¿Cuál es su diagnóstico? / What would your diagnosis be?

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Fibroxantoma atípico / Atypical fibroxanthoma

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Distracción maxilar con dispositivos internos en pacientes fisurados: Planificación virtual y transferencia de datos al campo quirúrgico / Maxillary distraction with internal devices in cleft patients: virtual planing and transference of dates to surgical field

Objetivo. Los dispositivos internos de distracción maxilar han sido poco utilizados debido a la dificultad que supone su colocación precisa. Esto se debe a que pequeñas imprecisiones en su orientación dan lugar a grandes imprecisiones en la posición final del hueso distraído. En este sentido, la cirugía asistida por ordenador es una herramienta de gran ayuda para alcanzar la máxima precisión. El objetivo de este trabajo es presentar nuestro protocolo de planificación de la posición de distractores internos, así como un nuevo objeto CAD/CAM para transferir los datos al campo quirúrgico. Material y método. Se planifica de forma virtual el avance maxilar de 2 pacientes fisurados y los vectores de movimiento virtual. Para la transferencia de datos al campo quirúrgico se utiliza una férula especial con acoples laterales que orientan el vector de distracción. Resultados. Dos pacientes fueron intervenidos con resultados satisfactorios. Conclusión. Tanto el protocolo de planificación virtual del vector de distracción como el objeto CAD/CAM para transferencia de datos al campo quirúrgico presentado son útiles para aumentar la precisión en la posición final del maxilar. De esta forma el uso de distractores internos para avances menores de 12 mm resulta una técnica predecible (AU)

Objetive. Maxillary internal distractors have not been widely used since the accurate positioning is challenging. This is because a small deviation in the positioning results in a great deviation in the final position of the distracted maxilla. Computer assisted surgery is a powerful tool to reach accurate results. The authors report a protocol for internal distractor positioning as well as a new object for transferring dates from virtual planning to surgical field. Material and method. Virtual planning was performed to plan the maxillary advance in 2 cleft patients. A wafer with 2 lateral attachments was used to transfer the vector of distraction from virtual planning to surgical field. Results. Satisfactory result was achieved in both patients. Conclusion. This virtual planning protocol as well as the CAD/CAM objet to transfer dates from computer to surgical field are useful in order to achieve a suitable final position of the maxilla. These tools facilitate the positioning of internal distractors, leaving the use of external distractors for advancement greater than 12 mm (AU)

Osteochondroma of coronoid process: a rare etiology of jacob disease.

Jacob disease is a rare entity consisting of the formation of a pseudojoint between the inner surface of the zygoma and the coronoid process. This requires constant contact between the two implicated surfaces. It can be achieved by two mechanisms: one by an enlarged coronoid process and two by an anterior displacement of the coronoid process caused by a temporomandibular joint (TMJ) disorder. Although von Langenbeck described coronoid process hyperplasia in 1853, Oscar Jacob was the first author to describe the pathology in 1899. Since then, only a few cases have been published in the literature. The authors report a rare case of Jacob disease caused by an osteochondroma of the coronoid process, which is even less common, and review the literature.