Correlation between single photon emission computed tomography and histopathologic findings in condylar hyperplasia of the temporomandibular joint.

PURPOSE: To analyse the correlation between the level of activity measured in the single photon emission computed tomography (SPECT) and the pathological findings in patients with condylar hyperplasia (CH). MATERIALS AND METHODS: All patients evaluated in our department between 2007 and 2014 with a diagnosis of condylar hyperplasia who had undergone SPECT, evidenced signs of activity, and had undergone surgery were included. We included 28 patients, of whom 20 were women and 8 men. RESULTS: The male:female ratio was 2,5:1. The mean age of the subjects was 24.4 years at the time of diagnosis (with a range between 14 and 42 years). In 19 cases the affected condyle was the right, and in the remaining 9 it was the left (ratio R:L 2,1:1). On the SPECT, in 16 patients a high level of activity was identified (57.1%) and in the remaining 12 a low level (42.9%). Only 13 patients (6 in the low-activity group and 7 in the high-activity group) presented with islands of cartilage. When comparing the results between the two groups, the main differences were observed in the parameters related to the islands of cartilage. These were more frequent in the group with high activity compared with low activity (5.5 versus 0 per mm2 of median). Besides being more frequent, these islands were larger (more than double) in the high-activity group (385.1 µm versus 169.7 µm of median). This is the only statistically significant difference found, a fact that can be explained by the small sample size in the study. CONCLUSION: Radioisotope tests are the best indicator of the level of activity in condylar hyperplasia, which seems to be directly related to the intensity signal collection.

Subclavicular pectoralis major myocutaneous flap for optimal reconstruction of large orbitozygomatic defects: a case report.

Since the introduction of microvascular free flaps, the pectoralis major myocutaneous flap (PMMF) has been relegated to background for most reconstructive surgeons. The objective of this article is to show the advantages of cervicofacial defects reconstruction with PMMF using the subclavicular plane route in a challenging clinical case. An 83-year-old man presented with cutaneous temporomalar lesion with orbital spread. Tumor resection was performed, including 12 × 11 cm skin and subcutaneous tissue, overlying zygomatic and malar bone, and orbital exenteration. Radical parotidectomy and functional neck dissection were performed. PMMF was chosen as reconstructive option routing the pedicle to the subclavicular plane. The length of the pedicle was 31 cm. The subclavicular route for PMMF increases the flap's length and arc of rotation compared with the conventional supraclavicular one. This procedure decreases the bulk of the PMMF pedicle which makes it functionally and cosmetically favorable. By using this modification, we may widen the "safe" reconstructive possibilities.

Intraoral electrostimulator for xerostomia relief: a long-term, multicenter, open-label, uncontrolled, clinical trial.

OBJECTIVE: A previous sham-controlled multinational study demonstrated the short-term efficacy and safety for xerostomia treatment of an intraoral device that delivers electrostimulation to the lingual nerve. The objective of this study was to test the hypothesis that those beneficial effects would be sustained over an 11-month period. STUDY DESIGN: The device was tested on a mixed sample of 94 patients with xerostomia in an open-label, uncontrolled, prospective multicenter trial. Statutory outcome assessments were done at 5th, 8th, and 11th months and analyzed by multiple comparisons. RESULTS: Improvements achieved at month 5 from baseline were sustained throughout the follow-up period for the primary outcome, xerostomia severity, and the secondary outcomes resting whole salivary flow rate, xerostomia frequency, oral discomfort, and difficulties in speech, swallowing, and sleeping. No significant side effects were detected. CONCLUSIONS: The beneficial effects of a removable intraoral electrostimulating device were sustained for an 11-month period.