RESUMEN
PURPOSE: The potential relationship between mastication ability and cognitive function in idiopathic normal pressure hydrocephalus (iNPH) patients is unclear. This report investigated the association between mastication and cognitive function in iNPH patients using the gray level of the co-occurrence matrix on the lateral pterygoid muscle. METHODS: We analyzed data from 96 unoperated iNPH patients who underwent magnetic resonance imaging (MRI) between December 2016 and February 2023. Radiomic features were extracted from T2 MRI scans of the lateral pterygoid muscle, and muscle texture parameters were correlated with the iNPH grading scale. Subgroup analysis compared the texture parameters of patients with normal cognitive function with those of patients with cognitive impairment. RESULTS: The mini-mental state examination score correlated positively with the angular second moment (P < 0.05) and negatively with entropy (P < 0.05). The dementia scale (Eide's classification) correlated negatively with gray values (P < 0.05). Gray values were higher in the cognitive impairment group (64.7 ± 16.6) when compared with the non-cognitive impairment group (57.4 ± 13.3) (P = 0.005). Entropy was higher in the cognitive impairment group (8.2 ± 0.3) than in the non-cognitive impairment group (8.0 ± 0.3) (P < 0.001). The area under the receiver operating characteristic curve was 0.681 (P = 0.003) and 0.701 (P < 0.001) for gray value and entropy, respectively. CONCLUSION: Our findings suggest an association between heterogeneity of mastication and impaired cognitive function in iNPH patients and highlight muscle texture analysis as a potential tool for predicting cognitive impairment in these patients.
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Cognición , Disfunción Cognitiva , Hidrocéfalo Normotenso , Imagen por Resonancia Magnética , Músculos Pterigoideos , Humanos , Hidrocéfalo Normotenso/diagnóstico por imagen , Hidrocéfalo Normotenso/cirugía , Hidrocéfalo Normotenso/psicología , Hidrocéfalo Normotenso/fisiopatología , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Cognición/fisiología , Disfunción Cognitiva/psicología , Disfunción Cognitiva/fisiopatología , Disfunción Cognitiva/diagnóstico por imagen , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patología , Masticación/fisiologíaRESUMEN
Objective: To explore the correlation between the attachment type of lateral pterygoid muscle (LPM) and the position of temporomandibular joint (TMJ) disc in patients with temporomandibular disorders (TMD) by using wireless amplified magnetic resonance imaging detector (WAND) coupled with conventional head and neck joint coil for high resolution imaging of TMJ. Methods: Eighty-five patients with TMD diagnosed by oral and maxillofacial surgeons of Guizhou Provincial People's Hospital from October 2019 to January 2022 were collected. A total of 160 TMJ were included. There were 16 males and 69 females, aged (32.7±14.2) years. All patients were scanned with open, closed oblique sagittal and coronal WAND coupled head and neck coils with bilateral TMJ. Based on TMJ and LPM high resolution imaging, to explore the correlation between LPM attachment types and the position of TMJ disc in TMD patients, and to evaluate the potential clinical value of LPM attachment types in TMD patients. χ2 test and Pearson correlation analysis were used to evaluate the correlation between LPM attachment type and TMJ disc location. Results: There were three types of LPM attachment: type â in 51 cases [31.9% (51/160)], type â ¡ in 77 cases [48.1% (77/160)] and type â ¢ in 32 cases [20.0% (32/160)]. There was a significant correlation between the type of LPM attachment and the position of articular disc (χ2=28.20, P=0.002, r=0.776). There was no statistical significance between the type of LPM attachment and the reversible displacement of articular disc (χ2=0.24, P=0.887, r=0.825). Conclusions: There is a correlation between the attachment type of LPM and the position of the disc in TMD patients. WNAD coupled with conventional head and neck joint coil TMJ high resolution scan can provide reliable imaging evidence for TMD patients in evaluating the type of LPM attachment and the location of disc.
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Luxaciones Articulares , Trastornos de la Articulación Temporomandibular , Masculino , Femenino , Humanos , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Disco de la Articulación Temporomandibular/patología , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patología , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/patologíaRESUMEN
OBJECTIVE: We aimed to evaluate the effectiveness of clinical examination combined with texture analysis of magnetic resonance imaging (MRI) and fasciculation patterns of the lateral pterygoid muscle (LPM) in distinguishing among the different anatomic causes of temporomandibular disorder. METHODS: We divided the patients into four groups: healthy control (HC), disk without displacement (DWoD), disk displacement with reduction (DDWR), and disk displacement without reduction (DDWoR). Demographic information and clinical symptoms of patients in each group were recorded. LPM textures were compared among groups. LPM fasciculation was examined. P<0.05 indicated significant difference. RESULTS: Several clinical symptoms and signs, but not age or sex, differed significantly among groups. Oblique sagittal planar MRI revealed significant differences in the parameters of Angular Second Moment, Contrast, Correlation, Inverse Difference Moment, and Entropy between the healthy controls and the 3 patient groups. MRI of the patients, both without and with disk displacement, demonstrated relative uniformity in gray distribution and correlation of gray values, with greater complexity but an unclear texture and no obvious regularity. The proportion of type B LPM fascicles was significantly higher in the DDWR and DDWoR groups CONCLUSION: Temporomandibular disorder, without and with disk displacement, is associated with clinical symptoms and texture analysis values that differ from healthy muscle. The types of LPM fascicles are related to the position of the articular disk.
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Luxaciones Articulares , Trastornos de la Articulación Temporomandibular , Humanos , Articulación Temporomandibular/patología , Disco de la Articulación Temporomandibular , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patología , Fasciculación/patología , Luxaciones Articulares/patología , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/patología , Imagen por Resonancia Magnética/métodosRESUMEN
OBJECTIVE: To compare volume and surface area measurements of the lateral pterygoid (LPM), medial pterygoid (MPM), and masseter muscles (MM) as calculated on magnetic resonance imaging (MRI) based on the position of the temporomandibular joint disk, mouth position, and patient sex, and to calculate the correlations of the measurements among the muscles. STUDY DESIGN: Measurements of muscle volume and area were performed on the MRIs of 51 patients. Wilcoxon, Kruskal-Wallis, and Mann-Whitney U tests were used to calculate the significance of differences in measurements. The Spearman correlation coefficient calculated the correlation of measurements among the muscles. The significance of difference was established at P < .05. RESULTS: Volume and area of the left MPM in patients with disk displacement without reduction (DDWOR) were larger than in patients with normal disk position (P ≤ .040). MM volumes were smaller with DDWOR than with DD with reduction bilaterally (P ≤ .031). The volume and area of LPM and MM were significantly different between closed and open mouth positions (P < .001). Differences in volume and area between females and males were significant for all muscles in volume (P ≤ .021) and for MPM and MM in area (P ≤ .021). Significant positive correlations were found among all muscles for volume and area. CONCLUSION: Volume and area measurements of the masticatory muscles varied according to disk and mouth position and patient sex and exhibited significant positive correlations.
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Músculos Masticadores , Trastornos de la Articulación Temporomandibular , Masculino , Femenino , Humanos , Músculos Masticadores/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/patología , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patología , Imagen por Resonancia Magnética/métodos , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/patologíaRESUMEN
OBJECTIVE: To use quantitative MRI to assess gender differences in lateral pterygoid muscle (LPM) characteristics in patients with anterior disk displacement (ADD). METHODS: Lateral pterygoid muscle of 51 patients diagnosed with temporomandibular joint disorders (TMD) who underwent T1-weighted Dixon and T1-mapping sequences were retrospectively analyzed. There were 34 female patients (10 with bilateral normal position disk [NP]; 24 with bilateral ADD) and 17 male patients (eight with bilateral NP; nine with bilateral ADD) among them. After controlling for age, differences in fat fraction, T1 value, volume and histogram features related to gender and disk status were tested with 2-way ANCOVA or Quade ANCOVA with Bonferroni correction. RESULTS: Volume of LPM in NP was significantly smaller than that of ADD (p < 0.001). Fat fraction of LPM in females with NP was significantly higher than males with NP (p < 0.05). Females with ADD showed a significantly higher T1 value (p < 0.05), and higher intramuscular heterogeneity than males with ADD. CONCLUSIONS: Lateral pterygoid muscle in female TMD patients presented more fatty infiltration in the NP stage and might present more fibrosis in the ADD stage compared with males. Together, this leads to more serious intramuscular heterogeneity during the pathogenesis of ADD in females.
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Músculos Pterigoideos , Trastornos de la Articulación Temporomandibular , Humanos , Masculino , Femenino , Estudios Retrospectivos , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patología , Factores Sexuales , Trastornos de la Articulación Temporomandibular/patología , Imagen por Resonancia Magnética , Articulación Temporomandibular/patologíaRESUMEN
Objective: To explore the correlation between the attachment type of lateral pterygoid muscle (LPM) and the position of temporomandibular joint (TMJ) disc in patients with temporomandibular disorders (TMD) by using wireless amplified magnetic resonance imaging detector (WAND) coupled with conventional head and neck joint coil for high resolution imaging of TMJ. Methods: Eighty-five patients with TMD diagnosed by oral and maxillofacial surgeons of Guizhou Provincial People's Hospital from October 2019 to January 2022 were collected. A total of 160 TMJ were included. There were 16 males and 69 females, aged (32.7±14.2) years. All patients were scanned with open, closed oblique sagittal and coronal WAND coupled head and neck coils with bilateral TMJ. Based on TMJ and LPM high resolution imaging, to explore the correlation between LPM attachment types and the position of TMJ disc in TMD patients, and to evaluate the potential clinical value of LPM attachment types in TMD patients. χ2 test and Pearson correlation analysis were used to evaluate the correlation between LPM attachment type and TMJ disc location. Results: There were three types of LPM attachment: type Ⅰ in 51 cases [31.9% (51/160)], type Ⅱ in 77 cases [48.1% (77/160)] and type Ⅲ in 32 cases [20.0% (32/160)]. There was a significant correlation between the type of LPM attachment and the position of articular disc (χ2=28.20, P=0.002, r=0.776). There was no statistical significance between the type of LPM attachment and the reversible displacement of articular disc (χ2=0.24, P=0.887, r=0.825). Conclusions: There is a correlation between the attachment type of LPM and the position of the disc in TMD patients. WNAD coupled with conventional head and neck joint coil TMJ high resolution scan can provide reliable imaging evidence for TMD patients in evaluating the type of LPM attachment and the location of disc.
Asunto(s)
Masculino , Femenino , Humanos , Disco de la Articulación Temporomandibular/patología , Músculos Pterigoideos/patología , Luxaciones Articulares , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Articulación Temporomandibular/patologíaRESUMEN
PURPOSE: Lateral pterygoid muscle ossification has not been reported in condylectomy patients. This study aimed to explore the incidence, risk factors, and imaging characteristics of 38 cases with lateral pterygoid muscle ossification among 54 patients after condylectomy via intraoral approach. METHODS: This retrospective study included 54 patients following simultaneous orthognathic surgery and condylectomy with coronoid process resection via intraoral approach. The authors evaluated the preoperative, 1 week, 6 months, and 1 year or more postoperative computed tomographic (CT) scans for the presence of lateral pterygoid muscle ossification and its characteristics. Sex, age at the time of surgery, disease course, affected side, preoperative alkaline phosphatase, pathology diagnosis, the height of the removed condyle, condylar shape, operator, preoperative temporomandibular joint movement, and clinical symptoms were assessed as risk factors for ossification. RESULTS: No incidence of lateral pterygoid muscle ossification was found on preoperative CT images. Various small-size osseous masses were observed in the lateral pterygoid muscles on postoperative 6 months CT images in 38/54 patients (70.37%) after condylectomy. But no apparent enlargement of the osseous masses was found. No patients complained of clinical discomfort or functional disorder during the follow-up period (23.11 ± 13.16 months). No significant risk factors for ossification were found. CONCLUSIONS: Lateral pterygoid muscle ossification is relatively common in patients after condylectomy via intraoral approach. However, its enlargement is self-limited and remains stable 6 months after surgery. it has no adverse effects on the temporomandibular joint functional movement.
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Procedimientos Quirúrgicos Ortognáticos , Osificación Heterotópica , Músculos Pterigoideos , Fosfatasa Alcalina , Humanos , Cóndilo Mandibular/cirugía , Procedimientos Quirúrgicos Ortognáticos/efectos adversos , Osificación Heterotópica/etiología , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patología , Músculos Pterigoideos/cirugía , Estudios Retrospectivos , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/fisiología , Articulación Temporomandibular/cirugíaRESUMEN
PURPOSE: The aim of this study was to evaluate the lateral pterygoid muscle (LPM) area, attachment type, signal intensity and presence of arthrosis, effusion in the temporomandibular joint (TMJ) by magnetic resonance imaging (MRI) according to the position of the articular disc. METHODS: The study included a total of 126 TMJs belonging to 69 patients over the age of 18 years who had MRI due to TMJ complaints. The position of the articular disc, the area, attachment type, and signal intensity of the LPM, the presence of arthrosis on the condyle surface, and the presence of effusion in the joint space were evaluated. RESULTS: The attachment type of the LPM did not show a statistically significant difference according to the position of the articular disc. The groups were not statistically different in terms of LPM intensity. Although the distribution of the LPM area was found to be low in the anterior disc displacement with reduction (R+DD) group and high in the anterior disc displacement without reduction (R-DD) group. It was determined that the rate of arthrosis at the condyle head was significantly higher in the R-DD group compared to the normal disc position group. The incidence of effusion was found significantly higher in the R-DD and R+DD groups than joints with normal disc position. CONCLUSIONS: Pathological changes in LPM and TMJ can be detected by MRI. In the group with R-DD, the rate of arthrosis at the condyle head, effusion, LPM area, and intensity of the Sup. LPM were higher.
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Osteoartritis , Trastornos de la Articulación Temporomandibular , Humanos , Adulto , Persona de Mediana Edad , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patología , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Disco de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/epidemiología , Articulación Temporomandibular/diagnóstico por imagen , Osteoartritis/patologíaRESUMEN
OBJECTIVE: The objective of the study is to determine the role of Lateral Pterygoid Muscle LPM in the articular disc displacement ADD, which is considered controversial due to the variations in the pattern of insertion of the Superior Lateral Pterygoid Muscle SPLM. BACKGROUND: It is well understood that the superior head of the lateral pterygoid muscle has only a single insertion pattern among individuals, in which the muscle is attached to the articular disc and capsule. However, recent findings in many studies have shown a noticeable variation in the insertion pattern of the upper LPM. METHODS: MRI examinations were collected at King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. Scans of 61 patients (41 females, 20 males; mean age 33 years old) with symptoms of temporomandibular dysfunction were reviewed retrospectively. The direction of their articular disc displacement was evaluated through sagittal and coronal views in both open and closed mouth positions. RESULTS: There was no statistical significance found between the LPM attachment types and TMJ disc position. The chi-square test also showed no significant difference between the type of LPM attachment and the condylar location. Forty-five percent of the articular discs were located between the articular eminence and the glenoid fossa. The majority of the disc displacement was in the anterior direction. CONCLUSION: There was no statistically significant association found between the type of LPM attachments and the direction of disc displacement.
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Músculos Pterigoideos , Disco de la Articulación Temporomandibular , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patología , Estudios Retrospectivos , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Disco de la Articulación Temporomandibular/patologíaRESUMEN
Objective: This study explored the effect of qat chewing (QC) on the lateral pterygoid muscle (LPM), using magnetic resonance imaging (MRI).Methods: Forty qat chewers (QG), divided into three subgroups, according to duration of QC, and 20 non-qat chewers (NQG) were included. MRI sections were obtained to assess hypertrophy and atrophy of the superior belly (SB) and inferior belly (IB) of the LPM on the chewing and contralateral non-chewing side.Results: There was a significantly higher prevalence of atrophy of the IB (p < 0.001) and hypertrophy of the SB and IB (p = 0.002) in the QG. Hypertrophy of SB and IB was marked (p = 0.001) on the chewing side. Conversely, SB atrophy was marked on the non-chewing side (p = 0.003). MRI demonstrated a positive correlation between LPM alterations and the duration of QC in subgroup analysis.Conclusion: Unilateral QC might be a cause of LPM alterations.
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Masticación , Músculos Pterigoideos , Humanos , Hipertrofia , Imagen por Resonancia Magnética/métodos , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patologíaAsunto(s)
Miositis/diagnóstico , Miositis/microbiología , Dolor de Cuello/etiología , Músculos Pterigoideos/patología , Trismo/diagnóstico por imagen , Adolescente , Antibacterianos/uso terapéutico , Femenino , Humanos , Imagen por Resonancia Magnética , Miositis/tratamiento farmacológico , Músculos Pterigoideos/efectos de los fármacos , Músculos Pterigoideos/microbiologíaRESUMEN
BACKGROUND: Texture features were the intrinsic properties of the human tissues and could efficiently detect the subtle functional changes of involved tissue. The pathologic changes of the lateral pterygoid muscle (LPM) were significantly correlated with the temporomandibular disc displacement. However, the occult functional changes of LPM could not be detected by the naked eye on the medical images. The current study was aimed to evaluate the functional changes of the LPM in the patients with temporomandibular disorders (TMDs) using texture analysis. METHODS: Twenty-nine patients with TMD were performed with magnetic resonance (MR) imaging on a 3.0T MR scanner, who were consecutively recruited from the TMD clinic of Hainan Hospital of Chinese People's Liberation Army General Hospital from February 2019 to September 2019. The patients were classified into three groups according to the disc displacement: disc without displacement (DWoD), disc displacement with reduction (DDWR) and disc displacement without reduction (DDWoR). The gray-level co-occurrence matrix method was applied with the texture analysis of LPM on the axial T2-weighted imaging. The texture features included angular second moment, contrast, correlation, inverse different moment, and entropy. One-way analysis of variance was used for grouped comparisons and receiver operating characteristics (ROC) curve analysis was applied to evaluate the diagnostic efficacy of the texture parameters. RESULTS: Texture contrast of LPM presented significantly lower in DDWoR (46.30 [35.03, 94.48]) than that in DWoD (123.85 [105.06, 143.23]; test statisticâ=â23.05; Pâ<â0.001). Texture entropy of LPM showed significant differences among DWoD (7.62â±â0.33), DDWR (6.76â±â0.35), and DDWoR (6.46â±â0.39) (PDWoD-DDWRâ<â0.001, PDWoD-DDWoRâ<â0.001, and PDDWR-DDWoRâ=â0.014). Area under the ROC curve (AUC) demonstrated that texture entropy had an excellent diagnostic accuracy for DWoD-DDWR (AUCâ=â0.96) and DWoD-DDWoR (AUCâ=â0.98). CONCLUSION: The texture contrast and entropy could identify the altered functional status of LPM in patients with TMD and could be considered as the effective imaging biomarker to evaluate the functional changes of LPM in TMD.
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Imagen por Resonancia Magnética/métodos , Músculos Pterigoideos/patología , Músculos Pterigoideos/fisiopatología , Trastornos de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/fisiopatología , Adulto , Biomarcadores , Femenino , Humanos , Masculino , Persona de Mediana Edad , Músculos Pterigoideos/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Adulto JovenRESUMEN
PURPOSE: The purpose of the study was to analyze the total prevalence, morphologic, and morphometric characteristics of the pterygospinous (PS) bar and its gender and ethnic differences among populations. PS bar is an ossified anatomic structure stretching between the posterior margin of the lateral pterygoid lamina to the angular spine of the undersurface of the sphenoid, with potential clinical implications. There is no consensus in the literature on its prevalence, morphologic, and morphometric characteristics. METHODS: A thorough search of databases was conducted. Data on the prevalence, morphology, i.e., ossification type (complete and incomplete), side, gender, laterality, and morphometrics, of the PS bar were extracted and pooled into a meta-analysis. RESULTS: A total of 35 studies (n = 14,047 subjects) were analyzed. The overall pooled prevalence of a complete PS bar was 4.4% (95% CI 3.7-5.1), while the overall pooled prevalence of an incomplete PS bar was significantly higher (11.6% [95% CI 8.5-15.2]). A complete PS bar was more prevalent among males and was more commonly unilaterally, on the left side. CONCLUSION: The overall prevalence of PS bar is quite common. It could be of importance for clinicians who should consider its potential presence when planning surgical approaches to the retropharyngeal and parapharyngeal space.
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Ligamentos/patología , Osificación Heterotópica/epidemiología , Músculos Pterigoideos/patología , Hueso Esfenoides/patología , Femenino , Humanos , Ligamentos/anatomía & histología , Masculino , Prevalencia , Músculos Pterigoideos/anatomía & histología , Factores Sexuales , Hueso Esfenoides/anatomía & histologíaRESUMEN
Traumatic temporomandibular joint ankylosis (TMJA) is a common disease and disorder of the temporomandibular joint (TMJ); however, its pathogenesis has yet to be completely elucidated. In the authors' previous studies, the lateral pterygoid muscle (LPM) was confirmed to exert a function in distraction osteogenesis (DO) during the healing of a condylar fracture, which resulted in the formation of excess bone. The aim of the present study was to investigate alterations in the expression of any associated genes via an Affymetrix GeneChip method. The traumatic TMJA model was fabricated by a condylar fracture in the TMJ area of sheep with either a dissected LPM (LPD) or normal (LPN). The untreated sheep served as a control. At 4 and 12 weeks postsurgery, the condylar zone was isolated to perform the gene chip analysis, which was performed according to a standard Affymetrix protocol. The validated genes were further evaluated by reverse transcriptionquantitative polymerase chain reaction (RTqPCR). The gene chip analysis indicated that the LPN gene expression pattern was similar compared with the DO process, while LPD was similar to that of normal bone fracture healing. The validated genes were collagen type II α1 chain, Ctype lectin domain family 3 member A, interleukin 1A, cartilage oligomeric matrix protein, chondromodulin (LECT1), calcitonin receptor (CALCR), transforming growth factor (TGF)ß1, Fos protooncogene (FOS), bone γcarboxyglutamate protein and bone morphogenic protein (BMP)7, among which, BMP7, LECT1, CALCR and FOS were confirmed by RTqPCR. In conclusion, the present study demonstrated that LPM exerts a DO effect during the pathogenesis of traumatic TMJA, which may provide a novel target for preventing TMJA.
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Anquilosis/etiología , Anquilosis/patología , Músculos Pterigoideos/metabolismo , Músculos Pterigoideos/patología , Trastornos de la Articulación Temporomandibular/etiología , Trastornos de la Articulación Temporomandibular/patología , Heridas y Lesiones/complicaciones , Animales , Biología Computacional , Modelos Animales de Enfermedad , Perfilación de la Expresión Génica , Ontología de Genes , Análisis de Secuencia por Matrices de Oligonucleótidos , Reproducibilidad de los Resultados , Ovinos , TranscriptomaRESUMEN
OBJECTIVES: To investigate the olfactory fossa depths and lateral lamella lengths of patients with different types of developmental disorders of paranasal sinuses in comparison with normal controls. STUDY DESIGN: Retrospective, archival, radio-anatomical study. METHODS: We included 58 patients with maxillary sinus hypoplasia, 50 patients with frontal sinus hypoplasia/aplasia, 50 patients with sphenoid sinus hypoplasia/aplasia, and 40 normal controls. Reviewing paranasal computerized tomography scans, we noted the olfactory fossa depths and lateral lamella lengths of all the groups and compared between the hypoplasia groups and the control group. RESULTS: Compared with the normal controls, the maxillary hypoplasia group (P < 0.001), frontal hypoplasia/aplasia group (P = 0.004), and sphenoid hypoplasia/aplasia group had significantly deeper olfactory fossa (P = 0.003). The mean lateral lamella lengths in the type 1, type 2, and type 3 hypoplastic maxillary sinus groups were significantly greater compared with that in the control group (P < 0.001). Additionally, the mean lateral lamella lengths in the hypoplastic frontal sinus, aplastic frontal sinus, and hypoplastic sphenoid sinus groups were significantly greater compared with that in the control group (P < 0.001). CONCLUSION: The patients with pneumatization defects of the maxillary, frontal, and sphenoid sinuses had deeper olfactory fossa and longer lateral lamella related to increased risk of skull base injury during endoscopic sinus surgery. LEVEL OF EVIDENCE: 3 Laryngoscope, 129:2458-2463, 2019.
Asunto(s)
Fosa Craneal Anterior/diagnóstico por imagen , Hueso Etmoides/diagnóstico por imagen , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Hueso Esfenoides/diagnóstico por imagen , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Adolescente , Adulto , Estudios de Casos y Controles , Fosa Craneal Anterior/patología , Hueso Etmoides/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de los Senos Paranasales/patología , Músculos Pterigoideos/diagnóstico por imagen , Músculos Pterigoideos/patología , Estudios Retrospectivos , Hueso Esfenoides/patología , Adulto JovenRESUMEN
OBJECTIVE: Patulous eustachian tube (PET) is currently treated using a variety of conservative or surgical approaches. To further elucidate the pathology of PET and to establish new therapies, the development of an animal model is necessary. The objective of this study was to develop a highly reproducible and sustainable rat model of PET by mandibular nerve resection. METHODS: Sixteen rats underwent mandibular nerve resection. Following an external incision, the main trunk of the mandibular nerve at the foramen ovale was identified in the pterygoid fossa, and its branches were resected. This surgery was performed on the right side, with the unoperated left side used as the control. To determine eustachian tube (ET) function, passive opening pressure (POP) was measured using inflation method up to Week 16 post-surgery. Changes in POP were statistically compared to the preoperative level on the operated and control sides. In addition, specimens of the ET and its surrounding tissue at Week 16 post-surgery were prepared for morphological evaluation in eight rats. RESULTS: On the control side, POP did not significantly decrease across the 16 weeks post-surgery compared to the preoperative level. In contrast, on the operated side, POP was significantly decreased at Week 2 and continued to be lower than the preoperative level until at least Week 16 post-surgery. POP dropped 10% or more on the operated side examined in thirteen rats. Histologically, the medial pterygoid muscle was atrophied on the operated side mainly. CONCLUSION: Mandibular nerve resection in rats may be an effective method for generating an animal model of PET. It was suggested that this rat model may be useful for verifying new treatments for PET.
Asunto(s)
Modelos Animales de Enfermedad , Enfermedades del Oído/patología , Trompa Auditiva/patología , Nervio Mandibular/cirugía , Ratas , Animales , Enfermedades del Oído/fisiopatología , Trompa Auditiva/fisiopatología , Atrofia Muscular/patología , Presión , Músculos Pterigoideos/inervación , Músculos Pterigoideos/patologíaRESUMEN
Locally advanced oral cancers extending to infratemporal fossa (ITF) are a challenge to head and neck surgeons. These tumors are classified as T4b whenever the masticator space (MS), pterygoid muscles (PM), and pterygoid plates (PP) are involved according to AJCC classification. Until recently, these tumors were considered inoperable and treated only with palliative intent. However, a few studies in the last decade showed that many of these tumors could be resected with a reasonably favorable prognosis by compartment resection of ITF, particularly when the tumor was below sigmoid notch of mandible. A few studies attempted to downstage these tumors by neo-adjuvant chemotherapy before attempting resection. Oral Squamous cell carcinoma has a high prevalence in South India. Majority of these patients are females addicted to tobacco quid chewing and present with locally advanced disease. In this retrospective analysis, we evaluated the outcome of treatment of oral squamous cell carcinoma extending to ITF and staged T4b in 52 patients. All patients underwent Composite resection including compartment resection of ITF followed by adjuvant treatment. 20 patients had received neo-adjuvant chemotherapy. Pectoralis major myocutaneous flap was the mainstay of reconstruction. After mean follow-up of 2 years, 31 patients are alive and disease free. 14 patients had local recurrence in ITF and 2 patients had recurred in cervical nodes. 8 patients died due to disease and 6 are on palliative care. Neo-adjuvant chemotherapy did not benefit the outcome. Close margins of resection, extra nodal spread from lymph nodes and supra notch and involvement of posterior part of ITF were factors which predisposed to recurrence.
Asunto(s)
Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Hospitales Rurales , Neoplasias de la Boca/patología , Neoplasias de la Boca/terapia , Centros de Atención Terciaria , Adulto , Anciano , Carcinoma de Células Escamosas/mortalidad , Quimioterapia Adyuvante , Femenino , Humanos , India , Ganglios Linfáticos/patología , Masculino , Mandíbula/patología , Persona de Mediana Edad , Neoplasias de la Boca/mortalidad , Músculos Pterigoideos/patología , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
Myositis ossificans (MO) is a rare non-neoplastic disorder characterized by heterotopic ossification in soft tissues, mainly muscles. MO traumatica is characterized by ossification of the soft tissues after acute or repetitive trauma, burns, or surgical intervention. Muscular or soft tissue trauma is usually present as the underlying etiology. MO traumatica usually involves the extremity muscles. The number of reported cases involving the masticatory muscles is extremely low. The most common clinical sign of this condition is progressive limitation of mouth opening. Surgical resection of the ossified tissue has been the most commonly used treatment for this disorder, with a high postoperative recurrence rate. We report a case of traumatic MO of the medial pterygoid muscle to draw attention to the possibility of the condition in patients with a limited mouth opening and to review the reported data about MO traumatica involving the medial pterygoid muscle.
Asunto(s)
Tercer Molar/cirugía , Miositis Osificante/etiología , Músculos Pterigoideos/patología , Extracción Dental/efectos adversos , Adulto , Femenino , Humanos , Miositis Osificante/diagnóstico por imagen , Miositis Osificante/terapia , Músculos Pterigoideos/diagnóstico por imagenRESUMEN
Psychological stress is an important perpetuating, worsening and risk factor for temporomandibular disorders of muscular or articular origin. Occlusion instability, by the way, is considered a risk factor of this pathology and can be reproduced in some experimental animal models. The exact physiologic mechanism underlying these relations however, remains unclear. Our purpose was to test the hypothesis that chronic stress and unilateral exodontia induce metabolic and vascular changes in the medial pterygoid muscle of rats. Adult Wistar rats were submitted to chronic unpredictable stress and/or unilateral exodontia and their plasma and medial pterygoid muscle were removed for analysis. The parameters evaluated included plasma levels of corticosterone, metabolic activity by succinate dehydrogenase, oxidative capacity by nicotinamide adenine dinucleotide diaphorase, capillary density by laminin and alfa-CD staining and reactive oxidative species production. Chronic unpredictable stress as an isolated factor, increased oxidative metabolism, capillary density and reactive oxygen species production at medial pterygoid muscle. Conversely, exodontia has a main effect in metabolism, promoting glycolytic transformation of muscle fibers. Association of both factors induced a major glycolytic pattern in muscle and vascular changes. Our findings provide insights into the mechanisms, possibly inducing metabolic and vascular alterations on medial pterygoid muscle of rats, by which chronic stress and occlusal instabilities might be involved as risk factors in the pathophysiology of temporomandibular disorders with muscular components.
Asunto(s)
Músculos Pterigoideos/irrigación sanguínea , Músculos Pterigoideos/metabolismo , Estrés Psicológico/metabolismo , Extracción Dental , Animales , Capilares/metabolismo , Capilares/patología , Enfermedad Crónica , Corticosterona/metabolismo , Modelos Animales de Enfermedad , Masculino , Diente Molar , NAD/metabolismo , Músculos Pterigoideos/patología , Distribución Aleatoria , Ratas Wistar , Especies Reactivas de Oxígeno/metabolismo , Estrés Psicológico/patología , Succinato Deshidrogenasa/metabolismo , Trastornos de la Articulación Temporomandibular/metabolismo , Trastornos de la Articulación Temporomandibular/patología , Extracción Dental/efectos adversos , IncertidumbreRESUMEN
The purpose of this report is to document a unique location of an oropharyngeal foreign body, diagnosed via contrast computed tomography (CT), as well as a novel surgical approach to the pterygoid muscle region. Oropharyngeal foreign objects are an uncommon but potentially serious disease that can lead to chronic abscessation and pain. Two dogs were presented with chronic complaints, including pain and inability to fully open the mouth for a 1 yr and 5 mo duration, respectively. There was no history or evidence of skin sinus or submandibular/cervical swelling on physical examination of either dog. Both dogs had normal oropharyngeal anatomy with the exception of an asymmetric contrast-enhancing lesion within the pterygoid muscle on CT imaging. As there were no gross abnormalities visible during surgery, the use of contrast CT was vital in order to isolate the focus of infection. A paramedian submandibular approach was used to explore this region, and in both cases, foreign material was successfully removed with subsequent resolution of clinical signs. The dogs were immediately free of clinical signs and showed no recurrence for at least 8 and 17 mo after the exploration, respectively. A novel surgical approach is described to remove oropharyngeal foreign objects and necrotic debris within the pterygoid muscle.