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2.
Gen Dent ; 69(2): 60-63, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33661117

RESUMEN

Osteoblastoma is a rare benign osteoblastic tumor accounting for less than 1% of all bone tumors; approximately 10% to 12% of cases occur in the maxillofacial skeleton. This case report describes the clinical, imaging, and histopathologic findings of an atypical osteoblastoma occurring in the mandible of a 60-year-old man. The characteristics of the lesion and the differential diagnosis from other bone pathoses are reviewed.


Asunto(s)
Neoplasias Mandibulares , Osteoblastoma , Diagnóstico Diferencial , Humanos , Masculino , Mandíbula , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/cirugía , Persona de Mediana Edad , Osteoblastoma/diagnóstico por imagen , Osteoblastoma/cirugía
3.
Bull Tokyo Dent Coll ; 62(1): 49-54, 2021 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-33583881

RESUMEN

An ameloblastic fibroma (AF) is a proliferative mixed tumor which includes components of both odontogenic epithelium and mesenchymal tissue. It is a relatively rare neoplasm, accounting for approximately only 1.5-4.5% of odontogenic tumors. This case report describes an AF that occurred in the mandibular anterior tooth region in a 9-year-old girl who presented with the chief complaint of swelling in the left mandibular anterior tooth region. Intraoral examination revealed a swelling along the labial gingiva, extending from the left mandibular lateral incisor region to the left mandibular canine. Upon palpation, the swelling appeared to comprise a hard tissue. Computed tomography revealed a supernumerary impacted tooth; soft tissue density in the bone surrounding the region extending from the left mandibular lateral incisor to the left mandibular canine; labial bone expansion; and thinning of the labial cortical bone. A biopsy was performed under local anesthesia and the lesion subsequently diagnosed as an AF. Tumor resection and extraction of the supernumerary impacted tooth were carried out under general anesthesia. At 2 years postoperatively the prognosis is good. Although relapse with an AF is rarer than that with an ameloblastoma, strict follow-up is required, as malignant transformation to an ameloblastic fibrosarcoma has been reported in relapsed cases.


Asunto(s)
Ameloblastoma , Fibroma , Neoplasias Mandibulares , Tumores Odontogénicos , Diente Impactado , Niño , Femenino , Humanos , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/cirugía , Tumores Odontogénicos/diagnóstico por imagen , Tumores Odontogénicos/cirugía
4.
BMJ Case Rep ; 13(12)2020 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-33372024

RESUMEN

Ossifying fibroma (OF) is a rare, benign, fibro-osseous lesion of the jawbone characterised by replacement of the normal bone with fibrous tissue. The fibrous tissue shows varying amount of calcified structures resembling bone and/or cementum. The central variant of OF is rare, and shows predilection for mandible among the jawbone. Although it is classified as fibro-osseous lesion, it clinically behaves as a benign tumour and can grow to large size, causing bony swelling and facial asymmetry. This paper reports a case of large central OF of mandible in a 40-year-old male patient. The lesion was treated by segmental resection of mandible. Reconstruction of the surgical defect was done using avascular fibula bone graft. Role of three-dimensional printing of jaw and its benefits in surgical planning and reconstruction are also highlighted.


Asunto(s)
Fibroma Osificante/cirugía , Neoplasias Mandibulares/cirugía , Adulto , Asimetría Facial/etiología , Fibroma Osificante/complicaciones , Fibroma Osificante/diagnóstico , Fibroma Osificante/diagnóstico por imagen , Peroné/trasplante , Humanos , Imagenología Tridimensional , Maxilares/anatomía & histología , Masculino , Neoplasias Mandibulares/complicaciones , Neoplasias Mandibulares/diagnóstico , Neoplasias Mandibulares/diagnóstico por imagen , Procedimientos Quirúrgicos Ortognáticos , Impresión Tridimensional , Tomografía Computarizada por Rayos X
5.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(11): 1410-1416, 2020 Nov 15.
Artículo en Chino | MEDLINE | ID: mdl-33191699

RESUMEN

Objective: To investigate the influence of the design and application of novel surgical template on the accuracy of reconstructed mandibula and implant position in occlusion-guided functional mandibular reconstruction, so as to provide guidance for clinical treatment. Methods: Between January 2017 and May 2019, 11 patients with segmental mandible defects were treated, including 8 males and 3 females with an average age of 31.8 years (range, 19-45 years). There were 6 cases of ameloblastoma, 3 cases of keratocystic tumor, and 2 cases of ossifying fibroma. According to Urken classification of mandible defects, there were 1 case of CRB, 4 cases of RB, 2 cases of RBS, and 4 cases of SB. According to the occlusion relationship, a novel surgical template with the reconstruction titanium plate screws and implants drill-guided information was designed and manufactured. With the help of the novel surgical template, the "one and a half" fibula reconstruction mode was used for jaw functional reconstruction, and the implant supported denture was finally completed. The postoperative CT at 1 week were collected to analyze the morphology of the preoperative virtual design jaw and postoperative jaw. The coincidence of fibular reconstructed mandible (fibular upper barrel, fibular reconstructed ramus and condyle, and whole mandible) and implant in mandible were calculated. When the coincidence was less than 80%, it was considered that the deviation was obvious. Oral panoramic X-ray film and cone beam CT were examined at 6 months after operation to evaluate the osseointegration before implant repair. Results: None of the 11 flaps had postoperative vascular crisis. One flap occurred necrosis at 1 month after reconstruction combined with 3 implants failed, and had been removed at 6 months after reconstructed surgery; the others had no flap necrosis. One week postoperatively, the coincidence of the fibular upper barrel was 87.55%±3.08%, the whole mandible was 82.68%±5.94%, and the implant in mandible was 88.00%, with significant differences ( t=8.131, P=0.000; t=2.118, P=0.046; Z=4.070, P=0.000) when compared to 80%, respectively. The fibular reconstructed ramus and condyle was 77.82%±3.54%, with no significant difference ( t=-2.042, P=0.068) when compared to 80%. Six months postoperatively, oral panoramic X-ray film and cone beam CT showed that all 22 implants achieved osseointegration and the palatal mucosa transplantation was performed, then finally completed the denture rehabilitation at 6-9 months after operation. All patients were satisfied with their postoperative appearance. Conclusion: The novel surgical template can guarantee the accuracy of functional mandible reconstruction guided by occlusal guidance, and ultimately achieve the beautiful contour of jaw and occlusal function reconstruction, and improve the patient's life quality.


Asunto(s)
Ameloblastoma , Colgajos Tisulares Libres , Neoplasias Mandibulares , Reconstrucción Mandibular , Procedimientos Quirúrgicos Reconstructivos , Adulto , Ameloblastoma/cirugía , Trasplante Óseo , Femenino , Peroné/cirugía , Humanos , Masculino , Mandíbula/cirugía , Neoplasias Mandibulares/cirugía , Persona de Mediana Edad , Colgajos Quirúrgicos , Adulto Joven
6.
Cesk Patol ; 56(3): 168-171, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33076669

RESUMEN

Gossypiboma is not a commonly known surgical complication. It is a tumorous lesion usually caused by hemostatic material used in surgery. Such lesions are most commonly described after abdominal surgery. In this case report, the authors describe a case of a 17 year old female patient, operated for a mandible tumor. Histopathologically it was an ameloblastoma. The patient was treated lege artis, with the use of Surgicel® felt (Surgicel FibrillarTM Absorbable Hemostat). After two months, the young woman returned to clinics with a tumorous lesion at the same location. On the CT scan the lesion appeared to be a recurrence of the originally diagnosed ameloblastoma. Histopathologically, the lesion consisted of a foreign material with surrounding granulation tissue and massive inflamation. The foreign material had an atypical structure. Subsequent consultations and consensus at the clinic confirmed that it was a haemostatic foreign material with a surrounding hyper-inflammatory response mimicking a tumor, known in the literature under various names, most often as gossypiboma or textiloma.


Asunto(s)
Cuerpos Extraños , Neoplasias Mandibulares , Adolescente , Diagnóstico Diferencial , Femenino , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Humanos , Mandíbula , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/cirugía , Recurrencia Local de Neoplasia
7.
Medicine (Baltimore) ; 99(35): e21942, 2020 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-32871940

RESUMEN

RATIONALE: Currently, digital surgical techniques have been widely used in the precise treatment of mandibular resection and reconstruction with fibula flaps. Utilizing these innovative techniques in surgical planning and hardware fabrication before surgery has shown to provide great help. However, it is difficult for even experienced surgeons to place the preformed reconstruction plate in the same position as its preoperative design, causing surgical results to differ from preoperative planning. This study aims to solve these acknowledged challenges by creating newly designed equipment. PATIENT CONCERNS: Two patients suffering from long-term expansion of the mandible were admitted to our department. Case I was a 39-year-old female patient who was concerned about the disease in the middle of the mandible, Case II was a 45-year-old female patient who was concerned about the disease at the left mandibular angle and ramus region. DIAGNOSES: Two patients were diagnosed with the mandibular ameloblastoma based on computed tomography (CT) scan and pathological results. INTERVENTIONS: Personalized 3-dimensional (3D) surgical guides were applied to 2 patients with mandibular ameloblastoma who underwent mandibular resection and reconstruction with vascularized fibula flaps using a specially optimized and designed reconstruction guide plate. OUTCOMES: We achieved precise mandibular repair with such a guide in full accordance with the preoperative plan and ensured the restoration of patient facial symmetry. LESSONS: Optimized reconstruction guide template could accurately locate the preformed reconstruction plate. This component had the ability to ensure that the location of the actual reconstruction plates were highly consistent with preoperative designed models.


Asunto(s)
Ameloblastoma/cirugía , Peroné/trasplante , Mandíbula/cirugía , Neoplasias Mandibulares/cirugía , Procedimientos Quirúrgicos Reconstructivos/instrumentación , Adulto , Ameloblastoma/diagnóstico por imagen , Femenino , Peroné/irrigación sanguínea , Humanos , Mandíbula/diagnóstico por imagen , Neoplasias Mandibulares/diagnóstico por imagen , Persona de Mediana Edad , Medicina de Precisión , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/trasplante
8.
Rev. esp. cir. oral maxilofac ; 42(3): 132-135, jul.-sept. 2020. ilus
Artículo en Español | IBECS | ID: ibc-196629

RESUMEN

El tumor maligno de la vaina nerviosa periférica (TMVNP) es un tumor mesenquimal raro que surge de las células de la vaina del nervio periférico. Tiene un comportamiento agresivo. Generalmente se presenta en extremidades y tronco, siendo su presencia en cabeza y cuello muy poco frecuente. Reportamos un caso raro de TMVNP del nervio dentario inferior en su trayecto intraóseo mandibular, no asociado a neurofibromatosis


Malignant peripheral nerve sheath tumour (MPNST) is a rare mesenchymal tumor that arises from peripheral nerve sheath cells. It has aggressive behavior. It usually occurs in extremities and trunk, being its presence in head and neck very infrequent. We report a rare case of TMVNP of the inferior dental nerve in its mandibular intraosseous pathway, not associated with neurofibromatosis


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Vaina del Nervio/patología , Neoplasias Mandibulares/patología , Neurilemoma/patología , Inmunohistoquímica/métodos , Radiografía Panorámica/métodos , Neoplasias de la Vaina del Nervio/cirugía , Neoplasias Mandibulares/cirugía , Neurilemoma/cirugía
9.
J Cancer Res Ther ; 16(3): 647-652, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32719283

RESUMEN

The leiomyoma is a benign smooth-muscle neoplasm commonly found in the female genital tract, gastrointestinal tract, or skin. Leiomyomas of the oral cavity are unusual. Oral leiomyomas are uncommon due to the paucity of the smooth muscle in the mouth (except in blood vessels) and thus the involvement of jaw bones is extremely rare. Leiomyomas have been classified as solid angiomyoma, angioleiomyoma (vascular leiomyoma), and epithelioid variants. Angioleiomyomas are benign mesenchymal tumors derived from smooth muscle, which rarely occur in the oral cavity. Malignant transformation probably does not occur but careful histopathologic examination is still necessary to differentiate these benign lesions from their malignant counterparts due to different prognosis. Although uncommon in the maxilla and mandible, they should be included in the differential diagnosis of radiolucent lesions of jaw bones. An extensive search of literature was carried out on the Medline-PubMed and Google Scholar database using the keywords such as leiomyoma, angioleiomyoma, jaw bones, maxilla, mandible, intra-osseous to thoroughly search and collect all the reported cases of intraosseous leiomyoma (but our search was not limited to these terms only). To the best of our knowledge, only 23 cases of intraosseous leiomyomas have been reported so far in the jaw bones, among which only 8 belonged to angioleiomyomas. Herein, we report the 9th case of intraosseous angioleiomyoma, one of the variants of leiomyoma and overall 24th intraosseous leiomyoma in a 6-year-old female child, together with conventional histopathologic and immunohistochemical findings.


Asunto(s)
Angiomioma/patología , Neoplasias Mandibulares/patología , Enfermedades Raras/patología , Actinas/metabolismo , Angiomioma/metabolismo , Angiomioma/cirugía , Antígenos CD34/metabolismo , Biomarcadores de Tumor/metabolismo , Niño , Femenino , Humanos , Neoplasias Mandibulares/metabolismo , Neoplasias Mandibulares/cirugía , Músculo Liso/metabolismo , Músculo Liso/patología , Enfermedades Raras/metabolismo , Enfermedades Raras/cirugía
10.
J Cancer Res Ther ; 16(3): 641-646, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32719282

RESUMEN

Schwannoma, a benign nerve sheath tumor, is quite rare and more so in jawbones. We report a rare case of a plexiform variant of mandibular schwannoma in a 12-year-old female with a swelling in the left mandible. Clinical features were suggestive of dentigerous cyst as a result of missing premolars and canine. Occlusal and panoramic radiography revealed an osteolytic lesion with scalloping margins, bicortical plate expansion, and agenesis of several teeth. Odontogenic keratocyst, central giant cell granuloma, odontogenic myxoma, and ameloblastic fibroma were given as radiological differential diagnoses. Histopathological examination revealed features of plexiform schwannoma which was given as the final diagnosis. The lesion was treated with surgical excision. Although odontogenic cysts/tumors are often thought of in differential diagnosis whenever well-defined radiolucencies in the jaw are encountered, it is prudent to include schwannoma. This exceptional case adds light to the fact that schwannoma should not be overlooked though it is a rare possibility and must be included in differential diagnosis of odontogenic cysts/tumors.


Asunto(s)
Neoplasias Mandibulares/diagnóstico , Neoplasias/diagnóstico , Neurilemoma/diagnóstico , Radiografía Panorámica/métodos , Niño , Diagnóstico Diferencial , Femenino , Granuloma de Células Gigantes/diagnóstico , Granuloma de Células Gigantes/diagnóstico por imagen , Granuloma de Células Gigantes/cirugía , Humanos , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/cirugía , Neoplasias/diagnóstico por imagen , Neoplasias/cirugía , Neurilemoma/diagnóstico por imagen , Neurilemoma/cirugía , Quistes Odontogénicos/diagnóstico , Quistes Odontogénicos/diagnóstico por imagen , Quistes Odontogénicos/cirugía , Tumores Odontogénicos/diagnóstico , Tumores Odontogénicos/diagnóstico por imagen , Tumores Odontogénicos/cirugía
11.
J Cancer Res Ther ; 16(3): 668-671, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32719288

RESUMEN

Chordomas are rare tumors which arise from the embryological remnants of the notochord. These tumors can potentially arise from any region within the craniospinal axis and often clinically present as a diagnostic challenge. Chordomas are rare in patients younger than 40 years of age. The most common primary cancers that metastasize to the jaw bones are the ones originating from the breast, lung, kidney adrenal, colo-rectum, or prostate. Mandibular metastasis from a primary chordoma is an extremely rare occurrence with only five prior reports, three originating from primaries in the sacrococcygeal region, one from a lumbar spine primary and the other from a primary arising from the spheno-occipital region. A literature review did not reveal any prior reports of mandibular metastasis at presentation from a clival chordoma. We possibly report the first case of such an unusual clinical scenario in a 7-year-old male child and further discuss the evaluation and management of these rare tumors.


Asunto(s)
Cordoma/patología , Neoplasias de Cabeza y Cuello/secundario , Neoplasias Mandibulares/secundario , Neoplasias de la Base del Cráneo/patología , Biomarcadores de Tumor/metabolismo , Niño , Cordoma/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Neoplasias Mandibulares/cirugía , Clasificación del Tumor , Neoplasias de la Base del Cráneo/cirugía
12.
J Cancer Res Ther ; 16(3): 683-685, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32719292

RESUMEN

Squamous cell carcinomas of the oral cavity are quite common, but primary intraosseous squamous cell carcinomas (PIOSCCs) are rare. Their origin from lining of different odontogenic cysts has been documented. More than 50% of such cases have been reported to occur in periapical inflammatory cysts, and less than 10 cases are reported to arise from odontogenic keratocyst (OKC). One such rare case of a PIOSCC, which presented as an OKC initially, is being reported.


Asunto(s)
Carcinoma de Células Escamosas/patología , Neoplasias Mandibulares/patología , Quistes Odontogénicos/patología , Tumores Odontogénicos/patología , Adulto , Carcinoma de Células Escamosas/cirugía , Humanos , Masculino , Neoplasias Mandibulares/cirugía , Clasificación del Tumor , Quistes Odontogénicos/cirugía , Tumores Odontogénicos/cirugía
13.
Head Face Med ; 16(1): 12, 2020 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-32487178

RESUMEN

BACKGROUND: Ameloblastoma is one of the most common benign odontogenic neoplasms. Its surgical excision has the potential to lead to postoperative malocclusion. In this case report, we describe the successful interdisciplinary orthodontic treatment of a patient with ameloblastoma who underwent marginal mandibulectomy. CASE PRESENTATION: A woman of 20-year-old was diagnosed with ameloblastoma, and underwent marginal mandibulectomy when she was 8 years of age. She had an excessive overjet (11.5 mm) and a mild open bite (- 1.5 mm) with a severely resorbed atrophic edentulous ridge in the area around the mandibular left lateral incisor, canine and first premolar. An alveolar bone defect associated with tumor resection was regenerated by vertical distraction osteogenesis (DO). Subsequently, 3 dental implants were placed into the reconstructed mandible. Orthodontic treatment using implant-anchored mechanics provided a proper facial profile with significantly improved occlusal function. The occlusion appeared stable for a 7-year retention period. CONCLUSIONS: These results suggest that surgically assisted and implant anchored-orthodontic approaches might be effective for the correction of such malocclusions.


Asunto(s)
Aumento de la Cresta Alveolar , Ameloblastoma , Implantes Dentales , Neoplasias Mandibulares , Osteogénesis por Distracción , Ameloblastoma/cirugía , Implantación Dental Endoósea , Femenino , Humanos , Mandíbula , Neoplasias Mandibulares/cirugía , Adulto Joven
15.
J Craniofac Surg ; 31(5): 1390-1394, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32310874

RESUMEN

Mandibular condylar osteochondroma (OC) can result in facial asymmetry, malocclusion, and temporomandibular joint dysfunction. The authors have previously demonstrated a novel method for conservative condylectomy and simultaneous orthognathic surgery for treatment of mandibular condylar OC. The purpose of this study was to evaluate the immediate improvement and long-term stability of mandibular symmetry in the treatment of condylar OC. Fifty-six patients with unilateral mandibular condylar OC combined with secondary facial asymmetry and malocclusion were enrolled in this retrospective study. The computerized tomography (CT) scans were acquired with the mandible in centric relation (CR) before surgery, 1 week and 12 to 18 months after surgery. The images were reconstructed and processed for the analysis with ProPlan CMF 2.1 software. After defining the skeletal landmarks and the reference planes, the chin deviation, chin rotation and mandibular asymmetry index were calculated. The operations and healing were uneventful and the patients showed no signs of recurrence or temporomandibular joint ankylosis during the follow-up. Facial symmetry was greatly improved right after the surgery in the chin deviation (from 9.2 to 1.7 mm, P < 0.01), chin rotation (from 11.2 to 2.3, P < 0.01) and the asymmetry index of three mandibular landmarks (Go, MF and Sg, all P < 0.01). It also showed a stable result after 12 to 18 months follow-up. We also established a novel measurement method, which showed that the combination of conservative condylectomy via the intraoral approach based on intraoperative navigation and simultaneous orthognathic surgery is effective for improving the facial symmetry when treat the mandibular condylar OC.


Asunto(s)
Asimetría Facial , Cóndilo Mandibular/diagnóstico por imagen , Neoplasias Mandibulares/diagnóstico por imagen , Procedimientos Quirúrgicos Ortognáticos , Osteocondroma/diagnóstico por imagen , Adolescente , Adulto , Anquilosis/diagnóstico por imagen , Femenino , Humanos , Masculino , Cóndilo Mandibular/cirugía , Neoplasias Mandibulares/cirugía , Persona de Mediana Edad , Osteocondroma/cirugía , Recurrencia , Estudios Retrospectivos , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto Joven
16.
Rev. esp. cir. oral maxilofac ; 42(1): 25-28, ene.-mar. 2020. ilus, graf
Artículo en Español | IBECS | ID: ibc-195295

RESUMEN

La fístula linfática cervical se produce por daño iatrogénico del conducto torácico en cirugías de cabeza y cuello. Ante la sospecha de una fístula linfática se debe iniciar rápidamente un manejo nutricional y seguimiento estrecho, ya que pueden tener consecuencias graves como inmunosupresión, compromiso metabólico y necrosis cutánea con exposición e incluso ruptura carotídea. A continuación se presenta el caso de un paciente con fístula linfática cervical que precisó reintervención quirúrgica para lograr el cese de la fístula


Chyle leak formation is produced by iatrogenic damage to the thoracic duct in head and neck surgeries. Given the suspicion of a cervical chyle leak, nutritional management and close follow-up should be initiated quickly, since they can have serious consequences such as immunosuppression, metabolic compromise and skin necrosis with exposure or even carotid rupture. We report the case of a patient with cervical chyle leak that required surgical reexploration to reach the chyle leak closure


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Fístula/cirugía , Traumatismos del Cuello/cirugía , Conducto Torácico/lesiones , Neoplasias Mandibulares/cirugía , Fístula/diagnóstico por imagen , Enfermedad Iatrogénica , Neoplasias Mandibulares/complicaciones , Drenaje Linfático Manual , Biopsia/métodos
17.
BMJ Case Rep ; 13(2)2020 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-32047087

RESUMEN

Osteomas are bone tumours arising from the cortical or medullary bones of craniofacial skeleton. Involvement of frontal bone and paranasal sinuses is more frequent than jaw bones. Jaw osteomas are slow growing benign lesions, which are usually asymptomatic or present as painless swelling. Those involving mandibular condyle are relatively rare and result in significant functional and aesthetic disturbances. This paper reports a case of solitary central compact osteoma of mandibular condyle in an adult Indian female patient. A comprehensive review of previously published reports is also presented.


Asunto(s)
Neoplasias Óseas/cirugía , Cóndilo Mandibular/patología , Cóndilo Mandibular/cirugía , Neoplasias Mandibulares/cirugía , Osteoma/cirugía , Anciano , Femenino , Humanos , Enfermedades Raras
18.
J Oral Maxillofac Surg ; 78(5): 844-850, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32035839

RESUMEN

PURPOSE: The double-barrel fibula flap and vascularized iliac crest flap are both commonly used for mandibular reconstruction. The present study compared the usage and reconstruction outcomes of transplanted bone with these 2 methods. PATIENTS AND METHODS: The data from 30 patients who had undergone mandibular osteotomy and reconstruction were retrospectively reviewed. Of the 30 patients, 20 received a vascularized iliac crest flap (group A) and 10 received a double-barrel fibula flap (group B). The following variables were compared between the 2 groups: volume of bone flap (VBF), volume of effective bone flap (VEBF; ie, overlap between the volume of the ideal mandible [VIM] and the VBF), usage of the bone flap (VEBF divided by the VBF), mandibular reconstruction rate (VEBF divided by the VIM), volume of needless bone flap (VNBF; ie, VBF minus VEBF; the VNBF included the volume of needless buccal bone flap [VNBBF] and the volume of needless lingual bone flap [VNLBF]), percentage of alveolar crest restoration (PACR; ie, effective bone flap width divided by ideal alveolar crest width), and height of the bone flap (HBF). The independent-samples t test and the χ2 test were used to compare the variables between the 2 groups. Statistical significance was at P ≤ .05. RESULTS: Usage of the bone flap and the length of the mandibular defect were significantly greater in group B than in group A (P = .039 and P < .001, respectively). The VBF, VNBF, and VNLBF were significantly greater in group A than in group B (P < .001 for both). The mandibular reconstruction rate, VNBBF, PACR, HBF, and tooth implantation rate were comparable between the 2 groups. CONCLUSIONS: The double-barrel fibula flap can effectively restore the height of the alveolar crest, reconstruct longer mandibular defects, and provide a better buccal and lingual appearance compared with the vascularized iliac crest flap. Although the vascularized iliac crest flap can provide sufficient bone quantity, it must be contoured to the mandible.


Asunto(s)
Neoplasias Mandibulares/cirugía , Reconstrucción Mandibular , Procedimientos Quirúrgicos Reconstructivos , Trasplante Óseo , Peroné , Humanos , Ilion , Mandíbula/cirugía , Estudios Retrospectivos
19.
J Craniofac Surg ; 31(3): e266-e270, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32097381

RESUMEN

The purpose of this study is to present the chimeric scapula tip-free flap as a reconstructive choice in composite head and neck defects and to highlight the experiences of the authors in this field.A retrospective study and a literature review were conducted. Data about preoperative condition, intraoperative images, and radiological and clinical documentation were collected.Excision of head and neck advanced cancers may result in large composite defects containing different types of soft tissue and bone. This topic is particularly challenging in salvage surgery after radiation therapy. In this setting, reconstructive techniques are very complex and traditionally require the use of multiple microvascular flaps. Chimeric free flaps, based on the subscapular system, allow complex reconstructions, providing both soft tissue and bone on a single vascular peduncle.The regional anatomy of the subscapular system and the possible chimeric flaps that can be harvested will be discussed, together with the reconstructive surgical technique used and the positioning of the patient. Two representative clinical cases of complex head and neck reconstruction after radiotherapy are presented.Different types of chimeric flap can be harvested from the subscapular system. These flaps can include different tissues: skin, bone, muscle on a single vascular peduncle. This characteristic is particularly useful in complex defects with different tissue types involved, following large en-bloc excision of advanced head and neck tumors.Free flaps based on the subscapular system can be an excellent reconstructive choice in complex head and neck defects.


Asunto(s)
Colgajos Tisulares Libres/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Neoplasias Mandibulares/cirugía , Procedimientos Quirúrgicos Reconstructivos , Anciano , Femenino , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Humanos , Masculino , Neoplasias Mandibulares/diagnóstico por imagen , Persona de Mediana Edad , Estudios Retrospectivos , Tomografía Computarizada por Rayos X
20.
BMC Endocr Disord ; 20(1): 6, 2020 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-31931802

RESUMEN

BACKGROUND: Primary hyperparathyroidism is characterized by hypercalcemia and elevated or inappropriately normal serum levels of parathyroid hormone. Brown tumor of bone is a rare non-neoplastic lesion resulted from abnormal bone metabolism in hyperparathyroidism. However, nowadays, skeletal disease caused by primary hyperparathyroidism is uncommon. We report a case of brown tumor in the mandible as the initial exhibition of primary hyperparathyroidism associated with an atypical parathyroid adenoma. CASE PRESENTATION: The patient was a 49-year-old female, she had a pain mass on the right mandible a year ago and was treated with root canal therapy and marginal resection. After seven months, the mass recurred and enlarged. Enhanced CT scan, laboratory examination, Ultrasonography, 99mTc-MIBI SPECT-CT scintiscan and pathological examination were used to confirm the diagnosis of brown tumor. The patient's symptom improved after parathyroidectomy. CONCLUSIONS: 99mTc-MIBI SPECT/CT scintigraphy is a highly sensitive examination of the localization diagnosis of hyperparathyroidism. Brown tumors should be considered in the differential diagnosis of osteolytic lesions to avoid unnecessary and harmful interventions.


Asunto(s)
Hiperparatiroidismo Primario/diagnóstico , Neoplasias Mandibulares/diagnóstico , Osteítis Fibrosa Quística/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Hiperparatiroidismo Primario/cirugía , Neoplasias Mandibulares/cirugía , Persona de Mediana Edad , Osteítis Fibrosa Quística/cirugía , Paratiroidectomía , Pronóstico
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