Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.210
Filtrar
1.
Cient. dent. (Ed. impr.) ; 18(1): 7-13, feb. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-201765

RESUMO

El quiste dentígero se considera un quiste odontogénico del desarrollo que está asociado a la corona de un diente no erupcionado. Suele ser asintomático y carecer de clínica asociada por lo que frecuentemente se trata de un hallazgo casual. Sin embargo puede haber situaciones en los que el quiste afecte a estructuras próximas y/o alcance gran tamaño. Se presenta un caso de un paciente de 65 años que acude derivado por su odontólogo general al constatar la presencia de una lesión radiotransparente de gran tamaño en el cuarto cuadrante. Se realizó un abordaje mediante tres cavidades de la lesión para su completa remoción, así como del cordal incluido asociado a la misma. Por último se colocó una mini placa como refuerzo


The dentigerous cyst is considered an odontogenic developmental cyst that is associated with the crown of a non-erupted tooth. It is usually asymptomatic and has no associated clinic, so it is usually a casual fi nding. However, it can affect nearby structures and / or reach large size. A case of a 65-year-old patient is presented who is referred by his general dentist to verify the presence of a large radiolucent lesion in the fourth quadrant. An approach was made using 3 cavities of the lesion for its complete removal, as well as the included wisdom tooth associated with it. Finally, a mini fi xing plate was placed as reinforcement


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Cisto Dentígero/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Dente não Erupcionado/cirurgia , Placas Ósseas , Procedimentos Cirúrgicos Ortognáticos/métodos , Resultado do Tratamento
2.
Biomed Res Int ; 2021: 8840598, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33506039

RESUMO

The present investigation is aimed at systematically analyzing the recent literature about the innovative scaffold involved in the reconstructive surgeries by applying growth factors and tissue engineering. An extensive review of the contemporary literature was conducted according to the PRISMA guidelines by accessing the PubMed, Embase, and Scopus Elsevier databases. Authors performed the English language manuscript research published from 2003 to 2020. A total of 13 relevant studies were included in the present review. The present systematic review included only papers with significant results about correlation between scaffold, molecular features of growth factor, and reconstructive surgeries in oral maxillofacial district. The initial research with filters recorded about 1023 published papers. Beyond reading and considering of suitability, only 42 and then 36 full-text papers were recorded for the revision. All the researches recorded the possibility of using growth factors on rebuilding atrophic jaws. Different growth factors like morphogenetic factors, cytokines, and inflammatory ones and their application over different scaffold materials were recorded. Further investigations should be required in order to state scientific evidence about a clear advantage of applying tissue engineering for therapeutic purpose.


Assuntos
Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Procedimentos Cirúrgicos Bucais/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Engenharia Tecidual/métodos , Humanos
4.
Laryngoscope ; 131(2): 312-318, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32379355

RESUMO

OBJECTIVES/HYPOTHESIS: For early-stage oral tongue carcinoma and carcinoma in situ (ESOTCCIS), we evaluated patient-reported quality-of-life (QOL) outcomes following resection with primary closure (R-PC). STUDY DESIGN: Retrospective review at an academic cancer center. METHODS: Thirty-nine ESOTCCIS patients (Tis, T1, T2) who underwent R-PC without radiation completed the University of Washington Quality of Life Questionnaire Version 4 (UW-QOL) at least 6 months since R-PC (mean = 2.39 years; range = 0.5-6.7 years). We compared UW-QOL scores for pain, swallowing, chewing, speech, and taste to established normative population scores. Multivariable regression analysis evaluated factors associated with QOL impairment. RESULTS: ESOTCCIS patients who underwent R-PC in comparison to the normative population reported significantly worse mean speech (87.7 vs. 98, P < .001) and taste (85.6 vs. 95, P = .002) scores and no significant differences in mean pain (91.7 vs. 86, P = .96), swallowing (100 vs. 98, P = .98), chewing (97.4 vs. 94, P = .98) scores. For speech and taste, 59% (23/39) reported no postoperative change from baseline, whereas 41% (16/39) and 35.9% (14/39) reported mild impairment, respectively. Overall, postoperative QOL was reported as good, very good, or outstanding by 87.2% (34/39). Higher American Society of Anesthesiologists class, cT1 compared to CIS, and ventral tongue involvement were independently associated with worse speech. Age < 60 years was independently associated with worse taste. CONCLUSIONS: ESOTCCIS patients who undergo R-PC without radiation can expect long-term swallowing, chewing, and pain to be in the normative range. Although a majority of patients can expect to achieve normative speech and taste outcomes, R-PC carries the risks of mild speech and/or taste impairments. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:312-318, 2021.


Assuntos
Carcinoma in Situ/psicologia , Carcinoma de Células Escamosas/psicologia , Procedimentos Cirúrgicos Bucais/psicologia , Qualidade de Vida , Neoplasias da Língua/psicologia , Centros Médicos Acadêmicos , Adulto , Idoso , Carcinoma in Situ/fisiopatologia , Carcinoma in Situ/cirurgia , Carcinoma de Células Escamosas/fisiopatologia , Carcinoma de Células Escamosas/cirurgia , Deglutição , Feminino , Humanos , Masculino , Mastigação , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais/métodos , Medição da Dor , Medidas de Resultados Relatados pelo Paciente , Período Pós-Operatório , Análise de Regressão , Estudos Retrospectivos , Índice de Gravidade de Doença , Fala , Inquéritos e Questionários , Paladar , Neoplasias da Língua/fisiopatologia , Neoplasias da Língua/cirurgia , Resultado do Tratamento
5.
Laryngoscope ; 131(1): E176-E183, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32239760

RESUMO

OBJECTIVE: To assess functional outcomes in patients treated by compartmental tongue surgery (CTS) and reconstruction for advanced oral tongue/floor-of-mouth cancer. STUDY DESIGN: Retrospective case series. METHODS: A retrospective cohort of patients (n = 48) treated by CTS and free flap reconstruction was prospectively evaluated concerning postoperative functional outcomes at different time points (6 months and 1 year). Swallowing was studied by videonasal endoscopic evaluation (VEES) and videofluoroscopy (VFS), testing various food consistencies and grading the results with the Donzelli scale. Speech articulation, lingual strength, and endurance were studied by phone call and Iowa Oral Performance Instrument (IOPI). Subjective tests (EORTC H&N35 and UWQOL) were administered. RESULTS: After 1 year, VEES showed a Donzelli scale of 67% level 1, 23% level 2, and 10% level 3. Vallecular pouch was present in 81% of patients. VFS showed levels 1, 2, and 3 in 42%, 25%, and 33%, respectively, with liquids (L); 48%, 19%, and 33%, with semi-liquids (SL); and 54%, 33%, and 13%, with semi-solids (SS). Vallecular pouch residue was present in 69% with L, 73% with SL, and 87% with SS. The mean number of words recognized at phone call was 56 of 75 (range, 27-74). IOPI showed a mean tongue strength of 19.2 kPa (range, 0-40), and a mean endurance of 16.2 seconds (range, 0-60). CONCLUSION: CTS does not significantly affect speech. Sub-clinical food aspiration and vallecular pouch are present in a significant proportion of patients, especially when adjuvant treatments are administered. Residual tongue strength is not affected when proper reconstruction is performed. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E176-E183, 2021.


Assuntos
Soalho Bucal , Neoplasias Bucais/cirurgia , Recuperação de Função Fisiológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais/métodos , Estudos Retrospectivos , Fatores de Tempo , Língua/fisiologia , Língua/cirurgia , Neoplasias da Língua/cirurgia , Resultado do Tratamento
6.
Surg Endosc ; 35(2): 921-927, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32691205

RESUMO

BACKGROUND AND AIMS: Transoral incisionless fundoplication (TIF) is an effective endoscopic treatment for refractory GERD with small or absent hiatal hernia (< 2 cm in length and width). The single-session laparoscopic hernia repair followed by transoral incisionless fundoplication (HH + TIF) aims to repair mechanical defects in the lower esophageal sphincter that leads to GERD in patients with hiatal hernias ≥ 2 cm. The procedure effectively treats GERD without causing added post-surgical dysphagia and gas bloating commonly associated with partial laparoscopic fundoplication. We aimed to assess patient satisfaction, symptom resolution, safety, and proton pump inhibitor use following the HH + TIF procedure. METHODS: Thirty-three patients underwent single-session laparoscopic hernia repair with intraoperative TIF using the EsophyX Z device (EndoGastric Solutions, Inc.) between June 2015 and June 2018. The presence of GERD and normal esophageal motility were confirmed with pH testing and manometry prior to the procedure. Data were collected on pre- and post-procedure symptoms, patient satisfaction, PPI use, and complications. Median post-procedure follow-up with symptom surveys was 9 months (11-29 months). RESULTS: Patients reported significant decreases in common GERD symptoms including heartburn, regurgitation, cough, and hoarse voice. Eighty-one percent (27/33) of patients were off daily PPIs. Ninety-four percent (31/33) of patients reported 75% or greater satisfaction with the procedure and outcomes. One patient had a superficial mucosal laceration after the procedure, likely due to vomiting, which was treated conservatively. CONCLUSIONS: The majority of patients reported 75% or greater satisfaction with the procedure and had an improvement in GERD symptoms as well as decreased PPI use. There were no serious adverse events.


Assuntos
Fundoplicatura/métodos , Herniorrafia/métodos , Laparoscopia/métodos , Procedimentos Cirúrgicos Bucais/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Resultado do Tratamento
8.
Rev. Ateneo Argent. Odontol ; 64(1): 28-35, 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1252444

RESUMO

El carcinoma de conductos salivales (CCS) es una neoplasia maligna primaria clínica y patológicamente distinta de las glándulas salivales. Debido a su rareza existe una falta de documentación exhaustiva en la literatura con respecto a sus características, manejo y resultados clínicos. En la presente publicación se presenta un caso de un paciente de sexo masculino de 74 años, que acudió al servicio de odontología del Hospital Interzonal General de Agudos Presidente Perón de Avellaneda. El resultado ecográfico arrojó a nivel submaxilar derecho una imagen nodular de aspecto solido que mide 25 x 24 mm Se le realizó la intervención quirúrgica y el resultado anatomopatológico confirmó el diagnóstico de carcinoma de conductos salivales, una de las neoplasias salivales más agresivas. En la actualidad, la muerte ocurre en 60 a 80% de los pacientes, por lo general dentro de los 5 años; alrededor del 33% desarrolla recidiva local y más del 50% metástasis a distancia, en sitios que incluyen pulmones, huesos, hígado, cerebro y piel (AU)


Salivary duct carcinoma (SDC) is a clinically and pathologically distinct primary malignant neoplasm of the salivary glands. Due to its rarity, there is a lack of exhaustive documentation in the literature regarding its characteristics, management, and clinical results. This publication presents a case of a 74-year-old male patient who attended the dentistry service of the Interzonal General Acute Hospital President Perón by Avellaneda. The ultrasound result revealed a nodular image at the right submaxillary level solid aspect measuring 25 x 24 mm. Surgical intervention was performed, and the pathological result confirmed the diagnosis of salivary duct carcinoma, one of the most aggressive salivary neoplasms. Currently, death occurs in 60% to 80% of patients, usually within 5 years; about 33% develop local recurrence and more than 50% distant metastases, at sites including the lungs, bones, liver, brain, and skin (AU)


Assuntos
Humanos , Masculino , Idoso , Neoplasias das Glândulas Salivares/cirurgia , Neoplasias das Glândulas Salivares/diagnóstico por imagem , Carcinoma/classificação , Argentina , Cuidados Pós-Operatórios , Recidiva , Biópsia , Neoplasias das Glândulas Salivares/mortalidade , Imuno-Histoquímica , Procedimentos Cirúrgicos Bucais/métodos , Unidade Hospitalar de Odontologia , Distribuição por Idade e Sexo , Metástase Neoplásica
9.
Am J Otolaryngol ; 42(1): 102793, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33130532

RESUMO

PURPOSE: Human papilloma virus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) treatment outcomes are re-defining management. Traditional margins, the role of extranodal extension (ENE) and adjuvant treatment intensity continue to be debated. This study aimed to determine the impact of margins, ENE and adjuvant therapy on survival following transoral robotic surgery (TORS). METHODS: Patients treated with TORS at an academic center were retrospectively identified (2013-2019). Survival outcomes were evaluated using Kaplan-Meier curves. RESULTS: 48 patients were included. 40 (83%) were male. Mean age was 61.2 years. 43 (90%) were stage I. 22 (45.8%) had ENE. 31 (65%) had margins >1 mm. 38 (79%) had indications for radiation therapy; 9 (24%) refused. Chemotherapy was recommended in 36 (75%) patients; 24 (67%) refused. Locoregional control was 98%, metastasis-free survival was 96%, and disease-specific survival was 100% at 5-years. Overall survival was 95%. CONCLUSIONS: Given the high survival rate seen after TORS, it is likely that margins, ENE and adjuvant treatment may not significantly contribute to outcomes.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Quimiorradioterapia Adjuvante , Margens de Excisão , Procedimentos Cirúrgicos Bucais/métodos , Neoplasias Orofaríngeas/cirurgia , Infecções por Papillomavirus/complicações , Procedimentos Cirúrgicos Robóticos/métodos , Adulto , Idoso , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/etiologia , Neoplasias Orofaríngeas/mortalidade , Neoplasias Orofaríngeas/patologia , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
10.
Medicine (Baltimore) ; 99(52): e23860, 2020 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-33350779

RESUMO

ABSTRACT: Malnutrition is common among patients who have oral cavity squamous cell carcinoma (OSCC), but its effect on the incidence of postoperative complications remains uncertain. Validated nutrition and complication assessment tools were used to evaluate the effects of nutrition on the likelihood of postoperative complications after curative surgery for OSCC.A retrospective study that spanned January 2014 to December 2018 enrolled 70 patients who received curative surgery for OSCC. Nutritional status before surgery was evaluated with the scored Patient-Generated Subjective Global Assessment (PG-SGA), and patients were classified as either well-nourished (rating A) or malnourished (ratings B and C). Complications 30 days after the operation were graded using Clavien-Dindo classification. The perioperative clinicopathological characteristics of the groups were compared, and risk factors for postoperative complications were identified through logistic regression.A total of 44 (62.8%) patients formed the malnourished group, and they tended to be older (P = .03), weigh less (P = .001), have lower Body Mass Index (P = .003), higher PG-SGA scores (P < .001), higher neutrophil-to-lymphocyte ratio (P = .034), more postoperative complications (P < .001), and longer hospital stays (P = .021). Major complications (Clavien-Dindo classification ≥ IIIa) were experienced by 18.5% (n = 13) of patients and were more common in the malnourished group (P = .007). Multivariate logistic regression demonstrated that PG-SGA score ≥4 was an independent risk factor for postoperative complications (hazard ratio = 4.929, P = .008).Malnutrition defined using the PG-SGA is an independent risk factor for postoperative complications of curative surgery in patients with OSCC. More prospective studies are warranted to confirm our findings.


Assuntos
Desnutrição , Estado Nutricional , Procedimentos Cirúrgicos Bucais/efeitos adversos , Complicações Pós-Operatórias , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/etiologia , Pessoa de Meia-Idade , Neoplasias Bucais/complicações , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Avaliação Nutricional , Procedimentos Cirúrgicos Bucais/métodos , Complicações Pós-Operatórias/classificação , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Medição de Risco , Fatores de Risco
11.
Plast Reconstr Surg ; 146(6): 1331-1339, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33234964

RESUMO

BACKGROUND: For the cleft surgeon, palatal fistulae after cleft palate repair remain a difficult problem, with a paucity of local tissue options to aid closure. Small clinical series have described the use of the buccal fat pad flap to repair palatal fistulae; however, there is no literature detailing the anatomical coverage of the flap. This study delineates the anatomy of the buccal fat pad flap to guide surgeons in patient selection and examines the residual buccal fat after flap harvest to provide new information with regard to possible effects on the donor site. METHODS: Buccal fat pad flaps were raised in 30 hemicadavers. The reach of the flap across the midline, anteriorly and posteriorly, was recorded. In 18 hemicadavers, the entire buccal fat pad was then exposed to determine the effects of flap harvest on movement and volume of the residual fat. RESULTS: All buccal fat pad flaps provided coverage from the soft palate to the posterior third of the hard palate and all across the midline. Approximately three-fourths of flaps would cover the mid hard palate. The flap constitutes 36 percent of the total buccal fat pad on average, and a series of retaining ligaments were identified that may prevent overresection. CONCLUSIONS: The buccal fat pad flap is a useful tool for coverage of fistulae in the soft palate to the posterior third of the hard palate. In most cases, it will also reach the middle third; however, it is not suitable for more anterior defects. On average, two-thirds of the buccal fat pad remains within the cheek after flap harvest, which may protect against unwanted alteration in aesthetics.


Assuntos
Bochecha/cirurgia , Fístula/cirurgia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Coleta de Tecidos e Órgãos/efeitos adversos , Sítio Doador de Transplante/cirurgia , Tecido Adiposo/transplante , Cadáver , Bochecha/anatomia & histologia , Estética , Estudos de Viabilidade , Fístula/patologia , Humanos , Procedimentos Cirúrgicos Bucais/métodos , Palato Duro/patologia , Palato Duro/cirurgia , Palato Mole/patologia , Palato Mole/cirurgia , Seleção de Pacientes , Retalhos Cirúrgicos/efeitos adversos , Retalhos Cirúrgicos/transplante , Coleta de Tecidos e Órgãos/métodos , Sítio Doador de Transplante/anatomia & histologia
12.
Afr J Paediatr Surg ; 17(1-2): 1-4, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33106444

RESUMO

Background: Presurgical nasoalveolar molding (PNAM) technique gave a new perspective to presurgical infant orthopedics. Nasal reconstruction presents a challenge for the plastic surgeons in case of patients with unilateral cleft lip and palate (UCLP). PNAM facilitates the reshaping of the nasal cartilage and molding of maxillary arch preoperatively. This therapy not only aids the surgical repair of lip but also enhances the overall postsurgical results with negligible postoperative scar. Aim: The aim of the study was to analyze nasal changes before and after PNAM in patients with complete UCLP. Materials and Methods: This was a retrospective review of 22 ULCP patients who underwent PNAM before lip surgeries. A series of standard basilar view photographs in 1:1 ratio were taken, and linear measurements were done directly on the photographs. Results: After PNAM therapy, there was highly significant increase in the nostril height, nostril dome height, and columella length (P < 0.001*) and highly significant reduction in the nostril width and nasal basal width (P < 0.001*). Conclusion: Significant improvement in the nasal symmetry was found after PNAM therapy in patients with complete UCLP.


Assuntos
Processo Alveolar/cirurgia , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Cuidados Pré-Operatórios/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fenda Labial/diagnóstico , Fissura Palatina/diagnóstico , Feminino , Humanos , Recém-Nascido , Masculino , Cartilagens Nasais/cirurgia , Moldagem Nasoalveolar , Nariz/cirurgia , Estudos Retrospectivos
13.
Int J Mol Sci ; 21(20)2020 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-33092073

RESUMO

The complex tissue engineering/regenerative medicine now represents a therapeutic reality applicable to various organic substrates, with the aim of repairing deficient tissues and restoring normal organ function. Among the possible specialized uses, in the dental field, the treatment of periodontal, pre- and peri-implant bone defects should be mentioned. Nowadays, in oral surgery, there are many surgical methods that can be used, despite that the literature still seems controversial regarding the actual advantages of their use. Surely, this work will bring to light the current clinical-surgical orientations and the different perspectives.


Assuntos
Regeneração Tecidual Guiada Periodontal/métodos , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Procedimentos Cirúrgicos Bucais/métodos , Medicina Regenerativa/métodos , Cicatrização/efeitos dos fármacos , Humanos
14.
BMJ Case Rep ; 13(10)2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33127696

RESUMO

Kimura's disease is a chronic inflammatory disorder involving subcutaneous tissue and locoregional lymph nodes of head and neck region, characterised by angiolymphoid proliferation. It is typically associated with peripheral eosinophilia, increased serum IgE and lymphadenopathy. Diagnosis is usually based on histopathological examination. Though various treatment modalities have been put forward, surgical management remains the first line of treatment, followed by systemic steroids application. This case report discusses the diagnostic dilemma and therapeutic management of a rare clinical presentation and management of oropharyngeal Kimura's disease in a young immunocompetent woman.


Assuntos
Doença de Kimura/diagnóstico , Linfonodos/patologia , Linfadenopatia/diagnóstico , Procedimentos Cirúrgicos Bucais/métodos , Orofaringe , Biópsia , Criança , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Doença de Kimura/complicações , Doença de Kimura/cirurgia , Linfadenopatia/etiologia , Linfadenopatia/cirurgia
15.
BMJ Case Rep ; 13(10)2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33122221

RESUMO

Foregut duplication cysts (FDCs) are rare malformations arising along primitively derived alimentary tract. Head and neck cases comprise 0.3% of all FDCs with 60% occurring in the oral cavity. We present a case of neonatal airway obstruction secondary to a prenatally diagnosed massive lingual FDC. Definitive treatment requires surgical excision. Histologically, the cysts are lined gastric and respiratory epithelium. FDC should be a consideration in prenatally diagnosed masses affecting the oral cavity.


Assuntos
Obstrução das Vias Respiratórias/etiologia , Cistos/complicações , Doenças da Língua/complicações , Língua/diagnóstico por imagem , Obstrução das Vias Respiratórias/diagnóstico , Obstrução das Vias Respiratórias/cirurgia , Biópsia , Cistos/congênito , Cistos/diagnóstico , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Procedimentos Cirúrgicos Bucais/métodos , Língua/cirurgia , Doenças da Língua/congênito , Doenças da Língua/diagnóstico , Ultrassonografia
16.
Acta otorrinolaringol. esp ; 71(5): 281-288, sept.-oct. 2020. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-195214

RESUMO

INTRODUCCIÓN: El objetivo del siguiente trabajo es la revisión de las modificaciones y avances en cirugía reconstructiva de tejidos blandos de la cavidad oral basándonos exclusivamente en los principales colgajos que dependen de arterias nominadas del sistema de la arteria facial. MÉTODOS: Revisión de la literatura y la experiencia propia respecto a reconstrucciones de cavidad oral basadas en colgajos del sistema de la arteria facial. DISCUSIÓN: La reconstrucción de la cavidad oral basada en colgajos dependientes del sistema de la arteria facial ofrece resultados satisfactorios y permite realizar reconstrucciones limitadas evitando la utilización de colgajos pediculados regionales o de colgajos libres. CONCLUSIONES: El conocimiento de las opciones reconstructivas utilizando el sistema de la arteria facial en cirugía de la cavidad oral permitirá a los cirujanos de cabeza y cuello ampliar las opciones de reconstrucción, adaptar de forma efectiva las reconstrucciones a los defectos quirúrgicos, permitiendo un abordaje de alta calidad, seguro y con menor consumo de recursos


INTRODUCTION: to review the modifications and advances in reconstructive surgery of the soft tissues of the oral cavity exclusively based on flaps that depend on the facial artery system. METHODS: review of the literature regarding oral cavity reconstructions based on main facial artery system flaps. DISCUSSION: The reconstruction of the soft tissues of the oral cavity, based on facial artery system flaps, offers satisfactory results and allows limited reconstructions avoiding the use of pedicled regional flaps or free flaps. CONCLUSIONS: Knowledge of reconstructive options using the facial artery system in oral cavity surgery allows expanding reconstructive options for head and neck surgeons, enabling safe, high quality and effective reconstructions, with limited resources consumption


Assuntos
Humanos , Cervicoplastia/métodos , Retalhos Cirúrgicos , Face/irrigação sanguínea , Procedimentos Cirúrgicos Bucais/métodos , Orofaringe/cirurgia , Artérias/cirurgia , Mucosa Bucal/cirurgia , Carcinoma de Células Escamosas/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Resultado do Tratamento
17.
Niger J Clin Pract ; 23(9): 1260-1265, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913166

RESUMO

Backgound: There are many methods used to alleviate edema, trismus, and pain after impacted third molar (3M) removal, one of which is Kinesio Taping (KT). Aims: This study aimed to evaluate the effectiveness of Kinesio Taping with Web Strip technique on postoperative morbidity after impacted mandibular 3M extraction. Methods: The study employed a split-mouth and controlled randomized clinical trial design. A total of 60 patients were scheduled for surgical extractions of bilateral lower 3Ms. They were randomly divided into two groups, and KT was applied to one group while the others was determined as a control group without KT application. Tape was applied directly after surgery and maintained for postoperative (post-op) 7 days. Pain intensity was recorded subjectively using a Visual Analogue Scale (VAS). Pain and analgesic usage were recorded on the post-op 1st, 2nd, 3rd, and 7th days. Trismus was evaluated before the surgery and on the post-op 2nd and 7th days. Facial edema was analyzed on the post-op 2nd and 7th days by VAS and by measuring the lengths of three lines using a flexible plastic tape measure. Results: VAS pain scores were statistically lower in the KT group on the post-op 1st, 3rd and 7th days. Total analgesic usage was also significantly lower in the KT group. On the post-op 2nd day, measurement of the lengths of three lines showed a statistically less edema in the KT group. Similar results were obtained from the measurement of edema using VAS. Maximum mouth opening was statistically higher in the KT group on the post-op 2nd and 7th day. Conclusion: KT with the web strip technique should be considered more economic and less traumatic than other approaches, as it is free from systemic side effects and is a simple method to carry out to decrease morbidity.


Assuntos
Fita Atlética/estatística & dados numéricos , Mandíbula/cirurgia , Dente Serotino/cirurgia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Dor Pós-Operatória/reabilitação , Trismo/reabilitação , Adolescente , Adulto , Edema/epidemiologia , Edema/etiologia , Edema/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Procedimentos Cirúrgicos Bucais/métodos , Medição da Dor , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/reabilitação , Período Pós-Operatório , Resultado do Tratamento , Trismo/epidemiologia , Trismo/etiologia , Escala Visual Analógica , Adulto Jovem
18.
Rev. cuba. invest. bioméd ; 39(3): e676, jul.-set. 2020. graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1138938

RESUMO

Introducción: La profilaxis antibiótica es controvertida, además que su uso inapropiado expone a los pacientes en riesgo de reacciones adversas y desarrollo de resistencia bacteriana. Objetivo: Realizar una revisión sistemática de ensayos clínicos aleatorizados que evaluaron le eficacia de la profilaxis antibiótica en la reducción de infecciones posoperatorias luego de la extracción de terceros molares impactados. Métodos: Fueron utilizadas las bases de datos ScienceDirect, Clinical trials.gov y Scopus para ubicar ensayos clínicos. Las variables primarias incluyeron: presencia de infecciones posoperatorias (de la herida y/o alveolitis), reacciones adversas, trismo y dolor. Se realizó un metaanálisis con los estudios homogéneos a través del análisis de efectos aleatorios. El riesgo de sesgo de los ensayos incluidos fue evaluado a través de la guía Cochrane. El riesgo relativo global fue calculado utilizando el enfoque del inverso de la varianza con el método de efectos aleatorios. Resultados: Fueron analizados cualitativamente 14 ensayos clínicos y 9 cuantitativamente. De un total de 874 pacientes, 49 (5,6 por ciento) presentaron infecciones posoperatorias (16/446 para el grupo experimental y 33/428 para el grupo placebo). El metaanálisis arrojó un riesgo relativo global de 0,5 (IC 95 por ciento: 0,27-0,94). El riesgo de sesgo para los estudios que utilizaron solo amoxicilina como medida profiláctica fue de 0,53 (IC 95 por ciento: 0,27-1,03). Las principales reacciones adversas incluyeron: diarreas, reacciones gastrointestinales, fiebre y dolor gástrico. Conclusiones: Los antibióticos sistémicos administrados antes de la cirugía fueron eficaces para reducir las frecuencias de aparición de infecciones posoperatorias luego de la extracción de terceros molares impactados(AU)


Introduction: Antibiotic prophylaxis is controversial, and its inappropriate use exposes patients to the risk of adverse reactions and the development of bacterial resistance. Objective: Carry out a systematic review of randomized clinical trials evaluating the efficacy of antibiotic prophylaxis for the reduction of postoperative infections after extraction of impacted third molars. Methods: The search for clinical trials was conducted in the databases ScienceDirect, Clinicaltrials.gov and Scopus. The primary variables considered were presence of postoperative infections (of the wound and/or alveolitis), adverse reactions, trismus and pain. A meta-analysis was made of homogeneous studies applying the random effects model. The risk of bias in the trials included was evaluated using the Cochrane guide. The inverse variance approach and the random effects method were used for estimation of the global relative risk. Results: Fourteen clinical trials were analyzed qualitatively and 9 quantitatively. Of the total 874 patients, 49 (5.6 percent:) developed postoperative infections (16 / 446 for the experimental group and 33 / 428 for the placebo group). The meta-analysis found a global relative risk of 0,5 (CI 95 percent: 0,27-0,94). Bias risk for studies using only amoxicillin as a prophylactic measure was 0,53 (CI 95 percent:: 0,27-1,03). The main adverse reactions were diarrhea, gastrointestinal reactions, fever and abdominal pain. Conclusions: The systemic antibiotics administered before the surgery were effective to reduce the frequency of appearance of postoperative infections after extraction of impacted third molars(AU)


Assuntos
Humanos , Infecção da Ferida Cirúrgica/prevenção & controle , Antibioticoprofilaxia/métodos , Dente Serotino/cirurgia , Procedimentos Cirúrgicos Bucais/métodos
19.
PLoS One ; 15(8): e0236981, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810135

RESUMO

This study aimed to assess the dosage and types of antibiotics prescribed in oral implant surgery, compare them among the different subpopulations (country and prescription regimens) and against the evidence-based recommended dosage: a 2-gram single preoperative dose of amoxicillin. A meta-analysis of cross-sectional surveys was conducted, which reports the overall dosage (and type) of antibiotics prescribed in combination with implant placement. PubMed, Cochrane, Science, Direct, and EMBASE via OVID were searched until April 2019. Three reviewers independently undertook data extraction and risk of bias assessment. The outcome variable was set on the average of prophylactic antibiotics prescribed per oral implant surgery. Overall, 726 participants from five cross-sectional surveys, representing five different countries were finally included. Amoxicillin was the most prescribed antibiotic. On average, 10,724 mg of antibiotics were prescribed per implant surgery. This average was significantly (p<0.001) higher than 2,000 mg. Overall, amoxicillin doses were significantly higher than 2,000 mg (9,700 mg, p<0.001). All prescribed amoxicillin regimens independently contained more than 2,000 mg, including those comprising only preoperative amoxicillin (2,175 mg, p = 0.006). Exclusive preoperative antibiotic regimens were the only subgroup with prescription dosages below this threshold (p = 0.091). Significant variations in antibiotic prescriptions were found among different countries and antibiotic regimens (p<0.001). In conclusion, the average dose of antibiotics prescribed per oral implant surgery was larger than the evidence-based recommended dose in healthy patients and straightforward conditions. In addition, variations in the average antibiotic dosages were found among different countries and prescription regimens.


Assuntos
Antibacterianos/administração & dosagem , Antibioticoprofilaxia/métodos , Implantes Dentários , Procedimentos Cirúrgicos Bucais/métodos , Amoxicilina/administração & dosagem , Estudos Transversais , Odontologia Baseada em Evidências , Humanos , Inquéritos e Questionários
20.
Medicine (Baltimore) ; 99(31): e21537, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756204

RESUMO

In head and neck surgery where the oropharyngeal area is the operative field, postoperative respiratory depression and upper airway obstruction are common. Therefore, supplemental oxygen is administered to prevent severe postoperative early hypoxemia. However, a high concentration of oxygen increases the likelihood of secondary complications, such as carbon dioxide (CO2) narcosis. Nasal high-flow (NHF) therapy generates high flows (≤60 L/min) of heated and humidified gas delivered via nasal cannula and provides respiratory support by generating positive airway pressure, clearance of dead space and reduction of work of breathing. This study aims to determine whether the postoperative hypoxemia and hypercapnia can be prevented by NHF without the requirement of supplemental oxygen. The study will recruit adult patients undergoing planned oral surgery under general anesthesia at Nagasaki University Hospital. It is a randomized parallel group comparative study with 3 groups: NHF with room air only and no supplemental oxygen, no respiratory support, and face mask oxygen administration. The study protocol will begin at the time that the patient is returned to the general ward and will finish 3 hours later. The primary endpoint is the time-weighted average of transcutaneous O2 over the 180 minutes and secondary endpoints are the time-weighted average of transcutaneous CO2 (tcpCO2), SpO2, and respiratory rate, incidence rate of marked hypercapnia (tcpCO2 ≥60 mm Hg for 5 minutes or longer), incidence rate of moderate hypercapnia (tcpCO2 ≥50 mm Hg for 5 minutes or longer) and the percentage of time that SpO2 is <90%. Included also is a group in which the postoperative management is performed only by spontaneous breathing without performing respiratory support such as oxygen administration, to investigate the efficacy and necessity of conventional oxygen administration. This exploratory study will investigate the use of NHF without supplemental oxygen as an effective respiratory support during the acute postoperative period. TRIAL REGISTRATION:: The study was registered the jRCTs072200018. URL https://jrct.niph.go.jp/latest-detail/jRCTs072200018.


Assuntos
Anestesia Geral/métodos , Hipercapnia/prevenção & controle , Hipóxia/prevenção & controle , Procedimentos Cirúrgicos Bucais/métodos , Oxigenoterapia/métodos , Cânula , Humanos , Oxigênio/sangue , Oxigenoterapia/efeitos adversos , Período Pós-Operatório , Projetos de Pesquisa
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...