Is Reflex Parotitis a Forgotten or an Unknown Pathology?

Reflex parotitis is a recurrent parotid inflammation caused by an imbalance in the parasympathetic innervation of the salivary gland. However, due to a poor understanding of its pathophysiology, it can go unnoticed. Causes of ignored norms can trigger these repetitive episodes of glandular disease with a difficult diagnosis and inadequate treatment.

Pedicled Tragal Chondral Flap for Interpositional Gap Arthroplasty in a TMJ Ankyloses.

Interpositional gap arthroplasty has shown good results; however, these techniques could be improved by taking into account the biological bases of the tissue used. Therefore, we suggest the pedicled tragal chondral flap as a safe, simple, and low-morbidity alternative.

A Novel Method for Lengthening Iliac Crest Grafts for Mandibular Reconstruction.

The objective of this article is to propose a technique for mandibular reconstructions of up to 17 cm, in order to obtain anterior iliac crest grafts smaller than those required, and then lengthen them using corticotomies. This technique has been performed in 5 patients with an indication for reconstruction after partial mandibulectomy due to pathology. Reconstruction of the body of the mandible, including the angle in some cases, was performed using nonvascularized anterior iliac crest grafts. These were elongated using corticotomies and fixed to cover the defect using reconstruction plates and screws (2.4 system). The wedge spaces that were formed by lengthening the bone block were grafted with autologous medullary bone and platelet-rich plasma. There was no loss of any of the grafts and there was no need for second surgical times to place more grafts. All cases were able to be rehabilitated with removable prostheses or dental implants. This method optimizes the amount of graft obtained, favors revascularization of the graft, reduces hypoxia times and allows the placement of osteoconductive and/or osteoinductive grafts directly on the exposed medullary areas, with the aim of promoting integration and reducing the resorption rate in large grafts.

The Use of Inferior Meatal Antrostomy to Decrease Sinusitis with the Placement of Zygomatic Implants.

PURPOSE: To present a case series treated by inferior meatal antrostomy as a prophylactic maneuver after the placement of zygomatic implants to decrease the risk of sinusitis. MATERIALS AND METHODS: All patients undergoing zygomatic implant placement using the lower meatal antrostomy protocol between June 2011 and March 2019 at the Department of Oral and Maxillofacial Surgery, Universidad El Bosque, were included. Patients were evaluated after 12 months of the procedure using clinical and radiologic criteria described by Kuriyama and Reiskin. RESULTS: Forty-eight patients were included, in whom 184 implants were placed. Complications were as follows: paresthesia (6.2%), orosinusal fistula (4.1%), skin infection (2.1%), and loss of the implant (1.6%). There were no cases of sinusitis. CONCLUSION: This study provides evidence that the technique is effective and should be considered because of its simplicity. The inferior meatal antrostomy has been proven to be a simple, effective, and reliable technique to decrease the risk of sinusitis associated with the placement of zygomatic implants.

The Morpho-Functional Three-Dimensional Analysis for Zygomatic Implants: A Clinical Tool With Surgical Implications.

ABSTRACT: Zygomatic implants (ZIs) have been used successfully for the rehabilitation of jaws with severe atrophy for the past 2 decades. The development of computed tomography, three-dimensional (3D) analysis software, and stereolithographic models has positively impacted the development of preoperative planning. This article describes the protocol developed by the Department of Oral and Maxillofacial Surgery of El Bosque University, Bogotá, Colombia, through 10 years of experience, for the installation of ZIs, covering from the times when the implants were placed through intraoperative guidance, until now, in which drilling guides developed by computer-aided design and computer-aided manufacturing are used, without neglecting in their design multiple factors that must be considered. To date, this protocol for the treatment of patients with atrophic jaws through ZIs includes a detailed clinical examination, in which variables such as bone and dental relationship between the jaws, oral opening and dynamic interaction between soft cervicofacial tissues are considered. It also includes a 3D computed tomography planning for the design and preparation of surgical guides whose insertion patterns must be executable during surgery. Together, clinical and imaging analysis converge in what it has been called morpho-functional 3D planning.

Previously Reported Approach Now Used for Temporomandibular Joint Replacement.

Over time, different techniques have been described to obtain broad access to the temporomandibular joint (TMJ), in order to allow good visibility, minimizing post-operative complications at the same time. Most of these techniques have been very useful to perform joint replacement using custom made prostheses, varying in its extension, aesthetics and functional results. The aim of this study was to present the authors' experience using the Blair approach modified by Fernández in 2015, to replace failed TMJ prostheses, when distortion of the surgical reference points has occurred.

Pedicled Tragal Chondral Flap for Irreparable Temporomandibular Joint Disc.

Several techniques have been proposed for the management of perforation of or severe damage to the temporomandibular joint disc, with a wide range of success rates reported. We describe a new method using a pedicled sliding flap of the tragal cartilage.

Is the Mandibular Growth Affected by Internal Rigid Fixation?: A Systematic Review.

PURPOSE: The purpose of this systematic review was to evaluate, in animal model-based studies, whether there are mandibular growth alterations, after open reduction and internal rigid fixation with titanium plates and screws. METHODS: A literature search was conducted using the MEDLINE, EMBASE, and LILACS databases, up to and including August 2015. Surgical reduction and internal rigid fixation (IRF) of induced fractures were compared to non-invasive procedures, in order to investigate if there were alterations in the mandibular growth patterns. RESULTS: Of a total of 624 potentially relevant papers identified through the searching process, five were eligible for inclusion. Three studies using 3-month old New Zealand white rabbits induced fractures of mandibular body or symphysis and internal fixation with titanium microplates and screws, whereas two were based on 6-month old goats with condylar fracture. None of the studies showed statistically significant difference between experimental and control groups. CONCLUSION: As literature regarding this subject is scarce, and the included studies show low level of evidence, it is not possible to conclude that open reduction and internal rigid fixation with titanium plates and screws cause significant growing alteration of the mandible.

Inferior Meatal Antrostomy as a Prophylactic Maneuver to Prevent Sinusitis After Zygomatic Implant Placement Using the Intrasinusal Technique.

PURPOSE: To determine whether performing an inferior meatal antrostomy as a prophylactic intraoperative maneuver in patients who underwent zygomatic implant surgery significantly reduces the incidence of postoperative sinusitis. MATERIALS AND METHODS: A double-blind randomized controlled trial was implemented. The study included 44 patients seen at the Oral and Maxillofacial Surgery Department at Universidad El Bosque in Bogota, Colombia, who required zygomatic implant surgery. Patients were randomly allocated to either group 1 (without inferior meatal antrostomy) or group 2 (with inferior meatal antrostomy). Patients were evaluated clinically and radiographically 15 days and 3 months after surgery, and classified depending on whether they did or did not develop sinusitis. Results were analyzed using descriptive and bivariate statistics. The control group event rate, experimental group event rate, relative risk, relative risk reduction, absolute risk reduction, and number needed to treat values were calculated for further analysis. RESULTS: Three patients allocated to group 1 showed clinical and radiographic signs of sinusitis after zygomatic implant surgery, for an overall rate of sinusitis of 13.6%. No patient in group 2 developed clinical or radiographic signs of sinusitis. CONCLUSION: The results of this study suggest that performing an inferior meatal antrostomy as a prophylactic intraoperative maneuver in patients who require zygomatic implant surgery is an effective method to prevent postoperative sinusitis.

Modification of Blair Approach With a Modified Endaural Component to Access the Parotid Region.

OBJECTIVE: The aim of this study is to present our experience with a modification of the Blair approach to the parotid area, by means of a modified endaural component, which provides both excellent exposure and optimal functional and esthetic results, mainly over the preauricular area. PATIENTS AND METHODS: A retrospective case series study was performed. It included surgical cases of patients who were operated on the parotid region in which the mentioned approach was indicated. The information was collected from the database available at the Universidad El Bosque Oral and Maxillofacial Surgery Department in Bogota, Colombia from 2008 to 2013. RESULTS: The sample consisted of 12 patients, with ages ranging from 23 to 56 years and a mean age of 38 years. A total of 8 patients were women and 4 patients were men. Parotid pathologies included salivary gland tumor (10 patients) and cranial base tumor (2 patients). Procedures executed were: superficial lobe and total parotidectomy resection, pharynx extended and cranial base tumor resections. CONCLUSIONS: This investigation presents our experience with a modified approach to the parotid region. This approach gives an extended and safe exposure to the region with excellent cosmetic outcomes.

A modified lateral canthal approach for the treatment of zygomatic complex fractures.

We present a modification of the classic lateral canthal approach by means of which the anatomy of the lateral palpebral edges will remain unscathed, with the incision beginning 2 mm lateral to the external canthus. We have used this technique in 76 patients at 3 major trauma centers in Bogota, Colombia, from January 2006 to January 2012. The approach provided excellent access to the frontozygomatic area, lateral wall of the orbit, and malar body. This method avoids important anatomic structures and offers outstanding cosmetic results, especially in adult patients.