Pliegues coroideos. Diagnóstico diferencial a propósito de un caso / Choroidal folds. Differential diagnosis and report of a case

Caso clínico: Presentamos un casos clínico de una paciente con pliegues coroideos unilaterales en el polo posterior en los cuales, tras un completo examen oftalmológico encontramos la causa subyacente. Discusion: Los pliegues coroideos están presentes en una gran variedad de procesos oculares. Pese a que se han descrito frecuentemente asociados a un síndrome benigno consistente en hipermetropía adquirida, existen una gran variedad de procesos oculares y orbitarios que hay que tener en cuenta. Por ello, es muy importante realizar un correcto diagnóstico diferencial (AU)

Case report: We present a cases of a patient withunilateral choroidals folds in the posterior pole in which, after a complete ophthalmic examination, we found a subsequent cause. Discussion: Choroidal folds are present in a variety of ocular disease. Despite there were associated as a benign condition consisted in acquired hyperopia, there are a variety of ocular and orbital disease that have to be considered. For that reason, an exhaustive differential diagnosis is essential (AU)

Angiolipoma in head and neck: report of two cases and review of the literature.

Angiolipomas are either encapsulated or non-encapsulated fatty tumours. They are distinguished from other lipomas by the excessive degree of vascular proliferation and because they are mixed with mature adipocytes. They commonly occur in the trunk and extremities and are rare in the maxillofacial area. Only 36 cases in the head and neck have been reported in the literature. The authors report the first non-infiltrating intramasseterine angiolipoma, and a case of non-infiltrating angiolipoma of the cheek. These tumours appear as homogenous low-density areas on CT with no contrast enhancement. MRI gives better tumour delineation and clear definition of the location and longitudinal extent of the mass. Histopathology demonstrates mature adipose tissue and the proliferation of numerous small branching blood vessels. Management of angiolipomas requires complete surgical excision.

Herida por asta de toro en el área maxilofacial: revisión de la literatura y presentación de un caso / Maxillofacial injury by bull goring: literature review and case report

Introducción. Las heridas por asta de toro son relativamente frecuentesen España y países iberoamericanos, donde los espectáculos con estos animalesson habituales. Dichas heridas presentan unas características específicas que las diferenciande cualquier otro tipo de heridas.Material y método. Se presenta el caso de un paciente varón de 18 años, remitido alHospital 12 de Octubre por el SAMUR tras sufrir una cornada en la región cérvicofacialdurante los encierros de San Sebastián de los Reyes en el verano de 2005. Elpaciente presenta una herida inciso-contusa y anfractuosa desde la región supraclavicularizquierda hasta la comisura labial ipsilateral, con fractura mandibularconminuta a nivel de ángulo izquierdo y cuerpo derecho, fractura dentoalveolar depiezas 1.3 a 2.3, y laceración severa de la musculatura lingual y suelo de boca.Discusión. La mayor parte de los politraumatizados por asta de toro son varones, conuna edad media de 30. Las victimas suelen ser participantes espontáneos, aficionadosa los eventos taurinos y no toreros profesionales.Si bien las heridas por asta de toro pueden producirse en cualquier parte del cuerpo,la localización más frecuente en todas las series revisadas es el miembro inferior. Laregión cérvicofacial es una de las menos afectadas en todas las series. Todos los autorescoinciden en la baja incidencia de heridas pese a la gran cantidad de aficionadosy curiosos atraídos y por esta modalidad de festejos taurinos. Por todas las característicasparticulares del mecanismo de lesión, el tratamiento debe ser urgente y deberealizarse un traslado lo más rápidamente posible a un hospital. Todos los autoresestán de acuerdo en que inicialmente el paciente con una lesión por asta de torodebe ser considerado un paciente politraumatizado y tratado como tal...AU)

Introduction. Injuries produced by bull goring are relativelycommon in Spain and South American countries, where bullfightsare scheduled regularly. These wounds have specific characteristicsthat differentiate them from any other type of wounds.Material and methods. In the summer of 2005, an 18-year-oldmale patient was brought to the Hospital 12 de Octubre byemergency services after being gored in the cervicofacial regionduring the running of the bulls in San Sebastián de los Reyes. Thepatient had an anfractuous, penetrating and blunt wound extendingfrom the left supraclavicular region to the left lip commissure,comminuted fracture of the left mandibular angle and rightmandibular body, dentoalveolar fractures of pieces 1.3 to 2.3, andsevere laceration of the lingual musculature and mouth floor.Discussion. Most patients who suffer multiple injuries as a result ofbull goring are men, with a mean age of 30 years. Victims usuallyare spontaneous participants, bullfighting fans rather thanprofessional bullfighters. The wounds produced by the horns of thebull may be located anywhere in the body, but the most frequentlocation in all the series reviewed was the lower limb. The cervicofacialregion is one of less frequently affected regions in all the series. Allauthors agree that these injuries have a low incidence despite thehuge number of bullfight fans and curious spectators who areattracted by bullfight events. Emergency treatment is requiredbecause of the particular characteristics of the mechanism of injury.The patient should be taken as rapidly as possible to a hospital.Authors generally agree that any patient who has been gored by abull must be considered initially, for purposes of management, asa patient with multiple injuries...(AU)

[Oral, mandibular and oropharyngeal reconstruction with a pedicled trapezius flap]. / Reconstruction orale, mandibulaire et de l'oropharynx avec le lambeau pédiculé de trapezius.

Reconstruction of large defects of the oral cavity (with or without jaw defects) and the oropharynx is one of the most important challenges in reconstructive maxillofacial surgery. Many reconstruction techniques have been proposed although none has provided total satisfaction. For each patient, accurate evaluation is required to choose the optimal solution. In this study, we reviewed our indications and results with the trapezius flap (with or without spina scapulae for lower jaw reconstruction). We review suggested indications, the technique we applied and results obtained over the past five years after an initial experience of fifteen years. The advantages and disadvantages of this technique are evaluated an indications suggested.