RESUMO
BACKGROUND: Coronoid process hyperplasia is an uncommon finding, characterized by an enlargement of the coronoid process, causing a mechanical obstacle by its interposing in the posterior portion of the maxilla or zygomatic arch. CASE PRESENTATION: The article presents a case report of a bilateral coronoid process hyperplasia in a 3-year-old girl demonstrated with inability to open the mouth and restricted jaw movement. Panoramic x-ray and 3-dimensional computed tomographic reconstruction showed bilateral elongation of the coronoid processes associated with deformation of the mandibular condyle with no involvement of the articular space. A coronoid resection by intraoral approach was done, followed by an aggressive physiotherapy. A considerable improvement in mouth opening of 30 mm was achieved. We strongly suggest early surgical treatment of coronoid hyperplasia to recover morphology and function consequently to reduce skeletofacial deformities in young patients. CONCLUSIONS: The article presents a clinical and surgical case of bilateral coronoidectomy in a 3-year-old girl, with retrognathic mandible. The diagnosis of bilateral coronoid process hyperplasia was confirmed, and the surgical treatment was under general anesthesia, with nasotracheal intubation guided by a nasofiber endoscope, using an intraoral approach.
RESUMO
UNLABELLED: The aim of this study is to determine the prognostic value of available clinical and histological parameters to predict subclinical nodal metastases and survival. For that purpose we used a modification of the Jakobsson [9] grading system proposed by Richard W. Nason [12] and applied it to a series of patients with oral carcinoma. Correlation between histological parameters and cervical lymph node metastasis were made and the chi-square test showed a strong significant association between mode of invasion, depth of tumor invasion, vascular invasion and cervical metastases. Analysis of overall survival showed that overall survival strongly correlates with cervical node metastases (p=0.0004). We found that overall survival correlates with vascular invasion (p=0.005) and also overall survival correlates with tumour depth (p=0.001). There is a strong relationship between malignancy score and survival (p=0.00001) and a high malignancy score is associated with poor prognoses. PATIENTS: a total 32 with over 14 points of malignancy score, 25 (78.1%) died and 7 (21.9%) are alive. Analysis of the risk factors for subclinical cervical metastases in patients with oral cancer is important for predicting prognosis and achieving a high survival rate.
