Remarkable Triple Pleomorphic Adenoma Affecting both Parotid and Submandibular Glands.

The objective of this article is to present the first case reported in the literature of metachronous pleomorphic adenoma of bilateral parotid glands and submaxillary gland. The authors report the case of a 27-year-old female with metachronous mixed tumors in her right parotid and submandibular glands. The patient has no history of previous radiotherapy. All three lesions were diagnosed by fine-needle aspiration. The histopathologic evaluation of all three major salivary gland masses demonstrated pleomorphic adenomas, with no occult malignancy observed on serial sections. The presentation of pleomorphic adenomas in the parotids and submandibular glands probably represents three unrelated primary sites of tumor, yet the possibility of metastasis from one gland to the other cannot be excluded.

Fibroscopic findings in patients following maxillary osteotomies in orthognathic surgery.

OBJECTIVE: To evaluate the intranasal complications in patients submitted to maxillary Le Fort osteotomy within the orthognathic evaluation through flexible fibroscope, method which is safety, reliable and minimally invasive. MATERIALS AND METHODS: A prospective, systematic non-randomized study is presented with a series of 47 patients who underwent a Le Fort I maxillary osteotomy due to dentofacial deformity between January 2008 and December 2008. The patients who were included underwent an evaluation of nasal respiratory function using a questionnaire designed for this objective, after which a fibroscopic examination was carried out. RESULTS: With regards to the results of the NOSE questionnaire, 4/47 patients had Grade 2 nasal obstruction before the surgery. After the intervention, three improved to a 0-1 grade. 3/47 patients reported snoring during sleep without OSAS that was not modified as a result of the surgery. 2/47 patients presented with sequelae regarding the deviation of the septum, and 1/47 had a luxation of the anterior nasal spine that had not been recorded before the orthognathic surgery. The presence of synechiae was observed in 3/47 cases. A septal perforated mucosa was found in the IV area of the nasal septum. Hypertrophy of the lower turbinate was observed in 4/47 cases. CONCLUSION: The fibroscope procedure is minimally invasive and it does not require local anesthesia or sedation, and it allows the surgeon to carry out an immediate and exhaustive evaluation, on an outpatient basis, of possible septal and nasal sequelae in patients undergoing orthognathic surgery.

Doble injerto microvascularizado de peroné para reconstrucción bilateral mandibular por osteorradionecrosis / Double-barrel microvascularised fibular graft for bilateral mandibular reconstruction due to osteoradionecrosis

La osteorradionecrosis mandibular supone una complicación grave del tratamiento radioterápico, que a menudo origina una seria deformidad facial. La dificultad para la masticación, la articulación y la deglución son también frecuentes. A pesar de los avances realizados en la última década en radioterapia para tumores de la cabeza y el cuello, las complicaciones por osteorradionecrosis aún se producen. La indicación para una cirugía radical no está claramente definida, pero esta modalidad de tratamiento debe instaurarse cuando las medidas conservadoras han fracasado o cuando prevalece la necrosis ósea y de partes blandas. Las fracturas patológicas o fístulas persistentes son claros indicadores para un abordaje radical. En este artículo se presenta un caso de osteorradionecrosis bilateral mandibular tratada con amplia extirpación quirúrgica y reconstrucción en dos tiempos con dos injertos microvascularizados de peroné(AU)

Osteoradionecrosis of the mandible is a serious complication of radiotherapy that often leads to severe facial deformity. Difficulties in mastication, articulation, and swallowing are also common. Despite major improvements in radiation therapy of head and neck cancers during the last decade, osteoradionecrosis complications still occur. The indication for radical surgery is not clearly defined, but this kind of treatment should only be instituted when conservative methods fail or when severe bone and soft-tissue necrosis prevails. Pathological fractures or persistent fistulas are strong indications for a more radical surgical approach. This article reports a case of bilateral osteoradionecrosis of the mandible treated with radical escision and reconstruction in two stages with two fibular osteoseptocutaneous free flaps(AU)