Asociación entre maloclusiones y posición de la cabeza y cuello / Association between Malocclusion and Position of the Head and Neck

Con la finalidad de contrastar la hipótesis nula "no hay asociación entre maloclusiones y alteraciones posturales de cabeza y cuello" se realizó un estudio descriptivo transversal en pacientes que consultaron por tratamiento de ortodoncia. La muestra consistió en 116 pacientes con maloclusión atendidos en el Programa de Especialización en Ortodoncia y Ortopedia Dento Máxilo Facial 2007-2009 de la Facultad de Odontología de la Universidad de Chile. Se analizaron las fichas de cada uno de ellos y se buscó asociación entre los valores del Análisis Cráneo Cervical de Rocabado, el cefalograma, estudio de modelos y la evaluación funcional de la lengua. Se encontró asociaciones estadísticas débiles entre la rotación anti horaria del cráneo (ángulo cráneo vertebral y distancia intervertebral C0-C1 disminuidas), con clase III esqueletal que además tenían rotación posterior mandibular y que eran dólico faciales. Altos valores del triángulo hioideo, se asociaron débilmente, con Clase II esqueletal, junto con alteraciones de la posición de la lengua en reposo y retrusión dentaria. Se concluye que en pacientes con maloclusión existe una asociación estadísticamente débil con alteraciones de la postura craneocervical.

In order to test the null hypothesis "there is no association between malocclusion and postural alterations in head and neck" a non-experimental analytical study was carried out in patients with clinical orthodontic treatment. The sample consisted of 116 patients with malocclusion treated at the Specialization Program in Orthodontics and Dento Maxillo Facial Orthopedics from 2007 to 2009, Faculty of Dentistry, Universidad de Chile. We analyzed the records of each patient, for search partnership between the values of Cervical Skull Rocabado Analysis, the cephalogram and study models. We found weak statistical associations between anti-rotation time of the cranium (skull, vertebral angle and distance diminished intervertebral C0-C1), with skeletal class III also had mandibular posterior rotation and were dolicho facial. High values of the hyoid triangle, were weakly associated with skeletal Class II, along with changes in tongue position at rest and dental retrusion. We conclude that in patients with malocclusion there is a statistically weak association with altered craniocervical posture.

Application of finite element method in evaluation of craniocerebral trauma / 法医学杂志

FEM combined with modern computer technology is a mathematical method for stress analysis. It has gradually become a significant experimental tool to explore the functions of biomechanically simulated human body structure and mechanism of craniocerebral injuries. This paper reviewed the features and biomechanical materials of the FEM human head models, materials assignment and their applications in blunt injury, fall, traffic accident. It also explore their merits and values in forensic head injury cases.

The relationship between temporomandibular dysfunction and head and cervical posture

OBJECTIVE: This study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between C0-C1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction. MATERIAL AND METHODS: The patients were evaluated following the guidelines set forth by RDC/TMD. Evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (TMJs) of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. Evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. Data were submitted to statistical analysis by Fisher's exact test at 5%significance level. To measure the degree of reproducibility/agreements between surveys, the kappa (K) statistics was used. RESULTS: Significant differences were observed between C0-C1 measurement for both symptomatic (p=0.04) and asymptomatic (p=0.02). No statistical differences were observed regarding craniocervical angle, C1-C2 and hyoid bone position in relation to the TMJs with and without disc displacement. Although statistically significant difference was found in the C0-C1 space, no association between these and internal temporomandibular joint disorder can be considered. CONCLUSIONS: Based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed.

Balance disorders in the elderly and the benefit of balance exercise.

Symptoms of balance disorders including 'unsteadiness', 'dizziness and vertigo' are common in the elderly and commonly found in general practice in medicine. There are many causes of balance disorders and vary from one person to another. Disorder of the internal ear or vestibular end-organ type is one cause. Unsteadiness of somato-sensory or proprioception is common in the elderly so is degenerative disorder of central control in brain. The elderly are prone to many chronic illnesses or disorders which are causes of balance disorder or give rise to more rapid degeneration of the central nervous system i.e. high blood pressure, diabetes mellitus, heart disease, proprioception and joint problems, arthritis and muscular weakness due to lack of good health and exercise. The objectives of this research study were to find the etiologies of balance disorders and how Balance Exercises and the 'National Health Service' can be of benefit in helping to prevent them. 1565 elderly inhabitants (age > or = 60 years) of 20 communities adjacent to Siriraj Hospital were selected for study. Among these, 625 persons had a history of balance disorders. Among those, 256 had symptoms during the week selected for examination. The average age was 66 years old, women outnumbered men with a ratio of 2.4:1. The common underlying causes were hypertension in 32.4%, diabetes mellitus 13.8%, arthritis 8.1%, and heart disease 4.4% respectively. All are still taking one or more types of drug. The subjects were randomly divided into two groups for the study purpose of effectiveness of balance exercise. Group 1 did not perform the head balance exercise and Group 2 performed the head balance exercise. Audiometric testing showed impaired hearing in 90% of the subjects. The majority slowed hearing loss in high frequencies. Testing of middle ear function found 75% of Group 1 to have normal middle ear function 77% of Group 2. Brainstem Electrical Response Audiometry (BERA) showed normal response latencies of in 96% of group 1 and 94% of Group 2. Poor morphology of waveform was found in 12% of Group 1 and 16% of Group 2. Doppler sonography for intra-cranial blood flow measurement showed abnormal flow of the ICA in 17.6% of group 1 and 20.16% of group 2. Basilar arterial abnormal flow was found in 77.6% of Group 1 and 80.6% of Group 2 respectively. The flow of ICA was improved after 8 weeks in both groups. The measurement of balance by Posturography showed 86.7% abnormality in Group 1 and 83.5% abnormality in Group 2 (and the majority due to inner ear problems but many cases had a mixture of joints and CNS problems too). Results of the self-evaluation (by questionaires) showed the elderly to have symptoms of light headedness in 51% and loss of balance in 29%, Vertigo with rotation occurred in 23.6%. 49% of the symptoms were intermittent, 56.4% experienced a 'fall". On questioning about the benefit and performance of Head and Neck Exercises, 82.8% found the exercises were easy to perform, 56.4% said the results were very beneficial.

The lateralizing significance of version of head and dystonic limb posturing in epileptic seizures.

Several clinical signs have been described for lateralization and localization of seizure focus in complex partial seizures; however, the specificity of each of these has been widely debated upon. The present study was done to evaluate 'dystonic unilateral limb posturing' and 'versive head movements' for lateralization and localization of epileptic foci in patients with intractable partial complex seizures, being investigated with long term Video-EEG monitoring. Fifteen patients with 46 seizures, studied with long term Video EEG, had either one or both of these signs. The video recordings of the clinical behaviour were noted and later compared with the corresponding EEG. Unilateral dystonic limb posturing and versive head movements had good lateralising value in complex partial seizures, suggestive of temporal lobe origin, contralateral to the seizure focus, with a specificity of 87.5% and 86% respectively. In addition, turning of the whole body to one side was associated with a contralateral seizure focus in 100% cases. Appendicular automatisms were found to be of no lateralising significance, as they occurred on either side with equal frequency. These motor phenomena should, therefore, be enquired about in detail, during history taking for lateralization or localization of seizure focus.

A importância do conhecimento das cadeias ganglionares da cabeça e do pescoço / The applied value of the head and neck lymph nodes knowledge

Os autores apresentam uma seqüência lógica e didática para o entendimento das cadeias ganglionares da região da cabeça e do pescoço, bem como seus envolvimentos com processos patológicos e a aplicação prática na clínica estomatológica e bucomaxilofacial.

Tumores malignos de cabeza y cuello (31 casos) / Malignant tumors of head and reck (3) cases

El objetivo de este trabajo es analizar nuestra propia experiencia en los últimos 6 años, en el manejo de los tumores malignos de cabeza y cuello, utilizando un tratamiento combinado de cirugía más radioterapia post operatoria. Se realizo exenteraciones oculares solo en 2 pacientes, 1 por invasión de contenido orbitario y otro por recidiva de tumor, luego de 8 meses post-cirugía.

Embolización de lesiones de la cabeza

La patología vascular y neoplásica de la cabeza ha tenido una importante alternativa terapéutica desde hace más de 15 años a travéz de las embolizaciones transcateter (1). El cateterismo superselectivo (2,3), el desarrollo de catéteres (1) y pequeñas partículas embólicas (4), de líquidos embolizantes (5), así como los avances en el estudio de áreas vasculares específicas (6), han determinado una evolución significativa en las técnicas terapéuticas de varios desórdenes intra y extracraneales (7). El presente es un reporte general de 43 procedimientos de oclusión intravascular con varias técnicas, realizadas en 39 pacientes portadores de malformaciones vasculares y tumores de la cabeza. los resultados fueron terapéuticos definitivamente en 19 pacientes y prequirúrgicos en 20. Los catéteres con balón desprendible y el polivinil-alcohol probaron ser los materiales más útiles.

Perfil neuroevolutivo del lactante con macrocefalia y ensanchamiento benigno del espacio subaracnoideo / Neuroevolutionary profile of nursing with macrocephalia and benign widening of the subarachnoid space

Con la finalidad de estudiar el pronóstico neuroevolutivo de los niños con macrocefalia (percentil>95) y ensanchamiento del espacio subaacnoideo identificados por TAC del cráneo, se seleccionaron cinco casos atendidos en el consultorio de Neurología Pediátrica del Hospital Regional Docente de Trujillo, Perú, entre enero de 1983 a enero de 1988 y cuyo seguimiento alcanzó entre 1.5 a 3 años. Todos los lactantes mostraron en la TAC, separación anormal del espacio subaracnoideo frontal, fisura interhemisférica y cisura de Silvio sin ventriculomegalia o mínima dilatación del sistema ventricular. Mediante la evaluación neurológica y la prueba de Desarrollo de Denver se observó en todos los casos, excepto uno, un patrón caracterizado por hipotonía y retardo motor grueso durante el primer año de vida, el cual fue modificándose hacia la normalidad los controles secuenciales hasta la edad de 25 a 40 meses. Estos hallazgos sugieren el buen pronóstico y la benignidad de esta condición que se resuelve espontáneamente y relacionada al parecer con macrocefalia familiar benigna