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1.
Kaohsiung J Med Sci ; 34(4): 231-237, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29655412

RESUMEN

In the last few decades, neurobiological and human brain imaging research have greatly advanced our understanding of brain mechanisms that support perception and memory, as well as their function in daily activities. Knowledge of the neurobiological mechanisms behind the deafferentation of stomatognathic systems has also expanded greatly in recent decades. In particular, current studies reveal that the peripheral deafferentations of stomatognathic systems may be projected globally into the central nervous system (CNS) and become an associated critical factor in triggering and aggravating neurodegenerative diseases. This review explores basic neurobiological mechanisms associated with the deafferentation of stomatognathic systems. Further included is a discussion on tooth loss and other dental deafferentation (DD) mechanisms, with a focus on dental and masticatory apparatuses associated with brain functions and which may underlie the changes observed in the aging brain. A new hypothesis is presented where DD and changes in the functionality of teeth and the masticatory apparatus may cause brain damage as a result of altered cerebral circulation and dysfunctional homeostasis. Furthermore, multiple recurrent reorganizations of the brain may be a triggering or contributing risk factor in the onset and progression of neurodegenerative conditions such as Alzheimer's disease (AD). A growing understanding of the association between DD and brain aging may lead to solutions in treating and preventing cognitive decline and neurodegenerative diseases.


Asunto(s)
Envejecimiento/patología , Enfermedad de Alzheimer/fisiopatología , Causalgia/fisiopatología , Disfunción Cognitiva/fisiopatología , Pérdida Auditiva/fisiopatología , Sistema Estomatognático/patología , Pérdida de Diente/fisiopatología , Enfermedad de Alzheimer/patología , Encéfalo/patología , Encéfalo/fisiopatología , Causalgia/patología , Circulación Cerebrovascular , Disfunción Cognitiva/patología , Dentición Permanente , Pérdida Auditiva/patología , Humanos , Masticación , Factores de Riesgo , Sistema Estomatognático/inervación , Pérdida de Diente/patología
2.
Codas ; 29(4): e20160240, 2017 Jul 20.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-28746465

RESUMEN

Purpose: to understand the main orofacial characteristics of functionally independent elderly individuals and to investigate their association with age, gender, socioeconomic level, and dental status. Methods: an observational, cross-sectional, and analytical study was carried out with a non-probabilistic sample. Inclusion criteria: minimum age of 60 years, individual in good health conditions according to a pre-established protocol published by the health care service. In order to collect the data, we used the validated Orofacial Myofunctional Evaluation with Scores for Aged Protocol. Results: The elderly individuals presented normal patterns in more than 60% of the appearance and mobility parameters. Significant alterations observed were: pronounced nasolabial sulcus; flaccid or arched cheeks; labial sealing with tension or absence of sealing; and depressed labial commissures. Alterations in mobility were few, between 20.6% and 33.8%, with higher prevalence of alterations when raising the tongue, lateralizing air inflated in cheeks and jaw. There was no relationship between these findings and the progression of age and socioeconomic classes. Women were more likely to show normal appearance of lips and some alterations in lips mobility. The number of teeth was associated with the volume and shape of lips and with jaw mobility. In addition, the use of dental prosthesis was shown to be significantly related to the nasolabial sulcus aspect and the configuration/tension of cheeks. Conclusion: This study suggests normal patterns of oromyofacial system in most functionally independent elderly individuals. It supports multidisciplinary action for prevention, promotion, and treatment of the elderly population's oral functions.


Asunto(s)
Envejecimiento/fisiología , Salud Bucal , Sistema Estomatognático/fisiopatología , Factores de Edad , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Estudios Transversales , Cara/fisiopatología , Evaluación Geriátrica , Humanos , Persona de Mediana Edad , Factores Sexuales , Factores Socioeconómicos , Estadísticas no Paramétricas , Sistema Estomatognático/patología
3.
Cranio ; 34(1): 29-37, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26856384

RESUMEN

OBJECTIVES/HYPOTHESIS: This study assessed the kinesiographic recordings of jaw movements during reading a text in Galician and Spanish language. STUDY DESIGN: Cross-sectional blind study. METHODS: A homogeneous healthy group of 25 normal stomatognathic system and native Galician participants was studied. Frontal and parasagittal plane recordings of the intraborder lateral jaw movements and during reading Galician and Spanish texts were recorded using a calibrated jaw-tracking device, kinesiograph. RESULTS: Although movements were similar in both languages, a greater retrusion of the jaw in the Spanish language was shown; moreover, a tendency exists for a left-side motion envelope in this right-handedness preference sample. CONCLUSIONS: This study supports the hypothesis that speech is controlled by the central nervous system rather than by peripheral factors and that the hemispheric dominance influences the asymmetry of the speech envelope.


Asunto(s)
Registro de la Relación Maxilomandibular/instrumentación , Registro de la Relación Maxilomandibular/métodos , Mandíbula/fisiología , Movimiento , Pruebas de Articulación del Habla , Patología del Habla y Lenguaje/métodos , Habla/fisiología , Adolescente , Estudios Transversales , Femenino , Lateralidad Funcional/fisiología , Hispanoamericanos , Humanos , Terapia del Lenguaje/instrumentación , Terapia del Lenguaje/métodos , Masculino , Mandíbula/inervación , Movimiento (Física) , Sistema Nervioso , Rango del Movimiento Articular , Lectura , Patología del Habla y Lenguaje/instrumentación , Estadísticas no Paramétricas , Sistema Estomatognático/inervación , Sistema Estomatognático/patología , Articulación Temporomandibular/fisiología , Adulto Joven
4.
Radiol Clin North Am ; 53(1): 133-44, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25476177

RESUMEN

Evaluating the complex anatomy of the suprahyoid neck on imaging studies can be a daunting task without a sound understanding of anatomy and a systematic approach. In this article, the suprahyoid neck is divided into characteristic anatomic spaces, which allow for the accurate localization of both normal structures and abnormal pathology in the neck. Once a lesion is localized to a specific suprahyoid space, imaging characteristics and clinical data can be used in a logical fashion to provide a clinically useful imaging differential diagnosis.


Asunto(s)
Cuello/anatomía & histología , Diagnóstico por Imagen , Neoplasias de Cabeza y Cuello/patología , Humanos , Imagen por Resonancia Magnética , Cuello/diagnóstico por imagen , Glándula Parótida/anatomía & histología , Glándula Parótida/patología , Músculos Faríngeos/anatomía & histología , Músculos Faríngeos/patología , Sistema Estomatognático/anatomía & histología , Sistema Estomatognático/patología , Tomografía Computarizada por Rayos X
5.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 34(4): 180-184, oct.-dic. 2014.
Artículo en Español | IBECS | ID: ibc-127424

RESUMEN

Este trabajo tuvo como objetivo buscar en la literatura científica, informaciones que evidencien de forma clara la importancia de la musculatura supra e infrahioidea en la biomecánica mandibular. Fue realizada una revisión de la literatura de forma amplia, no sistemática, mediante la investigación en diferentes bases de datos como SCIELO Brasil, MEDLINE y PubMed. Fueron utilizadas las palabras en portugués: «músculos supra-hióideos» y «músculos infra-hióideos» unidos por la palabra inglesa AND con los siguientes términos: «biomecânica mandibular», «mastigação», «amplitude de movimento articular» y «movimientos bordejantes» además de la aplicación de sus términos correspondientes en inglés. También fueron usados libros de texto. Se observó que la acción funcional de los músculos supra e infrahioideos son esenciales para la biomecánica mandibular y para el equilibrio de la cabeza sobre el cuello. Se observó además que las situaciones parafuncionales que engloban la región supra e infrahioidea necesitan de más evidencias científicas (AU)


This study aimed to search for data in the literature that clearly indicate the importance of the supra- and infra-hyoid muscle in mandibular biomechanics. A broad, non-systematic search of the literature was carried out through research in different databases such as SCIELO Brasil, MEDLINE and PubMed. The following terms, in the Portuguese language, were utilized: «músculos supra-hióideos» and «músculos infra-hióideos», followed by the English word AND with the terms «biomecânica mandibular», «mastigação», «amplitude de movimento articular» and «movimientos bordejantes», in addition to applying their corresponding terms in the English language. Some textbooks were also utilized. According to the literature, the functional action of the supra- and infra-hyoid muscles are essential for mandibular biomechanics and for balancing the head on the neck. There is still a need for more scientific evidence in the approach to para-functional situations involving the supra- and infra-hyoid areas, despite the existence of some publications on this subject (AU)


Asunto(s)
Humanos , Masculino , Femenino , Fenómenos Biomecánicos/fisiología , Mandíbula/fisiología , Articulación Temporomandibular/patología , Músculos/fisiología , Hueso Hioides/fisiología , Bibliometría , Sistema Estomatognático/patología
6.
Jpn J Radiol ; 32(3): 123-37, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24500138

RESUMEN

We aim to review the normal anatomy and imaging appearance of masticator space lesions. Because the masticator space is not amenable to direct examination, cross-sectional imaging with computed tomography and magnetic resonance imaging play an important role in diagnosis and characterization of lesions occurring there. Masticator space lesions can be classified on the basis of their origin into the following categories: inflammatory lesions, benign tumors, malignant tumors, vascular lesions, and developmental lesions. A diverse spectrum of malignant tumors and benign lesions are seen extending from the adjacent spaces. In addition, one should also be familiar with pseudolesions as well as post-treatment changes in the masticator space that can be mistaken for pathologic conditions.


Asunto(s)
Enfermedades Estomatognáticas/diagnóstico , Sistema Estomatognático/diagnóstico por imagen , Sistema Estomatognático/patología , Humanos , Imagen por Resonancia Magnética , Sistema Estomatognático/anatomía & histología , Tomografía Computarizada por Rayos X
7.
J Oral Rehabil ; 40(2): 130-8, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23211044

RESUMEN

The aim of this review of the literature was to assess the biological effects of occlusal trauma on the stomatognathic system focusing on animal studies. However, there are no conclusive explanations on the association between occlusal trauma and disease of the stomatognathic system. A literature survey was performed using the Medline database, covering the period from 1967 to 2012. Over 300 abstracts were reviewed, and 70 manuscripts were selected. Additional references from citations within the articles were obtained, and current textbooks were also used. This review does not include the effects of occlusal trauma on dental implants or dental prostheses/appliances. A total of 70 full articles were included for the final analysis. The selected 70 articles were classified into the following five categories, including the effects of occlusal trauma on the pulp tissues, periodontal tissues, masticatory muscle, temporomandibular joint (TMJ) and central nervous system (CNS). It was demonstrated that occlusal trauma caused a variety of harmful biological effects on stomatognathic system. Additionally, occlusal trauma could lead to some pain substance changes in the pulp, periodontal tissues, masticatory muscle, TMJ and CNS, which was possibly related to the peripheral and the central neuronal sensitisation. However, these findings demonstrate that there are remaining disagreements by various authors. More randomised trials are needed to validate these effects.


Asunto(s)
Oclusión Dental Traumática/fisiopatología , Enfermedades Estomatognáticas/etiología , Sistema Estomatognático/patología , Sistema Estomatognático/fisiopatología , Proceso Alveolar/patología , Animales , Sistema Nervioso Central/patología , Pulpa Dental/patología , Músculos Masticadores/patología , Músculos Masticadores/fisiopatología , Periodoncio/patología , Periodoncio/fisiopatología , Articulación Temporomandibular/patología , Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/etiología
8.
J Otolaryngol Head Neck Surg ; 41(5): 345-60, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23092837

RESUMEN

BACKGROUND: Interruption of mandibular continuity in transmandibular (mandibulotomy and mandibulectomy) surgery for tumour resection in the oral cavity and oropharynx may alter oral and temporomandibular joint (TMJ) morphology and function. OBJECTIVE: To critically analyze available evidence regarding the effects of transmandibular surgeries on morphologic and functional changes in the TMJ and stomatognathic system. DATA SOURCES: Electronic search of Medline, Embase, Evidence-Based Medicine Reviews, Ovid HealthStar, and Scopus and hand searches. INCLUSION CRITERIA: Any article investigating the TMJ morphologic changes and/or functional outcomes following transmandibular surgeries. RESULTS AND SYNTHESIS METHODS: Two hundred seventy-one articles were obtained through the electronic database scan and six articles via a hand search. Twelve full articles were initially selected as potentially meeting the eligibility for this review; however, only five articles finally fulfilled the study inclusion criteria and were analyzed for their methodology. All articles used clinical records and/or patient reports to evaluate TMJ pain, motion, dental occlusion, mouth opening, and deflection during opening as outcome measures. In only four articles was a clinical examination conducted after surgery, with associated patients' interviews and reports. The quality of all included articles was considered poor with a high risk of bias according to the Research Triangle Institute item bank quality of assessment. CONCLUSION: Based on the limited available evidence for this systematic review and a high risk of bias of the analyzed articles, no firm conclusions can be established regarding the effects of transmandibular surgery on morphologic and functional changes in the TMJ and stomatognathic system.


Asunto(s)
Neoplasias Orofaríngeas/cirugía , Procedimientos Quirúrgicos Otorrinolaringológicos , Rango del Movimiento Articular/fisiología , Sistema Estomatognático/patología , Sistema Estomatognático/fisiopatología , Trastornos de la Articulación Temporomandibular/etiología , Articulación Temporomandibular/patología , Humanos , Periodo Posoperatorio , Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/fisiopatología
9.
Expert Rev Anticancer Ther ; 12(3): 359-71, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22369327

RESUMEN

Perineural involvement is a well-recognized clinicopathologic entity found in head and neck (H&N) cancers, including mucosal epithelial carcinomas and salivary gland malignancies. Perineural disease remains a diagnostic, prognostic and therapeutic challenge for the multidisciplinary H&N oncology team. Nerves are important routes of tumor spread in H&N malignancies, yet the biology and prognostic implications of perineural tumor growth are not fully understood. On balance, the available evidence suggests that it is associated with an increased risk of locoregional recurrence but the impact on survival remains uncertain. Perineural involvement has implications for locoregional disease diagnosis and management. MRI is the best imaging modality to detect tumor extent. Advanced radiotherapy technologies such as intensity-modulated radiation therapy and image-guided radiation therapy have the potential for more accurate targeting and treatment of anatomically complex patterns of disease spread. This review is limited to nondermatologic H&N cancers.


Asunto(s)
Carcinoma/secundario , Neoplasias de Cabeza y Cuello , Imagen por Resonancia Magnética/métodos , Neoplasias del Sistema Nervioso/secundario , Nervios Periféricos/patología , Radioterapia Guiada por Imagen/métodos , Manejo de la Enfermedad , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/fisiopatología , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Membrana Mucosa/inervación , Membrana Mucosa/patología , Invasividad Neoplásica , Recurrencia Local de Neoplasia , Senos Paranasales/inervación , Senos Paranasales/patología , Sistema Estomatognático/inervación , Sistema Estomatognático/patología , Tecnología Radiológica
10.
Expert Rev Anticancer Ther ; 12(3): 373-80, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22369328

RESUMEN

The use of robotics in the field of head and neck surgery has provided surgeons with the ability to access anatomic locations that were previously only managed via open techniques. This has resulted in decreased overall morbidity, excellent functional results and the promise of equivalent oncologic outcomes. Transoral robotic surgery (TORS) provides access to the oropharynx, hypopharynx, larynx, oral cavity, parapharyngeal space and skull base vial the oral aperture. Studies reviewing the application of TORS to these subsites have been promising, and for many applications TORS has been accepted as a safe and efficacious option for surgical management. However, despite these promising results, TORS remains a surgical instrument that requires sound surgical skill, clinical judgment and oncologic principles, and should be chosen based on the needs of the individual patient and the comfort of the treating surgeon. In this article, we review the history of TORS, relevant anatomy and provide a review of the literature, highlighting the applications, advantages, functional outcomes and disadvantages of TORS for each anatomic subsite.


Asunto(s)
Neoplasias de Cabeza y Cuello , Robótica , Sistema Estomatognático , Procedimientos Quirúrgicos Operativos/métodos , Competencia Clínica , Análisis de Falla de Equipo , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Manejo de Atención al Paciente , Robótica/instrumentación , Robótica/métodos , Robótica/tendencias , Sistema Estomatognático/patología , Sistema Estomatognático/cirugía , Procedimientos Quirúrgicos Operativos/tendencias , Resultado del Tratamiento
11.
Rev cienc méd pinar río ; 15(3)sept. 2011. tab
Artículo en Español | CUMED | ID: cum-47440

RESUMEN

Las maloclusiones son la tercera causa de la pérdida de dientes en el mundo y consideradas un factor importante que atenta contra la integridad del sistema estomatognático. Se realizó un estudio descriptivo transversal en 156 niños de 5 a 11 años de edad de la escuela Pablo de la Torriente Brau atendidos en la Clínica Estomatológica Antonio Briones Montoto de Pinar del Río, en el período comprendido entre febrero de 2009 y diciembre de 2010 con el objetivo de determinar las características epidemiológicas de las maloclusiones y las necesidades asistenciales según el tipo de tratamiento. La muestra fue seleccionada a través de un muestreo aleatorio estratificado, proporcional al tamaño de los estratos. Se examinaron los estudiantes en sus aulas, con luz natural, depresores linguales para separar los carrillos y regla milimetrada para las mediciones, lo que permitió observar las relaciones de las arcadas dentarias en oclusión y cada una de ellas por separado. La información recogida fue llevada a una base de datos mediante Microsoft Excel. Se realizó la comparación de proporciones de grupos independientes con el objetivo de determinar las variables de prevalencia más significativas y la prueba Ji cuadrado en su variante de independencia para verificar la relación entre las categorías seleccionadas. El sexo más afectado fue el masculino así como el grupo de edades de 5-8 años y las necesidades asistenciales mayores fueron las del tratamiento interceptivo...(AU)


Malocclusions are the third cause of teeth lost all over the world and are considered an important factor that threatens the integrity of the stomatognathic system. A descriptive, cross-sectional study was conducted with 156 children (5 to 11 years old) who studied at Pablo de la Torriente Brau Elementary School belonging to the health area of Antonio Briones Montoto dentist's clinic, Pinar del Rio, from February 2009-December 2010 aimed at determining the epidemiological characteristics of malocclusions and the needs of assistance regarding type of treatment. The sample was chosen by means of a random sample proportionally stratified to the size of the stratus. The information was collected in a Microsoft Excel database. The comparison of proportions for independent groups was carried out with the purpose of determining the most significant variables of prevalence and chi square test in its variant of contingency tables. Male sex and the group of ages from 5 to 8 years were the most affected; the major needs of assistance fell into the interceptive treatment...(AU)


Asunto(s)
Humanos , Maloclusión , Maloclusión/complicaciones , Oclusión Dental , Sistema Estomatognático/patología
12.
Acta Otorhinolaryngol Ital ; 30(2): 94-9, 2010 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20559479

RESUMEN

Aim of the study was to assess the different roles of magnetic resonance imaging and computed tomography in the evaluation of anatomical origin and pathological nature of lesions involving the masticator space. Overall 41 cases (31 computed tomography and 14 magnetic resonance imaging) of lesions involving masticator space were retrospectively reviewed by two experienced radiologists in consensus. Reference standards were histopathological results and clinical-radiological follow-up after one year. Both computed tomography and magnetic resonance imaging were performed with and without intravenous injection of contrast. Computed tomography and magnetic resonance imaging were correct in identifying the space of origin of lesions respectively in 96% and 92% of cases. Computed tomography correctly diagnosed the nature of lesions in 81% of cases and magnetic resonance imaging in 93% of cases; computed tomography and magnetic resonance imaging correctly characterized, respectively, 88% and 100% of malignant lesions and, respectively, 73% and 83% of benign lesions. In conclusion both computed tomography and magnetic resonance imaging were effective in the identification of the origin of non-extensive lesions involving masticator space. Computed tomography was more precise in depicting lesions originating from masticator space, while magnetic resonance imaging was more correct in depicting lesions originating from contiguous spaces and involving secondarily the masticator space. Magnetic resonance imaging should always be preferred to characterise lesions, nevertheless computed tomography should be chosen in cases with suspected inflammatory involvement of mandible bone.


Asunto(s)
Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/patología , Imagen por Resonancia Magnética , Sistema Estomatognático/diagnóstico por imagen , Sistema Estomatognático/patología , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
13.
Artículo en Inglés | MEDLINE | ID: mdl-20399693

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the value of diffusion-weighted magnetic resonance (MR) imaging in differentiating various masticator-space solid lesions. STUDY DESIGN: Before surgery and/or pathologic verification, diffusion-weighted echo-planar MR imaging was performed on 78 subjects who had lesions in their masticator spaces. Based on their pathologic outcomes, lesions were classified into 3 groups: group 1: benign tumors and tumor-like lesions (23 cases); group 2: inflammatory diseases (14 cases); and group 3: malignant tumors (41 cases). Mean apparent diffusion coefficients (ADCs) were calculated from diffusion-weighted MR images that were obtained with a b factor of 0 and 1,000 s/mm(2). Differences between groups and lesion types were statistically compared with the Kruskal-Wallis and Mann-Whitney U tests. RESULTS: The ADCs were significantly different (P = .0001) among the 3 groups, between group 1 (1.52 +/- 0.29 [SD] x 10(-3) mm(2)/s) and group 2 (1.01 +/- 0.31 x 10(-3) mm(2)/s), and between group 1 and group 3 (1.11 +/- 0.29 x 10(-3) mm(2)/s). There was no statistically significant difference (P = .31) in ADCs between group 2 and group 3. In addition, there were significant differences between osteosarcomas (1.40 +/- 0.28 x 10(-3) mm(2)/s) and inflammatory diseases (P = .038) and between osteosarcomas and carcinomas (1.11 +/- 0.26 x 10(-3) mm(2)/s; P = .035). CONCLUSIONS: Diffusion-weighted MR imaging may be valuable in differentiating between benign solid lesions and malignant tumors in the masticator space. Inflammatory lesions cannot, however, be separated from most malignant tumors, except for osteosarcomas.


Asunto(s)
Quistes/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Enfermedades Estomatognáticas/diagnóstico por imagen , Sistema Estomatognático/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Quistes/patología , Diagnóstico Diferencial , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Músculos Masticadores/patología , Persona de Mediana Edad , Radiografía , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Enfermedades Estomatognáticas/patología , Sistema Estomatognático/patología , Adulto Joven
14.
RFO UPF ; 14(3): 250-255, set.-dez. 2009.
Artículo en Portugués | LILACS | ID: lil-534637

RESUMEN

A síndrome do processo estiloide alongado ou síndrome de Eagle e a dor miofascial fazem parte das disfunções craniomandibulares. Vários relatos de casos clínicos encontrados na literatura enfatizam as anormalidades do complexo estiloideo associadas a vários sintomas, como dor muscular, tender points, trigger points, que confundem o diagnóstico ou associam esses sintomas a outras enfermidades. Nesse sentido, é importante a obtenção de um diagnóstico preciso, em virtude de sintomatologia confundente. Este artigo relata um caso de dor miofascial no qual a paciente se apresentava com dor em região de cabeça e pescoço com o processo estiloide alongado em torno de 78 mm (observado em radiografia panorâmica). O diagnóstico final foi obtido por meio de exame clínico investigatório associado a imagens.


Asunto(s)
Humanos , Femenino , Anciano , Dolor Facial , Sistema Estomatognático/patología , Trastornos de la Articulación Temporomandibular , Síndrome de la Disfunción de Articulación Temporomandibular
15.
Eur Arch Otorhinolaryngol ; 266(4): 535-42, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-18956206

RESUMEN

The aim of this study was to describe the similarities and differences as well as the convenience in using of cephalometric radiographs and craniofacial computed tomography in obstructive sleep apnea syndrome (OSAS) patients and to demonstrate the relationship between the severity of sleep-disordered breathing and severity of cephalometric abnormalities. A total of 28 randomly selected patients with snoring, and varying degrees of sleep-disordered breathing were included in this study. A control group included 22 patients. These patients had no snoring or clinical evidence of sleep-disordered breathing as evaluated by polysomnographic test. No patients had prior pharyngeal or maxillomandibular surgery. All patients were evaluated by otolaryngological examination and had polysomnography, cephalometric radiographs and craniofacial CT scans. In study group the evaluation between cephalometric analysis on radiographs and CT scans was made. The comparison between the control and the study group was also assessed as far as cephalometric data are concerned. The cephalometric parameters revealed major differences between controls and patients with OSAS regarding the size and position of soft palate and uvula, volume and position of tongue, hyoid position, mandibulo-maxillary protrusion and size of the pharyngeal airway space. OSAS is associated with statistically significant changes in cephalometric measurements. Lateral cephalometric analysis and craniofacial CT scans add further information to the anatomical assessment of patients with OSAS. We found craniofacial CT scan measurements to be easier and more accurate especially when applying to soft tissues. We believe that this method may also be useful for patient classification to surgical procedures.


Asunto(s)
Cefalometría , Huesos Faciales/diagnóstico por imagen , Apnea Obstructiva del Sueño/diagnóstico por imagen , Apnea Obstructiva del Sueño/patología , Sistema Estomatognático/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Anciano , Índice de Masa Corporal , Huesos Faciales/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Sistema Estomatognático/patología
17.
Pró-fono ; 19(4): 347-351, out.-dez. 2007. tab
Artículo en Inglés, Portugués | LILACS | ID: lil-471304

RESUMEN

TEMA: a utilização da antroposcopia na avaliação das características posturais e morfológicas do sistema estomatognático de crianças respiradoras orais. OBJETIVO: descrever as características posturais e morfológicas do sistema estomatognático de crianças respiradoras orais, segundo a idade. MÉTODO: Participaram 100 crianças, de ambos os sexos, com idades entre 7 anos e 11 anos e 11 meses, leucodermas, em dentição mista e com diagnóstico de respiração oral. As características posturais e morfológicas do sistema estomatognático pesquisadas foram posição habitual de lábios e de língua, possibilidade de vedamento labial, hiperfunção do músculo mentual durante a oclusão labial, mordida e morfologia do lábio inferior, das bochechas e do palato duro, por meio da antroposcopia. RESULTADOS: no que se refere à caracterização da população do estudo segundo o diagnóstico otorrinolaringológico principal, tem-se que foi mais freqüente o aumento de tonsila faríngea e de tonsilas palatinas. Não foi encontrada diferença estatisticamente significativa entre as porcentagens de cada diagnóstico otorrinolaringológico, de acordo com a idade. Os resultados relativos às características do sistema estomatognático indicaram que os aspectos mais comuns na amostra foram posição habitual de lábios entreaberta, posição habitual de língua no assoalho oral, possibilidade de vedamento labial, hiperfunção do músculo mentual durante a oclusão dos lábios, mordida alterada, lábio inferior com eversão, simetria de bochechas e palato duro alterado, sendo que todas as características estudadas apresentaram a mesma freqüência com o avançar da idade, não havendo diferença estatisticamente significativa de acordo com essa variável. CONCLUSÃO: as crianças respiradoras orais apresentaram adaptações patológicas das características posturais e morfológicas do sistema estomatognático, sugerindo a importância do diagnóstico precoce como forma de evitar alterações orofaciais.


BACKGROUND: the use of anthroposcopy in the assessment of posture and morphology of the stomatognathic system of mouth breathing children. AIM: to describe the postural and morphologic characteristics of the stomatognathic system of mouth breathing children, according to age. METHOD: participants were 100 children, of both genders, with ages ranging from 7 to 11 years and 11 months, leukoderms, in mixed dentition and with the diagnosis of mouth breathing. The investigated postural and morphologic characteristics of the stomatognathic system were labial and lingual resting position, possibility of labial occlusion, hyperfunction of the mentalis muscle during labial occlusion, bite and morphology of the lower lip, cheeks and hard palate, using the anthroposcopy methodology. RESULTS: the results referring to the characterization of the studied population, according to the most frequent otorhinolaryngologic diagnosis, was of enlarged pharyngeal and palatine tonsils. A statistically significant difference was found between the percentages of each otorhinolaryngologic diagnosis, according to age. The results of the characteristics of the stomatognathic system indicated that the most common aspects in the studied sample were: half-open lips when in the resting position, tongue lowered on the mouth's floor in the resting position, possibility of labial occlusion, hyperfunction of the mentalis muscle during labial occlusion, alterations of bite, labioverted, symmetry of the cheeks and alteration of the hard palate. All of the studied characteristics presented the same frequency with the increase in age, with no statistically significant difference. CONCLUSION: mouth breathing children presented pathologic adaptations in the postural and morphological characteristics of the stomatognathic system. This suggests the importance of early diagnosis in order to avoid orofacial alterations.


Asunto(s)
Niño , Femenino , Humanos , Masculino , Respiración por la Boca/fisiopatología , Sistema Estomatognático/patología , Músculos Faciales/fisiopatología , Labio/fisiología , Sistema Estomatognático/fisiopatología , Lengua/fisiología
18.
Head Neck ; 29(12): 1156-9, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17427965

RESUMEN

BACKGROUND: CT-guided fine-needle aspiration (FNA) is a safe procedure, but major complications can occur rarely. Pseudoaneurysm rupture in the head and neck region following CT-guided FNA is an emergency that can result in life-threatening hemorrhage. This case emphasizes the salient risk factors for pseudoaneurysm formation and rupture in the head and neck region following CT-guided FNA. METHODS: A patient was seen with oral and facial hemorrhage as a result of a ruptured pseudoaneurysm 11 weeks following CT-guided FNA in a previously irradiated surgical bed. RESULTS: The patient was treated with coil embolization in and around the pseudoaneurysm and discharged without any further complications. CONCLUSIONS: Although CT-guided FNA is a safe and effective procedure, some patients may be at increased risk for rare but major complications. Caution should be used in proceeding with CT-guided FNA in an irradiated surgical bed of the head and neck.


Asunto(s)
Aneurisma Falso/etiología , Arteria Maxilar , Neoplasias Craneales/radioterapia , Neoplasias Craneales/cirugía , Sistema Estomatognático/patología , Aneurisma Falso/terapia , Arteriopatías Oclusivas/diagnóstico , Arteriopatías Oclusivas/terapia , Biopsia con Aguja Fina , Embolización Terapéutica , Hemorragia/etiología , Hemorragia/terapia , Humanos , Masculino , Melanoma/radioterapia , Melanoma/cirugía , Persona de Mediana Edad , Radiografía Intervencional , Radioterapia/efectos adversos , Rotura/terapia , Hueso Temporal/efectos de la radiación , Hueso Temporal/cirugía , Tomografía Computarizada por Rayos X , Cigoma/efectos de la radiación , Cigoma/cirugía
19.
Am J Surg Pathol ; 31(1): 44-57, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17197918

RESUMEN

To further define the clinicopathologic spectrum of epithelial-myoepithelial carcinoma (EMCa), we report the gross, histologic, and immunophenotypic characteristics of 61 tumors seen within a 30-year-period. The mean age at presentation was 60.9 years, with a female predominance (1.5:1). The most common sites were parotid (62.1%), sinonasal mucoserous glands (10.3%), palate (8.6%), and submandibular (8.6%). Most EMCas showed a characteristic nodular/multinodular growth pattern and classic biphasic tubular histology. However, new morphologies in EMCa such as ancient change (8.2%), "Verocay"-like change (3.3%), and sebaceous differentiation (13.1%) were noted. Specific histologic variants were dedifferentiated EMCa (3.3%), oncocytic EMCa (8.2%), EMCa ex pleomorphic adenoma (1.6%), double-clear EMCa (3.3%), and EMCa with myoepithelial anaplasia (3.3%). All cytokeratin cocktails selectively highlighted the epithelial component well. Of the myoepithelial markers, p63, smooth muscle actin and vimentin performed best. Bcl-2 and c-kit were frequently positive (66.7% and 69.2%, respectively). p53 was highly expressed only in 1 dedifferentiated EMCa. The recurrence rate was 36.3% (median disease-free survival 11.34 y), but death was rare with 5-year and 10-year disease-specific survivals of 93.5% and 81.8%, respectively. The most important univariate predictors of recurrence were margin status (log rank P=0.006), angiolymphatic invasion (P=0.002), tumor necrosis (P=0.004), and myoepithelial anaplasia (P=0.038). Thus, EMCa is generally a low-grade tumor with a broader morphologic spectrum than previously thought, with several key features predictive of recurrence. Immunohistochemistry can aid diagnosis by highlighting the biphasic nature of the tumor.


Asunto(s)
Carcinoma/secundario , Tumor Mixto Maligno/secundario , Mioepitelioma/secundario , Neoplasias de las Glándulas Salivales/patología , Sistema Estomatognático/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/análisis , Carcinoma/química , Carcinoma/mortalidad , Niño , Femenino , Humanos , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Tumor Mixto Maligno/química , Tumor Mixto Maligno/mortalidad , Mioepitelioma/química , Mioepitelioma/mortalidad , Fenotipo , Neoplasias de las Glándulas Salivales/química , Neoplasias de las Glándulas Salivales/mortalidad , Tasa de Supervivencia
20.
Pro Fono ; 19(4): 347-51, 2007.
Artículo en Portugués | MEDLINE | ID: mdl-18200382

RESUMEN

BACKGROUND: the use of anthroposcopy in the assessment of posture and morphology of the stomatognathic system of mouth breathing children. AIM: to describe the postural and morphologic characteristics of the stomatognathic system of mouth breathing children, according to age. METHOD: participants were 100 children, of both genders, with ages ranging from 7 to 11 years and 11 months, leukoderms, in mixed dentition and with the diagnosis of mouth breathing. The investigated postural and morphologic characteristics of the stomatognathic system were labial and lingual resting position, possibility of labial occlusion, hyperfunction of the mentalis muscle during labial occlusion, bite and morphology of the lower lip, cheeks and hard palate, using the anthroposcopy methodology. RESULTS: the results referring to the characterization of the studied population, according to the most frequent otorhinolaryngologic diagnosis, was of enlarged pharyngeal and palatine tonsils. A statistically significant difference was found between the percentages of each otorhinolaryngologic diagnosis, according to age. The results of the characteristics of the stomatognathic system indicated that the most common aspects in the studied sample were: half-open lips when in the resting position, tongue lowered on the mouth's floor in the resting position, possibility of labial occlusion, hyperfunction of the mentalis muscle during labial occlusion, alterations of bite, labioverted, symmetry of the cheeks and alteration of the hard palate. All of the studied characteristics presented the same frequency with the increase in age, with no statistically significant difference. CONCLUSION: mouth breathing children presented pathologic adaptations in the postural and morphological characteristics of the stomatognathic system. This suggests the importance of early diagnosis in order to avoid orofacial alterations.


Asunto(s)
Respiración por la Boca/fisiopatología , Sistema Estomatognático/patología , Niño , Músculos Faciales/fisiopatología , Femenino , Humanos , Labio/fisiología , Masculino , Sistema Estomatognático/fisiopatología , Lengua/fisiología
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