In-and-out Technique: An In-house Efficient Predictive Hole Fabrication Workflow.

Virtual surgical planning (VSP) and three-dimensional (3D) printing can increase precision and reduce surgical time in craniofacial reconstruction. However, the elevated cost and manufacturing time of outsourced workflows is increasing the development of in-house solutions. One of the main challenges in in-house workflows is to create cutting guides that hold plate position information. This is due to the fact that hospitals usually lack the infrastructure required to design and 3D print custom-made plates. Including plate-positioning information in resection guides is especially relevant in complex reconstructions and when tumor extension limits plate placement before resection. Current in-house workflows revolve around the idea of 3D scanning the bent plate's shape and to fuse it with the VSP. The goal of this article is to share our technique to transfer plate position information to resection guides. Our protocol uses a 3D model of the reconstruction as an intermediate step to transfer the plate position of a bent stock reconstruction plate to cutting guides. Two patients who required mandibular reconstruction with fibula flap are presented to illustrate the technique. This workflow requires a 3D-printed model of the desired outcome, cutting guides, and a stock plate. Results were satisfactory in terms of cutting location and angulation, plate adaptation and condylar position. This technique allows for a simple, safe, cheap, and quick alternative to add reconstruction plate information to cutting guides.

Tumor miofibroblástico inflamatorio en el espacio masticador / Inflammatory myofibroblastic tumour in the masticator space

No disponible

Leishmaniasis mucocutánea en paciente inmunocompetente: a propósito de un caso / Mucocutaneous leishmaniasis in an immunocompetent patient: a case report

No disponible

Granuloma vegetal oral: a propósito de un caso / Oral pulse granuloma: a case report

No disponible

Fístula de líquido cefalorraquídeo recidivante postraumática asociada a meningocele esfenoidal. Técnica abierta-endoscópica / Cerebrospinal fluid fistula associated with posttraumatic recurrent sphenoidal meningocele. Open-endoscopic technique

Introducción. Las fístulas de líquido cefalorraquídeo surgen tras la ruptura de las barreras que separan la cavidad nasal y senos paranasales de los espacios subaracnoideos: base craneal, duramadre y membrana aracnoidea. Aproximadamente el 80% surgen en el contexto de traumatismos craneofaciales con fracturas de la base craneal. La elección del abordaje y técnica quirúrgica más adecuada en cada caso es esencial para la obtención de resultados quirúrgicos globales satisfactorios. El desarrollo de la cirugía endoscópica endonasal ha supuesto un arma terapéutica menos invasiva y eficaz, siendo las fístulas de líquido cefalorraquídeo una indicación bien establecida para su tratamiento definitivo. Caso clínico. Se presenta el caso de una paciente con fístula de líquido cefalorraquídeo recurrente con meningoencefalocele asociado tratada vía endoscópica. Discusión. Se discute el tratamiento conservador versus quirúrgico de las fístulas de líquido cefalorraquídeo. Ventajas y desventajas de los distintos tipos de abordajes relacionados con el manejo definitivo(AU)

Introduction. Cerebrospinal fluid fistulas arise after the breakdown of the barriers that separate the nasal cavity and paranasal sinuses of the subarachnoid space, skull base, dura and arachnoid membrane. Approximately 80% arise in the context of craniofacial trauma with fractures of the skull base. The choice of approach, appropriate surgical technique in each case is essential to achieve a good overall surgical outcome. Development of endoscopic endonasal surgery has become a less invasive and effective therapeutic tool, with cerebrospinal fluid fistulas being a well-established indication for definitive treatment. Case report. A case of a patient with cerebrospinal fluid fistula associated with recurrent meningoencephalocele, treated endoscopically. Discussion. We discuss the surgical versus conservative treatment of spinal fluid fistulas, and the advantages and disadvantages of different types of approaches related to definitive management(AU)

Osteonecrosis of the jaws and bisphosphonates. Report of fifteen cases. Therapeutic recommendations.

Recently there have been reports of osteonecrosis of the jaw (ONJ) in patients with chronic therapy with bisphosphonates (Bps). So far three drugs have been linked: Pamidronate of disodium, Zoledronic acid and Alendronate of sodium. It is due to a non detected side effect in clinical trials before commercialization, and reverberates significantly in the quality of life of these patients. Most of the cases are seen in oncology patients that have received long term concurrent antineoplasic therapy and were treated sporadically with steroids, together with Bps endovenous, for treatment of cancer and its symptoms. Among these cases we find the reported by R.E. Marx (1), S.L. Ruggiero (2) and J. V. Bagán (3). In this report fifteen cases diagnosed, treated and followed up at the author's surgery department are presented and some suggestions are given in order to reduce the incidence in patients with cancer who are going to receive Bps, as well as in patients with established ONJ being treated with these drugs who may need a surgical intervention.

Osteonecrosis of the jaws and bisphosphonates. Report of fifteen cases. Therapeutic recommendations

Recientemente se han descrito casos de osteonecrosis mandibular y maxilar (ONM) en pacientes sometidos a tratamiento crónico con bisfosfonatos (BF). Hasta el momento tres han sido los fármacos implicados: Pamidronato de disodio, Ácido Zoledrónico y Alendronato de sodio. Se trata de un efecto secundario muy poco frecuente, no detectado en ensayos clínicos precomercialización, que repercute de forma significativa en la calidad de vida de estos pacientes.La mayoría de los casos se dan en pacientes oncológicos que reciben tratamiento antineoplásico concomitante a largo plazo y muchos de ellos estaban sometidos a tratamiento intermitente con esteroides a corto plazo, junto a los bisfosfonatos vía endovenosa, para el tratamiento del cáncer y de los síntomas. Entre estos casos se encuentran los publicados por R.E. Marx (1), S.L. Ruggiero (2) y J. V. Bagán (3).Este artículo presenta quince casos clínicos diagnosticados, tratados y seguidos por nuestro servicio y da una serie de recomendaciones para reducir su incidencia en pacientes con cáncer que van a recibir BF, así como en pacientes con ONM establecida en tratamiento con dichos fármacos y que puedan necesitar un tratamiento quirúrgico

Recently there have been reports of osteonecrosis of the jaw (ONJ) in patients with chronic therapy with bisphosphonates (Bps). So far three drugs have been linked: Pamidronate of disodium, Zoledronic acid and Alendronate of sodium. It is due to a non detected side effect in clinical trials before commercialization, and reverberates significantly in the quality of life of these patients.Most of the cases are seen in oncology patients that have received long term concurrent antineoplasic therapy and were treated sporadically with steroids, together with Bps endovenous, for treatment of cancer and its symptoms. Among these cases we find the reported by R.E. Marx (1), S.L. Ruggiero (2) and J. V. Bagán (3).In this report fifteen cases diagnosed, treated and followed up at the author´s surgery department are presented and some suggestions are given in order to reduce the incidence in patients with cancer who are going to receive Bps, as well as in patients with established ONJ being treated with these drugs who may need a surgical intervention