Uso del músculo temporal en reconstrucción periorbitaria post exéresis de carcinoma epidermoide cutáneo del globo ocular izquierdo / Use of the temporal muscle in post exeresis periorbital reconstruction of cutaneous epidermoid carcinoma of the left eyeball

Introducción. El carcinoma epidermoide cutáneo (CEC) es la segunda neoplasia cutánea más frecuente después del carcinoma basocelular. La incidencia del CEC ha aumentado de forma considerable durante los últimos 20 años y predicen un incremento en la próxima década. La mayoría de los CEC están localizados y se resuelven habitualmente mediante la extirpación quirúrgica u otros procedimientos locales. El uso del músculo temporal es una alternativa quirúrgica para corregir el defecto periorbitario tras la extirpación del CEC. Objetivo. Evaluar el resultado de la cobertura del músculo temporal en la corrección del defecto periorbitario. Material y métodos. Se presenta un caso quirúrgico de un paciente masculino, 62 años, que presenta una gran lesión tumoral que compromete el globo ocular, región orbitaria y periorbitaria izquierda, acompañado de dolor, anemia, astenia y pérdida ponderal de aproximadamente 20 libras. Con una evolución de 6 años. Conclusión. El uso del músculo temporal es una alternativa eficaz en la reconstrucción de lesiones craneofaciales, que ha sido utilizado por más de 100 años.

Introduction. Skin epidermoid carcinoma (SEC) is the second most common skin neoplasm after basal cell carcinoma. The incidence of SEC has increased considerably over the past 20 years and predicts an increase over the next decade. Most SECs are located and usually resolved by surgical removal or other local procedures. The use of the temporal muscle is a surgical alternative to correct the peri-orbital defect after removal of the SEC. Objective. To evaluate the result of temporal muscle coverage in the correction of the peri-orbital defect. Material and methods. There is a surgical case of a male patient, 62 years old who has a large tumor injury that compromises the eyeball, orbital region and left periorbital. Accompanied by pain, anemia, asthenia, and weight loss approximately 20 pounds. With an evolution of 6 years. Conclusion. The use of the temporalis muscle is an effective alternative in the reconstruction of craniofacial lesions that has been used for more than 100 years

Interpositional Arthroplasty with Temporomyofascial Flap to Correct TMJ Reankylosis in Child: A Case Report.

Temporomandibular joint ankylosis (TMA) is a highly distressing condition in which the temporomandibular joint (TMJ) is replaced by scar tissue. Most frequently reported complications after surgical treatment are limited mouth opening and re-ankylosis. Reankylosis happens due to inadequate bone removal, lack of sufficient interpositional material, fibrous tissue adhesions and elongation of coronoid process and regrowth of bone in the sigmoid notch area. In gap arthroplasty treatment chances to recurrence is 53% than interpositional arthroplasy. We treated a case of right sided TMJ reankylosis by interpositional arthroplasty with temporomyofacial flap and physiotherapy was started 3 days after surgery and maintained for 6 months. In 2 years follow-up, no signs of recurrence and maximum mouth opening 45 mm were observed. The success in preventing reankylosis after TMJ interpositional arthroplasty with temporomyofacial flap is relatively better than gap arthroplasty alone.

Treatment of Unilateral TMJ Ankylosis in a Pediatric Patient with Temporalis Fascia Flap A Case Report.

The definite cause of temporomandibular joint (TMJ) ankylosis is still an unknown fact. TMJ ankylosis may result from, infection, trauma or insufficient surgical treatment of the mandibular condyle region. Different techniques have been described so far for the treatment of TMJ ankylosis, but no technique has successfully given uniform results. Relapse causing limited mouth opening, infection, open bite, reankylosis are the complications. Many authors agree that aggressive physiotherapy immediately after the surgical procedure, interpositional graft as spacer and wide bone resection are the basic principles in treating TMJ ankylosis. In this article, we discussed a case of unilateral TMJ ankylosis, in a 9-year-old boy, treated with the intre-positional gap arthroplasty with superficial temporalis fascia flap.

Colgajo miofascial de temporal en la reconstrucción de maxilar superior: informe de un caso / Temporal myofascial flap in the reconstruction of the maxilla: a case report

Objetivo: exponer las ventajas y desventajas del colgajo de músculo temporal en la reconstrucción del maxilar superior. Describir la técnica quirúrgica completa, desde el colgajo hemicoronal hasta la tunelización y fijación al maxilar contralateral. Caso clínico. Se trata de un paciente de 75 años con diangóstico de carcinoma espinocelular de la infraestructura del maxilar superior izquierdo. Se determina su resección y reconstrucción con colgajo de músculo temporal. Conclusión: para este fin, existe una gran cantidad de colgajos, como los colgajos a distancia, a pedicuro vascular y los microvascularizados. Estos últimos poseen la gran ventaja de transportar todos los tejidos necesarios, a diferencial del colgajo temporal. Pese a esto, el colgajo de temporal constituye una solución rápida, segura, estética y funcionalmente excelente para la reconstrucción del maxilar superior.

Reconstrucción de la parálisis facial con colgajo del músculo temporal / Reconstruction of facial paralysis with temporalis muscle flap

INTRODUCCIÓN. La transposición de un sistema muscular vital y dinámico en una cara paralizada presenta ventajas biológicas sobre otras técnicas de suspensión que emplean trasplantes musculares de diferentes sitios anatómicos. El objetivo del presente estudio fue describir los resultados, las complicaciones encontradas y la satisfacción de los pacientes tratados mediante transposición del músculo temporal. MÉTODOS. Se realizó una investigación descriptiva y prospectiva con 7 pacientes atendidos entre septiembre de 1997 y julio de 1999. A estos pacientes se les practicó una incisión preauricular que se prolongó hasta la región temporal, en forma de T; se les separó el músculo temporal en toda su extensión y se confeccionaron dos segmentos que a su vez se seccionaron en 4 pequeños colgajos. Se labraron túneles subcutáneos en ambos párpados y labios, donde se introdujeron los colgajos y luego se fijaron al ligamento del canto interno y al tejido celular subcutáneo mediante suturas no absorbibles. El defecto de la fosa temporal fue rellenado con hidroxiapatita en granulado. RESULTADOS. Se obtuvo mejoría en la elevación de la comisura labial en el 100 por ciento de los pacientes operados, pero solo en un paciente (14,3 por ciento) se observó un cierre parcial del ojo. El 87,5 por ciento de los pacientes estuvieron satisfechos con los resultados funcionales obtenidos. Se observaron complicaciones en tres pacientes, las más frecuentes de las cuales fueron la dehiscencia de las suturas musculares, el rechazo al material de relleno y la sepsis local. CONCLUSIONES. Se pudo concluir que esta técnica está indicada en pacientes con secuelas funcionales graves, con atrofia muscular evidente y desviación de la comisura labial(AU)

INTRODUCTION. The transposition of vital and dynamic muscle system in a paralyzed face presents biological advantages over other suspension techniques using muscle transplants from different anatomical sites. The objective of the present study was to describe the results, the complications found and the satisfaction of the patients treated by temporalis muscle transposition. METHODS. A descriptive and prospective research was conducted in 7 patients treated between September 1997 and July 1999. A T-shaped preauricular incision that was prolonged to the temporal region was made. The temporalis muscle was separated in all its extension, the two segments obtained were sectioned into 4 small flaps. Subcutaneous tunnels were made in both eyelids and lips, where the flaps were introduced and fixed then to the ligament of the inner edge and to the subcutaneous cellular tissue by non-absorbable sutures. The defect of the temporal fossa was filled with granulated hydroxyapatite. RESULTS. An improvement of the elevation of the lip commissure was attained in 100 percent of the patients that were operated on, A partial closure of the eye was observed in only one patient (14.3 percent). 87.5 percent of the patients were satisfied with the functional results. Complications were reported in 3 patients. The most frequent were dehiscence of the muscle sutures, the rejection to the filling material and local sepsis. CONCLUSIONS. It was concluded that this technique is indicated in patients with severe functional sequelae, with muscle atrophy and deviation of the lip commissure(AU)

Anaesthetic considerations of temporomandibular joint ankylosis with obstructive sleep apnoea: a case report.

The peroperative management of a 4 1/2 yr old child having bilateral recurrent temporomandibular joint (TMJ) ankylosis and obstructive sleep apnoea (OSA) is presented here. From the anaesthesiologist's point of view, the patient demands special considerations as regards difficulty in intubation, high sensitivity to all central depressant drugs, awake extubation, and post-operative maintenance of a clear airway. It is to be concluded that these conditions call for strict adherence to the basic principles of airway management and close observation extending into the post-operative period.

Mixoma de los maxilares: ¿tumor de alta agresividad? / Maxillary myxoma: a highly aggressive tumor?

Los tumores de los maxilares de origen odontogénico son aquellos que se originan a partir de la células epiteliales y mesenquimales especializadas que forman los tejidos del diente. En la patología oral y máxilo facial tenemos tumores de alta agresividad, tales como el Mixoma, el Tumor Odontogénico Epitelial Calcificante y el Ameloblastoma, importantes a tener en cuenta para el diagnóstico diferencial. Los autores reportan cuatro casos de mixoma en los maxilares, de los cuales dos fueron ubicados en la mandíbula y los restantes en el maxilar superior. El uso del colgajo de Weber-Ferguson para la resección de los Mixomas del maxilar superior fueron los elegidos debido al comportamiento y tamaño de dicho tumor. Mientras que los Mixomas mandibulares fueron resecados marginalmente debido al menor compromiso de estructuras mandibulares afectadas

An analytic study of surgical management of the temporomandibular joint ankylosis: an experience in Bangladesh.

The clinical observations on 14 cases of temporomandibular joint (TMJ) ankylosis including age and sex incidences as well as surgical management are presented in this paper. Ankylotic TMJ arthroplasty which include condylectomy with or without interpositional materials such as auricular cartilage and temporalis muscle flap to prevent reankylosis was used as the corrective measure. The accessory procedures like costochondral grafts and saggital split osteotomy to restore ramus height accompanied by camouflaging genioplasty in some of these cases were carried out. Besides, bilateral concomitant coronoidectomy were done in all cases. The patients were divided in three groups. In four cases only condylectomy was performed; the result was poor in three cases and moderate in one case. Condylectomy accompanied by interpositioning of auricular cartilage was done in another four patients; the result was poor in one case, moderate in one case and good in 2 cases. Six subjects were treated with condylectomy along with interpositioning of temporalis muscle flap; the result was good in 5 and moderate in 1 case. Condylectomy with temporalis muscle flap appeared to be the best method for TMJ ankylosis.

Transposiçäo muscular na reabilitaçäo da face paralisada / Muscle transposition in facial paralysis

As paralisias faciais tardias acarretam grandes alteraçöes neurofisiológicas e de fibras musculares, sendo geralmente proporcionais ao tempo de paralisia facial, trazendo, por isso, dificuldades na sua reabilitaçäo. A eletromiografia e a biopsia muscular säo os exames-chaves para determinar qual o método ideal a ser utilizado na reabilitaçäo facial, ou seja, através de reinervaçäo (enxerto autôgeno de nervo, anastomose hipoflosso-facial) ou de transposiçäo muscular. A transposiçäo muscular é indicada quando: 1. Inadequaçäo do sistema neuromuscular facial periférico; 2. Inviabilidade do coto central do nervo facial, para que se possa fazer a anastomose, ou quando o paciente se recusa a ter o nervo hipoglosso sacrificado na anastomose hipoglosso-facial; 4. Grau insatisfatório de melhora no paciente que tenha sofrido reparo no nervo, enxerto, anastomose hipoglosso-facial e/ou enxerto fásico-facial. Tratamos com a técnica de transposiçäo do músculo temporal cinco pacientes portadores de paralisia perférica unilateral,com idades variando entre 10 e 62 anos, sendo quatro do sexo masculino e um do sexo feminino. As paralisias faciais tinham tempo de duraçäo de dois a dez anos. A etiologia da paralisia facial nos cinco pacientes foram: congênita, traumática, tumoral e iatrogênica. Os resultados da transposiçäo muscular säo baseados na movimentaçäo dos esfíncteres da boca e das pálpebras (excelente, bom, razoável ou mau). O objetivo deste estudo é demonstrar a eficácia do emprego da transposiçäo do músculo temporal em cinco pacientes portadores de paralisia facial periférica unilateral tardia de etiologias variáveis