ABSTRACT
RATIONALE: Sublingual hematoma is a potentially lethal complication following mandibular implant placement. Due to the scarce cases reported, the management is controversial. In this article, a case is discussed focusing on the different treatment options to establish an orientative guideline. PATIENT CONCERNS: A patient with sublingual hematoma following implant surgery was urgently referred. Despite no active bleeding, breathing difficulty due to oropharyngeal obstruction and oxygen saturation decrease were present. DIAGNOSIS: Stable sublingual hematoma with respiratory distress, based on clinical findings and observation. TREATMENT: Under local anaesthesia, percutaneous tracheostomy without previous intubation was performed for airway preservation. No surgical approach for the hematoma was made. OUTCOMES: Uneventful recovery with spontaneous resolution of the hematoma in few days. TAKEAWAY LESSONS: Anatomic knowledge of this area and proper surgical planning are required to avoid this complication. Regarding management, airway preservation is mandatory. Surgical approach for the bleeding source will depend on hematoma progression.
ABSTRACT
Objetivos: el presente estudio se realizó para encontrar posiblesfactores pronósticos del Carcinoma oral de células escamosaspuesto que es una enfermedad frecuente ( 3 4 % de los tumoresmalignos ) que origina una gran morbilidad y mortalidad y quejustifica cualquier intento que trate de aportar algo para conocermejor esta patología. Diseño del estudio: hemos realizadoun estudio sobre 81 carcinomas orales de células escamosasextraídos del archivo del Hospital Universitario Marqués deValdecilla ( Santander ) , tratados con el mismo procedimiento, de los cuales en 67 de ellos se realizó citometría de flujo.Resultados: No hemos encontrado diferencias estadísticamentesignificativas entre el índice de proliferación celular y el índicemitótico , la ploidía y la fase S. Así mismo ninguna de lasvariables citométricas estudiadas ha presentado relación conla aparición de recidiva loco-regional , metástasis a distanciani con la supervivencia.Conclusiones: no podemos utilizar éstas variables como factor pronósticoen el carcinoma de células escamosas de la cavidad oral
Objectives: the present study was made in order to find possibleprognostic factors in oral squamous cell carcinoma, given thatit is a frequent disease (3-4% of all malignant tumors) and isthe cause of a high morbidity and mortality which justifies anyattempt to contribute something towards the understanding ofthis pathology.Study design: 81 oral squamous cell carcinomas, treated with thesame procedure, and retrieved from the archive of the HospitalUniversitario Marqués de Valdecilla (Santander) were studied.Flow cytometry was carried out on 67 of the samples.Results: no statistically significant differences were foundbetween the cellular proliferative index and the mitotic index,ploidy and the S-phase factor. Likewise, none of the cytometricvariables studied presented any association with the appearanceof local relapse, distant metastases or survival.Conclusions: these variables cannot be used as a prognosticfactors in squamous cell carcinomas of the oral cavity
Subject(s)
Humans , Carcinoma, Squamous Cell/pathology , Mouth Neoplasms/pathology , Analysis of Variance , Aneuploidy , Carcinoma, Squamous Cell/genetics , Cell Physiological Phenomena , Cytogenetic Analysis , Flow Cytometry , Prognosis , Proportional Hazards Models , S Phase , Survival Analysis , Mitotic Index , DNA, Neoplasm/analysis , Mouth Neoplasms/geneticsABSTRACT
OBJECTIVES: The present study was made in order to find possible prognostic factors in oral squamous cell carcinoma, given that it is a frequent disease (3-4% of all malignant tumors) and is the cause of a high morbidity and mortality which justifies any attempt to contribute something towards the understanding of this pathology. STUDY DESIGN: 81 oral squamous cell carcinomas, treated with the same procedure, and retrieved from the archive of the Hospital Universitario Marqués de Valdecilla (Santander) were studied. Flow cytometry was carried out on 67 of the samples. RESULTS: No statistically significant differences were found between the cellular proliferative index and the mitotic index, ploidy and the S-phase factor. Likewise, none of the cytometric variables studied presented any association with the appearance of local relapse, distant metastases or survival. CONCLUSIONS: These variables cannot be used as a prognostic factors in squamous cell carcinomas of the oral cavity.
Subject(s)
Carcinoma, Squamous Cell/pathology , Mouth Neoplasms/pathology , Analysis of Variance , Aneuploidy , Carcinoma, Squamous Cell/genetics , Cell Proliferation , Cytogenetic Analysis , DNA, Neoplasm/analysis , Flow Cytometry , Humans , Mitotic Index , Mouth Neoplasms/genetics , Prognosis , Proportional Hazards Models , S Phase , Survival AnalysisABSTRACT
En este artículo, a propósito de un caso clínico, se presenta elcóndilo bífido como una rara alteración mandibular con muchasincógnitas. Su diagnóstico suele ser un hallazgo casual en radiografíaspanorámicas de rutina. El número de casos relatados enliteratura ha experimentado en los últimos años un crecimientodebido al aumento de pruebas radiológicas que se realizan. Sediscute sobre las diferentes teorías existentes con respecto a laetiología de este proceso. En lo referente a la relevancia clínicadel cóndilo bífido señalamos que la gran mayoría son asintomáticos.Es importante realizar un buen diagnóstico diferencialde éste proceso con otras lesiones que producen alteracionesmorfológicas condilares, la prueba de elección es la tomografíacomputerizada. El tratamiento conservador suele ser efectivo enlos casos con clínica de disfunción articular leve, la cirugía tansólo suele indicarse en casos de anquilosis condilar, normalmenteéstos casos son secundarios a traumatismos
The double headed mandible condyle is a rare alteration that isfrequently diagnosticated as an incidental finding in a panoramicradiograph. The different theories about its etiology areexplained in this article. Symptoms described with bifid condylesvary from case to case, but in most instances are absent.Computer tomography is the ideal imaging method to evaluatethe condyle morphology and to role out any degenerative processto achieve the differential diagnosis. Treatment is conservativefor symptomatic patients with TMJ disorders, surgical treatmentis described in literature in TMJ ankylosis that develops in bifidcondyles secondary to trauma
Subject(s)
Female , Adult , Humans , Mandibular Condyle/abnormalities , Mandibular Condyle , Temporomandibular Joint Disorders/diagnosis , Temporomandibular Joint Disc/pathology , Mandibular Condyle/surgery , Joint Dislocations/diagnosis , Temporomandibular Joint , Tomography, X-Ray Computed , Magnetic Resonance Imaging , Radiography, Panoramic , Diagnosis, DifferentialABSTRACT
The double headed mandible condyle is a rare alteration that is frequently diagnosticated as an incidental finding in a panoramic radiograph. The different theories about its etiology are explained in this article. Symptoms described with bifid condyles vary from case to case, but in most instances are absent. Computer tomography is the ideal imaging method to evaluate the condyle morphology and to role out any degenerative process to achieve the differential diagnosis. Treatment is conservative for symptomatic patients with TMJ disorders, surgical treatment is described in literature in TMJ ankylosis that develops in bifid condyles secondary to trauma.
