RESUMO
BACKGROUND: Rhabdomyosarcoma is the most common malignant tumor in the nasal and paranasal sinus area at childhood. Multimodal treatment for this disorder has severe side effects due to normal tissue damage. As a result of this treatment, facial growth retardation and oral abnormalities such as malformation of teeth and microstomia can cause esthetic and functional problems. CASE REPORTS: Two cases are presented of patients with severe midfacial hypoplasia and reduced oral function as a result of treatment of rhabdomyosarcoma of the nasopharyngeal and nasal-tonsil region. With a combined surgical (osteotomy, distraction osteogenesis, implants) and prosthetic (implant-based overdenture) treatment, esthetics and function were improved.
Assuntos
Prótese Dentária Fixada por Implante , Neoplasias Faciais/reabilitação , Rabdomiossarcoma/reabilitação , Adulto , Neoplasias Faciais/cirurgia , Feminino , Humanos , Masculino , Anormalidades Maxilofaciais/etiologia , Anormalidades Maxilofaciais/reabilitação , Anormalidades Maxilofaciais/cirurgia , Microstomia/etiologia , Microstomia/reabilitação , Microstomia/cirurgia , Osteogênese por Distração/métodos , Osteotomia/métodos , Rabdomiossarcoma/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
Radiation-associated (RA) osteosarcomas (OS) are exceptional in children, presenting more frequently in middle-aged and elderly patients. This is a case report of RA-OS of the sinonasal cavities in a 13-yr-old girl after combined therapy for rhabdomyosarcoma (RMS) of the nose diagnosed at the age of five. The treatment of choice is radical surgery with wide margins and postoperative adjuvant chemotherapy and radiotherapy. Despite an episode of recurrence, at the present time the patient is alive and free of disease 5 yr after the initial treatment of OS. The association between radiation, chemotherapy and sarcomas is reviewed and discussed.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Nasais/tratamento farmacológico , Neoplasias Nasais/reabilitação , Osteossarcoma/etiologia , Neoplasias dos Seios Paranasais/etiologia , Radioterapia/efeitos adversos , Rabdomiossarcoma/tratamento farmacológico , Rabdomiossarcoma/reabilitação , Adolescente , Terapia Combinada , Feminino , Humanos , Imuno-Histoquímica , Recidiva Local de Neoplasia , Neoplasias Nasais/diagnóstico , Osteossarcoma/diagnóstico , Neoplasias dos Seios Paranasais/diagnóstico , Doses de Radiação , Rabdomiossarcoma/patologia , Tomografia Computadorizada por Raios XRESUMO
The use of three-dimensional, computer-generated anatomic models can be used in the diagnosis and reconstruction of a variety of craniofacial problems. They are readily manufactured from computed tomography scans at a reasonable cost with only several weeks of preparation and delivery time. Their contemporary value is in the preoperative treatment planning, intraoperative implant fashioning, and preoperative implant fabrication in appropriately selected patients.
Assuntos
Simulação por Computador , Ossos Faciais/cirurgia , Modelos Anatômicos , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Fibroma/cirurgia , Histiocitoma Fibroso Benigno/reabilitação , Histiocitoma Fibroso Benigno/cirurgia , Humanos , Masculino , Neoplasias Mandibulares/cirurgia , Prótese Mandibular , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/reabilitação , Neoplasias Nasofaríngeas/cirurgia , Neoplasias Orbitárias/reabilitação , Neoplasias Orbitárias/cirurgia , Planejamento de Assistência ao Paciente , Rabdomiossarcoma/reabilitação , Rabdomiossarcoma/cirurgia , Rinoplastia/métodos , Osso Temporal/cirurgia , Tomografia Computadorizada por Raios XRESUMO
The authors present the prosthetic rehabilitation of a young patient nineteen years old, radiated at four years old, during the treatment of right nasal fossa malignant tumour. Only metallic mandibular and maxillary dentals coverage can be considered after the realization of temporary supra-dental resin removable dentures, testing the possibilities of treatment, on esthetic and functional points of view.
