ABSTRACT
OBJECTIVES: The aim of the study was to investigate the clinical effect of stainless-steel wire fixation on the early mouth-opening movement of an intracapsular fracture involving the condylar process. MATERIALS AND METHODS: In this study, patients who underwent mandibular condylar intracapsular fracture surgery in our hospital from 2012 to 2020 were selected as research subjects. A total of 44 patients received steel wire internal fixation treatment, 32 patients received titanium plate-and-nail rigid internal fixation, and 28 patients underwent conservative non-surgical treatment. RESULTS: For the patients in the stainless-steel wire group, the degree of mouth opening reached normal levels of 3.7 cm approximately 10 days after surgery. The recovery time for the patients in the titanium plate-and-nail rigid internal-fixation group was 21 days, while the patients in the conservative treatment group needed 60 days to recover. CONCLUSION: The treatment of fixation with a stainless-steel wire for intracapsular condylar fracture reduced the time taken to perform mouth-opening exercises and improved the recovery rate of patients.
OBJETIVO: Explorar el efecto clínico de la fijación de alambre de acero inoxidable en el movimiento temprano de apertura de la boca en la fractura interna del cóndilo. MÉTODO: Este estudio seleccionó a pacientes que se sometieron a cirugía de fractura intracapsular de cóndilo en nuestro hospital de 2012 a 2020 como sujetos de investigación. Un total de 44 pacientes recibieron tratamiento de fijación interna de alambre de acero, 32 recibieron placa de titanio y fijación interna con clavos, y 28 recibieron tratamiento conservador no quirúrgico. RESULTADOS: En los pacientes del grupo de alambre de acero inoxidable, alrededor de 10 días después de la cirugía el grado de apertura de la boca alcanzó un valor normal de 3.7 cm. El tiempo de recuperación de los pacientes en el grupo de fijación interna con clavos y placa de titanio fue de 21 días, mientras que los pacientes en el grupo de tratamiento conservador tardaron 60 días en recuperarse. CONCLUSIONES: La fijación con alambre de acero inoxidable para el tratamiento de la fractura intracapsular del cóndilo acorta el tiempo hasta la apertura de la boca y mejora la tasa de recuperación de los pacientes.
Subject(s)
Bone Plates , Bone Wires , Fracture Fixation, Internal , Mandibular Condyle , Mandibular Fractures , Stainless Steel , Humans , Fracture Fixation, Internal/methods , Fracture Fixation, Internal/instrumentation , Mandibular Fractures/surgery , Mandibular Condyle/injuries , Mandibular Condyle/surgery , Male , Female , Adult , Middle Aged , Titanium , Range of Motion, Articular , Bone Nails , Young Adult , Retrospective StudiesABSTRACT
Introducción: el proceso de atención del paciente adulto mayor con fractura de cadera exige el análisis de forma sistemática de las secuencias y añade valor a cada una de las acciones con el objetivo de la disminuir la variabilidad de la práctica clínica y elevar la calidad de la atención a estos pacientes. Objetivo: caracterizar los pacientes anulados e intervenidos de urgencia por fractura de cadera. Método: se realizó un estudio cuasiexperimental para un solo grupo en los pacientes propuestos para intervención quirúrgica urgente por fractura de cadera en el Hospital Universitario Manuel Ascunce Domenech de la provincia Camagüey en el periodo del 1 de enero al 31 de diciembre de 2014. Se estudiaron 204 pacientes los que se dividieron en dos grupos menos de 60 años y 60 años y más. Resultados: predominó el sexo femenino con 60 años y más en 119 de los pacientes intervenidos por fractura de cadera, la probabilidad de fractura extracapsular fue de un odss ratio de 17, se representó la fractura extracapsular con 124 pacientes, la estadía hospitalaria osciló para los pacientes intervenidos en seis días y en los que se les canceló la intervención 15 días. La mortalidad de los pacientes cancelados está en relación con sepsis grave. Conclusión: los pacientes intervenidos de urgencia por fractura de cadera se catalogaron de alto riesgo anestésico quirúrgico y egresan en condición de vivo(AU)
Introduction: caring for the elderly patient with hip fracture requires an analysis of systematic sequences and adds value to each of the actions, with the aim at reducing the variability of clinical practice and improving the quality of caring for these patients. Objective: To characterize patients canceled and intervened as an emergency due to hip fracture. Method: A quasiexperimental study was carried out with a single group in the patients chosen for emergency surgery due to hip fracture, at Manuel Ascunce Domenech University Hospital of Camagüey Province and in the period from January 1 to December 31, 2014. 204 patients were studied and divided into two groups: at ages under 60 and 60 years or older. Results: the female sex predominated as aged 60 years and older in 119 patients intervened due to hip fracture, the probability of extracapsular fracture had an odds ratio of 17, extracapsular fracture was represented by 124, hospital stay ranged up to six days for patients intervened and for those who were cancelled their operation, up to 15 days. The mortality of canceled patients is in connection with severe sepsis. Conclusion: Patients who were performed emergency surgery due to hip fracture were classified as high surgical-anesthetic risk and admitted under the alive condition(AU)
Subject(s)
Humans , Female , Aged , Hip Fractures/diagnosis , Hip Fractures/surgery , Patient Care/methods , Emergency Medical Services , Quality of Health Care/statistics & numerical data , Anesthesia Department, HospitalABSTRACT
Background: Cranial cruciate ligament rupture occurs frequently in dogs and causes hind limb lameness because of joint instability. Affected patients require surgical joint reconstruction, which may be extracapsular or intracapsular. To prevent complications caused by limb disuse such as muscular atrophy and ankylosis, physiotherapy is performed postoperatively to improve the quality of life. Accordingly, the present study evaluated the influence of physiotherapy on functional stifle recovery and joint stability in dogs undergoing intracapsular surgical stabilization to repair cruciate ligament rupture.Materials, Methods & Results: Eight dogs were randomly allocated into control (GI, n = 4) and physiotherapy (GII, n = 4) groups. Physiotherapy was initiated immediately postoperatively in the GII group and including the following interventions: cryotherapy, passive joint movement, massage, passive elongation, electrical neuromuscular stimulation, hot hydrotherapy, and underwater treadmill at the major trochanter and tibial malleolus levels. Therapeutic exercises were also performed including: walks on grass and hard-floor, ball, ramp, cones, obstacles, platform, and mattress. Gait evaluation, thigh circumference, stifle goniometry, hind limb and stifle radiography, and joint stability (drawer test) were assessed preoperatively, and at 45 and 90 days postoperatively...
Subject(s)
Animals , Dogs , Fractures, Bone/rehabilitation , Fractures, Bone/veterinary , Ligaments, Articular/injuries , Intermittent Claudication , Physical Therapy Modalities/veterinaryABSTRACT
Background: Cranial cruciate ligament rupture occurs frequently in dogs and causes hind limb lameness because of joint instability. Affected patients require surgical joint reconstruction, which may be extracapsular or intracapsular. To prevent complications caused by limb disuse such as muscular atrophy and ankylosis, physiotherapy is performed postoperatively to improve the quality of life. Accordingly, the present study evaluated the influence of physiotherapy on functional stifle recovery and joint stability in dogs undergoing intracapsular surgical stabilization to repair cruciate ligament rupture.Materials, Methods & Results: Eight dogs were randomly allocated into control (GI, n = 4) and physiotherapy (GII, n = 4) groups. Physiotherapy was initiated immediately postoperatively in the GII group and including the following interventions: cryotherapy, passive joint movement, massage, passive elongation, electrical neuromuscular stimulation, hot hydrotherapy, and underwater treadmill at the major trochanter and tibial malleolus levels. Therapeutic exercises were also performed including: walks on grass and hard-floor, ball, ramp, cones, obstacles, platform, and mattress. Gait evaluation, thigh circumference, stifle goniometry, hind limb and stifle radiography, and joint stability (drawer test) were assessed preoperatively, and at 45 and 90 days postoperatively...(AU)
Subject(s)
Animals , Dogs , Ligaments, Articular/injuries , Fractures, Bone/rehabilitation , Fractures, Bone/veterinary , Intermittent Claudication , Physical Therapy Modalities/veterinaryABSTRACT
Introducción: La reducción y osteosíntesis con tornillos canulados en las fracturas mediales de cadera constituye una opción terapéutica válida. Nuestro objetivo es identificar factores pronósticos y grupos de riesgo. Materiales y Métodos: Se estudiaron retrospectivamente 93 fracturas intracapsulares de cadera tratadas con fijación interna con tornillos canulados de 6,5 mm, entre junio de 1995 y marzo de 2011 (71 no desplazadas y 22 desplazadas). Resultados: En 82 de los 93 casos, se observó la consolidación de la fractura. Once pacientes tuvieron complicaciones (5 seudoartrosis y 6 necrosis avascular). En el grupo de fracturas no desplazadas, la consolidación fue del 95,8 por ciento y, en el grupo de las desplazadas, del 63,6 por ciento. En este último grupo, si presentaban conminución, la consolidación fue del 50 por ciento y, en el grupo sin conminución, fue del 71,4 por ciento. El índice de consolidación fue del 46,1 por ciento con reducción cerrada y del 88 por ciento con reducción abierta. Conclusión: La reducción cerrada y la osteosíntesis con tornillos canulados en fracturas impactadas o no desplazadas del cuello del fémur, cualquiera sea la edad del paciente, resulta un método exitoso. En las fracturas desplazadas, en cambio, la consolidación sin necrosis es menos previsible, por lo que su indicación deberá ser más meditada. (AU)
Background: Reduction and osteosynthesis with cannulated screws in femoral neck fracture is a valid therapeutic option. Our objective is to identify prognostic factors and risk groups. Methods: We studied retrospectively 93 femoral neck fractures treated with internal fixation with cannulated screw between June 1995 and March 2011 (71 non-displaced and 22 displaced). Results: In 82 of the 93 cases we observed bone consolidation of the fracture. Eleven patients presented complications (5 non-union and 6 avascular necrosis). Consolidation rates were 95.8% and 63.6% in the non-displaced group and the displaced group of fractures. If the displaced fractures presented conminution, consolidation rate was 50% and 71.4% in the group without conminution. The consolidation index was 46.1% with closed reduction and 88% with open reduction. Conclusion: Closed reduction and internal fixation with cannulated screws in non-displaced femoral neck fractures, regardless of the patientÆs age, is a successful method. In displaced fractures, on the other hand, necrosis free consolidation is less predictable, so its indication must be evaluated carefully. (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Femoral Neck Fractures/surgery , Fracture Fixation, Internal/methods , Hip Joint/surgery , Bone Screws , Age Factors , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
Introducción: La reducción y osteosíntesis con tornillos canulados en las fracturas mediales de cadera constituye una opción terapéutica válida. Nuestro objetivo es identificar factores pronósticos y grupos de riesgo. Materiales y Métodos: Se estudiaron retrospectivamente 93 fracturas intracapsulares de cadera tratadas con fijación interna con tornillos canulados de 6,5 mm, entre junio de 1995 y marzo de 2011 (71 no desplazadas y 22 desplazadas). Resultados: En 82 de los 93 casos, se observó la consolidación de la fractura. Once pacientes tuvieron complicaciones (5 seudoartrosis y 6 necrosis avascular). En el grupo de fracturas no desplazadas, la consolidación fue del 95,8 por ciento y, en el grupo de las desplazadas, del 63,6 por ciento. En este último grupo, si presentaban conminución, la consolidación fue del 50 por ciento y, en el grupo sin conminución, fue del 71,4 por ciento. El índice de consolidación fue del 46,1 por ciento con reducción cerrada y del 88 por ciento con reducción abierta. Conclusión: La reducción cerrada y la osteosíntesis con tornillos canulados en fracturas impactadas o no desplazadas del cuello del fémur, cualquiera sea la edad del paciente, resulta un método exitoso. En las fracturas desplazadas, en cambio, la consolidación sin necrosis es menos previsible, por lo que su indicación deberá ser más meditada.
Background: Reduction and osteosynthesis with cannulated screws in femoral neck fracture is a valid therapeutic option. Our objective is to identify prognostic factors and risk groups. Methods: We studied retrospectively 93 femoral neck fractures treated with internal fixation with cannulated screw between June 1995 and March 2011 (71 non-displaced and 22 displaced). Results: In 82 of the 93 cases we observed bone consolidation of the fracture. Eleven patients presented complications (5 non-union and 6 avascular necrosis). Consolidation rates were 95.8% and 63.6% in the non-displaced group and the displaced group of fractures. If the displaced fractures presented conminution, consolidation rate was 50% and 71.4% in the group without conminution. The consolidation index was 46.1% with closed reduction and 88% with open reduction. Conclusion: Closed reduction and internal fixation with cannulated screws in non-displaced femoral neck fractures, regardless of the patients age, is a successful method. In displaced fractures, on the other hand, necrosis free consolidation is less predictable, so its indication must be evaluated carefully.
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Hip Joint/surgery , Fracture Fixation, Internal/methods , Femoral Neck Fractures/surgery , Age Factors , Bone Screws , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
Introducción: Las fracturas de cadera son muy frecuentes en ancianos. La hemiartroplastia es un tratamiento aceptado para las fracturas mediales desplazadas en pacientes ancianos y con baja demanda funcional. El objetivo de este trabajo es documentar la tasa de mortalidad a los 30 días y al año, y las complicaciones asociadas en pacientes con mal estado general. Materiales y Métodos: Desde 2003 hasta 2010, se operaron 1134 pacientes con diagnóstico de fractura medial de cadera. El 9% (101) fue tratado con hemiprótesis de Austin Moore, y 91 de ellos fueron incluidos en esta serie. Todos eran deambuladores intradomiciliarios y tenían múltiples comorbilidades asociadas. La supervivencia fue evaluada con el método de Kaplan-Meier; y la asociación entre mortalidad y sexo, infección y luxación, con un modelo de regresión de riesgos proporcionales de Cox. Resultados: Setenta pacientes eran mujeres (77 %) y la media de la edad era de 85 años. La mortalidad fue del 7 % a los 30 días y del 36 % al año. Diez pacientes (11 %) presentaron algún episodio de luxación protésica y 13 (14,3 %) sufrieron una complicación infecciosa. La asociación entre infección/mortalidad y sexo masculino/mortalidad fue estadísticamente significativa (p = 0,009 y p = 0,013). Los pacientes con infección tuvieron una tasa más alta de luxación (p = 0,00001). Conclusión: La hemiartroplastia con prótesis de Austin Moore es una alternativa válida para pacientes con fractura medial desplazada, baja demanda funcional y mal estado general, pues es un procedimiento rápido, que elimina el dolor, y permite una movilidad precoz...(AU)
Background: Hip fractures are common in elderly people. Hemiarthroplasty is an accepted treatment for intracapsular fractures of the hip in elderly patients with low functional demands. The objective of this study is to show the 30-day and 1-year mortality rates and associated complications in patients with bad performance status. Methods: Between 2003 and 2010, 1,134 patients with intracapsular fractures of the hip were treated. One hundred and one patients (9 %) were treated with Austin Moore hemiprosthesis and 91 of them were included in this series. All were toddlers in their homes and they had multiple comorbidities. Kaplan-Meier estimator was used to evaluate survival. Mortality was then related to sex, age, infection and dislocation using a Cox proportional hazards regression model. Results: Seventy patients were women (77 %) and the mean age of the series was 85 years. The 30-day and 1-year mortality rates were 7 % and 36 %, respectively. Ten patients (11 %) had an episode of prosthetic dislocation and 13 (14.3 %) had an infectious complication. Infection/mortality and male/mortality associations were statistically significant (p = 0.009 and p = 0.013). Patients who suffered an infection had a higher rate of dislocation (p = 0.00001). Conclusion: Hemiarthroplasty with Austin Moore prosthesis is a good option for patients with displaced intracapsular hip fractures, low activity demand and multiple comorbidities, since it is a quick procedure that eliminates pain, allowing early mobility...(AU)
Subject(s)
Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/methods , Femoral Neck Fractures/mortality , Femoral Neck Fractures/surgery , Prosthesis-Related Infections , Hemiarthroplasty/methods , Hip Dislocation/diagnosis , Prosthesis Failure , Treatment Outcome , Follow-Up Studies , Retrospective Studies , Postoperative Complications , Survival Rate , MortalityABSTRACT
Introducción: Las fracturas de cadera son muy frecuentes en ancianos. La hemiartroplastia es un tratamiento aceptado para las fracturas mediales desplazadas en pacientes ancianos y con baja demanda funcional. El objetivo de este trabajo es documentar la tasa de mortalidad a los 30 días y al año, y las complicaciones asociadas en pacientes con mal estado general. Materiales y Métodos: Desde 2003 hasta 2010, se operaron 1134 pacientes con diagnóstico de fractura medial de cadera. El 9% (101) fue tratado con hemiprótesis de Austin Moore, y 91 de ellos fueron incluidos en esta serie. Todos eran deambuladores intradomiciliarios y tenían múltiples comorbilidades asociadas. La supervivencia fue evaluada con el método de Kaplan-Meier; y la asociación entre mortalidad y sexo, infección y luxación, con un modelo de regresión de riesgos proporcionales de Cox. Resultados: Setenta pacientes eran mujeres (77 %) y la media de la edad era de 85 años. La mortalidad fue del 7 % a los 30 días y del 36 % al año. Diez pacientes (11 %) presentaron algún episodio de luxación protésica y 13 (14,3 %) sufrieron una complicación infecciosa. La asociación entre infección/mortalidad y sexo masculino/mortalidad fue estadísticamente significativa (p = 0,009 y p = 0,013). Los pacientes con infección tuvieron una tasa más alta de luxación (p = 0,00001). Conclusión: La hemiartroplastia con prótesis de Austin Moore es una alternativa válida para pacientes con fractura medial desplazada, baja demanda funcional y mal estado general, pues es un procedimiento rápido, que elimina el dolor, y permite una movilidad precoz...
Background: Hip fractures are common in elderly people. Hemiarthroplasty is an accepted treatment for intracapsular fractures of the hip in elderly patients with low functional demands. The objective of this study is to show the 30-day and 1-year mortality rates and associated complications in patients with bad performance status. Methods: Between 2003 and 2010, 1,134 patients with intracapsular fractures of the hip were treated. One hundred and one patients (9 %) were treated with Austin Moore hemiprosthesis and 91 of them were included in this series. All were toddlers in their homes and they had multiple comorbidities. Kaplan-Meier estimator was used to evaluate survival. Mortality was then related to sex, age, infection and dislocation using a Cox proportional hazards regression model. Results: Seventy patients were women (77 %) and the mean age of the series was 85 years. The 30-day and 1-year mortality rates were 7 % and 36 %, respectively. Ten patients (11 %) had an episode of prosthetic dislocation and 13 (14.3 %) had an infectious complication. Infection/mortality and male/mortality associations were statistically significant (p = 0.009 and p = 0.013). Patients who suffered an infection had a higher rate of dislocation (p = 0.00001). Conclusion: Hemiarthroplasty with Austin Moore prosthesis is a good option for patients with displaced intracapsular hip fractures, low activity demand and multiple comorbidities, since it is a quick procedure that eliminates pain, allowing early mobility...
Subject(s)
Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/methods , Femoral Neck Fractures/surgery , Femoral Neck Fractures/mortality , Hemiarthroplasty/methods , Hip Dislocation/diagnosis , Prosthesis Failure , Prosthesis-Related Infections , Follow-Up Studies , Mortality , Postoperative Complications , Retrospective Studies , Survival Rate , Treatment OutcomeABSTRACT
A ruptura do ligamento cruzado cranial está entre as afecções mais comuns do joelho de cães e uma das causas principais de doença articular degenerativa. O objetivo desse trabalho é relatar um caso de rupturade ligamento cruzado bilateral em um cão, o qual foi submetido à técnica intra-articular com retalho de fáscia lata em ambos os joelhos, na mesma intervenção cirúrgica. No pós-operatório o cão foi mantido em repouso e exercitado com caminhadas controladas por guia, não sendo realizada imobilização externa temporária. Aos 18 meses de pós-operatório o cão manifestava atividade deambulatória normal, sem qualquer sinal de claudicação.AU
Rupture of the cranial cruciate ligament is one of the most common disorders of the knee of dogs and a major cause of degenerative joint disease. The aim of this study is to report a case of bilateralcruciate ligament rupture in a dog that was submitted to the technical intraarticular fl ap of fascia lata in both knees at the same surgery. Post operative the dog was kept at rest with hinking controlled,not being held temporary external immobilization. At 18 months postoperative the dog manifested activity ambulatory normal without any sign of lameness.AU
Subject(s)
Animals , Dogs , Ligaments , Rupture/surgery , Rupture/veterinaryABSTRACT
A ruptura do ligamento cruzado cranial está entre as afecções mais comuns do joelho de cães e uma das causas principais de doença articular degenerativa. O objetivo desse trabalho é relatar um caso de rupturade ligamento cruzado bilateral em um cão, o qual foi submetido à técnica intra-articular com retalho de fáscia lata em ambos os joelhos, na mesma intervenção cirúrgica. No pós-operatório o cão foi mantido em repouso e exercitado com caminhadas controladas por guia, não sendo realizada imobilização externa temporária. Aos 18 meses de pós-operatório o cão manifestava atividade deambulatória normal, sem qualquer sinal de claudicação.
Rupture of the cranial cruciate ligament is one of the most common disorders of the knee of dogs and a major cause of degenerative joint disease. The aim of this study is to report a case of bilateralcruciate ligament rupture in a dog that was submitted to the technical intraarticular fl ap of fascia lata in both knees at the same surgery. Post operative the dog was kept at rest with hinking controlled,not being held temporary external immobilization. At 18 months postoperative the dog manifested activity ambulatory normal without any sign of lameness.
Subject(s)
Animals , Dogs , Ligaments , Rupture/surgery , Rupture/veterinaryABSTRACT
Introducción: La hipertrofia amigdalina es una de las principales causas de ronquido infantil, tiene una prevalencia que oscila entre el 9 y el 10% y alcanza hasta el 30% en niños de 3-6 años. Se debe nombrar que solo el 3% de ese 30% tienen OSA, pues esa es la verdadera indicación de la cirugía. El objetivo fue evaluar la seguridad y eficacia de la vaporización de amígdalas con láser CO2 en pacientes pediátricos con OSA, del Servicio de Otorrinolaringología de la Clínica Carlos Ardila Lülle - Bucaramanga. Métodos: Estudio descriptivo de 47 niños entre 3 y 11 años, sometidos al procedimiento entre enero del 2011 y febrero del 2012, por obstrucción ventilatoria alta con pausas respiratorias mayores de 10 segundos durante el sueño, secundaria a hipertrofia del tejido amigdalino. Resultados: 97,8% de los niños estudiados tenían amígdalas grado IV y 2,1% grado III. Se debe exponer por qué existe tan alto porcentaje en el grado IV, pues la diferencia es muy grande, y eso puede ser objeto de censura. El tiempo quirúrgico fue, en promedio, de 25 minutos. En el 100% el procedimiento fue ambulatorio. Hay que tener cuidado con esto, porque los niños que van a cirugía por OSA como indicación deben someterse a hospitalización posterior en la UCI, pues corren el riesgo de presentar apneas, puesto que sus receptores de CO2 disminuyen la sensibilidad de hipoxia, pues al quitar el tejido no hay obstrucción; entonces, sus niveles de CO2 se reducen mucho, y esto es lo único que estimula en los centros respiratorios de ellos, y así se produce la apnea. 24 niños no registraron dolor (51%), y dos presentaron emesis (0,94%). La evolución postintervención fue satisfactoria en la mayoría, y ninguno de los pacientes presentó cuadros de sangrado o infección. Un mes después del procedimiento, 98% de los padres referían una notable mejoría de la respiración oral (ronquido), del sueño y los síntomas diurnos, o episodios de apnea. De lo contrario, sería una cirugía sin criterios adecuados, según lo relatado en la literatura. En ninguno de los pacientes que cumplieron un año de evolución se evidenció hipertrofia del tejido residual...
Introduction: Tonsillar hypertrophy is one of main causes of child snoring, having a prevalence ranging between 9 and 10% and reaching until 30% in children between 3 to 6 years old. The aim of our study was to determinate the efficacy and safety of tonsil laser vaporization with CO2 in the Otorrinolaryngology Service at the Clínica Carlos Ardila Lülle, Bucaramanga, Colombia. Methods: Descriptive study on 47 children between 3 and 11 years old, who underwent tonsil laser vaporization with CO2 in the last year by presented high ventilatory obstruction secondary to tonsillar hypertrophy tissue. Results: 97.8% had Grade IV tonsils and 2.1% were grade III. The operating time averaged 25 minutes. The 100% of the procedures were ambulatory. 24 children no reported pain (51%), 2 patients experienced emesis (0.94%). The evolution was satisfactory in more of them and not body presented bleeding or infection. After one month, 98% of parents reported a significant improvement in mouth breathing, snoring, sleep, and daily symptoms. Between children with one year evolution nobody of them presented residual tissue hypertrophy...
Subject(s)
Child , Laser Therapy , Palatine Tonsil , Palatine Tonsil/abnormalities , Palatine Tonsil/surgery , Palatine Tonsil/injuriesABSTRACT
Stroma desmoplasia was studied by immunohistochemistry for alpha-smooth muscle actin (alpha-SMA) in 17 instances of carcinoma ex-pleomorphic adenoma (CXPA) classified according to the presence of epithelial and myoepithelial cells and the degree of invasion: intracapsular, minimally and frankly invasive carcinoma. In "resident" pleomorphic adenoma, no desmoplasia was detected. In invasive areas of the intracapsular type of CXPA with only an epithelial component, desmoplasia started to be revealed by the presence of myofibroblasts close to the capsule. In the minimally invasive type, myofibroblasts were seen in the septum between islands of malignant cells and in focal peripheral areas of the tumor interpreted as the actual front of invasion. In the frankly invasive type of CXPA showing large blocks of cells, intense desmoplasia was seen, also separating the tumor cells from the neighboring normal tissue. In tumors with cords and/or small nests of cells, desmoplasia was very slight. In the invasive type of CXPA with a myoepithelial component, alpha-SMA expression was seen in the septum between the islands of cells. The expression was less intense and not present in all areas of the stroma. In CXPA with epithelial and myoepithelial cells, myofibroblasts were rarely seen in the septum separating sheets of cells. Thus, we may deduce that the presence of desmoplasia parallels the capacity of invasion of CXPA by epithelial cells, being minimum in the intracapsular and minimally invasive type of CXPA and increasing as the tumor becomes frankly invasive. Furthermore, we may also conclude that in CXPA with a myoepithelial component, desmoplasia is very rare.