RESUMO
Retinoblastoma (RB) is an aggressive intraocular tumor arising from cells of the retina. Infrequently, distant metastasis occurs in advanced stages of the disease. This case report describes the metastasis of the tumor to the mandible, an extremely rare phenomenon. This condition was observed for a recurrent tumor in a patient who initially underwent chemotherapy, making this case report unique and providing new insights into the behavior of this tumor. An overview of the management of a metastatic RB also is discussed.
Assuntos
Neoplasias Mandibulares/secundário , Retinoblastoma/patologia , Biópsia , Pré-Escolar , Diagnóstico por Imagem , Humanos , Imuno-Histoquímica , Masculino , Neoplasias Mandibulares/diagnóstico , Recidiva Local de NeoplasiaRESUMO
Haemocoagulase is a snake venom protein derivative that is known to possess haemostatic activity. It is reported to minimise blood loss in orthopaedic, otorhinolaryngologic, and abdominal surgeries. The use of intravenous haemocoagulase in orthognathic surgery is unknown and not yet reported. The purpose of this trial is to study the efficacy of haemocoagulase in haemorrhage control in orthognathic surgery. Forty-six consecutive patients scheduled to undergo bi-maxillary orthognathic surgery within the time period of the study were recruited and randomized. They received either the study drug or placebo. All patients underwent operation with hypotensive anaesthesia. Intraoperative blood loss, operating time, drop in haemoglobin and haematocrit were the variables analysed in the study. Haemocoagulase caused an 11% (52 ml) reduction in blood loss in the study group (p = 0.01). There was no adverse reaction in any of the patients.
Assuntos
Batroxobina/uso terapêutico , Perda Sanguínea Cirúrgica/prevenção & controle , Cirurgia Ortognática/métodos , Método Duplo-Cego , Humanos , Maxila/cirurgia , Estudos ProspectivosRESUMO
BACKGROUND: In maxillofacial surgery, children represent a special group of patients, as they have significant differences from adults as far as the facial skeleton is concerned. The etiology and epidemiology of pediatric trauma involving the facial skeleton has been reported in a large series of patients. Nevertheless, few of these reports review large numbers of pediatric patients, and little is known about treatment protocols for fractures in children. The aims of this study were to retrospectively analyze the treatment methods and outcomes of pediatric mandibular fractures in children and young adolescents up to the age of 15 years, to discuss the findings, and to propose treatment protocols for maxillofacial fractures in childhood. MATERIALS AND METHODS: The present study retrospectively analyzed the treatment methods and outcome of the pediatric mandibular fractures in children and young adolescents' up to the age of 15 years over a period of 5 years. All patients were followed up for an average period of 18 months, with a maximum follow-up of 2 years. A total of 74 patients were treated for mandibular and dentoalveolar fractures in children upto the age of 15 years at the Department of Oral and Maxillofacial Surgery at Nair Hospital Dental College, Mumbai from 2007 to 2012. RESULTS: AND CONCLUSIONS: The treatment methods used at our centre had satisfactory outcomes at the end of a follow-up period of 2 years. Reported complications were minimal. Our results confirm the usefulness of open reduction and plate fixation in older children (>12 years of age) and a conservative approach in younger children (≤12 years of age) in treating mandibular fractures.
Assuntos
Redução Fechada/métodos , Fixação Interna de Fraturas/métodos , Fraturas Mandibulares/terapia , Adolescente , Fatores Etários , Processo Alveolar/lesões , Placas Ósseas , Criança , Pré-Escolar , Tratamento Conservador/métodos , Oclusão Dentária , Feminino , Seguimentos , Fixação Interna de Fraturas/instrumentação , Humanos , Lactente , Técnicas de Fixação da Arcada Osseodentária/instrumentação , Masculino , Côndilo Mandibular/lesões , Fraturas Mandibulares/cirurgia , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Articulação Temporomandibular/fisiologia , Resultado do TratamentoRESUMO
OBJECTIVE: Orthognathic surgeries and distraction osteogenesis (DO) of the jaw bones cause a change in the pharyngeal airway space (PAS). The aim of our study was to evaluate the magnitude of changes occurring in the pharyngeal airway after mandibular set-back surgeries and DO of maxilla/mandible. MATERIALS AND METHODS: The study undertaken was a retrospective cephalometric study. Subjects included in our study had undergone mandibular set-back surgery or DO of maxilla/mandible. Lateral cephalograms of the subjects taken pre-operatively (T0), immediate post-operatively (T1) and after a minimum follow-up period of 6 months (T2) were studied. The cephalograms were traced manually and the following parameters were evaluated: Surface area of the PAS, pharyngeal airway width at the level of the base of the tongue, position of the hyoid bone and the tongue. Repeated measure ANOVA test was done to assess the presence of any significant changes in the proposed parameters at T0, T1 and T2. A correlation analysis was made between the mandibular/maxillary movements and the corresponding changes in the PAS. RESULTS: Surgical movements of maxilla and mandible do have an effect on the pharyngeal airway. CONCLUSION: It was clearly evident that the effects of mandibular movements on the PAS and the hyoid bone is more significant than the maxillary movements.