Morbilidad de los defectos bucomaxilofaciales en Sancti Spíritus. Noviembre 1998-diciembre 2010 / Morbidity of the buccomaxillofacial defects in Sancti Spíritus. November 1998-December 2010

Fundamento: El conocimiento de la morbilidad de los defectos bucomaxilofaciales brinda información valiosa que permite ser utilizada en pos de garantizar una atención integral a los pacientes con estos defectos. Objetivo: Determinar la morbilidad y caracterizar los defectos bucomaxilofaciales en el Hospital General Provincial Camilo Cienfuegos. Sancti Spíritus. Metodología: Se realizó un estudio descriptivo de corte transversal, en una población constituida por 475 pacientes que recibieron tratamiento en el Departamento de Prótesis Bucomaxilofacial entre noviembre de 1998 y diciembre de 2010. Se utilizaron métodos del nivel teórico, empírico y estadístico. Resultados: Predominó el grupo de edad de 60 y más años (38,1 %) y el sexo masculino (75,4 %). Prevaleció el defecto ocular (73,9 %) y el factor etiológico traumático (56,6 %). La prótesis más requerida por años fue la ocular con 351 y el año más representativo el 2001. Conclusiones: Se observó un predominio en el grupo de edad de 60 y más años, y el sexo masculino. En cuanto a la localización el defecto ocular resultó ser el más representado, en casi las tres cuartas partes de la población, con un predominio del trauma como factor causal. El tipo de prótesis más demandada fue la ocular y su cantidad se comportó de forma irregular en los diferentes años.

Background: The knowledge of the morbidity of the buccomaxillofacial defects offers valuable information that allows to be used after guaranteeing an integral attention to the patients with these defects. Objective: To determine the morbidity and to characterize the buccomaxillofacial defects in the Provincial General Hospital Camilo Cienfuegos. Sancti Spíritus. Methodology: It was carried out a descriptive study of traverse cut, in a population constituted by 475 patients that received treatment in the Department of buccomaxillofacial Prosthesis between November 1998 and December 2010. The theoretical, empiric and statistical level methods were used. Results: Prevailed the group of age from 60 and more years old (38,1 %) and the masculine sex (75,4 %). the ocular defect prevailed (73,9 %) and the traumatic etiologic factor (56,6 %). The prosthesis more required per years was the ocular one with 351 and the most representative year was 2001. Conclusions: Was observed a prevalence in the group of age from 60 years old and more, and the masculine sex. As for the localization the ocular defect turned out to be the most represented one, in almost fourth three parts of the population , with a prevalence of the trauma like causal factor. The ocular prosthesis was most demanded and its quantity behaved in an irregular way in the different years.

Management of difficult recipient vessel preparation in microsurgical reconstruction for oral and maxillofacial defects with free flaps / 中华显微外科杂志

Objective To investigate the management of difficult recipient vessel preparation in microsurgical reconstruction for oral and maxillofacial defects with free flaps and to assess the clinical outcome.Methods A total number of 739 patients with oral and maxillofacial defects underwent consecutive free flap reconstruction with 761 free flaps from May,2012 to May,2015.There were 37 patients who could not find or lack of proper recipient vessels for microvascular anastomosis during operation.Among them,22 were recurrent oral cancer after tumor ablation,10 of them undrewent post-operative radiotherapy;5 were second primary oral cancer,7 diagnosed with osteoradionecrosis,and 3 suffered from oral and maxillofacial defect and deformity caused by trauma or inflammation.Forty free flaps including 23 anterolateral thigh flaps (ALT),10 fibular flaps and 7 radial forearm flaps were harvested.Methods and techniques used during the operation,instant patency rate after anastomosis,the overall survival rate of free flaps,and post-operative complications were recorded.Results Ninety-one anastomoses were performed between 87 pairs of vessels in 37 patients.Fifty recepient vessels were located on ipsilateral side of neck,and the most frequently used recipient vessels were those preserved or not being damaged in former operation and radiation,former transferred free flap vascular pedicles and residual ends of the ligated vessels.Thirty-seven recepient vessels were found on the contralateral side of neck.Thirty-one cases of long-pedicle flap harvesting,2 cases of vein and artery grafting,4 cases of vessel transposition,5 cases of phleboplasties,9 cases of end-to-side anastomoses,and 1 case of flow-through technique were applied in recipient vessels preparation alone or in combination.The patency rate of anastomosis during operation was 100％ and the overall survival rate of free flaps was 97.5％.Conclusion Recurrent oral cancer after tumor ablation,second primary oral cancer,osteoradionecrosis and deformity caused by trauma and inflammation are the main reasons of unsuitable recipient vessel conditions in microsurgical reconstruction for oral and maxillofacial defects.Methods including long-pedicle flap harvesting,venous grafting,vessel transposition,phleboplasty,end-to-side anastomosis and flow-through technique applied alone or in combination are still reliable choices for management of neck difficult recipient vessel preparation and anastomosis.

Fabrication of Hollow Bulb Obturator with Maxillary Partial Denture for Congenital Cleft Palate Defect.

Rehabilitation of congenital cleft palate defect improves the quality of life for the patient as normal as possible. Obturator size depends on defect’s size and volume. The prosthesis should be easy to handle, simple to maintain, biocompatible, light in weight and conventional for future adjustments. This case report describes a cleft palate patient, which was rehabilitated with a hollow bulb obturator.