RESUMEN
This report focuses on the clinical course and treatment of an infant male who had a progressively enlarging tongue mass initially thought to be an infantile hemangioma but was later found to be an infantile fibrosarcoma. Treatment included surgical excision with anticipated difficult mask ventilation with active rhino/enterovirus infection bronchiolitis and recent croup. Complete surgical excision is the mainstay of treatment, and the patient did have negative margins after complete surgical re-excision. The patient has surveillance MRI scans and remains without fibrosarcoma recurrence. This case report highlights complex pediatric airway management and the need for vigilance in healthcare when common presentations, such as infantile hemangioma, also present with a concurrent rare disease at a different anatomic location, such as infantile fibrosarcoma in this case.
RESUMEN
Purpose:To investigate the oral health needs and comorbidities among patients with autism spectrum disorder (ASD) undergoing oral rehabilitation under general anesthesia (GA) at a university hospital.
Methods: Records of patients with ASD who underwent oral rehabilitation under GA between January 2016 and May 2019 were reviewed to identify comorbid conditions and oral health needs. Statistical analysis consisted of descriptive and bivariate analyses (alpha = 0.05).
Results:A total of 160 patients from three to 18 years of age fulfilled the inclusion criteria. Seventy-eight percent were male and 69 percent had public insurance. Be- havioral issues, such as anxiety, aggression and nonverbal status, were observed more frequently than reported in the ASD literature. Dental caries, poor oral hygiene and gingivitis were the most common dental conditions observed. Radiographs, sealants, stainless steel crowns and extractions were the most common treatments rendered. Bivariate analysis revealed that subjects who had eight to 15 comorbidities were likely to be older.
Conclusions: Patients with ASD have many dental needs and may have comorbid medical conditions that directly affect the safe delivery of GA and dental treatments. As patients with ASD age, the number of comorbidities increases.