Tercer molar ectópico a nivel de región infraorbitaria-seno maxilar / Ectopic third molar of the maxillary sinus-infraorbital region

Introducción. Los cordales ectópicos son aquellos incluidos enposiciones inusuales o desplazados a distancia de su normal localizaciónanatómica. La erupción ectópica de un diente dentro de la cavidad oral escomún pero en otros lugares es raro. La erupción ectópica puede ir asociadacon alteraciones en el desarrollo, procesos patológicos o yatrogenia.Caso Clínico. Mujer de 56 años de edad con tercer molar superior derechoectópico a nivel de región infraorbitaria-seno maxilar. Presentaba dolor einflamación hemifacial derecha de larga evolución y resistente a tratamientomédico. Se realizó exéresis quirúrgica de dicho cordal mediante abordajede Caldwell-Luc.Discusión. En muchos casos la etiología de un cordal ectópico no puedeser identificada. La mayor parte de las veces son asintomáticos y diagnosticadosmediante estudios radiológicos.Conclusión. La indicación de la exodoncia en el caso de un diente ectópicoen general viene determinada por la presencia de sintomatología o enprevención de futuras complicaciones(AU)

Introduction. Ectopic third molar teeth are those that areimpacted in unusual positions, or that have been displaced and areat a distance from their normal anatomic location. Ectopic eruptionof a tooth within the oral cavity is common, but rare in other sites.Ectopic eruption can be associated with developmental disturbances,pathologic processes or iatrogenic activity.Case Report. Female, fifty-six years old, with an upper right ectopicthird molar located in the maxillary sinus-infraorbital region. Shepresented with pain and inflammation of the right side of her facethat she had been experiencing for along time and which had beenresistant to treatment. Surgical excision was carried out of the thirdmolar tooth using the Caldwell-Luc approach.Discussion. In many cases the etiology of ectopic third molars cannotbe identified. Generally they are asymptomatic and diagnosed byradiology studies.Conclusion. The indication for extraction in ectopic teeth cases isin general determined by the presence of symptomatology, or bythe need for preventing future complications(AU)

Colgajo de SMAS en la prevención del síndrome de Frey / SMAS flap for the prevention of Frey’s syndrome

Objetivo. El síndrome de Frey puede surgir como complicación tras cirugía de la glándula parótida. Este artículo pretende analizar la prevención de dicho síndrome tras cirugía parotídea cuando se realiza laelevación de un colgajo de sistema músculo aponeurótico superficial (SMAS).Material y Método. Presentamos un estudio retrospectivo con 81 pacientes a los que se realizó cirugía sobre la glándula parótida, en el Servicio de Cirugía Oral y Maxilofacial del Hospital Infanta Cristina de Badajoz desde Octubre de 1997 hasta Febrero de 2005.Resultados. La técnica más comúnmente realizada en nuestro Servicio fue la parotidectomía superficial conservadora (68%). El grupo más numerosolo formaron aquellos pacientes en los que se realizó colgajo de SMAS y no desarrollaron posteriormente síndrome de Frey con un total de 56 casos (69%).Conclusión. Consideramos adecuada la realización de colgajo de SMAS en cirugía parotídea, para disminuir la frecuencia de aparición del síndrome de Frey (AU)

Objective. Frey’s syndrome may occur as a complication following parotid gland surgery. The aim of this article is to analyze the prevention of this syndrome after parotid surgery during which a superficial musculoaponeurotic system (SMAS) flap is elevated.Material and Methods. A retrospective study is presented of 81 patients who underwent parotid gland surgery in the department of Oral and Maxillofacial Surgery of the Hospital Infanta Cristina, Badajoz, from October 1997 to February 2005.Results. The most common technique used in our department was the superficial conservative parotidectomy (68%). The most numerous group was made up of patients with SMAS flaps who did not go on to develop Frey’s syndrome, with a total of 56 cases (69%).Conclusion. We consider carrying out a SMAS flap in parotid surgery appropriate for reducing the frequency with which Frey’s syndrome appears (AU)

La técnica de detección y biopsia del ganglio centinela cervical en el carcinoma de células escamosas de cabeza y cuello / The technique of detection and biopsy of the centinel lymh node in the squamous cell carcinoma of the head and neck

En el momento actual, las técnicas de diagnóstico por imagen no permiten detectar, de forma totalmente fidedigna, la presencia de metástasis ganglionares cervicales (MGC) en el carcincoma de células escamosas (CCE) de cabeza y cuello. Esto ha motivado la realización rutinaria de linfadenectomias cervicales profilactico-diagnósticas de estadiaje, la mayoría de las cuales son innecesarias al no existir infiltración tumoral en el estudio histopatológico (pNO). Tras demostrar su efectividad en el melanoma cutáneo y en el cancer de mama, la técnica de la biopsia del ganglio centinela (BGC) está emergiendo como uno de los principales métodos de estadiaje cervical en el CCE oral y orofaríngeo, y podría llegar a convertirse en el procedimiento de elección. La técnica se basa en la premisa de que el estado histopatológico de el/los ganglios centinelas debe reflejar con seguridad la histología de los otros ganglios linfáticos regionales. De esta forma, el estadiaje cervical puede conseguirse mediante una biopsia minimamente invasiva que sustituirá a la diseccion cervical, con la consiguiente reducción de morbilidad, tiempo quirúrgico, y estancia hospitalaria. En el presente trabajo se realiza una actualización sobre la técnica de BGC en el CCE oral y orofaríngeo: su metodología, equipos necesarios, indicaciones y controversias. Se proyecta, así mismo, un estudio de caracter prospectivo, que ya es una realidad en nuestro Hospital, con el fin de validar esta técnica como método del estadiaje cervical en estos pacientes. Esperamos la incorporación a nuestro estudio de la mayoría de los Servicios españoles de Cirugía de Cabeza y Cuello (AU)

Report of ejections in the Spanish Air Force, 1979-1995: an epidemiological and comparative study.

BACKGROUND: Ejection seats have saved many lives with more than 80% of pilots having survived an ejection. Nevertheless, ejection injuries are seen in all modern air forces. PURPOSE: An epidemiological study has been carried out on the 48 ejections made by the Spanish Air Force (SpAF) from 1979-1995. METHODS: From data facilitated by the Flight Safety Section of the SpAF Staff, by the Flight Safety Section of Squadrons, and from personal reports of pilots who survived ejections a form was created. Relationships between data concerning aeronautical parameters, pilot data and injuries have been found, and a comparative study was made between these results and data shown by air forces of other countries. RESULTS: Of 48 pilots who ejected, 7 died, 25 had severe injuries, 11 had minor injuries and 5 had no injuries. The reason for the ejections included 35 cases of technical failure, and 13 cases of human error. Of 43 surviving pilots, 23 were injured only at the egress phase, 1 1 only at landing, and 9 cases at both moments. None of the five pilots who ejected outside the ejection envelope were able to adopt the correct position. However, of 43 pilots who ejected within the envelope, 19 were seated in good position. Of 13 pilots who maintained control of the airplane, 9 were able to adopt a correct position. Of 35 pilots who effected the ejection without control of the aircraft, 25 were not able to achieve a correct seated position. CONCLUSIONS: The pilot position in the ejection seat, plane control, ejection inside the envelope, the pilot's training in how to assume the necessary body position at both egress and landing phases are determining factors for successful ejections.

Unexplained peripheral nervous conduction velocity variations in young military males.

Peripheral nervous conduction velocity has widely been used in neurology and traumatology. Recently, it has been added to diagnostic tests of several metabolic disorders since the myelin sheath is highly sensitive to internal environment variations. The catecholamines liberation induced by stress (physical and/or psychological) produces an important internal environment alteration characterized by an anaerobic metabolism increase causing acid catabolites generation. This paper describes an unexpected neurophysiological finding observed in the course of a wide aeronautical medicine research project. A homogeneous group (similar age, sex, diet, physical training and life-style) of young healthy military males (belonging to the Air Force Academy) (n = 60) showed statistically significant differences on peripheral nervous conduction velocity (both motor and sensory ways) among them and in front of reference values. Authors can not explain that observation decisively. They suggest both the different complexity of academic curriculum and the different oxygen consumption as possible factors that could provoke mentioned conduction velocity variations.

Influence of diet and physical exercise on plasma lipid concentrations in an homogeneous sample of young Spanish Air Force pilots.

This study evaluates the influence of diet and physical exercise on plasma lipid concentrations--total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), and the TC:HDL-C ratio, in a homogeneous (age, sex and anxiety levels) group of young pilots divided into the following groups: A. uncontrolled diet and exercise programme; B. controlled diet and uncontrolled exercise programme; C. controlled diet and exercise programme (n = 90). The dietary intake was a typical Mediterranean diet, which was supervised by the Flight Surgeon. The exercise was based on a physical training programme for pilots, directed by the Physical Training Officer. The State-Trait Anxiety Inventory test was performed to evaluate the anxiety levels. This test was supervised by a psychologist. The results showed a marked difference in all the lipid parameters studied between groups with an ad libitum diet versus groups with a controlled diet, this difference being demonstrated by TC and TG concentrations lower in the group with a controlled diet, than in the group with an ad libitum diet. A difference in HDL-C concentrations and TC:HDL-C ratio was found between groups with regular physical training (high HDL-C concentration and low TC:HDL-C ratio) versus groups with unlimited exercise (low HDL-C concentrations and high TC:HDL-C ratio). No differences in the state and trait of anxiety were found among any of the groups. Nevertheless, all the pilots showed a considerable increase in their anxiety state over their own anxiety trait.

A case of hemidiaphragmatic paralysis after an anti-G suit failure.

This paper reports a case of left hemidiaphragmatic paralysis in an instructor pilot and his later recuperation. This incident was provoked by a failure in the anti-G suit, which remained inflated after the aircraft completed the maneuver that had originated the inflation. The spontaneous recuperation of both the respiratory functional test and the neurophysiological pattern are consistent with a Type II Seddon's axonotmesis of the phrenic nerve. Considering the short time of regeneration (6 months), this lesion must have involved the distal portion of the phrenic nerve.

Relation between flight hours and peripheral nervous conduction velocity.

The peripheral nervous system is highly sensitive to variations in the internal medium. A neurophysiological study (peripheral nervous conduction velocity) and an enzymatic study (catalase and glutathione-peroxidase) were performed in both instructor and student pilots. Pilots do not show the age-dependent decrease in the peripheral sensory nervous conduction velocity observed in non-pilot subject controls. The sensory conduction velocity (SCV) was significantly (p less than 0.01) increased when hours of flight experience increased, yielding a positive correlation (r = 0.6461; p = 0.0016). A significant (p less than 0.01) increase in the erythrocite catalase and glutathione-peroxidase activities were observed in pilots vs. controls. The present data suggest that a chronically increased oxygen consumption could be the reason for the increase in peripheral nervous conduction velocity observed in pilots.