Comparative response to PDT with methyl-aminolevulinate and temoporfin in cutaneous and oral squamous cell carcinoma cells.

Cutaneous and Head and Neck squamous cell carcinoma (CSCC, HNSCC) are among the most prevalent cancers. Both types of cancer can be treated with photodynamic therapy (PDT) by using the photosensitizer Temoporfin in HNSCC and the prodrug methyl-aminolevulinate (MAL) in CSCC. However, PDT is not always effective. Therefore, it is mandatory to correctly approach the therapy according to the characteristics of the tumour cells. For this reason, we have used cell lines of CSCC (A431 and SCC13) and HNSCC (HN5 and SCC9). The results obtained indicated that the better response to MAL-PDT was related to its localization in the plasma membrane (A431 and HN5 cells). However, with Temoporfin all cell lines showed lysosome localization, even the most sensitive ones (HN5). The expression of mesenchymal markers and migratory capacity was greater in HNSCC lines compared to CSCC, but no correlation with PDT response was observed. The translocation to the nucleus of ß-catenin and GSK3ß and the activation of NF-κß is related to the poor response to PDT in the HNSCC lines. Therefore, we propose that intracellular localization of GSK3ß could be a good marker of response to PDT in HNSCC. Although the molecular mechanism of response to PDT needs further elucidation, this work shows that the most MAL-resistant line of CSCC is more sensitive to Temoporfin.

Perceived surgical difficulty of mandibular third molar extraction. A comparative cross-sectional study of dentists with postgraduate qualification in oral surgery and maxillofacial surgeons in a Spanish subpopulation.

BACKGROUND: Mandibular third molar (MTM) extraction is one of the most frequently performed surgeries in the oral cavity. Establishing the level of surgical difficulty pre-operatively is an essential step to ensure correct treatment planning. In Spain, MTM extraction - especially in cases presenting greater difficulty - is normally performed by doctors specializing in oral and maxillofacial surgery, or by dentists with postgraduate qualifications in oral surgery. The present work set out to analyze the extent to which perceptions of surgical difficulty of the said intervention vary in relation to professional training. MATERIAL AND METHODS: This cross-sectional, descriptive, observational study took the form of a survey. Using a visual analog scale (VAS), participants evaluated both the perceived difficulty of 30 cases of MTM extraction described by means of digital panoramic radiographs and the perceived difficulty deriving from a series of factors conditioning MTM extraction. The results underwent statistical analysis with SPSS Statistics 28.0 software. Non-parametric tests (Mann Whitney test for independent samples and the Kruskal-Wallis test) were applied. RESULTS: A total of 213 surveys were available for analysis. Both groups awarded the greatest importance to clinical experience, followed by anatomical and radiographic factors, root morphology obtaining the highest score among anatomical factors (9.01±1.42), while proximity of the MTM to the inferior alveolar nerve was regarded as the least important anatomical factor (8.11±2.54). Significant differences were only found for patient age, whereby maxillofacial surgeons awarded this factor more importance than dentists. CONCLUSIONS: The different training received by dentists specialized in oral surgery and maxillofacial surgeons did not influence either perceptions of surgical difficulty of MTM extraction, or opinions as to the factors influencing surgical difficulty.

[Is it necessary to prescribe antibiotics in impacted third molar surgical removal?: comparative study between prescribing patterns]. / ¿Está indicada la prescripción de antibióticos en la extracción del tercer molar retenido?: Estudio comparativo entre patrones de prescripción.

OBJECTIVE: To assess whether there is a significant difference in infection rate after surgery tooth extraction in two different hospitals from Norway and Spain where different surgical antimicrobial prophylaxis protocols are applied. METHODS: An analytical observational study was conducted, retrospective cohorts type, analyzing healthy patients with no risk factors, who were third molar tooth operated in maxillofacial services of two different hospitals: St. Olav in Trondheim (Norway) and Clínico San Carlos in Madrid (Spain). The collected variables were: age, number of tooth removed, anesthesia type, and observations about the course of the operation registered in the clinical history. To assess the development of postoperative infection, patient's data of those who chose the hospital as the place to remove the suture thread were collected in Norway, whereas in Spain a telephone survey was conducted to determine the course of the operation months later. RESULTS: In St. Olav Hospital 11.1% of patients operated received antibiotic regimen after surgery, while in Hospital San Carlos were 100%. The infection rate was 15% in St.Olav Hospital and 7.5% in Hospital San Carlos. These differences were no statistically significant. CONCLUSIONS: The routine administration of antibiotics to healthy patients with no risk factors undergoing impacted third molar surgical removal is a common clinical practice which it does not seem to be justified.

[Anterior bulbar compresion with basilar impresion. Surgical management by 2-Piece Le Fort I Transmaxilar Osteotomy]. / Tratamiento quirúrgico de la impresión basilar mediante osteotomía tipo Le Fort I segmentada. A propósito de un caso.

The expansive lesions, whether tumoral or not, originated at the level of the anatomical region of the skull base (SB), show a great histologic variety and clinicaly they cause a variable chronic neurological disfunction. Surgical treatment appears to be the best therapeutic option. An exhaustive knowledge of the topographic anatomy of this area is the mandatory in order to design an appropriate surgical strategy. In many cases, a narrow cooperation with specialists is necesary. As in any other surgical activity, a complete excision of the lesion and an optimal functional and aesthetic rehabilitation, without complications, is the challenge of the surgical team. The approach to the anatomical area of the SB is not single, but is based on a number of procedures, although none of them could be considered the best, or without technical difficulty or any complications. Within the group of transoral approaches, the Le Fort I-Palatal split (LFPS) technique has been considered by different authors an excellent way to approach the clivus and the occipito-vertebral joint. We report the case of a patient, treated in cooperation with the Department of Neurosurgery of our hospital. He was clinical and radiologically diagnosed of basilar impresion with bulbar compression, and the MRI revealed the presence of a located extradural fibrous injury above the odontoid apophysis. Therefore we chose the use of a LFPS to approach this lesion. With an optimal surgical field, a complete excision of the lesion was obtained. The postoperatory result in the subsequent follow-up was highly satisfactory.

Tratamiento quirúrgico de la impresión basilar mediante osteotomía tipo Le Fort I segmentada. A propósito de un caso / Anterior bulbar compresion with basilar impresion. Surgical management by 2-Piece Le Fort I transmaxilar osteotomy

La patología de carácter expansivo, tumoral o no, originada a nivel de la región anatómica de la base del cráneo (BC), presenta una gran diversidad histológica; desde un punto de vista clínico provoca una disfunción neurológica crónica de mayor o menor gravedad. El tratamiento quirúrgico representa la opción terapéutica más empleada. Un conocimiento exhaustivo de la anatomía topográfica de esta área es prioritario para un correcto diseño de la estrategia operatoria. En muchos casos se requiere una estrecha colaboración multidisciplinar. Como en cualquier actividad quirúrgica, la exéresis lesional completa y una correcta rehabilitación funcional y estética, en ausencia de complicaciones, es el reto del equipo quirúrgico. El abordaje a la encrucijada anatómica que constituye la BC no es único, si no que se sustenta en un gran abanico de posibilidades; ninguna vía se puede considerar la mejor, ni ninguna está exenta de dificultad técnica, ni de posibles complicaciones. Dentro del grupo de las vías transorales, la osteotomía maxilar tipo Le Fort I (OMLF I) segmentado, es aceptada por distintos autores como una excelente posibilidad de abordaje a la región del clivus y de la charnela occipito-vertebral. Presentamos el caso de un paciente, tratado de forma conjunta con el Servicio de Neurocirugía de nuestro hospital. Fue diagnosticado clínica y radiológicamente de impresión basilar con compresión bulbar. El estudio de imagen mediante Resonancia Magnética (RM) ponía de manifiesto la presencia de un lesión fibrosa extradural localizada alrededor de la apófisis odontoides. En sesión clínica conjunta se decidió emplear un abordaje mediante OMLF I segmentado para abordar dicha lesión. La exposición del lecho quirúrgico fue óptima, obteniéndose una resección completa. Los resultados postoperatorios fueron altamente satisfactorios (AU)

No disponible

Quistes dermoides del suelo de boca. Casos clínicos / Dermoid cysts of the floor of the mouth. Clinical cases

Los quistes dermoides (QD) son lesiones congénitas que surgen de la diferenciación ectodérmica de células multipotenciales. La tasa de incidencia de estas lesiones en el territorio maxilofacial es especialmente baja (6,9 por ciento). Son más frecuentes entre los 15 a 35 años, con independencia del sexo. Suelen permanecer asintomáticos, si bien las manifestaciones clínicas se relacionan con su localización y su tamaño. El diagnóstico se realiza en función de una detallada exploración clínica, de las pruebas de imagen y es confirmada mediante el estudio histológico. El único tratamiento correcto es el quirúrgico. (AU)

Empleo del colgajo del sistema músculo-aponeurótico superficial (SMAS) en la cirugía de parótida

No disponible

Estudio comparativo de abordaje subciliar vs transconjuntival en el tratamiento de las fracturas orbitarias / A comparative study of the subcilliary vs transconjunctival approach for the treatment of the orbital fractures

Objetivo: La incisión subciliar y la incisión transconjuntival son probablemente las vías de abordaje más utilizadas en el tratamiento de las fracturas del complejo orbitomalar. El objetivo del presente artículo es la comparación de los resultados estéticos y funcionales postoperatorios según la vía principal de abordaje en las fracturas orbitomalares. Material y Método: Para ello se realizó un estudio de cohortes retrospectivo de 70 pacientes. En 53 casos se empleó una vía de abordaje subciliar y en 16 casos una incisión transconjuntival. Se realizó un estudio de la calidad percibida, para ello se cruzaron distintas variables con la vía principal de abordaje. Resultados: Se observaron peores resultados estéticos y funcionales con la incisión subciliar. Conclusiones: Aunque los resultados obtenidos en el presente estudio no son definitivos, se recomienda la incisión transconjuntival para el tratamiento de fracturas de carácter moderado de la órbita (AU)