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1.
Eur Arch Otorhinolaryngol ; 280(9): 4205-4214, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37280380

RESUMO

BACKGROUND: The submandibular gland (SMG) is routinely excised during neck dissection. Given the importance of the SMG in saliva production, it is important to understand its involvement rate by cancer tissue and the feasibility of its preservation. METHODS: Retrospective data were collected from five academic centers in Europe. The study involved adult patients affected by primary oral cavity carcinoma (OCC) undergoing tumor excision and neck dissection. The main outcome analyzed was the SMG involvement rate. A systematic review and a meta-analysis were also conducted to provide an updated synthesis of the topic. RESULTS: A total of 642 patients were enrolled. The SMG involvement rate was 12/642 (1.9%; 95% CI 1.0-3.2) when considered per patient, and 12/852 (1.4%; 95% CI 0.6-2.1) when considered per gland. All the glands involved were ipsilateral to the tumor. Statistical analysis showed that predictive factors for gland invasion were: advanced pT status, advanced nodal involvement, presence of extracapsular spread and perivascular invasion. The involvement of level I lymph nodes was associated with gland invasion in 9 out of 12 cases. pN0 cases were correlated with a reduced risk of SMG involvement. The review of the literature and the meta-analysis confirmed the rare involvement of the SMG: on the 4458 patients and 5037 glands analyzed, the involvement rate was 1.8% (99% CI 1.1-2.7) and 1.6% (99% CI 1.0-2.4), respectively. CONCLUSIONS: The incidence of SMG involvement in primary OCC is rare. Therefore, exploring gland preservation as an option in selected cases would be reasonable. Future prospective studies are needed to investigate the oncological safety and the real impact on quality of life of SMG preservation.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Adulto , Humanos , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Glândula Submandibular/cirurgia , Estudos Retrospectivos , Qualidade de Vida , Neoplasias Bucais/cirurgia , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Esvaziamento Cervical , Neoplasias de Cabeça e Pescoço/patologia , Estudos Multicêntricos como Assunto
4.
Artigo em Inglês | MEDLINE | ID: mdl-22669156

RESUMO

BACKGROUND: Osteochondromas (OCs) are rare in the craneofacial area (0.6%). We present 2 cases of OC of the mandibular condyle, emphasizing the surgical decision of each case. CASE 1: In a 48-year-old woman with facial asymmetry, left cross-bite, and mandible deviation to the left, a computerized tomographic (CT) scan confirmed the presence of a bony expansion of the right condyle. The clinical diagnosis was osteochondroma. The patient underwent condylectomy with costochondral reconstruction. CASE 2: In a 76-year-old woman with a 1-month history of right preauricular pain, CT showed a deformed right condyle with a bony mass at the base of the temporal bone and the articular fossa. OC of the skull base was diagnosed, with possibly a concurrent lesion of the condyle. The patient underwent condylectomy with the removal of the skull base mass and an inmediate TMJ reconstruction by means of an appropriately sized stock total TMJ prosthesis. CONCLUSIONS: It is necessary to personalize the temporomandibular joint reconstructive options.


Assuntos
Côndilo Mandibular/cirurgia , Neoplasias Mandibulares/cirurgia , Osteocondroma/cirurgia , Neoplasias da Base do Crânio/cirurgia , Transtornos da Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/cirurgia , Idoso , Transplante Ósseo , Cartilagem/transplante , Feminino , Humanos , Prótese Articular , Pessoa de Meia-Idade , Medicina de Precisão , Amplitude de Movimento Articular , Procedimentos de Cirurgia Plástica , Base do Crânio/cirurgia
5.
Rev. esp. cir. oral maxilofac ; 33(2): 53-60, abr.-jun. 2011.
Artigo em Espanhol | IBECS | ID: ibc-88092

RESUMO

Introducción: Las nuevas técnicas de planificación quirúrgica virtual, como la tecnología CAD/CAM, así como los avances en biomateriales, permiten abordar casos cada vez más complejos de reconstrucción de la articulación temporomandibular. La planificación y la fabricación de dispositivos aloplásticos a medida permiten una adaptación excelente a las estructuras anatómicas. Las deformidades dentofaciales coexisten en muchas ocasiones con la afección articular. Con estos métodos de planificación es posible asociar procedimientos de cirugía ortognática, a la vez que reconstruimos la articulación temporomandibular en un solo tiempo quirúrgico. Material y métodos: En este artículo presentamos nuestra experiencia en la planificación virtual y posterior cirugía de 3 casos de anquilosis articular bilateral (6 articulaciones), con simulación de osteotomías, movimientos maxilomandibulares y diseño de prótesis totales aloplásticas a medida de la articulación temporomandibular. Conclusiones: El abordaje integral de la biomecánica articular, la relación intermaxilar y la oclusión dental es imprescindible para obtener resultados predecibles y satisfactorios. La planificación virtual y la utilización de dispositivos aloplásticos a medida permiten la reconstrucción total articular de una forma precisa y segura (AU)


Introduction: New virtual surgery planning techniques like CAD/CAM and advances in biomaterials have made it possible to undertake increasingly complex cases of temporomandibular joint reconstruction. The planning and preparation of custom alloplastic devices makes it possible to accurately accommodate anatomic structures. Dental and facial deformities often coexist with articular pathology. Using computerized planning methods, orthognathic surgery procedures can be combined with temporomandibular joint reconstruction in a single procedure. Material and methods: The authors' experience with computerized planning and surgical execution of three cases of bilateral articular ankylosis (6 joints) is presented with simulation of osteotomies, maxillomandibular movements and custom total alloplastic prosthesis design for the temporomandibular joint. Conclusions: A comprehensive approach to articular biomechanics, intermaxillary relations and dental occlusion is necessary to obtain predictable and satisfactory results. Computer modeling and the use of custom alloplastic devices allows exact, safe total articular reconstruction (AU)


Assuntos
Humanos , Masculino , Feminino , Materiais Biocompatíveis/uso terapêutico , Articulação Temporomandibular/cirurgia , Anquilose/cirurgia , Anquilose , Anquilose Dental/complicações , Anquilose Dental/cirurgia , Anquilose Dental , Osteotomia , Oclusão Dentária , Prótese Total , Má Oclusão/cirurgia , Má Oclusão
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