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1.
BMJ Case Rep ; 13(12)2020 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-33334753

RESUMEN

A 2-month-old full-term female infant with medical history of situs inversus totalis presented to the emergency department with congestion and abnormal breathing. She was discovered to have failure to thrive (FTT) and subsequently admitted. Investigations revealed a large vallecular mass at the base of her tongue which was noted to cause severe, intermittent airway obstruction. The mass underwent marsupialisation by otolaryngology (ENT) and pathology confirmed a diagnosis of vallecular cyst. The patient made a full recovery and is now growing and thriving. This case emphasises the need to consider anatomic airway abnormalities in the differential diagnosis of young infants with the constellation of respiratory symptoms and FTT. Such airway abnormalities can cause life-threatening airway obstruction if not discovered.


Asunto(s)
Obstrucción de las Vías Aéreas/etiología , Quistes/diagnóstico , Insuficiencia de Crecimiento/etiología , Enfermedades de la Lengua/diagnóstico , Obstrucción de las Vías Aéreas/diagnóstico , Quistes/complicaciones , Quistes/cirugía , Insuficiencia de Crecimiento/diagnóstico , Femenino , Humanos , Lactante , Lengua/cirugía , Enfermedades de la Lengua/complicaciones , Enfermedades de la Lengua/cirugía , Resultado del Tratamiento
2.
JAMA ; 324(12): 1168-1179, 2020 09 22.
Artículo en Inglés | MEDLINE | ID: mdl-32886102

RESUMEN

Importance: Many adults with obstructive sleep apnea (OSA) use device treatments inadequately and remain untreated. Objective: To determine whether combined palatal and tongue surgery to enlarge or stabilize the upper airway is an effective treatment for patients with OSA when conventional device treatment failed. Design, Setting, and Participants: Multicenter, parallel-group, open-label randomized clinical trial of upper airway surgery vs ongoing medical management. Adults with symptomatic moderate or severe OSA in whom conventional treatments had failed were enrolled between November 2014 and October 2017, with follow-up until August 2018. Interventions: Multilevel surgery (modified uvulopalatopharyngoplasty and minimally invasive tongue volume reduction; n = 51) or ongoing medical management (eg, advice on sleep positioning, weight loss; n = 51). Main Outcomes and Measures: Primary outcome measures were the apnea-hypopnea index (AHI; ie, the number of apnea and hypopnea events/h; 15-30 indicates moderate and >30 indicates severe OSA) and the Epworth Sleepiness Scale (ESS; range, 0-24; >10 indicates pathological sleepiness). Baseline-adjusted differences between groups at 6 months were assessed. Minimal clinically important differences are 15 events per hour for AHI and 2 units for ESS. Results: Among 102 participants who were randomized (mean [SD] age, 44.6 [12.8] years; 18 [18%] women), 91 (89%) completed the trial. The mean AHI was 47.9 at baseline and 20.8 at 6 months for the surgery group and 45.3 at baseline and 34.5 at 6 months for the medical management group (mean baseline-adjusted between-group difference at 6 mo, -17.6 events/h [95% CI, -26.8 to -8.4]; P < .001). The mean ESS was 12.4 at baseline and 5.3 at 6 months in the surgery group and 11.1 at baseline and 10.5 at 6 months in the medical management group (mean baseline-adjusted between-group difference at 6 mo, -6.7 [95% CI, -8.2 to -5.2]; P < .001). Two participants (4%) in the surgery group had serious adverse events (1 had a myocardial infarction on postoperative day 5 and 1 was hospitalized for observation following hematemesis of old blood). Conclusions and Relevance: In this preliminary study of adults with moderate or severe OSA in whom conventional therapy had failed, combined palatal and tongue surgery, compared with medical management, reduced the number of apnea and hypopnea events and patient-reported sleepiness at 6 months. Further research is needed to confirm these findings in additional populations and to understand clinical utility, long-term efficacy, and safety of multilevel upper airway surgery for treatment of patients with OSA. Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12614000338662.


Asunto(s)
Presión de las Vías Aéreas Positiva Contínua , Paladar Blando/cirugía , Apnea Obstructiva del Sueño/cirugía , Apnea Obstructiva del Sueño/terapia , Somnolencia , Lengua/cirugía , Adulto , Presión Sanguínea , Presión de las Vías Aéreas Positiva Contínua/instrumentación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Polisomnografía , Autoinforme , Índice de Severidad de la Enfermedad , Apnea Obstructiva del Sueño/fisiopatología , Latencia del Sueño
3.
Med. oral patol. oral cir. bucal (Internet) ; 25(5): e660-e667, sept. 2020. ilus, tab, graf
Artículo en Inglés | IBECS | ID: ibc-196522

RESUMEN

BACKGROUND: The extraction of third molars is one of the most common procedures in oral and maxillofacial surgery clinic. Surgical extraction involves the manipulation of both soft and hard tissues, so the patient usually experiences pain, swelling, and trismus in the immediate post-operative period. Several studies have been conducted using different types of surgical flaps to provide access with the least possible damage of soft tissues. Designing and implementing an optimum flap, which provides easier technique, better visibility, minimal post-operative complications, and best healing, is an aspired goal of every oral surgeon. This study aimed to compare lingual-based four-cornered flap with conventional triangular flap, and to evaluate its effect on post-operative pain after surgical extraction of impacted lower third molars. MATERIAL AND METHODS: Seventeen patients (age ranged from 19 to 26 years) with bilateral, symmetrical impacted lower third molars (n=34) were included in the study. This was a randomized clinical trial with a split-mouth design. The impacted molars were assigned randomly, by coin flipping, to two groups: Case side with lingual-based four-cornered flap (Group A), and control side with conventional triangular flap (Group B). Away from the incision, the prognosis, surgical intervention, and postoperative procedures were exactly the same for the two groups. Postsurgical pain was assessed for 5 days using visual analogue scale (VAS) and by recording patients need for analgesics on a daily basis. Patients were also evaluated via a self-reporting questionnaire, i.e. Postoperative Symptoms Severity (PoSSe) scale, administered on the seventh postoperative day. RESULTS: Pain scores recorded in Group A were found to be significantly lower as compared to pain scores in Group B in the 5 postoperative days (P < 0.05). Total analgesic intake in Group B was significantly higher (P < 0.05). PoSSe scores were lower in Group A, however, this difference was insignificant (P > 0.05). CONCLUSIONS: According to the data of the current study and within its limits, it appeared that lingual-based four-cornered flap design was superior to the conventional triangular flap regarding the postsurgical discomfort and pain


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Tercer Molar/cirugía , Extracción Dental/métodos , Colgajos Quirúrgicos/cirugía , Lengua/cirugía , Dolor Postoperatorio/prevención & control , Diente Impactado/cirugía , Dimensión del Dolor , Resultado del Tratamiento , Factores de Tiempo , Tempo Operativo , Reproducibilidad de los Resultados , Autoinforme
4.
Artículo en Chino | MEDLINE | ID: mdl-32842225

RESUMEN

Objective:The aim of this study is to investigate the effect of modified uvulopalatopharyngoplasty (UPPP) combined with endoscopic hypothermic Plasma glossectomy (Eco-TBR) on the severe Obstructive sleep apnea syndrome. Method:Sixty patients with severe OSAHS were diagnosed by polysomnography, and their obstructive plane located in the oropharynx and tongue base. Patients were divided into the control group (30 cases of simple H-UPPP) and the experimental group (30 cases of H-UPPP combined with Eco-TBR) according to their random hospital sequence. SPSS 20.0 software package was used to analyze the preoperative and postoperative data of the two groups. Result:Fifty-seven OSAHS patients had full data and a minimum 6 month follow up to assess the efficacy. The total effective rate in the control group was 41.38% lower than that in the experimental group 67.85%, and the difference was statistically significant (χ²=4.03, P<0.05). The postoperative data of the control group, AHI was 28.07±10.283, LSaO2 was 72.660±6.405, ESS was 12.620±2.731, and snoring VAS were 3.93±1.307. After the operation, in the experimental group, AHI was 25.74±14.140, LSaO2 was 75.360±7.299, ESS was 11.320±3.209, and snoring VAS were 3.00±1.305. The differences in AHI, LSaO2, ESS and snoring VAS before and after surgery in the two groups were statistically significant (P<0.001). After surgery, compared between the two groups, except for snoring VAS, the differences of AHI, LSaO2 and ESS were not statistically significant(P>0.05). Conclusion:The effect of H-UPPP combined with Eco-TBR on severe OSAHS patients with obstructive plane of oropharynx and tongue root is definite.


Asunto(s)
Glosectomía , Apnea Obstructiva del Sueño/cirugía , Lengua/cirugía , Humanos , Faringe , Temperatura , Resultado del Tratamiento , Úvula
5.
J Prosthodont ; 29(8): 725-729, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32794594

RESUMEN

Amyloidosis of the tongue can result in significant and irreversible alterations of tooth position and function due to prolonged application of imbalanced force on the teeth by the enlarged tongue. Due to the rarity of this oral form of systemic disease, little has been elucidated on management of the resulting impaired oral function. While surgery can address the size of the tongue, it carries significant morbidities, enlargement can recur, and does not address adverse tooth positioning. Prosthetic rehabilitation can more aptly restore oral function but it also needs to be tailored based on the patient's expectations and goals as well as biologic and mechanical parameters of treatment. This report discusses an effective and noninvasive application of a tooth-supported, removable prosthesis with an onlay occlusal design to restore occlusion, speech, and esthetics in a patient with tongue-based amyloidosis.


Asunto(s)
Amiloidosis , Estética Dental , Enfermedades de la Lengua , Amiloidosis/complicaciones , Oclusión Dental , Humanos , Lengua/cirugía
7.
J Ayub Med Coll Abbottabad ; 32(2): 266-267, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32584007

RESUMEN

Venolymphatic malformations (VLM) are the rare congenital disorders but the parotid gland VLMs are the rarest. Most of the parotid lesions present with unilateral swellings. Aetiology is unknown. Interestingly, this case came in OPD with the macroglossia and only complaint was cosmetic problem. Diagnosis was confirmed on the basis of Magnetic resonance imaging which is gold standard. Doppler ultrasonography showed low flow. Intra lesion electro cautery was done. There is need to focus on malformations and work to find out the causes.


Asunto(s)
Macroglosia/congénito , Glándula Parótida , Niño , Electrocoagulación , Humanos , Macroglosia/diagnóstico , Macroglosia/patología , Macroglosia/cirugía , Imagen por Resonancia Magnética , Masculino , Glándula Parótida/anomalías , Glándula Parótida/irrigación sanguínea , Glándula Parótida/cirugía , Lengua/diagnóstico por imagen , Lengua/patología , Lengua/cirugía , Ultrasonografía
8.
Rev. esp. cir. oral maxilofac ; 42(2): 76-82, abr.-jun. 2020. ilus, tab
Artículo en Inglés | IBECS | ID: ibc-189944

RESUMEN

AIMS: A retrospective study was conducted in the Department of Oral and Maxillofacial Surgery Dr. Atilio Perdomo; Ángel Larralde Hospital, Carabobo- Venezuela, which describes the procedure and protocol of the postoperative period of patients operated on multiple occasions for the closure of palatal fistulas. MATERIAL AND METHODS: A total of 20 patients treated for palatal fistulas were included in this study, in the period between 2014-2018. Patients with presence of sequelae of palatal fistulas, large fistulas with inadequate local scars, presence of oronasal communication and hypernasal resonance were considered. Patients were evaluated during the first 24 hours, 21 days and 6 months. RESULTS: A total of 20 patients (12 men and 8 women) with palatal fistulas were treated with tongue flap, aged between 25 and 40 years. In the postoperative period, patients reported 58 % of cases, mild pain. The most frequent clinical signs during the postoperative period were presented in 60 % of the patients, showing headache, passive bleeding, severe pain. No significant changes in lingual motility. Acoustic analysis of the 6-month late postoperative control voice, presented favorable changes in the intonation line, showing its continuity. All remaining cases showed satisfactory cure, and donor site morbidity was minimal. CONCLUSIONS: The tongue flaps are an excellent alternative for closing large or recurrent palatal fistulas, due to their versatility and excellent vascularity of the area. However, the design and the delicate manipulation of the flap are also decisive


OBJETIVOS: Se realizó un estudio retrospectivo en el Departamento de Cirugía Oral y Maxilofacial Dr. Atilio Perdomo, Hospital Ángel Larralde, Carabobo- Venezuela, que describe el procedimiento y protocolo del postoperatorio de pacientes operados en múltiples oportunidades para el cierre de fístulas palatales. MATERIAL Y MÉTODOS: Se incluyeron en este estudio un total de 20 pacientes tratados por fístulas palatinas, en el periodo comprendido entre 2014 y 2018. Se consideraron secuelas de fístulas palatinas, las fístulas grandes con cicatrices locales inadecuadas, la presencia de comunicación oronasal y resonancia hipernasales. Los pacientes fueron evaluados durante las primeras 24 horas, 21 días y 6 meses. RESULTADOS: Un total de 20 pacientes (12 hombres y 8 mujeres) con fístulas palatales fueron tratados con colgajo de lengua, con edades entre 25 y 40 años. En el postoperatorio, los pacientes informaron el 60 % de los casos, dolor leve. Los signos clínicos más frecuentes durante el postoperatorio se presentaron en el 60 % de los pacientes, con cefalea, sangrado pasivo y dolor intenso. No hay cambios significativos en la motilidad lingual. El análisis acústico de la voz de control postoperatorio tardío de 6 meses presentó cambios favorables en la línea de entonación mostrando su continuidad. Todos los casos restantes mostraron una cura satisfactoria, y la morbilidad del sitio donante fue mínima. CONCLUSIONES: Los colgajos de lengua son una excelente alternativa para el cierre de fístulas palatinas grandes o recurrentes debido a su versatilidad y excelente vascularización del área, lo que brinda una gran seguridad al cirujano en el éxito del tratamiento, sin embargo, el diseño y la delicada manipulación del colgajo también son determinantes


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Colgajos Quirúrgicos , Fisura del Paladar/cirugía , Lengua/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
9.
Ann R Coll Surg Engl ; 102(7): 514-518, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32436723

RESUMEN

INTRODUCTION: Major glossectomy is the treatment of choice in locally advanced tongue cancer. It remains the only option in the presence of recurrent or residual disease. The long-term outcomes for patients undergoing major glossectomy have traditionally been poor, with significant morbidity and poor oncological outcomes. The aim of this study was to report on oncological outcomes in patients undergoing major glossectomy. METHODS: All patients undergoing major glossectomy between 2014 and 2018 were included in the study. The data of 85 patients with advanced carcinoma of the oral tongue were evaluated. All were under the care of a single surgical and reconstructive team at two hospitals in Mumbai. RESULTS: The median patient age was 45 years. At the most recent follow-up, 55 patients (65%) were alive, 47 of whom were disease free. Twenty-nine patients (34%) had locoregional recurrence and twenty-five (29%) had distant metastasis. At a median follow-up of 19 months, rates for 2-year locoregional control, disease free survival (DFS) and overall survival (OS) were 69%, 61% and 62% respectively. Perinodal extension demonstrated a trend towards poor DFS (p=0.060), as did perineural invasion (p=0.055). Node positivity was a significant factor for poor OS, DFS and locoregional control. Multiple node involvement was significantly associated with poor OS on multivariate analysis (p=0.002). CONCLUSIONS: Node positivity and multiple node involvement were associated with poor outcomes. Major glossectomy may be offered as a curative option for selected patients with advanced carcinoma of the oral tongue with node negative or limited neck nodal disease (N1).


Asunto(s)
Glosectomía/métodos , Recurrencia Local de Neoplasia/epidemiología , Estadificación de Neoplasias , Neoplasias de la Lengua/cirugía , Lengua/patología , Adolescente , Adulto , Anciano , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , India/epidemiología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico , Estudios Retrospectivos , Tasa de Supervivencia/tendencias , Lengua/cirugía , Neoplasias de la Lengua/diagnóstico , Neoplasias de la Lengua/secundario , Adulto Joven
10.
J Oral Maxillofac Surg ; 78(9): 1572-1582, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32442425

RESUMEN

PURPOSE: Localized amyloidosis of the tongue is a benign condition in which surgical management may be considered. The aim of the study was to review the current literature and report a case. MATERIALS AND METHODS: We searched the PubMed database for all relevant articles reporting cases of localized tongue amyloidosis published between 1980 and February 2020. In addition, we updated 1 case diagnosed and treated in our department. RESULTS: A 49-year-old male patient presented with an asymptomatic tongue nodule of the dorsum mimicking median rhomboid glossitis. The results of an incisional biopsy showed an amyloid on Congo red staining and positive findings for the κ light chain by immunohistochemical analysis. The findings of the systemic workup were negative. Therefore, a diagnosis of localized κ light-chain amyloidosis was made. The patient underwent a resection of the lesion, and no recurrence or progression was observed during a period of 18 months. The literature review showed 12 reports describing 21 patients (11 men, 52.3%) with localized tongue amyloidosis. The most common clinical presentation was nodular with a single lesion of the tongue dorsum (15 patients, 71.4%). All cases showed positive findings on Congo red staining. Immunohistochemical analysis findings were available for only 9 patients (42.8%) and showed light-chain amyloidosis. No case showed any systemic involvement or the development of systemic disease. Surgical excision was performed in 9 cases, with recurrence at the site of operation in 2 cases. CONCLUSIONS: Localized amyloidosis of the tongue is a rare disease in which surgical excision may be therapeutic when a multidisciplinary evaluation does not show any systemic disease. We recommend an excision when the lesion is persistent or shows an enlargement or when discomfort is reported. In the case of any further local recurrence, resection may be repeated.


Asunto(s)
Amiloidosis , Enfermedades de la Lengua , Amiloide , Amiloidosis/diagnóstico , Amiloidosis/cirugía , Biopsia , Humanos , Masculino , Persona de Mediana Edad , Lengua/cirugía , Enfermedades de la Lengua/diagnóstico , Enfermedades de la Lengua/cirugía
11.
Tissue Cell ; 63: 101319, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32223947

RESUMEN

Salivary epidermal growth factor (EGF) plays an important role in the maintenance of the oral and gastro-esophageal mucosa. Sialoadenectomy delays healing of oral wounds and affects lingual papillae. In this work, we aimed to determine the effect of EGF deficiency induced by sialoadenectomy and evaluate the effect of exogenous EGF administration on the lingual papillae and taste buds in rats. Thirty male adult Wistar albino rats were equally divided into 3 groups; sham-operated control group, sialoadenectomy group and group of sialoadenectomy + EGF. EGF was given 8 weeks after sialoadenectomy in a dose of 1 µg /ml/day in drinking water for 2 weeks. The anterior two-thirds of the tongue was dissected and cut longitudinally into two halves; one half for light microscope and the other for electron microscope examinations. Saliva and blood were collected to determine salivary and plasma EGF. Our results revealed that sialoadenectomy significantly reduced plasma and saliva levels of EGF which resulted in severe disruption of the architecture of lingual papillae. These changes were effectively improved by the exogenous EGF administration. In conclusion, EGF supplementation reversed the effects of sialoadenectomy and restored almost normal architecture of lingual papillae and taste buds.


Asunto(s)
Factor de Crecimiento Epidérmico/metabolismo , Glándulas Salivales/metabolismo , Papilas Gustativas/metabolismo , Lengua/metabolismo , Animales , Factor de Crecimiento Epidérmico/deficiencia , Factor de Crecimiento Epidérmico/farmacología , Mucosa Esofágica/efectos de los fármacos , Mucosa Esofágica/metabolismo , Humanos , Mucosa Bucal/efectos de los fármacos , Mucosa Bucal/metabolismo , Ratas , Saliva/efectos de los fármacos , Saliva/metabolismo , Glándulas Salivales/efectos de los fármacos , Glándulas Salivales/cirugía , Papilas Gustativas/efectos de los fármacos , Papilas Gustativas/cirugía , Lengua/efectos de los fármacos , Lengua/patología , Lengua/cirugía
12.
Plast Reconstr Surg ; 145(4): 803e-813e, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32221229

RESUMEN

BACKGROUND: Macroglossia, a cardinal feature of the (epi)genetic disorder Beckwith-Wiedemann syndrome, is associated with obstructive sleep apnea, speech and/or feeding difficulties, and dental or jaw malalignment. These sequelae may be treated and/or prevented with tongue reduction surgery; the authors sought to determine whether certain Beckwith-Wiedemann syndrome patients may benefit from early surgical intervention before age 12 months. METHODS: The authors conducted a retrospective review of patients with Beckwith-Wiedemann syndrome who underwent tongue reduction from 2014 to 2019. The authors assessed primary outcomes of change in obstructive sleep apnea by polysomnography, respiratory support required, and feeding route before and after tongue reduction, and reviewed postoperative complications and the need for repeated tongue reduction. RESULTS: Of the 36 patients included, the median age at tongue reduction was 9.5 months (interquartile range, 3.8 to 22.8 months). For those with severe obstructive sleep apnea, there was a significant reduction in the obstructive apnea hypopnea index from 30.9 ± 21.8 per hour to 10.0 ± 18.3 per hour (p =0.019) and improvement in nadir oxyhemoglobin saturation from 72 ± 10 percent to 83 ± 6 percent (p =0.008). Although there was no significant change in overall supplemental feeding tube or respiratory support, there were specific patients who experienced clinically meaningful improvement. Of note, these positive outcomes applied equally to those who underwent surgery at a younger age (<12 months). To date, only one patient required a repeated tongue reduction. CONCLUSION: Based on improved polysomnographic findings and rarity of surgical complications or repeated surgery, the authors' data support the safety and efficacy of this early intervention when clinical indications are present and an experienced multidisciplinary team is available for consultation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Asunto(s)
Síndrome de Beckwith-Wiedemann/cirugía , Glosectomía/métodos , Macroglosia/congénito , Complicaciones Posoperatorias/epidemiología , Apnea Obstructiva del Sueño/cirugía , Síndrome de Beckwith-Wiedemann/complicaciones , Síndrome de Beckwith-Wiedemann/genética , Preescolar , Estudios de Factibilidad , Métodos de Alimentación/estadística & datos numéricos , Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Trastornos de Alimentación y de la Ingestión de Alimentos/prevención & control , Femenino , Estudios de Seguimiento , Glosectomía/efectos adversos , Humanos , Lactante , Macroglosia/complicaciones , Macroglosia/genética , Macroglosia/cirugía , Masculino , Polisomnografía/estadística & datos numéricos , Complicaciones Posoperatorias/etiología , Sistema de Registros/estadística & datos numéricos , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/etiología , Trastornos del Habla/etiología , Trastornos del Habla/prevención & control , Tiempo de Tratamiento , Lengua/cirugía , Resultado del Tratamiento
13.
J Craniofac Surg ; 31(4): e334-e337, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32176002

RESUMEN

OBJECTIVE: To enable tongue incisions to be repaired more easily, rapidly, and practically, particularly in pediatric patients by using 2-octyl cyanoacrylate (OCA) tissue adhesive. METHODS: A single linear incision was made on the midline dorsal part of the tongue. Twenty-four rats were randomly divided into the four groups: Group 1 (n = 6), OCA healing at day 5; group 2 (n = 6), OCA healing at day 21; group 3 (n = 6), Vicryl healing at day 5; group 4 (n = 6), Vicryl healing at day 21. In groups 1 and 2, OCA was applied to the incision site. The incisions of the rats in groups 3 and 4 were closed using Vicryl sutures. Histopathological examination was compared between and within the groups at day 5 and 21. RESULTS: The operation duration was significantly shorter with OCA than with Vicryl sutures(P < 0.001). Regarding the histopathological results, there were no differences between group 1 and group 3 in epithelial regeneration, inflammation, fibroblastic activity, edema, presence of giant cells, fibrin deposition, ulceration, abscess formation, and granulation tissue. However, moderate infiltration of acute inflammatory cells was significantly more frequent in group 1 than in group 3. At day 5, the incidence of moderate foreign body residue was significantly higher in group 1 than in group 3. No difference was observed between group 2 and group 4 at day 21 (P > 0.05). CONCLUSION: OCA is a practical, rapid, and effective method for repairing tongue lacerations. Although infiltration by inflammatory cells and foreign bodies increased in the early period, the long-term results of OCA were indistinguishable from those of suturing.


Asunto(s)
Cianoacrilatos/farmacología , Laceraciones/patología , Traumatismos de los Tejidos Blandos/patología , Suturas , Lengua/patología , Animales , Femenino , Laceraciones/tratamiento farmacológico , Laceraciones/cirugía , Procedimientos Neuroquirúrgicos , Ratas , Ratas Sprague-Dawley , Traumatismos de los Tejidos Blandos/tratamiento farmacológico , Traumatismos de los Tejidos Blandos/cirugía , Lengua/cirugía
15.
J Craniofac Surg ; 31(2): e184-e185, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32028359

RESUMEN

Congenital bifid tongue is a rare malformation, which is usually present in association with other oral findings such as cleft palate and tongue mass. The authors present a rare case of congenital bifid tongue together with cleft palate, labial-buccal frenulum deformity, absence of lingual frenulum, and 3 hamartomas in the oral cavity. The authors excised oral hamartomas and repaired the palate and tongue with satisfactory results.


Asunto(s)
Fisura del Paladar/cirugía , Hamartoma/cirugía , Enfermedades de la Boca/cirugía , Lengua/cirugía , Fisura del Paladar/complicaciones , Femenino , Hamartoma/complicaciones , Humanos , Lactante , Frenillo Lingual , Enfermedades de la Boca/complicaciones
16.
Biomed Res Int ; 2020: 3283080, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32083127

RESUMEN

Purpose: To compare the effects of counterclockwise rotation (CCR) and clockwise rotation (CR) of the mandible on the pharyngeal airway during mandibular setback surgery. Materials and Methods. Serial cephalograms of 40 patients with mandibular prognathism, including 20 who underwent CCR and 20 who underwent CR, were taken at the following time intervals: preoperatively (T1), immediately postoperatively (T2), >1 year after surgery (T3), final surgical changes (T31), postoperative stability (T32), and immediate surgical change (T21). Changes in menton (Me) and hyoid (H) positions, soft palate width, soft palate length, soft palate angle and craniovertebral angle (C2C4-SN), and pharyngeal airway spaces (nasal pharyngeal airway (NOP), uvula pharyngeal airway (UOP), tongue pharyngeal airway (TOP), and epiglottis pharyngeal airway (EOP)) were evaluated. Results: The mean Me (T31) setback for CCR and CR was 12.56 and 13.06 mm, respectively, with 2.41 mm upward and 3.29 mm downward, respectively. The vertical Me position of CR exhibited significant downward movement compared with that of CCR. The mean H setback results for CCR and CR were 4.42 and 5.75 mm, respectively, with 1.47 mm downward and 2.97 mm downward, respectively. The C4C2-SN angles for CCR and CR increased by 2.68° and 3.65°, respectively, whereas their palatal angles increased by 2.35° and 5.25°, respectively. Pearson's correlation analysis (T31) revealed that for CCR, no pharyngeal airway spaces were significantly correlated with any measured variables. In CR, NOP was significantly correlated (r = 0.58) with the vertical Me position. Significant relapse (T32) was observed after CR in the horizontal (r = 0.58) with the vertical Me position. Significant relapse (T32) was observed after CR in the horizontal (r = 0.58) with the vertical Me position. Significant relapse (T32) was observed after CR in the horizontal (. Conclusion: Pharyngeal airway space narrowed postoperatively, and its patency was appropriately maintained through natural physiological regulation of the craniovertebral angle (C2C4-SN). Significant postoperative relapse was correlated with CR.


Asunto(s)
Nasofaringe/fisiología , Nasofaringe/cirugía , Faringe/fisiología , Faringe/cirugía , Adulto , Epiglotis/fisiología , Epiglotis/cirugía , Femenino , Humanos , Hueso Hioides/fisiología , Hueso Hioides/cirugía , Masculino , Mandíbula/fisiología , Mandíbula/cirugía , Movimiento/fisiología , Procedimientos Quirúrgicos Ortognáticos/métodos , Paladar Blando/fisiología , Paladar Blando/cirugía , Periodo Posoperatorio , Rotación , Lengua/fisiología , Lengua/cirugía , Adulto Joven
17.
J Craniofac Surg ; 31(1): 62-63, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31469729

RESUMEN

BACKGROUND: An anterior palatal fistula in a bilateral cleft lip and palate is a challenging clinical dilemma. The authors evaluate the feasibility and outcomes of the reconstruction of large anterior palatal fistulae using anteriorly based dorsal tongue flaps. METHODS: Eight patients with anterior palatal fistulae after repair of a bilateral cleft lip and palate using anteriorly based dorsal tongue flaps. The defect size varied from 1.0 × 1.0 cm to 1.5 × 2.0 cm, and the tongue flap size varied from 1.5 × 3.5 cm to 2.0 × 3.5 cm. RESULTS: All patients underwent successful reconstruction of palatal defects using anteriorly based tongue flaps, and no case of spontaneous detachment of the tongue flap occurred. The patients with palatal fistulae were followed up for 10 to 30 months, and no recurrence was encountered. CONCLUSION: An anteriorly based dorsal tongue flap is a safe and feasible surgical technique for the closure of anterior palatal fistulae.


Asunto(s)
Fístula/cirugía , Colgajos Quirúrgicos/cirugía , Lengua/cirugía , Adolescente , Labio Leporino/cirugía , Femenino , Humanos , Masculino , Recurrencia , Adulto Joven
18.
Ann Anat ; 227: 151418, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31626903

RESUMEN

The present study aims to provide anatomical evidence for clinical application of the medial sural artery perforator (MSAP) flap. The current study investigated the vascular anatomy of the flap, evaluated the postoperative appearance and function of the donor and recipient sites, and investigate the clinical value in reconstruction of oral cavity. Six lower limbs of Chinese adult cadavers were microsurgically dissected. The locations and courses of the medial sural artery perforators were identified and recorded, which provided an anatomical basis for clinical application. Then, 16 clinical cases employing this flap were evaluated, ranging from 3×4cm to 6×8cm, and were employed for defects in the oral cavity region. Sixteen clinical cases with intraoral soft tissue defects, which included four clinical cases with inner cheek defects, were successfully followed up for 10-47 months (24 months on average). The donor site function, contour of recipient site and oral function recovery were evaluated as acceptable or better in cases with intraoral soft tissue defect, which were further verifying the value of clinical application of MSAP in repairing oral cavity defects. Moreover, two typical clinical cases were described in detail. To conclude, the MSAP flap is a favorable choice for small- to medium-size defects based on minor donor site morbidity, satisfactory oral function recovery, perforator stability and adaptation of the pedicle for anastomosis in the oral cavity region.


Asunto(s)
Boca/cirugía , Anciano , Arterias , Cadáver , Mejilla/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/cirugía , Músculo Esquelético/anatomía & histología , Músculo Esquelético/irrigación sanguínea , Arteria Poplítea/anatomía & histología , Estudios Prospectivos , Colgajos Quirúrgicos/irrigación sanguínea , Encuestas y Cuestionarios , Lengua/cirugía , Neoplasias de la Lengua/cirugía
19.
J Craniofac Surg ; 31(1): e45-e50, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31609947

RESUMEN

BACKGROUND: The palatal fistula is an important surgical challenge within the longitudinal follow-up of patients with repaired cleft palate as the success rate of palatal fistula reconstruction by adopting several surgical techniques is variable and often unsatisfactory. The purpose of this retrospective study was to report the clinical outcomes of an algorithm for the surgical management of palatal fistulae in patients with repaired cleft palate. METHODS: Consecutive patients (n = 101) with repaired cleft palate and palatal fistula-related symptoms who were treated according to a specific algorithm between 2009 and 2017 were included. Based on the anatomical location (Pittsburgh fistula types II-V), amount of scarring (minimal or severe scarred palate), and diameter of the fistula (≤5 mm or >5 mm), 1 of 3 approaches (local flaps [62.4%], buccinator myomucosal flaps [20.8%], or tongue flaps [16.8%]) was performed. For clinical outcome assessment, symptomatic and anatomical parameters (fistula-reported symptoms and residual fistula, respectively) were combined as follows: complete fistula closure with no symptoms; asymptomatic narrow fistula remained; or failure to repair the fistula ("good," "fair," or "poor" outcomes, respectively). Surgical-related complication data were also collected. RESULTS: Most patients (91.1%) presented "good" clinical outcomes, ranging from 86.2% to 100% (86.2%, 100%, and 100% for local flaps, buccinator flaps, and tongue flaps, respectively). All (8.9%) "fair" and "poor" outcomes were observed in fistulae reconstructed by local flaps. All "poor" (5%) outcomes were observed in borderline fistulae (4-5 mm). No surgical-related complications (dehiscence, infections, or necrosis) were observed, except for an episode of bleeding after the 1st stage of tongue flap-based reconstruction (1.0%). CONCLUSION: A high rate of fistula resolution was achieved using this algorithm for surgical management of palatal fistulae in patients with repaired cleft palate.


Asunto(s)
Fisura del Paladar/cirugía , Fístula Oral/cirugía , Preescolar , Cicatriz/cirugía , Humanos , Necrosis/cirugía , Complicaciones Posoperatorias , Procedimientos Quirúrgicos Reconstructivos/métodos , Estudios Retrospectivos , Colgajos Quirúrgicos/cirugía , Lengua/cirugía
20.
Br J Oral Maxillofac Surg ; 58(3): 355-357, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31862118

RESUMEN

A 34-year-old woman presented with a progressive oral ulcer, and redness and swelling of the skin over the mandible. Radiological and histological examination showed adenoid cystic carcinoma of the mandible and floor of the mouth with extensive invasion. We radically resected the tumour with sufficient margins, and cut off segments of fibula, reshaped them and fixed them into the mandibular angles bilaterally. We used three perforator flaps, (the soleus muscle, the third, and fourth perforator flaps) to reconstruct the defects of the tongue, mentum, and oral floor, respectively. Recovery was good postoperatively, and there was no infection or any other complications.


Asunto(s)
Colgajos Tisulares Libres , Colgajo Perforante , Procedimientos Quirúrgicos Reconstructivos , Adulto , Femenino , Peroné , Humanos , Mandíbula/cirugía , Lengua/cirugía
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