Sentinel node biopsy in relation to survival in floor of the mouth carcinoma.

Promising results have been obtained with sentinel node biopsy (SNB) in early oral carcinoma, but the floor of the mouth remains a site at risk of misdiagnosis. A retrospective and prospective study was designed to test the safety of SNB by comparing survival among patients with early stage carcinoma of the floor of the mouth (FOM) undergoing SNB, to a control group managed traditionally by a combination of clinical observation and elective neck dissection (END). A total of 63 patients with early stage carcinoma of the FOM were treated between 1991 and 2005. In the control group, 26 patients were managed with END and nine by close observation. In the test group, 28 patients were managed prospectively with SNB. Regional recurrence occurred in 23% (8/35) of control patients and 25% (7/28) of test patients. Approximately 25% of patients were successfully treated by salvage surgery. Disease-specific survival was 65.5% for control patients and 85% for SNB patients; the difference was not statistically significant. The use of SNB in the management of cancers of the FOM did not adversely affect survival and prevented 69.5% of patients undergoing unnecessary neck dissections, while clinical progress was better in the SNB group than in controls.

Temporomandibular arthroscopy: a retrospective clinical study (1995-1999) of 61 cases.

OBJECTIVES: A study was made of the internal derangements of the temporomandibular joint (TMJ) in order to: (a) determine the coincidence between the preoperative clinical diagnosis and imaging findings and the intraoperative arthroscopic observations, (b) establish the efficacy of arthroscopic treatment, and (c) evaluate the complications of the procedure. DESIGN: A descriptive and retrospective clinical study (1995-1999) of 61 TMJ arthroscopies was design. RESULTS: Coincidence was recorded between the clinical diagnosis and arthroscopic findings in 66.6% of cases, and the imaging diagnostic observations (magnetic resonance imaging) in 71.6%. The surgical outcome in terms of movement range was considered excellent (aperture > 40 mm) in 19 patients (42.2%), good (30-40 mm) in 19 (42.2%), and poor (< 30 mm) in 7 patients (15.6%). Postoperative pain assessment was in turn excellent (absence of pain) in 27 patients (60%), good (significant pain remission) in 9 (20%) and poor (persistent or increased pain) in 9 patients (20%). There were 7 complications and all healed without sequelae. CONCLUSIONS: The global results indicate an excellent or good movement range in 84.2%, with either no postoperative pain or only minimum pain in 81.4% of cases. Consequently, if arthroscopy is used for a precise indication in an adequate patient, it can improve the quality of life of individuals with TMJ pathology in situations where conservative procedures have failed.