ABSTRACT
A odontologia reabilitadora tem como um dos seus ramos a especialidade de Prótese Bucomaxilofacial (PBMF), que visa restaurar ou substituir estruturas perdidas na região facial e no sistema estomatognático artificialmente, podendo ser ou não removidos pelo paciente. O presente trabalho objetiva revisar a leitura a respeito da reabilitação com PBMF e a sua aplicabilidade na clínica odontológica. Os indivíduos com alguma perda de estrutura na região de cabeça e pescoço, devido a traumas físicos e/ou químicos, defeitos congênitos, doenças autoimunes, neoplasias, infecções e parasitas, são pacientes para os quais há a indicação da reposição da parte ausente. As reconstruções podem ser perdas intraorais (área da maxila, mandíbula), extraorais (oculopalpebral, ocular, nasal, facial extensa e auricular) ou conjugadas. Esse é um trabalho multidisciplinar, com especialistas de áreas abrangentes e todos os especialistas trabalham de forma conjunta. Pode-se concluir que, embora seja uma das especialidades mais nobres da odontologia, ainda é muito desconhecida por parte dos estudantes e profissionais das áreas da saúde e são próteses absolutamente fundamentais para a reabilitação e qualidade de vida dos indivíduos que tem a necessidade do uso da prótese PBMF(AU)
Rehabilitating dentistry has as one of its branches the specialty of Oral and Maxillofacial Prosthesis (PBMF), which aims to restore or replace structures lost in the facial region and in the stomatognathic system artificially, which may or may not be removed by the patient. The present study aims to review the reading about rehabilitation with PBMF and its applicability in dental clinic. Individuals with some loss of structure in the head and neck region, due to physical and/or chemical trauma, birth defects, autoimmune diseases, neoplasms, infections and parasites, are patients in whom there is an indication for replacement of the absent part. Reconstructions can be intraoral (maximal area, mandible), extraoral (oculopalpebral, ocular, nasal, extensive facial and auricular) or conjugated losses. It is a multidisciplinary work, with specialists from the comprehensive areas and that all specialists work together. It can be concluded that although it is one of the noblest specialties of dentistry, it is still very unknown to students and health professionals, and they are absolutely fundamental prostheses for the rehabilitation and quality of life of individuals who need the use the PBMFprosthesis(AU)
Subject(s)
Head/abnormalities , Maxillofacial Prosthesis , Neck/abnormalities , Quality of Life , Rehabilitation , Autoimmune Diseases , Congenital Abnormalities , Stomatognathic System/injuries , Mandibular Reconstruction , Oral and Maxillofacial Surgeons , NeoplasmsABSTRACT
OBJECTIVE@#To explore the genetic basis for two Chinese pedigrees affected with Coffin-Siris syndrome (CSS).@*METHODS@#Whole exome sequencing (WES) was carried out for the probands. Candidate variants were verified by Sanger sequencing of the probands and their family members.@*RESULTS@#The two probands were respectively found to harbor a heterozygous c.5467delG (p.Gly1823fs) variant and a heterozygous c.5584delA (p.Lys1862fs) variant of the ARID1B gene, which were both of de novo in origin and unreported previously. Based on the guidelines of American College of Medical Genetics and Genomics, both variants were predicted to be pathogenic (PVS1+PS2+PM2).@*CONCLUSION@#The c.5467delG (p.Gly1823fs) and c.5545delA (p.Lys1849fs) variants of the ARID1B genes probably underlay the CSS in the two probands. Above results have enabled genetic counselling and prenatal diagnosis for the pedigrees.
Subject(s)
Humans , Abnormalities, Multiple , China , DNA-Binding Proteins/genetics , Face/abnormalities , Hand Deformities, Congenital , Intellectual Disability , Micrognathism , Neck/abnormalities , Pedigree , Transcription Factors/geneticsABSTRACT
El síndrome de Klippel-Feil (KFS) es un grupo heterogéneo de malformaciones a nivel vertebral que presentan un componente genético monogénico; se caracteriza por presentar un defecto en la formación o segmentación de las vértebras cervicales, que da como resultado una apariencia fusionada. La tríada clínica consiste en un cuello corto, una línea de implantación baja del cabello y un movimiento limitado del cuello. Presentamos el caso de un paciente masculino de 17 años que manifiesta los hallazgos clínicos y radiológicos de esta anomalía. (AU)
Klippel-Feil syndrome (KFS) is a heterogeneous group of vertebral malformations that presents a monogenic genetic component, characterized by a defect in the formation or segmentation of the cervical vertebrae, which results in a fused appearance. The clinical triad consists of a short neck, a low hairline and a limited movement of the neck. We present the case of a 17 year-old male patient who presented the clinical and radiological findings of this anomaly. (AU)
Subject(s)
Humans , Male , Female , Pregnancy , Adolescent , Adult , Young Adult , Klippel-Feil Syndrome/therapy , Neck/abnormalities , Scoliosis/diagnostic imaging , Antipyretics/therapeutic use , Hearing Loss , Analgesics/therapeutic use , Klippel-Feil Syndrome/etiology , Klippel-Feil Syndrome/genetics , Klippel-Feil Syndrome/diagnostic imaging , Anti-Bacterial Agents/therapeutic useABSTRACT
Los quistes epidermoides localizados en cabeza y cuello son poco comunes y pueden ser difíciles de diagnosticar. Se describen los casos de cuatro pacientes con quistes epidermoides de cabeza y cuello, dos con localización en la región sublingual y extensión suprahioidea, otro localizado en la pared orofaríngea posterolateral y otro en la región submaxilar y submentoniana. Fueron tratados con éxito mediante abordajes transorales y transcervical, respectivamente. Se realizó una revisión de la bibliografía y se describieron las características anatómicas, clínicas e histológicas y el tratamiento de estas infrecuentes lesiones. (AU)
Epidermoid cysts of the head and neck are rare and can be difficult to diagnose. Two cases of patients with epidermoid cysts of the floor of the mouth with suprahyoid extension, other located at posterolateral oropharynx wall andother located at the submandibular and submental space with extention to midline are described. They were successfully treated by a transoral and transcervical approach respectively. A review of the literature was performed, and the anatomical, clinical and histological aspects and treatment of these uncommon tumors were reported. (AU)
Subject(s)
Humans , Male , Female , Adult , Epidermal Cyst/diagnosis , Head/abnormalities , Mouth Floor/abnormalities , Neck/abnormalities , Oropharynx/abnormalities , Epidermal Cyst/surgery , Epidermal Cyst/embryology , Epidermal Cyst/physiopathology , Epidermal Cyst/pathology , Epidermal Cyst/diagnostic imagingABSTRACT
RESUMO A artrogripose é uma síndrome múltipla congênita rara que se caracteriza por uma série de malformações congênitas e enrijecimento e contrações articulares e não possui caráter progressivo. Trata-se de um estudo de caso clínico, cujo objetivo é descrever a manifestação funcional relacionada à fonoaudiologia através do processo de avaliação em um caso de artrogripose em pediatria. Foi realizada uma análise do prontuário clínico de um paciente desde o nascimento, bem como uma avaliação clínica completa de investigação de disfagia pediátrica, na qual foi estabelecido o diagnóstico de disfagia orofaríngea de grau grave, apontada por alterações no exame funcional e estrutural. Associa-se ao quadro, uma perda auditiva.
ABSTRACT Arthrogryposis is a rare, multiple, congenital syndrome of non-progressive nature characterized by a series of genetic malformations, as well as stiffness and joint contractures. This is a clinical case study whose objective is to describe speech-language pathology disorders through the evaluation process in a case of arthrogryposis in Pediatrics. The medical records of a patient were analyzed from birth. A complete clinical evaluation of pediatric dysphagia was performed, establishing a diagnosis of severe oropharyngeal dysphagia evidenced by functional and structural impairments. Hearing loss was detected in association with this condition.
Subject(s)
Humans , Male , Infant , Arthrogryposis/diagnosis , Speech Disorders/diagnosis , Deglutition Disorders/diagnosis , Head/abnormalities , Neck/abnormalities , Arthrogryposis/complications , Speech Disorders/etiology , Severity of Illness Index , Deglutition Disorders/etiologyABSTRACT
Los tumores del cuerpo carotídeo son relativamente infrecuentes y raramente se diagnostican antes de la exposición quirúrgica, su diagnóstico es benigno, pero suelen ser muy vasculares por lo que su extirpación quirúrgica muchas veces resulta difícil. Estos tumores son de crecimiento lento y pueden evolucionar durante años. El objetivo de este estudio es presentar un caso con un tumor del cuerpo carotídeo en región lateral derecha del cuello. Clínicamente se observó un aumento de volumen de aproximadamente 4 cm, no doloroso a la palpación, de tipo gomoso y adherido a planos profundos, asintomático, tratado en nuestra institución durante el año 2014. Se le realizó exéresis simple de la lesión, y el departamento de Anatomía Patológica reportó el diagnóstico de referencia. La evolución de la paciente después de 17 meses ha sido satisfactoria (AU).
The tumors of the carotid body are relatively uncommon and rarely diagnosed before the surgical exeresis, their diagnosis is benign, but they are usually very vascular and its extirpation is very difficult. These tumors have a slow growth and it can evolve during years. The aim of this study is to present a case with a tumor of the carotid body in the right lateral region of the neck. An increase of volume was observed of approximately 4 cm, not painful, of gummy type and stuck to deep, asymptomatic plans, treaty in our institution during the year 2014. It was carried out exeresis of the lesion, and the department of Pathological Anatomy reported the reference diagnosis. The patient's evolution after 17 months has been satisfactory (AU).
Subject(s)
Humans , Female , Aged , Carotid Body Tumor/surgery , Carotid Body Tumor/diagnosis , Carotid Body Tumor/epidemiology , Neoplasms/surgery , Neoplasms/complications , Neoplasms/diagnosis , General Surgery/methods , Neck/abnormalities , Neck/surgeryABSTRACT
Retalhos do músculo esternocleidomastoideo têm sido descritos na literatura para reconstrução dos defeitos da cavidade oral e tratamento da síndrome de Frey. Apesar de largamente estudado, esses retalhos não são utilizados com frequência para reconstruções na região de cabeça e pescoço devido limitações como tamanho reduzido, camadas inseguras, contorno da deformidade no pescoço e questões de segurança oncológica. Relata-se uso de perfurador baseado em transposição de retalho para defeito na região da posterior do pescoço, seguido por excisão de sarcoma de partes moles. Trata-se de alternativa válida para procedimentos de reconstrução como retalhos regionais de pedículo ou transferência de tecido livre em um grupo apropriado de pacientes.
Sternocleidomastoid musculocutaneous flaps have been described in the literature for reconstruction of oral cavity defects and treatment of Frey's syndrome. Although widely studied, it is not used routinely in head and neck reconstruction due to limitations like small size, unreliable skin paddle, contour deformity in the neck and the question of oncologic safety. We report use of perforator based musculocutaneous transposition flap for defect over nape of the neck, followed by excision of a soft tissue sarcoma. This constitutes a valid alternative to other reconstructive procedures like pedicled regional flaps or free tissue transfer in a suitable group of patients.
Subject(s)
Humans , Male , Adult , History, 21st Century , Sarcoma , Surgical Flaps , Plastic Surgery Procedures , Diffusion of Innovation , Body Contouring , Neck , Neck Muscles , Neoplasms, Connective Tissue , Sarcoma/surgery , Sarcoma/pathology , Surgical Flaps/surgery , Plastic Surgery Procedures/methods , Body Contouring/adverse effects , Body Contouring/methods , Neck/abnormalities , Neck/surgery , Neck Muscles/surgery , Neoplasms, Connective Tissue/surgerySubject(s)
Humans , Female , Pregnancy , Otorhinolaryngologic Surgical Procedures , Airway Obstruction/surgery , Airway Obstruction/diagnosis , Head/abnormalities , Neck/abnormalities , Prenatal Diagnosis , Abnormalities, Multiple , Airway Obstruction/congenital , Fetal Diseases/diagnosis , Pregnancy, TwinABSTRACT
The Pterigium colli is a cervical malformation included in several syndromes, produces an important stigmatization of patients because of its evident location, implying that a real solution becomes necessary in a 100 percent of the cases. Through history, many reconstructive alternatives have been described; the aim of this paper is to present a review of the most common surgical technics, its results and complications.
El Pterigium colli es una malformación cervical que forma parte de varios síndromes, produce una importante estigmatización de los pacientes portadores dado lo notorio de su ubicación, lo cual hace que su solución sea necesaria casi en el 100 por ciento de los casos. A través de la historia se han descrito varias alternativas reconstructivas, el objetivo de este documento es presentar una revisión de las técnicas más utilizadas, sus resultados y complicaciones.
Subject(s)
Humans , Neck/abnormalities , Neck/surgery , Plastic Surgery Procedures , Turner Syndrome/complicationsABSTRACT
Introduction: congenital midline cervical cleft is a rare congenital mid-line anomaly of the neck. There are different theories as to the origins of CMCC. Nevertheless, most believe that is due to impaired fusion of the first and second branchial arches during mesoderm formation. There are less than 100 reported cases in the literature. Case report: a newborn with a mid-line cervical injury without other associated abnormalities. A complete excision of the lesion and the blind-ended sinus were performed and the skin was closed with a Z-plasty approach. Discussion: congenital mid-line cervical cleft requires early diagnosis, the study of associated abnormalities and an early repair is recommended to aesthetically handle the case and to prevent blind-ended sinus infection.
Introducción: la fisura cervical media o cursiva cervical es una anomalía congénita rara de la línea media. Existen varias hipótesis para explicar su origen, la más aceptada es la falla en la fusión del primer y segundo arco branquial durante la mesodermización. Han sido reportados menos de 100 casos en la literatura. Caso clínico: se reporta el caso de un recién nacido con una lesión cervical media sin otras malformaciones asociadas. Se realizó extracción completa de la lesión visible y del seno ciego caudal, cerrándose el defecto con una Z-plastía. Discusión: la fisura cervical media requiere de un diagnóstico precoz y un estudio de malformaciones asociadas, junto con una resolución temprana de este defecto, tanto para el manejo estético como para evitar retracciones e infección del seno ciego.
Subject(s)
Humans , Male , Infant, Newborn , Congenital Abnormalities/surgery , Congenital Abnormalities/diagnosis , Neck/abnormalitiesSubject(s)
Humans , Female , Neck/abnormalities , Head and Neck Neoplasms , Congenital Abnormalities , CystsABSTRACT
Las infecciones profundas de cuello ameritan diagnóstico oportuno y terapéutica urgente, debido a potenciales complicaciones y mortalidad. El objetivo del presente estudio fue revisar nuestra experiencia en el manejo de pacientes con esta patología, conocer los gérmenes más frecuentes yanalizar los factores asociados a complicaciones y estancia hospitalaria. Materiales y métodos: Se analizaron retrospectivamente 46 pacientes que acudieron al Hospital Carlos Andrade Marín de Quito, Ecuador, desde enero 2005 a junio de 2009. Resultados: El 63 por ciento fueron hombres y la medianade edad fue 33 años. Tratamiento antibiótico previo recibió un 50 por ciento de pacientes. El espacio más afectado fue el submaxilar 68 por ciento; dos compartimentos se afectaron en 11 por ciento. El 13 por ciento de pacientes presentó co-morbilidades. En el 48 por ciento la causa se relacionó con patología dental. La sintomatología encontrada estuvo conformada de tumor cervical, dolor y fiebre. La tomografía axial computarizada se realizó en el 22 por ciento de casos. Los antibióticos utilizados fueron: B lactámicos + inhibidores de Blactamasa en el 65 por ciento y penicilina cristalina + clindamicina en el 17 por ciento. En el 28 por ciento se utilizó corticoterapia como tratamiento coadyuvante. La estancia hospitalaria fue 9 días. El abordaje quirúrgico se realizó en el 48 por ciento y ninguno necesito re-intervención. La bacteria aislada más frecuentemente fue el estafilococo aureus. Complicaciones se presentaron en el 33 por ciento y no hubo mortalidad. Conclusiones: La infección dental es nuestra principal etiología, lo cual tiene relación topográfica de los compartimentos afectados. El estafilococo aureus fue la bacteria más encontrada. El tratamiento antibiótico utilizado fue de gran eficacia y el uso de corticoide disminuyó la estancia hospitalaria. Encontramos pocas co-morbilidades en nuestros pacientes lo cual podría explicar la ausencia de mortalidad en nuestra serie.
Objective: Deep neck infections need urgent diagnostic and treatment because of potential complications and mortality. The aim of this study was to review our experience in the management of patients with this disease, know the most common germs and analyze the factors associated withcomplications and hospital stay. Methods: We retrospectively analyzed 46 patients who attended the Carlos Andrade Marín Hospital in Quito, Ecuador, from January 2005 to June 2009. Results: 63% were men and median age was 33 years. Previous antibiotic treatment received 50% of patients. The most affected area was the submaxilar 68%, two compartments were affected in 11%. 13% of patientshad co-morbidities. In 48% the cause was related to dental disease. The symptoms found were cervical tumor, pain and fever. Computed tomography was performed in 22% of cases. The antibiotics used were: B-lactamics + B-lactamase inhibitors in 65% and clindamycin + penicillin G in 17%. In 28%received corticosteroids as adjunctive therapy. The hospital stay was 9 days. The surgical approach was performed in 48%. The most frequently isolated bacterium was Staphylococcus aureus.Complications occurred in 33% and we had no mortality. Conclusions: Dental infection is our main etiology, which is related topographic compartments affected. The bacteria staphylococcus aureus was the most found. The antibiotic regimen used was highly effective and steroid use decreasedhospital stay. We found few co-morbidities in our patients which could explain the absence of mortality in our series.
Subject(s)
Neck/abnormalities , Neck/virologyABSTRACT
Variations of vessels and nerves in the left neck side, of 65 year old male cadaver, during the routine dissections, were detected. It was observed that the linguofacial trunk originated from external carotid artery and that the ascending pharyngeal artery originated from the occipital artery. It was determined that after the laryngeopharyngeales rami originated from the superior cervical ganglion, the branch wound around the origin of the superior thyroid artery. As an additional variation, the internal jugular vein divided. The cervical ansa and the inferior belly of the omohyoid muscle passed through the parts of the vein. We think that these type of variation can entail important difficulties during radiologic and surgical procedures of the neck region. To know these anatomical variations, is important for the anatomist and surgeons.
Durante una disección de rutina, fue observada en el lado izquierdo del cuello de un cadáver de sexo masculino de 65 años de edad variaciones anatómicas vasculares y nerviosas. Se observó que el tronco linguofacial se originaba de la arteria carótida externa y que la arteria faríngea ascendente se origina en la arteria occipital. Se determinó que los ramos laringofaríngeos originadas desde el ganglio cervical superior, giraban en torno al origen de la arteria tiroidea superior. Como una variación adicional, la vena jugular interna se encontró dividida. El asa cervical y el vientre inferior del músculo omohioideo pasaban a través de las partes de la división de la vena. Creemos que este tipo de variaciones supone dificultades importantes durante procedimientos radiológicos y quirúrgicos de la región del cuello, y por tanto, es importante que los cirujanos conozcan estas variaciones.
Subject(s)
Humans , Male , Aged , Neck/abnormalities , Neck/blood supply , Jugular Veins/anatomy & histology , Carotid Artery, External/abnormalities , Cadaver , Jugular Veins/abnormalitiesABSTRACT
Ectopic cervical thymus is a rare cause of neck masses and can be found anywhere along its embryologic tract of descent from the angle of the mandible to the superior mediastinum, and it should be included in the differential diagnosis of neck masses, especially in children. Because most cases are not symptomatic, usually remains without diagnosis. Such anomalies are rarely diagnosed pre-operatively and often revealed by pathologic examination after operation. We introduced a 12-years-old girl with a soft left cervical mass anterior to Sternocleidomastoid muscle, from four months prior to refer, with firm consistency in touch and mild pain. With the initial diagnosis of lymphadenopathy was treated with antibiotics but did not respond to treatment. The patient underwent complete excision of the lesion and histological examination that showed an ectopic thymic cyst. This anomaly rarely diagnosed before surgery and can be mistaken easily with other cervical masses. Surgery is curative and the disease has excellent prognosis
Subject(s)
Humans , Female , Child , Neck/abnormalities , Diagnosis, Differential , Mediastinal Cyst/diagnosis , Mediastinal Cyst/surgery , PrognosisABSTRACT
The aims of the study were to assess the prevalence of birth defects [BDs] in Ahwaz, Iran amongst the live births born between 1 Oct 2006 and 31 Oct 2007. There were a total of 4176 live births in Ahwaz during this study period. The interview included the Father and mother's date of birth, Number of gravidity, paternal smoking, maternal delivery age and the occupation of the mother and father. Out of 4176 subjects, 1.43 per 1000 live births presented with multiple anomalies. The overall occurrence of malformation among working mothers were 1.67 and 7.42 for working fathers. Parents in the occupational group 'Commerce' had the highest rates [3.83 per 1000 live births]. The frequencies of BDs in smokers were 3.5 [per 1000 live births]. The gravidity profiles showed that all three types were very close to each other. The occurrence rate of BDs increased in the maternal delivery age of 18-35 years [5.74 per 1000 live birth]. The prevalence of BDs in Southwest of Iran is comparable to those in other countries. Some of the birth defects are not diagnosed at birth and may occur later in the life
Subject(s)
Humans , Female , Head/abnormalities , Neck/abnormalities , Cross-Sectional Studies , Gravidity , Paternal Behavior , Maternal AgeSubject(s)
Branchial Region , Cartilage Diseases , Choristoma/congenital , Humans , Infant , Male , Neck/abnormalities , Skin Diseases/diagnosisSubject(s)
Child , Cysts , Neck/abnormalities , Neck/pathology , Diagnostic Imaging/classification , Diagnostic ImagingABSTRACT
Cervical thymic cyst is not a common pathology encountered in either an adult or a child. Our case presentation is of an infant girl with a right cervical soft mass. It was totally resected and histological analysis revealed a thymic cyst. The diagnosis of thymic cyst is not possible prior to histological examination. Therefore, in children the disorder should be considered as a differential diagnosis of each cervical soft tissue mass and evaluation of mediastinum should be done for the presence of thymic tissue
Subject(s)
Humans , Female , Cysts , Diagnosis, Differential , Tomography, X-Ray Computed , Neck/abnormalities , Neck/pathology , MediastinumABSTRACT
Correction of the anterior neck burn deformities are preventable rather than surgically correctable by splinting the burned neck in extension position during the acute stage of burn at the end of edema stage. This article aims to compare between releasing of contractures with immediate resurfacing with split thickness skin graft in 30 patients and releasing of contractures of the neck and resurfacing with skin flap in 34 patients. Points of comparison were good aesthetic results as determined by the cervicomental angle obtained, the subjective opinion of patients and good range of motion of the neck, complications of surgery as recontracture again, complementary procedure, postoperative splint and its duration. Regarding patients' satisfaction and complications rate patients of group two revealed better aesthetic results and good range of motion rather than in group one. There were four flap failure attributed to bleeding disorder and to technical errors. Anterior neck burn sequelae thus can be safely treated by enbloc resection and resurfacing with flaps rather than skin graft if possible