Prevalencia de la exóstosis del conducto auditivo externo entre practicantes de surf y bodyboard en la costa central de Chile / Prevalence of auditory canal exostosis among surfers and bodyboarding athletes of the central Chilean coast

La exóstosis del conducto auditivo externo (ECAE), también conocida como oído de surfista, es una alteración del tejido óseo del oído externo, principalmente causada debido a la sobrexposición al frío. Considerando que los practicantes de deportes acuáticos como el surf y bodyboard de las costas del pacífico sur se exponen a aguas con temperaturas entre 12-16 °C, se busca determinar, en este estudio, la prevalencia y grado de ECAE en practicantes de surf y bodyboard de las localidades de Reñaca y Concón durante el año 2018. Se realizó una evaluación del CAE mediante video-otoscopía a 67 personas (134 oídos) practicantes de surf y bodyboard de las playas de Reñaca y Concón, y se les aplicó un cuestionario respecto a sus hábitos de práctica. Como resultado, se observó una prevalencia de ECAE del 77,6%, siendo el 61,2% ECAE bilateral y el 16,4% ECAE unilateral. Se pudo determinar, además, que el 62,3%de los participantes no usa protecciones. A partir de estos hallazgos, es posible concluir que existe una alta prevalencia de la ECAE en practicantes de surf y bodyboard en las costas centrales chilenas, lo que debería alertar tanto a la población practicante como a profesionales de la salud auditiva con el fin de promover una vida saludable en esta población.

External auditory canal exostosis (ECAE), also known as surfer's ear, is an alteration of the bone tissue of the external ear, mainly caused due to overexposure to cold. Considering that those who practice water sports such as surfing and bodyboarding on the Pacific coast are exposed to waters with temperatures between 12-16 °C,. We seek to determine, in this study, the prevalence and degree of ECAE in surfers and bodyboarders from the coast of the south of Pacific Ocean, Reñaca and Concón, during the year 2018. An evaluation of the ECAE was carried out by means of video-otoscopy in 67 people (134 ears) who practiced surfing and bodyboarding from the beaches of Reñaca and Concón, and a questionnaire was used to collect information about their practice habits. As a result, a prevalence of ECAE of 77.6% was observed, with 61.2% bilateral ECAE and 16.4% unilateral ECAE. It was also possible to determine that 62.3% of the participants do not use protections. Based on these findings, it is possible to conclude that there is a high prevalence of ECAE in surfers and bodyboarders on the central Chilean coasts, which should alert both the practicing population and hearing health professionals to promote a healthy life in this population.

Clinical Features and Surgical Outcomes of Osteochondroma of the Spine

@#Introduction: Spinal osteochondroma is rare. The purpose of this study is to examine the clinical characteristics and surgical treatment outcomes of 11 patients with spinal osteochondroma. Materials and methods: The study included 11 patients with spinal osteochondroma. In these patients, we examined the onset level, onset site, initial symptoms, surgical procedure, outcomes and complications. Results: Of the 11 patients, 9 presented with solitary tumours, and 2 had multiple. The mean post-operative observation period was six years and two months. The onset level was the cervical spine in eight patients, thoracic in two, and lumbar in one. The most common onset site was the posterior elements. The initial presentation was myelopathy in seven patients, radiculopathy in two, neck pain in one and feeling of mass in one. All patients underwent excision of the tumour, and depending on the tumour onset site, additional posterior or anterior decompression with or without fusion was performed. There was no recurrence in all patients. Intra-operative complications included dura tear and oesophageal injury in one patient with cervical onset, while post-operative complications included C5 palsy in one patient. Conclusions: In this study, surgical excision for osteochondroma of the spine were excellent with no recurrence of the tumour.

Torus mandibular e palatino predisponentes em um grupo familiar: fatores genéticos e ambientais, relato de uma série de casos / Mandibular and palatine torus predisposing in a family group: genetic and environmental factors, report of a series of cases / Torus mandibular y palatino predisponente en un grupo familiar: factores genéticos y ambientales, informe de una serie de casos

As exostoses mais conhecidas são o Torus palatino e mandibular, que se desenvolvem a partir do crescimento benigno da cortical óssea, localizadas respectivamente na linha média palatina e superfície lingual de caninos e pré-molares, podendo ser unilaterais ou bilaterais. Esse trabalho tem como objetivo o estudo de um grupo familiar que apresentaram o Torus como característica em comum, buscando confirmar a presença e prevalência das características clínicas multifatoriais listadas na literatura, possibilitando o diagnóstico da etiologia e assim traçando um plano de tratamento individual, se necessário. Como metodologia, foi realizada uma triagem com cada membro familiar na clínica Odontológica da Faculdade Sete Lagoas - FACSETE, descartando a participação no estudo os membros que não apresentaram o Torus. Os indivíduos que apresentaram indicação da remoção cirúrgica foram encaminhados para clínica de cirurgia da própria instituição. Concluímos, portanto, com este estudo que fatores genéticos e ambientais colaboram como fator etiológico mais predominantes para surgimento do Torus no grupo familiar estudado... (AU)

The best known exostosis are the palatine and mandibular Torus, which develop from the benign growth of the cortical bone, located respectively in the midpalatal line and lingual surface of canines and premolars, and maybe unilateral or bilateral. This work aims to study a family group that had Torus as a common feature, confirming the presence and prevalence of multifactorial clinical features listed in the literature, enabling the diagnosis of etiology and thus outlining an in dividual treatment plan, if necessary. As a methodology, a screening was performed by each family member at the Dental Clinic of Facul dade Sete Lagoas - FACSETE, discarding the participation in the study for members who did not present Torus. Individuals who indicated surgical removal were referred to the institution's own surgery clinic. Therefore, we conclude with this study that genetic and environmental factors collaborate as the most predominant etiological factor for the emergence of Torus in the studied family group... (AU)

Las exostosis más conocidas son el Torus palatino y el Torus mandibular, las cuales se desarrollan a partir del crecimiento benigno del hueso cortical y están ubicadas respectivamente en la línea medio palatina y en la cara lingual de los caninos y de los premolares que pueden ser unilaterales o bilaterales. Este proyecto tiene como objetivo el estudio de un grupo familiar que presentó en sus características comunes el Torus, buscando confirmar la presencia y el predominio de las características clínicas multifactoriales listadas en la literatura, lo que hizo posible el diagnóstico de la etiología y diseñar un plan de tratamiento individual, caso necesiten. Como la metodología fue hecho una selección con los miembros de la familia en la clínica odontologica de la Faculdade Sete Lagoas - FACSETE, quitando de los estudios las personas de la familia que no presentaron el Torus. Los individuos que presentaron indicación de extirpación quirúrgica fueron enviados a la clínica de cirugía de la escuela. Concluimos con este estudio que los factores genéticos y ambientales colaboraron como los factores etiológicos más predominantes para la aparición del Torus en la familia analizada... (AU)

Exostosis múltiple: variabilidad clínica y factores relacionados a la calidad de vida en niños y en adultos / Osteochondromatosis: clinical variability and factors related to quality of life in children and adults

Introducción. La exostosis múltiple hereditaria es una enfermedad poco frecuente autosómica dominante caracterizada por presencia de múltiples proyecciones óseas. Objetivo. Analizar factores asociados a la calidad de vida relacionada con la salud (CVRS) en niños >2 años y en adultos en seguimiento en un hospital de pediatría de alta complejidad de Argentina. Población y métodos. Estudio transversal de una cohorte en seguimiento. La CVRS se midió con Pediatric Quality of Life Inventory (PedsQL) y Short Form Health Survey (SF-36). Se registró sexo, edad, características sociodemográficas, estatura, radiología, alteración de eje y función de miembros, presencia de dolor y malignización. Se clasificó la gravedad según Pedrini y col. Se realizaron pruebas paramétricas, no paramétricas y análisis de regresión. Resultados. Se incluyeron 66 casos (47 niños y 19 adultos). Relación sexo masculino/femenino: 1,7/1. Mediana de edad: 13,4 años (r: 2,2155,3). Presentaron dolor 30 de 47 niños y 17 de 19 adultos. Si se considera la edad ósea adulta (o cierre epifisario) como punto de corte para definir el estado de adulto, 11 de 37 niños y 18 de 27 adultos presentaron forma grave de enfermedad, y se observó baja estatura en 2 de 38 niños y en 9 de 27 adultos. El valor promedio del componente físico de CVRS en niños fue 65,9 (DE: 22,5) y, en adultos, 27,2 (RIC: 18,5-34,7). La presencia de dolor y la gravedad clínica se asoció significativamente a menor CVRS tanto en niños como en adultos. Conclusiones. En este estudio se observó que el dolor y la gravedad de la enfermedad tuvieron un efecto negativo en la CVRS.

Introduction. Hereditary osteochondromatosis is an uncommon, autosomal, dominant condition characterized by the presence of multiple bone growths. Objective. To analyze factors associated with health-related quality of life (HRQoL) among children > 2 years and adults receiving follow-up at a tertiary care children's hospital in Argentina. Population and methods. Cross-sectional study of a follow-up cohort. HRQoL was measured using the Pediatric Quality of Life Inventory (PedsQL) and the Short Form Health Survey (SF36). Sex, age, sociodemographic characteristics, height, radiology, axis alteration and limb function, presence of pain, and malignant change were recorded. Severity was classified as per Pedrini et al. Parametric and non-parametric tests and regression analysis were done. Results. A total of 66 cases (47 children and 19 adults) were included. Male/female ratio: 1.7/1. Median age: 13.4 years (r: 2.21-55.3). Pain was observed in 30/47 children and in 17/19 adults. Considering the adult bone age (or epiphyseal closure) as the cutoff point to define adult status, 11/37 children and 18/27 adults had a severe disease and 2/38 children and 9/27 adults had short stature. The average value of the physical component of HRQoL in children was 65.9 (SD: 22.5) and, in adults, 27.2 (IQR: 18.534.7). The presence of pain and clinical severity were significantly associated with a lower HRQoL, both in children and adults. Conclusions. This study found that pain and disease severity had a negative effect on HRQoL.

Diagnóstico e manejo das exostoses maxilares: relato de caso / Diagnosis and management of maxillary exostoses: case report

As exostoses maxilares são protuberâncias ósseas de caráter benigno, que se originam da cortical óssea e de etiologia controversa. Sua denominação vai depender da localização anatômica em que se encontra. Podem interferir na mastigação, fonação e adaptação de próteses removíveis parciais ou totais, devendo sua remoção ser considerada. O intuito deste trabalho é relatar o manejo de uma paciente com exostoses vestibulares em maxila e realizar uma breve revisão de literatura.

Maxillary exostoses are benign bony protuberances, which originate from the cortical bone and of controversial etiology. Its denomination will depend on its anatomical location. They can interfere with chewing, phonation and adaptation of partial or total removable prostheses, and their removal should be considered. The aim of this work is to report the management of a patient with vestibular exostosis in the maxilla and perform a brief literature review.

Variability of exostoses on human jaws during the past six millennia in Northern China / Variabilidad de las exostosis en las mandíbulas humanas durante los últimos seis milenios en el norte de China

SUMMARY: The aim of this study was to survey oral exostoses in human populations that belonged to the same region encompassing five periods over 6000 years, to determine the prevalence and its changing trend over time. A total of 306 human jaws belonging to the modern Xi'an region and four archeological sites, Banpo (6700-5600 years BP), Shaolingyuan (3000 years BP), Shanren (2200 years BP) and Chang'an (1000-1300 years BP), were investigated. The degree of buccal exostosis (BE), torus mandibularis (TM) and torus palatinus (TP) and the TP shape were recorded. The prevalence of BE, TM, and TP in the five groups was 20.8 %-62.5 %, 17.5 %-71.5 %, and 31.7 %-74.2 %, respectively. The differences in the three types of exostoses among the five groups were all statistically significant, but only TM and TP showed a decreasing trend over time. A high and quite diverse prevalence of oral exostoses was found in the five groups of samples. Decreasing trends in relation to time for TM and TP were detected.

RESUMEN: El objetivo de este estudio fue sondear las exostosis orales en poblaciones humanas que pertenecían a la misma región abarcando cinco períodos durante 6000 años, para determinar la prevalencia y su tendencia cambiante a lo largo del tiempo. Un total de 306 mandíbulas humanas pertenecientes a la moderna región de Xi'an y cuatro sitios arqueológicos, Banpo (6700-5600 años AP), Shaolingyuan (3000 años AP), Shanren (2200 años AP) y Chang'an (1000-1300 años AP) BP), fueron investigados. Se registró el grado de exostosis bucal (EO), torus mandibular (TM) y torus palatino (TP) y la forma de TP. La prevalencia de EO, TM y TP en los cinco grupos fue 20,8 % -62,5 %, 17,5 % -71,5 % y 31,7 % -74,2 %, respectivamente. Las diferencias en los tres tipos de exostosis entre los cinco grupos fueron todas estadísticamente significativas, pero solo TM y TP mostraron una tendencia decreciente con el tiempo. Se encontró una prevalencia alta y bastante diversa de exostosis oral en los cinco grupos de muestras. Se detectaron tendencias decrecientes en relación al tiempo para TM y TP.

Evaluation of oral stereognosis in completely edentulous patients with palatal tori / Evaluación de la estereognosia oral en pacientes completamente edéntulos con toros palatinos

Background: The corollary is not investigated in the completely edentulous patients with palatal tori. Objective: The aim of this study was to assess the oral stereognostic ability in completely edentulous patients with palatal tori. Material and Methods: Thirty-four completely edentulous patients aged 50 to 89 years were allocated to Group 1 (without palatal tori, n=18) and Group 2 (with palatal tori, n=16). The oral stereognostic test was conducted using 6 intraoral test pieces (circle/square/rectangle/triangle/plus/toroid) that were fabricated to standard dimensions using the light cure acrylic resin. Each test piece was placed in the patient's mouth and was asked to manipulate the test piece between the tongue and the palate. The patients identified the shapes by matching them on a shape chart. Each correct identification was assigned a score of 1. The response time taken to identify each shape was recorded. Statistical computation was done using a chi - square test and Mann-Whitney U test. Results: Significant difference was observed in the overall scoring percentages between the 2 groups (p<0.05). Group 2 had lower oral stereognostic scores compared to group 1 (p<0.05). There was no statistically significant difference in the mean response time for identifying the shapes among the groups, however group 2 patients had longer response time. Conclusion: Oral stereognostic ability of the completely edentulous patients with torus palatinus was lower when compared to completely edentulous patients without tori.

Antecedentes: el corolario no se investiga en los pacientes completamente desdentados con toros palatinos. Objetivo:El objetivo de este estudio fue evaluar la capacidad estereognóstica oral en pacientes completamente edéntulos con toros palatinos. Material y Métodos: Treinta y cuatro pacientes completamente edéntulos de 50 a 89 años fueron asignados al Grupo 1 (sin toros palatinos, n = 18) y al Grupo 2 (con toros palatinos, n = 16). La prueba estereognóstica oral se realizó utilizando 6 piezas de prueba intraorales (círculo / cuadrado / rectángulo / triángulo / cruz / aro) que se fabricaron a dimensiones estándar utilizando la resina acrílica fotopolimerizable. Cada pieza de prueba se colocó en la boca del paciente y se le pidió que manipulara la pieza de prueba entre la lengua y el paladar. Los pacientes identificaron las formas haciéndolas coincidir en un gráfico de formas. A cada identificación correcta se le asignó una puntuación de 1. Se registró el tiempo de respuesta necesario para identificar cada forma. El cálculo estadístico se realizó mediante la prueba de chi-cuadrado y la prueba U de Mann-Whitney. Resultados: Se observó una diferencia significativa en los porcentajes de puntuación generales entre los 2 grupos (p<0,05). El grupo 2 tuvo puntuaciones estereognósticas orales más bajas en comparación con el grupo 1 (p<0,05). No hubo diferencia estadísticamente significativa en el tiempo medio de respuesta para identificar las formas entre los grupos, sin embargo, los pacientes del grupo 2 tuvieron un tiempo de respuesta más largo.Conclusión: La capacidad estereognóstica oral de los pacientes completamente edéntulos con torus palatino fue menor en comparación con los pacientes completamente edéntulos sin torus.

An Unusual Early Oral Presentation of Acromegaly: A Case Report

ABSTRACT@#Acromegaly is a devastating chronic slowly progressive disease. Its early diagnosis is a challenging issue that necessitates clinical suspicion of signs and symptoms as a first step. This report introduces an unusual early sign in the oral cavity that lead to the early diagnosis of an acromegaly case. A case of a healthy 40-year-old male patient presented with progressively growing multiple hard swellings in the upper and lower jaws. Clinical examination revealed bony hard multiple small spiky exostosis-like swellings, located at the maxillary and mandibular alveolar bones. An array of investigations revealed a 2-mm diameter pituitary tumour in MRI of sella. To the best of the author’s knowledge, this is the first report of spiky exostosis-like growths in the alveolar bone as an early sign of acromegaly. In this case, thorough examination of oral signs and symptoms was the first step for early diagnosis and hence, better prognosis for acromegaly.

Escisión de torus mandibular bilateral en paciente sistémicamente comprometido: reporte de caso / Excision of bilateral mandibular torus in a systemically com-promised patient: a case report

Introducción: El torus mandibular es un crecimiento exofítico óseo ubicado en el área lingual de la mandíbula, generalmente bilateral. Puede estar asociado con trastornos temporomandibulares, afectar la pronunciación, producir halitosis, interferir con la deglución y causar dolor en la mucosa cuando está bajo prótesis mal diseñadas. Normalmente, el tratamiento no es necesario, excepto por necesidades protésicas, problemas funcionales, retención de alimentos, trastornos fonéticos o en caso de que se vaya a usar como injerto óseo autólogo. El objetivo de este reporte de caso fue realizar la escisión del torus mandibular bilateral en un paciente sistémicamente comprometido para su posterior rehabilitación con una prótesis parcial removible. Se realizo la atención de una paciente de 66 años sexo femenino, a quien, luego de analizar los medios diagnósticos y la evidencia científica, se le pudo realizar la escisión del torus mandibular bilateral de forma atraumática; esto permitió el correcto asentamiento de una prótesis parcial removible. La escisión del torus mandibular bilateral es un procedimiento seguro y predecible, y ayuda a evitar complicaciones protésicas, como el diseño de la estructura, y biológicas, como úlceras, depósitos de comida o halitosis, lo que devuelve la estabilidad y la función al sistema estomatognático. (AU)

The mandibular torus is a bony exophytic growth located in the lingual area of the mandible. While this growth is generally bilateral, it can be associated with temporomandibular disorders. I It affects pronunciation, produces halitosis, interferes with swallowing, and causes pain in the mucosa under poorly designed prostheses. Normally, treatment is not necessary, except in cases with prosthetic needs, functional problems, food retention, phonetic disorders or if it is to be used as an autologous bone graft. The aim of this study was to perform a bilateral mandibular torus excision in a systemically compromised patient for subsequent rehabilitation with a removable partial denture. A 66-year-old female presenting a bilateral mandibular torus attended our dental clinic. After achieving the diagnosis and analyzing the scientific evidence available, the bilateral mandibular torus was atraumatically excised, allowing correct seating of a removable partial denture. Bilateral mandibular torus excision is a safe and effective procedure, which helps to avoid prosthetic complications involving structural design and biological complications such as ulcers, food deposits and / or halitosis, restoring stability and function to the stomatognathic system. (AU)

Exostosis múltiple hereditaria presentación de caso / Multiple hereditary exostosis. Case report

RESUMEN La exostosis hereditaria múltiple es un trastorno autosómico dominante que se suele presentar en las dos primeras décadas de la vida. Caracterizada por el remodelado metafisaria alterado y crecimiento óseo asimétrico con acortamiento secundario de los huesos de las extremidades. Estas exostosis óseas rodeadas de cartílagos se hacen prominentes a las partes blandas, se diferencia de la enfermedad de Ollier en que esta última no es hereditaria. Se presentó el caso de una mujer de 36 años, que presentaba acortamiento de los miembros especialmente, cubito y radio, metacarpianos y metatarsianos. Su hijo de 18 años afectado también de dicha enfermedad presentaba una deformidad de Madelung asociada (acortamiento de cubito y radio con arqueamiento del radio) (AU).

ABSTRACT Multiple hereditary exostosis is an autosomal dominant disorder, usually found in the first two decades of life. It is characterized by the altered metaphyseal remodeling and asymmetric bone growth with a secondary shortening of extremities bones. These bone exostoses surrounded by cartilages become prominent to the soft parts, and are different from the Ollier disease because this last one is not hereditary. The authors present the case of a woman, aged 36 years, presenting a shortening of the members, especially ulna and radius, metacarpus and metatarsus. Her 18-years-old son was also affected by this disease, having an associated Madelug deformity (shortening of ulna and radius, and radius bowing) (AU).

Osteocondromatosis múltiple. Caso clínico / Multiple osteochondromatosis. Clinical case / Osteocondromatose múltipla. Caso clínico

RESUMEN Introducción: la osteocondromatosis múltiple hereditaria, entidad autosómica dominante, que se caracteriza por el crecimiento de múltiples tumores benignos llamados osteocondromas. Presentación del caso: paciente femenina de 12 años de edad, que acude a consulta refiriendo dolor constante en rodilla derecha, más acentuado con la marcha. Examen físico SOMA: Aumento de volumen de rodilla derecha hacia sus caras externas e internas con dolor a la palpación, se palpa masa dura, no movible, de bordes irregulares. También se constatan tumoraciones de similares características en ambos hombros y rodillas. Discusión: se le realizan radiografías, observando lesiones óseas en la metáfisis proximal de ambos húmeros a predominio derecho. Exostosis a nivel de metáfisis proximal y distal de ambos fémures, en tibia y peroné bilateral. En rodilla derecha se observa crecimiento hacia la línea media de la tumoración del peroné desplazando en valgo la metáfisis proximal de la tibia. Conclusiones: se plantea una exostosis múltiple como diagnóstico. Se realizó tratamiento quirúrgico escisión tumoral del extremo proximal del peroné de la rodilla derecha y de la cara interna de la metáfisis proximal de la tibia y biopsia que confirmó el diagnóstico.

ABSTRACT Introduction: hereditary multiple osteochondromatosis, an autosomal dominant entity, characterized by the growth of multiple benign tumors called osteochondromas. Case presentation: 12-year-old female patient, who comes to the consultation referring to constant pain in the right knee, more accentuated with the gait. PHYSICAL exam SOMA: Increase of volume of right knee towards their outer and inner faces with pain to palpation, it palps hard mass, not movable, of irregular edges. Tumors of similar characteristics are also found in both shoulders and knees. Discussion: X-rays are performed, observing bone lesions in the proximal metaphysis of both humeruses to right predominance. Exostosis at the level of proximal and distal metaphysis of both femurs, in tibia and bilateral fibula. In the right knee, growth is observed towards the midline of the fibula tumor displacing the proximal metaphysis of the tibia in valgo. Conclusions: Multiple exostosis is raised as a diagnosis. Surgical treatment was performed tumor excision of the proximal end of the fibula of the right knee and the inner face of the proximal metaphysis of the tibia and biopsy that confirmed the diagnosis.

RESUMO Introdução: osteocondromatose múltipla hereditária, uma entidade autossômica dominante, caracterizada pelo crescimento de múltiplos tumores benignos chamados osteochondromas. Apresentação do caso: paciente do sexo feminino de 12 anos, que chega à consulta referindo-se a dores constantes no joelho direito, mais acentuadas com a marcha. Exame FÍSICO SOMA: Aumento do volume do joelho direito em direção aos seus rostos externos e internos com dor à palpação, palpa massa dura, não móvel, de bordas irregulares. Tumores de características semelhantes também são encontrados em ambos os ombros e joelhos. Discussão: São realizados raios-X, observando lesões ósseas na metafise proximal de ambos os úmeros à predominância direita. Exostose ao nível de metafísica proximal e distal de ambos os fêmures, natíbia e fíbula bilateral. No joelho direito, observa-se crescimento para a linha média do tumor de fíbula deslocando a metafísica proximal da tíbia em valgo. Conclusões: A exostose múltipla é levantada como diagnóstico. Foi realizado tratamento cirúrgico excisão tumoral da extremidade proximal da fíbula do joelho direito e da face interna da metafise proximal da tíbia e biópsia que confirmou o diagnóstico.

Exostose palatina aberrante / Exostosis palatina aberrante / Aberrant palatal exostosis

RESUMO Introdução: Exostose é um crescimento ósseo benigno que comumente acomete a mandíbula e a maxila, porém raramente apresenta grandes dimensões. Objetivo: Descrever um caso de exostose palatina de apresentação rara e discutir os principais aspectos clínicos envolvidos. Relato de caso: Paciente, gênero masculino, 66 anos, melanoderma, com história de aumento de volume no palato duro com tempo de evolução indeterminado, sem queixas álgicas, porém relatava transtornos de mastigação e fonação. O conjunto da lesão obliterava toda a profundidade do palato e ocupava grande volume na cavidade oral. A Tomografia Computadorizada de Feixe Cônico demonstrava áreas bem corticalizadas na superfície da lesão e áreas centrais menos hiperdensas, compatíveis com osso medular maduro. Após exames e pareceres pós-operatórios o paciente foi submetido a tratamento cirúrgico sob anestesia geral para remoção da massa óssea e osteoplastia subjacente, a fim de dar contornos normais ao palato, e o material colhido foi enviado para a biópsia que estabeleceu o diagnóstico de exostose. O paciente evoluiu sem complicações. Conclusão: Embora a exostose seja um crescimento ósseo benigno, ela causou problemas funcionais ao paciente, necessitando assim de um tratamento cirúrgico. Após três meses da remoção, os distúrbios foram revertidos à normalidade, e a sua reabilitação protética está em andamento(AU)

RESUMEN Introducción: La exostosis es un crecimiento óseo benigno que generalmente afecta la mandíbula y el maxilar, pero rara vez es grande. Objetivo: Describir un caso de exostosis palatina rara y discutir los principales aspectos clínicos involucrados. Presentación del caso: Paciente masculino de 66 años, melanoderma, con antecedentes de aumento de volumen del paladar duro con una evolución de tiempo indefinido, trastornos de masticación y fonación El conjunto de lesiones borró toda la profundidad del paladar y ocupó un gran volumen en la cavidad bucal. La tomografía computarizada de haz cónico mostró áreas corticalizadas en la superficie de la lesión y áreas centrales menos hiperdensas, compatibles con la médula ósea madura. Después de los exámenes y consejos preoperatorios, el paciente se sometió a un tratamiento quirúrgico con anestesia general para eliminar la masa ósea con osteoplastia subyacente a fin de obtener contornos del paladar normales, y el material recolectado fue enviado para realizar biopsia que estableció el diagnóstico de exostosis. El paciente progresó sin complicaciones. Conclusiones: Aunque la exostosis es un crecimiento óseo benigno, causó problemas funcionales al paciente, por lo que requirió tratamiento quirúrgico. Tres meses después de la extracción, los trastornos han vuelto a la normalidad y su rehabilitación protésica está en proceso(AU)

ABSTRACT Introduction: Exostosis is a benign bone growth that commonly affects the jaw and maxilla, but is rarely large. Objective: Describe a case of rare palatal exostosis and discuss the main clinical aspects involved. Case presentation: A case is presented of a male 66-year-old dark-skin patient with a history of hard palate enlargement of an indefinite time of evolution, and chewing and phonation disorders. The lesions had obliterated the entire palatal depth and occupied a large section of the oral cavity. Cone beam computed tomography revealed corticalized areas on the surface of the lesion and less hyperdense central areas compatible with mature bone marrow. After preoperative examination and advice, the patient underwent surgical treatment under general anesthesia to remove the bone mass and underlying osteoplasty to obtain normal palatal contours. The material collected was sent for biopsy testing, which established the diagnosis of exostosis. The patient recovered without any complications. Conclusions: Although exostosis is a benign bone growth, in this case it caused functional problems to the patient, thus requiring surgical treatment. Three months after removal, the disorders have been reverted to normal and prosthetic rehabilitation is underway(AU)

Oído del surfista y síndrome vertiginoso asociado a perforación timpánica con riesgo de asfixia por inmersión / Surfer's ear and vergo associated with tympanum perforaon with immersion asphyxia risk

A partir del relato de la experiencia personal del autor con una perforación timpánica asociada a la práctica del surf, se revisa suscintamente la literatura relacionada con el "oído del surfista" (exostosis ósea del canal auditivo externo) y se discuten algunos elementos relativos a los riesgos y seguridad personal en las prácticas recreativas o deportivas en el mar.

The author's personal experience of a surfing associated tympanum perforation triggered a concise revision of the literature related to surfer's ear (osseous exostosis of the ear canal) and we discuss risks and personal safety with regard to recreational or sporting activities at sea.

Exostose palatina bilateral em bebê / Exostosis palatina bilateral en bebé / Bilateral palatal exostosis in an infant

RESUMO Introdução: As exostoses são definidas como protuberâncias ósseas localizadas, de caráter benigno, sendo uma rara patologia em bebês. Objetivo: Relatar um caso de exostose palatina bilateral em um bebê melanoderma do sexo feminino de 1 ano e 4 meses de idade. Relato de caso: A criança compareceu a Clínica Escola de Odontopediatria, acompanhada de sua mãe, para avaliação odontológica. Durante a anamnese, o responsável queixou-se de atraso na irrupção dos dentes decíduos e presença de protuberância na arcada superior, sem sintomatologia dolorosa. Foi relatado que três membros da família também apresentavam essa mesma alteração na maxila ou mandíbula, possivelmente sugerindo um componente genético. Ao exame clínico intrabucal, verificou-se um aumento de volume ósseo bilateral plano localizado na maxila, na região lingual das tuberosidades palatinas, recoberto por mucosa bucal normal. A superfície era rígida à palpação e com bordas claramente definidas. O componente genético foi associado ao aspecto clínico da lesão, bem como o sexo e a etnia. O diagnóstico estabelecido foi exostose palatina bilateral. A biópsia e o tratamento ativo para remoção da patologia não se justificaram devido à pouca idade da criança, ausência de sintomatologia dolorosa e de interferências na alimentação, deglutição ou outra função bucal. A paciente foi acompanhada periodicamente e apresentou sequência de irrupção dos dentes decíduos normal. Conclusão: Embora a exostose palatina apresente baixa prevalência em crianças, é importante que o cirurgião-dentista tenha conhecimento para realizar seu correto diagnóstico e plano de tratamento(AU)

RESUMEN Introducción: Las exostosis son definidas como bultos óseos, de carácter benigno, y contituyen una infrecuente afección en bebés. Objetivo: Describir un caso de exostosis palatina bilateral en un bebé melanoderma del sexo femenino de 1 año y 4 meses de edad. Presentación del caso: La niña acudió a la Clínica Escuela de Odontopediatría, con su madre, para evaluación odontológica. Durante la anamnesis, la madre refiere retraso en la erupcíon de los dientes deciduos, además de la presencia de bultos en la arcada superior, sin dolores sintomáticos. Fue informado que tres familiares también presentaban la misma alteración en la maxila o mandíbula, posiblemente sugiriendo componente genético. El examen clínico intrabucal, verificó un aumento de volumen óseo bilateral plano ubicado en la maxila, en la región lingual de las tuberosidades palatinas, recubierto por una mucosa bucal normal. La superficie era rígida a la palpación y con bordes bien definidos. El componente genético fue asociado al aspecto clínico de la lesión, al igual que el sexo y la etnia. El diagnóstico establecido fue exostosis palatina bilateral. La biopsia y el tratamiento activo para la remoción de la afección no se pudieron justificar por la poca edad de la niña, ausencia de dolores sintomáticos, además de interferencias en la alimentación, deglución u otra función bucal. La paciente fue controlada periódicamente y presentó secuencia de irrupción de dientes deciduos normal. Conclusiones: Aunque la exostosis palatina sea infrecuente en niños, es importante que el cirujano dentista tenga conocimiento para realizar el correcto diagnóstico y el plan de tratamiento(AU)

ABSTRACT Introduction: Exostoses are localized bony lumps of a benign nature. They are an infrequent condition in infants. Objective: Present a case of bilateral palatal exostosis in a dark-skinned female infant aged one year and four months. Case presentation: The girl was brought by her mother to the Children's Dental Clinic for oral examination. During anamnesis, the mother referred to delay in the eruption of deciduous teeth and the presence of lumps on the upper arch without any painful symptom. She also reported that three relatives had the same alteration in their maxilla or mandible. Oral examination revealed a bilateral flat bony lump in the maxilla, in the lingual region of the palatal tuberosities, covered by normal oral mucosa. The surface was stiff to palpation with well defined borders. The genetic factor was associated to the clinical aspect of the lesion, as well as the sex and ethnicity of the patient. The diagnosis was bilateral palatal exostosis. Biopsy and active treatment for removal of the lesion were not justified due to the patient's age, absence of painful symptoms, and potential interference with feeding, swallowing and other oral functions. The patient was periodically followed-up and was observed to present a normal process of deciduous tooth eruption. Conclusions: Even though palatal exostosis is infrequent in children, it is important for dental surgeons to be knowledgeable about the topic so as to reach an appropriate diagnosis and treatment plan(AU)

Osteocondroma del radio. Presentación de un caso / Osteochondroma of the radio. Presentation of a case

RESUMEN Se presenta un paciente portador de un osteocondroma localizado en la metáfisis del radio izquierdo, diagnosticado por estudios radiográficos y anatomopatológicos, en el Hospital Universitario Celia Sánchez Manduley de Manzanillo, provincia Granma. Se realiza intervención quirúrgica con exéresis del tumor. La evolución clínica del paciente fue satisfactoria. El objetivo del presente trabajo fue realizar una revisión de la entidad y señalar la importancia de su conocimiento para establecer el diagnóstico correcto y la toma de decisiones terapéuticas adecuadas y oportunas.

ABSTRACT We present a patient with an osteochondroma located in the metaphysis of the left radius, diagnosed by radiographic and anatomopathological studies, at the Celia Sánchez Manduley University Hospital of Manzanillo, Granma province. Surgical intervention is performed with excision of the tumor. The clinical evolution of the patient was satisfactory. The objective of the present work was to conduct a review of the entity and indicate the importance of their knowledge to establish the correct diagnosis and the appropriate and timely therapeutic decisions.

Clinical Analysis of External Auditory Canal Osteoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: External auditory canal osteoma is an uncommon benign lesion and represents as unilateral solitary pedunculated mass. The aim of this study is to evaluate the clinical symptoms of osteoma and its treatment outcomes over a 10-year period in a tertiary hospital. SUBJECTS AND METHOD: Eight patients underwent operation to remove an external auditory canal osteoma at Chungbuk National University Hospital from 2008 to 2017. The medical records were retrospectively reviewed with regard to clinical characteristics, size and location of osteoma, method of surgery and treatment outcomes. RESULTS: The average age of patients was 41.8 years with the male predominance of 6:2. All of the lesions in the osteoma were unilateral and solitary (average size 5.0 mm). All of the eight cases were pedunculated: in four cases, the stalks of the osteoma were found on the tympanomastoid suture line and in three cases, it was found on the tympanosquamous suture line. Four patients were asymptomatic, where the lesions were found incidentally during unrelated evaluations. No patients were found with conductive hearing loss in the pure tone audiometry. Transcanal and endaural approach were used in five and three cases, respectively. Most of the cases were removed by curettage only, except for the two who needed additional drilling. The average surgery time was 15.6 minutes. There was no postoperative complication or recurrence. CONCLUSION: The external auditory canal osteoma was mostly unilateral and solitary. The removal of osteoma in the early stage was relatively easy with no recurrence or complication.

Osteocondroma solitario del tercio proximal del fémur. Indicación y resultados de la exceresis sin luxación de la cadera / Solitary osteochondroma of the proximal third of the femur. Indication and results of exceresis without hip dislocation

Los osteocondromas constituyen el grupo de tumores óseos benignos más frecuentes en cadera, solitarios o como parte de una enfermedad exostosante múltiple; pueden ser asintomáticos o sintomáticos. Se tratan para evitar el riesgo de una degeneración sarcomatosa relativamente frecuente en este sitio. El propósito del estudio es revisar la entidad a partir de experiencia hospitalaria con énfasis en las manifestaciones clínicas y tratamiento. Se reporta el caso de un paciente masculino de 22 años e historia de hemofilia, que presentó una tumoración ósea a nivel de cadera derecha que los limita rangos de movilidad

Osteochondromas constitute the group of benign bone tumors most frequent in the hip, solitary or as part of a multiple exostosante disease; They can be asymptomatic or symptomatic. They are treated to avoid the risk of a relatively frequent sarcomatous degeneration at this site. The purpose of the study is to review the entity based on hospital experience with emphasis on clinical manifestations and treatment. The case of a 22-year-old male patient and a history of hemophilia is reported, who presented a bone tumor at the right hip level that limits mobility ranges.

Concomitant neurogenic and vascular thoracic outlet syndrome due to multiple exostoses

We report a rare case of multiple hereditary exostosis where patient presented with bilateral base of neck exostoses with concurrent compression of brachial plexus and subclavian artery and vein. The patient was a young 26-year-old woman with chief complaints of pain in the left upper extremity, paresthesia in the left ring and little finger, and weakness in hand movement and grip. On referral, history, physical examination, radiological imaging, and electrodiagnostic tests evaluated the patient. Due to severe pain and disability in performing routine activities, surgical intervention was necessary. In the current case, the patient had thoracic outlet syndrome with concomitant venous, arterial, and neurogenic sub types. Radial pulse returned and pain associated with brachial plexus compression was resolved after the surgery.

Aparición de exostosis 7 años después de aumento del reborde alveolar con técnica de bolsillo / Exostosis 7 years after alveolar ridge augmentation with pocket technique

Antecedentes: Las técnicas de manejo de tejidos blandos para aumentar rebordes alveolares atrofiados incluyen el uso de injertos de tejido conectivo, con o sin collar de epitelio, y técnicas en rollo. Algunas veces generan complicaciones posoperatorias. Objetivo: Describir el caso de una paciente a la que se le realizó aumento de reborde alveolar y se produjo una exostosis. Caso clínico: A una paciente de 35 años se le realizó un aumento del reborde alveolar con la técnica de bolsillo en el área del diente incisivo central superior derecho. Se tomó un injerto de tejido conectivo sin collar epitelial del paladar que se trasplantó y cubrió con el colgajo. La paciente regresó siete años después y clínicamente presentaba una aparente exostosis en la zona vestibular del diente tratado que la afectaba estéticamente. Se realizó osteoplastia para mejorar el contorno y se tomó una biopsia del hueso cuya histopatología mostró un tejido compatible con hueso alveolar. Conclusiones: La exostosis es una complicación posoperatoria inusual en casos de reborde alveolar que puede ser tratado con éxito. Se requiere más investigación sobre dichos efectos.

Background: Soft-tissue treatment techniques for alveolar ridge augmentation include connective tissue grafts, with or without epithelial collar, and roll techniques. Sometimes, there are postoperative complications. Purpose: To describe a case for a female patient who underwent an alveolar ridge augmentation and developed an exostosis. Case description: A 35-year-old female patient underwent an alveolar ridge augmentation procedure through a pocket technique in the upper right central incisor. A connective tissue graft without epithelial collar from the palate was transplanted and covered with the flap. Seven years later the patient returned with an exostosis in the buccal area of the treated tooth that affected her aesthetically. An osteoplasty was performed and a bone biopsy was taken, whose histopathological analysis showed a bone-compatible tissue. Conclusion: Exostosis is an unusual postoperative complication in cases of alveolar ridge augmentation that can be successfully treated. More research is necessary about such complications.

Correção estética em paciente portador de exostose frontal: relato de caso / Aesthetic correction in patients with frontal exostose: case report

Introdução: Exostoses são protuberâncias ósseas benignas e calcificadas, geralmente surgindo na região cortical dos ossos, cuja etiologia ainda não é bem definida. Clinicamente, são lesões fixas, indolores que apresentam crescimento lento. Em geral, nenhum tratamento para exostose frontal é sugerido, à exceção de acometimento funcional, estético, com repercussão social do paciente, em função da fisionomia desarmônica. Nesses casos, é indicada a exérese da lesão. Objetivo: Relatar um caso clínico de exostose em região frontal. Relato do caso: Paciente do sexo feminino, 30 anos, com queixa estética em terço superior da face. Ao exame físico, foi constatado um crescimento ósseo assintomático, em região frontal. Na tomografia computadorizada, ficou evidente aumento da espessura da tábua óssea externa do osso frontal. Foram realizadas osteotomias e osteoplastias da região. Estudo histopatológico dos fragmentos removidos confirmou a hipótese diagnóstica de exostose do osso frontal. Resultados: A paciente teve uma evolução satisfatória, e no 30º dia foi detectada a correção da assimetria facial. O acompanhamento segue há 6 meses, sem sinal de recidiva. Conclusão: Exostose do osso frontal, muitas vezes, não requer tratamento cirúrgico, porém pode causar agravos estéticos e comprometimento emocional. Sendo assim, normalmente recomenda se a correção da assimetria presente e melhores resultados estéticos... (AU)

Introduction: Exostosis are benign and calcified bony protuberances, usually arising in the cortical region of bones, whose etiology is not well defined. Clinically, these lesions are fixed, painless and slow growing. In general, no treatment for frontal exostosis is suggested, except for functional, aesthetic involvement, with social repercussion of the patient, due to the disharmonious physiognomy. In such cases, surgical excision is indicated. Objective: Report a clinical case of exostosis in frontal region. Case report: Womenkid patient, 30 years old, with aesthetic complaint in the upper third of the face. Upon physical examination, asymptomatic bone growth was observed in the frontal region. Computed tomography revealed an increase in the thickness of the external bone of the frontal bone. Performing osteotomies and osteoplasties of the region. A histopathological study of the fragments removed confirmed the diagnostic hypothesis of frontal bone exostosis. Results: The patient had a satisfactory evolution and on the 30th day the facial asymmetry correction was detected. Follow-up has been ongoing for 6 months, with no sign of relapse. Conclusion: Exostosis of the frontal bone often does not require surgical treatment, however it can cause aesthetic damage and emotional impairment. Therefore, it is usually recommended to correct the asymmetry present and better aesthetic results... (AU)