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INTRODUCTION: Unicystic ameloblastomas are a rare variant of ameloblastomas, which are characterized by slow growth and being relatively locally aggressive, with the main site of origin being the posterior portion of the mandible, it also refers to those cystic lesions that show clinical, radiographic, or gross features of a jaw cyst. PRESENTATION OF CASE: A 27-year-old female patient presented with a chief complaint of extensive mass of mandible along with severe swelling and numbness of right lips and chin. The oral examination revealed a swelling in the molar region of the right mandible with buccal plate expansion. The radiographic and histopathologic features were consistent with the diagnosis of unicystic ameloblastoma. Consequently, the lesion was surgically removed, and no clinical or radiological recurrence was detected during 5 years post-operative follow-up. DISCUSSION: While previous reports of unicystic ameloblastoma in the posterior portion of the jaw showed favorable prognosis lesions appeared as a unilocular entity, this case reports multilocular appearance and aggressive behavior of expansive unicystic ameloblastoma. Furthermore, while some studies linked the unilocular appearance of unicystic ameloblastoma to impacted tooth, our case suggests a possible traumatic link of preexisting lesion into multilocular unicystic ameloblastoma related to impacted tooth. CONCLUSIONS: This case presents a rare multilocular unicystic ameloblastoma appearance, notably with impacted tooth involvement. It also indicates the potential transformation of solid ameloblastoma into unicystic ameloblastom.
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Introduction and importance: Odontogenic keratocyst (OKC) is a distinctive form of developmental odontogenic cyst that deserves special consideration because of its specific clinical behaviour and histopathologic features. The clinical and radiographic features of OKC are indefinite; while some may be associated with pain, swelling or drainage, most of them are asymptomatic. This case reports rare radiographic and histopathological features of recurrence OKC. Case presentation: A 47-years-old male patient presented with a main complaint of a painful mass in the oral cavity with a history of previous lesions that occurred in the posterior portion of the mandible related to extraction of impacted third molar. The oral examination revealed a swelling in the molar region of the right mandible with lingual plate expansion. The radiographic and histopathologic were consistent with the diagnosis of OKC. Consequently, the lesion was surgically removed, and no clinical or radiological recurrence was observed during the 8-month postoperative follow-up. Clinical discussion: This case explained the clinical differences between OKC and other lesions and highlights the distinctive radiologic and microscopic features that a conflict with previous studies concerning the symptoms that may related to naevoid basal cell carcinoma syndrome, and revealed the proper treatment depending on the recurrence appearance and the treatment methods that used previously. Conclusions: This case highlights a rare multilocular appearance of recurrent OKC in the mandible with no naevoid basal cell carcinoma syndrome related, supports the marginal resection as an effective procedure in the management of recurrent OKCs cases.
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The odontogenic myxoma is a tumor of the jaws which arises from the mesenchymal portion of the tooth germ, either the dental papilla, the follicle, or the periodontal ligament. It is a slow-growing, painless, nonmetastasizing, central tumor of the jaws, chiefly the mandible. Radiographically, the classic presentation may vary from a unilocular radiolucency to a multilocular lesion with well-defined or diffuse margins. On histological study, it is composed of triangular or stellate connective cells, anastomosed by fine extensions, and embedded in abundant mucoid material. Case presentation: We present the unusual case of an odontogenic myxoma involving a 37-year-old female patient, which had acquired large dimensions and involved the right half of the mandible, including the ramus; the patient was treated with large resection surgery, with satisfying medium-term results. Clinical discussion: Early diagnosis of such lesions is very important, as the patient avoids extensive surgical procedures that involve losing a large part of the jawbones and their subsequent impact on the patient's quality of life. Conclusion: Although there is no fixed treatment plan for the management of odontogenic myxoma, treatment includes surgical management that may range from simple enucleation and curettage to surgical excision; wide surgical resection is appropriate for cases of large size to avoid recurrence.
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BACKGROUND: Reduced time allocation, changes in teaching methods and Covid-19 have resulted in undergraduate anatomy teaching being marginalised.This has implications on patient safety, litigation, student satisfaction and surgical workforce planning. AIMS: The aim of this study is to survey a cohort of recent English medical graduates to attain their perspective on anatomy training and to propose an innovative solution to solve existing problems in undergraduate anatomy training. METHODS: An online survey was sent out to 40 foundation doctors to offer insights into their undergraduate anatomy training. We asked participants to rate their perceived importance of anatomy, the importance offered to anatomy teaching at undergraduate level, preparation for clinical practice and future career plans. RESULTS: 22 participants responded to the online survey. All trained across England with equal spread between Northern and Southern medical schools. All participants perceived anatomy to be either important or very important in the survey. 20/22 felt that their undergraduate anatomy teaching was given very low to average importance by their institutions. 8/22 were confident or very confident with their anatomy knowledge on beginning clinical practice. Of the 22, 5 planned surgical careers, 10 did not know or gave other responses and 7 wanted to do General Practice. 16/22 said anatomy training had or will impact their decision on choosing a speciality. CONCLUSION: The current literature and above survey highlight the deficiencies that current doctors are facing.We suggest implementation of a standardised anatomy curriculum and the development of an online anatomy course.
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BACKGROUND: Working time restraints; senior led care; and a reduction in 'out of hours' operating has resulted in less operating time for orthopaedic trainees in the United Kingdom. Therefore, there has been an attempt to overcome these challenges by implementing novel techniques. Cognitive Task Analysis (CTA) focuses on the mental steps required to complete complex procedures. It has been used in training athletes and in general surgery but is new to orthopaedic training. AIM: To undertake a systematic review to analyse if CTA is beneficial to train novice surgeons in common orthopaedic and trauma procedures. MATERIALS AND METHODS: A systematic review was performed evaluating CTA in trauma and orthopaedic surgery on MEDLINE and EMBASE. Search terms used were: 'Cognitive task', 'mental rehearsal' and 'Orthop*'']. 33 studies were originally identified. Duplicate studies were excluded (11). Articles not relating to Orthopaedic surgery were excluded (15). The CTA research ranking scale was used to evaluate the impact of the studies included. RESULTS: 7 studies were identified as appropriate for inclusion. 264 participants. 178 M, 86F. All studies showed objective or subjective benefits from CTA in orthopaedic training when compared to traditional methods. The majority of the participants highlighted high subjective satisfaction with the use of the CTA tools and reported that they proved to be excellent adjuncts to the traditional apprenticeship model. CONCLUSION: CTA learning tools have demonstrated significant objective and subjective benefits in trauma and orthopaedic training. It is cost effective, easily accessible and allows repeated practice which is key in simulation training.
