Outpatient Submaxillectomy Using Active Drains. Safety of the Procedure and Patient Satisfaction.

Surgical interventions on an outpatient basis are defined as those procedures in which the patient is discharged the same day of the surgery after monitoring the subject during the immediate postoperative period. Submaxillectomies have conventionally been performed on an inpatient basis, and hospital stay was determined by the drain removal. This study aims to establish both safety and patient satisfaction following outpatient submaxillectomies using active drains. Fifteen patients between March 2016 and March 2020 underwent submaxillectomies using active drains in an outpatient basis. No patient had to be readmitted, and there were no complications that could be associated with the outpatient basis of this procedure, showing the safety of this surgical regimen. Patient satisfaction degree was high, with 86.7% of the patients declaring low or no pain as well as appropriate hospital stay. Most of the patients stated that they would accept the surgery in an outpatient basis once again. The performance of an outpatient submandibular gland removal is a safe and well-accepted procedure by the patient.

Submental Perforator Flap for Soft-Tissue Reconstruction in Bisphosphonate-Related Osteonecrosis of the Jaws.

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) has emerged as an important and increasingly common comorbidity, especially in patients undergoing long-term treatment with high doses of bisphosphonates. The management of BRONJ remains controversial. Surgical treatment is necessary in severe cases. Treatment of the bone requires sequestrectomy or resection. Given the lack of sufficient mucosa to perform the operation and fragility of margins in many patients, local flaps are crucial. We report two cases of stage-3 BRONJ presenting secondary infection with Actinomyces , receiving treatment consisting of marginal resection of the necrotic bone, reinforcement with a reconstruction plate, and reconstruction of soft tissues using a submental perforator artery flap ipsilateral to the lesion. Total cure was achieved in both cases, achieving favorable aesthetic and functional outcomes.

¿Cuál es su diagnóstico? / What would your diagnosis be?

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Local flap reconstruction of large scalp defects.

Scalp defects can have a number of origins, and their repair is dependent upon their location, size and depth. In the case of the scalp, the repair of even small defects is complicated. Local flaps are the reference for the reconstruction of such defects. Knowledge of scalp anatomy is essential for preparing these flaps, which must be based on one or two vascular pedicles to afford a large rotation angle--thereby facilitating closure of the defect. The parietal zone is the location offering the greatest flap mobilization possibilities. We present a case involving the repair of a major pericranial frontoparietal scalp defect. A local transverse posterior transpositioning scalp flap was raised with the posterior auricular and occipital arteries as vascular pedicle. Following repositioning of the flap, a free partial-thickness skin graft from the thigh was used to cover the donor zone. A review is provided of the different techniques for the reconstruction of large scalp defects.

Local flap reconstruction of large scalp defects

Scalp defects can have a number of origins, and their repair is dependent upon their location, size and depth. In the case of the scalp, the repair of even small defects is complicated. Local flaps are the reference for the reconstruction of such defects. Knowledge of scalp anatomy is essential for preparing these flaps, which must be based on one or two vascular pedicles to afford a large rotation angle – thereby facilitating closure of the defect. The parietal zone isthe location offering the greatest flap mobilization possibilities.We present a case involving the repair of a major pericranial frontoparietal scalp defect. A local transverse posterior transpositioning scalp flap was raised with the posterior auricular and occipital arteries as vascular pedicle. Following repositioning of the flap, a free partial-thickness skin graft from the thigh was used to cover the donor zone. A reviewis provided of the different techniques for the reconstruction of large scalp defects

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Localized Leishmaniasis of the oral mucosa. A report of three cases.

The term leishmaniasis comprises a group of diseases caused by different species of a protozoon called Leishmania. Leishmaniasis is found worldwide, and is considered to be endemic in 88 countries. There are three main clinical forms of leishmaniasis: visceral leishmaniasis, cutaneous leishmaniasis and mucocutaneous leishmaniasis. Exclusive involvement of the mucosa is very rare. We present a series of three cases of mucosal leishmaniasis located in the oral cavity. The fact that all three cases were recorded in Spain (an area where L. infantum is endemic), suggests that the latter was the causal agent. The only manifestation of leishmaniasis disease in the described cases was the appearance of an oral lesion. Treatment was provided in the form of meglumine antimoniate in two patients, with a favorable response. One of the patients left the hospital after diagnosis, without receiving treatment, and the subsequent course is not known. A review is made of the literature on the subject.

Gingival neurofibroma in a neurofibromatosis type 1 patient.

Neurofibroma is a benign peripheral nerve sheath tumour. It is one of the most frequent tumours of neural origin and its presence is one of the clinical criteria for the diagnosis of type 1 neurofibromatosis (NF-I). Neurofibromatosis type 1 is an autosomal dominantly inherited disease due to an alteration in the long arm of chromosome 17. About 50% of NF-I patients have no family history of the disease. NF-I patients have skin lesions (cafe au lait spots and neurofibromas) as well as bone malformations and central nervous system tumours. Diagnosis is based on a series of clinical criteria. Gingival neurofibroma in NF-I is uncommon. Treatment of neurofibromas is surgical resection. The aim of this paper is to report a case of NF-I with gingival involvement and to review the literature.

Localized leishmaniasis of the oral mucosa. A report of three cases

El término leishmaniasis comprende un grupo de enfermedades causadas por diferentes especies de un protozoo llamado Leishmania. La leishmaniasis se produce en todo el mundo, considerándose endémica en 88 países. Existen tres formas clínicas principales de leishmaniasis: leishmaniasis visceral, leishmaniasis cutánea y leishmaniasis mucocutánea. La afectación de la mucosa, de manera exclusiva, por la Leishmania es muy rara. Presentamos una serie de tres casos de leishmaniasis mucosa localizados en la cavidad oral. El hecho de que todos los casos se produjeran en España, área endémica de L infantum, nos hace presuponer que éste fue el agente causal. La única manifestación de enfermedad de leishmaniasis en los casos descritos, fue la aparición de una lesión oral. Se administró tratamiento con antimoniato de meglumina en dos de ellos, respondiendo favorablemente. Uno de los pacientes abandonó el hospital tras el diagnóstico sin recibir tratamiento y se desconoce la evolución. Realizamos también una revisión de la literatura

The term leishmaniasis comprises a group of diseases caused by different species of a protozoon called Leishmania. Leishmaniasis is found worldwide, and is considered to be endemic in 88 countries. There are three main clinical forms of leishmaniasis: visceral leishmaniasis, cutaneous leishmaniasis and mucocutaneous leishmaniasis. Exclusive involvement of the mucosa is very rare. We present a series of three cases of mucosal leishmaniasis located in the oral cavity. The fact that all three cases were recorded in Spain (an area where L. infantum is endemic), suggests that the latter was the causal agent. The only manifestation of leishmaniasis disease in the described cases was the appearance of an oral lesion. Treatment was provided in the form of meglumine antimoniate in two patients, with a favorable response. One of the patients left the hospital after diagnosis, without receiving treatment, and the subsequent course is not known. A review is made of the literature on the subject

Gingival neurofibroma in a neurofibromatosis type 1 patient. Case report

El neurofibroma es un tumor benigno, de los nervios periféricos, desarrollado a partir de la vaina neural. Representa uno de los tumores de origen neurógeno más frecuente y es uno de los criterios clínicos de diagnóstico de neurofibromatosis tipo 1 (NF-I). La NF-I es una enfermedad genética producida por una alteración en el brazo largo del cromosoma 17. La mitad de los casos tienen antecedentes familiares y el 50% son mutaciones nuevas. Los pacientes con NF-I principalmente presentan lesiones en la piel (manchas “café con leche” y neurofibromas), así como malformaciones óseas y tumores del sistema nervioso central. El diagnóstico de la enfermedad se basa en una serie de criterios clínicos. La aparición de neurofibromas en la encía en pacientes con NF-I es poco común El tratamiento de los neurofibromas es la escisión quirúrgica. El objetivo de este artículo es presentar un caso de NF-I con afectación neurofibromatosa de la encía maxilar, diagnosticado y tratado quirúrgicamente en nuestro Servicio de Cirugía Oral y Maxilofacial y realizar una revisión de la literatura

Neurofibroma is a benign peripheral nerve sheath tumour. It is one of the most frequent tumours of neural origin and its presence is one of the clinical criteria for the diagnosis of type 1 neurofibromatosis (NF-I). Neurofibromatosis type 1 is an autosomal dominantly inherited disease due to an alteration in the long arm of chromosome 17. About 50% of NF-I patients have no family history of the disease. NF-I patients have skin lesions (café au lait spots and neurofibromas) as well as bone malformations and central nervous system tumours. Diagnosis is based on a series of clinical criteria. Gingival neurofibroma in NF-I is uncommon. Treatment of neurofibromas is surgical resection. The aim of this paper is to report a case of NF-I with gingival involvement and to review the literature

Histiocitosis de Células de Langerhans en el área maxilofacial en adultos. Informe de tres casos / Langerhans cell histiocytosis in the maxillofacial area in adults. Report of three cases

La Histiocitosis de Células de Langerhans (HCL), es una enfermedad de etiología desconocida, que se caracteriza por la proliferación e infiltración anormal, de órganos, por células de Langerhans patológicas. Afecta predominantementea pacientes en edad pediátrica, siendo en adultos la incidencia de la enfermedad de uno a dos casos por millón de habitantes. Las manifestaciones en cabeza y cuello aparecen en casi un 90% de los casos. El diagnóstico se obtiene por medios anatomopatológicos, siendo necesarias una serie de pruebas, determinantes de extensión, en todos los pacientes diagnosticados de HCL. No existen estudios, controlados, que determinen un tratamiento óptimo para la HCL. El pronósticode esta enfermedad en adultos es generalmente bueno debido a la lenta evolución de la enfermedad y a su buena respuesta al tratamiento. Presentamos una revisión de tres casos de HCL, de 16, 24 y 28 años de edad, con manifestación primaria en el área Maxilofacial. Así mismo, realizamos una revisión de la literatura

Langerhans cell histiocytosis (LCH) is a disease of unknown etiology, characterized by proliferation of pathological Langerhans cells within different organs. It mainly affects children, but adult cases also occur, with an incidence rate of one to two per million. The head and neck are affected in almost 90% of cases. Diagnosis is made by means of histopathologicalanalysis, and imaging studies are necessary in order to determine extent of the disease. There are no controlled trials proposing an optimal treatment protocol for LCH. Prognosis in adults is generally good due to the slow evolution of the disease and its favourable response to treatment. In our report, we present three cases of LCH in patients aged 16, 24, and 28 years respectively, with primary manifestation in the maxillofacial area. A literature review was also conducted

Langerhans cell histiocytosis in the maxillofacial area in adults. Report of three cases.

Langerhans cell histiocytosis (LCH) is a disease of unknown etiology, characterized by proliferation of pathological Langerhans cells within different organs. It mainly affects children, but adult cases also occur, with an incidence rate of one to two per million. The head and neck are affected in almost 90% of cases. Diagnosis is made by means of histopathological analysis, and imaging studies are necessary in order to determine extent of the disease. There are no controlled trials proposing an optimal treatment protocol for LCH. Prognosis in adults is generally good due to the slow evolution of the disease and its favourable response to treatment. In our report, we present three cases of LCH in patients aged 16, 24, and 28 years respectively, with primary manifestation in the maxillofacial area. A literature review was also conducted.