Assessment of quality of life of oral cancer survivors compared with Spanish population norms.

This study evaluated the quality of life (QL) of patients who survived oral cancer more than 5 years after treatment, using the Short-Form 36 questionnaire (SF-36), and assessed the impact of factors influencing QL compared with the Spanish population norms. 60 oral cancer patients (65.41 years; 49 males) with cancer-free survival after surgery of >5 years were enrolled. The outcomes of every dimension of the SF-36 questionnaire in every patient were compared with those of a reference Spanish population. Females had statistically significant negative differences in the dimensions of role-emotional, social functioning and vitality. Patients under 65 years had statistically significant negative differences in the dimensions of physical functioning and general health. In the other variables analysed the differences between groups were only clinically relevant. The QL of patients with oral cancer who survive more than 5 years, when assessed with the SF-36 questionnaire, presented similar values to those of the general population, even exceeding these reference values in some dimensions. It is necessary to evaluate QL in the long-term since patients may need a long time to recover from the disease, and to complement QL assessment with other specific questionnaires.

Telemedicina en cirugía maxilofacial / Telemedicine in maxillofacial surgery

En nuestra especialidad el cáncer oral, debido a su elevada mortalidad,así como otras patologías de menor gravedad pero de gran morbilidady presión asistencial como la cirugía oral y la patología de la articulacióntemporomandibular, nos obligan a minimizar las demoras optimizandolos recursos de que disponemos. Dentro de estos recursos, la aplicaciónde las nuevas tecnologías a la medicina se está imponiendo en todaslas especialidades. Entre estas nuevas tecnologías, está adquiriendo un papelprotagonista la telemedicina. Creemos que ésta nos puede servir como sistemaóptimo y eficaz de cribado y derivación de pacientes desde atenciónprimaria (AP) hasta el nivel hospitalario. En el presente artículo describimostodos los detalles relacionados con el desarrollo, la utilización y las ventajasde una teleconsulta como herramienta integrante de una unidad degestión clínica para el proceso diagnóstico y terapéutico de la patología dela articulación temporomandibular valorando de esta forma su aplicabilidaden otros ámbitos de la cirugía oral y maxilofacial(AU)

There is a group of pathologies that tolerate little delayand require optimal use of the resources available to us in our dailywork as oral and maxillofacial surgeons. For instance, oral cancerhas a high mortality and other pathologies, which otherwise arenot serious, have a high morbidity and care burden, e.g., oral surgeryand temporomandibular joint dysfunction.Among these resources, the use of new technologies in medicinehas become routine practice in every specialty. Among thesetechnologies, telemedicine is becoming prominent. We believe thattelemedicine could be an optimal system for screening patientsfor referral from primary care to hospitals. The development, use,and advantages of teleconsultation as a tool used in a clinicalmanagement unit for the diagnosis and treatment oftemporomandibular joint disorders is described. The potential useof teleconsultation in other fields of oral and maxillofacial surgeryis evaluated(AU)

Tratamiento de la displasia fibrosa asociada a hemofilia C: a propósito de un caso / Treatment for fibrous dysplasia when associated with hemophilia C: A case report

La displasia fibrosa es una enfermedad ósea benigna que cambiael tejido óseo normal por una proliferación de tejido conectivo. Se piensaque la alteración del gen Gsα es la principal razón de la enfermedad.La hemofilia C es una enfermedad sanguínea, hereditaria rara, que provocahemorragias en pacientes afectos. Es autonómica recesiva, por lo quehombres y mujeres pueden estar afectos.Paciente de 13 años que desarrolla una displasia fibrosa en maxilar superiorderecho que empieza con dolor durante la masticación de alimentosduros. Presenta abombamiento de vestíbulo y enrojecimiento de paladarderecho.Presenta un déficit discreto de factor XI (heterocigoto). Por ello, necesitauna preparación especial antes de extirpar la lesión debido a su déficit.Se ha descubierto que la razón de la displasia fibrosa es la mutación delgen Gsα (GNAS1) que está en el cromosoma 20q.La causa de la hemofilia C es el déficit del factor XI debido a una mutacióndel gen FXI en el cromosoma 4. Quizás estas dos raras enfermedades tenganuna relación, porque ambas se presentan en el mismo paciente(AU)

Fibrous Dysplasia is a benign bone disease that changesnormal bone tissue for a proliferation of connective fibrous tissue.It is thought that an alteration of the Gsα gene is the main causeof the disease.Hemophilia C is a rare inherited blood disease leading to abnormalhemorrhages in affected patients. They have a factor XI deficiency.It is the least frequent of all hemophilias. It is a recessive autosomaldisease, affecting both men and women.A 13 year-old patient developed fibrous dysplasia in right uppermaxilla. The patient started with pain on chewing hard food. Shehad vestibular swelling and reddening of the right side of the palate.She had a discrete factor XI deficiency (heterozygotic). She neededspecial preparation before the lesion could be removed because ofher deficiency.It has been discovered that the mutation of gene Gsα (GNAS1) isthe reason for fibrous dysplasia. This gene is in chromosome 20q.The cause of hemophilia C is a factor XI deficiency due to a mutationin the FXI gene in chromosome 4. Perhaps these two rare diseasesare related, because both are unusual diseases and both are in thesame patient(AU)

Tratamiento de la osteomielitis esclerosante difusa con roxitromicina a largo plazo: a propósito de un caso / Long-term roxithromycin treatment for diffuse sclerosing osteomyelitis: a case report

La osteomielitis esclerosante difusa (OED) es una enfermedad de etiología desconocida, con dificultades para el diagnóstico y tratamiento ya que la literatura existente al respecto es confusa, con un gran desconocimiento respecto a su causa y evolución natural. Existen de dos teorías para explicar su origen:Infecciosa: difícil de confirmar mediante los datos bacteriológicos. Hiperplasia ósea derivada de una tendoperiostitis crónica, por una disfunciónmuscular y hábitos parafuncionales. Se caracteriza por dolor recurrente y tumefacción hemimandibular, aunquepuede presentar otras localizaciones, acompañada habitualmente de trismus, presión y parestesia y adenopatías regionales, cursa de forma episódica.El tratamiento de la OED es complejo, debido a que se han intentado múltiples terapias sin que ninguna haya dado un resultado satisfactorio a largo plazo.Tras revisar el tema, a propósito de un caso clínico, recomendamos roxitromicina a largo plazo como una línea de tratamiento a tener en cuenta en la OED por la eficacia que viene demostrando y los tolerables efectossecundarios, si bien cada caso debido a la complejidad de la enfermedad debe ser revisado individualmente, pero teniendo en cuenta esta opción terapéutica

Diffuse sclerosing osteomyelitis (DSO) is a disease of unknown etiology which is difficult to diagnose and treat as the literature available on the subject is confused, and there is a considerable lack of knowledge with regards to what causes it and its naturalevolution. There are two theories explaining its origin.One suggests an infectious origin, but this is difficult to confirm by means of bacteriological data. The other suggests an osseous hyperplasia origin derived from chronic tendoperiostitis as a result of muscular dysfunction and parafunctional habits. The disease ischaracterized by recurrent pain and hemimandibular tumefaction, although it can present in other locations. It is accompanied normally by trismus, pressure and paresthesia and regional adenopathy. It has an episodic clinical course.Treating DSO is complex due to the fact that many therapies have been tried but with no long-term success. After reviewing the subject as a result of a clinical case, we recommend considering roxithromycinin the long term as a line of treatment for DSO in view of its efficacy and its tolerable secondary effects. Needless to say, each case should be reviewed individually given the complexity of the disease, while taking into account this therapeutic option

Quiste odontogénico calcificante asociado con odontoma complejo: Presentación de un caso y revisión bibliográfica

Se presenta un caso de quiste odontogénico calcificante asociado con odontoma (QOCaO) y con un canino permanente incluido en maxilar superior, en un paciente varón de 19 años.El Quiste Odontogénico Calcificante (QOC) fue descrito por primera vez cómo una entidad patológica por Gorlin y col. en 1962.Se trata de un tumor benigno odontogénico mixto,y aunque la mayoria de estas lesiones presentan características quísticas en algunos casos se presenta como una masa sólida (15 %), y su transformación maligna está bien documentada. El QOC se presenta en ocasiones asociado a otros tumores odontogénicos, el más común es el odontoma al que aparece relacionado en el 24% de los casos. Para esta asociación se ha sugerido el término de "Quiste Odontogénico Odontocalcificante".Radiológicamente es una lesión mixta, bien definida y que histológicamente consiste en un gran quiste en cuya parte central existe un área sólida con acúmulos de esmalte y dentina distribuidos irregularmente en algunas zonas y en otros lugares adopta un aspecto organoide bien definido.Se efectúa una revisión de la literatura y se discute su patogénesis.

Fine needle aspiration in the pre-operative diagnosis of melanotic neuroectodermal tumour of infancy.

A case of melanotic neuroectodermal tumour of infancy is described. The pre-operative diagnosis was made on cytological material obtained by fine needle aspiration. The patient was a three-month-old male infant with a rapidly growing maxillary tumour mass that also involved the pterygomaxillary fossae and the floor of the orbit. In addition to the typical clinical presentation, the cytology is also distinctive showing a dual population of small neuroblastic cells and large melanin-containing epithelial cells. Histological, immunohistochemical and electron microscopic examination of the excised mass confirmed the initial diagnosis. The pre-operative distinction of this tumour from other small round cell tumours of infancy (rhabdomyosarcoma, neuroblastoma, melanoma and lymphoma), is essential in order to plan the most complete resection therefore reducing the possibilities of tumour recurrence. This tumour belongs to a field of pathology with which many otolaryngologists may not be familiar.

[Small cell carcinoma of the parotid gland. A case report]. / Carcinoma de células pequeñas de glándula parótida. A propósito de un caso.

A case of small-cell carcinoma (SCC) of the parotid gland in an 82-year-old woman is reported. SCC arising in major salivary glands are extremely rare. By immunohistochemical study, this case was classified as a small-cell carcinoma with neuroendocrine differentiation. These neoplasms seem to have a far better prognosis than those arising from the bronchial tree. Treatment is mainly local and regional surgery with complementary radiotherapy.

[Tumors of the carotid body. A case report]. / Tumores del glomus carotídeo. A propósito de un caso.

Tumors of the carotid body are uncommon. This primary neoplasm arises from the paraganglionar cells located at the bifurcation of the common carotid artery. They are usually multicentric and bilateral. Most patients consult for a painful, pulsatile mass situated in the angle of the jaw. Diagnosis is based on contrast CT, MRI and angiography. The treatment of choice is selective embolization followed by surgery.

[Acute mediastinitis with fatal outcome secondary to odontogenic infection]. / Mediastinitis aguda de evolución fatal secundaria a infección odontógena.

This article describes a patient who developed a deep neck and mediastinal infection that was initiated by a odontogenic infection. The history of the patient's illness and the surgical procedures are reviewed and the anatomic and microbial considerations of deep neck infections are discussed. Despite antibiotic therapy, cervicomediastinal drainage, tracheostomy and treatment for septic shock, the patient expired.