplasia. Case report: female patient, 11 years old, referred due to chewing difficulty by mouth opening limitation. No history of trauma in the face or joint area. The tomographic examination showed the bilateral elongation of the coronoid process, causing it to collide with the zygomatic arch during mouth opening, which caused locking. The treatment proposed was bilateral coronoidectomy with intraoral surgical access, which enhanced mouth opening at the immediate postoperative period. Final considerations: coronoidectomy is a surgical approach with easy intraoral access, non-traumatic, and effective in the treatment of patients with coronoid process hyperplasia. (AU)

Assessment of spontaneous resolution of idiopathic bone cavity.

Idiopathic Bone Cavity (IBC) or Simple Bone Cyst (SBC) is a non- epithelialized bone cavity with serosanguinous fluid content or empty. There is a literature debate regarding its pathogenesis that remains unclear. The main treatment option is the surgical exploration, although there are successful cases described in the literature in which just a follow-up with clinical and radiographic evaluation was performed. Objective This study aimed to assess the spontaneous resolution of idiopathic bone cavity untreated by surgery. Material and Methods Twenty-one patients diagnosed with surgically untreated IBC were submitted to a follow-up protocol modified from Damante, Guerra, and Ferreira5 (2002). A clinical and radiographic evaluation was performed in 13 patients (13/21), while eight patients (8/21) were only radiographically evaluated. Three observers evaluated the panoramic radiographs of 21 patients and the Kappa test was performed by intra and inter-examiners. Inductive and descriptive statistics were applied to the results. Results Only one patient had a positive response to palpation and percussion of the teeth in the cyst area. Most of the cysts evaluated were rated as 3 (lesion "in involution"), 4 (lesion "almost completely resolved"), or 5 ("completely resolved"). Conclusions We observed progressive spontaneous resolution of IBC. Most cysts were found in the recovery process in different follow-up periods. Patient's follow-up, without surgery, may be considered after the diagnosis based on epidemiological, clinical, and radiographic features of the lesion.

Assessment of spontaneous resolution of idiopathic bone cavity

Abstract Idiopathic Bone Cavity (IBC) or Simple Bone Cyst (SBC) is a non- epithelialized bone cavity with serosanguinous fluid content or empty. There is a literature debate regarding its pathogenesis that remains unclear. The main treatment option is the surgical exploration, although there are successful cases described in the literature in which just a follow-up with clinical and radiographic evaluation was performed. Objective This study aimed to assess the spontaneous resolution of idiopathic bone cavity untreated by surgery. Material and Methods Twenty-one patients diagnosed with surgically untreated IBC were submitted to a follow-up protocol modified from Damante, Guerra, and Ferreira5 (2002). A clinical and radiographic evaluation was performed in 13 patients (13/21), while eight patients (8/21) were only radiographically evaluated. Three observers evaluated the panoramic radiographs of 21 patients and the Kappa test was performed by intra and inter-examiners. Inductive and descriptive statistics were applied to the results. Results Only one patient had a positive response to palpation and percussion of the teeth in the cyst area. Most of the cysts evaluated were rated as 3 (lesion "in involution"), 4 (lesion "almost completely resolved"), or 5 ("completely resolved"). Conclusions We observed progressive spontaneous resolution of IBC. Most cysts were found in the recovery process in different follow-up periods. Patient's follow-up, without surgery, may be considered after the diagnosis based on epidemiological, clinical, and radiographic features of the lesion.

How does mandibular bone atrophy influence the masticatory function, OHRQoL and satisfaction in overdenture wearers? Clinical results until 1-year post-loading.

This longitudinal clinical study investigated the differences in the masticatory function (MF), satisfaction and oral health-related quality of life (OHRQoL) between atrophic patients (AP) and non-atrophic patients (NAP) before and after rehabilitation with mandibular overdenture (MO). Twenty-six complete denture (CD) wearers were categorised into two groups, according to the mandibular bone atrophy (MBA) degree. MF was evaluated before and after 1, 3, 6 and 12 months of the MO loading via 2 standardised tests: (i) MP, masticatory performance (MP_X50, MPB, ME 5·6, ME 2·8) and (ii) ST, swallowing threshold (time, number of cycles, ST_X50, STB, ME 5·6, ME 2·8). The dental impact on daily living (DIDL) questionnaire measured changes in the satisfaction level and OHRQoL. MP comparisons showed significant difference only for ME 5·6 12 months after MO loading (AP=33·79 ± 23·6; NAP=17·58 ± 20·1). ST presented significant differences before MO loading for: ST_X50 (AP=5·48 ± 0·83; NAP=4·31 ± 1·44), ME 5·6 (AP=53·17 ± 24·71; NAP=29·83 ± 31·45) and ME 2·8 (AP=8·76 ± 6·91; NAP=18·61 ± 10·71). One month after MO loading, NAP performed the ST test 21% faster than AP. After 3 months, significant improvements in STB (AP=4·93 ± 4·82; NAP=2·73 ± 1·27) and ME 2·8 (AP=17·15 ± 10·00; NAP=24·69 ± 7·82) also were observed. DIDL evaluation showed significant differences in the oral comfort domain after 3 months (AP=0·66 ± 0·29; NAP=0·87 ± 0·16) and after 6 months (AP=0·79 ± 0·22; NAP=0·98 ± 0·08), with lower satisfaction levels in the AP. MBA negatively affects the MF mainly the ST. After 6 months, differences between AP and NAP disappeared and ST results were equalised. AP initially has lower satisfaction levels reaching similar levels of satisfaction as NAP after 1 year.

Masticatory function parameters in patients with varying degree of mandibular bone resorption.

PURPOSE: This cross-sectional study analyzes how bone resorption affects the masticatory function and investigates the relation between perceived and measured masticatory function. METHODS: Thirty complete dentures wearers were divided in two groups according to mandible bone atrophy based on the classification criteria from Cawood & Howell. Retention and stability of the mandibular complete denture, masticatory performance (MP) indexes (X_50 and B) and masticatory efficiency (ME, sieves 4 and 2.8) were evaluated. Geriatric Oral Health Assessment Index (GOHAI) and Dental Impact on Daily Living (DIDL) questionnaires were completed by the patients. RESULTS: A strong correlation between bone atrophy and poor retention was found (P=0.0132). Neither masticatory performance indexes nor GOHAI and DIDL domains showed statistical differences (P>0.05) when patients were compared according to the atrophy criteria. Mandibular length showed a negative correlation with ME4, showing a positive association (R2=0.17, ß=-0.67, P=0.029). Mandibular denture retention was significantly correlated with MPB (P=0.01) and ME2.8 (P=0.01). GOHAI showed a positive association between the physical and the functional domains and ME2.8 (R2=0.17; ß=1.22; P=0.02). DIDL showed a negative association between ME4 and oral comfort domain (R2=0.16; ß=-2.94; P=0.02). CONCLUSION: Mandibular bone height does not directly affect the masticatory function and is inversely correlated with the self-perceived masticatory ability.

Ameliorative effect of black grape juice on systemic alterations and mandibular osteoradionecrosis induced by whole brain irradiation in rats.

PURPOSE: Whole brain irradiation (WBI) causes a variety of secondary side-effects including anorexia and bone necrosis. We evaluated the radiomodifying effect of black grape juice (BGJ) on WBI alterations in rats measuring food and water intake, body weight, hemogram, and morphological and histological mandibular parameters. MATERIALS AND METHODS: Forty male rats (200-250 g) were exposed to eight sessions of cranial X-ray irradiation. The total dose absorbed was 32 Gy delivered over 2 weeks. Four groups were defined: (i) NG: non-irradiated, glucose and fructose solution-supplemented (GFS); (ii) NJ: non-irradiated, BGJ-supplemented; (iii) RG: irradiated, GFS-supplemented; and (iv) RJ: irradiated, BGJ-supplemented. Rats received daily BGJ or GFS dosing by gavage starting 4 days before, continuing during, and ending 4 days after WBI. RESULTS: RJ rats ingested more food and water and showed less body weight loss than RG rats during the irradiation period. Forty days after WBI, irradiated animals started losing weight again compared with controls as a consequence of masticatory hypofunction by mandibular osteoradionecrosis (ORN). Osteoclastic activity and inflammation were apparent in RG rat mandibles. BGJ was able to attenuate the severity of ORN as well as to improve white and red blood cell counts. CONCLUSIONS: Fractionated whole brain irradiation induces mandibular changes that interfere with normal feeding. BGJ can be used to mitigate systemic side-effects of brain irradiation and ORN.

Electromyographic activity of masticatory muscles in women with osteoporosis.

The purpose of this study was to analyze the electromyographic (EMG) activity and the maximal molar bite force in women diagnosed with osteoporosis in the maxillary and mandibular regions, considering the habits and conditions that lead to development of generalized skeletal bone loss, including on face bones, can disturb the functional harmony of the stomatognathic system. Twenty-seven women with mandibular and maxillary osteoporosis and 27 healthy controls volunteered to participate in the study. A 5-channel electromyographer was used. Muscle activity was evaluated by means of EMG recordings of the masticatory musculature (masseter and temporalis muscles, bilaterally) during the following clinical conditions: rest (5 s); right and left lateral excursions (5 s); protrusion (5 s); maximal dental clenching on Parafilm (4 s) and maximal voluntary contraction (4 s). This latter clinical condition was used as the normalization factor of the sample data. It was observed that individuals with osteoporosis presented greater EMG activity when maintaining mandible posture conditions and less activity during dental clenching and when obtaining maximal molar bite force. It may be concluded that facial osteoporosis can interfere on the patterns of masticatory muscle activation and maximal bite force of the stomatognathic system.

Influence of ovariectomy and masticatory hypofunction on mandibular bone remodeling.

INTRODUCTION: This study was designed to examine the effect of masticatory hypofunction and estrogen deficiency on mandible bone mass and compare this site with spine and femoral bone. METHODS: Twenty-four rats were ovariectomized (OVX) or Sham-operated (Sham) and analyzed after feeding with hard diet (Hard) or soft diet (Soft). They were divided into four groups: (GI)Sham-Hard; (GII)OVX-Hard; (GIII)Sham-Soft and (GIV)OVX-Soft. Bone mineral density (BMD) was measured in the spine and femur in the baseline and at the end of the study, and DeltaBMD (final BMD - baseline BMD) was calculated. In mandible bone, BMD and histomorphometry were analyzed at the end of the experiment. RESULTS: Sham rats showed higher spine (GI: 13.5%vs GII: 0.74%, P < 0.01; GIII: 10.67%vs GIV: -4.36%, P < 0.001) and femur DeltaBMD (GI: 14.43%vs GII: 4.42%, P < 0.01; GIII: 10.58%vs GIV: 0.49%, P < 0.001) than OVX, but no difference was observed in mandible BMD among these groups (P > 0.05). Soft-diet groups showed decreased mandible BMD compared with hard-diet groups (GIV vs GII, P < 0.01; GIII vs GI, P < 0.01). Similarly, mandibular condyle histomorphometry showed that soft-diet groups presented a significant decrease in trabecular thickness and volume (GIV vs GII, P < 0.05; GIII vs GI, P < 0.01) compared with hard diet. CONCLUSION: Our results suggest that mandibular bone loss resulted from decreased of mechanical loading during mastication, and was not affect by estrogen depletion.

Electromyographic activity of masticatory muscles in women with osteoporosis

The purpose of this study was to analyze the electromyographic (EMG) activity and the maximal molar bite force in women diagnosed with osteoporosis in the maxillary and mandibular regions, considering the habits and conditions that lead to development of generalized skeletal bone loss, including on face bones, can disturb the functional harmony of the stomatognathic system. Twenty-seven women with mandibular and maxillary osteoporosis and 27 healthy controls volunteered to participate in the study. A 5-channel electromyographer was used. Muscle activity was evaluated by means of EMG recordings of the masticatory musculature (masseter and temporalis muscles, bilaterally) during the following clinical conditions: rest (5 s); right and left lateral excursions (5 s); protrusion (5 s); maximal dental clenching on Parafilm™ (4 s) and maximal voluntary contraction (4 s). This latter clinical condition was used as the normalization factor of the sample data. It was observed that individuals with osteoporosis presented greater EMG activity when maintaining mandible posture conditions and less activity during dental clenching and when obtaining maximal molar bite force. It may be concluded that facial osteoporosis can interfere on the patterns of masticatory muscle activation and maximal bite force of the stomatognathic system.

Este estudo teve como objetivo analisar a atividade eletromiográfica e a força de mordida molar máxima de indivíduos diagnosticados com osteoporose na região maxilar e mandibular, visto que os hábitos e condições que provocam o desenvolvimento de uma perda óssea generalizada no esqueleto, inclusive no esqueleto facial, podem causar distúrbios na harmonia funcional do sistema mastigatório. Vinte e sete indivíduos portadores de osteoporose na mandíbula e maxila e 27 voluntários sem a doença participaram deste estudo. Um eletromiógrafo de 5 canais foi utilizado. A avaliação da atividade muscular foi realizada por meio de registros eletromiográficos da musculatura mastigatória (músculos masseter e temporal, bilateralmente) durante as seguintes condições clínicas: Repouso (5 s); Lateralidades direita e esquerda (5 s); Protrusão (5 s); Apertamento dental máximo com parafilme (4 s) e a contração voluntária máxima (4 s), sendo que esta condição clínica foi utilizada como fator de normalização dos dados da amostra. Verificou-se que os indivíduos com osteoporose apresentaram maior atividade eletromiográfica durante a manutenção das condições posturais da mandíbula e menor atividade durante o apertamento dental e na obtenção da força de mordida molar máxima. Conclui-se que a osteoporose na região dos ossos da face pode interferir nos padrões de ativação da musculatura mastigatória e na força de mordida máxima do sistema estomatognático.

Evaluation by digital subtraction radiography of induced changes in the bone density of the female rat mandible.

OBJECTIVES: To verify whether changes in bone mass induced by glucocorticoid and bisphosphonate can be detected by digital subtraction radiography of lateral X-rays in female rat mandibles. METHODS: 36 Rattus norvegicus (Wistar) females were randomly allocated to three groups: Group 1, control (n = 12); Group 2, induced osteopaenia (n = 12); and Group 3, induced osteopaenia plus risedronate (n = 12). Group 1 received subcutaneous saline solution (2 ml kg(-1)) injections for 12 weeks. Group 2 received 1 mg kg(-1) methylprednisolone acetate for 12 weeks. Group 3 received the same treatment as Group 2, plus 3 mg kg(-1) risedronate sodium for a further 12 weeks. A radiograph of the left mandible was taken on day 0 and after 12 weeks. A third radiograph was taken in Group 3 after risedronate treatment. Digital subtraction of the radiographs was used to compare the intensity of pixels in the control area and the test area. The animals were killed and the same area assessed by subtraction was histologically evaluated. RESULTS: ANOVA revealed statistically significant histological differences between the three groups. Tukey's multiple comparisons test showed that Group 2 had the smallest mean proportion of bone trabeculae per field and Group 3 the largest (F = 37.56; P < 0.01). Radiographic subtraction revealed a higher mean pixel intensity in Groups 1 and 3 vs Group 2. In Group 3, glucocorticoid caused a significant loss in radiographic density, and risedronate restored that loss (Friedman's non-parametric test). CONCLUSIONS: Subtraction radiography was able to detect changes in bone mass induced by glucocorticoid and bisphosphonate.

The influence of loss of bone mass on induced periodontal disease: a radiographic and densitometric study of female rats.

BACKGROUND: Changes in mineral density in the mandibular and femoral bones (BMD) after estrogen deficiency caused by ovariectomy (OVX) and the influence of these changes on induced periodontal disease were evaluated in female rats. METHODS: Forty-eight female Holtzman rats (90 days old) were randomly divided into five groups: 0: control (N = 9); 1: SHAM without induced periodontal disease (N = 11); 2: SHAM with induced disease (N = 10); 3: OVX without induced disease (N = 9); and 4: OVX with induced disease (N = 9). In groups 2 and 4, the first lower molars were tied with ligatures for 30 days 120 days after surgery. After 5 months the animals were sacrificed to measure global mineral density (BMD) and that of the sub-regions of the mandible and femur by dual energy x-ray absorptiometry (DXA). The extent of vertical bone loss was evaluated with digital radiography by measuring the distance from the bone crest to the cemento-enamel junction at the mesial of the first lower molar. RESULTS: Results of the femur (Kruskal-Wallis test) showed a significant difference (P <0.001) between the groups SHAM and OVX in bone density values for all regions. Comparison between the groups in relation to the BMD of the mandible, both in the sub-regions and global revealed no differences (P >0.05). The vertical bone loss measured for the groups with induced disease was similar (P = 0.713). CONCLUSIONS: Differences between the groups were found in the bone mineral density BMD of the femur but not of the mandible. OVX had no influence on induced periodontal disease.

Aggressive behaviour of cherubism in a teenager: 4-years of clinical follow-up associated with radiographic and histological features.

Cherubism is a rare hereditary fibro-osseous childhood disease characterized by bone degradation and fibrous tissue replacement at the angles of the mandible and at the tuberosity areas of the maxilla that leads to prominence of the lower face and an appearance reminiscent of the cherub's portrayal in Renaissance art. This disease has an autosomal dominant hereditary characteristic. The purpose of this report is to analyse laboratory tests, clinicopathological and radiographic features of cherubism and its intraoral manifestations in a patient during 4-years of follow-up, correlating the features observed in this case with those of the literature. Also discussed is the atypical and aggressive behaviour of this case during puberty.

Querubismo: relato de caso e revisão da literatura com aspectos imaginológicos / Cherubism: case report and review of the literature and imaging findings

Querubismo é uma doença óssea hereditária não neoplásica caracterizada, clinicamente, por aumento indolor bilateral da mandíbula e maxilar em crianças, produzindo uma aparência querubínica. Pode ocorrer em casos isolados ou em membros de uma mesma família. Relatamos o caso de querubismo em uma menina sem história familiar, com lesões osteolíticas expansivas na mandíbula e maxila demonstradas em exames radiológicos.

Spontaneous resolution of simple bone cysts.

OBJECTIVE: To determine whether spontaneous resolution of simple bone cysts (SBC) is possible. METHODS: Ten patients were diagnosed as SBC on clinical and radiographic criteria and followed up for 1 to 7 years (mean 3.8). The degree of resolution was assessed subjectively by four radiologists and objectively by changes in the grey level histogram. RESULTS: All cases remained asymptomatic over the follow-up period. One of the lesions was considered static, two were increased, six remodeled and one resolved. The mean difference in grey levels between the lesion and the contralateral normal mandible decreased in 8 out of 10 cases. CONCLUSION: It is probable that SBC resolves spontaneously. A protocol for clinical and radiographic diagnosis and follow-up is proposed.

Diagnóstico del trabajo multidisciplinario en las disfunciones de la articulación temporomandibular en la ciudad de Santa Cruz / Diagnosis of the multidisciplinary work in the dysfunctions of the temporomandibular articulation in the city of Santa Cruz

Son varios los cuestionamientos que motivan realización del presente trabajp, sin embargo considerando que los aspectos más importantes son: Es un tema poco difundido, amplia el campo de acción de los fisioterapeutas en esta ciudad. Ante el planteamiento del problema y la revisión bibliográfica que se realizó surgieron nuevos cuestionamientos. ¿ porque qué el fisioterapeuta no trabaja con DTM? ¿existe en nuestra ciudad un trabajo interdiciplinarios?, ¿es muy frecuente?. Para dar respuesta a todas estas interrogantes, ejecutamos un trabajo de tipo exploratorio y el método que usamos fue el de entrevista-encuesta, para asi tener datos más precisos del tema en cuestion...

Granuloma reparador de células gigantes tipo periférico: presentación de un caso, revisión de la experiencia del Instituto Nacional de Pediatría en 10 años y revisión de la literatura / Giant cell reparative peripherical granuloma: a case report, review of experience at the Instituto Nacional de Pediatría in 10 years and review of the literature

Se presenta un caso de granuloma reparador de células gigantes tipo periférico atendido en el Instituto Nacional de Pediatría en el Servicio de Otorrinolaringología cuyos síntomas y signos cardinales fueron: epistaxis moderada, disfagia, congestión nasal, aumento de volumen en surco nasogenario derecho y tumoración redonda en fosa nasal derecha. Se presenta la casuística de 10 años de experiencia en forma retrospectiva de 1985 a 1995 en el Instituto Nacional de Pediatría (INP), así como revisión de la literatura en relación al tema

[Histopathological aspects of the benign lymphoreticulosis, cat scratch disease, or cervical localization]. / Aspectos histopatológicos de la linforreticulosis benigna o enfermedad por arañazo de gato de localización cervical.

Report about 2 children affected with the cat scratch disease or lymphoreticulosis. The AA. discuss some etiological and clinic features of the malady, especially emphasizing the typical anatomopathological findings, which in the majority of the occurrences, allow the actual diagnosis. This is a disease of low incidence, but must be bear in mind when dealing with any cervical lump.