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1.
J Oral Maxillofac Surg ; 68(10): 2452-8, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20598416

RESUMO

PURPOSE: The carotid sheath has not been adequately assessed in the literature as a potential site of neck recurrence. The purpose of this prospective study was to investigate the histopathologic characteristics of the carotid sheath in patients with oral cancer, in an effort to clarify whether it is essential or redundant to include the carotid sheath in the neck dissection specimen. PATIENTS AND METHODS: A total of 29 patients underwent 32 selective neck dissections in the Department of Oral and Maxillofacial Surgery at "Evangelismos" General Hospital of Athens, Greece. Twenty-six unilateral and 3 bilateral neck dissections were performed. The carotid sheath specimens were examined to identify possible traces of metastatic disease. The existence of lymphatic vessels and the possible presence of cancer cells within their lumen was also investigated. RESULTS: Light microscopy of the 32 carotid sheath specimens showed that there was no evidence of tumor invasion. Immunohistochemical evaluation showed an abundance of lymphatic vessels in the carotid sheath with no evidence of microscopic intraluminal metastatic emboli. CONCLUSIONS: There was no evidence of carotid sheath invasion or presence of intraluminal lymphatic tumor emboli. Evidence of extracapsular spread warrants carotid sheath excision. Our findings suggest that if no extracapsular spread is present, there is no need to perform a tedious dissection of the carotid sheath. Preserving the carotid sheath adds protection to the neurovascular bundle, cuts operating time, and avoids possible injury to the major vessels and vagus nerve, as well as stimulation of the carotid body.


Assuntos
Carcinoma de Células Escamosas/secundário , Fáscia/patologia , Neoplasias Bucais/patologia , Esvaziamento Cervical/métodos , Idoso , Artéria Carótida Primitiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos
2.
J Craniomaxillofac Surg ; 32(6): 350-3, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15555516

RESUMO

AIM: The purpose of this study was to evaluate the adequacy of partial superficial parotidectomy and tumour enucleation in the surgical management of patients with pleomorphic adenoma of the parotid. MATERIAL AND METHODS: A total of 62 patients were treated for pleomorphic adenoma of the parotid during the years 1995-1999; 17 patients were treated with conventional superficial parotidectomy, whereas 42 patients were subjected to partial superficial parotidectomy. In three patients, tumour size and facial nerve proximity essentially resulted in enucleation of the parotid mass. In partial superficial parotidectomy, only the tumour-bearing area of the gland parenchyma was excised with identification of the main trunk and preservation of the facial nerve division that was adjacent to the tumour site with no need for more extensive facial nerve dissection. RESULTS: There was no incidence of recurrence or facial nerve injury in our group of patients. The incidence of Frey's syndrome was 4.8%.


Assuntos
Adenoma Pleomorfo/cirurgia , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Adulto , Idoso , Nervo Facial/patologia , Nervo Facial/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Glândula Parótida/inervação , Complicações Pós-Operatórias , Estudos Retrospectivos , Sudorese Gustativa/etiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-14716259

RESUMO

Renal osteodystrophy is a common long-term complication of end-stage renal disease. Involvement of the jaws is common and radiographic alterations are often one of the earliest signs of chronic renal disease. However, marked enlargement of the jaws is a rare complication of renal osteodystrophy. A case of localized asymptomatic enlargement of the mandible in a 38-year-old woman with chronic renal failure is presented. The clinical, radiographic, and histological findings were consistent with renal osteodystrophy. To our knowledge, this is the third case of localized mandibular enlargement of renal osteodystrophy reported in the English-language literature.


Assuntos
Distúrbio Mineral e Ósseo na Doença Renal Crônica/complicações , Doenças Mandibulares/etiologia , Adulto , Matriz Óssea/patologia , Diagnóstico Diferencial , Feminino , Fibroblastos/patologia , Humanos , Falência Renal Crônica/complicações , Doenças Mandibulares/patologia , Osteíte/patologia
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