Orbital Solitary Fibrous Tumor: Four Case Reports-Clinical and Histopathological Features.

PURPOSE: To retrospectively describe the clinical characteristics, management, and outcomes of four cases of orbital solitary fibrous tumor (SFT). In one patient, we present an ultrasonic aspirator system for tumor removal. METHODS: Four patients with orbital SFT were selected: one patient with orbital SFT, another patient with frontal and ethmoidal SFT and orbital affectation with high rates of recurrence, the third patient with frontal lobe SFT and orbital invasion with multiple recurrences, and the fourth case with a history of craniopharyngioma surgery and SFT located on the orbital apex. RESULTS: All cases showed proptosis, eye movement restriction, and, in three cases, visual acuity alteration. Different treatments were applied: in three cases, excision was performed, one of them with an ultrasonic aspirator system, and in the remaining case, an exenteration was done (in two cases, radiosurgery treatment was also applied). The immunohistochemical study revealed SFT, similar to hemangiopericytomas (HPCs). No recurrence has been observed after surgical treatment. CONCLUSION: The SFT is a spectrum of different tumors with similar histopathological characteristics. The use of immunohistochemical markers is very helpful in the diagnosis. The main problem of orbital involvement is the risk of damaging important structures adjacent to the tumor during the surgical removal. The ultrasonic aspirator system allows elimination of the tumor without damaging other orbital structures.

Eyelid Eccrine Poroma: A Case Report and Review of Literature.

Poroma is a rare benign tumor of the epidermal sweat duct unit with predilection for the head and neck. Only six cases with eyelid location have been described in the literature (PubMed). A 34-year-old male presented with a single tumor on the left upper eyelid. It was skin-colored, nodular, solid, tender with some telangiectatic vessels, and showed no ulcerated lesion. Clinical diagnosis was basal cell carcinoma. This type of lesion can mimic a malignancy. Complete excisional biopsy revealed features consistent with eccrine poroma. After three year of follow up, no recurrence was observed. The authors reviewed all the cases reported in the literature and made a summary comparing them.

Rhino-Orbito-Cerebral Mucormycosis: Two Cases with Amaurosis as Presentation, Medical Surgical Management and Follow-Up.

Purpose: Mucormycosis is an infection caused by fungi to the class Zygomycetes that usually appears in immunosuppressed patients. Diagnostic confirmation is often delayed, with fatal prognosis in cases in which treatment is not rapidly established. Case report: We present two clinical cases of rhino-orbito-cerebral mucormycosis with an atypical presentation form, consisting of a unilateral complete sudden vision loss. Intravenous treatment with liposomal amphotericin B was started and total orbital exenteration surgery was performed. The removed surgical area was filled with gauze impregnated with liposomal amphotericin B and was left open for cures every 12 hours. Due to the good clinical evolution, a reconstruction of the orbital exenteration defect was performed in Case 1 with a temporal muscle flap and a skin island pedicled flap. In Case 2, reconstruction was not performed due to the poor evolution of the patient. Discussion: As it is a very aggressive surgery, the aesthetic and functional sequelae are very important. When the survival of the patient is achieved, we should offer reconstructive solutions that improve their quality of life. The reconstruction carried out using a flap of the temporal muscle can be made in a single act without requiring microvascular surgery.

Case report: Bilateral uveitis and papillitis secondary to treatment with pembrolizumab.

Pembrolizumab is a programmed cell death protein 1 (PD-1) monoclonal antibody used in the treatment of metastatic melanomas. Severe ocular complications appear in less than 1% of the patients and require early treatment. We present the case of a patient diagnosed with a BRAF mutated metastatic melanoma. Ocular pain and a blurred vision appeared after treatment and the patient visited the ophthalmology emergency room, where he was diagnosed with acute anterior uveitis (AAU), synechiae, and bilateral papillitis. The patient was treated with topical corticosteroids, prednisone, and mydriatics, which immediately improved the patient's status. Therefore, when an ocular inflammatory disease exists, immune checkpoint inhibitor treatments must be ruled out as possible causes.

Validation of the "Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)" scale for wearers of implant-supported fixed partial dentures.

OBJECTIVES: To validate the 'Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)' questionnaire for assessing the whole concept of oral health-related quality of life (OHRQoL) of implant-supported fixed partial denture (FPD) wearers. METHODS: 107 patients were assigned to: Group 1 (HP; n=37): fixed-detachable hybrid prostheses (control); Group 2 (C-PD, n=35): cemented partial dentures; and Group 3 (S-PD, n=35): screwed partial dentures. Patients answered the QoLFAST-10 and the Oral Health Impact Profile (OHIP-14sp) scales. Information on global oral satisfaction, socio-demographic, prosthetic, and clinical data was gathered. The psychometric capacity of the QoLFAST-10 was investigated. The correlations between both indices were explored by the Spearman's rank test. The effect of the study variables on the OHRQoL was evaluated by descriptive and non-parametric probes (α=0.05). RESULTS: The QoLFAST-10 was reliable and valid for implant-supported FPD wearers, who attained comparable results regardless of the connection system being cement or screws. Both fixed partial groups demonstrated significantly better social, functional, and total satisfaction than did HP wearers with this index. All groups revealed similar aesthetic-related well-being and consciousness about the importance of health-behavioural habits. Several study variables modulated the QoLFAST-10 scores. CONCLUSIONS: Hybrid prostheses represent the least predictable treatment option, while cemented and screwed FPDs supplied equal OHRQoL as estimated by the QoLFAST-10 scale. CLINICAL SIGNIFICANCE: The selection of cemented or screwed FPDs should mainly rely on clinical factors, since no differences in patient satisfaction may be expected between both types of implant rehabilitations.

Validation of a new, specific, complete, and short OHRQoL scale (QoLFAST-10) for wearers of implant overdentures and fixed-detachable hybrid prostheses.

OBJECTIVES: To validate a new index for assessing the whole concept of oral health-related quality of life (OHRQoL) of implant-prosthesis wearers. METHODS: 113 patients who were not requesting dental treatment were assigned to: Group 1 (CD; n=38): complete denture users (control); Group 2 (IO; n=38): implant overdenture wearers; and Group 3 (HP; n=37): hybrid implant prosthesis users. Patients answered the newly-designed 'Quality of Life related to Function, Aesthetics, Socialization, and Thoughts about health-behavioural habits' (QoLFAST-10) and the Oral Health Impact Profile (OHIP-20sp) questionnaires. Information on global oral satisfaction, socio-demographic, clinical, and prosthetic-related data were gathered. The QoLFAST-10 was investigated for reliability and validity. The Spearman's test determined the correlations between both indices' scores. Descriptive and non-parametric probes were run to assess the influence of the study variables on the OHRQoL (α=0.05). RESULTS: The QoLFAST-10 confirmed its psychometric capacity. HP wearers reported significantly better global and functional satisfaction than did IO wearers. The latter revealed significantly less consciousness about the importance of health-behavioural habits than did CD and HP groups. The level of education, complaints about the mouth, and the global oral satisfaction measures significantly modulated the QoLFAST-10 scores. CONCLUSIONS: Implant overdentures supplied lower functional and global satisfaction than did hybrid prostheses, and represent the least predictable option concerning the maintenance of the restoration. CLINICAL SIGNIFICANCE: The QoLFAST-10 may help in estimating the impact of implant restorations on patients' well-being. In this regard, hybrid prostheses seem to be the implant treatment of choice when compared with overdentures.

Oral aesthetic-related quality of life of muco-supported prosthesis and implant-retained overdenture wearers assessed by a new, short, specific scale (QoLDAS-9).

OBJECTIVES: To validate a new questionnaire for evaluating the 'Oral aesthetic-related quality of life (OARQoL)' of prosthetically restored patients. 'OARQoL' assesses the impact of the self-perceived dental aesthetics on patients' well-being. METHODS: The 'Quality of Life associated with Dental Aesthetic Satisfaction (QoLDAS)' index was designed. After a pilot trial, 70 patients were distributed into two groups depending on their type of prosthetic rehabilitation: Group 1 (CD; n=34): muco-supported complete dentures, and Group 2 (IO; n=36): implant-retained overdentures. Patients answered the QoLDAS and the Oral Health Impact Profile (OHIP-20sp) questionnaires, and reported their satisfaction on a visual analogue scale (VAS). Socio-demographic and prosthesis-related factors were registered. Psychometric properties of the QoLDAS were investigated. Correlations between both indices were explored using the Spearman's rank test. Descriptive and non-parametric probes were run to evaluate the effect of the study variables on the OARQoL (α=0.05). RESULTS: The QoLDAS-9 was reliable and valid. The factor analysis confirmed the existence of three dimensions and meaningful inter-correlations among the nine finally included items. Both scales were inversely correlated. The self-reported aesthetic and functional satisfaction and the education level significantly modulated the OARQoL as measured with the QoLDAS-9. CONCLUSIONS: The QoLDAS-9 confirmed its psychometric capacity for assessing the OARQoL of CD and IO wearers. Both groups showed comparably high OARQoL. Superior education degrees lead to lower OARQoL. CLINICAL SIGNIFICANCE: The QoLDAS-9 may be recommended for anticipating the effect of prosthetic restorations on OARQoL. CD and IO are predictable treatment options for improving the aesthetic self-perception of edentulous patients.

Validation of the 'Quality of Life with Implant Prostheses (QoLIP-10)' questionnaire for wearers of cement-retained implant-supported restorations.

OBJECTIVES: To validate the 'Quality of Life with Implant-Prostheses (QoLIP-10)' questionnaire for assessing the impact of cemented implant prostheses on Oral Health-Related Quality of Life (OHRQoL). METHODS: 84 subjects wearing implant restorations were distributed as follows: Group 1 (SD-I; n=35): screwed FDPs (fixed dental prostheses) supported by 2 implants; Group 2 (SD-II; n=7): screwed FDPs supported by 3-5 implants; Group 3 (CD-I; n=36): cemented FDPs supported by 2 implants; and Group 4 (CD-II; n=6): cemented FDPs supported by 3-5 implants. The QoLIP-10 and the Oral Health Impact Profile (OHIP-14sp) scales were used. Data related to global oral satisfaction, socio-demographics, health-behaviors, and prostheses, were gathered. Reliability and validity of the QoLIP-10 were investigated. Correlations between both indices were explored with the Spearman's rank test. Descriptive and non-parametric probes were run to evaluate the effect of the study variables on the OHRQoL (α=0.05). RESULTS: The QoLIP-10 confirmed its psychometric capacity for cemented implant prosthesis wearers. Both tests were inversely correlated. The QoLIP-10 attributed the significantly worst QoL to long-span cemented prostheses. Groups were significantly discriminated by the QoLIP-10 performance dimension. The variable complaints about the mouth and the three global oral satisfaction measures significantly modulated the OHRQoL. CONCLUSIONS: Patient satisfaction depends upon the extension and the type of retention of implant FDPs. CLINICAL SIGNIFICANCE: The QoLIP-10 may help estimating the effect of cemented FDPs on patients' well-being. When compared to screwed FDPs, short cemented implant restorations lead to greater improvements in patients' self-perceived QoL.

Oral health-related quality of life in complete denture wearers depending on theirsocio-demographic background, prosthetic-related factors and clinical condition

Objectives: To investigate the differences in impact on oral health-related quality of life (OHRQoL) among complete denture wearers depending on their socio-demographic characteristics, prosthetic-related factors and oral status. Study Design: 51 patients aged 50-90 years treated, from 2005 to 2010, with at least one complete denture at the Department of Buccofacial Prostheses of the Complutense University (Madrid) were enrolled in this crosssectional study. All of the participants answered the Oral Health Impact Profile (OHIP-14sp) questionnaire. The additive scoring method was used. The prevalence of impacts was calculated by using the occasional threshold (..) (AU)

Oral health-related quality of life in complete denture wearers depending on their socio-demographic background, prosthetic-related factors and clinical condition.

OBJECTIVES: To investigate the differences in impact on oral health-related quality of life (OHRQoL) among complete denture wearers depending on their socio-demographic characteristics, prosthetic-related factors and oral status. STUDY DESIGN: 51 patients aged 50-90 years treated, from 2005 to 2010, with at least one complete denture at the Department of Buccofacial Prostheses of the Complutense University (Madrid) were enrolled in this cross-sectional study. All of the participants answered the Oral Health Impact Profile (OHIP-14sp) questionnaire. The additive scoring method was used. The prevalence of impacts was calculated by using the occasional threshold (OHIP-14sp score ≥ 2). Socio-demographic and prosthetic-related variables were gathered. Patients underwent clinical examination to assess their oral condition. Descriptive probes and Chi-Square tests were run (p ≤ 0.05). RESULTS: The predominant participants' profile was that of a man with a mean age of 69 years wearing complete dentures in both the maxilla and the mandible. The prevalence of impact was 23.5%, showing an average score of 19 ± 9.8. The most affected domains were "functional limitation" and "physical pain", followed by "physical disability". Minor impacts were recorded for the psychological and social subscales ("psychological discomfort", "psychological disability", "social disability" and "handicap"). The prosthesis' location significantly influenced the overall patient satisfaction, the lower dentures being the less comfortable. Having a complete removable denture as antagonist significantly hampered the patient satisfaction. Patients without prosthetic stomatitis and those who need repairing or changing their prostheses, recorded significantly higher OHIP-14sp total scores. CONCLUSIONS: The use of conventional complete dentures brings negative impacts in the OHRQoL of elderly patients, mainly in case of lower prostheses that required reparation or substitution, with a removable total denture as antagonist. The prosthetic stomatitis in this study was always associated to other severe illness, which may have influenced the self-perceived discomfort with the prostheses, as those patients were daily medicated with painkillers.