RESUMO
Computed tomography is currently the standard in preoperative evaluation of facial fractures, but cone beam computed tomography (CBCT) or digital volume tomography (DVT) offers potential advantages. Intraoperative imaging may facilitate adequate fracture reduction, optimising fracture repair. The aim of this article is to demonstrate the potential benefits of a new mobile CBCT system in a series of patients with complex facial fractures. Intraoperative imaging was performed with the xCAT ENT portable CBCT system. Images were provided in three planes and in a three-dimensional reconstruction. This system was used for intraoperative imaging of 46 consecutive facial trauma patients. The impact of intraoperative CBCT on the management of these cases is described and two select cases are presented to illustrate the potential benefits of this technique. Intraoperative CBCT was successfully performed in all patients and has led to immediate consequences in 12 (26%) cases. In 5 cases, fracture reduction turned out to be insufficient and was further optimized and in 5 other cases the titanium implant (orbital mesh) was not placed in the optimal position and the position was corrected. Bony fragments were detected and removed in 2 cases. Intraoperative imaging provides a number of advantages over post-therapeutic imaging in the management of facial fractures.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Ossos Faciais/diagnóstico por imagem , Ossos Faciais/lesões , Fixação Interna de Fraturas/métodos , Fraturas Orbitárias/diagnóstico por imagem , Fraturas Cranianas/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Placas Ósseas , Ossos Faciais/cirurgia , Traumatismos Faciais/diagnóstico por imagem , Traumatismos Faciais/cirurgia , Feminino , Humanos , Imageamento Tridimensional/métodos , Cuidados Intraoperatórios , Fraturas Maxilomandibulares/diagnóstico por imagem , Fraturas Maxilomandibulares/cirurgia , Masculino , Pessoa de Meia-Idade , Fraturas Orbitárias/cirurgia , Implantes Orbitários , Fraturas Cranianas/cirurgia , Telas Cirúrgicas , Titânio , Adulto Jovem , Fraturas Zigomáticas/diagnóstico por imagem , Fraturas Zigomáticas/cirurgiaRESUMO
In a clinical trial the effect of chemoprevention with beta-carotene, vitamin E and C on dysplastic tissue was studied. The study included 24 patients with oral leukoplakia and 24 patients after radical resection of a primary oral cancer. There was a reduction of increased cell kinetic parameters like the S-phase portion or the average number of nuclear-organizer regions (NOR) per cell nucleus, a decrease of the micronuclei portion and a normalization of the cytokeratin gene-expression. The general response was 97.5%. Stopping the alcohol and tobacco abuse the effect of the antioxidative vitamins on redifferentiation of the oral mucosa was more intense than by persistance of the alcohol and tobacco abuse, but a long term prevention seems to be ineffective.
