RESUMO
Five cases are presented to exemplify technical difficulties and complications which may be encountered when performing distraction osteogenesis in the facial skeleton. The procedure should be performed under close supervision by the surgical and orthodontic colleagues. Errors in the choice of vector may be managed by earlier removal of the distractor and subsequent traction on the previously osteotomized segments using orthodontic appliances and principles. Multiple distractors may be inserted in the same jaw and bimaxillary procedures are possible, increasing the likelihood of encountering technical difficulties. Detailed planning and close follow-up, with early recognition and active management of the complications, may be useful in ensuring a successful outcome of this versatile procedure.
Assuntos
Procedimentos Cirúrgicos Bucais/efeitos adversos , Procedimentos Cirúrgicos Ortognáticos , Osteogênese por Distração/efeitos adversos , Adolescente , Adulto , Falha de Restauração Dentária , Falha de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/lesões , Osteonecrose/etiologia , Traumatismos Dentários/etiologia , Falha de TratamentoRESUMO
10 cleft lip and palate temporary facilities were set up 1994-2003 in a Christian Hospital in Central India. 725 patients were operated upon. An analysis of the operations in regard to lip closure, closure of the soft and the hard palate, secondary cleft operations and cleft-related surgery is given. Differing therapy concepts in developed countries are discussed and compared to experiences of other third world volunteer medical groups.
Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Países em Desenvolvimento , Procedimentos Cirúrgicos Bucais/métodos , Adolescente , Adulto , Anestesia Dentária , Anestesia por Inalação , Criança , Feminino , Humanos , Índia , Masculino , Procedimentos Cirúrgicos Bucais/economia , Procedimentos Cirúrgicos Bucais/instrumentação , Cuidados Pré-Operatórios , Procedimentos de Cirurgia Plástica/economia , Procedimentos de Cirurgia Plástica/instrumentação , Procedimentos de Cirurgia Plástica/métodos , VoluntáriosRESUMO
Malignant solitary fibrous tumours (MSFTs) are rare tumours of fibrous origin, which can occur at all anatomical sites and represent 20% of solitary fibrous tumours. Fine-needle aspiration cytology is not able to distinguish benign from malignant disease, and sufficient tissue has to be obtained for accurate histological diagnosis to be made. Lesions > 10 cm in diameter and incomplete resection or non-resectability are predictive factors for poor long-term survival. We present a 57-year-old patient with a presumably metastatic MSFT from the peritoneal cavity to the skull-base who is in a stable state 17 months after surgical debulking of the skull-base and removal of the peritoneal lesion, followed by post-operative chemotherapy. We suggest the terminology metastatic malignant solitary fibrous tumour for a description of this disease.
