Survival rate of odontogenic descending necrotizing mediastinitis. Our experience in last 5 years.

BACKGROUND: Descending necrotising mediastinitis is one of the most lethal and least frequent forms of mediastinitis. It is a life-threatening infection most frequently originating from an oropharyngeal or odontogenic infection. MATERIAL AND METHODS: A retrospective study of 6 patients diagnosed and treated for descending necrotising mediastinitis between 2015 and 2020 is reported. RESULTS: All patients were male, mean age of 34.83 years; 66% were smokers. 83% had an orocervical infection and 34% had initial mediastinal spread. All patients were treated initially with empirical broad-spectrum antibiotics and surgical drainage, with subsequent admission to the Intensive Care Unit; only one of them required tracheostomy. The mean hospital stay was 27.37 days. After a mean follow-up of 6 months, 100% of the cases had a complete recovery. CONCLUSIONS: Early diagnosis and surgical treatment combined with improved life-support treatment in intensive care units and broad-spectrum antibiotic therapy leads to a decrease in associated mortality.

Large cell neuroendocrine carcinoma on the floor of the mouth: a rare entity in an unusual location.

Neuroendocrine carcinomas (NEC) are a group of malignant neoplasms usually located in the lungs or gastrointestinal tract. Fewer cases are located in the head and neck, and in these rare presentations, the lingual tonsil, larynx, and major salivary glands are the most frequently affected sites. NECs exhibit similar characteristics regardless of where they arise. However, because these neoplasms are rare, a clear understanding of their aetiopathogenesis has yet to be described, and options for treatment have varied and are not unified. A rare NEC of the floor of the mouth is reported here; it appears that this location has not been reported previously. The diagnosis was established through histopathological analysis, and the patient underwent systemic treatment. He had a partial response to treatment in the first 3 months, but died 6 months after the initial diagnosis. This highly uncommon tumour can pose a significant diagnostic challenge for clinicians and pathologists alike and can result in diagnostic delay.

Carcinoma ductal sobre adenoma pleomorfo de parótida / Duct carcinoma over the pleomorphic adenoma of the parotid gland

No disponible

No disponible

Luxación crónica recidivante. Tratamiento: osteotomía glenotemporal de Norman / Chronic recurring dislocation treatment: Norman glenotemporal osteotomy

Introducción: Varios procedimientos quirúrgicos se han utilizadopara limitar la apertura mandibular en pacientes con luxaciones recidivantesde la articulación temporomandibular (ATM). Éstas incluyen la inyecciónde agentes esclerosantes y el bloqueo mecánico mandibular. Otros métodosse basan en bloquear la traslación del cóndilo mandibular mediante la fracturadel arco zigomático o mediante injerto óseo con aumento de la eminenciaarticular y la creación de un impedimento mecánico usando mallade vitalio o tornillos de acero inoxidable. Objetivo: Evaluar la experienciade los autores en el tratamiento de las luxaciones recidivantes de mandíbulacuando se tratan ambos componentes: el óseo (eminencia) y el muscular(pterigoideo lateral). Material y métodos: 25 pacientes afectados de luxaciónrecidivante (>3episodios/año) entre Enero 1997- Agosto 2008 con unaedad media de 30 años; 21 de ellos son tratados de manera primaria y 4 porrecidivas. Se realiza la técnica quirúrgica bajo anestesia general, incidiendoa lo largo del arco zigomático con una disección roma hasta exponer la paredanterior de la cápsula articular. Colocación de placa en “L” con fijación bicorticalcon tornillos. Resultados: Tras seguimiento radiológico y clínico tras laintervención (de 6 a 36 meses), se objetiva la ausencia de pérdidas de injerto,sin recidivas, remisión completa o parcial del dolor, buena apertura oraly ausencia de complicaciones importantes. Conclusión: La técnica descritapara restringir los movimientos de la ATM en casos de la dislocación crónicaes relativamente simple, normalizando la función articular de forma inmediatasin necesitar tratamiento suplementario(AU)

Background. Various surgical procedures have been usedto limit mandible opening in patients with recurrent dislocations ofthe temporo mandible joint (TMJ). These include intracapsularinjection of sclerosing agents and tethering of the mandible. Othermethods include obstruction of the condylar translation bydownfracturing the zygomatic arch or by bone graft augmentationof the tuberculum and creating a mechanical impediment usingVitallium mesh or a stainless steel pin. Objective. To evaluate theauthor’s experience in the treatment of recurrent dislocation of themandible when both components, the osseous (eminence) and themuscular one (lateral pterigoideum), are treated. Material andmethods. From January 1997 to August 2008, twenty-five patientes,30 years old of averaged age, are affected by recurrent luxation (>3episodes/year). Twenty-one of them are treated primarily and fourof them because of recurrences. The operative procedure is developedunder general anesthesia, incising along the zygomatic arch usingblunt dissection so that the front wall of the articular capsule canbe exposed completely. An L-shaped plate is fixed bicortically withpins. Results. Radiological and clinical follow-up after the surgicaltreatment (6 to 36 months postoperatively) manifest the absenceof lost graft, no recurrence, completed or partial pain remission,adequate mouth aperture and absence of important complications.Conclusion. The technique described for restricting TMJ movementsin cases of chronic dislocation is relatively simple. The function ofthe TMJ was immediately normalized and no supplementarytreatment was necessary(AU)

Fracaso de la osteosíntesis mandibular. Consideraciones biomecánicas y tratamiento. A propósito de dos casos clínicos / Mandibular osteosynthesis failure. Biomechanical and therapeutic considerations. Two clinical cases

No disponible

No disponible