Estados emocionales en pacientes con rehabilitación protésica bucomaxilofacial / Emotional States in Patients with Bucomaxilofacial Prosthetic Rehabilitation

RESUMEN Introducción: Las emociones son reacciones psicofisiológicas que representan modos de adaptación a ciertos estímulos o eventos, como enfermedades o traumas, que se relacionan con la necesidad de tratamiento protésico bucomaxilofacial. Objetivo: Identificar los estados emocionales en pacientes antes y después de la rehabilitación protésica bucomaxilofacial. Métodos: Se realizó un estudio observacional descriptivo transversal, en 48 pacientes atendidos en el Hospital General Universitario "Carlos Manuel de Céspedes y del Castillo", entre junio de 2018 a junio de 2019, a los cuales se le aplicaron instrumentos de evaluación psicológica antes y después del tratamiento rehabilitador. Se estudió la experiencia emocional, la ansiedad y depresión. Resultados: Antes del tratamiento protésico los pacientes presentaron: tristeza (66,66 por ciento), sufrimiento (60,41 por ciento), abatimiento (54,16 por ciento), angustia (43,75 por ciento) y apatía (41,66 por ciento) con un alto nivel de intensidad vivencial. Luego de la rehabilitación protésica bucomaxilofacial, disminuyeron los estados emocionales: la ansiedad disminuyó en el 58,33 por ciento de los participantes y la depresión en el 52,08 por ciento. Conclusiones: Los pacientes con necesidad de protésica bucomaxilofacial experimentan tristeza, sufrimiento, abatimiento, angustia, apatía y altos niveles de ansiedad y depresión como estado antes del tratamiento. Estas emociones disminuyen luego de la rehabilitación protésica bucomaxilofacial(AU)

ABSTRACT Introduction: Emotions are psychophysiological reactions that represent modes of adaptation to certain stimuli or events, such as illnesses or trauma, related to the need for bucomaxilofacial prosthetic treatment. Objective: To identify emotional states in patients before and after prosthetic bucomaxilofacial rehabilitation. Methods: A cross-sectional, descriptive and observational study was carried out in 48 patients cared for at Carlos Manuel de Céspedes y del Castillo General University Hospital, between June 2018 and June 2019, and who were applied psychological assessment instruments before and after they received rehabilitation treatment. Emotional experience, anxiety and depression were studied. Results: Before prosthetic treatment, patients presented sadness (66.66 percent), suffering (60.41 percent), weariness (54.16 percent), anguish (43.75 percent), and apathy (41.66 percent), with a high level of life experience-related intensity. After bucomaxilofacial prosthetic rehabilitation, emotional states decreased: anxiety decreased in 58.33 percent and depression decreased in 52.08 percent of the participants. Conclusions: Patients in need of bucomaxilofacial prosthesis experience sadness, suffering, weariness, anguish, apathy and high levels of anxiety and depression as a state before treatment. These emotions decrease after oral bucomaxilofacial prosthetic rehabilitation(AU)

Rehabilitación protésica de un paciente con defecto nasal / Prosthetics rehabilitation of a patient with nasal defect

Se describe el caso clínico de un paciente de 84 años de edad, a quien se le realizó exéresis total del órgano nasal desde hacía 5 años aproximadamente en el Hospital Oncológico Conrado Benítez de Santiago de Cuba, a causa de un carcinoma epidermoide del apéndice nasal, por lo cual fue remitido al Centro de Rehabilitación Protésica Bucomaxilofacial de esta provincia para ser rehabilitado. Al examen físico extrabucal se observó ausencia total de la nariz, que simulaba una facies leonina, con bordes cicatrizados y bien definidos. La mayor preocupación del paciente era ocultar su defecto, de manera que se le realizó una prótesis nasal de silicona para mejorar su estética y funcionalidad

The case report of an 84 years patient is described, to whom a total removal of the nasal organ was carried out about 5 years ago-at Conrado Benítez Cancer Hospital in Santiago de Cuba - due to an epidermoid carcinoma of the nasal appendix, reason why he was referred to the Oralmaxillofacial Prosthetics Rehabilitation Center of this province to be rehabilitated. A total absence of the nose was observed in the extraoral physical examination that simulated a leonine facies, with well defined healed borders. The patient's biggest concern was to hide his defect, so a nasal silicone prosthesis was placed to improve his aesthetics and functionality

Rehabilitation of a mandibular segmental defect with magnet retained maxillofacial prosthesis.

Resection or loss of a portion of the mandible can result in a variety of functional, cosmetic and psychological deficits that are dependent on the extent of the defect, the concomitant therapy and the timing of rehabilitative efforts. These impairments greatly affect the patient's Quality of life (QOL). The thrust in cancer care is not simply on survival but on rehabilitation, which aims to improve multiple impairments and QOL. This article describes a case of a 58-year-old female with segmental resection of the anterior mandible, extending to lower lip, resulting in a large intraoral as well extra oral defect. Prosthodontics rehabilitation was done using a two-piece intra oral and extra oral prosthesis oriented to each other using magnets. Use of magnets for retaining the extra oral prosthesis simplifies the clinical and laboratory phase enhancing patient's comfort and psychological morale.

Plastic Surgical vs. prosthetic reconstruction after total loss of the orbital contents and the auricle / Cirurgia plástica ou reconstrução protética na perda total do conteúdo orbitário e do pavilhão auricular

In the reconstruction of facial defects, there are two competing approaches: transplantation of body tissue and the use of foreign material. Most clinics prefer either the one or he other technique, wich makes comparison difficult. At the Frankfurt University Medical School since 1992, cases of plastic surgical and prosthetic reconstruction of particularly difficult regions after orbital exenteration (n=13) and total auricular loss (n=5) were examined in relation to the medical literature, in order to enable a critical evaluation. Today, facial prostheses still are esthetically superior to plastic surgical reconstructions and need much less time and interventions. Age and general condition of a patient are important for the decision. In the case of the auricle, autologous reconstruction is preferred whenever possible. While facial prostheses are seen today in many cases as a practical means of rehabilitation which can help the heavily disfigured patient at short notice, the future, however, lies with autologous replacement despite the larger amount of work required