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1.
SAGE Open Med Case Rep ; 9: 2050313X211048279, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34589223

RESUMO

Steroid has recently been reported as a treatment for new coronavirus disease (COVID-19). The incidence of oropharyngeal candidiasis due to the inhaled steroid ciclesonide is lower than that due to other inhaled steroids. We report the first case of oral candidiasis with COVID-19 pneumonia using ciclesonide. A 75-year-old man was hospitalized for COVID-19 pneumonia. After admission, an oral combination of lopinavir/ritonavir was administered, and ciclesonide was inhaled for 7 days. On the 14th day of hospitalization, white plaque was found in his oral mucosa. Candida albicans was identified by oral bacterial tests, and amphotericin B was initiated. On the 35th hospital day, negative result for C. albicans was confirmed. Intraoral monitoring and intervention by dental care workers are considered important for the prevention of infectious complications induced by corticosteroids.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34517156

RESUMO

In oral and maxillofacial surgery such as orthognathic surgery and open treatment of maxillofacial fracture, plate fixation is commonly performed. Although the removal of titanium miniplates is controversial, the plates are removed routinely or symptomatically. By excessive torque during the screw removal, stripping or breaking of screw heads may occur. Although miniplates and screws are used with angled screwdrivers for osteosynthesis in bilateral sagittal split osteotomy (BSSO) or open treatment of mandibular angle or subcondylar fracture, the removal of a damaged screw, especially with the angled screwdriver, is very difficult. Therefore, we report a simple method with a sterilized surgical glove for removal of the stripped screw.

3.
J Craniofac Surg ; 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34538801

RESUMO

ABSTRACT: The purpose of this study was to investigate the anatomical relationship between the lingual nerve and submandibular duct. This study included 1403 patients with submandibular or sublingual gland diseases who underwent intraoral removal of submandibular gland sialoliths, submandibular glands, or sublingual glands. Of all patients, 33 patients underwent bilateral surgeries. All surgeries were performed a single surgeon, and the anatomical relationship between the lingual nerve and submandibular duct was always identified intraoperatively and recorded in the operation recorded. The anatomical relationship was investigated based on the intraoperative findings. The lingual nerve which crosses above the submandibular duct was detected in 8 of 1436 sides (0.6%). There were 4 in the right sides and 4 in the left sides. The lingual nerve below the submandibular gland was seen in 99.4%. Although the lingual nerve crosses above the submandibular duct with a rarer incidence, surgeons should beware of injuring the lingual nerve during intraoral salivary gland surgery.

4.
Lymphat Res Biol ; 2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34415778

RESUMO

Background: In patients with secondary upper limb lymphedema, positive correlations have been observed between the dermal back flow (DBF) type and visualization of lymph nodes around the clavicle, between the former and the lymph flow pathway type, and between the latter and the visualization of lymph nodes around the clavicle when using single photon-emission computed tomography/computed tomography/lymphoscintigraphy (SPECT-CT LSG). Methods and Results: We analyzed the associations between the visualization of inguinal lymph nodes, the lymph flow pathway type, and the DBF type using SPECT-CT LSG in 81 patients with unilateral secondary lower limb lymphedema by statistical analysis using Fisher's exact test. We revealed that the lymph flow pathways in the lower limb can be classified into nine types because the type in the lower leg is not always equal to the type in the thigh. Associations were observed between the visualization of inguinal lymph nodes and types of DBF (p < 0.01), between the types of lymph flow pathway in the thighs and visualization of the inguinal lymph nodes (p = 0.02), and between the lymph flow pathway types in the thighs and lower legs (p < 0.01). Conclusion: Detriment to the superficial lymph flow pathways in the lower limb appears to usually start from the proximal side, and deep pathways are considered to become dominant from a compensatory perspective as lymphedema severity increases.

5.
Cranio ; : 1-4, 2021 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-34275422

RESUMO

Background: Osteochondromas of the mandibular condyle show facial asymmetry and malocclusion. Because condylar osteochondromas are generally resected in a preauricular approach with risks of facial nerve injury and visible scar, the authors report endoscopically assisted intraoral resection of osteochondroma of the mandibular condyle with a piezoelectric surgical device.Case presentation: A 38-year-old woman presented with malocclusion and facial asymmetry caused by deviation of the chin to the left. Computed tomography showed a hyperdense, well-circumscribed mass arising from the medial aspect of the right mandibular condyle with resorption of the skull base. The patient underwent an endoscopically-assisted intraoral condylectomy with a piezoelectric surgical device. The postoperative course was uneventful without trismus, malocclusion, or facial asymmetry, and there was no recurrence 4 years after surgery.Conclusion:Endoscopically assisted intraoral resection of osteochondroma of the mandibular condyle with a piezoelectric surgical device is a minimally invasive and safe surgery.

7.
J Med Case Rep ; 15(1): 99, 2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33648548

RESUMO

BACKGROUND: Dermoid cysts are well-known lesions that manifest as subcutaneous tumors around the lateral sides of the eyebrows in young patients. Computed tomography or magnetic resonance imaging (MRI) is often performed to confirm the diagnosis. On the other hand, a lipoma is usually a circular lesion, which is sometimes observed in the upper part of the face. The signals of both T1-weighted and T2-weighted images of MRI of a lipoma are, in general, relatively highly homogenous, and the signals decrease in fat-suppressed images. Therefore, differential diagnosis between a dermoid cyst and a lipoma is usually made with MRI, especially based on fat-suppressed images. Here, we present a case of misdiagnosis of a dermoid cyst as a lipoma because of atypical magnetic resonance images. CASE PRESENTATION: We report a case of a 24-year-old Japanese woman with a dermoid cyst around the lateral edge of the eyebrow. The cyst had been gradually increasing in size for the past 2 years. On MRI, it showed high internal signals on T1- and T2-weighted images. However, the signal intensity decreased homogeneously in the fat-suppressed T2-weighted images. The observed tumor had a yellowish appearance under the endoscope. On the basis of these findings, the lesion was considered a lipoma until it ruptured intraoperatively. The pathological diagnosis confirmed it to be a dermoid cyst. CONCLUSION: Some dermoid cysts contain lipid-rich liquid, and these may be misdiagnosed as lipomas by MRI. When a tumor is located at a common site for a dermoid cyst, the MRI images should be validated carefully if it appears like a lipoma, and the differential diagnosis should be considered carefully.


Assuntos
Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/diagnóstico , Cisto Dermoide/patologia , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Humanos , Lipoma/diagnóstico , Lipoma/diagnóstico por imagem , Imageamento por Ressonância Magnética , Adulto Jovem
8.
J Oral Implantol ; 2021 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-33760031

RESUMO

This study was conducted to determine the most secure implant positioning on the marginally resected mandible to support a fixed complete denture through finite element analysis. Three or four implants were placed at near, middle, or far positions from the resected margin in a simulation model with a symmetrical marginal defect in the mandibular symphysis. The height of the residual bone was 5, 10, or 15 mm. The four possible implant patterns for 3 or 4 implants were defined as: (1) asymmetrically isolated position one to position two, (2) asymmetrically isolated position one to position three, (3) asymmetrically isolated with greater length position one to position two, and (4) two implants symmetrically positioned on each side of the defect. The von Mises stress in the resected and peri-implant bone with respect to the occlusal force was calculated. Initially, as the peri-implant bone stress around isolated implant at the near position was greater than at the middle and far positions regardless of the residual bone height, the near position was excluded. Second, the von Mises stress in the resected bone region was > 10 MPa when the isolated implant was at the far position, and it increased inversely depending on the bone height. However, the stress was < 10 MPa when the isolated implant was placed at the middle position regardless of the bone height, and it was significantly lower compared to the far position, and equivalent to the symmetrically positioned implants. Furthermore, the use of greater length implant reduced the peri-implant bone stress, which was even lower than that of the symmetrically positioned implants. These results suggest that the asymmetrically positioned three-implant-supported fixed denture, using a greater length isolated implant, placed neither too close to nor too far from the resected margin, can be an effective alternative to the symmetrically positioned four-implant-supported fixed denture.

9.
Med Biol Eng Comput ; 59(3): 663-672, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33594630

RESUMO

Superselective intraarterial infusion chemoradiotherapy is a modality of oral cancer therapy in which the artery feeding the tumor is catheterized. 3D information about the carotid artery is required to enable the surgeon to judge whether to advance, retract, or rotate the catheter. For this purpose, we proposed and conducted a model experiment to assess a new method of catheterization that applies a tracking system using registration with a monocular camera using the maxillary arch as the anatomical landmark. In this method, the preoperative 3D computer tomography angiographic image of the carotid artery that the catheter will be passed through is overlaid on the 2D video image. The mean TRE was 0.96 ± 0.36 mm and 0.88 ± 0.31 mm and 1.12 ± 0.46 mm when images were registered with the anterior and posterior teeth as the landmarks, respectively; the difference was not significant (p = 0.21). This tracking system that enables markerless registration simply by taking images of the maxillary anterior teeth with a single camera was convenient and effective for catheterization. In this study, we propose the new application of this tracking system and a novel method of catheterization for superselective intraarterial infusion chemoradiotherapy for oral cancer. In retrograde superselective intraarterial catheterization, a catheter is inserted into a tumor-feeding artery originating from the external carotid artery (ECA) (the lingual artery [LA], facial artery [FA], or maxillary artery [MA]). Because the maxillary dentition is located near the external carotid artery, we focused on real-time markerless registration using maxillary dentition fixed to the skull.


Assuntos
Neoplasias Bucais , Artéria Carótida Externa , Cateteres , Humanos , Imageamento Tridimensional , Infusões Intra-Arteriais , Neoplasias Bucais/terapia
11.
Dentomaxillofac Radiol ; 50(4): 20200333, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33180632

RESUMO

OBJECTIVES: The purpose of this pilot study was to evaluate the usefulness of magnetic resonance lymphography (MRL) with superparamagnetic iron oxide (SPIO) in sentinel lymph node (SLN) mapping of clinically N0 early oral cancer, and to conduct a comparative study of this MRL with CT lymphography (CTL). METHODS: CTL and MRL were performed for SLN mapping before surgery for 20 patients with clinically N0 early oral cancer. The detection rate, number, and location of SLNs in CTL and MRL were evaluated. Furthermore, optimal scanning/imaging timing in MRL was examined. RESULTS: SLNs were detected by CTL in 18 (90%) patients, and the total and mean number of SLN were 35 and 1.8, respectively. All SLNs could be detected 2 min and 3.5-5 min after contrast medium injection. In all patients, SLNs were detected by MRL at 10 min after SPIO injection, and the total and mean number of SLN was 53 and 2.7, respectively. MRL at 30 min after the injection showed additional 18 secondary lymph nodes. CONCLUSION: MRL with SPIO is safe and useful imaging for the detection of SLNs in clinically N0 early oral cancer, and the optimal imaging timing is 10 min after SPIO injection.


Assuntos
Neoplasias Bucais , Linfonodo Sentinela , Compostos Férricos , Humanos , Linfonodos/diagnóstico por imagem , Linfografia , Nanopartículas Magnéticas de Óxido de Ferro , Neoplasias Bucais/diagnóstico por imagem , Projetos Piloto , Linfonodo Sentinela/diagnóstico por imagem , Biópsia de Linfonodo Sentinela , Tomografia Computadorizada por Raios X
12.
Oral Radiol ; 37(1): 137-145, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32607939

RESUMO

Actinomycotic osteomyelitis is an aggressive and persistent disease capable of invading and destroying bone, and chronic osteomyelitis with proliferative periostitis represents new bone formation with periosteal reaction. We report a rare case of actinomycotic osteomyelitis with proliferative periostitis arising in the mandibular ramus and spontaneous bone regeneration after coronoidectomy. A 14-year-old girl was referred for swelling in the right parotid-masseteric region and severe trismus. Contrast-enhanced CT revealed that heterogenous enhancement of the right masseter muscle, and a reactive bone formation over the lateral cortex of the right mandibular ramus and osteolysis of the condyle were seen in plain CT. MRI showed that the mandibular ramus was a low-signal intensity and the reactive bone on the ramus was signal intensity similar to muscle on T1-weighted images. The lesion was clinically and radiologically diagnosed as chronic osteomyelitis of the mandibular ramus. However, a biopsy was performed intraorally under general anesthesia to rule out a malignant bone tumor, and pathological examination showed fibrous bone and Actinomyces druses. Finally, the lesion was diagnosed as actinomycotic osteomyelitis with proliferative periostitis. She underwent image-guided intraoral removal of impacted right third molar and reactive proliferative bone on the right mandibular ramus under general anesthesia. To improve trismus, coronoidectomy also was performed. After the discharge, AMPC was administrated intraorally for 7.5 months. Postoperative panoramic radiograph and CT showed the right mandibular angle resorption and coronoid process regeneration. There was no recurrence of mandibular osteomyelitis 7 years after surgery.


Assuntos
Doenças Mandibulares , Osteomielite , Periostite , Adolescente , Regeneração Óssea , Feminino , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/cirurgia , Osteomielite/diagnóstico por imagem , Osteomielite/cirurgia
13.
Oral Radiol ; 37(2): 251-255, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-32419102

RESUMO

OBJECTIVE: The purpose of this study was to reevaluate preoperative computed tomography lymphography (CTL) and enhanced CT images during follow-up to clarify whether SLNs enhanced by CTL were identified accurately before primary surgery with sentinel lymph node biopsy (SLNB) for clinically N0 early oral cancer. METHODS: Thirty two early oral cancer patients without cervical lymph node metastasis were enrolled in this study. To clarify whether SLNs enhanced by CTL were identified accurately before primary surgery with SLNB, we reevaluated preoperative CTL and enhanced CT images during follow-up in all patients. RESULTS: SLNs were detected by CTL in 31 of 32 patients (96.9%). During follow-up after primary surgery with SLNB, 4 of 27 patients without SLN metastasis had occult neck metastasis. Of the 4 patients, only 1 patient with cancer of floor of the mouth had overlooking of SLN, and the overlooking rate of SLN was 3.1%. The overlooked small SLN (2.9 × 3.3 × 3.1 mm) was located at contralateral level IB. The CT numbers before, 2, 5, 10 min after iopamidol injection, were 33 HU, 37 HU, 62 HU, 52 HU, respectively. The CT numbers of overlooked SLN 5 and 10 min after the injection was higher than CT images scanned before the iopamidol injection. CONCLUSIONS: The enhancement of SLNs in CTL images after iopamidol injection should be compared sufficiently with CT images before iopamidol injection to avoid overlooking of SLNs in N0 early oral cancer.


Assuntos
Neoplasias Bucais , Linfonodo Sentinela , Humanos , Linfografia , Neoplasias Bucais/diagnóstico por imagem , Linfonodo Sentinela/diagnóstico por imagem , Biópsia de Linfonodo Sentinela , Tomografia Computadorizada por Raios X
14.
Oral Radiol ; 37(1): 125-129, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32440975

RESUMO

We report a rare case of schwannoma arising from the sublingual glandular branch of the lingual nerve radiologically masquerading as sublingual gland tumor. A 42-year-old female was referred to our department with a painless swelling in the left submandibular region. Contrast-enhanced computed tomography showed a well-circumscribed, heterogeneous low-density tumor with cystic change in the left sublingual region. Magnetic resonance imaging showed a well-circumscribed, heterogeneous sublingual tumor with low-signal intensity on T1-weighted image and high-signal intensity in T2-weighted image. The lesion was diagnosed radiologically as benign sublingual gland tumor. The patient underwent resection of sublingual gland tumor under general anesthesia. There was no definitive continuity between the tumor and the sublingual gland, and the tumor originated from sublingual glandular branch of the lingual nerve. Pathological examination of the specimen showed schwannoma with highly cellular areas (Antoni A) and hypocellular areas (Antoni B). The postoperative course was uneventful without lingual nerve palsy, and there was no recurrence 4 years after surgery.


Assuntos
Neurilemoma , Neoplasias da Glândula Sublingual , Adulto , Feminino , Humanos , Nervo Lingual/diagnóstico por imagem , Nervo Lingual/cirurgia , Imageamento por Ressonância Magnética , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Glândula Sublingual/diagnóstico por imagem , Glândula Sublingual/cirurgia , Neoplasias da Glândula Sublingual/diagnóstico por imagem , Neoplasias da Glândula Sublingual/cirurgia
16.
J Clin Med ; 9(9)2020 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-32847061

RESUMO

Our objective was to evaluate the seven-year results of photofunctionalized implants placed in regular, complex, and cancer-related cases. This study was a prospective, single-center study. Photofunctionalization was performed immediately prior to implantation with Ultraviolet (UV) light for 15 minutes. The success rate of each patient group and the influential factors on implant failure were analyzed. Seventy implants in 16 patients were included. Four implants were left submerged (sleep). The seven-year success rate of 30 implants in regular cases and 21 implants in complex cases was 100%. The success rate of 15 implants in cancer-related cases was 22.2%, in which implants were placed in resection or reconstructed sites with or without pre- or postoperative radiation history. Implant stability quotient (ISQ) values increased at second-stage surgery by 3.2 in regular cases and by 21.9 in complex cases, while it decreased by -3.5 in cancer cases. Multivariate analysis indicated that bone quality, location, and cancer resection significantly influenced implant failure. A very reliable seven-year success rate was obtained by UV-photofunctionalized implants in regular and complex cases, even with significant site-development procedures. However, the success rate in cancer cases was significantly and remarkably lower, suggesting remaining challenges of pathophysiologically compromised conditions, such as bone resection, segmental defect, and radiation.

20.
Ear Nose Throat J ; : 145561320937080, 2020 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-32579433
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