Viability of costochondral graft in temporomandibular joint ankylosis

Temporomandibular joint [TMJ] ankylosis is a very distressing structural condition that causes severe facial disfigurement leading to pathopsychological stress. Impairment of speech, difficulty with mastication, rampant caries, poor oral hygiene, disturbances of facial growth and severely compromised airway are the leading consequences of TMJ ankylosis. Surgical intervention is the widely accepted treatment modality of TMJ ankylosis. Current study was performed on 30 patients for three years [2009-2012] department of Oral and Maxillofacial Surgery, Children Hospital and Department of Nuclear Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore and costochondral graft was used to treat mandibular ankylosis. 21 [70%] patients were males and were divided into age groups of 2-5, 6-12 and 13-18 years. Regarding the side of mandible involved in male patients, unilateral ankylosis was found in 15[50%] and bilateral ankylosis were found in 6[20%] patients. Similarly in female patients, unilateral ankylosis was found in 7[23%] and bilateral ankylosis was seen in 2[7%] patients. Regarding post-operative monitoring of graft, bone scintigraphy was performed one week after the surgery and then after 12 weeks and 16 weeks to assess the viability and uptake of costochondral graft. Tc.99m MDP bone scan was performed in supine position with intravenous administration of 370MBq one week after the placement of graft. Results showed that out of 30 patients, CCG graft was viable in 28[93%] while it was non-viable in 2[7%] patients

Displasia cráneometafisiaria. Análisis radiológico de las variantes autosómica dominante y recesiva: Informe de dos pacientes / Craniometaphyseal displasia. Radiological study of two patients with autosomal dominant and recesive form

Introducción: La Displasia Cráneo Metafisiaria (DCM) es una enfermedad genética del metabolismo óseo, caracterizada por: hiperostosis del cráneo, esclerosis de la cara y deformidad metafisiaria en los huesos largos. Existen dos tipos de variantes, que se diferencian por su modo de herencia en: Autosómica Dominante y Autosómica Recesiva. El objeto del presente trabajo es determinar si existen diferencias clínicas y radiográficas entre ambos tipos, a fin de brindar un adecuado asesoramiento genético. Material y Métodos: Se presentan los dos espectros de la patología, con fotografías clínicas, historia clínica y estudios radiográficos (radiografías simples y tomografía axial computarizada con reconstrucción tridimencional). Una paciente femenina de 10 años y un masculino de 17 años de edad. Ambos comparten las mismas características clínicas pero en diferente severidad: macrocráneo, desproporción cráneo-cara, facies grotesca, falta de expresión facial, ensanchamiento mandibular y datos de engrosamiento óseo del tórax. Radiográficamente manifiestan: hiperostosis de la base y bóveda craneana, y ensanchamiento de las metáfisis de los huesos largos. Conclusiones: Se enfatiza que el análisis clínico, radiográfico y tomográfico de estos pacientes y sus progenitores, son parámetros útiles para orientar hacia el tipo de herencia