[Normal and pathologic mandible development: practical deductions in maxillo-dento-facial orthopedics].

Science.gov (United States)

Salagnac, Jean-Michel

2016-09-01

The mandible consists of different segments, each of which possess its own specific characteristics regarding emergence, ossification during growth and pathologies. Orthodontists need to be very familiar with these developmental anomalies if they are to avoid failure in their orthopedic or orthodontic treatments and in order to understand the reasons for the lack of success of "conventional" treatments. Each segment must develop correctly if the mandible is to achieve optimal development and occupy a normal position within the cranio-facial complex. The position of the mandible in the cranio-facial block is also conditioned by its attachment to the base of the skull. Combining a detailed semiologic study and a three-dimensional architectural and structural radiologic analysis of clinical cases, this article investigates the various anomalies affecting the mandibular segments and their impact on the craniofacial structure as a whole. An understanding of these anomalies and this analytical method can enable clinicians to perform early diagnosis, avoid undertaking orthopedic and orthodontic treatments which are likely to fail, understand the reasons for unsuccessful "conventional" treatments, provide an orthopedic-surgical guide and make it possible to inform patients correctly. Anomalies affecting the growth of the mandible and its position on the cranial base and their impact on cranio-facial skeletal balance are clearly revealed by structural and architectural analysis, which pinpoints the different clinical elements in skeletal Class II et III cases. In maxilla-dento-facial orthopedics when confronted with a pathology of mandibular origin, it is essential to carefully study the radiographs of each segment of the mandible, to seek out the minor forms of the anomalies and to calculate the position of the mandible on the cranial base relative to the neighboring structures; the skull, the cervical vertebrae and the maxilla. © EDP Sciences, SFODF, 2016.

[Comparative effectiveness of surgical and non-surgical treatment for pediatric mandibular condylar fractures].

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Hu, Min; Wang, Yanyi; Zhang, Lihai; Yao, Jun

2010-12-01

To compare the effectiveness of open reduction and conservative treatment for pediatric mandibular condylar fractures and to provide the evidence for the selection of clinical therapy. The clinical data were retrospectively analyzed from 25 patients with the mandibular condylar fractures between January 1988 and December 2006. Of them, 8 patients (11 fractures) were treated with surgical treatment (surgical group) and 17 patients (22 fractures) with non-surgical treatment (non-surgical group). In surgical group, there were 6 males (9 fractures) and 2 females (2 fractures) with an age range of 8-13 years; fracture was caused by tumbling in 7 cases and by traffic accident in 1 with an interval of 1-6 days between injury and hospitalization; and 5 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 3 cases as bilateral condylar fractures complicated by mental fractures. In non-surgical group, there were 12 males (15 fractures) and 5 females (7 fractures) with an age range of 3-12 years; fracture was caused by falling from height in 4 cases, by tumbling in 10, and by traffic accident in 3 with an interval of 1-25 days between injury and hospitalization; and 12 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 5 cases as bilateral condylar fractures (1 complicated by mental fracture). Incision healed by first intention in surgical group, and 25 cases were followed up 1-6 years with an average of 3.5 years. At 12 months after treatment, no temporomandibular joint pain, eating disorder, or limited mandibular movement occurred in 2 groups. No significant difference was observed in opening mouth extent, protrusive and lateral movements between 2 groups at 6 and 12 months (P > 0.05). During centric occlusion, mental point located at the midline with symmetric face figure. Two patients in surgical group and 3 in non-surgical group had slight snap when opening their mouths. Mandible

Surgical treatments of the impacted canine tooth in young dogs

International Nuclear Information System (INIS)

Amimoto, A.; Iwamoto, S.; Hachimura, H.; Sasaki, K.; Taura, Y.; Nakama, S.; Yamanouchi, T.

1993-01-01

Surgical treatments of the impacted canine tooth were carried out in 8 young dogs, and the results were successful in 12 out of 14 cases (85.7%). The treatments consisting of surgical correction by immediate tipping movement, fenestration of the gingiva, and removal of the impacted tooth, were applied to 14 cases radiographically showing the immature tooth root and no abnormalities in the tooth root or alveolar bone. Impacted teeth were seen in 8 regions of the maxilla and 6 regions of the mandible. Mesioversion was seen in almost all maxillary impacted teeth, while linguoversion or lingual mesioversion in all mandibular cases. Surgical correction was carried out by immediate tipping movement after removal of the retained deciduous canine with or without resection of the alveolar bone. Fixation of the moved teeth was done using a wedge made from the deciduous canine root, which was driven into the vacant alveolar cavity after moving. An additional fixation using a steel wire and/or self-curing resin was done, if necessary

Agressive fibromatosis involving the mandible--case report and review of the literature.

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Seper, László; Bürger, Horst; Vormoor, Josef; Joos, Ulrich; Kleinheinz, Johannes

2005-01-01

Aggressive fibromatosis (AF) involving the mandible is rare, and surgery is often complicated by a high recurrence rate. A 4-year-old boy was referred because of a fast growing painless mass which involved the entire left angle of the mandible. Excisional biopsy revealed AF, and local excision of the tumor was performed. Six months after surgery a recurrence was detected. The tumor was determined to be unresectable and the boy was treated with low-dose chemotherapy including methotrexate and vinblastine for 1 year. With combined chemotherapy and surgical debulking, mutilating surgical resection will be delayed as long as possible or until completion of facial growth. According to the literature, surgery is the most common treatment of AF in the head and neck region. However, particularly in children, alternative modes of therapy must be considered because of the high recurrence rate and to avoid mutilating operations.

Keratocystic odontogenic tumor of mandible

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Ankita Bohra

2016-01-01

Full Text Available Keratocystic odontogenic tumor is considered to be a benign cystic neoplasia of jaw bone with a higher rate of recurrence. It is noted to be third most common odontogenic cyst after radicular and dentigerous cyst. Most common location is posterior mandible and ascending ramus. A case with odontogenic keratocyst of the right posterior mandible is presented with proper clinical and radiographic examinations along with histopathological investigation. Cystic lesion was surgically resected with iliac crest bone graft replacement and reconstruction plate placement. Follow-up of 1 year is completed with repeated radiographic examinations in 4 months interval with no evidence of recurrence.

A worldwide comparison of the management of surgical treatment of advanced oral cancer.

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Kansy, Katinka; Mueller, Andreas Albert; Mücke, Thomas; Koersgen, Friederike; Wolff, Klaus Dietrich; Zeilhofer, Hans-Florian; Hölzle, Frank; Pradel, Winnie; Schneider, Matthias; Kolk, Andreas; Smeets, Ralf; Acero, Julio; Haers, Piet; Ghali, G E; Hoffmann, Jürgen

2018-03-01

Microvascular surgery following tumor resection has become an important field of oral and maxillofacial surgery (OMFS). Following the results from management of T1/T2 floor-of-mouth and tongue squamous cell carcinoma (SCC) in German-speaking countries, Europe, and worldwide, this paper presents specific concepts for the management of resection and reconstruction of T3/T4 SCC of the maxillary and mandibular alveolar process and tongue. The DÖSAK questionnaire was distributed in three different phases to a growing number of maxillofacial units worldwide. Within this survey, clinical patient settings were presented to participants and center-specific treatment strategies were evaluated. A total of 188 OMFS units from 36 different countries documented their treatment strategies for T3/T4 maxillary and mandibular alveolar process and tongue SCC. The extent of surgical resections and subsequent reconstructions is more consistent than with T1/T2 tumors, although the controversy surrounding continuity resections and mandible-sparing procedures remains. For continuity resection of the mandible the fibula free flap is the most frequently used bone replacement, whereas maxilla reconstruction concepts are less consistent, ranging from locoregional coverage concepts and different microvascular reconstruction options to treatment via obturator prosthesis. Results from treatment strategies for T3/T4 tumors underline the limited evidence for the appropriate amount of resection and subsequent reconstruction process, especially in cases involving the mandible. Prospective randomized trials will be necessary in the long term to establish valid treatment guidelines. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Problem in the surgical correction of long-face with vertical open bite

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Coen Pramono D

2005-12-01

Full Text Available Long-face cases usually need both treatment of orthodontic and surgery. The problem appearing in the correction of long-face might be able to be related with some difficult factors such as the crowded teeth and excessive vertical height. A class III malocclusion and excessive open bite can be also followed in long face. This situation might worsen the facial aesthetic condition and increase the difficulty in orthodontic treatment. The orthodontic approach is oriented toward positioning the teeth pre-surgically to facilitate the surgical plan. The form of mandible which has grown in the downward direction in the area of mandible angle makes an extreme vertical open bite. The maxilla is usually presented with a maxillary hypolasia. Double-jaw surgery was done as the correction of the lower jaw alone would produce a flattened face appearance and difficulty in repositioning the mandible to achieve a good facial performance. Several cephalometric points were measured to observe the facial situation progress after surgery. Two cases of longface are reported, and the same surgical treatments were performed and showed different results.

Case report 380: Desmoplastic fibroma of the mandible

International Nuclear Information System (INIS)

Schultz, E.; Irwin, G.A.L.; Hermann, G.; Shih, H.

1986-01-01

A seven-year-old girl presented with swelling of the jaw and difficulty in opening her mouth. A large, grossly lytic, expanding lesion in the left ramus of the mandible was demonstrated radiologically. Biopsy and curettage were performed. Five months later the patient returned because of a recurrent mass in the area of the biopsy. Radiological studies now showed that the grossly osteolytic lesion in the mandible had enlarged considerably and a soft tissue mass had developed again. On readmission, wide surgical excision of the lesion was accomplished after the presence of a desmoplastic fibroma was established. The differential diagnosis was discussed and the characteristic clinical, radiological and pathological features of desmoplastic fibroma were considered. Appropriate treatment was discussed in the instance of this child. It was stressed in the discussion that the distinction histologically between a desmoplastic fibroma, a desmoid, a low grade fibrosarcoma and even fibrous histiocytoma might be extremely difficult. (orig.)

Surgical Management of a Mandible Subcondylar Fracture

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Dong Hee Kang

2012-07-01

Full Text Available Open reduction and anatomic reduction can create better function for the temporomandibularjoint, compared with closed treatment in mandible fracture surgery. Therefore, the doubleminiplate fixation technique via mini-retromandibular incision was used in order to makethe most stable fixation when performing subcondylar fracture surgery. Those approachesprovide good visualization of the subcondyle from the posterior edge of the ramus, allow thesurgeon to work perpendicularly to the fracture, and enable direct fracture management.Understanding the biomechanical load in the fixation of subcondylar fractures is alsonecessary in order to optimize fixation methods. Therefore, we measured the biomechanicalloads of four different plate fixation techniques in the experimental model regardingmandibular subcondylar fractures. It was found that the loads measured in the two-platefixation group with one dynamic compression plate (DCP and one adaption plate showed thehighest deformation and failure loads among the four fixation groups. The loads measuredin the one DCP plate fixation group showed higher deformation and failure loads than theloads measured in the two adaption plate fixation group. Therefore, we conclude that theselection of the high profile plate (DCP is also important in order to create a stable load in thesubcondylar fracture.

[The application of the asymmetry index in assessment of mandible size in difficult diagnostic case].

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Syryńska, Maria; Szyszka, Liliana; Post, Marcin

2008-01-01

Recognised and unrecognised bone diseases including maxilla and/or mandible may have influance on formation of malocclusions. In first stages of diseases the patients are directed or report for orthodontic treatment which starting need additional examinations mainly pantomographic views. In spite doing necessary additional examinations sometimes we can't recognise disorder like patient presented in our study. Then we can observate and if changes will begin disturbing the function--surgical intervention. Establishment of orthodontic treatment plan and explanation if during three years the dimension of asymmetry resulting from wrong growth right and left part of mandible and the estimation the rate of changes happening in this time. In study we used the own asymmetry index to estimate the patient's pantomographic views who reported for orthodontic treatment because of occlusion disorders, facial asymmetry and discomfort of mastication and speech. The telerentgenographic lateral views in right and posterior-anterior (PA) projection were also done. We measured and estimated the own asymmetry index on pantomographic views. The radiographs reveal the asymmetry of left part of mandible. The comparative analysis of pantomographic views enables the estimation of changes happening in time and the telerentgenographic lateral views, PA and computer tomography (CT) confirm changes which increase the asymmetry. The asymmetry index is the instrument which enable the estimation of growth changes in mandible with unsteady aetiology and histopathological unrecognised, allow determine the growth rate and facilitate the permanent control the dimension of mandible asymmetry.

Treatment of Obstructive Sleep Apnea Using Temporary Mandible Advancement Device: A Case Report

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Young-Chan Choi

2015-06-01

Full Text Available Obstructive sleep apnea (OSA is the most prevalent type of sleep apnea, and oral appliance may be one of the options for treatment of OSA. But, the problems with the oral appliance are high cost, possible low compliance, and complications such as temporomandibular disorder. In this article, we described a severe OSA case that was successfully improved by using temporary mandible advancement device, which was designed for therapeutic effect of mandible advancement with low cost and simplified fabrication procedure.

[Dynamic magnetotherapy use in comprehensive treatment phlegmons of maxillofacial region and mandible fractures].

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Lepilin, A V; Raĭgorodckiĭ, Iu M; Nozdrachev, V G; Erokina, N L

2007-01-01

145 patients (60 with phlegmons of submandibular and submental regions, 85--with fractures of mandible) were observed and treated with the use of moving pulse magnetic field (MPMF) produced by special apparatus (AMO-ATOS-E, , Saratov-city), 60 patients with the same pathology were treated by traditional physical methods and served as control. Use of MPMF led to quicker patient recovery: quicker reduction (if compared with traditional physical methods of treatment) of oedema and soft tissue inflammatory infiltration, quicker relief from inflammatory reaction (according to data of cytokinin profile), improvement of tissue blood supply in the region of fractures in patients with mandible fractures. As the result--we had shortening treatment terms of such patients and complication number reduction.

Long-term surgical-orthodontic management of hemimandibular hyperplasia.

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Bennett, Samuel C; Goonewardene, Mithran S

2016-05-01

Hemimandibular hyperplasia (HH), also known as hemimandibular hypertrophy, is characterised by excessive unilateral three-dimensional growth of the mandible after birth. Vertical unilateral elongation of the mandible becomes clinically evident as a rare form of vertical facial asymmetry. Aberrant growth of the facial skeleton affects the developing dentition and the dental compensatory mechanism is usually unable to maintain optimal occlusal relationships. The resulting malocclusion is effectively managed by combined surgical-orthodontic care to address the facial, skeletal and dental problems that confront clinicians. Orthodontists are advised to assess patients with HH during the post-treatment retention stage for continuing mandibular growth and assess the stability of treatment outcomes with long-term follow-up and records as required. To present a case of hemimandibular hyperplasia treated successfully by combined surgical-orthodontic care and evaluated for stability over a seven-year follow-up period. Surgical-orthodontic management was accomplished in four stages: 1) pre-surgical orthodontic; 21 surgical; 3) post-surgical orthodontic; and 4) post-treatment orthodontic retention. Complete orthodontic records, including extra- and intra-oral photographs, study models, and cephalograms plus panoramic radiographs were taken at the pretreatment, post-treatment, and seven-year orthodontic retention time-points. Facial, skeletal and dental goals were achieved in the three planes of space and the long-term stability of the treatment results was shown during a post-treatment orthodontic retention period of seven years. Hemimandibular hyperplasia is a true growth anomaly which may be managed effectively. Clinicians may expect successful long-term correction and stability by utilising a comprehensive surgical-orthodontic treatment approach.

The conservative treatment of pediatric mandibular fracture with prefabricated surgical splint: a case report.

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Kocabay, Ceyda; Ataç, Mustafa Sancar; Oner, Burak; Güngör, Nadir

2007-08-01

The use of rigid fixation in children is controversial and may cause growth retardation along cranial suture lines. Intermaxillary fixation for mandibular fractures should be used cautiously as bony ankylosis in the temporomandibular joint (TMJ) and trismus may develop. The high osteogenic potential of the pediatric mandible allows non-surgical management to be successful in younger patients with conservative approaches. In this case, successful conservative treatment of mandibular fracture of a 3-year-old patient is presented.

Bilateral radicular cyst in mandible: an unusual case report.

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Bava, Fareed Ahmed; Umar, Dilshad; Bahseer, Bahija; Baroudi, Kusai

2015-02-01

A radicular cyst is one of the furthermost everyday odontogenic cysts of the anterior maxilla, not regularly comprehended in youth. They are found mostly at the apices of the tooth (periapical cyst), lateral surface of the roots (lateral radicular cyst) and remains in the jaw after removal of the offending tooth (residual cyst). The radicular cyst has been catalogued as an inflammatory cyst, as an outcome to pulpal necrosis succeeding caries, with a linked periapical inflammatory reaction. They advance sluggishly and asymptomatic lest infected. Because of this they can extent to big dimensions. Many times it is perplexing to segregate radicular cysts from the obligatory pre-existing chronic periapical periodontitis lesions radiographically. Here, we present a rare case with bilateral radicular cyst in relation to first molar of the mandible in a 19-year-old. Orthopantomograph showed a large unilocular radiolucency with a well-defined border in the periapical region of the first molar on the left side extending from the root of the second premolar to the mesial root of the second molar. Correspondingly another well-defined unilocular radiolucency with a well-defined border was seen on the right side of the mandible. Several treatment possibilities are presented for a radicular cyst such as surgical endodontic treatment, extraction of the transgressing tooth, enucleation with primary closure, and marsupialization trailed by enucleation. The patient management comprised surgical enucleation of cystic sac followed by rehabilitation of the same area.

Mandible osteoradionecrosis. Incidence and clinical evaluation of its therapy

International Nuclear Information System (INIS)

Biazolla, E.R.

1989-01-01

The incidence and the efficiency of mandible osteoradionecrosis in patients with oral neoplasms and submitted to radiotherapy were studied. The osteoradionecrosis incidence in mandible was 6,67%. The treatment with sodium iodide 2% and hydrogen peroxide 10 v was the best treatment for mandible osteoradionecrosis. (L.M.J.)

Surgical Management of a Mandible Subcondylar Fracture

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Dong Hee Kang

2012-07-01

Full Text Available Open reduction and anatomic reduction can create better function for the temporomandibular joint, compared with closed treatment in mandible fracture surgery. Therefore, the double miniplate fixation technique via mini-retromandibular incision was used in order to make the most stable fixation when performing subcondylar fracture surgery. Those approaches provide good visualization of the subcondyle from the posterior edge of the ramus, allow the surgeon to work perpendicularly to the fracture, and enable direct fracture management. Understanding the biomechanical load in the fixation of subcondylar fractures is also necessary in order to optimize fixation methods. Therefore, we measured the biomechanical loads of four different plate fixation techniques in the experimental model regarding mandibular subcondylar fractures. It was found that the loads measured in the two-plate fixation group with one dynamic compression plate (DCP and one adaption plate showed the highest deformation and failure loads among the four fixation groups. The loads measured in the one DCP plate fixation group showed higher deformation and failure loads than the loads measured in the two adaption plate fixation group. Therefore, we conclude that the selection of the high profile plate (DCP is also important in order to create a stable load in the subcondylar fracture.

Mandible Fracture Complications and Infection: The Influence of Demographics and Modifiable Factors.

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Odom, Elizabeth B; Snyder-Warwick, Alison K

2016-08-01

Mandible fractures account for 36 to 70 percent of all facial fractures. Despite their high prevalence, the literature lacks a comprehensive review of demographics, fracture patterns, timing of management, antibiotic selection, and outcomes, particularly when evaluating pediatric versus adult patients. The authors aim to determine the complication and infection rates after surgical treatment of mandibular fractures and the bacterial isolates and antibiotic sensitivities from mandible infections after open reduction and internal fixation at their institution. Data were collected retrospectively for all mandible fractures treated at the authors' institution between 2003 and 2013. Patients were divided into pediatric (younger than 16 years) and adult (16 years or older) subgroups. Demographics, fracture location, fracture cause, comorbidities, antibiotic choice, and subsequent complications and infections were analyzed. Data were evaluated using appropriate statistical tests for each variable. Three hundred ninety-five patients were evaluated. Demographics and fracture cause were similar to those reported in current literature. Of the 56 pediatric patients, complications occurred in 5.6 percent. Time from injury to operative intervention did not affect outcome. The complication rate was 17.5 percent and the infection rate was 9.4 percent in the adult subgroup. Time from injury to operative intervention, sex, and edentulism were not significant predictors of complication or infection. Tobacco use, number of fractures, number of fractures fixated, and surgical approach were predictors of complication and infection. Perioperative ampicillin-sulbactam had a significantly lower risk of infection. Certain demographic and operative factors lead to significantly higher risks of complications after surgical management of mandibular fractures. Ampicillin-sulbactam provides effective antibiotic prophylaxis. Risk factor modification may improve outcomes. Risk, IV.

The effects of combined treatment with radiation and bleomycin on the oral carcinoma involving the mandible

International Nuclear Information System (INIS)

Okamoto, Manabu; Ozeki, Satoru; Higuchi, Yoshinori; Tashiro, Hideo

1988-01-01

The effect of concurrent combined treatment with 22.5 Gy of radiation and 110 mg of bleomycin or 55 mg of peplomycin on oral carcinoma involving the mandible was examined histologically. In 14 of 18 patients who had mandibles resected after this combined treatment, bone invasion by carcinoma was observed histologically. According to Shimosato's classification of histological effects, 3 belonged to Grade III/IV, 4 to IIb, 3 to IIa and 4 to I. The formation of new bone that was considered to be reparable was observed in the marked effective patients. In 4 patients the Grade IIb, residual surviving cancer cells were observed in the mandible. Accordingly, excision was needed in the area of radiologic features of mandibular infiltration. But it is considered that although the excision scope for the patient who has received the preoperative treatment is the same as that for the patient who has not, it is advantageous for the former patient that a wider safety region is obtained. (author)

Early treatment of simphysis mandible fracture in children 12 years old using Erich arch bar (case report

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Syahril Samad

2016-06-01

Full Text Available Incidence rate of symphysis mandible fracture in children was about 15 – 20%. Boys are effected twice as frequently as girls. The pattern of craniomaxillofacial fractures seen in children varies with evolving skeletal anatomy and socioenvironmental factors. The treatment of pediatric maxillofacial fractures is due to physiological, developmental, and anatomical characteristic of children. Management of pediatric mandible fracture by anatomic reduction is combine with stabilization adequate to maintain it until bone union has occured. This case report is aimed to explain about the management of simphysis mandible fracture in pediatric using erich arch bar. A 12 years old boy has fracture in mandible due to accident with mechanisme the chin hit the touching motorcyle tank. Clinically, was a deformity at the anterior of mandible and malocclusion has occured. Patient also complaint a  pain with swelling and bleeding at the regio of fracture and lip. Suturing was done  in wound area intra and extra oral, followed by application of arch bar in maxilla and mandible. Control at the third day was found a vague fracture line in panoramic radiograph. Management of emergency trauma in oral and maxillofacial surgery was based on principle of ATLS was done in this case. Following treatment was application of erich arch bar for mobility reducing the fracture of mandible symphisis. Management of mandibular symphisis fracture in 12 years old children with full eruption of teeth has been given a good healing  due to the teeth  was act to develop retention and stabilize the erich arch bar. Management of pediatric simphysis mandible fracture for 12 years old children with full eruption of teeth using erich bar revealed a healed fracture.

A new 2-dimensional method for constructing visualized treatment objectives for distraction osteogenesis of the short mandible.

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van Beek, H

2010-01-01

Open bite development during distraction of the mandible is common and partly due to inaccurate planning of the treatment. Conflicting guidelines exist in the literature. A method for Visualized Treatment Objective (VTO) construction is presented as an aid for determining the correct orientation of monodirectional and multidirectional distractors. Distraction on the left and on the right side of the mandible takes place in a parallel manner in order to maintain intercondylar width. It follows that in the absence of marked asymmetry, the amount of mandibular body distraction, the amount of ramus distraction and (should it apply), the amount of closure of the gonial angle, can be derived from a simple 2-dimensional plan. After presurgical orthodontic treatment, a cephalogram is taken and a VTO is constructed, that aims at a good occlusion with the enhanced mandible in centric relation, with little or no change of the original position of the rami.

Anesthetic and Surgical Management of a Bilateral Mandible Fracture in a Patient With Charcot-Marie-Tooth Disease: A Case Report.

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Smith, Jeffrey D; Minkin, Patton; Lindsey, Sean; Bovino, Brian

2015-10-01

This report describes the case of a 74-year-old man who had been diagnosed with Charcot-Marie-Tooth disease as a child. Because the patient had serious motor and sensory neuropathy associated with his disease, special anesthetic and surgical recommendations had to be considered before he underwent general anesthesia to repair his mandibular fracture. Repair of the mandible was performed under general anesthesia with a nasal endotracheal tube and the use of the nondepolarizing muscle relaxant rocuronium. Open reduction and internal fixation through extraoral approaches were used to fixate the displaced right subcondylar and symphyseal fractures. A closed reduction approach using maxillary fixation screws and a mandibular arch bar with light elastic guidance was used to treat a nondisplaced fracture of the left mandibular ramus. Rigid fixation allowed for avoidance of a period of intermaxillary fixation. General anesthesia and muscle relaxant were administered without complication. Treatment of bilateral mandibular fractures with combined open and closed approaches resulted in restoration of premorbid occlusion and masticatory function. Repair of mandibular fractures under general anesthesia appears to be a safe procedure in patients with Charcot-Marie-Tooth disease when appropriate anesthetic and surgical methods are used. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Long-term observation of a large keratocystic odontogenic tumour of the mandible treated by a single enucleation procedure: A case report and literature review

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Tobias L. Pittl

2017-01-01

Conclusion: Immediate enucleation in combination with a titanium plate offers an effective surgical approach for the treatment of large KCOTs of the mandible without the need for radical tooth removal or resection of the afflicted side.

Surgical Treatment, Oral Rehabilitation, and Orthognathic Surgery After Failure of Pharmacologic Treatment of Central Giant Cell Lesion: A Case Report.

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Maia Nogueira, Renato Luiz; Osterne, Rafael Lima Verde; Cavalcante, Roberta Barroso; Abreu, Ricardo Teixeira

2016-12-01

Although pharmacologic treatments for central giant cell lesions have gained much emphasis, these treatment modalities do not always have successful outcomes, and surgical treatment may be necessary. The purpose of the present study was to report a case of aggressive central giant cell lesion initially treated by nonsurgical methods without satisfactory results, necessitating segmental mandibular resection for definitive treatment and oral rehabilitation. A 20-year-old woman was diagnosed with an aggressive central giant cell lesion in the mandible. The patient was first treated with intralesional corticosteroid injections. Subsequently, the lesion increased in size. Therefore, a second pharmacologic treatment was proposed with salmon calcitonin nasal spray, but no signs of a treatment response were noted. Because of the lack of response, surgical excision was performed, and a mandibular reconstruction plate was installed. At 12 months after surgical resection, the patient underwent mandibular reconstruction with bone grafts. After 6 months, 7 dental implants were installed, and fixed prostheses were made. After installation of the prostheses, the patient experienced persistent mandibular laterognathism, and a mandibular orthognathic surgery was performed to correct the laterognathia. The follow-up examination 4 years after orthognathic surgery showed no signs of recurrence and good facial symmetry. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Fractures of the growing mandible.

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Kushner, George M; Tiwana, Paul S

2009-03-01

Oral and maxillofacial surgeons must constantly weigh the risks of surgical intervention for pediatric mandible fractures against the wonderful healing capacity of children. The majority of pediatric mandibular fractures can be managed with closed techniques using short periods of maxillomandibular fixation or training elastics alone. Generally, the use of plate- and screw-type internal fixation is reserved for difficult fractures. This article details general and special considerations for this surgery including: craniofacial growth & development, surgical anatomy, epidemiology evaluation, various fractures, the role rigid internal fixation and the Risdon cable in pediatric maxillofacial trauma. It concludes with suggestions concerning long-term follow-up care in light of the mobility, insurance obstacles, and family dynamics facing the patient population.

Utility of preoperative imaging diagnosis for a malignant tumor of the mandible. A malignant tumor of the mandible is difficult to discriminate from bisphosphonate-related osteonecrosis of the jaw

International Nuclear Information System (INIS)

Kamio, Takashi; Imaizumi, Akiko; Nishikawa, Keiichi; Shibui, Takeo; Inoue, Kenji; Matsuzaka, Kenichi; Sakamoto, Junichiro; Sano, Tsukasa

2014-01-01

We report our experience of a case with a malignant tumor of the mandible in which diagnostic imaging played an important role in the differential diagnosis and therapeutic strategy decisions. The patient was a 78-year-old woman who visited our hospital because of poor healing after tooth extraction. Multiple cytological diagnoses provided class II results, and a histopathological diagnosis of a biopsy also failed to show malignant findings. Therefore, a definitive diagnosis could not be made. Although the patient had a history of osteoporosis treatment, details of her medications were unclear. Therefore, bisphosphonate-related osteonecrosis of the jaw (BRONJ) could not be excluded, causing difficulty in management of the patient's condition. Eventually, we mainly focused on the diagnostic imaging and planned the therapeutic strategy in accordance with treatment for a malignant tumor. A postoperative histopathological examination of the surgical specimen revealed squamous cell carcinoma. It is sometimes difficult to differentiate among atypical diseases such as malignant tumors of the mandible and BRONJ, based solely on clinical or diagnostic imaging results. However, in the present patient, diagnostic imaging suggested a malignant tumor, and the appropriate treatment could be selected. (author)

Mandible vertical height correction using lingual bone-split pedicle onlay graft technique

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Coen Pramono D

2006-09-01

Full Text Available As edentulous mandible become atrophic, a denture bearing area will also be reduced. Difficulty in the removable prosthesis rehabilitation will be present as well. The purpose of this paper reports an innovative surgical technique to cope a problem of unstable complete lower denture due to bone atrophy and resulted of vertical height reduction of the anterior region of the mandible necessary for denture retention. Vertical advancement of the lower jaw using lingual bone split pedicle onlay graft technique in the anterior region of the mandible and followed by secondary epithelization vestibuloplasty in achieving the vertical height dimension. The surgery was achieved satisfactorily as the vertical dimension of the mandible anterior region had increased and the denture seated more stable comparing with the previous denture worn by the patient. It concluded that the surgery was achieved with a great result as the vertical height of the anterior region of the mandible had increased positively therefore lead the denture seated more stable.

The edentulous mandible opposing maxillary natural teeth: treatment considerations utilizing implant overdentures.

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Winkler, S; Monasky, G E

1993-01-01

The restoration of the edentulous mandible opposing all or part of the maxillary natural dentition with implant overdentures is described. There are many situations in which the maxillary teeth opposing an edentulous mandible can and should be retained. Mandibular implant overdentures can be utilized as long as health considerations, morphologic features of the resorbed mandible, and maxillomandibular jaw relationships are satisfactory.

Surgical Approaches to First Branchial Cleft Anomaly Excision: A Case Series

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Lourdes Quintanilla-Dieck

2016-01-01

Full Text Available Objectives. First branchial cleft anomalies (BCAs constitute a rare entity with variable clinical presentations and anatomic findings. Given the high rate of recurrence with incomplete excision, identification of the entire tract during surgical treatment is of paramount importance. The objectives of this paper were to present five anatomic variations of first BCAs and describe the presentation, evaluation, and surgical approach to each one. Methods. A retrospective case review and literature review were performed. We describe patient characteristics, presentation, evaluation, and surgical approach of five patients with first BCAs. Results. Age at definitive surgical treatment ranged from 8 months to 7 years. Various clinical presentations were encountered, some of which were atypical for first BCAs. All had preoperative imaging demonstrating the tract. Four surgical approaches required a superficial parotidectomy with identification of the facial nerve, one of which revealed an aberrant facial nerve. In one case the tract was found to travel into the angle of the mandible, terminating as a mandibular cyst. This required en bloc excision that included the lateral cortex of the mandible. Conclusions. First BCAs have variable presentations. Complete surgical excision can be challenging. Therefore, careful preoperative planning and the recognition of atypical variants during surgery are essential.

Surgical Approaches to First Branchial Cleft Anomaly Excision: A Case Series.

Science.gov (United States)

Quintanilla-Dieck, Lourdes; Virgin, Frank; Wootten, Chistopher; Goudy, Steven; Penn, Edward

2016-01-01

Objectives. First branchial cleft anomalies (BCAs) constitute a rare entity with variable clinical presentations and anatomic findings. Given the high rate of recurrence with incomplete excision, identification of the entire tract during surgical treatment is of paramount importance. The objectives of this paper were to present five anatomic variations of first BCAs and describe the presentation, evaluation, and surgical approach to each one. Methods. A retrospective case review and literature review were performed. We describe patient characteristics, presentation, evaluation, and surgical approach of five patients with first BCAs. Results. Age at definitive surgical treatment ranged from 8 months to 7 years. Various clinical presentations were encountered, some of which were atypical for first BCAs. All had preoperative imaging demonstrating the tract. Four surgical approaches required a superficial parotidectomy with identification of the facial nerve, one of which revealed an aberrant facial nerve. In one case the tract was found to travel into the angle of the mandible, terminating as a mandibular cyst. This required en bloc excision that included the lateral cortex of the mandible. Conclusions. First BCAs have variable presentations. Complete surgical excision can be challenging. Therefore, careful preoperative planning and the recognition of atypical variants during surgery are essential.

Evidence-based medicine: Mandible fractures.

Science.gov (United States)

Morrow, Brad T; Samson, Thomas D; Schubert, Warren; Mackay, Donald R

2014-12-01

After studying this article, the participant should be able to: 1. Describe the anatomy and subunits of the mandible. 2. Review the cause and epidemiology of mandible fractures. 3. Discuss the preoperative evaluation and diagnostic imaging. 4. Understand the principles and techniques of mandible fracture reduction and fixation. The management of mandibular fractures has undergone significant improvement because of advancements in plating technology, imaging, and instrumentation. As the techniques in management continue to evolve, it is imperative for the practicing physician to remain up-to-date with the growing body of scientific literature. The objective of this Maintenance of Certification article is to present a review of the literature so that the physician may make treatment recommendation based on the best evidence available. Pediatric fractures have been excluded from this article.

Application of different types of mandible resection in combined treatment of oral cancer patient (pt.): results and complications

International Nuclear Information System (INIS)

Matyakin, E.G.; Uvarov, A.A.; Kropotov, M.A.; Azizjan, R.I.

1998-01-01

Surgery is the main part of combined treatment of advanced oral cancer. Three types of mandible resection were applied in our center. Rim mandibulectomy leads to satisfactory cosmetic and functional results, in case of segmental mandibulectomy different methods of mandible restoration are applied. Middle mandibulotomy creates the optimum access to the operation field in patients with a large primary tumor of mobile tongue and a tumor thai is posteriorly located. Aims of the study: analyse of material to estimate the results and complications in cases of application of different types of mandible resection. Conclusions: Segmental mandibulectomy should be performed if erosion of alveolar ridge is detected. Rim manidibulectomy and segmental mandibylectomy with reconstructive surgery lead to good cosmetic and functional results. Usage of mini plates in reconstruction of mandibular arch decrease the number of postoperative complications even in patients after radiation therapy. Previous radiotherapy significantly increase the risk of the postoperative osteomyelitis of mandible

Lung abscess combined with chronic osteomyelitis of the mandible successfully treated with video-assisted thoracoscopic surgery.

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Arai, Hiromasa; Inui, Kenji; Watanabe, Keisuke; Watanuki, Kei; Okudela, Koji; Tsuboi, Masahiro; Masuda, Munetaka

2015-04-01

With the progress of antibiotic therapy, the mortality of lung abscess has been improved, and surgical intervention has declined. However, surgery is still required in selected cases that are intractable to antibiotic treatment. Video-assisted thoracoscopic surgery (VATS) is beneficial for treatment and/or diagnosis of pulmonary disease as it provides a less invasive surgical technique and reduces prolongation of post-operative recovery. However, the indication of VATS lobectomy for lung abscess is controversial as a result of particular complications, i.e. wet lung, intrapleural adhesion and ease of bleeding. We herein report a rare combination of lung abscess and osteomyelitis of mandible resulting from the same pathogen successfully treated with VATS lobectomy. We propose VATS lobectomy for lung abscess. This procedure might be the best treatment candidate for selected cases of lung abscess. © 2014 John Wiley & Sons Ltd.

Assessment of temporomandibular joint dysfunction in condylar fracture of the mandible using the Helkimo index

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S Suhas

2017-01-01

Full Text Available Introduction: Condylar fractures of the mandible are functionally important fractures as the condyle of the mandible being a part of the temporomandibular joint (TMJ and can lead to TMJ dysfunction if not properly treated. Materials and Methods: This was a cross-sectional study of a total of 33 treated patients with fracture of the mandibular condyle who underwent examination as per the Helkimo index. Their dysfunction was quantified and clinicoepidemiological characteristics were assessed. It was found that majority of our patients were young males involved in a two-wheeler accident. All patients underwent intermaxillary fixation as the minimum treatment and 30% underwent open reduction and internal fixation in addition. Results: There was no statistically significant association between the degree of clinical dysfunction and factors such as age, mechanism of injury, type of condyle fracture, presence of other mandible fractures, and surgical procedure. However, dislocation of the mandibular condyle was found to be a negative prognostic factor and all these patients had some degree of dysfunction. Conclusion: The overall prevalence of TMJ dysfunction according to the Helkimo index was 90%. About 61% of patients had mild dysfunction (Di1 and 30% had moderate dysfunction (Di2. None of the patients had severe dysfunction. To conclude, the Helkimo index is a simple, effective, inexpensive, reliable screening index to assess TMJ dysfunction in condylar fractures of mandible.

Temporomandibular joint ankylosis: Case-series of two different surgical procedures

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Gholamreza Shirani

2014-01-01

Full Text Available Introducation: The long-term outcome and clinical results of gaparthroplasty used for the treatment of condylar ankylosis of the mandible in children with application of postoperative activator appliances and costochondral rib graft are evaluated and compared. The purpose of this study was to compare the effect of gap arthroplasty and costochondral graft methods on reankylosis, a mount of mouth opening and growth. Materials and Methods: A non-randomized, retrospective clinical study of l0 cases (5-12 years old of condylar ankylosis of the mandible, surgically treated during a 10 year period from 2002 to 2012 was performed. Four patients were treated by condylectomy and interpositional flap, whereas six were treated by condylectomy and immediate costachondral rib grafts. The first group underwent long-term postoperative therapy using removable activator appliances. Casts, radiographs, photographs, and computed tomography (CT were used post surgically to evaluate rib graft, condylar growth and function, occlusion, facial, and condylar symmetry. Data were analyzed by SPSS 16 statistical software using Mann-Whitney, Paired T-test and Chi-square tests. Results: Children with long-standing condylar ankylosis of the mandible treated by condylectomy and interpositional flap showed more favorably when activators were used post-surgically. Conclusions: Gaparthroplasty with functional activator post-operatively can be considering for TMJ ankylosis.

Cancer of Oral Cavity Abutting the Mandible; Predictors of Loco-regional Failure

International Nuclear Information System (INIS)

Saber, T.K.; Hussein, H.A.; Mebeed, A.H.; El Sebai, H.I.; Sami, I.; Farahat, I.G.

2009-01-01

The purpose of this study is to analyze the causes of Loco-regional failure in 51 patients with tumors of the oral cavity abutting the mandible. Patients and Methods: This cross-sectional study (27 patients were operated upon in the retrospective section and 24 patients in the prospective section of the study) was done in the department of Surgical Oncology, National Cancer Institute, Cairo University, from January 2003 to January 2008. Fifty-one patients, with oral cavity cancerous lesions abutting the mandible, were operated upon by segmental mandibulectomy en-bloc with primary tumor resection in addition to modified radical or selective neck dissection according to the status of the cervical lymph nodes. Results: During a median follow-up of 2 years, 29 patients (56.8%) had local recurrences, the incidence of nodal recurrence after neck dissection was detected in 4 patients (7.8%). On multivariate analysis, tumor depth, tumor grade, oral mucosa, soft tissue and bone surgical margins in addition to metastatic lymphadenopathy were independent prognostic factors of loco-regional failure and disease-free survival. Conclusion: Oral cavity cancers abutting the mandible should be treated with great caution by a multidisciplinary oncology team (resection and reconstruction surgeons) as it has a very aggressive biologic behavior. Negative intraoperative pathological margins should be attempted since this is the critical point for patients with cancers abutting the mandible? Further research on the biologic margin and genetic study is required

A new 2-dimensional method for constructing visualized treatment objectives for distraction osteogenesis of the short mandible

NARCIS (Netherlands)

van Beek, H.

2010-01-01

Open bite development during distraction of the mandible is common and partly due to inaccurate planning of the treatment. Conflicting guidelines exist in the literature. A method for Visualized Treatment Objective (VTO) construction is presented as an aid for determining the correct orientation of

A novel 3D template for mandible and maxilla reconstruction: Rapid prototyping using stereolithography

Science.gov (United States)

Kumta, Samir; Kumta, Monica; Jain, Leena; Purohit, Shrirang; Ummul, Rani

2015-01-01

Introduction: Replication of the exact three-dimensional (3D) structure of the maxilla and mandible is now a priority whilst attempting reconstruction of these bones to attain a complete functional and aesthetic rehabilitation. We hereby present the process of rapid prototyping using stereolithography to produce templates for modelling bone grafts and implants for maxilla/mandible reconstructions, its applications in tumour/trauma, and outcomes for primary and secondary reconstruction. Materials and Methods: Stereolithographic template-assisted reconstruction was used on 11 patients for the reconstruction of the mandible/maxilla primarily following tumour excision and secondarily for the realignment of post-traumatic malunited fractures or deformity corrections. Data obtained from the computed tomography (CT) scans with 1-mm resolution were converted into a computer-aided design (CAD) using the CT Digital Imaging and Communications in Medicine (DICOM) data. Once a CAD model was constructed, it was converted into a stereolithographic format and then processed by the rapid prototyping technology to produce the physical anatomical model using a resin. This resin model replicates the native mandible, which can be thus used off table as a guide for modelling the bone grafts. Discussion: This conversion of two-dimensional (2D) data from CT scan into 3D models is a very precise guide to shaping the bone grafts. Further, this CAD can reconstruct the defective half of the mandible using the mirror image principle, and the normal anatomical model can be created to aid secondary reconstructions. Conclusion: This novel approach allows a precise translation of the treatment plan directly to the surgical field. It is also an important teaching tool for implant moulding and fixation, and helps in patient counselling. PMID:26933279

A novel 3D template for mandible and maxilla reconstruction: Rapid prototyping using stereolithography.

Science.gov (United States)

Kumta, Samir; Kumta, Monica; Jain, Leena; Purohit, Shrirang; Ummul, Rani

2015-01-01

Replication of the exact three-dimensional (3D) structure of the maxilla and mandible is now a priority whilst attempting reconstruction of these bones to attain a complete functional and aesthetic rehabilitation. We hereby present the process of rapid prototyping using stereolithography to produce templates for modelling bone grafts and implants for maxilla/mandible reconstructions, its applications in tumour/trauma, and outcomes for primary and secondary reconstruction. Stereolithographic template-assisted reconstruction was used on 11 patients for the reconstruction of the mandible/maxilla primarily following tumour excision and secondarily for the realignment of post-traumatic malunited fractures or deformity corrections. Data obtained from the computed tomography (CT) scans with 1-mm resolution were converted into a computer-aided design (CAD) using the CT Digital Imaging and Communications in Medicine (DICOM) data. Once a CAD model was constructed, it was converted into a stereolithographic format and then processed by the rapid prototyping technology to produce the physical anatomical model using a resin. This resin model replicates the native mandible, which can be thus used off table as a guide for modelling the bone grafts. This conversion of two-dimensional (2D) data from CT scan into 3D models is a very precise guide to shaping the bone grafts. Further, this CAD can reconstruct the defective half of the mandible using the mirror image principle, and the normal anatomical model can be created to aid secondary reconstructions. This novel approach allows a precise translation of the treatment plan directly to the surgical field. It is also an important teaching tool for implant moulding and fixation, and helps in patient counselling.

A novel 3D template for mandible and maxilla reconstruction: Rapid prototyping using stereolithography

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Samir Kumta

2015-01-01

Full Text Available Introduction: Replication of the exact three-dimensional (3D structure of the maxilla and mandible is now a priority whilst attempting reconstruction of these bones to attain a complete functional and aesthetic rehabilitation. We hereby present the process of rapid prototyping using stereolithography to produce templates for modelling bone grafts and implants for maxilla/mandible reconstructions, its applications in tumour/trauma, and outcomes for primary and secondary reconstruction. Materials and Methods: Stereolithographic template-assisted reconstruction was used on 11 patients for the reconstruction of the mandible/maxilla primarily following tumour excision and secondarily for the realignment of post-traumatic malunited fractures or deformity corrections. Data obtained from the computed tomography (CT scans with 1-mm resolution were converted into a computer-aided design (CAD using the CT Digital Imaging and Communications in Medicine (DICOM data. Once a CAD model was constructed, it was converted into a stereolithographic format and then processed by the rapid prototyping technology to produce the physical anatomical model using a resin. This resin model replicates the native mandible, which can be thus used off table as a guide for modelling the bone grafts. Discussion: This conversion of two-dimensional (2D data from CT scan into 3D models is a very precise guide to shaping the bone grafts. Further, this CAD can reconstruct the defective half of the mandible using the mirror image principle, and the normal anatomical model can be created to aid secondary reconstructions. Conclusion: This novel approach allows a precise translation of the treatment plan directly to the surgical field. It is also an important teaching tool for implant moulding and fixation, and helps in patient counselling.

Mandible osteoradionecrosis: a clinical case report

International Nuclear Information System (INIS)

Biazolla, E.R.; Biazolla, T.C.M.; Oliveira Marinho, M.A.

1991-01-01

This is a case report of the mandible osteoradionecrosis with its evolution and treatment, until the patient's cure. It's briefly discussed the treatment used, stressing the dentistry conscientiousness about the careless upon the manipulation of the patients submitted to radiotherapy. (author)

Osteochondroma of the mandibular condyle: surgical excision followed by occlusal stabilization.

Science.gov (United States)

Yoo, Ji-Yeon; Choi, Byung-Joon; Kwon, Yong-Dae; Lee, Deok-Won; Ohe, Joo-Young; Suh, Joon-Ho

2012-03-01

Osteochondroma of the mandibular condyle in adults can be treated by surgical excision, condylectomy followed by costochondral graft or orthognathic surgery. Such complex treatment plan may not be appropriate for patients with old age, affected with chronic osteochondroma of the condyle. In this clinical report, we present a patient with osteochondroma of the condyle treated by surgical excision. The patient's postoperative occlusion was a contraindication for orthognathic surgery because of the severe abrasion of the teeth and the chronic compensation of the dentition to the deviated mandible. Surgical excision of the lesion was carried out under general anesthesia, and the remaining condylar head was salvaged as much as possible. No graft materials or posthodontic condyle reconstruction was carried out. Because there was no occlusal stop to secure the mandible in a centric relation position of the condyle, a stabilization splint was delivered to position the condyle in a relatively stable position. The stability of the condyle position was evaluated by follow-up cone beam computed tomographic scans of the pathologic and the contralateral condyle, along with clinical factors such as occlusal contact points and mandible movements assayed by ARCUSdigma (KaVo). After significant condylar position was achieved, full prosthodontic reconstruction was performed to both the patient's and the dentist's satisfaction.

Vertical distraction of the severely resorbed mandible - The Groningen Distraction Device

NARCIS (Netherlands)

Raghoebar, GM; Heydenrijk, K; Vissink, A

2000-01-01

In this paper, both the surgical procedure and the clinical results of a novel distraction device to augment a severely resorbed anterior edentulous mandible are described. The distraction device is non-voluminous, and consists of two distraction screws and one guide screw. Two months after the last

Strategic Considerations for Effective Sagittal Resection of the Mandible to Achieve a Slim and Attractive Jawline.

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Park, Sanghoon; Lee, Tae Sung

2018-01-01

Sagittal resection of the mandible has been widely used to reduce the width of the lower face and is usually carried out in combination with a mandibular contouring procedure. However, the surgical outcomes of this procedure are unclear because sagittal resection is rarely performed as a single procedure. The authors clarify misunderstandings regarding this procedure and introduce an improved strategic approach for sagittal resection of the mandible. Under general anesthesia, mandible contouring was performed first with a curved osteotomy, followed by sagittal resection of the outer cortex of mandible. The amount and extent of each procedure was determined in accordance with preoperative analysis. From 2012 to 2014, a consecutive series of 212 patients who underwent mandible contouring surgery without concomitant chin surgery were included in the study. A total of 189 patients underwent both mandibular contouring surgery and sagittal resection, whereas 13 underwent only sagittal resection and 10 underwent only mandibular contouring surgery. All operations were carried out successfully without any severe complications, and most patients had satisfactory aesthetic outcomes. The authors found that the sagittal resection of the mandible should be performed in accordance with the shape of the mandible to effectively reduce facial width and achieve better aesthetic outcomes for both profile and frontal views. In an outcurved-type mandible, conventional mandibular contouring may be effective alone, whereas sagittal resection focusing on removing the mandible body region is essential for incurved-type mandibles. In straight line-type mandibles, both procedures are necessary. Therapeutic, IV.

Preoperative CT analysis of the mandible and maxilla for permanent dental prosthetic implantation

International Nuclear Information System (INIS)

Rothman, S.L.G.; Rhodes, M.L.; Schwarz, M.; Chafetz, N.I.

1987-01-01

The Branemark technique for permanently implanting dental prostheses is becoming universally accepted. The surgeon requires detailed knowledge of the cross-sectional anatomy of the alveolar ridges and inferior alveolar nerve for safe placement of the titanium fixtures. Axial CT scans of the mandible and maxilla, with oblique and panoramic CT reformations, were obtained in more than 100 patients. This report describes the anatomic variations in the maxilla and mandible as they relate to dental implantation surgery. The authors demonstrate the utility of this technique in preoperative surgical planning and postoperative evaluation

Achievability of 3D planned bimaxillary osteotomies: maxilla-first versus mandible-first surgery

OpenAIRE

Liebregts, Jeroen; Baan, Frank; de Koning, Martien; Ongkosuwito, Edwin; Berg?, Stefaan; Maal, Thomas; Xi, Tong

2017-01-01

The present study was aimed to investigate the effects of sequencing a two-component surgical procedure for correcting malpositioned jaws (bimaxillary osteotomies); specifically, surgical repositioning of the upper jaw?maxilla, and the lower jaw?mandible. Within a population of 116 patients requiring bimaxillary osteotomies, the investigators analyzed whether there were statistically significant differences in postoperative outcome as measured by concordance with a preoperative digital 3D vir...

Prevention of collapse of the contralateral half of the mandible after hemimandibulectomy: Our experience in a low-resource center

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Charles E Anyanechi

2017-01-01

Full Text Available Background: The management of pathologic lesions of the mandible includes plans for the reconstruction of the resultant defect to give the patients optimal surgical reconstructive and prosthetic results. Objective: To evaluate the degree of deviation of the contralateral half of the mandible toward the surgical defect after hemimandibulectomy and intermaxillary fixation (IMF. Patients and Methods: This is a 9-year prospective single-blinded clinical study conducted at the Dental and Maxillofacial Surgery Clinic of our institution. Information obtained from the patients included age, gender, type of mandibular lesion, method of wound closure, duration of IMF, temporo-mandibular joint (TMJ symptom(s, and the deviation toward the surgical defect of the remnant contralateral half of the mandible, measured in centimeter at maximum mouth opening. Results: Ninety-six patients, unevenly distributed according to their duration of tolerance of IMF, were studied. The age of the patients ranged from 29 to 57 years with an overall mean age of 42.6 ± 5.1 years. There were 72 males and 24 females with a male-to-female ratio of 3:1 (P = 0.001. The lesions that were extirpated were all benign, and ameloblastoma was the most common tumor (P = 0.001. The shorter the duration of IMF, the greater the deviation of the mandibular mid-line toward the surgical defect (P = 0.001. Conclusion: This study shows that there is a deviation of mid-line of the residual mandible toward the surgical defect after hemimandibulectomy, even after its immobilization with IMF for 4–12 weeks. IMF is still useful in the prevention of mandibular collapse after hemimandibulectomy.

Clinicopathological study of surgically treated osteoradionecrosis

International Nuclear Information System (INIS)

Ohishi, Shin-ichiro

2001-01-01

To evaluate prognostic factors affecting surgically treated osteoradionecrosis (ORN) of the mandible, 13 patients with mandibular bone necrosis caused by irradiation for head and neck cancer were examined chlinicopathologically. The subjects were included 12 men and 1 woman, with a mean age of 65.3 years at surgery. The mean total dose of irradiation was 61.6 Gy. The clinical stage according to Epstein et al. (1987) was IIB in 1 patient, IIIA in 4, and IIIB in 8. The mandible was resected 10 mm or more from the lesion. Delayed healing was found in two patients, and three had recurrence of necrosis of the remaining bone. Patients whose mandibular periosteum had been resected previously who received mandibular reconstruction had a poor outcome. Pathological changes, such as stenosis of the inferior alveolar artery, fibrosis of bone marrow, and low osteocyte density in cortical bone, were found in all resected mandibles. Among them, mandibles lacking sequestra and bone remodeling had poor viability. Therefore, the periosteal blood supply should be conserved and surgical interventions, particularly heat, must be minimized to avoid recurrence of ORN. (author)

Surgical treatment of jaw osteonecrosis in "Krokodil" drug addicted patients.

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Poghosyan, Yuri M; Hakobyan, Koryun A; Poghosyan, Anna Yu; Avetisyan, Eduard K

2014-12-01

Retrospective study of jaw osteonecrosis treatment in patients using the "Krokodil" drug from 2009 to 2013. On the territory of the former USSR countries there is widespread use of a self-produced drug called "Krokodil". Codeine containing analgesics ("Sedalgin", "Pentalgin" etc), red phosphorus (from match boxes) and other easily acquired chemical components are used for synthesis of this drug, which used intravenously. Jaw osteonecrosis develops as a complication in patients who use "Krokodil". The main feature of this disease is jawbone exposure in the oral cavity. Surgery is the main method for the treatment of jaw osteonecrosis in patients using "Krokodil". 40 "Krokodil" drug addict patients with jaw osteonecrosis were treated. Involvement of maxilla was found in 11 patients (27.5%), mandible in 21 (52.5%), both jaws in 8 (20%) patients. 35 Lesions were found in 29 mandibles and 21 lesions in 19 maxillas. Main factors of treatment success are: cessation of "Krokodil" use in the pre- (minimum 1 month) and postoperative period and osteonecrosis area resection of a minimum of 0.5 cm beyond the visible borders of osteonecrosis towards the healthy tissues. Surgery was not delayed until sequestrum formation. In the mandible marginal or segmental resection (with or without TMJ exarticulation) was performed. After surgery recurrence of disease was seen in 8 (23%) cases in the mandible, with no cases of recurrence in the maxilla. According to our experience in this case series, surgery is the main method for the treatment of jaw osteonecrosis in patients using "Krokodil". Cessation of drug use and jaw resection minimize the rate of recurrences in such patients. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Clinicopathologic correlation of chondrosarcoma of mandible with a case report

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Sanchita Kundu

2011-01-01

Full Text Available Chondrosarcoma is a rare primary malignant neoplasm of the head, neck, oral and maxillofacial regions. The clinicopathological and radiographic findings are usually characteristic; however, not decisive. The neoplasm is usually treated by wide surgical resection because it is traditionally radioresistant. However, radiotherapy is generally advised for high-grade lesions, and chemotherapy has a palliative role. The treatment and management are primarily guided by the histological grades of the neoplasm. Prognosis of jaw lesions is poor as compared to the lesions affecting the long bones of the body, and the cause of death is usually by direct extension in the base of the skull or due to distant metastasis to lungs and other bones. A clinical case of chondrosarcoma, involving the right half of mandible of a 36 year old male patient is discussed herewith, encompassing the entire gamut of clinicopathological, radiological and treatment modalities rendered.

Aneurysmal bone cyst of the mandible managed by conservative surgical therapy with preoperative embolization

Energy Technology Data Exchange (ETDEWEB)

An, Seo Young [School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of)

2012-03-15

A 9-year-old girl visited our hospital, complaining of a rapid-growing and rigid swelling on the left posterior mandibular area. Panoramic radiograph showed a moderately defined multilocular honeycomb appearance involving the left mandibular body. CT scan revealed an expansile, multilocular osteolytic lesion and multiple fluid levels within cystic spaces. Bone scan demonstrated increased radiotracer uptake and angiography showed a highly vascularized lesion. The lesion was suspected as aneurysmal bone cyst (ABC) and preoperative embolization was performed, which minimize the extent of operation and the surgical complication. The lesion was treated by surgical curettage and lateral decortication with repositioning. No additional treatment such as a surgical reconstruction or bone graft was needed. Early diagnosis of ABC is very important and appropriate treatment should be performed considering several factors such as age, surgical complication, and possibility of recurrence.

Duration of orthognathic-surgical treatment.

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Paunonen, Jaakko; Helminen, Mika; Peltomäki, Timo

2017-07-01

The objective of this study was to determine the duration of orthognathic-surgical treatment conducted with conventional pre- and post-surgical orthodontic treatment phases. The study material was comprised of the files of 185 consecutive patients treated in Oral and Maxillofacial Unit, Tampere University Hospital, Finland, in 2007-2014. The files were reviewed and the following data was obtained: gender and age of patients, ICD-10 diagnosis, type of malocclusion, duration of pre- and post-surgical orthodontic treatment and type of operation. Total treatment duration (median) from placement of separating rings for banding until fixed orthodontic appliances were removed and retention period started was 31.1 months, of which pre-surgical orthodontics took 24.4 months and postsurgical 6.4 months. Treatment duration (median) was in BSSO was 32.1, LeFort 1 30.1 and bimaxillary osteotomy 29.7 months. Orthodontic extractions were performed in 35 patients (19%). If the orthodontic treatment included tooth extraction, the duration of pre-surgical treatment was on average 10 months longer, which is a statistically highly significant difference (p pre-surgical orthodontic treatment prolong treatment time by an average of 8-9 months.

Morphological and morphometric analysis of the shape, position, number and size of mental foramen on human mandibles

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Alma Voljevica

2015-05-01

Full Text Available Objective. To provide anatomical information on the position, morphological variations and incidence of mental foramen (MF and accessorymental foramen (AMF as they are important for dental surgeons, anesthetists in nerve block and surgical procedures, to avoid injury to the neurovascular bundle in the mental foramen area. Methods. Our study was conducted on 150 adult dry human mandibles from the osteological collection of the Department of Anatomy of the Faculty of Medicine, University of Sarajevo. The location and shape of the MF and the presence of the AMF were studied by visual examination. The size and position of the MF were measured using a digital vernier caliper. SPSS, version 17 software was used for the statistical analysis. Results. Bilateral mental foramina were presented in all 150 mandibles. In the majority of mandibles, the MF was located between the first and second premolar (20.3% or on the level of the root of the second premolar (60.3%, midway between the inferior margin and the alveolar margin of the mandible. Most of the mental foramina were oval in shape (83.3%. An AMF was present in four mandibles (2.7% on the right side. Conclusion. This study may be a very useful new supplement to data on variations in the incidence, position, shape and size of mental and accessory mental foramina, which may help surgeons, anaesthetists, neurosurgeons and dentists in carrying out surgical procedures successfully.

ASPERGILLOSIS OF MANDIBLE : A RARE CASE OF OSTEOMYELITIS

OpenAIRE

ÖZTÜRK, Nurdan; ERSOY, Burak; SÖNMEZ, Ahmet; ÇELEBİLER, Özhan; NUMANOĞLU, Ayhan

2007-01-01

Aspergillus species are saprophyticus fungi which may be the cause of infection predominantly in immunocompromised hosts. Aspergillosis is usually manifested in the respiratory system and bone involvement is rarely encountered. Osteomyelitis of the mandible with aspergillus species has been reported in only two cases in the literature. Treatment mainly consists of antimicrobial therapy in combination with surgery. We report a case of aspergillosis of the mandible in a patient who was under im...

Adaptation of D-P flap to the oro-facial fistula induced by radio-osteomyelitis of mandible

Energy Technology Data Exchange (ETDEWEB)

Yamamoto, E.; Genba, R.; Hayatsu, Y.; Sunakawa, H.; Kohama, G. (Sapporo Medical Coll. (Japan))

1980-06-01

Intraoral partial resection of the mandible was performed on 3 patients with radiation-induced ostomyelitis and ostonecrosis of the mandible, and inflammation in the mandible disappeared. Residual oro-facial fistula was closed with D-P flap, and a good result was obtained. Treatments of radiation osteopathy, the time of the treatments, and the period from resection of necrotic mandible to the closure of the fistula with D-P flap and reconstructive surgery for the mouth were also considered.

Large Peripheral Osteoma of the Mandible: A Case Report

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Emel Bulut

2010-01-01

Full Text Available Osteomas are benign, slow-growing osteogenic tumors commonly occurring in the craniofacial bones. Osteomas are characterized by the proliferation of compact and/or cancellous bone. It can be of a central, peripheral, or extraskeletal type. The peripheral type arises from the periosteum and is rarely seen in the mandible. The lingual surface and lower border of the body are the most common locations of these lesions. They are usually asymptomatic and can be discovered in routine clinical and radiographic examination. In this paper, we presented a large solitary peripheral osteoma located in the buccal surface of the left posterior mandible and causing facial deformity in a 37-year-old woman. Radiographic examination by computed tomography revealed radiopacity with a well-circumscribed, pedunculated mass approximately 3 cm in size. The osteoma was removed surgically, and no recurrence has been observed.

Adaptation of D-P flap to the oro-facial fistula induced by radio-osteomyelitis of mandible

International Nuclear Information System (INIS)

Yamamoto, Etsuhide; Genba, Ryo-ichi; Hayatsu, Yoshikazu; Sunakawa, Hajime; Kohama, Gen-iku

1980-01-01

Intraoral partial resection of the mandible was performed on 3 patients with radiation-induced ostomyelitis and ostonecrosis of the mandible, and inflammation in the mandible disappeared. Residual oro-facial fistula was closed with D-P lap, and a good result was obtained. Treatments of radiation osteopathy, the time of the treatments, and the period from resection of necrotic mandible to the closure of the fistula with D-P lap and reconstructive surgery for the mouth were also considered. (Tsunoda, M.)

Osteomyelitis of the mandible in the patient with plasmocytoma – case report

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Wioletta Anna Bal

2017-12-01

Full Text Available Osteomyelitis is an infection of bone which may be caused by infection carried to the bone via the bloodstream or from surrounding tissue. Treatment of osteomyelitis of the mandible is extremely difficult because of oral environment and teeth presence. Management often involves both debridement and antibiotic selection. Despite this, aggressive surgical interventions and conservative therapy are most important aspects of treatment. Medication-related osteonecrosis of the jaw (MRONJ is an avascular necrosis related to osteomyelitis and characterized by necrotic bone in the maxillofacial region. The prevalence of this is associated with treatment with high-potency bisphosphonates or denosumab and it seems to be getting increasingly frequent. Due to lack of prospective studies with long-term follow-up there are no recommendation for treatment of MRNOJ. The main aim of treatment of patients with MRNOJ is to continue and to support oncological treatment as well as to provide patient education, comfort to life, control of pain and to prevent from secondary infection and development of new areas of necrosis.

Are short implants in the mandible safe?

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Sergio Henrique Gonçalves Motta

2009-10-01

Full Text Available Objective: To analyze the importance of bioengineering and the improvement in surgical techniques demonstrated by the rates attained of the prevalence of successful placement of dental implants in the posterior region of the mandible, in D3 bone quality in patients between the ages of 52 and 60 years, with dentures fixed on 8.5 mm implants. Methods: The statistical data for this retrospective study were collected at the Post-Graduation Center of the Integrated Dentistry Center, Faculty of Sarandi / Academy of Dentistry - Rio de Janeiro, at the CLIVO clinic, from among a total of 2.294 implants placed in the mandible, in the period from 1999 to 2007. There was a total of 1.056 short implants, of a length shorter than or equal to 10 mm, among which 20 implants were randomly chosen and analyzed. Results: The data were treated statistically and comparison of these data was consubstantiated in constructive data analysis by means of Statistical Pattern Recognition Methods for each variable under study. A success rate of 85% was obtained, and the need to take certain care when indicating the use of short implants was verified. Conclusion: Bioengineering and the development of present day surgical techniques have optimized the use of short implants, with the aim of avoiding advanced surgeries. To compensate the smaller size, there are some factors that must be observed, such as: Bone quality, crown/implant ratio, number and diameter of implants, macroscopic and microscopic geometry of the implants, magnitude of mesial occlusal forces.

Orthodontic camouflage versus orthodontic-orthognathic surgical treatment in class II malocclusion: a systematic review and meta-analysis.

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Raposo, R; Peleteiro, B; Paço, M; Pinho, T

2018-04-01

This systematic review was performed to compare dental, skeletal, and aesthetic outcomes between orthodontic camouflage and surgical-orthodontic treatment, in patients with a skeletal class II malocclusion and a retrognathic mandible who have already finished their growth period. A literature search was conducted, and a modified Downs and Black checklist was used to assess methodological quality. The meta-analysis was conducted using the DerSimonian-Laird random-effects method to obtain summary estimates of the standardized mean differences and corresponding 95% confidence intervals. Nine articles were included in the qualitative synthesis and seven in the meta-analysis. The difference between treatments was not statistically significant regarding SNA angle, linear measurement of the lower lip to Ricketts' aesthetic line, convexity of the skeletal profile, or the soft tissue profile excluding the nose. In contrast, surgical-orthodontic treatment was more effective with regard to ANB, SNB, and ML/NSL angles and the soft tissue profile including the nose. Different treatment effects on overjet and overbite were found according to the severity of the initial values. These results should be interpreted with caution, due to the limited number of studies included and because they were non-randomized clinical trials. Further studies with larger sample sizes and similar pre-treatment conditions are needed. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Combined Surgical Treatment of Gynecomastia

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Yordanov Y.

2015-05-01

Full Text Available Surgical treatment of gynecomastia could present unique challenges for the plastic surgeon. Achieving a good balance between effectiveness of the selected approach and the satisfactory aesthetic outcome often is a difficult endeavor. Optimal surgical treatment involves a combination of liposuction and direct excision. In the present study the charts of 11 patients treated with suction-assisted liposuction and direct surgical excision were retrospectively reviewed; a special emphasis is placed on the surgical technique. The mean follow-up period of the patients was 11.6 months. No infection, hematoma, nipple-areola complex necrosis and nipple retraction was encountered in this series. The combined surgical treatment of gynecomastia has shown to be a reliable technique in both small and moderate breast enlargement including those with skin excess.

Development of 3D statistical mandible models for cephalometric measurements

International Nuclear Information System (INIS)

Kim, Sung Goo; Yi, Won Jin; Hwang, Soon Jung; Choi, Soon Chul; Lee, Sam Sun; Heo, Min Suk; Huh, Kyung Hoe; Kim, Tae Il; Hong, Helen; Yoo, Ji Hyun

2012-01-01

The aim of this study was to provide sex-matched three-dimensional (3D) statistical shape models of the mandible, which would provide cephalometric parameters for 3D treatment planning and cephalometric measurements in orthognathic surgery. The subjects used to create the 3D shape models of the mandible included 23 males and 23 females. The mandibles were segmented semi-automatically from 3D facial CT images. Each individual mandible shape was reconstructed as a 3D surface model, which was parameterized to establish correspondence between different individual surfaces. The principal component analysis (PCA) applied to all mandible shapes produced a mean model and characteristic models of variation. The cephalometric parameters were measured directly from the mean models to evaluate the 3D shape models. The means of the measured parameters were compared with those from other conventional studies. The male and female 3D statistical mean models were developed from 23 individual mandibles, respectively. The male and female characteristic shapes of variation produced by PCA showed a large variability included in the individual mandibles. The cephalometric measurements from the developed models were very close to those from some conventional studies. We described the construction of 3D mandibular shape models and presented the application of the 3D mandibular template in cephalometric measurements. Optimal reference models determined from variations produced by PCA could be used for craniofacial patients with various types of skeletal shape.

Development of 3D statistical mandible models for cephalometric measurements

Energy Technology Data Exchange (ETDEWEB)

Kim, Sung Goo; Yi, Won Jin; Hwang, Soon Jung; Choi, Soon Chul; Lee, Sam Sun; Heo, Min Suk; Huh, Kyung Hoe; Kim, Tae Il [School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Hong, Helen; Yoo, Ji Hyun [Division of Multimedia Engineering, Seoul Women' s University, Seoul (Korea, Republic of)

2012-09-15

The aim of this study was to provide sex-matched three-dimensional (3D) statistical shape models of the mandible, which would provide cephalometric parameters for 3D treatment planning and cephalometric measurements in orthognathic surgery. The subjects used to create the 3D shape models of the mandible included 23 males and 23 females. The mandibles were segmented semi-automatically from 3D facial CT images. Each individual mandible shape was reconstructed as a 3D surface model, which was parameterized to establish correspondence between different individual surfaces. The principal component analysis (PCA) applied to all mandible shapes produced a mean model and characteristic models of variation. The cephalometric parameters were measured directly from the mean models to evaluate the 3D shape models. The means of the measured parameters were compared with those from other conventional studies. The male and female 3D statistical mean models were developed from 23 individual mandibles, respectively. The male and female characteristic shapes of variation produced by PCA showed a large variability included in the individual mandibles. The cephalometric measurements from the developed models were very close to those from some conventional studies. We described the construction of 3D mandibular shape models and presented the application of the 3D mandibular template in cephalometric measurements. Optimal reference models determined from variations produced by PCA could be used for craniofacial patients with various types of skeletal shape.

Duration of surgical-orthodontic treatment.

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Häll, Birgitta; Jämsä, Tapio; Soukka, Tero; Peltomäki, Timo

2008-10-01

To study the duration of surgical-orthodontic treatment with special reference to patients' age and the type of tooth movements, i.e. extraction vs. non-extraction and intrusion before or extrusion after surgery to level the curve of Spee. The material consisted files of 37 consecutive surgical-orthodontic patients. The files were reviewed and gender, diagnosis, type of malocclusion, age at the initiation of treatment, duration of treatment, type of tooth movements (extraction vs. non-extraction and levelling of the curve of Spee before or after operation) and type of operation were retrieved. For statistical analyses two sample t-test, Kruskal-Wallis and Spearman rank correlation tests were used. Mean treatment duration of the sample was 26.8 months, of which pre-surgical orthodontics took on average 17.5 months. Patients with extractions as part of the treatment had statistically and clinically significantly longer treatment duration, on average 8 months, than those without extractions. No other studied variable seemed to have an impact on the treatment time. The present small sample size prevents reliable conclusions to be made. However, the findings suggest, and patients should be informed, that extractions included in the treatment plan increase chances of longer duration of surgical-orthodontic treatment.

Piezoelectric-assisted removal of a benign fibrous histiocytoma of the mandible: An innovative technique for prevention of dentoalveolar nerve injury

Science.gov (United States)

2011-01-01

In this article, we present our experience with a piezoelectric-assisted surgical device by resection of a benign fibrous histiocytoma of the mandible. A 41 year-old male was admitted to our hospital because of slowly progressive right buccal swelling. After further radiographic diagnosis surgical removal of the yellowish-white mass was performed. Histologic analysis showed proliferating histiocytic cells with foamy, granular cytoplasm and no signs of malignancy. The tumor was positive for CD68 and vimentin in immunohistochemical staining. Therefore the tumor was diagnosed as primary benign fibrous histiocytoma. This work provides a new treatment device for benign mandibular tumour disease. By using a novel piezoelectric-assisted cutting device, protection of the dentoalveolar nerve could be achieved. PMID:22040611

Piezoelectric-assisted removal of a benign fibrous histiocytoma of the mandible: An innovative technique for prevention of dentoalveolar nerve injury

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Kokemueller Horst

2011-10-01

Full Text Available Abstract In this article, we present our experience with a piezoelectric-assisted surgical device by resection of a benign fibrous histiocytoma of the mandible. A 41 year-old male was admitted to our hospital because of slowly progressive right buccal swelling. After further radiographic diagnosis surgical removal of the yellowish-white mass was performed. Histologic analysis showed proliferating histiocytic cells with foamy, granular cytoplasm and no signs of malignancy. The tumor was positive for CD68 and vimentin in immunohistochemical staining. Therefore the tumor was diagnosed as primary benign fibrous histiocytoma. This work provides a new treatment device for benign mandibular tumour disease. By using a novel piezoelectric-assisted cutting device, protection of the dentoalveolar nerve could be achieved.

Reconstruction of the mandible bone by treatment of resected bone with pasteurization.

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Uehara, Masataka; Inokuchi, Tsugio; Sano, Kazuo; Sumita, Yoshinori; Tominaga, Kazuhiro; Asahina, Izumi

2012-11-01

The results of long-term follow-up for reimplantation of the mandibular bone treated with pasteurization are reported. Mandibulectomy was performed for mandibular malignancy in 3 cases. The resected bones were subsequently reimplanted after treatment with pasteurization in 3 cases to eradicate tumor cells involved in the resected bone. Although postoperative infection was observed in 2 of 3 cases, reimplantation of the resected mandibular bone treated by pasteurization was finally successful. Ten to 22 years of follow-up was carried out. Pasteurization was able to devitalize tumor cells involved in the resected bone and to preserve bone-inductive activity. Reimplantation of pasteurization could be a useful strategy for reconstruction of the mandible in patients with mandibular malignancy.

Open treatment of unilateral mandibular condyle fractures in adults : A systematic review

NARCIS (Netherlands)

Rozeboom, A.; Dubois, L.; Bos, R.; Spijker, R.; de Lange, J.

2017-01-01

Since the introduction of rigid internal fixation devices, more and more surgeons favour an open approach to treating condylar fractures of the mandible in adult patients. Different indications for open treatment have been published. Open treatment is associated with surgical complications because

Clear cell odontogenic carcinoma of the mandible: a treatment strategy

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Sabrina FERREIRA

2018-01-01

Full Text Available Abstract Clear cell odontogenic carcinoma (CCOC is a rare odontogenic tumor of the jaws, histologically characterized by the presence of agglomerates of cells with eosinophilic cytoplasm. The patient, a 62-year-old Caucasian woman, presented an intraosseous lesion in the mandibular symphysis. A clinical examination revealed a discrete volumetric increase with a hard consistency, palpable to extraoral and intraoral examinations. Imaging studies revealed an extensive radiolucent area, without defined limits, extending from the region of the right second premolar to the left canine. Incisional biopsy analysis indicated a diagnosis of CCOC. The treatment proposed was segmental resection of the mandible with a safety margin. After six months without recurrence, definitive mandibular reconstruction was performed using an iliac crest graft, followed by rehabilitation with implant-supported denture after five months. After three years of post-resection follow-up, the patient has shown no evidence of recurrence or metastasis. She continues to be under follow-up. To conclude, CCOC must be considered a malignant tumor with aggressive behavior. Previous studies have shown that resection with free margins is a treatment with a lower rate of recurrence. Nevertheless, long-term follow-up is necessary for such patients.

Reconstruction of the mandible and the maxilla: the evolution of surgical technique.

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Genden, Eric M

2010-01-01

The upper and lower jaws play an essential role in mastication, articulation, and cosmetic form. The mandible provides support for tongue position and elevation of the larynx during swallowing, while the maxilla provides support for the nasal structures as well as an opposing structure to the mandible during mastication. The evolution of mandibular and maxillary reconstruction dates back to the early 19th century. Before the introduction of free tissue transfer, a variety of local flaps, regional flaps, and prosthetics were introduced, yet each was met with eventual failure. Since the introduction of free tissue transfer, mandibular and maxillary reconstruction has become as much of an art as it has a science. Whether the mandibular or the palatomaxillary defects are a result of trauma, congenital deformity, or tumor extirpation, the resultant effect often disrupts both form and function. With these considerations taken together, jaw reconstruction is a unique undertaking in which the artistic reconstruction of the facial skeleton is met with the science of reestablishing the mechanics of mastication. The site, size, and associated soft-tissue defects represent the 3 most important factors in determining the impact of a given defect on function and aesthetics. There is also an inherent difference between defects that are sustained in a controlled fashion, such as during cancer ablation, and those that result from trauma. The consideration of these complexities in jaw reconstruction is reflected in the wide variety of approaches and techniques that have evolved over the past century.

Calcifying epithelial odontogenic cyst with odontome in left mandible

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R Kamala

2009-01-01

Full Text Available Calcifying epithelial odontogenic cyst is a mixed odontogenic benign tumor but most of the cases present cystic characteristics. We present a case report of calcifying epithelial odontogenic cyst with odontoma in a 20-year-old male who presented with a painless unilateral swelling of the jaw. The lesion involved an impacted 37 which was displaced to the lower border of the mandible and a calcified mass that was within the cystic lesion that was recognized as odontoma. The lesion was surgically removed along with 36 and 37 was allowed to erupt.

The Use of Invisalign® System in the Management of the Orthodontic Treatment before and after Class III Surgical Approach.

Science.gov (United States)

Pagani, Renato; Signorino, Fabrizio; Poli, Pier Paolo; Manzini, Pietro; Panisi, Irene

2016-01-01

The approach to skeletal dysmorphisms in the maxillofacial area usually requires an orthodontic treatment by means of fixed appliances, both before and after the surgical phase. Since its introduction, Invisalign system has become a popular treatment choice for the clinicians because of the aesthetics and comfort of the removable clear aligners compared with the traditional appliances. Therefore, the aim of the present report was to illustrate the management of a malocclusion by means of Invisalign system associated with the traditional surgical technique. The present paper shows a case of a 23-year-old male patient characterized by a Class III malocclusion with lateral deviation of the mandible to the left side and cross-bite on teeth 2.2, 2.3, and 2.4. Invisalign system was used during the pre- and postsurgical phases rather than fixed appliances. The posttreatment cephalometric analysis emphasized the stability of the dental and skeletal symmetry corrections, occlusion and functional balance, over a 6-year follow-up. The results achieved at the end of the treatment showed how Invisalign can be effective in the management of the orthodontic phases in orthognathic surgery. The follow-up after 6 years emphasizes the stability of the treatment over time.

The Use of Invisalign® System in the Management of the Orthodontic Treatment before and after Class III Surgical Approach

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Renato Pagani

2016-01-01

Full Text Available The approach to skeletal dysmorphisms in the maxillofacial area usually requires an orthodontic treatment by means of fixed appliances, both before and after the surgical phase. Since its introduction, Invisalign system has become a popular treatment choice for the clinicians because of the aesthetics and comfort of the removable clear aligners compared with the traditional appliances. Therefore, the aim of the present report was to illustrate the management of a malocclusion by means of Invisalign system associated with the traditional surgical technique. The present paper shows a case of a 23-year-old male patient characterized by a Class III malocclusion with lateral deviation of the mandible to the left side and cross-bite on teeth 2.2, 2.3, and 2.4. Invisalign system was used during the pre- and postsurgical phases rather than fixed appliances. The posttreatment cephalometric analysis emphasized the stability of the dental and skeletal symmetry corrections, occlusion and functional balance, over a 6-year follow-up. The results achieved at the end of the treatment showed how Invisalign can be effective in the management of the orthodontic phases in orthognathic surgery. The follow-up after 6 years emphasizes the stability of the treatment over time.

[Metastatic lung cancer origin from osteosarcoma of mandible invading tracheal lumen].

Science.gov (United States)

Taguchi, K; Noriyuki, T; Furonaka, O; Kuroda, Y; Akimoto, E; Kuranishi, F; Nakahara, M; Fukuda, T; Ishizaki, Y; Okuda, H; Hashimoto, M; Yonehara, S

2009-07-01

A 52-year-old woman underwent the surgical treatment for osteosarcoma of the left mandible in 2003 and was followed up afterward. She suffered from dry cough and bloody sputum, and was admitted to our hospital in April 2007. Computed tomography (CT) revealed several nodules in bilateral lung, and bronchofiberscopy showed the endobronchial tumor obstructing in the right main bronchus. The metastatic tumor progressed in the right main bronchus from the right S6 lung segment. The tumor rapidly progressed in the right bronchus in comparison with the CT findings in about 2 weeks, and the possibility of the tracheal obstruction was considered. She underwent the right middle and lower lobectomy, and the endobronchial tumor was pulled through the right main bronchus. The postoperative course was uneventful, the patient was discharged on 14th postoperative day, and the chemotherapy using cisplatin (CDDP) and adriamycin (ADR) is on-going.

Factors related to stability following the surgical correction of skeletal open bite.

Science.gov (United States)

Ito, Goshi; Koh, Myongsun; Fujita, Tadashi; Shirakura, Maya; Ueda, Hiroshi; Tanne, Kazuo

2014-05-01

If a skeletal anterior open bite malocclusion is treated by orthognathic surgery directed only at the mandible, the lower jaw is repositioned upward in a counter-clockwise rotation. However, this procedure has a high risk of relapse. In the present study, the key factors associated with post-surgical stability of corrected skeletal anterior open bite malocclusions were investigated. Eighteen orthognathic patients were subjected to cephalometric analysis to assess the dental and skeletal changes following mandibular surgery for the correction of an anterior open bite. The patients were divided into two groups, determined by an increase or decrease in nasion-menton (N-Me) distance as a consequence of surgery. Changes in overbite, the displacements of molars and positional changes in Menton were evaluated immediately before and after surgery and after a minimum of one year post-operatively. The group with a decreased N-Me distance exhibited a significantly greater backward positioning of the mandible. The group with an increased N-Me distance experienced significantly greater dentoalveolar extrusion of the lower molars. A sufficient mandibular backward repositioning is an effective technique in the prevention of open bite relapse. In addition, it is important not to induce molar extrusion during post-surgical orthodontic treatment to preserve stability of the surgical open bite correction.

REVIEW OF 40 CASES OF ISOLATED FRACTURE MANDIBLE

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Shashikant Kondiram Mhashal

2016-10-01

Full Text Available BACKGROUND Mandible fractures are a frequent injury because of the mandible's prominence and relative lack of support. The purpose of this study is to clinically determine the most common sites and the prevalence of isolated fracture mandible in our scenario and determine most common traumatic aetiology factor responsible for fracture mandible. Numerous investigators have reported studies on populations on all continents; fractures of the mandible have been reported to account for 36-70% of all maxillofacial fractures. All reports apparently show a higher frequency in males aged 21-30 yrs. There is an emerging trend towards an increase in the frequency of violent mechanisms of fracture and in the proportion of adolescents and young adults sustaining such injuries. MATERIALS AND METHODS Patients treated at the Otorhinolaryngology Head and Neck Surgery Department of B.D.B.A. Hospital from a period between January 2014 to January2016 were (retrospectively evaluated with respect to age groups, gender, aetiology, localisation, type of fractures and treatment. RESULTS Total number of patients 38, 2 patients had bilateral fracture, males 27 (71.05%, females 11 (28.95%. Anatomical location symphysis and parasymphysis 14 (35%, condylar 12 (30%, body 7 (17.5%, angle 6 (15%, coronoid 1 (2.5%. Aetiological factors road traffic accidents 19 (50%, assault 13 (34.24%, fall 3 (7.89%, work-related trauma 2 (5.26%, sports trauma 1 (2.6%. CONCLUSION This study indicates that most common fracture in adult patient were symphysis and parasymphysis, second most common were condylar followed by body fracture and angle fracture. The most common cause of the injury maybe road traffic accidents, second most common assault followed by work related injuries, fall and sports injuries.

Evaluation of Mandibular Anatomy Associated With Bad Splits in Sagittal Split Ramus Osteotomy of Mandible.

Science.gov (United States)

Wang, Tongyue; Han, Jeong Joon; Oh, Hee-Kyun; Park, Hong-Ju; Jung, Seunggon; Park, Yeong-Joon; Kook, Min-Suk

2016-07-01

This study aimed to identify risk factors associated with bad splits during sagittal split ramus osteotomy by using three-dimensional computed tomography. This study included 8 bad splits and 47 normal patients without bad splits. Mandibular anatomic parameters related to osteotomy line were measured. These included anteroposterior width of the ramus at level of lingula, distance between external oblique ridge and lingula, distance between sigmoid notch and inferior border of mandible, mandibular angle, distance between inferior outer surface of mandibular canal and inferior border of mandible under distal root of second molar (MCEM), buccolingual thickness of the ramus at level of lingula, and buccolingual thickness of the area just distal to first molar (BTM1) and second molar (BTM2). The incidence of bad splits in 625 sagittal split osteotomies was 1.28%. Compared with normal group, bad split group exhibited significantly thinner BTM2 and shorter sigmoid notch and inferior border of mandible (P bad splits. These anatomic data may help surgeons to choose the safest surgical techniques and best osteotomy sites.

Peripheral ostectomy with the use of Carnoy’s solution as a rational surgical approach to odontogenic keratocyst: A case report with a 5-year follow-up

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Matijević Stevo

2012-01-01

Full Text Available Introduction. Odontogenic keratocyst (OKC is a rare developmental, epithelial and benign cyst of the jaws of odontogenic origin with high recurrence rates. The third molar region, especially the angle of the mandible and the ascending ramus are involved far more frequently than the maxilla. The choice of treatment approach was based on the size of the cyst, recurrence status, and radiographic evidence of cortical perforation. Different surgical treatment options like marsupialization, decompression, enucleation, enucleation with Carnoy’s solution, peripheral ostectomy with or without Carnoy’s solution, and jaw resection have been discussed in the literature with variable rates of recurrence. Case report. We presented a 52-yearold male with orthokeratinized odontogenic keratocyst. Elliptical unilocular radiolucency located in the third molar region and the ascending ramus of the mandible, 40 × 25 mm in diameter with radiographic evidence of cortical perforation at the anterior ramus border of the mandible 20 mm in diameter, was registrated on orthopantomographic radiography. Surgical treatment included enucleation of the cyst and peripheral ostectomy with the use of Carnoy’s solution and excision of the overlying attached mucosa. Postoperatively, no paresthesia in the inervation area of the inferior alveolaris nerve was registrated. Recurrences were not registrated within 5 years post-intervention. Coclusion. Treatment of odontogenic keratocyst with enucleation and peripheral ostectomy with the use of Carnoy’s solution and excision of the overlying attached mucosa had a very low rate of recurrence. Radical and more aggressive surgical treatments as jaw resection should be reserved for multiple recurrent cysts and when OKC is associated with nevoid basal cell carcinoma syndrome (NBCCS. Following the treatment protocol in the management of OKC and systematic and long-term postsurgical follow-up are considered key elements for successful

Advances in surgical treatment of chronic pancreatitis.

Science.gov (United States)

Ni, Qingqiang; Yun, Lin; Roy, Manish; Shang, Dong

2015-02-08

The incidence of chronic pancreatitis (CP) is between 2 and 200 per 100,000 persons and shows an increasing trend year by year. India has the highest incidence of CP in the world at approximately 114 to 200 per 100,000 persons. The incidence of CP in China is approximately 13 per 100,000 persons. The aim of this review is to assist surgeons in managing patients with CP in surgical treatment. We conducted a PubMed search for "chronic pancreatitis" and "surgical treatment" and reviewed relevant articles. On the basis of our review of the literature, we found that CP cannot be completely cured. The purpose of surgical therapy for CP is to relieve symptoms, especially pain; to improve the patient's quality of life; and to treat complications. Decompression (drainage), resection, neuroablation and decompression combined with resection are commonly used methods for the surgical treatment of CP. Before developing a surgical regimen, surgeons should comprehensively evaluate the patient's clinical manifestations, auxiliary examination results and medical history to develop an individualized surgical treatment regimen.

Surgical treatment for mandibular osteoradionecrosis. Stepwise surgical treatment before wide resection

International Nuclear Information System (INIS)

Aoki, Shinjiro; Hirota, Makoto; Saito, Tomokatsu; Watanuki, Kei; Matsui, Yoshiro; Fujita, Kiyohide

2006-01-01

A method corresponding to the state of progress of necrosis is necessary for the treatment of mandibular osteoradionecrosis considering the healing conditions of the original focus. We devised a three-step treatment method that combined active application of platelet rich plasma (PRP) with particulate cancellous bone marrow (PCBM) with resolutive treatment using external skeletal fixation, as a step preceding wide segmental mandibulectomy and vascularized free combination flap graft when bone necrosis progressed. From January 2002 until December 2004, 14 patients (12 patients of oral cancer and 2 patients of mesopharygeal cancer) in whom mandibular osteoradionecrosis developed after radiation therapy, were treated. First step: when only alveolectomy is done, the wound is closed with a mucosal flap after PRP is applied to the bone surface as there is little sequestration. Second step: when sequestrectomy spreads to the central part of the mandible, PCBM is transplanted in addition to PRP, and the wound is closed by a local skin flap. Third step: when bone defect is segmental, any issue with soft tissue is first resolved and bone grafting is performed after that, while holding the remaining bone in position by using an external skeletal fixation device. A decrease in exposure of bone surface and alleviation of pain symptoms were achieved in all cases by treatment with the first step. However, outer cortical bone necrosis relapsed. The outcome of the second and third step treatment was good, and bone regeneration was achieved in 8 cases where PRP and transplantation of PCBM were done. Two cases suffered an infection, and curettage or retransplantation of PCBM was necessary. It is suggested that improvement of blood circulation and resolution of soft tissue are important for treatment of osteoradionecrosis. Therefore, waiting for resolution of the soft tissue using external skeletal fixation was effective, and PRP was useful in the healing process. (author)

ANALYSIS OF MORPHOMETRIC PARAMETERS OF THE ROE DEER MANDIBLE (Capreolus capreolus AND MANDIBLE OF THE SHEEP (Ovis aries

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Rizah Avdić

2013-08-01

Full Text Available Morphology and morphometry of the bones are the methods often used for identification of species, estimation of animals' age, and genetic and forensic investigation. The mandible as the largest bone of the head is perhaps the most representative sample for this research. The aim of this study was to determine the basic morphometric parameters of the mandible of roe deer and sheep in order to identify the species. All samples were described by linear measure morphometric analysis of 12 specific anatomical points on the mandibles of roe deer and sheep. The results obtained are presented in the Table as mean and standard deviation.Key words: morphology, morphometry, mandible, roe deer, shee

Capping of the radicular exposed surface (part II). Surgical and not surgical treatment

OpenAIRE

Grados Pomarino, Sixto; Estrada, Andrew Alejandro; Maetahara Rubio, Denis Miguel; Guzmán Vera, Yanina Sara; Tello Barbarán, Javier

2014-01-01

The gingival recession treatment can be made surgical1y with a high predictability of success due to the great advance during the last ones of the mucogingival surgical techniques. The use of connective grafts in coverage of recessions has obtained high rates of success reason why these procedures are common within the modern periodontal surgical practice. Knowing that all patients do not accept the surgical treatment, many investigators have come studying the possibility of treating non-surg...

Multi Vesicular Osseous Hydatid Disease of the Mandible- A Case Report

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M Nematollahi

2010-02-01

Full Text Available "nHydatid disease is a common and major public health issue caused by parasite Echinococcus granulosus. The highest prevalence of the parasite can be found in different parts of world like Africa, Australia, and South America. This infection can occurs in almost any part of the body. Here we present clinical, radiological, histological features and treatment of a multi ve­sicular osseous hydatid disease of the mandible in an Afghan 5 year old boy with a firm swelling in the right side of mandible.

Low-grade Myxofibrosarcoma in the Mandible: A Rare Case Report

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Neda Kargahi

2017-04-01

Full Text Available Myxofibrosarcoma is a malignant neoplasm of connective tissue origin commonly found in the extremities. It is very rare in the head and neck regions. Only 25 cases of myxofibrosarcoma have been reported in the head and neck regions until 2014. Here we report a 61-year-old male with this neoplasm in the lower border of his mandible. During a two-year follow-up, this case recurred four times despite a complete resection. This study suggested combined surgical and adjuvant radiotherapy for unresectable lesions and tumors with positive margins to prevent recurrence and risk of progression.

Cephalometric evaluation of surgical mandibular advancement

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Eloísa Marcantônio Boeck

2010-06-01

Full Text Available The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6°. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23° (from 8.1° to 4.9°. Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm, and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm. It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM or indirectly to it (ANB, AOBO and OJ.

Cephalometric evaluation of surgical mandibular advancement.

Science.gov (United States)

Boeck, Eloísa Marcantônio; Kuramae, Mayury; Lunardi, Nádia; Santos-Pinto, Ary dos; Mazzonetto, Renato

2010-01-01

The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6 degrees. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23 degrees (from 8.1 degrees to 4.9 degrees). Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm), and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm). It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM) or indirectly to it (ANB, AOBO and OJ).

[Diverticular disease of the large bowel - surgical treatment].

Science.gov (United States)

Levý, M; Herdegen, P; Sutoris, K; Simša, J

2013-07-01

Surgical treatment, despite the rapid development of the numerous modern miniinvasive intervention techniques, remains essential in the treatment of complicated diverticular disease. The aim of this work is to summarize indications for surgical treatment in both acute and elective patients suffering from diverticular disease of the large bowel. Review of the literature and recent findings concerning indications for surgical intervention in patients with diverticulosis of the colon. The article describes indications, types of procedures, techniques and postoperative care in patients undergoing surgical intervention for diverticular disease.

Radiation-induced fibrosarcoma of the mandible following treatment for bilateral retinoblastoma

Energy Technology Data Exchange (ETDEWEB)

Ferlito, A; Recher, G [Padua Univ. (Italy); Tomazzoli, L

1979-10-01

A case of fibrosarcoma of the mandible following radiotherapy for bilateral retinoblastoma and occurring in an 11-year-old female child is described. After a clinical description of the case, reported with histological documentation, problems connected with the pathogenesis of the malignancies are dealt with. Besides irradiation, genetic mutation as a carcinogenetic co-factor is taken into consideration. (author).

Surgical treatment of gynecomastia: complications and outcomes.

Science.gov (United States)

Li, Chun-Chang; Fu, Ju-Peng; Chang, Shun-Cheng; Chen, Tim-Mo; Chen, Shyi-Gen

2012-11-01

Gynecomastia is defined as the benign enlargement of the male breast. Multiple surgical options have been used to improve outcomes. The aim of this study was to analyze the surgical approaches to the treatment of gynecomastia and their outcomes over a 10-year period. All patients undergoing surgical correction of gynecomastia in our department between 2000 and 2010 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and revision rate. The surgical result was evaluated with self-assessment questionnaires. A total of 41 patients with 75 operations were included. Techniques included subcutaneous mastectomy alone or with additional ultrasound-assisted liposuction (UAL) and isolated UAL. The surgical revision rate for all patients was 4.8%. The skin-sparing procedure gave good surgical results in grade IIb and grade III gynecomastia with low revision and complication rates. The self-assessment report revealed a good level of overall satisfaction and improvement in self-confidence (average scores 9.4 and 9.2, respectively, on a 10-point scale). The treatment of gynecomastia requires an individualized approach. Subcutaneous mastectomy combined with UAL could be used as the first choice for surgical treatment of grade II and III gynecomastia.

A Case of Maxillary Protrusion with Congenitally Missing Canine Teeth in the Mandible

OpenAIRE

松井, 啓至; 酒徳, 明彦

1996-01-01

A patient that had a maxillary protrusion with congenitally missing canine teeth in the mandible was successfully treated with the extraction of the maxillary first premolars. The patient's cooperation in wearing headgear appliance was highly favorable. Her profile changes were pronounced and esthetically pleasing. A review of her post-treatment records revealed an excellent esthetic and occlusal result even though the first premolars were aligned instead of the canine teeth in the mandible. ...

Random Positional Variation Among the Skull, Mandible, and Cervical Spine With Treatment Progression During Head-and-Neck Radiotherapy

International Nuclear Information System (INIS)

Ahn, Peter H.; Ahn, Andrew I.; Lee, C. Joe; Shen Jin; Miller, Ekeni; Lukaj, Alex; Milan, Elissa; Yaparpalvi, Ravindra; Kalnicki, Shalom; Garg, Madhur K.

2009-01-01

Purpose: With 54 o of freedom from the skull to mandible to C7, ensuring adequate immobilization for head-and-neck radiotherapy (RT) is complex. We quantify variations in skull, mandible, and cervical spine movement between RT sessions. Methods and Materials: Twenty-three sequential head-and-neck RT patients underwent serial computed tomography. Patients underwent planned rescanning at 11, 22, and 33 fractions for a total of 93 scans. Coordinates of multiple bony elements of the skull, mandible, and cervical spine were used to calculate rotational and translational changes of bony anatomy compared with the original planning scan. Results: Mean translational and rotational variations on rescanning were negligible, but showed a wide range. Changes in scoliosis and lordosis of the cervical spine between fractions showed similar variability. There was no correlation between positional variation and fraction number and no strong correlation with weight loss or skin separation. Semi-independent rotational and translation movement of the skull in relation to the lower cervical spine was shown. Positioning variability measured by means of vector displacement was largest in the mandible and lower cervical spine. Conclusions: Although only small overall variations in position between head-and-neck RT sessions exist on average, there is significant random variation in patient positioning of the skull, mandible, and cervical spine elements. Such variation is accentuated in the mandible and lower cervical spine. These random semirigid variations in positioning of the skull and spine point to a need for improved immobilization and/or confirmation of patient positioning in RT of the head and neck

Random Positional Variation Among the Skull, Mandible, and Cervical Spine With Treatment Progression During Head-and-Neck Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Ahn, Peter H. [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (United States)], E-mail: phahn@mdanderson.org; Ahn, Andrew I [Albert Einstein College of Medicine of Yeshiva University, Bronx, NY (United States); Lee, C Joe; Jin, Shen; Miller, Ekeni; Lukaj, Alex; Milan, Elissa; Yaparpalvi, Ravindra; Kalnicki, Shalom; Garg, Madhur K [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (United States)

2009-02-01

Purpose: With 54{sup o} of freedom from the skull to mandible to C7, ensuring adequate immobilization for head-and-neck radiotherapy (RT) is complex. We quantify variations in skull, mandible, and cervical spine movement between RT sessions. Methods and Materials: Twenty-three sequential head-and-neck RT patients underwent serial computed tomography. Patients underwent planned rescanning at 11, 22, and 33 fractions for a total of 93 scans. Coordinates of multiple bony elements of the skull, mandible, and cervical spine were used to calculate rotational and translational changes of bony anatomy compared with the original planning scan. Results: Mean translational and rotational variations on rescanning were negligible, but showed a wide range. Changes in scoliosis and lordosis of the cervical spine between fractions showed similar variability. There was no correlation between positional variation and fraction number and no strong correlation with weight loss or skin separation. Semi-independent rotational and translation movement of the skull in relation to the lower cervical spine was shown. Positioning variability measured by means of vector displacement was largest in the mandible and lower cervical spine. Conclusions: Although only small overall variations in position between head-and-neck RT sessions exist on average, there is significant random variation in patient positioning of the skull, mandible, and cervical spine elements. Such variation is accentuated in the mandible and lower cervical spine. These random semirigid variations in positioning of the skull and spine point to a need for improved immobilization and/or confirmation of patient positioning in RT of the head and neck.

Treatment of Class III malocclusion in a young adult patient: a case report.

Science.gov (United States)

Kiran, B H Jyothi; Kumar, Prashanth; Ravi, S; Shivalinga, B M; Bhagyalaxmi; Pradeep; Kudagi, Vishal

2012-01-01

This article describes the treatment of a young adult male with a concave profile, skeletal class III malocclusion because of a prognathic mandible and proclined upper incisors. The therapy included stages: 1. Pre-surgical orthodontics involving leveling and aligning of upper and lower arches, protraction of lower molars and retraction of upper incisors; 2. Surgical phase involving BSSO with mandibular setback and 3. Post-surgical orthodontics for finishing and detailing. The treatment lasted 23 months and improved facial esthetics significantly The treatment resulted in a functional occlusion with a lack of lateral cuspid guidance that could be accepted considering the difficulty of the case. Over jet and overbite are within norms.

Surgical Treatment of Tattoo Complications.

Science.gov (United States)

Sepehri, Mitra; Jørgensen, Bo

2017-01-01

With a continuing increase in the number of tattoos performed worldwide, the need to treat tattoo complications is growing. Earlier treatments of chronic inflammatory tattoo reactions were dominated by a medical approach, or with no active intervention. In this chapter, we will address modern surgical approaches applied to situations when medical treatment is inefficient and lasers are not applicable. Dermatome shaving is positioned as first-line treatment of allergic tattoo reactions and also indicated in a number of other tattoo reactions, supplemented with excision in selected cases. The methods allow fundamental treatment with removal of the culprit pigment from the dermis. The different instruments, surgical methods, and treatment schedules are reviewed, and a guide to surgeons is presented. Postoperative treatments and the long-term outcomes are described in detail. An algorithm on specialist treatment and follow-up of tattoo reactions, which can be practiced in other countries, is presented. © 2017 S. Karger AG, Basel.

Geometric modelling of a make mandible utilising CT imaging

International Nuclear Information System (INIS)

Baker, N.; Basu, A.; McLean, A.G.; Jamieson, D.; Jonkman, M.

1996-01-01

Full text: The mandible is one of the most important and frequently used bones in the human body. It is responsible for basic actions such as mastication, communication and swallowing. It houses and provides protection for the tongue, teeth and salivary glands. The mandible is unique in that it has two anatomically identical articulations, each providing the same function. Both articulations, however, rarely have synchronous force and motion characteristics. The mandible is the only moveable bone in the skull and is capable of the following motions: depression - lowering the mandible, as in yawning, elevation - raising the mandible, protraction - thrusting the jaw forward, retraction - withdrawing the jaw posteriorly, and lateral deviation - sideways displacement in the transverse plane. The mandible is an irregular bone comprising a broad U shaped body with two ascending rami. The rami are quadrilateral plate like structures with lateral sides which are nearly flat. The mandible is subjected to repetitive loading and is susceptible to wear at its articulations, cyclic fatigue and dislocation. Despite the importance of the mandible little is understood about its mechanical properties and loading parameters. The purpose of this study was to create a three dimensional geometric model of a human mandible based on anatomical data. A 21 year old male with no history of mandible fracture or temporomandibular joint dysfunction was selected. The mandible was non-invasively imaged by Computed Tomography (CT). The subject was imaged lying on his back with the head supported and immobilised by a U shaped head rest. Seventeen parallel cross-sectional images oblique to the transverse plane were constructed. Cortical and cancellous bone boundaries were manually digitised for every image using a Science Accessories Corporation GP-9 digitiser linked to an IBM 286 SX personal computer. The data was transferred to a global coordinate system and entered into MSC/PATRAN finite element

Surface-bounded growth modeling applied to human mandibles

DEFF Research Database (Denmark)

Andresen, Per Rønsholt

1999-01-01

This thesis presents mathematical and computational techniques for three dimensional growth modeling applied to human mandibles. The longitudinal shape changes make the mandible a complex bone. The teeth erupt and the condylar processes change direction, from pointing predominantly backward...... of the common features. 3.model the process that moves the matched points (growth modeling). A local shape feature called crest line has shown itself to be structurally stable on mandibles. Registration of crest lines (from different mandibles) results in a sparse deformation field, which must be interpolated...... old mandible based on the 3 month old scan. When using successively more recent scans as basis for the model the error drops to 2.0 mm for the 11 years old scan. Thus, it seems reasonable to assume that the mandibular growth is linear....

Shoulder morbidity after non-surgical treatment of the neck

International Nuclear Information System (INIS)

Wouwe, Merian van; Bree, Remco de; Kuik, Dirk J.; Goede, Cees J.T. de; Verdonck-de Leeuw, Irma M.; Doornaert, Patricia; Rene Leemans, C.

2009-01-01

Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides were treated by surgery (n = 51) or (chemo)radiation (n = 123). Abduction, anteflexion, endorotation and exorotation were assessed. Subjective measurements were performed using the Visual Analogue Scale for pain, the Shoulder Disability Questionnaire (SDQ) and stiffness reporting. Results: Predictive factors for SDQ-score > 0 (n = 54) were VAS pain score, stiffness, abduction, anteflexion, physiotherapy, low shoulder position and surgical treatment. The SDQ, stiffness and pain scores were significantly higher in the surgically treated group than in the non-surgical group (p < 0.01). Anteflexion, abduction and exorotation were less impaired in the non-surgically treated group than in the surgically treated group (p < 0.01). No differences between neck dissection and neck dissection with post-operative radiotherapy, and radiotherapy and chemoradiation were found for these movements. Conclusions: Shoulder morbidity is often present after non-surgical treatment of the neck, but to a lesser extent compared to surgical treatment. Radiotherapy adds no morbidity to neck dissection and chemotherapy does not add extra morbidity to primary radiation

Surgical treatment of polymicrogyria-related epilepsy.

Science.gov (United States)

Cossu, Massimo; Pelliccia, Veronica; Gozzo, Francesca; Casaceli, Giuseppe; Francione, Stefano; Nobili, Lino; Mai, Roberto; Castana, Laura; Sartori, Ivana; Cardinale, Francesco; Lo Russo, Giorgio; Tassi, Laura

2016-12-01

The role of resective surgery in the treatment of polymicrogyria (PMG)-related focal epilepsy is uncertain. Our aim was to retrospectively evaluate the seizure outcome in a consecutive series of patients with PMG-related epilepsy who received, or did not receive, surgical treatment, and to outline the clinical characteristics of patients who underwent surgery. We evaluated 64 patients with epilepsy associated with magnetic resonance imaging (MRI)-documented PMG. After presurgical evaluation, 32 patients were excluded from surgical treatment and 32 were offered surgery, which was declined by 8 patients. Seizure outcome was assessed in the 40 nonsurgical and 24 surgical patients. Of 40 nonsurgical patients, 8 (20%) were seizure-free after a mean follow-up of 91.7 ± (standard deviation) 59.5 months. None of the eight patients who declined surgical treatment was seizure-free (mean follow-up: 74.3 ± 60.6 months). These seizure outcomes differ significantly (p = 0.000005 and p = 0.0003, respectively) from that of the 24 surgical patients, 18 of whom (66.7%) were Engel's class I postoperatively (mean follow-up: 66.5 ± 54.0 months). Of the eight patients excluded from surgery for seizure control at first visit, two had seizure recurrence at last contact. At last contact, antiepileptic drugs (AEDs) had been withdrawn in 6 of 24 surgical and in one of 40 nonsurgical cases (p = 0.0092). The present study indicates that, at least in a subset of adequately selected patients with PMG-related epilepsy, surgery may provide excellent seizure outcomes. Furthermore, it suggests that surgery is superior to AEDs for achieving seizure freedom in these cases. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

Most common surgical mistakes with treatment of prosthetic joint infections

Directory of Open Access Journals (Sweden)

Boštjan Kocjančič

2014-08-01

Full Text Available The treatment of infections of orthopedic implants is often difficult and complex, although the chances of successful treatment with properly selected diagnostics, surgical and antibiotic treatment protocol have recently increased significantly. Surgical treatment is a key stone factor in the treatment of infections of orthopedic implants and any errors in it often lead to worse clinical outcomes. The most important and frequent surgical errors include: conservative treatment of periprothetic infections with antibiotics only, to-late surgical revision, insufficient debridement during surgical revision, inadequate intraoperative samples for bacteriological and histological analysis. It is important to have and to follow proper treatment algorithm for periprosthetic joint infection. In this work we present the listed surgical and most illustrative key errors.

Normal and pathologic CT anatomy of the mandible

International Nuclear Information System (INIS)

Osborn, A.G.; Hanafee, W.H.; Mancuso, A.A.

1982-01-01

The value of computed tomography (CT) in the diagnosis and management of a wide variety of facial lesions has been amply demonstrated. While a number of studies have focused on CT anatomy of the paranasal sinuses, nose, and nasopharynx, none has concentrated on the mandible. Although the mandible is difficult to image because of its complex, curving surfaces and the presence of artifact-producing amalgam fillings or restorations, CT of the mandible can nevertheless be highly informative in selected cases. This pictorial essay depicts normal gross and CT anatomy of the mandible and presents a series of cases that illustrate the utility of CT in examining mandibular lesions

Predicted versus executed surgical orthognathic treatment.

Science.gov (United States)

Falter, B; Schepers, S; Vrielinck, L; Lambrichts, I; Politis, C

2013-10-01

This study aimed to analyse combined surgical-orthodontic treatment plans, compare them with the actual surgery performed, and define factors resulting in changes of the original plan during orthodontic pre-surgical preparation. The clinical files of 312 orthognathic surgery patients, operated between January 2008 and December 2010, were retrospectively reviewed. Of these 312 patients, 129 had a bimaxillary operation. One hundred sixty patients had osteotomy of the lower jaw only and 23 had osteotomy of the upper jaw only. Factors analysed in the study include Angle Class malocclusion, patient sex, and age. Lip-to-incisor relationship, overjet, overbite and midline deviations of the upper and lower jaw were recorded. Effects of surgical assisted rapid palatal expansion (SARPE) on the eventual surgery were also investigated. Reasons for changing the original treatment plan at the time of the finished pre-surgical-orthodontic alignment were analysed. The original treatment plan was changed in 42 of the 312 patients (13.5%). Changes occurred generally in case of a larger interval between set-up of the first treatment plan and the eventual operation (average 22.4 versus 16.4 months for patients with changed versus unchanged treatment plan, respectively). All Class I patients had surgery performed as planned. Class III patients had a significantly higher rate of altered treatment plan (27.3%) than Class II patients (7.6%). More men (52.4%) saw their treatment plan changed, although there were more women than men in the study population (59.6 versus 40.4%). One in seven patients (13.5%) had a different operation than was planned at the start of treatment. Class III patients with small overjet and overbite commonly have a treatment plan for a monomaxillary operation that, after decompensation, needs to be adapted to a bimaxillary operation. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The appearance of foramen in the internal aspect of the mental region of mandible from japanese cadavers and dry skulls under macroscopic observation and three-dimensional CT images

International Nuclear Information System (INIS)

Yoshida, Shunji; Kawai, Taisuke; Okutsu, Koichiro; Yosue, Takashi; Sunohara, Masataka; Sato, Iwao; Takamori, Hitoshi

2005-01-01

The lingual canal with foramen displays different appearances on the internal surfaces of mandible as confirmed by macroscopic observation and computerized tomography (CT). The lingual canal was observed in the inside of mental region run to the outside of lingual foramen, which is extend internally from mandibular canal in right and left sides of the mandible in cadavers (13 sides out of 88 sides) and in dry skulls (43 out of 94 sides) examined. The spinal foramen connected with mental canal occurred at the midline of mandible in 6 cases (6 out of 47 cases) in dry skulls. In this small foramen, the inferior alveolar artery give some branches to the inside of mental region at the anterior mandible and which may be run pass through the lingual canal to the lingual foramen, where they emerge to enter the mylohyoid or anterior belly of digastric muscles. The observations of these are important considerations for surgical placement of dental implants in the region in the mandible. (author)

Triple bone labeling of canine mandibles

DEFF Research Database (Denmark)

Pinholt, E M; Kwon, P H

1990-01-01

Fluorescence microscopy was used for evaluation of new bone formation in 16 canine mandibles augmented with hydroxylapatite (HA) granules. Three fluorochromes were injected at different time intervals during therapeutic radiation treatment. Oxytetracycline, DCAF, and alizarin-complexone were given...... intravenously to mark the bone level at these times, respectively. Oxytetracycline, which defined the baseline of bone at implantation of HA, was detectable in 42% of animals that were irradiated and in no animal of the nonirradiated control group. The marker DCAF, designating levels of bone at the start...

Total knee replacement and non-surgical treatment of knee osteoarthritis

DEFF Research Database (Denmark)

Skou, Søren T; Roos, Ewa M; Laursen, Mogens B

2018-01-01

OBJECTIVES: To compare 2-year outcomes of total knee replacement (TKR) followed by non-surgical treatment to that of non-surgical treatment alone and outcomes of the same non-surgical treatment to that of written advice. DESIGN: In two randomized trials, 200 (mean age 66) adults with moderate...... to severe knee osteoarthritis (OA), 100 eligible for TKR and 100 not eligible for TKR, were randomized to TKR followed by non-surgical treatment, non-surgical treatment alone, or written advice. Non-surgical treatment consisted of 12 weeks of supervised exercise, education, dietary advice, use of insoles......, and pain medication. The primary outcome was the mean score of the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, covering pain, symptoms, activities of daily living (ADL), and quality of life (QOL). RESULTS: Patients randomized to TKR had greater improvements than patients randomized...

Progress in surgical palliative treatment for malignant obstructive jaundice

Directory of Open Access Journals (Sweden)

LIANG Zhang

2013-06-01

Full Text Available Obstructive jaundice, also known as surgical jaundice, is divided into benign and malignant types. Most of the patients newly diagnosed with malignant obstructive jaundice have lost the opportunity of receiving radical surgery due to its insidious onset, so surgical palliative treatment is very important for patients with advanced malignant obstructive jaundice. This paper elaborates on various current modalities of surgical palliative treatment for malignant obstructive jaundice. Appropriate modality of surgical palliative treatment is of great significance for patients with advanced malignant obstructive jaundice.

Possibilities of reconstruction and implant-prosthetic rehabilitation following mandible resection

Directory of Open Access Journals (Sweden)

Konstantinović Vitomir S.

2013-01-01

Full Text Available Introduction. Mandible reconstruction is still very challenging for surgeons. Mandible defects could be the consequence of ablative surgery for malignancies, huge jaw cysts, infection and trauma. Segmental resection of the mandible may compromise orofacial function and often lead to patients psychological disorders. Despite very frequent use of microvascular flaps, autogenous bone grafts are still very reliable technique for mandible reconstruction. Comprehensive therapy means not only mandible reconstruction, but prosthodontic rehabilitation supported by dental implants, which can significantly improve patients quality of life. The aim of this paper was to evaluate possible techniques of mandible reconstruction and to present a patient who had been submitted to mandible resection and reconstruction with autogenous iliac bone graft and prosthodontic rehabilitation with fixed denture anchoraged by disc-shaped implants in early loading protocol. Case report. Mandible reconstruction was performed simultaneously with resection. Autogenous iliac bone graft was taken, reshaped and placed in two parts, to the required optimal contour of the mandible. After graft consolidation, decision was made for prosthodontics rehabilitation with fixed dentures supported by implants. In addition to the standard preoperative procedures, planning was done based on a biomodel gained by rapid prototyping after CT scan. It offered a real 3D planning to obtain a proper shape, dimension and the position of implants. Conclusion. If bone dimensions of a reconstructed mandible are insufficient, like in the presented case, the use of basal osseointegrated implants may be a method of choice. Avoiding bone augmentation procedures, as well as early loading protocol for this type of implants, shorten the total rehabilitation time, which is very convenient for patients. Fixed denture supported by dental implants is the best solution for comprehensive rehabilitation after mandible

Complete oral rehabilitation of a deep bite patient with Ewing’s sarcoma; surgical and prosthetic phases: A clinical report

Directory of Open Access Journals (Sweden)

Mehran Bahrami

2017-01-01

Full Text Available Introduction: Ewings sarcoma (ES is an unusual, aggressive malignant neoplasm occurring primarily in the long bones of the lower and upper extremities followed by pelvis, ribs, vertebrae, skull, and jaws-bones. Patients with ES tumor need long-term complete oral reconstruction. The location of the primary tumor in the face is predominantly in the mandible, and usually in the posterior mandible. Case Report: Here, both surgical procedures and prosthetic reconstruction in three stages of a 10-year-old childs life presented. Definitive prosthetic reconstruction is extremely challenging in such patients after previous excessive surgical resection, especially when the patient has complex dental abnormality. Fixed dental prostheses and implant-supported fixed restorations have been selected as the preferred treatment option in this case after increasing occlusal vertical dimension (OVD to create sufficient interocclusal space (IOS. Discussion: In this case, ES patient treated in three phases. In the first-stage, only surgical resection of tumor and bone graft reconstruction with titanium plate fixation was performed. In the second-stage, Lefort I surgery for maxilla with dental implants insertion in mandible was done simultaneously. For definitive restorations fabrication, it was mandatory to increase occlusal vertical dimension (OVD to create sufficient inter-occlusal space (IOS for the restorations. OVD has been altered to achieve more stable relationship of mandibular teeth with maxillary teeth, and to obtain an optimum esthetic and functional result. Several factors should be considered as determinants for increasing the OVD such as remaining tooth structure, the space available for the restorations such as the current situation, occlusal variables, and esthetics.

Incidence of bisphosphonate-related osteonecrosis of the jaw in high-risk patients undergoing surgical tooth extraction.

Science.gov (United States)

Bodem, Jens Philipp; Kargus, Steffen; Eckstein, Stefanie; Saure, Daniel; Engel, Michael; Hoffmann, Jürgen; Freudlsperger, Christian

2015-05-01

As the most suitable approach for preventing bisphosphonate-related osteonecrosis of the jaw (BRONJ) in patients undergoing surgical tooth extraction is still under discussion, the present study evaluates the incidence of BRONJ after surgical tooth extraction using a standardized surgical protocol in combination with an adjuvant perioperative treatment setting in patients who are at high-risk for developing BRONJ. High-risk patients were defined as patients who received intravenous bisphosphonate (BP) due to a malignant disease. All teeth were removed using a standardized surgical protocol. The perioperative adjuvant treatment included intravenous antibiotic prophylaxis starting at least 24 h before surgery, a gastric feeding tube and mouth rinses with chlorhexidine (0.12%) three times a day. In the follow-up period patients were examined every 4 weeks for the development of BRONJ. Minimum follow-up was 12 weeks. In 61 patients a total number of 184 teeth were removed from 102 separate extraction sites. In eight patients (13.1%) BRONJ developed during the follow-up. A higher risk for developing BRONJ was found in patients where an additional osteotomy was necessary (21.4% vs. 8.0%; p = 0.0577), especially for an osteotomy of the mandible (33.3% vs. 7.3%; p = 0.0268). Parameters including duration of intravenous antibiotic prophylaxis, the use of a gastric feeding tube and the duration of intravenous BP therapy showed no statistical impact on the development of BRONJ. Furthermore, patients currently undergoing intravenous BP therapy showed no higher risk for BRONJ compared with patients who have paused or completed their intravenous BP therapy (p = 0.4232). This study presents a protocol for surgical tooth extraction in high-risk BP patients in combination with a perioperative adjuvant treatment setting, which reduced the risk for postoperative BRONJ to a minimum. However, the risk for BRONJ increases significantly if an additional osteotomy is necessary

Shoulder morbidity after non-surgical treatment of the neck.

NARCIS (Netherlands)

van Wouwe, V.; de Bree, R.; Kuik, D.J.; de Goede, C.J.T.; de Leeuw, I.M.; Leemans, C.R.

2009-01-01

Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides

Fully 3-dimensional digitally planned reconstruction of a mandible with a free vascularized fibula and immediate placement of an implant-supported prosthetic construction

NARCIS (Netherlands)

Schepers, Rutger H.; Raghoebar, Gerry M.; Vissink, Arjan; Lahoda, Lars U.; Van der Meer, W. Joerd; Roodenburg, Jan L.; Reintsema, Harry; Witjes, Max J.

Background Reconstruction of craniofacial defects becomes complex when dental implants are included for functional rehabilitation. We describe a fully 3-dimensional (3D) digitally planned reconstruction of a mandible and immediate prosthetic loading with a fibula graft in a 2-step surgical approach.

Surgical versus Non-surgical Management of Rotator Cuff Tears: Predictors of Treatment Allocation

OpenAIRE

Kweon, Christopher Y.; Gagnier, Joel Joseph; Robbins, Christopher; Bedi, Asheesh; Carpenter, James E.; Miller, Bruce S.

2014-01-01

Objectives: Rotator cuff tears are a common shoulder disorder resulting in significant disability to patients and strain on the health care system. While both surgical and non-surgical management are accepted treatment options, little data exist to guide the surgeon in treatment allocation. Defining variables to guide treatment allocation may be important for patient education and counseling, as well as to deliver the most efficient care plan at the time of presentation. The objective of this...

Scaling of rotational inertia of primate mandibles.

Science.gov (United States)

Ross, Callum F; Iriarte-Diaz, Jose; Platts, Ellen; Walsh, Treva; Heins, Liam; Gerstner, Geoffrey E; Taylor, Andrea B

2017-05-01

The relative importance of pendulum mechanics and muscle mechanics in chewing dynamics has implications for understanding the optimality criteria driving the evolution of primate feeding systems. The Spring Model (Ross et al., 2009b), which modeled the primate chewing system as a forced mass-spring system, predicted that chew cycle time would increase faster than was actually observed. We hypothesized that if mandibular momentum plays an important role in chewing dynamics, more accurate estimates of the rotational inertia of the mandible would improve the accuracy with which the Spring Model predicts the scaling of primate chew cycle period. However, if mass-related momentum effects are of negligible importance in the scaling of primate chew cycle period, this hypothesis would be falsified. We also predicted that greater "robusticity" of anthropoid mandibles compared with prosimians would be associated with higher moments of inertia. From computed tomography scans, we estimated the scaling of the moment of inertia (I j ) of the mandibles of thirty-one species of primates, including 22 anthropoid and nine prosimian species, separating I j into the moment about a transverse axis through the center of mass (I xx ) and the moment of the center of mass about plausible axes of rotation. We found that across primates I j increases with positive allometry relative to jaw length, primarily due to positive allometry of jaw mass and I xx , and that anthropoid mandibles have greater rotational inertia compared with prosimian mandibles of similar length. Positive allometry of I j of primate mandibles actually lowers the predictive ability of the Spring Model, suggesting that scaling of primate chew cycle period, and chewing dynamics in general, are more strongly influenced by factors other than scaling of inertial properties of the mandible, such as the dynamic properties of the jaw muscles and neural control. Differences in cycle period scaling between chewing and locomotion

Kerathocyst odontogenic tumor: Importance of selection the best treatment modality and a periodical follow-up to prevent from recurrence: A case report and literature review

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Nasim Jafaripozve

2013-01-01

Full Text Available The keratocystic odontogenic tumor (KCOT is a relatively common oral and maxillofacial lesion with specific characteristics such us rapid growth, extension into the surrounding tissues and high rates of recurrence. Various treatment modalities have been reported. Due to the very thin and friable lining characteristic of the tumor, enucleation can be difficult undertaken and for this reason it is associated with the highest recurrence rates. A 22-year-old male referred to our clinic due to a slight expansion in the right mandible from 2 years ago. He has a history of occurrence of KCOT in this region that was treated surgically by enucleation and curettage 5 years ago. Cone beam computed tomography showed a multilocular radiolucent lesion that extended from the angle of the mandible to the symphysis. Incisional biopsy showed a KCOT recurrence that surgically treated with resection of the right mandible by continuity preservation. Selection of the best treatment modality and also a periodical lifelong follow-up is very important to reduce the rate of recurrence and morbidity of the patient.

Cone Beam CT in Diagnosis and Surgical Planning of Dentigerous Cyst

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Naira Figueiredo Deana

2017-01-01

Full Text Available Diagnosis and preoperative planning are critical in the execution of any surgical procedure. Panoramic radiography is a routine method used in dentistry to assist clinical diagnosis; however, with this technique 3D anatomical structures are compressed into 2D images, resulting in overlapping of structures which are of interest in the diagnosis. In this study we report the case of a patient who presented with a dentigerous cyst of expressive dimensions in the body of the mandible region. The surgery was planned and executed after observing the margins of the lesion by Cone Beam Computed Tomography (CBCT. We conclude that CBCT is a precise method to help diagnosis; it provides greater accuracy in surgical treatment planning through 3D image display, allowing more effective results.

Large Complex Odontoma of Mandible in a Young Boy: A Rare and Unusual Case Report

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G. Siva Prasad Reddy

2014-01-01

Full Text Available Odontomas are the most common odontogenic tumors. They are broadly classified in to Compound Odontoma and Complex Odontoma. Among them complex odontoma is a rare tumor. Occasionally this tumor becomes large, causing expansion of bone followed by facial asymmetry. Otherwise these tumors are asymptomatic and are generally diagnosed on radiographic examination. We report a rare case of complex odontoma of mandible in a young boy. The tumor was treated by surgical excision under general anesthesia.

Microarray Analysis of the Developing Rat Mandible

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Hideo KABURAGI; Naoyuki SUGANO; Maiko OSHIKAWA; Ryosuke KOSHI; Naoki SENDA; Kazuhiro KAWAMOTO; Koichi ITO

2007-01-01

To analyze the molecular events that occur in the developing mandible, we examined the expression of 8803 genes from samples taken at different time points during rat postnatal mandible development.Total RNA was extracted from the mandibles of 1-day-old, 1-week-old, and 2-week-old rats. Complementary RNA (cRNA) was synthesized from cDNA and biotinylated. Fragmented cRNA was hybridized to RGU34A GeneChip arrays. Among the 8803 genes tested, 4344 were detectable. We identified 148 genes with significantly increased expression, and 19 genes with significantly decreased expression. A comprehensive analysis appears to be an effective method of studying the complex process of development.

Non-Hodgkin's lymphoma of the mandible in HIV patient - A Rare Case Report

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Mahesh Neerupakam

2018-01-01

Full Text Available Non-Hodgkin's lymphoma (NHL is a lymphatic system tumor originating from either B or T lymphocytes and shows a high malignant potential. In HIV-seropositive patients, NHL of head and neck is mainly found in Waldeyer's ring, oral mucosa, salivary glands, paranasal sinuses, and laryngeal tissue. Primary NHL rarely affects the bone. When the lesion affects the bones of the jaws, it is rare in the mandible when compared to the maxilla. In the reported cases, only 0.6% are found in the mandible. NHL of the mandible can be difficult to diagnose, and so the prime aim of the present case report is to establish appropriate diagnosis of one of such kinds. Clinically, they may imitate a dental infection with symptoms of pain and discomfort. A delay in diagnosis may lead to a poor prognosis. Herewith, we present a case of NHL on the lower-right mandible in a 40-year-old male. A correlation of clinical findings, radiological examination, and histopathological examination enabled us in early diagnosis and differentiating it from other similar conditions, thus aiding in initiation of prompt treatment.

Surgical treatment of Chiari malformation: review and progress

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ZHANG Yuan-zheng

2012-08-01

Full Text Available The surgical treatment of Chiari malformation (CM began in 1932. With the advance of medical technology, the surgical technique of CM is also in constant improvement. But due to its pathogenesis has not yet clear, there is no accepted optimal method, and different levels of the operation is still controversial. The author reviewed the concept, pathogenesis, diagnosis and surgical treatment of CM. The hot topics and new technological application were also reviewed in this article.

Endoscopic versus surgical drainage treatment of calcific chronic pancreatitis.

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Jiang, Li; Ning, Deng; Cheng, Qi; Chen, Xiao-Ping

2018-04-21

Endoscopic therapy and surgery are both conventional treatments to remove pancreatic duct stones that developed during the natural course of chronic pancreatitis. However, few studies comparing the effect and safety between surgery drainage and endoscopic drainage (plus Extracorporeal Shock Wave Lithotripsy, ESWL).The aim of this study was to compare the benefits between endoscopic and surgical drainage of the pancreatic duct for patients with calcified chronic pancreatitis. A total of 86 patients were classified into endoscopic/ESWL (n = 40) or surgical (n = 46) treatment groups. The medical records of these patients were retrospectively analyzed. Pain recurrence and hospital stays were similar between the endoscopic/ESWL treatment and surgery group. However, endoscopic/ESWL treatment yielded significantly lower medical expense and less complications compared with the surgical treatment. In selective patients, endoscopic/ESWL treatment could achieve comparable efficacy to the surgical treatment. With lower medical expense and less complications, endoscopic/ESWL treatment would be much preferred to be the initial treatment of choice for patients with calcified chronic pancreatitis. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Superselective intra-arterial infusion via the superficial temporal artery and occipital artery for gingival carcinoma of the mandible. Simultaneous catheter placement to the maxillary artery and facial artery

International Nuclear Information System (INIS)

Iwai, Toshinori; Mitsudo, Kenji; Fukui, Takafumi

2009-01-01

Superselective intra-arterial infusion via the superficial temporal artery (STA) has become useful for oral cancer. Approaching via the occipital artery (OA) enables superselective intra-arterial infusion when catheter placement via the STA is impossible. Therefore, simultaneous catheter placement via the STA and OA is possible. We report a surgical method of simultaneous catheter placement via the STA and OA to achieve retrograde superselective intra-arterial infusion for gingival carcinoma of the mandible. Preoperatively, three-dimensional computed tomography angiography was performed to identify the route of the external carotid artery and branches such as the STA, OA, maxillary artery, and facial artery (FA). Thirteen patients with mandibular gingival cancer underwent catheter placement via the STA and OA under local anesthesia. Catheter placement via the STA and OA was superselectively successful in all the patients. The mean operating time was 150.8 min. Catheter placed to the FA via the OA was dislocated during the treatment in one patient, and so the catheter was replaced. This method is useful to enable superselective intra-arterial chemotherapy to the whole gingival carcinoma of the mandible from the start of treatment compared with approaching via the STA. (author)

Surgical treatment of buried penis.

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Lipszyc, E; Pfister, C; Liard, A; Mitrofanoff, P

1997-10-01

The buried penis is a rare congenital entity, whose treatment is surgical. There are few publications concerning this matter. The authors report on their experience in 10 cases (1990-1995). In this abnormality, the tip of the glans does not project from the pubic or scrotal skin. It is due to: 1) an excessive development of the penile fascia which retracts the penis; 2) insufficient attachment of the penile skin at the base of the penis; 3) often excessive prepubic fat worsens the appearance of the abnormality but does not by itself totally explain it; 4) a tight phimosis is often present. Surgical treatment is necessary because this aspect tends to persist even after puberty. One cannot indeed count on the development at the age of puberty, neither on the diminution of the fat, nor on the simple cure of the phimosis. One must above all ban circumcision which causes the risk of eliminating the skin necessary for reconstruction. The surgical procedure will comprise: 1) a longitudinal dorsal incision extended circumferentially; 2) resection of the thickened fascia penis; 3) anchoring of the deep face of the dermis to the proximal part of the fascia penis at the base of the penis. This surgical procedure has always brought a significant improvement to the appearance of the penis.

Beneficial role of periosteum in distraction osteogenesis of mandible. Its preservation prevents the external bone resorption

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Takeuchi, Sawako; Matsuo, Akira; Chiba, Hiroshige

2010-01-01

Distraction osteogenesis (DO) is a surgical process of new bone generation through the gradual extension of two segments of existing bone. DO is applied for maxillofacial surgeries to manage defects in mandibular continuity. Vertical DO with an oral device is often employed to augment the alveolar bone height for better implant anchorage for esthetic purposes or functional prosthetic requirements. To determine how the periosteum affects the vertical DO in mandibular reconstruction, we extracted the teeth and resected the alveolar parts of the mandible on both sides of dogs, along with removal of the surrounding periosteum in the right, but not left side. Three months later, box-shaped bone segments (vectors) were prepared from the resected alveolar part, and the segments were vertically elongated using a distraction device on both sides at 0.9 mm/day for one week. The extent of bone formation after distraction was determined with micro-focused computed tomography and by measuring incorporation of tetracycline and calcein with confocal laser scanning microscopy. During the initial two months after distraction, new bone formation was observed more prominently in the left side than in the right side of mandible with the periosteum. However, this difference was less clear during the bone-remodeling period. One notable change was the reduced height of the alveolar part of the right-side mandible, a sign of external bone resorption, observed in two out of three dogs at 6-month post-consolidation. These findings suggest that preservation of periosteum prevents the external bone resorption during the vertical DO of mandible. (author)

[Surgical treatment of gynecomastia].

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Târcoveanu, E; Lupaşcu, C; Vasilescu, A; Moldovanu, R; Ichim, Mihaela; Georgescu, St; Niculescu, D; Dănilă, N; Dimofte, G; Anton, Raluca; Crumpei, Felicia; Florea, Niculina; Ungureanu, Cristina

2008-01-01

Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, the surgical procedure is the treatment of choice. There are two main surgical procedures: subdermal mastectomy and liposuction. To evaluate the results after surgical treatment (mastectomy) performed in a general surgery unit. We performed a retrospective study; all the patients operated for gynecomastia were reviewed. The clinical, imaging, biological, intraoperative and histological data were included into a MS Access database and statistical analyzed. From 1990-2007, 114 patients were admitted in the First Surgical Clinic Iaşi for gynecomastia. Only 12.6% from the patients were with bilateral gynecomastia. The mean age was 40.54 +/- 1.83 years old (range 12-84). Mean body mass was 26.72 +/- 0.46 kg/m2 (range 18.5-41), and about 20% from the patients had a BMI of over 30 kg/m2. We also noted that 46.5% were smokers. Simon classification was used for preoperative staging: 2.6% from the cases (N = 3) were included in stage I, 16.7% (N = 19) in stage IIa, 50% (N = 57) in stage IIb and 30.7% in stage III. The patients included in stages IIa and I are younger then the patients included in stage III (p = 0.024). Mastodynia was noted in 46 cases (40.4%). Ultrasound exam was performed in all the cases, and the larger diameter of the nodule measured was 3.75 +/- 0.18 cm (range 0.5-9.7). Only three cases were preoperatively treated with tamoxifen. Most of the cases were operated using general anesthesia (53.5%). Mastectomy was performed by peri-areolar (70.2%), elliptical (28.9%) or radial (0.9%) incisions. The subdermal mastectomy using peri-areolar approach was performed especially for the cases included in stages I, IIa and IIb--p gynecomastia in 6 cases; the other cases presented dilated ducts. We also noted intraductal papillary hyperplasia in 87 cases and chronic inflammation in 35 cases. The histological exam also revealed intraductal papilloma--9 cases, fibro

Surgical treatment of pathological obesity

International Nuclear Information System (INIS)

Portie Felix, Antonio; Navarro Sanchez, Gustavo; Hernandez Solar, Abel; Grass Baldoquin, Jorge Alberto; Domloge Fernandez, Joana

2011-01-01

The obesity is the chronic non-communicable disease with a higher rate of growth in past 20 years. It is a risk factor for type 2 diabetes mellitus, high blood pressure, cardiovascular and respiratory affections, infertility, sexual and functional impotence, metabolic syndrome, load joint disorders and some types of cancer (breast, colon, prostate). The metabolic bariatric surgery is the surgical treatment more effective for the morbid obesity at long -and medium- term and not the pharmacologic treatment and the isolated diets. The aim of present historical review of the international literature on the evolution of surgical techniques of the bariatric surgery (malabsorption techniques, gastric restrictive techniques and mixed techniques), is to make available to those interested in this subject, a valuable therapeutic tool to be rationally used. (author)

SURGICAL TREATMENT OF TROCHANTERIC FRACTURES BY GAMMA3 NAIL

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Aleksandar Vukićević

2010-09-01

Full Text Available Fractures of the greater trochanter rank amongst severe injuries of bone tissue. They occur most frequently in patients over 65 years of age, nearly all of whom are diagnosed with osteoporosis. Non-surgical treatment does not prove to be satisfactory and results in high mortality rate. Surgical treatment is a method of fracture treatment of the trochanteric region, which enables early activation and thus prevents numerous complications in bedridden patients. Gamma3 nails are one of the most state-of-the-art implants for trochanteric fracture fixation. The implant is easy to embed, which does not require a large surgical team. This implant embedding requires the least invasive surgery and complications are rare.This paper describes 47 patients who received surgical treatment and is focused on the first nine months of 2009. The patients were treated at the Orthopaedics Ward of Health Centre Valjevo. They were in their seventies, average age: 72.21 years, with female sex prevailing (63.82%. The outcome was as follows: excellent in 65.96%, good in 17.02% and satisfactory in 4.25% of patients. Surface infections occurred in 6.38% of patients. One implant broke.We had one death outcome in the early post-surgical treatment.Surgical treatment of trochanteric fractures by Gamma3 implants proved very effective as it resulted in few complications and numerous excellent functional and anatomic outcomes. Thus we recommend it as an option when decision on treatment of this type of fractures is made.

Effects of dose reduction on multi-detector computed tomographic images in evaluating the maxilla and mandible for pre-surgical implant planning: a cadaveric study.

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Koizumi, Hiroshi; Sur, Jaideep; Seki, Kenji; Nakajima, Koh; Sano, Tsukasa; Okano, Tomohiro

2010-08-01

To assess effects of dose reduction on image quality in evaluating maxilla and mandible for pre-surgical implant planning using cadavers. Six cadavers were used for the study using multi-detector computed tomography (CT) operated at 120 kV and the variable tube current of 80, 40, 20 and 10 mA. A slice thickness of 0.625 mm and pitch 1 were used. Multi-planar images perpendicular and parallel to dentitions were created. The images were evaluated by five oral radiologists in terms of visibility of the anatomical landmarks including alveolar crest, mandibular canal, floors of the maxillary sinus and nasal cavity, contours/cortical layer of jaw bones and the details of trabecular bone. Observers were asked to determine the quality of the images in comparison with 80 mA images based on the criteria: excellent, good, fair or non-diagnostic. The average scores of all observers were calculated for each specimen in all exposure conditions. The 40 mA images could visualize such landmarks and were evaluated to be same or almost equivalent in quality to the 80 mA images. Even the 20 mA images could be accepted just for diagnostic purpose for implant with substantial deterioration of the image quality. The 10 mA images may not be accepted because of the obscured contour caused by image noise. Significant dose reduction by lowering mA can be utilized for pre-surgical implant planning in multi-detector CT.

Non-surgical treatment of esophageal achalasia

OpenAIRE

Annese, Vito; Bassotti, Gabrio

2006-01-01

Esophageal achalasia is an infrequent motility disorder characterized by a progressive stasis and dilation of the oesophagus; with subsequent risk of aspiration, weight loss, and malnutrition. Although the treatment of achalasia has been traditionally based on a surgical approach, especially with the introduction of laparoscopic techniques, there is still some space for a medical approach. The present article reviews the non-surgical therapeutic options for achalasia.

Evaluation of surgical treatment in mandibular condyle fractures.

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Vesnaver, Aleš; Ahčan, Uroš; Rozman, Janez

2012-12-01

In the past, fractures of the mandibular condylar process were, as a rule, treated conservatively. At the Department of Maxillofacial and Oral Surgery of the University Medical Centre Ljubljana, Slovenia, our doctrine was changed in 2002 on the basis of preliminary results and reports in the literature, and these fractures were started to be treated surgically by open reduction and internal fixation with miniplates and screws, which led to good results and a shorter rehabilitation period. The goal of this study was to determine the safety and efficiency of surgical treatment, as well as to compare long-term results of surgical and conservative treatment, as objectively as possible. Two groups of patients, which had all sustained a unilateral, extra-articular mandibular condyle fracture, were compared. In the test group, there were 42 surgically treated patients, and in the control group, 20 conservatively treated patients. Clinical parameters and X-ray images were assessed in both groups and compared by the two tailed Student t test, and in case of attributive variables by the χ(2) test. Within the surgically treated group, postoperative and intraoperative complications were noted: temporary facial nerve palsy, development of a parotid salivary fistula, disturbance of auricle sensibility due to injury of the greater auricular nerve, miniplate fracture, as well as intraoperative bleeding, postoperative haematoma formation, infection, reoperation due to fragment malposition and other complications. Postoperative scars were also assessed. Statistically significant differences between the surgically and conservatively treated patients were found when comparing clinical parameters as well as X-ray images, the results being better in the surgically treated group. Complications of surgical treatment were also noted, the most important among them temporary paresis of facial nerve branches, which occurred in 10 patients (24%). Plate fractures occurred in five patients (12

Automatic segmentation of mandible in panoramic x-ray.

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Abdi, Amir Hossein; Kasaei, Shohreh; Mehdizadeh, Mojdeh

2015-10-01

As the panoramic x-ray is the most common extraoral radiography in dentistry, segmentation of its anatomical structures facilitates diagnosis and registration of dental records. This study presents a fast and accurate method for automatic segmentation of mandible in panoramic x-rays. In the proposed four-step algorithm, a superior border is extracted through horizontal integral projections. A modified Canny edge detector accompanied by morphological operators extracts the inferior border of the mandible body. The exterior borders of ramuses are extracted through a contour tracing method based on the average model of mandible. The best-matched template is fetched from the atlas of mandibles to complete the contour of left and right processes. The algorithm was tested on a set of 95 panoramic x-rays. Evaluating the results against manual segmentations of three expert dentists showed that the method is robust. It achieved an average performance of [Formula: see text] in Dice similarity, specificity, and sensitivity.

Surgical treatment for residual or recurrent strabismus

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Tao Wang

2014-12-01

Full Text Available Although the surgical treatment is a relatively effective and predictable method for correcting residual or recurrent strabismus, such as posterior fixation sutures, medial rectus marginal myotomy, unilateral or bilateral rectus re-recession and resection, unilateral lateral rectus recession and adjustable suture, no standard protocol is established for the surgical style. Different surgical approaches have been recommended for correcting residual or recurrent strabismus. The choice of the surgical procedure depends on the former operation pattern and the surgical dosages applied on the patients, residual or recurrent angle of deviation and the operator''s preference and experience. This review attempts to outline recent publications and current opinion in the management of residual or recurrent esotropia and exotropia.

[Surgical treatment of chronic pancreatitis, 2010].

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Farkas, Gyula

2011-04-01

Chronic pancreatitis (CP) is a benign inflammatory process, which can cause enlargement of the pancreatic head accompanied by severe pain and weight loss, and often leads to a significant reduction in quality of life (QoL). Basically, the disease is characterised by pain and functional disorders which are initially treated with conservative therapy, but in case of complications (uncontrollable pain or obstruction) surgical treatment is required. This article reviews the relevant literature of CP treatment, in particular randomized controlled trials and meta-analyses were involved with a comparison of different surgical treatment options for the management of CP complications. Recent studies have demonstrated that surgical procedures are superior to endoscopic therapy as regards long-term results of QoL and pain control. There was no significant difference found in postoperative pain relief and overall mortality when duodenum-preserving pancreatic head resection (DPPHR) of Beger and its modification (duodenum and organ-preserving pancreatic head resection [DOPPHR]) were compared with pancreatoduodenectomy (PD), but hospital stay, weight gain, exocrine and endocrine insufficiency, and QoL were significantly better in the DPPHR and DOPPHR groups. DPPHR and PD seem to be equally effective in terms of postoperative pain relief and overall mortality. However, recent data suggest that DOPPHR is superior in the treatment of CP with regard to several peri- and postoperative outcome parameters and QoL. Therefore, this should be the preferable treatment option for CP complications.

En bloc resection of huge cemento-ossifying fibroma of mandible: avoiding lower lip split incision.

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Ayub, Tahera; Katpar, Shahjahan; Shafique, Salman; Mirza, Talat

2011-05-01

Cemento-ossifying Fibroma (COF) is an osteogenic benign neoplasm affecting the jaws and other craniofacial bones. It commonly presents as a progressively slow growing pathology, which can sometimes attain an enormous size, causing facial deformity. A case of a huge cemento-ossifying fibroma, appearing as a mandibular dumbell tumour in a male patient is documented, which caused massive bone destruction and deformity. It was surgically removed by performing en bloc resection of mandible avoiding the splitting of lower lip incision technique, thereby maintaining his normal facial appearance.

Management of comminuted but continuous mandible defects after gunshot injuries.

Science.gov (United States)

Rana, Majeed; Warraich, Riaz; Rashad, Ashkan; von See, Constantin; Channar, Kashif A; Rana, Madiha; Stoetzer, Marcus; Gellrich, Nils-Claudius

2014-01-01

Firearm injuries continue as a major public health problem, contributing significant morbidity, mortality, and expense to our society. There are four main steps in the management of patients with gunshot wounds to the face: securing an airway, controlling haemorrhage, identifying other injuries and definitive repair of the traumatic facial deformities. The objective of this study was to determine late outcome of two treatment options by open reduction and internal fixation versus closed reduction and maxillomandibular fixation (MMF) in the treatment of gunshot injuries of the mandible. Sixty patients of gunshot injury were randomly allocated in two groups. In group A, 30 patients were treated by open reduction and internal fixation and in group B, 30 patients were treated by closed reduction and maxillomandibular fixation. Patients were discharged as the treatment completed and recalled for follow up. Up to 3 months after injury, fortnightly complications like infection, malocclusion, malunion of fractured fragments, facial asymmetry, sequestration of bone and exposed plates were evaluated and the differences between two groups were assessed. The follow-up period ranged from 3 months to 10 months. Patients treated by open reduction tended to have less complications as compared to closed reduction. Based on this study open reduction and internal fixation is the best available method for the treatment of gunshot mandible fractures without continuity defect. Copyright © 2012 Elsevier Ltd. All rights reserved.

Non-surgical treatment of esophageal achalasia

Science.gov (United States)

Annese, Vito; Bassotti, Gabrio

2006-01-01

Esophageal achalasia is an infrequent motility disorder characterized by a progressive stasis and dilation of the oesophagus; with subsequent risk of aspiration, weight loss, and malnutrition. Although the treatment of achalasia has been traditionally based on a surgical approach, especially with the introduction of laparoscopic techniques, there is still some space for a medical approach. The present article reviews the non-surgical therapeutic options for achalasia. PMID:17007039

[Cerebral intraperenchymatous hematomas: surgical treatment not to start with].

Science.gov (United States)

Roda, J M

The surgical treatment of intraparenchymal hematomas is very controversial. To date, there has been no through analysis of the subject and neurological specialists need a broad study to indicate which patients should have surgical treatment and which is the surgical option which gives the best results with the least damage. In this paper, the author considers which patients should not have any operation, which should always be operated on and in which there is a relative indication for operation. The different techniques available, their advantages and disadvantages are briefly reviewed. In view of the results obtained to date, it is likely that in future the usual treatment for intraparenchymatous hematomas will be medical (not surgical) and aimed at the protection of surrounding tissue. When surgery is required, it should be as minimally invasive as possible.

Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part I: a Systematic Review of Surgical Techniques

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Boris Abayev

2015-03-01

Full Text Available Objectives: The purpose of this first part of a two-part series was to review the literature concerning the indications, contraindications, advantages, disadvantages and surgical techniques of the lateralization and transposition of the inferior alveolar nerve, followed by the placement of an implant in an edentulous atrophic posterior mandible. Material and Methods: A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC database, academic sites and books. The articles were searched from January 1997 to July 2014 and comprised English-language articles that included adult patients between 18 and 80 years old with minimal residual bone above the mandibular canal who had undergone inferior alveolar nerve (IAN repositioning with a minimum 6 months of follow-up. Results: A total of 16 studies were included in this review. Nine were related to IAN transposition, 4 to IAN lateralization and 3 to both transposition and lateralization. Implant treatment results and complications were presented. Conclusions: Inferior alveolar nerve lateralization and transposition in combination with the installation of dental implants is sometimes the only possible procedure to help patients to obtain a fixed prosthesis, in edentulous atrophic posterior mandibles. With careful pre-operative surgical and prosthetic planning, imaging, and extremely precise surgical technique, this procedure can be successfully used for implant placement in edentulous posterior mandibular segments.

SURGICAL TREATMENT OF ENDOMETRIOSIS IN INFERTILE PATIENTS

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Andrej Vogler

2003-12-01

Full Text Available Background. Endometriosis is nowadays probably the most frequent cause of infertility or subfertility and is revealed in approximately 30–40% of infertile women. The association between fertility and minimal or mild endometriosis remains unclear and controversial. Moderate and severe forms of the disease distort anatomical relations in the minor pelvis, resulting in infertility. The goals of endometriosis treatment are relief of pain symptoms, prevention of the disease progression and fertility improvement. Treatment of stages I and II endometriosis (according to the R-AFS classification may be expectative, medical or surgical. In severely forms of the disease (stage III and IV the method of choice is surgical treatment. Combined medical and surgical treatment is justified only in cases, in which the complete endometriotic tissue removal is not possible or recurrence of pain symptoms occur. Nowadays, laparoscopic surgical treatment is the golden standard being the diagnostic and therapeutic tool during the same procedure. The aim of this study was to evaluate the fertility rate after surgical treatment of different stages of endometriosis.Patients and methods. In prospectively designed study 100 infertile women were included. The only known cause of infertility was endometriosis. In group A there were 51 patients with stage I and II endometriosis, whereas in group B there were 49 patients with stage III and IV of the disease. Endometriosis was diagnosed and treated laparoscopically. Endometriotic implants were removed either with bipolar coagulation or CO2 laser vaporisation, whereas adhesions were sharp or blunt dissected, and endometriomas stripped out of ovaries. Pregnancy rates were calculated for both groups of patients, and statistically compared between the groups.Results. Mean age of patients was 29.25 (SD ± 4.08 years and did not significantly differ between the groups of patients (29.5 years in group A and 29 years in group B. In

The complex treatment of acute pancreatitis using miniinvasive surgical treatment

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G. I. Ohrimenko

2015-06-01

Full Text Available Nowadays methods used in acute pancreatitis diagnostic do not allow to find the most optimal indications, terms of surgical drainage approaches in surgical treatment of acute pancreatitis. Aim. In order to develop optimal diagnostic and treatment algorithm 316 patients took part in the study. Methods and results. Surgery outcomes were assessed by the next methods: ultrasound, computed tomography. We determined that destructive changes in pancreas in group of sterile pancreatic necrosis were limited. In cases of infected pancreatic necrosis the damage was spread and the disease course was septic. That’s why the operative treatment in cases of sterile pancreatitis has to be used with strict indications such as fermentative peritonitis, acute liquid formations, acute pseudocysts. Conclusion. In such cases miniinvasive surgery is mainly used while in the cases of infected pancreatic necrosis we ought to choose open surgery treatment.

Osteoradionecrosis and Radiation Dose to the Mandible in Patients With Oropharyngeal Cancer

International Nuclear Information System (INIS)

Tsai, Chiaojung Jillian; Hofstede, Theresa M.; Sturgis, Erich M.; Garden, Adam S.; Lindberg, Mary E.; Wei Qingyi; Tucker, Susan L.; Dong Lei

2013-01-01

Purpose: To determine the association between radiation doses delivered to the mandible and the occurrence of osteoradionecrosis (ORN). Methods and Materials: We reviewed the records of 402 oropharyngeal cancer patients with stage T1 or T2 disease treated with definitive radiation between January 2000 and October 2008 for the occurrence of ORN. Demographic and treatment variables were compared between patients with ORN and those without. To examine the dosimetric relationship further, a nested case-control comparison was performed. One to 2 ORN-free patients were selected to match each ORN patient by age, sex, radiation type, treatment year, and cancer subsite. Detailed radiation treatment plans for the ORN cases and matched controls were reviewed. Mann-Whitney test and conditional logistic regression were used to compare relative volumes of the mandible exposed to doses ranging from 10 Gy-60 Gy in 10-Gy increments. Results: In 30 patients (7.5%), ORN developed during a median follow-up time of 31 months, including 6 patients with grade 4 ORN that required major surgery. The median time to develop ORN was 8 months (range, 0-71 months). Detailed radiation treatment plans were available for 25 of the 30 ORN patients and 40 matched ORN-free patients. In the matched case-control analysis, there was a statistically significant difference between the volumes of mandible in the 2 groups receiving doses between 50 Gy (V50) and 60 Gy (V60). The most notable difference was seen at V50, with a P value of .02 in the multivariate model after adjustment for the matching variables and dental status (dentate or with extraction). Conclusions: V50 and V60 saw the most significant differences between the ORN group and the comparison group. Minimizing the percent mandibular volume exposed to 50 Gy may reduce ORN risk.

Case study: limitations of panoramic radiography in the anterior mandible.

LENUS (Irish Health Repository)

Walker, Cameron

2009-12-01

Dental Panoramic Tomography (DPT) is a widely used and valuable examination in dentistry. One area prone to artefacts and therefore misinterpretation is the anterior region of the mandible. This case study discusses a periapical radiolucency related to lower anterior teeth that is discovered to be a radiographic artefact. Possible causes of the artefact include a pronounced depression in the mental region of the mandible or superimposition of intervertebral spaces. Additional limitations of the DPT image include superimposition of radio-opaque structures, reduced image detail compared to intra-oral views and uneven magnification. These problems often make the DPT inappropriate for imaging the anterior mandible. Clinical Relevance: Panoramic radiography is often unsuitable for radiographic examination of the anterior mandible.

The shape of contention: adaptation, history, and contingency in ungulate mandibles.

Science.gov (United States)

Raia, Pasquale; Carotenuto, Francesco; Meloro, Carlo; Piras, Paolo; Pushkina, Diana

2010-05-01

Mandibles and teeth of ungulates have been extensively studied to discern the functional significance of their design. Grazing ungulates have deeper mandibles, longer coronoid processes, flatter incisor arcades, and more hypsodont molars in comparison to browsers. If the functional significance of both mandible and teeth shapes is well-established, it remains uncertain to what extent mandible shapes are really adapted to grazing, meaning that they evolved either to serve their current biological function or just as a structural requirement to accommodate higher crowned molars. Here, we address this question by studying the contribution of phylogeny, hypsodonty, and body size to mandibular shape variation. The mandible shape appeared to be significantly influenced by hypsodonty but not by body size. Interestingly, hypsodonty-related changes influenced the tooth row in artiodactyls and perissodactyls significantly but in the opposite directions, which is ultimately related to their different digestive strategies. Yet, we obtained a strong phylogenetic effect in perissodactyls, suggesting that their mandible shape should be strongly inherited. The strength of this effect was not significant within artiodactyls (where hypsodonty explained much more variance in mandible shape). Digestive strategy is deemed to interplay with hypsodonty to produce different paths of adaptation to particular diets in ungulates.

The surgical treatment of acromegaly.

Science.gov (United States)

Buchfelder, Michael; Schlaffer, Sven-Martin

2017-02-01

Surgical extraction of as much tumour mass as possible is considered the first step of treatment in acromegaly in many centers. In this article the potential benefits, disadvantages and limitations of operative acromegaly treatment are reviewed. Pertinent literature was selected to provide a review covering current indications, techniques and results of operations for acromegaly. The rapid reduction of tumour volume is an asset of surgery. To date, in almost all patients, minimally invasive, transsphenoidal microscopic or endoscopic approaches are employed. Whether a curative approach is feasible or a debulking procedure is planned, can be anticipated on the basis of preoperative magnetic resonance imaging. The radicality of adenoma resection essentially depends on localization, size and invasive character of the tumour. The normalization rates of growth hormone and IGF-1 secretion, respectively, depend on tumour-related factors such as size, extension, the presence or absence of invasion and the magnitude of IGF-1 and growth hormone oversecretion. However, also surgeon-related factors such as experience and patient load of the centers have been shown to strongly affect surgical results and the rate of complications. As compared to most medical treatments, surgery is relatively cheap since the costs occur only once and not repeatedly. There are several new technical gadgets which aid in the surgical procedure: navigation and variants of intraoperative imaging. For the mentioned reasons, current algorithms of acromegaly management suggest an initial operation, unless the patients are unfit for surgery, refuse an operation or only an unsatisfactory resection is anticipated. A few suggestions are made when a re-operation could be considered.

Radiological assessment of the inferior alveolar artery course in human corpse mandibles

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Bertl, Kristina [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Malmoe University, Department of Periodontology, Faculty of Odontology, Malmoe (Sweden); Hirtler, Lena [Medical University of Vienna, Center for Anatomy and Cell Biology, Department of Systematic Anatomy, Vienna (Austria); Dobsak, Toni [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Medical University of Vienna, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Vienna (Austria); Austrian Cluster for Tissue Regeneration, Vienna (Austria); Heimel, Patrick [Medical University of Vienna, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, Vienna (Austria); Austrian Cluster for Tissue Regeneration, Vienna (Austria); Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna (Austria); Gahleitner, Andre [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Medical University of Vienna, Department of Diagnostic Radiology, Division of Osteoradiology, General Hospital, Vienna (Austria); Ulm, Christian [Medical University of Vienna, Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Vienna (Austria); Plenk, Hanns [Medical University of Vienna, Bone and Biomaterials Research, Institute for Histology and Embryology, Vienna (Austria)

2015-04-01

CT assessment of the entire course of the inferior alveolar artery (IAA) within the mandibular canal. After contrast medium injection (180 or 400 mg/ml iodine concentration) into the external carotid arteries of 15 fresh human cadaver heads, the main IAA's position in the canal (cranial, buccal, lingual or caudal) was assessed in dental CT images of partially edentulous mandibles. The course of the main IAA could be followed at both iodine concentrations. The higher concentration gave the expected better contrast, without creating artefacts, and improved visibility of smaller arteries, such as anastomotic sections, dental branches and the incisive branch. The main IAA changed its position in the canal more often than so far known (mean 4.3 times, SD 1.24, range 2-7), but with a similar bilateral course. A cranial position was most often detected (42 %), followed by lingual (36 %), caudal (16 %) and buccal (6 %). With this non-invasive radiologic method, the entire course of the main IAA in the mandibular canal could be followed simultaneously with other bone structures on both sides of human cadaver mandibles. This methodology allows one to amend existing anatomical and histological data, which are important for surgical interventions near the mandibular canal. (orig.)

Radiological assessment of the inferior alveolar artery course in human corpse mandibles

International Nuclear Information System (INIS)

Bertl, Kristina; Hirtler, Lena; Dobsak, Toni; Heimel, Patrick; Gahleitner, Andre; Ulm, Christian; Plenk, Hanns

2015-01-01

CT assessment of the entire course of the inferior alveolar artery (IAA) within the mandibular canal. After contrast medium injection (180 or 400 mg/ml iodine concentration) into the external carotid arteries of 15 fresh human cadaver heads, the main IAA's position in the canal (cranial, buccal, lingual or caudal) was assessed in dental CT images of partially edentulous mandibles. The course of the main IAA could be followed at both iodine concentrations. The higher concentration gave the expected better contrast, without creating artefacts, and improved visibility of smaller arteries, such as anastomotic sections, dental branches and the incisive branch. The main IAA changed its position in the canal more often than so far known (mean 4.3 times, SD 1.24, range 2-7), but with a similar bilateral course. A cranial position was most often detected (42 %), followed by lingual (36 %), caudal (16 %) and buccal (6 %). With this non-invasive radiologic method, the entire course of the main IAA in the mandibular canal could be followed simultaneously with other bone structures on both sides of human cadaver mandibles. This methodology allows one to amend existing anatomical and histological data, which are important for surgical interventions near the mandibular canal. (orig.)

Occurrence of neanderthal features in mandibles from the Atapuerca-SH site.

Science.gov (United States)

Rosas, A

2001-01-01

Analysis of variation and distribution of evolutionary novelties is meaningful in understanding evolutionary processes. The mandible, as a morphological complex, comprises a large number of derived Neanderthal features. The present study investigates whether the features usually considered as European lineage apomorphies evolved independently; the occurrence of these features is studied in the mandibles from the Sima de los Huesos (SH) site (Atapuerca, Spain). For comparative purposes, a large sample of Neanderthal mandibles as well as older fossil Homo specimens have been used for the study. Chi-square tests were employed to test for independence. The SH mandibles present a set of features that clearly show the basic architecture of the Neanderthal mandible. A highly significant association is detected in the variation of the position of the mental foramen, the lateral prominence, and the anterior marginal tubercle, as well as in the development of retromolar space. However, a much weaker association is detected in the features of the internal aspect of the mandible, with a few exceptions. Features of the external aspect of the mandible occur chronologically earlier than those observed in the internal aspect. The hypothesis that two distinct and consecutive morphological processes have driven the emergence of the European lineage throughout the Middle Pleistocene is proposed. A first transformation affects the mandible by means of backwards displacement of the structures located at the external aspect, as well as the position of the condyle. A second process would modify the features of the internal aspect of the mandible, in which the relief of the masseteric and pterygoid fossae are affected, in association with a spatial rearrangement of the corpus and ramus. Analyzed individually, some of the considered features may be questioned as Neanderthal apomorphies (Trinkaus,1993; Franciscus and Trinkaus, 995); however, the joint occurrence of many of them suggests

Surgical treatment of pancreatic pseudocysts – clinical experience

Directory of Open Access Journals (Sweden)

Artur Zakościelny

2014-06-01

Full Text Available Introduction: Pancreatic pseudocysts are frequent complications after acute and chronic pancreatitis. They are diagnosed in 6–18% of patients with the history of acute pancreatitis and in 20–40% cases with chronic pancreatitis. The aim of the study was to analyse early results of surgical treatment of pancreatic acute and chronic pseudocysts based on our experience. Material and methods: The retrospective analysis was based on early results of surgical treatment of 46 patients aged between 20 and 78 (33 males and 13 females who underwent treatment of acute (n = 26 and chronic (n = 20 pancreatic pseudocysts from November 2005 to July 2011 at the Second Department of General and Gastrointestinal Surgery and Surgical Oncology of the Alimentary Tract in Lublin. Results: The choice of a surgical method of treatment depended on the size, localisation, thickness of pseudocystic wall and changes in the main pancreatic duct. We used the following surgical methods: cystogastrostomy (Jurasz procedure was conducted in 22 patients (47.8%, Roux-en-Y cystojejunostomy was performed in 19 cases (41.3%, complete excision of the pseudocyst was possible in two patients (4.3% and cystoduodenostomy – in one case (2.1%. Also, in single cases external drainage (2.1% and cystopancreaticojejunostomy of Puestow (2.1% were applied. Forty-four patients (95.6% were cured. Early postoperative complications were observed in 2 patients (4.4%. Two reoperations (4.4% were required. Early postoperative mortality was 0%. Conclusions: Classic internal drainage procedures, known since the 19th century, are still effective methods of treatment in acute and chronic pancreatic pseudocysts.

[ANALYSIS OF THE SURGICAL TREATMENT RESULTS IN THE THYROID GLAND DISEASES].

Science.gov (United States)

Tarashchenko, Yu N; Bolgov, M Yu

2015-08-01

The results of surgical treatment of the thyroid gland diseases were analyzed, including the specific morbidity rate, cosmetic effect of the operation, stationary treatment of patients duration, the operation radicalism. Improvement of the operation methods and introduction of modern electric surgical instruments have permitted to reduce the operation duration, the surgical access length, the rate of postoperative hypocalcaemia occurrence, duration of the patients stationary treatment.

Solitary rectal ulcer syndrome: clinical findings, surgical treatment, and outcomes.

Science.gov (United States)

Torres, Carlos; Khaikin, Marat; Bracho, Jorge; Luo, Cheng Hua; Weiss, Eric G; Sands, Dana R; Cera, Susan; Nogueras, Juan J; Wexner, Steven D

2007-11-01

Solitary rectal ulcer syndrome (SRUS) is a rare disorder often misdiagnosed as a malignant ulcer. Histopathological features of SRUS are characteristic and pathognomonic; nevertheless, the endoscopic and clinical presentations may be confusing. The aim of the present study was to assess the clinical findings, surgical treatment, and outcomes in patients who suffer from SRUS. A retrospective chart review was undertaken, from January 1989 to May 2005 for all patients who were diagnosed with SRUS. Data recorded included: patient's age, gender, clinical presentation, past surgical history, diagnostic and preoperative workup, operative procedure, complications, and outcomes. During the study period, 23 patients were diagnosed with SRUS. Seven patients received only medical treatment, and in three patients, the ulcer healed after medical treatment. Sixteen patients underwent surgical treatment. In four patients, the symptoms persisted after surgery. Two patients presented with postoperative rectal bleeding requiring surgical intervention. Three patients developed late postoperative sexual dysfunction. One patient continued suffering from rectal pain after a colostomy was constructed. Median follow-up was 14 (range 2-84) months. The results of this study show clearly that every patient with SRUS must be assessed individually. Initial treatment should include conservative measures. In patients with refractory symptoms, surgical treatment should be considered. Results of anterior resection and protocolectomy are satisfactory for solitary rectal ulcer.

Surgical treatment of cavernous malformations involving medulla oblongata.

Science.gov (United States)

Zhang, Si; Lin, Sen; Hui, Xuhui; Li, Hao; You, Chao

2017-03-01

Surgical treatment of cavernous malformations (CMs) involving medulla oblongata is more difficult than the CMs in other sites because of the surrounding vital structures. However, the distinctive features and treatment strategies have not been well illustrated. Therefore, we enrolled a total of 19 patients underwent surgical treatment of CMs involving medulla oblongata in our hospital from August 2008 to August 2014. The clinical features, surgical management and clinical outcome of these patients were retrospectively analyzed, while our institutional surgical indications, approaches and microsurgical techniques were discussed. In our study, gross total resection was achieved in 17 patients and subtotal resection in 2. Two patients underwent emergency surgeries due to severe and progressive neurological deficits. The postoperative new-onset or worsened neurological deficits occurred in 6 patients. After a mean follow-up of 45.8±22.2months, the neurological status was improved in 10 patients and remained stable in 7. The mean modified Rankin Scale (mRS) was 2.58±1.26 preoperatively, 3.11±0.99 postoperatively and 1.84±1.42 at the recent follow-up, respectively. During the follow-up period, no rehemorrhage and recurrence occurred, and the residual lesions remained stable. We recommended surgical resection of symptomatic CMs involving medulla oblongata via optimal approaches, feasible entry zones and meticulous microsurgical techniques in attempting to achieve safe resection and favorable outcome. The clinical features, surgical indications, timing and microsurgical techniques of this special entity should be distinctive from the brainstem cavernous malformations in other sites. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Pre- and post-surgical orthodontic treatment for skeletal open bite].

Science.gov (United States)

Zhou, Y; Hu, W; Sun, Y

2001-05-01

To Study the principles and rules of pre- and post-surgical orthodontic treatment for skeletal open bite patients. Thirty-two surgically treated open bite cases were analyzed, of which 9 were males, and 23 were females, aged from 16 to 38. Open bite was from 1 to 8.5 mm, average was 4 mm. 31 patients were Class III malocclusion, while 1 patient was Class II malocclusion. 1. Totally 21 patients were treated with orthodontics before and after orthognathic surgery, while 8 patients had pre-surgical orthodontics only, and other 3 had post-surgical orthodontics only. The duration for pre-surgical orthodontics was from 4 to 33 months, average was 12 months. The duration for post-surgical orthodontics was from 3 to 17 months, average was 8.5 months. 2. Presurgical orthodontic treatment included: Alignment of arches, decompensation of incisors, avoiding extrusion of incisors, and slight expansion of arches for coordination of arches. 3. Post-surgical orthodontic treatment included: Closure of residual spaces in the arches, realignment of arches, vertical elastics and Class II or III intermaxillary elastics. Skeletal open bites require combined orthodontic-orthognathic surgery for optimal and esthetical pleasing results.

[Surgical treatment of supraventricular tachycardia].

Science.gov (United States)

Vigano, A N; Minzioni, G; Graffigna, A; Paganini, F; Salerno, J A

1991-10-01

The article deals with the modern approaches to the treatment of supraventricular tachycardia . The authors analyse the results of operations in ectopic atrial tachycardias, the Wolff-Parkinson-White syndrome, modal re-entry tachycardias, and atrial fibrillation . The last-named is of most interest because the authors possess experience in a new operation for isolation of the internodal tracts. In all conditions the authors obtained convincing evidence on the efficacy of modern surgical treatment in supraventricular tachycardias.

Generating classes of 3D virtual mandibles for AR-based medical simulation.

Science.gov (United States)

Hippalgaonkar, Neha R; Sider, Alexa D; Hamza-Lup, Felix G; Santhanam, Anand P; Jaganathan, Bala; Imielinska, Celina; Rolland, Jannick P

2008-01-01

Simulation and modeling represent promising tools for several application domains from engineering to forensic science and medicine. Advances in 3D imaging technology convey paradigms such as augmented reality (AR) and mixed reality inside promising simulation tools for the training industry. Motivated by the requirement for superimposing anatomically correct 3D models on a human patient simulator (HPS) and visualizing them in an AR environment, the purpose of this research effort was to develop and validate a method for scaling a source human mandible to a target human mandible within a 2 mm root mean square (RMS) error. Results show that, given a distance between 2 same landmarks on 2 different mandibles, a relative scaling factor may be computed. Using this scaling factor, results show that a 3D virtual mandible model can be made morphometrically equivalent to a real target-specific mandible within a 1.30 mm RMS error. The virtual mandible may be further used as a reference target for registering other anatomic models, such as the lungs, on the HPS. Such registration will be made possible by physical constraints among the mandible and the spinal column in the horizontal normal rest position.

Surgical treatment of diplopia in Graves' Orbitopathy patients

NARCIS (Netherlands)

Jellema, H.M.

2016-01-01

This thesis addresses several aspects of the surgical treatment of diplopia in patients with Graves’ Orbitopathy (GO). We evaluated retrospectively the surgical outcome of different types of surgery on eye muscles to correct the diplopia. Each operated muscle seems to have its own dose-effect

Aneurysmal bone cyst of the coronoid process of the mandible

Directory of Open Access Journals (Sweden)

Rattan V

2006-09-01

Full Text Available A rare case of aneurysmal bone cyst (ABC located in the coronoid process of the mandible in a 12-year-old girl is presented. Treatment consisted of excision of the lesion through preauricular, submandibular and intraoral approach. An access osteotomy distal to second molar region was required to gain access to medial side of the coronoid process. To our knowledge, this is the third case of an aneurysmal bone cyst of the coronoid process of mandible. While examining a patient with a large expansile intrabony jaw cavity with thin peripheral bone, which is filled with blood without presence of bruit, thrills and pulse pressure, the diagnosis of aneurysmal bone cyst should be on top of the differential diagnosis list. Seventy-four to eighty-five percent of aneurysmal bone cysts of jaws occur in 10-20 years age group. Therefore, a pediatric dentist may be the first person to see such a lesion.

[Pre- and post-surgical orthodontic treatment of mandibular asymmetry and prognathism].

Science.gov (United States)

Chen, Song; Chen, Yang-xi; Hu, Jing

2005-01-01

The purpose of this study was to analyze the pre- and post surgical orthodontic treatment of mandibular asymmetry and prognathism in our hospital, and to summarize some helpful experiences for future clinical work. The data were derived from 21 adults aged from 19 - 28 years who had severe mandibular asymmetry and prognathism. The ANB angle of all patients is from -3 degrees to -8 degrees. The value of wits of all patients is from -7 mm to -14 mm. The deviation of chin point of all patients is from 3 mm to 7 mm. The duration of pre- and post-surgical orthodontic treatment was 10-20 months (mean 18 months) and 5-10 months (mean 7.5 months), respectively. The keys in pre-surgical orthodontic treatment include (1) three dimensional dental decompensation; (2) arch form and transverse discrepancy correction; (3) model surgery and the splint making. The main objective of post surgical orthodontic treatment is to detail the occlusion. Pre- and post surgical orthodontic treatment is essential for the orthognathic treatment of patients with mandibular asymmetry and prognathism.

Development of mandible in indigenous sheep fetuses

Directory of Open Access Journals (Sweden)

N. S. Ahmed

2011-01-01

Full Text Available The aim of this study was to detect the precise sites of the beginning of primary ossification centers of the mandible of sheep fetuses as well as their onset time, to achieve this goal, samples were taken weekly starting from the 7th week up to 20th week of intrauterine life. Sections of the samples were stained by the alizarin red and alcian blue technique. Primary centers appeared at the beginning of 7th week as big red spot on either sides of mesenchyme of first branchial arch (Meckel’s cartilage that developed by intramembranous ossification. The rostral part of the mandible, however, was developed by endochondral ossification. The successive bone development process (7–20 weeks, were moniterd by macerating the mandibles using either potassium hydroxide or fly larvae. Measuring tape and graph papers were employed for measurements and for localization of mandibular angle. The results revealed significant increase of these measurements during the successive weeks of intrauterine life.

Cemento-ossifying fibroma of mandible mimicking complex composite odontome.

Science.gov (United States)

Dewan, Hitesh Sudarshan; Dewan, Sudarshan Kumar; Bahl, Sumit; Tushar Parekh, Parth

2016-10-19

Cemento-ossifying fibroma (COF) is a fibro-osseous lesion or non-odontogenic tumour that affects craniofacial bones. These lesions are included in the spectrum of fibro-osseous lesions arising from periodontal ligament cells, which can deposit combination of cementum and bone surrounded by fibrous tissue. It clinically, macroscopically and radiologically resembles complex composite odontome and can be differentiated only on the basis of histopathology. They usually occur solitarily as a painless and expansile spherical or ovoid jawbone mass that may displace the roots of adjacent teeth. They predominantly occur in females in third and fourth decades of life. We present a case report of a 20-year-old man, with a mildly painful swelling in the mandible which was successfully treated with enucleation and diagnosed as COF. Its resemblance to complex composite odontome and unique surgical approach are highlighted in this paper. 2016 BMJ Publishing Group Ltd.

Surgical treatment analysis of idiopathic esophageal achalasia.

Science.gov (United States)

Aquino, José Luis Braga de; Said, Marcelo Manzano; Pereira, Douglas Rizzanti; Amaral, Paula Casals do; Lima, Juliana Carolina Alves; Leandro-Merhi, Vânia Aparecida

2015-01-01

Idiopathic esophageal achalasia is an inflammatory disease of unknown origin, characterized by aperistalsis of the esophageal body and failure of the lower esophageal sphincter in response to swallowing, with consequent dysphagia. To demonstrate the results of surgical therapy in these patients, evaluating the occurred local and systemic complications. Were studied retrospectively 32 patients, 22 of whom presented non-advanced stage of the disease (Stage I/II) and 10 with advanced disease (Stage III/IV). All of them had the clinical conditions to be submitted to surgery. The diagnoses were done by clinical, endoscopic, cardiological, radiological and esophageal manometry analysis. Pre-surgical evaluation was done with a questionnaire based on the most predisposing factors in the development of the disease and the surgical indication was based on the stage of the disease. The patients with non-advanced stages were submitted to cardiomyotomy with fundoplication, wherein in the post-surgical early assessment, only one (4,4%) presented pulmonary infection, but had a good outcome. In patients with advanced disease, seven were submitted to esophageal mucosectomy preserving the muscular layer, wherein one patient (14,2%) presented dehiscence of gastric cervical esophagus anastomosis as well as pulmonary infection; all of these complications were resolved with proper specific treatment; the other three patients with advanced stage were submitted to transmediastinal esophagectomy; two of them presented hydropneumothorax with good evolution, and one of them also presented fistula of the cervical esophagogastric anastomosis, but with spontaneous healing after conservative treatment and nutritional support. The two patients with fistula of the cervical anastomosis progressed to stenosis, with good results after endoscopic dilations. In the medium and long term assessment done in 23 patients, all of them reported improvement in life quality, with return to swallowing. The

A comparative study of surgical drain placement and the use of kinesiologic tape to reduce postoperative morbidity after third molar surgery.

Science.gov (United States)

Genc, Aysenur; Cakarer, Sirmahan; Yalcin, Basak Keskin; Kilic, Beril Berivan; Isler, Sabri Cemil; Keskin, Cengizhan

2018-04-19

Our aim was to compare the effects of the surgical drain and kinesiotape applications on postoperative morbidity after mandibular third molar surgery in a split-mouth study design. A single-centre, split-mouth study was performed in 23 patients who needed surgical removal of bilateral mandibular third molars. Each patient was treated with a drain tube on one side of the mandible and Kinesio tape (KT) on the contralateral side. Swelling was significantly greater in the KT group than in the drain group throughout the study period. The groups did not differ significantly in the amount of trismus at any time point. The Visual Analogue Scale (VAS)-measured pain intensity was significantly lower in the drainage group. Patients with KT had greater postoperative discomfort than those with a drain tube. All patients were generally satisfied with their treatments. Although both treatments were useful, a surgical drain was significantly more effective at reducing swelling and pain intensity than Kinesio tape. The effects of both on trismus were similar.

Three-dimensional CT of the mandible

International Nuclear Information System (INIS)

Zinreich, S.J.; Price, J.C.; Wang, H.; Ahn, H.S.; Kashima, H.

1988-01-01

Seventeen patients with mandibular oblation for facial neoplasia, primary neoplasm, and trauma were evaluated with CT and three-dimensional CT. In eight of these patients, a computerized acrylic model was generated for preoperative planning and postoperative reconstruction. The ramus and body of the mandible were reconstructed with mirror image and fusion techniques. Reconstructions of the anterior mandible were generated from models including the midface, skull based, and residual mandibular fragments. The results are preliminary; however, the authors believe that these represent a powerful new tool and a significant advance in mandibular reconstructive technique, reduced anesthesia time, and the optimized restoration of dental alignment and facial contour

Evaluation of applicability and efficacy of the reconstructive microvascular surgery of advanced cancer of the lower face with mandible infiltration

International Nuclear Information System (INIS)

Maciejewski, A.

2008-01-01

The aim of this study is to evaluate applicability and efficacy of reconstructive and microvascular surgery for patients with locally advanced cancer of the lower face with mandible infiltration, regarding to various technique of mandible and tongue reconstruction using flaps and to own modifications. Complex quality of life including functional, aesthetic, social and effect has also been evaluated. For patients with advanced cancer of the region infiltrating mandible reconstructive and microvascular surgery as a sole modality or combined with postoperative radiotherapy, is effective method of radical treatment, providing 80% of chance of 3-year disease-free survival and reduces the risk of recurrence by 60%. (author)

Vertical augmentation of the posterior atrophic mandible by interpositional grafts in a split-mouth design: a human tomography evaluation pilot study.

Science.gov (United States)

Domingues, Eduardo Pinheiro; Ribeiro, Rafael Fernandes; Horta, Martinho Campolina Rebello; Manzi, Flávio Ricardo; Côsso, Maurício Greco; Zenóbio, Elton Gonçalves

2017-10-01

Using computed tomography, to compare vertical and volumetric bone augmentation after interposition grafting with bovine bone mineral matrix (GEISTLICH BIO-OSS ® ) or hydroxyapatite/tricalcium phosphate (STRAUMANN ® BONECERAMIC) for atrophic posterior mandible reconstruction through segmental osteotomy. Seven patients received interposition grafts in the posterior mandible for implant rehabilitation. The computed tomography cone beam images were analysed with OsiriX Imaging Software 6.5 (Pixmeo Geneva, Switzerland) in the pre-surgical period (T0), at 15 days post-surgery (T1) and at 180 days post-surgery (T2). The tomographic analysis was performed by a single trained and calibrated radiologist. Descriptive statistics and nonparametric methods were used to analyse the data. There was a significant difference in vertical and volume augmentation with both biomaterials using the technique (P  0.05) in volume change of the graft, bone volume augmentation, or augmentation of the maximum linear vertical distance between the two analysed biomaterials. The GEISTLICH BIO-OSS ® and STRAUMANN ® BONECERAMIC interposition grafts exhibited similar and sufficient dimensional stability and volume gain for short implants in the atrophic posterior mandible. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Blunt hepatic trauma: comparison between surgical and nonoperative treatment.

Science.gov (United States)

Zago, Thiago Messias; Pereira, Bruno Monteiro; Calderan, Thiago Rodrigues Araujo; Hirano, Elcio Shiyoiti; Rizoli, Sandro; Fraga, Gustavo Pereira

2012-01-01

To examine the outcomes of blunt hepatic trauma, and compare surgical and non-surgical treatment in patients admitted with hemodynamic stability and with no obvious indications of laparotomy. This is a retrospective study of cases admitted to a university teaching hospital between the years 2000 and 2010. Patients undergoing surgical treatment were divided into two groups: (a) all patients undergoing surgical treatment, and (b) patients with obvious need for surgery. In this period, 120 patients were admitted with blunt hepatic trauma. Sixty five patients (54.1%) were treated non-operatively and fifty five patients were operated upon. Patients treated non-operatively had better physiologic conditions on admission, demonstrated less severe injuries (except the grade of hepatic injury), received less blood components and had lower morbidity and mortality than the patients operated upon. Patients who underwent non-operative treatment had a lower need for blood transfusion but higher rates of complications and mortality than the patients operated upon. Patients who were operated upon, with no obvious indications for surgery, had higher rates of complication and mortality than patients not operated upon. A non-operative approach resulted in lower complications, a lower need for blood transfusions and lower mortality.

Radiological and histopathological study of benign tumors of the mandible

Energy Technology Data Exchange (ETDEWEB)

Yoo, Seon Young; Baek, Seung Yon; Choi, Kyung Hee; Suh, Jeung Soo; Rhee, Chung Sik; Kim, Hee Seup [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

1984-06-15

Benign tumors of the mandible are uncommon lesions. That were classified into odontogenic tumors and nonodontogenic tumors. Author reviewed the radiological evaluation and pathological microscopic finding from 33 benign tumors of the mandible that were confirmed by the biopsy during last 10 years in Dental Clinics, Ewha Womans University Hospital and Seoul National University Dental Hospital. Following results were obtained; 1. Benign tumors of the mandible were classified into odontogenic (66.7%) and non-odontogenic tumors (33.3%). 2. The range of the age distribution was between 6 years and 67 years old. The commonest age group was the second decade (39.4%). 3. There was no difference to sex distribution. 4. The most frequent location was the body of the mandible (42.4%). 5. Radiographic findings were relatively characteristic in odontogenic tumors rather than non-odontogenic tumors. 1) Radiolucent cystic lesions-ameloblastoma, odontogenic myxoma, odontogenic fibtoma, aneurysmal bone cyst and neurofibroma. 2) Radiopaque mass lesions-odontoma, cementoma and osteoma. 3) Mixed patterns-ossifying fibroma, cementifying fibroma, calcifying odontogenic epithelial tumor and hemangioma. It was concluded that the radiographic examination was of value to diagnose the benign tumors of the mandible in symptomless patients.

Thin-plate spline graphical analysis of the mandible in mandibular prognathism.

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Chang, Hsin-Fu; Chang, Hong-Po; Liu, Pao-Hsin; Chang, Chih-Han

2002-11-01

The chin cup has been used to treat skeletal mandibular prognathism in growing patients for 200 years. The pull on the orthopedic-force chin cup is oriented along a line from the mandibular symphysis to the mandibular condyle. Various levels of success have been reported with this restraining device. The vertical chin cup produces strong vertical compression stress on the maxillary molar regions when the direction of traction is 20 degrees more vertical than the chin-condyle line. This treatment strategy may prevent relapse due to counter-clockwise rotation of the mandible. In this report, we describe a new strategy for using chin-cup therapy involving thin-plate spline (TPS) analysis of lateral cephalometric roentgenograms to visualize transformation of the mandible. The actual sites of mandibular skeletal change are not detectable with conventional cephalometric analysis. A case of mandibular prognathism treated with a chin cup and a case of dental Class III malocclusion without orthodontic treatment are described. The case analysis illustrates that specific patterns of mandibular transformation are associated with Class III malocclusion with or without orthopedic therapy, and that visualization of these deformations is feasible using TPS graphical analysis.

Accessory neurovascular foramina on the lingual surface of mandible: Incidence, topography, and clinical implications

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B V Murlimanju

2012-01-01

Full Text Available Context: It was suggested that the accessory neurovascular foramina of the mandible might be of significance in relation to the effectiveness of local anesthesia following the routine inferior alveolar nerve block. Aims: To investigate the incidence of neurovascular foramina over the lingual surface of the mandible in South Indian population. Settings and Design: The study was conducted at the department of anatomy. Materials and Methods: The study included 67 human adult dry mandibles, the exact ages and sexes of which were not known. The location and number of neurovascular foramina were topographically analyzed. Statistical Analysis Used: Descriptive statistics. Results: The foramina were observed in 64 mandibles (95.5% and were often multiple in most of the cases. They were located between the two medial incisors in 8 mandibles (1.9%, between the medial and lateral incisor in 34 mandibles (50.7%; 25-bilateral; 7-right; 2-left, between the lateral incisor and canine in 7 mandibles (10.4%; 2-bilateral; 3-right; 2-left, between the canine and first premolar in 6 cases (8.9%; 3 on each side. Foramina were also present around the genial tubercle in 56 mandibles (83.6%. Among them, 52 mandibles showed a single foramen just above the genial tubercle, 34 mandibles had foramina below the tubercles, 13 mandibles had foramina on the right side of genial tubercle and 17 were having on the left side. Conclusion: Since the anatomical details of these foramina are important to various fields of dentistry and oncology, the present investigation was undertaken. The clinical significance and implications are emphasized.

Surgical Treatment for Chronic Pancreatitis: Past, Present, and Future

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Stephanie Plagemann

2017-01-01

Full Text Available The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedures. Today, the well-known and standardized procedures are considered as safe due to the high experience of operating surgeons, the centering of pancreatic surgery in specialized centers, and optimized perioperative treatment. Although surgical procedures have become safer and more efficient than ever, the overall perioperative morbidity after pancreatic surgery remains high and management of postoperative complications stagnates. Current research focuses on the prevention of complications, optimizing the patient’s general condition preoperatively and finding the appropriate timing for surgical treatment.

SURGICAL TREATMENT FOR BONE METASTASES OF KIDNEY CANCER

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A. S. Semkov

2010-01-01

Full Text Available The data of 67 kidney cancer (KC patients with bone metastases, who had been treated at Moscow City Cancer Hospital Sixty-Two in 2002 to 2009 and had undergone skeletal bone surgery, were retrospectively analyzed. The role of surgical treatment for bone metastases from KC was assessed and the factors influencing the patients survival were determined. Surgical treatment for bone metastases from KC was ascertained to yield satisfactory results in improving the quality of life and increasing survival rates in the patients.

SURGICAL TREATMENT FOR BONE METASTASES OF KIDNEY CANCER

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A. S. Semkov

2014-08-01

Full Text Available The data of 67 kidney cancer (KC patients with bone metastases, who had been treated at Moscow City Cancer Hospital Sixty-Two in 2002 to 2009 and had undergone skeletal bone surgery, were retrospectively analyzed. The role of surgical treatment for bone metastases from KC was assessed and the factors influencing the patients survival were determined. Surgical treatment for bone metastases from KC was ascertained to yield satisfactory results in improving the quality of life and increasing survival rates in the patients.

A rare case of retained fourth molar teeth in maxilla and mandible. Case report

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Rahnama Mansur

2014-06-01

Full Text Available The study presents a case of the rarely occurring totally retained fourth molar teeth simultaneously in maxilla and mandible. The appearance of supernumerary teeth is a relatively uncommon dental anomaly and it is rare for patients to have impacted fourth molars in two quadrant. The aim of this work is to describe the presence of unilateral (right fourth molars in the maxilla and the mandible in a young female patient aged 24 years. Orthopantomogram revealed impacted lower third molars but also unerupted unilateral (right upper and lower fourth molars. Before orthodontic treatment, the patient was subsequently admitted for removal of third and fourth impacted upper and lower molars under local anesthesia.

Conseqüências no crescimento de maxila e mandíbula de defeito ósseo cirúrgico no ramo da mandíbula de ratos Consequences on the growth of maxilla and mandible of surgical bone defect on mandibular ramus of rats

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Lucimar Rodrigues

2004-10-01

Full Text Available OBJETIVO: Analisar as conseqüências no crescimento de maxila e mandíbula de defeito ósseo cirúrgico simulando fratura no ramo da mandíbula. MÉTODOS: Foram utilizados 25 ratos Wistar com um mês de idade. Sob anestesia geral e por meio de incisão submandibular. Foi realizada osteotomia vertical no ramo da mandíbula do lado direito com emprego de motor cirúrgico. Após período de dois meses os animais foram sacrificados, os tecidos moles retirados e as hemimandíbulas desarticuladas. Foram realizadas incidências radiográficas axiais para o crânio e laterais para as hemimandíbulas. A seguir, por intermédio de um sistema de computador foram obtidas medidas lineares da maxila e das hemimandíbulas. Foi empregado o teste "t" de Student para verificação da significância da diferença entre os lados experimental e controle. RESULTADOS: A diferença foi significante para a altura do ramo (p=0,010 e comprimento da mandíbula referente ao côndilo (p=0,015 e ao ângulo (pPURPOSE: To analyse the consequences on the growth of maxilla and mandible of a surgical bone defect that simulates a mandibular ramus fracture. METHODS: A group of 25 one-month-old Wistar rats were used in this study. Under general anesthesia, and through a submandibular incision, a vertical osteotomy on the right side of the mandibular ramus was made using a surgical drill. The animals were sacrificed after two months, soft tissues removed, and the mandible disarticulated. The skull was submitted to axial radiograph and the hemimandibles to a lateral radiograph. With these, cephalometric mensurations were made through a computer system, and the obtained values submitted to Student's t-test. RESULTS: The height of the mandibular ramus presented significant difference (p=0,010 as well as the length of mandible, both to the condyle (P=0,015 and the angle (p=0,001. There was no significant difference to the mensurations of the maxilla. CONCLUSION: The consequences of the

Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy.

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Boljanovic, S; Axelsson, C K; Elberg, J J

2003-01-01

The purpose of the present work has been to evaluate surgical treatment of gynecomastia performed by liposuction combined with subcutaneous mastectomy. It was designed as a prospective consecutive registration of 21 patients (28 breasts) operated in a four month period. Treatment was done in local anaesthesia in the out-patient clinic. Treatment was in one patient complicated with a haematoma. In 86% of cases the patients were satisfied with the postoperative result. Liposuction combined with surgical excision of the gland performed as an out-patient treatment in local anaesthesia is followed by few complications and good cosmetic results.

Gastroesophageal Reflux Disease: Medical or Surgical Treatment?

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Theodore Liakakos

2009-01-01

Full Text Available Background. Gastroesophageal reflux disease is a common condition with increasing prevalence worldwide. The disease encompasses a broad spectrum of clinical symptoms and disorders from simple heartburn without esophagitis to erosive esophagitis with severe complications, such as esophageal strictures and intestinal metaplasia. Diagnosis is based mainly on ambulatory esophageal pH testing and endoscopy. There has been a long-standing debate about the best treatment approach for this troublesome disease. Methods and Results. Medical treatment with PPIs has an excellent efficacy in reversing the symptoms of GERD, but they should be taken for life, and long-term side effects do exist. However, patients who desire a permanent cure and have severe complications or cannot tolerate long-term treatment with PPIs are candidates for surgical treatment. Laparoscopic antireflux surgery achieves a significant symptom control, increased patient satisfaction, and complete withdrawal of antireflux medications, in the majority of patients. Conclusion. Surgical treatment should be reserved mainly for young patients seeking permanent results. However, the choice of the treatment schedule should be individualized for every patient. It is up to the patient, the physician and the surgeon to decide the best treatment option for individual cases.

Fracture of the styloid process associated with the mandible fracture

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K N Dubey

2013-01-01

Full Text Available Fracture of the styloid process (SP of temporal bone is an uncommon injuries. Fracture of the SP can be associated with the facial injuries including mandible fracture. However, injury to the SP may be concealed and missed diagnosis may lead to the improper or various unnecessary treatments. A rare case of SP fracture associated with the ipsilateral mandibular fracture and also the diagnostic and management considerations of the SP fracture are discussed.

A 2D panoramic surgical stent imaging: Complete arch mandibular implant fixed prosthesis along with bar supported maxillary over denture

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Mukesh Kumar Singhal

2017-01-01

Full Text Available Successful rehabilitation of a patient should restore function, esthetic, and speech by prosthesis. Treatment modalities vary from patient to patient. Semi-precision attachments and implants offer several advantages over the traditional approach. The aim and objective of this report was to assess a case of a 55-year-old female patient who had lost all her teeth, except maxillary canines #13 and #23 and with severe bone loss in the mandible. Tooth-supported bar attachment was planned for maxilla, and a total of five dental implants were placed in the mandible using a flapless approach aided by radiographic gutta-percha surgical stents over panoramic two-dimensional imaging. Customized, radiographic stents help for the placement of implant in the view of paralleling and flapless surgery, completely. An immediate loading protocol is adopted as from day of the surgery to 6 weeks along with implant supported full arch fixed dentures after 4 months. The outcome of the treatment was impressive, and the patient gave a positive response with superb esthetics and functions.

Application of minimally invasive technique in surgical treatment of pancreatic diseases

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ZHANG Yixi

2015-05-01

Full Text Available In recent years, with the rapid development of minimally invasive concept, from laparoscopic operation to three-dimension laparoscopic technique and to robotic surgical system, treatment modalities have changed a lot. Pancreatic diseases, including multiple lesions, have different prognoses. An appropriate surgical procedure should be selected while ensuring the radical treatment of disease, so as to minimize the injury to patients and the impairment of organ function. Minimally invasive technique is of great significance in the surgical treatment of pancreatic diseases.

The application of digital surgical diagnosis and treatment technology: a promising strategy for surgical reconstruction of craniomaxillofacial defect and deformity.

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Wang, Li-ya; Du, Hong-ming; Zhang, Gang; Tang, Wei; Liu, Lei; Jing, Wei; Long, Jie

2011-12-01

The craniomaxillofacial defect and deformity always leads to serious dysfunction in mastication and facial contour damage, significantly reducing patients' quality of life. However, surgical reconstruction of a craniomaxillofacial hard tissue defect or deformity is extremely complex and often does not result in desired facial morphology. Improving the result for patients with craniomaxillofacial defect and deformity remains a challenge for surgeons. Using digital technology for surgical diagnosis and treatment may help solve this problem. Computer-assisted surgical technology and surgical navigation technology are included in the accurate digital diagnosis and treatment system we propose. These technologies will increase the accuracy of the design of the operation plan. In addition, the intraoperative real-time navigating location system controlling the robotic arm or advanced intelligent robot will provide accurate, individualized surgical treatment for patients. Here we propose the hypothesis that a digital surgical diagnosis and treatment technology may provide a new approach for precise surgical reconstruction of complicated craniomaxillofacial defect and deformity. Our hypothesis involves modern digital surgery, a three-dimensional navigation surgery system and modern digital imaging technology, and our key aim is to establish a technological platform for customized digital surgical design and surgical navigation for craniomaxillofacial defect and deformity. If the hypothesis is proven practical, this novel therapeutic approach could improve the result of surgical reconstruction for craniomaxillofacial defect and deformity for many patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

Surgical treatment of odontogenic keratocyst by enucleation.

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Singh, Mamta; Gupta, K C

2010-10-01

Although odontogenic keratocysts (OKCs) are benign, they are often locally destructive and tend to recur after conservative surgical treatment. They must therefore be distinguished from other cysts of the jaw. Keratocysts possess outpouchings and microscopic daughter cysts from which recurrences may arise. Histologic examination is essential for diagnosis since the appearances on roentgenograms and at operation usually do not reveal the true nature of the lesion. Since many non-dental surgeons and pathologists are unaware of OKCs, a case is presented in which surgical treatment was by original conservative method. Decompression causes a reduction in the cyst volume with new bone formation so that the structures impinged upon (e.g., teeth, nerves) are completely free.

Surgical treatment of odontogenic keratocyst by enucleation

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Mamta Singh

2010-01-01

Full Text Available Although odontogenic keratocysts (OKCs are benign, they are often locally destructive and tend to recur after conservative surgical treatment. They must therefore be distinguished from other cysts of the jaw. Keratocysts possess outpouchings and microscopic daughter cysts from which recurrences may arise. Histologic examination is essential for diagnosis since the appearances on roentgenograms and at operation usually do not reveal the true nature of the lesion. Since many non-dental surgeons and pathologists are unaware of OKCs, a case is presented in which surgical treatment was by original conservative method. Decompression causes a reduction in the cyst volume with new bone formation so that the structures impinged upon (e.g., teeth, nerves are completely free.

Rapid orthodontic treatment after the ridge-splitting technique--a combined surgical-orthodontic approach for implant site development: case report.

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Amato, Francesco; Mirabella, A Davide; Borlizzi, Diego

2012-08-01

This article presents a clinical case of bilateral partial edentulism in the posterior mandible with severe horizontal and moderate vertical bone atrophy. A new technique using rapid orthodontics after ridge splitting is presented. The split-crest technique was carried out using piezosurgical instruments in the first molar and second premolar areas to widen the bone crest and open a channel for tooth movement. Immediately after, orthodontic appliances were used to move the first premolars distally and the second molars mesially into the surgical site. The rationale was to facilitate and accelerate orthodontic movement of the teeth, which is otherwise difficult in a cortical knife-edged ridge. The bone defect was filled with the alveolar bone of the adjacent teeth that were moved into the surgically opened path. Adequate bone volume for implant placement was generated in the first premolar area. Implants were then inserted, and the patient was rehabilitated.

Surgical treatment for medically refractory myasthenic blepharoptosis

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Shimizu, Yusuke; Suzuki,Shigeaki; Nagasao,Tomohisa; Ogata,Hisao; Yazawa,Masaki; Suzuki,Norihiro; Kishi,Kazuo

2014-01-01

Yusuke Shimizu,1 Shigeaki Suzuki,2 Tomohisa Nagasao,1 Hisao Ogata,1 Masaki Yazawa,1 Norihiro Suzuki,2 Kazuo Kishi1 1Department of Plastic and Reconstructive Surgery, 2Department of Neurology, Keio University School of Medicine, Tokyo, JapanPurpose: Currently, only a few reports have recommended surgery as a suitable treatment for blepharoptosis associated with myasthenia gravis. The present study aims to introduce our surgical criteria, surgical options, outcomes, and precautions for medicall...

Non-surgical treatment for eyelid retraction in thyroid eye disease (TED).

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Grisolia, Ana Beatriz Diniz; Couso, Ricardo Christopher; Matayoshi, Suzana; Douglas, Raymond S; Briceño, César Augusto

2017-08-09

Thyroid eye disease (TED) is an autoimmune condition with an unpredictable course that may lead to permanent facial disfigurement. Eyelid retraction is one of the most common findings, and frequently demands attention due to ocular exposure and impaired cosmesis. Surgical treatment remains the most effective option, but there is a role for temporary corrections during the active phase of the disease, as well as in patients who are poor surgical candidates. The aim of this review is to describe the non-surgical modalities currently available for treatment of eyelid malposition in TED. The authors have focused on the use of hyaluronic acid, triamcinolone injections and botulinum toxin type A as non-surgical treatment alternatives, paying special attention to dosing, technique, efficacy and duration of effect. Non-surgical treatment modalities may represent viable in cases where surgical correction is not an option. Although temporary, these modalities appear to be beneficial for ocular exposure remediation, improving quality of life and broadening our therapeutic arsenal. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surgical treatment of brain metastases - a review. Part 2. Results of treatment

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Wronski, M.; Czernicki, Z.

1994-01-01

Results of treatment of most frequent brain metastases from nonsmall cell lung cancer, breast cancer, malignant melanoma and kidney tumors are discussed. Also efficacy of surgical treatment, chemotherapy, radiotherapy and radiosurgery is analyzed

Surgical techniques for treatment of gastroesophageal reflux disease

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Carlos Édder de Mello Cardoso Lima

2015-12-01

Full Text Available Gastroesophageal reflux is one of the most frequently gastrointestinal tract diseases currently found, having a great impact on the patient's quality of life. Purpose: to analyze the main surgical techniques used in the treatment of this pathology, their indications, advantages and disadvantages. Methods: this is a literature review. Thirteen articles published between 1998 and 2013 in the Lilacs, Bireme e Scielo databases, addressing different surgical techniques for the treatment of gastroesophageal reflux were selected. Results: Five hundred and thirty-eight total fundoplications and 466 partial fundoplications were performed. Conclusion: The findings of this review show that total fundoplication is the most commonly used technique in the treatment of gastroesophageal reflux disease.

Urinary Bladder Leiomyosarcoma: Primary Surgical Treatment

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Hakim Slaoui

2014-07-01

Full Text Available Cases of bladder leiomyosarcoma represent 0.1% of all nonurothelial tumors. We present a case report of a 73-year-old man who underwent a radical cystoprostatectomy for a high-grade bladder leiomyosarcoma with an ileal diversion. The patient recovered uneventfully and no surgical margins were verified in final pathology. Early follow-up at 3 months shows no signs of computed tomography recurrence and adequate adaptation to ileal diversion. Although bladder sarcomas were once thought to have a grim prognosis, recent studies suggest that adequate surgical treatment is able to achieve optimal cancer control outcomes.

Early treatment of Class III malocclusion with a tandem traction bow appliance

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Sneha Basaveshwar Valgadde

2016-01-01

Full Text Available Since Class III malocclusion is progressive in nature, the facial growth of Class III malocclusion worsens with age. Class III malocclusion is associated with a deviation in the sagittal relationship of the maxilla and the mandible, characterized by a deficient maxilla, retrognathic mandible, or a combination of both. The early orthopedic treatment of Class III malocclusions, at the end of primary dentition or the beginning of mixed dentition, prior to growth spurt, allows the accomplishment of successful results, providing facial balance, modifying the maxillofacial growth and development, and in many instances, preventing a future surgical treatment by increasing the stability. Many treatment approaches can be found in the literature regarding orthopedic and orthodontic treatment of Class III malocclusion, including intra- and extra-oral appliances. The major problem with extraoral anchorage has been of patient compliance due to its physical appearance. The case report presents an intraoral modified tandem appliance for maxillary protraction that has been used clinically to achieve successful results without relying much on patient co-operation.

Surgical Treatment of Chronic Retrocalcaneal Bursitis

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Wiegerinck, Johannes I.; Kok, Aimee C.; van Dijk, C. Niek

2012-01-01

Purpose: The purpose of this systematic review was to analyze the results of surgical treatments for chronic retrocalcaneal bursitis (RB). Methods: Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, and the Cochrane Library (1945 to December 2010) were systematically

Surgical resection versus radiofrequency ablation in treatment of small hepatocellular carcinoma

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HE Xiuting

2013-08-01

Full Text Available ObjectiveTo compare clinical efficacy and recurrence between surgical resection and radiofrequency ablation (RFA in the treatment of small hepatocellular carcinoma (HCC. MethodsThe clinical data of 97 patients with small HCC, who underwent surgical resection or RFA as the initial treatment in The First Hospital of Jilin University from January 2002 to December 2008, were collected. Sixty-three cases, who survived 2 years after treatment, were followed up; of the 63 cases, 34 underwent surgical resection, and 29 underwent RFA. The recurrence of these patients was analyzed retrospectively. The measurement data were analyzed by chi-square test. The Cox regression analysis was used for determining the risk factors for recurrence. The log-rank test was used for disease-free survival (DFS difference analysis. ResultsThe 3-month, 1-year, and 2-year intrahepatic recurrence rates for the patients who underwent surgical resection were 15%, 38%, and 64%, respectively, versus 21%, 35%, and 45% for those who underwent RFA, without significant differences between the two groups of patients. The intrahepatic recurrence after initial treatment was not significantly associated with treatment method, sex, age, Child-Pugh grade, tumor size, number of nodules, presence of cirrhosis, and alpha-fetoprotein level. There was no significant difference in DFS between the two groups of patients. ConclusionRFA produces a comparable outcome to that by surgical resection in the treatment of small HCC. RFA holds promise as a substitute for surgical resection.

The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

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Vasconcelos Belmiro CE

2008-09-01

Full Text Available Abstract Background Temporomandibular joint disorders (TMJD are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1 identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2 evaluate their methodological quality, and (3 evaluate the evidence grade within the systematic reviews. Methods A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July. Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews. Results The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd. In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies. Conclusion The results indicate that in spite of the widespread impact of TMJD, and the multitude of

Outcomes of surgical treatment of thyroid disease in children

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Olga S. Rogova

2017-01-01

Full Text Available Background. In recent years there has been a tendency of increase in the proportion of nodular goiter and Graves’ disease in thyroid pathology in children, which necessitates a choice of rational tactics for treatment of these diseases. At present there is no optimal method of treatment for thyroid gland pathology, but one of the methods is surgery. Thyroid surgery due to the determination of the indications and choice of the optimal volume of the surgical intervention continues to be under debate as postoperative complications of surgical treatment of thyroid diseases in children are possible.Aim: to study the outcomes of surgical treatment for thyroid pathology in children, depending on the volume of operation.Materials and methods. This article presents the results of a survey of 77 children operated on in the period of 2002–2016 for Graves’ disease, single-node goiter, and multinodular goiter. The examination included the determination of the levels of ionized calcium and TSH, FT4, FT3 in the blood serum, the evaluation of the functional state of the pituitary-thyroid system, thyroid ultrasound examination, and examination by an otolaryngologist.Results. The incidence of adverse outcomes of surgical treatment in children with nodular goiter was 27%. Adverse outcomes were observed equally often after organ-preserving operations and after thyroidectomy, but they were of different structure. The frequency of postoperative complications after thyroidectomy performed on the nodular goiter was 27%. Complications presented as postsurgical hypoparathyroidism and vocal cord paresis. In children with nodular goiter, after thyroidectomy hypoparathyroidism occurred more frequently than paresis of the vocal folds. Symptomatic hypocalcemia was observed more frequently than the asymptomatic variant, and in most cases hypoparathyrodism was transient. Among children with a single-node goiter who underwent organ-preserving surgery on the thyroid gland

[A phd completed 10. Implant-supported removable partial -dentures in a Kennedy Class I-situation in the mandible].

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Jensen-Louwerse, C

2017-06-01

Implant-supported removable partial dentures in the mandible often cause problems, which means that patients wear their dentures seldom if at all. A solution is to place implants that the dentures can be snapped onto. There is, however, no consensus about the best position of the implants in the mandible yet. In addition, it is worthwhile to balance the cost of treatment with its effectiveness. In a randomised cross-over clinical trial involving 30 patients with a shortened dental arch, the implant-supported removable partial denture in the mandible was evaluated based on the experience of the patient, mean time of wearing, chewing ability and the clinical and radiographic parameters in relation to 2 different implant positions: 2 in the pre-molar region or 2 in the molar region. The cost-effectiveness of both treatments was also evaluated. From the patient's point of view, the implant-supported removable partial dentures are best supported by implants placed in the molar region. The research also revealed, however, that significantly more bleeding occurred around implants placed in the molar region and from a clinical perspective placement in the pre-molar region would have preference. The cost-effectiveness of the treatment with an implant-supported removable partial denture depends on the choice of outcome measurement and monetary threshold.

Study of surgical treatment on neovascular glaucoma

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Xiao-Nü Liu

2014-05-01

Full Text Available AIM: To compare the effect of two surgical methods on neovascular glaucoma(NVG. METHODS: The clinical date of 46 cases(57 eyeswith NVG underwent surgical treatment were retrospectively analyzed and followed-up. Patients were divided into Ahmed glaucoma valve(AGVimplantation group(group A, 24 cases, 31 eyesand semiconductor diode laser transscleral ciliary body photocoagulation(TSCPCgroup(group B, 22cases, 26 eyesaccording to the surgical approach. The intraocular pressure, visual acuity and postoperative complications were compared before and after operation. RESULTS: The intraocular pressure postoperative in two groups were significantly lower than those preoperative(P P>0.05. The changes of visual acuity postoperative showed no statistical difference between the two groups(P>0.05. The postoperative complications of group A was significantly lower than that in group B, in which the incidence of eye pain, anterior chamber bleeding were significant differences between two groups(P CONCLUSION: AGV implantation treatment and TSCPC for NVG are both valid, but AGV implantation is filtration surgery, and TSCPC isciliary body destructive surgery, and the latter has higher rate of postoperative complications.

A case of Sotos syndrome treated with distraction osteogenesis in maxilla and mandible.

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Takano, Masayuki; Kasahara, Kiyohiro; Ogawa, Chiharu; Katada, Hidenori; Sueishi, Kenji

2012-01-01

Sotos syndrome is inherited in an autosomal-dominant manner and is characterized by increased birth weight, excessive growth, advanced bone age, and distinctive facial features, including dolichocephaly, hypertelorism, and a prominent mandible. We treated a jaw deformity due to Sotos syndrome consisting of malocclusion due to a narrow maxillary dental arch and mandibular retrusion from hypoplasia of the rami. The patient was a 17-year-old man. Malocclusion due to a narrow maxillary dental arch and mandibular retrusion was diagnosed. Rapid maxillary expansion with Lines corticotomy and mandibular advancement with distraction osteogenesis were performed. The maxilla was expanded laterally a total of 3 mm and the mandible prolonged 12 mm in the posterior area of the mandibular body. Subsequently, orthodontic treatment was continued. At present, 5 years after surgery, occlusion remains good and stable.

Surgical treatment of chronic pancreatitis in young patients.

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Zhou, Feng; Gou, Shan-Miao; Xiong, Jiong-Xin; Wu, He-Shui; Wang, Chun-You; Liu, Tao

2014-10-01

The main treatment strategies for chronic pancreatitis in young patients include therapeutic endoscopic retrograde cholangio-pancreatography (ERCP) intervention and surgical intervention. Therapeutic ERCP intervention is performed much more extensively for its minimally invasive nature, but a part of patients are referred to surgery at last. Historical and follow-up data of 21 young patients with chronic pancreatitis undergoing duodenum-preserving total pancreatic head resection were analyzed to evaluate the outcomes of therapeutic ERCP intervention and surgical intervention in this study. The surgical complications of repeated therapeutic ERCP intervention and surgical intervention were 38% and 19% respectively. During the first therapeutic ERCP intervention to surgical intervention, 2 patients developed diabetes, 5 patients developed steatorrhea, and 5 patients developed pancreatic type B pain. During the follow-up of surgical intervention, 1 new case of diabetes occurred, 1 case of steatorrhea recovered, and 4 cases of pancreatic type B pain were completely relieved. In a part of young patients with chronic pancreatitis, surgical intervention was more effective than therapeutic ERCP intervention on delaying the progression of the disease and relieving the symptoms.

Juvenile Ossifying Fibroma of the Mandible: a Case Report

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Bahar Keles

2010-04-01

Full Text Available Background: Fibro-osseous lesions of the jaws, including juvenile ossifying fibroma, pose diagnostic and therapeutic difficulties due to their clinical, radiological and histological variability. The aim of this study was to report the outcome of a 9 years old girl with diagnosed juvenile ossifying fibroma treatment.Methods: A 9 years old girl presented with a 6 x 8 cm sized hard fixed tumour on right ramus and corpus of the mandible. On the radiological examination tumour showed an irregular but well bordered, unilocular and expansive lesion on the right corpus and ramus of the mandible. There was no teeth displacement or teeth root resorbtion. Microscopically, the tumour had trabeculae, fibrillary osteoid and woven bone. After the clinical, radiological (panoramic radiography, computed tomography and magnetic resonance imaging and histologic analysis it was diagnosed juvenile ossifying fibroma. In the history of the patient there has been an acute lymphocytic leukaemia in the remission for 3 years.Results: Because of large size of mandibular tumour, resultant expansion and destruction of mandibular cortex, the patient underwent right hemimandibulectomy using transmandibular approach. There was no recurrence or complications for two years follow-up.Conclusions: Although juvenile ossifying fibroma is an uncommon clinical entity, its aggressive local behaviour and high recurrence rate means that it is important to make an early diagnosis, apply the appropriate treatment and, especially, follow-up the patient over the long-term.

Health-related quality of life after segmental resection of the lateral mandible: Free fibula flap versus plate reconstruction.

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van Gemert, Johannes; Holtslag, Irene; van der Bilt, Andries; Merkx, Matthias; Koole, Ron; Van Cann, Ellen

2015-06-01

Segmental resection of the mandible causes functional, aesthetic and social problems affecting health-related quality of life (HRQoL). It is often assumed that reconstruction with composite free flaps guarantees better function and aesthetics than bridging the defect with reconstruction plates. Using the European Organization for Research and Treatment of Cancer questionnaires (EORTC QLQ-C30 version 3.0 and EORTC QLQ-H&N35), we compared HRQoL in patients who received free fibula flaps versus reconstruction plates after segmental resection of the lateral mandible. Thirty-seven completed questionnaires (18 fibula reconstructions and 19 patients with reconstruction plates) were available. Reconstruction with a free fibula flap did not provide clear additional benefit to bridging the defect with a reconstruction plate after segmental resection of the lateral mandible. In particular aspects known to have the most impact on HRQoL like swallowing, speech and chewing were not influenced by the type of reconstruction. Reconstruction of segmental defects of the lateral mandible with free fibula flap and reconstruction plate resulted in comparable HRQoL. If dental rehabilitation by means of dental implants is not anticipated in the fibula, then plate reconstruction with adequate soft tissue remains a suitable technique for the reconstruction of segmental defects of the lateral mandible. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The study on changes of bone mineral content of mandible by quantitative computed tomography

International Nuclear Information System (INIS)

Tamai, Manabu; Ishii, Yasuo

1996-01-01

A method to measure bone mineral of mandible has not been established. The bone mineral content (BMC) of the mandible with single energy quantitative computed tomography (SEQCT), which was compared with that of the spine, was discussed. The subjects were 104 healthy persons (54 males and 50 females, age range: 21-69) and 33 patients of mandibular atrophy (10 males and 23 females, age range: 46-87). The BMC changes of the mandible differed according to sex. In males BMC of trabecular bone and cortical bone decreased slightly after 40 and 30 years of age respectively. In females, BMC decreased consistently during menopause. BMC of the spine tended to decrease with aging, especially in females. In males having mandibular atrophy, the BMC of trabecular bone of the mandible decreased, and that of cortical bone of the mandible increased with aging. In females having atrophy, the BMC of trabecular bone and cortical bone of the mandible decreased with aging. The BMC of the mandible was correlated with the length of the denture-wearing time in males. In females, it appears that the BMC of the mandible participates in estrogen deficiency like the BMC of the spine. From the above, measurement of the BMC of the mandible by SEQCT was considered to be very useful for grasping the severity and progressive rate, and other conditions of alveolar ridge atrophy and determining the remedial course. (author)

The study on changes of bone mineral content of mandible by quantitative computed tomography

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Tamai, Manabu; Ishii, Yasuo [Fukui Medical School, Matsuoka (Japan)

1996-04-01

A method to measure bone mineral of mandible has not been established. The bone mineral content (BMC) of the mandible with single energy quantitative computed tomography (SEQCT), which was compared with that of the spine, was discussed. The subjects were 104 healthy persons (54 males and 50 females, age range: 21-69) and 33 patients of mandibular atrophy (10 males and 23 females, age range: 46-87). The BMC changes of the mandible differed according to sex. In males BMC of trabecular bone and cortical bone decreased slightly after 40 and 30 years of age respectively. In females, BMC decreased consistently during menopause. BMC of the spine tended to decrease with aging, especially in females. In males having mandibular atrophy, the BMC of trabecular bone of the mandible decreased, and that of cortical bone of the mandible increased with aging. In females having atrophy, the BMC of trabecular bone and cortical bone of the mandible decreased with aging. The BMC of the mandible was correlated with the length of the denture-wearing time in males. In females, it appears that the BMC of the mandible participates in estrogen deficiency like the BMC of the spine. From the above, measurement of the BMC of the mandible by SEQCT was considered to be very useful for grasping the severity and progressive rate, and other conditions of alveolar ridge atrophy and determining the remedial course. (author).

Surgical Treatment of a Large Complex Odontoma

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Burak Cezairli

2017-08-01

Full Text Available The treatment modalities for odontomas are generally depend on the tumors size. Small and medium lesions can usually be removed easily allowing preservation of surrounding anatomical structures. In our study, we reported a conservative surgical treatment of a large complex odontoma. A 19-year-old woman was referred to our clinic after an incidentally observed lesion on her right mandibular angle. The patient was symptom-free at the time of visit. Computed tomography (CT images showed a mass with a size of 3.5 cm x 3 cm x 2 cm. CT sections and tridimensional images showed partially eroded buccal and lingual cortex. Surgical treatment was indicated with an initial diagnosis of compound odontoma. The lesion removed after sectioning with bur and maxillo-mandibular fixation (MMF were not thought to be necessary while the buccal and lingual cortexes were mostly reliable for preventing a fracture. In our case, the size of the odontoma was suitable for a conservative treatment method and with this modality we managed to prevent a possible fracture and eliminate the disadvantages of MMF.

Surgical treatment of functional mitral regurgitation

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Braun, Jerry

2012-01-01

In this thesis the surgical options for treatment of functional mitral regurgitation (MR) are described. In functional MR, the mitral valve has a normal anatomy, which distinguishes this type of insufficiency from organic MR. Regurgitation in functional MR is related to an abnormal geometry of the

Intussusception in children: not only surgical treatment

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Anna Maria Caruso

2017-02-01

Full Text Available Introduction: Intussusception is the commonest cause of acute in­testinal obstruction in children. Failure of timely diagnosis and treatment results in a surgical emergency leading to fatal outcome. The classic triad of symptoms is seen in less than one-third of the children affected. Aim of this study was to evaluate the comprehensive management of intussusception in children, evaluating the outcome of conservative treatment with hydrostatic ultrasound reduction and surgery.Material and methods: A retrospective analysis was conducted including pediatric patients (up to 14 years old with diagnosis of bowel intussusception. The management and treatment depended on the patients’ situation: for children in good general conditions initial hydrostatic reduction under continuous ultrasonographic monitoring was attempted; if severe dehydration and/or septic shock was observed, the conservative treatment was contraindicated and direct surgical treatment was performed.Result: A total of 44 pediatric patients were included in the study. The most frequent symptoms observed were paroxysmal abdominal pain (100% of cases and vomiting (72%; only 29% of patients presented with the classic triad of symptoms (abdominal pain, palpable mass and blood stained stools. 28 patients (64% were managed conservatively with ultrasound hydrostatic reduction. 10 patients (23% required primary surgical intervention because of clinical conditions; 6 patients (14% were operated after failure of conservative approach. The total percentage of operated patients was 36%, with lead points identified in 12 cases.Conclusion: Our data confirm that hydrostatic reduction is a simple, real time procedure, free of radiations, non invasive and safe. Age had no impact on the reducibility whereas bloody stool, a prolonged duration of symptoms and the presence of lead point were risk factors of failure.

Nonsurgical treatment of hemifacial microsomia by therapeutic ultrasound and hybrid functional appliance

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Tarek El-Bialy

2010-03-01

Full Text Available Tarek El-Bialy1, Ali Hasan2, Ahmad Janadas3, Tarik Albaghdadi41Division of Orthodontics, Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada; 2Division of Orthodontics, Department of Preventive Dental Sciences, Faculty of Dentistry; 3Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry; 4Division of Radiology, Faculty of Medicine, King Abdul Aziz University, Jeddah, Saudi ArabiaAim: Conventional treatment of patients with hemifacial microsomia involves orthognathic surgery and/or distraction osteogenesis of the mandible. Previous reports showed that low-intensity pulsed ultrasound (LIPUS enhances mandibular growth in growing rabbits and monkeys. In monkeys, LIPUS enhanced mandibular growth when combined with functional jaw orthopedic appliances. The purpose of this pilot study was to investigate if LIPUS could enhance mandibular growth in children with hemifacial microsomia.Methods: Five children (age range 3–11 years with hemifacial microsomia were treated with hybrid jaw orthopedic functional appliances and treatment of the affected mandibular condyle by LIPUS for 20 minutes per day.Results: The results showed that after one year of treatment, significant improvement of the underdeveloped side of patients’ faces and mandibles was recognized both clinically and radiographically.Discussion: Although improvement took a longer time than did a surgical approach, optimizing this technique may achieve better results in a shorter treatment time. A randomized controlled clinical trial to investigate the effect of optimized LIPUS application or functional appliances in the treatment of hemifacial microsomia is warranted.Keywords: hemifacial microsomia, LIPUS, non-surgical treatment, children

Mandible-first sequence in bimaxillary orthognathic surgery: a systematic review.

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Borba, A M; Borges, A H; Cé, P S; Venturi, B A; Naclério-Homem, M G; Miloro, M

2016-04-01

The sequencing of bimaxillary orthognathic surgery remains controversial, although the traditional maxilla-first approach is performed routinely. The goal of this study was to present a systematic review of the mandible-first sequence in bimaxillary orthognathic surgery, to provide data that may assist in the decision as to which jaw should undergo osteotomy first in bimaxillary orthognathic surgery cases. A literature search was conducted for articles published in the English language, reporting the use of the altered sequence for bimaxillary orthognathic surgery (mandible-first), using the following descriptors: 'orthognathic' and 'double-jaw', 'orthognathic' and 'two-jaw', 'orthognathic' and 'mandible-first', 'orthognathic' and 'bimaxillary'. Eight hundred eighty-seven abstracts were initially identified and were evaluated for inclusion according to the proposed inclusion criteria. After evaluation of these abstracts and relevant references, six publications met the criteria for consideration. Performing mandible-first surgery in bimaxillary orthognathic cases dates back to the 1970s; however the decision regarding the jaw to be operated on first seems to rely on accurate preoperative planning based upon the surgeon's experience and preference. While there appear to be significant theoretical advantages to support the use of the altered orthognathic sequence (mandible-first), future prospective studies on its reliability, accuracy, and short- and long-term outcomes are required. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Relationship between structure and the stress pattern in the human mandible.

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Mongini, F; Calderale, P M; Barberi, G

1979-12-01

The internal bony structure of ten dentate human mandibles was examined on lateral radiograms, and the condylar shape measured with a digital electronic machine. The external surface was coated with photoelastic material. Each mandible was then placed in centric occlusion with brass replicas of the upper arch and the glenoid fossae and set in a supporting frame. Occlusal loads were simulated and the isoclinics recorded in plane-polarized light. The isostatic flow lines were constructed for each mandible. A relation was found between the mandibular structure and the distribution pattern of these lines.

The removal of a malpositioned implant in the anterior mandible using piezosurgery.

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Marini, Ettore; Cisterna, Veronica; Messina, Antonello Maria

2013-05-01

In oral, cranio, and maxillofacial surgery, a close relationship among the bone, nerves, and blood vessels can be regularly observed. Surgical procedures for the removal of dental implants have the potential to cause vascular injury and bleeding in the floor of the mouth and internal anterior region of the mandible. Furthermore, conventional osteotomy techniques always require extensive protection of adjacent soft tissue because cutting is not limited to bone and could easily affect other tissues when applied improperly. We report the removal by means of piezosurgery of a malpositioned osseointegrated implant that had previously caused a sublingual hematoma during its insertion. The postoperative course was uneventful, no bleeding, infection, or hematoma formation was noted and the patient reported 100% resolution of all symptoms. Copyright © 2013 Elsevier Inc. All rights reserved.

Biomechanical evaluation of a new MatrixMandible plating system on cadaver mandibles.

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Gateno, Jaime; Cookston, Christopher; Hsu, Sam Sheng-Pin; Stal, Drew N; Durrani, Salim K; Gold, Jonathan; Ismaily, Sabir; Alexander, Jerry W; Noble, Philip C; Xia, James J

2013-11-01

Current mandibular plating systems contain a wide range of plates and screws needed for the treatment of mandibular reconstruction and mandibular fractures. The authors' hypothesis was that a single diameter screw could be used in all applications in a plating system. Therefore, the purpose of this study was to test if the 2.0-mm locking screws could replace the 2.4-mm screws to stabilize a 2.5-mm-thick reconstruction plate in the treatment of mandibular discontinuity. Thirty-six fresh human cadaveric mandibles were used: 18 were plated using 2.0-mm locking screws (experimental) and the other 18 were plated using 2.4-mm locking screws (control). Each group was further divided into 3 subgroups based on the site of loading application: the ipsilateral (right) second premolar region, the central incisal region, and the contralateral (left) first molar region. The same ipsilateral (right) mandibular angular discontinuity was created by the same surgeon. The mandible was mounted on a material testing machine. The micromotions between the 2 segments, permanent and elastic displacements, were recorded after incremental ramping loads. The magnitude of screw back-out and the separation between plate and bone were recorded using a laser scanner (resolution, 0.12 mm) before and after the loading applications. The data were processed. Descriptive analyses and a general linear model for repeated measures analysis of variance were performed. There was no statistically significant difference in permanent displacement (mean, 1.16 and 0.82 mm, respectively) between the 2.0-mm and 2.4-mm screw groups. There also was no statistically significant difference in elastic displacement between the 2 groups (mean, 1.48 and 1.21 mm, respectively). Finally, there were no statistically significant differences in screw back-out or separation between plate and bone between the 2 groups. All means for screw back-out and separation between screw and bone for each group were judged within the

Influence of X-ray irradiation on the mandible of ovariectomized rats

International Nuclear Information System (INIS)

Ikoma, Kazuyuki; Iwata, Hiroshi; Yosue, Takashi

2004-01-01

The aim of the present study was to investigate the influence of irradiation on the mandible of ovariectomized (OVX) rats. Female rats were subject to OVX or a sham operation (SHAM) at the age of 14 weeks. Ten Gy doses of X-ray were applied to the mandibles twelve weeks after the operation. The experimental animals were divided into four groups: the OVX non-irradiation group, the OVX irradiation group, SHAM non-irradiation group and SHAM irradiation group. Four, eight and twelve weeks after irradiation, the animals were sacrificed and the mandibles removed. The mandibles were investigated using μCT and pQCT, and from the images obtained, the rate of mineralized tissue in the bone as well as the bone mineral content (BMC) were evaluated. The rate of mineralized tissue in the bone as determined from the images of μCT was significantly (P<0.05) lower in the OVX non-irradiation group than in the SHAM non-irradiation group at four weeks after irradiation. Similarly, the rate in the OVX irradiation group was lower than that in the SHAM irradiation group at twelve weeks after irradiation. In both the SHAM and OVX groups, there was no difference between the non-irradiation and irradiation groups. From the pQCT images, the change in the BMC in the cortical bone was negligible when the BMC was measured in the mandibles. In the OVX non-irradiation group, the trabecular BMC of the mandibles was significantly lower than that in the SHAM non-irradiation group at four and twelve weeks after irradiation. The trabecular BMC of the mandibles in the SHAM and OVX irradiation groups were significantly lower than that of the SHAM and OVX non-irradiation groups respectively throughout the experimental period. In the rate of mineralized tissue in the mandibles, the influence of OVX was recognized, but the influence of irradiation was not. On the other hand, the BMC in the cortical bone was not significant through out the experiment. The influence of irradiation on the OVX group was

Research advances in surgical treatment of hepatic alveolar echinococcosis

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Maimaiti Wasili

2018-03-01

Full Text Available Hepatic alveolar echinococcosis (HAE is a parasitic disease characterized by invasive growth. Major treatment methods include pharmacotherapy and surgical treatment, and surgical treatment mainly includes radical hepatectomy and palliative surgery. Radical hepatectomy is the first choice, and palliative surgery is mainly used to alleviate disease conditions and complications. Pharmacotherapy also plays an important role in the delay and control of HAE. In recent years, autologous liver transplantation has been used in the treatment of HAE and has become an effective therapy for end-stage HAE patients who cannot be cured by routine surgery. This article introduces the indications and advantages/disadvantages of radical hepatectomy and palliative surgery, as well as the experience in the application of multidisciplinary treatment, the concept of fast-track surgery, and autologous liver transplantation in the treatment of HAE patients, in order to provide a reference for the treatment of HAE.

Immediate occlusal loading of implants in the partially edentate mandible: a prospective 1-year radiographic and 4-year clinical study.

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Ostman, Pär-Olov; Hellman, Mats; Sennerby, Lars

2008-01-01

The purpose of the present prospective clinical study was to evaluate the radiographic and clinical outcome of immediately loaded implants in the partial edentulous mandible over a 4-year follow-up period using a modified surgical protocol, primary implant stability criteria, and splinting for inclusion. Patients in need of implant treatment in the partial edentate mandible were consecutively included in the study. The implant sites were underprepared to obtain maximal stability. Inclusion criteria for the study were torque of a least 30 Ncm before final seating of the implant and an ISQ greater than 60. A provisional fixed partial denture was delivered within 24 hours and a definitive fixed partial denture within 3 months. The patients were monitored with clinical and radiographic follow-up examinations for up to 4 years. Stability of the implants was measured with resonance frequency analysis at placement and after 6 months. Ninety-six patients were evaluated, and 77 patients who met the inclusion criteria were included. A total of 111 fixed partial dentures supported by 257 Brånemark System implants (77 turned and 180 TiUnite implants) were delivered. Four (1.6%) of the 257 implants did not osseointegrate, giving an overall survival rate of 98.4% after 4 years. Three turned (3.9%) implants and 1 oxidized implant (0.6%) failed after 4 to 13 months. The average marginal bone resorption was 0.7 mm (SD 0.78) during the first year in function. Turned implants showed an average bone loss of 0.5 mm (SD 0.8) and oxidized implants an average of 0.7 mm (SD 0.8). Resonance frequency analysis showed a mean implant stability quotient of 72.2 (SD 7.5) at placement and 72.5 (SD 5.7) after 6 months of loading. It is concluded that immediate loading of implants with firm primary stability in partially edentulous areas of the mandible appears to be a viable procedure with predictable outcome.

Mechanical mandible competence in rats with nutritional growth retardation.

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Lezón, Christian Esteban; Pintos, Patricia Mabel; Bozzini, Clarisa; Romero, Alan Agüero; Casavalle, Patricia; Friedman, Silvia María; Boyer, Patricia Mónica

2017-08-01

In order to provide a better understanding of the sympathetic nervous system as a negative regulator of bone status, the aim of the study was to establish the biomechanical mandible response to different doses of a β-adrenergic antagonist such as propranolol (P) in a stress-induced food restriction model of growth retardation. Rats were assigned to eight groups: Control (C), C+P3.5 (CP3.5), C+P7 (CP7), C+P14 (CP14), NGR, NGR+P3.5 (NGRP3.5), NGR+P7 (NGRP7) and NGR+P14 (NGRP14). C, CP3.5, CP7 and CP14 rats were freely fed with the standard diet. NGR, NGRP3.5, NGRP7 and NGRP14 rats received, for 4 weeks (W4), 80% of the amount of controls food consumed. Propranolol 3.5, 7 and 14mg/kg/day was injected ip 5days per week in CP3.5 and NGRP3.5, CP7 and NGRP7, CP14 and NGRP14, respectively. At W4, zoometry, mandible morphometry, static histomorphometric and biomechanical competence were performed. A dose of Propranolol 7mg/kg/day induced interradicular bone volume accretion reaching a mandible stiffness according to chronological age. These findings evidenced that sympathetic nervous system activity is a negative regulator of mandible mechanical competence in the nutritional growth retardation model. Propranolol 7mg/kg/day, under the regimen usage, seems to be appropriate to blockade SNS activity on mandible mechanical performance in NGR rats, probably associated to an effect on bone mechanostat system ability to detect disuse mode as an error. Copyright © 2017 Elsevier Ltd. All rights reserved.

The longitudinal sagittal growth changes of maxilla and mandible according to quantitative cervical vertebral maturation.

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Chen, Lili; Lin, Jiuxiang; Xu, Tianmin; Long, Xiaosi

2009-04-01

To investigate the longitudinal sagittal growth changes of maxilla and mandible according to the quantitative cervical vertebral maturation (QCVM) for adolescents with normal occlusion, mixed longitudinal data were used. The samples included 87 adolescents aged from 8 to 18 y old with normal occlusion (32 males, 55 females) selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year, lasting for 6 y. The longitudinal sagittal growth changes of maxilla and mandible according to QCVM were measured. There were some significant differences between maxilla and mandible according to QCVM. The sagittal growth change of maxilla showed a trend towards high velocity-->decelerating velocity-->completing velocity from QCVM stage I to stage IV. The sagittal growth change of mandible showed a trend towards accelerating velocity-->high velocity-->decelerating velocity-->completing velocity from QCVM stage I to stage IV. With sagittal relationship, growth magnitude was almost the same between maxilla and mandible at QCVM stage I. At stage II the growth of mandible exceeded that of maxilla and growth in mandible continued at stages III and IV, while the maxilla ceased to grow. Growth magnitude was greater and the growth duration was longer with male mandible. It is concluded that the longitudinal sagittal growth changes of maxilla and mandible on the basis of QCVM is of value in the orthodontic practice.

Comparison of surgical and non-surgical orthodontic treatment approaches on occlusal and cephalometric outcomes in patients with Class II Division I malocclusions

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Sheila Daniels

2017-07-01

Full Text Available Abstract Background This study aimed to examine end-of-treatment outcomes of severe Class II Division I malocclusion patients treated with surgical or non-surgical approaches. This study tests the hypotheses that occlusal outcomes (ABO-OGS and cephalometric outcomes differ between these groups. Methods A total of 60 patients were included: 20 of which underwent surgical correction and 40 of which did not. Cast grading of initial and final study models was performed and information was gathered from pre- to post-treatment cephalometric radiographs. The end-of-treatment ABO-OGS and cephalometric outcomes were compared to Mann-Whitney U tests and multivariable linear regression models. Results Following adjustment for multiple confounders (age, gender, complexity of case, and skeletal patterns, the final deband score (ABO-OGS was similar for both groups (23.8 for surgical group versus 22.5 for non-surgical group. Those treated surgically had a significantly larger reduction in ANB angle, 3.4° reduction versus 1.5° reduction in the non-surgical group (p = 0.002. The surgical group also showed increased maxillary incisor proclination (p = 0.001 compared to the non-surgical group. This might be attributed to retroclination of maxillary incisors during treatment selection in the non-surgical group—namely, extraction of premolars to mask the discrepancy. Conclusions Those treated surgically had a significantly larger reduction in ANB angle and increased maxillary incisor proclination compared to those treated non-surgically with no significant changes in occlusal outcomes.

Surgical treatment of metachronous metastases in different organs following radical nephrectomy

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Carlos M. N. de Jesus

2003-06-01

Full Text Available Renal clear cell carcinoma (RCCC is a neoplasia resistant to radio and chemotherapy, with surgical treatment being the procedure that is recognized for its curative treatment. This case report demonstrates the success of an aggressive surgical treatment for consecutive and late metachronous metastases following radical nephrectomy. CASE REPORT: Asymptomatic 50-year old man. During a routine examination, an incidental mass was found by renal ultrasonography. He underwent right radical nephrectomy due to RCCC in June 1992. During the follow-up metastases were evidenced in cerebellum on the seventh year, and in left lung and pancreas on the eighth year following the radical nephrectomy, with all of them successfully treated by surgical excision. COMMENTS: The surgical excision of consecutive and late metachronous metastases in different organs arising from RCCC is feasible, being a good therapeutic alternative in selected cases.

Short-term efficacy of surgical treatment of secondary hyperparathyroidism.

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Liang, Y; Sun, Y; Ren, L; Qi, X-W; Li, Y; Zhang, F

2015-10-01

We wished to explore short-term efficacy of surgical treatment of secondary hyperparathyroidism in patients with the end-stage renal disease. The treatment methods were subtotal or total parathyroidectomy, or total parathyroidectomy and autotransplantation. 63 patients with secondary hyperparathyroidism were randomly divided into three groups which were respectively treated with subtotal parathyroidectomy (SPTX group), total parathyroidectomy (TPTX group), or total parathyroidectomy and autotransplantation (TPTX+AT group). The surgical outcomes included operating time, transoperative bleeding volume, length of stay, and cost of hospitalization. In addition, complication (e.g., postoperative wound infection, hematoma, hypocalcemia in perioperative period) rates were compared among groups. Blood levels of calcium and parathyroid hormone were assessed before the surgery, and 1 day, 1 months, 3 months and 6 months after the surgery. The follow-up period comprised 6 months. Surgical outcomes were the lowest in SPTX group and the highest in in TPTX+AT group. There were no significant differences among groups in treatment efficacy. Complication rates were also comparable among the three groups. The occurrence of hypocalcemia was the lowest in SPTX group (p < 0.05 vs. other groups). However, postoperative relapse rate was the highest in this group (p < 0.05 vs. other groups). There were no correlations between the levels of blood calcium and PTH preoperatively and postoperatively. Appropriate surgical treatment is selected in accordance with the patient's condition and willingness, with the attention paid to the prevention of hypocalcemia.

Surgical treatment of cleft lip

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Mateus Domingues Miachon

Full Text Available We performed a systematic review of the literature on the surgical treatment of cleft lip, emphasizing the prevalence, complications associated with the treatment and the points of disagreement between authors. We conducted a literature cross-sectional search that analyzed publications in books, articles and on the databases SciELO - Scientific Electronic Library Online, PubMed, of the National Center for Biotechnology Information. We conclude that: 1 the severity of the cleft will indicate the technique presenting more advantages; 2 the different approaches indicate that there is no consensus on the optimal technique; and 3 the surgeon experience contributes to choosing the best option.

Surgical versus injection treatment for injection-confirmed chronic sacroiliac joint pain

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Spiker, William Ryan; Lawrence, Brandon D.; Raich, Annie L.; Skelly, Andrea C.; Brodke, Darrel S.

2012-01-01

Study design: Systematic review. Study rationale: Chronic sacroiliac joint pain (CSJP) is a common clinical entity with highly controversial treatment options. A recent systematic review compared surgery with denervation, but the current systematic review compares outcomes of surgical intervention with therapeutic injection for the treatment of CSJP and serves as the next step for evaluating current evidence on the comparative effectiveness of treatments for non-traumatic sacroiliac joint pain. Objective or clinical question: In adult patients with injection-confirmed CSJP, does surgical treatment lead to better outcomes and fewer complications than injection therapy? Methods: A systematic review of the English-language literature was undertaken for articles published between 1970 and June 2012. Electronic databases and reference lists of key articles were searched to identify studies evaluating surgery or injection treatment for injection-confirmed CSJP. Studies involving traumatic onset or non-injection–confirmed CSJP were excluded. Two independent reviewers assessed the level of evidence quality using the grading of recommendations assessment, development and evaluation (GRADE) system, and disagreements were resolved by consensus. Results: We identified twelve articles (seven surgical and five injection treatment) meeting our inclusion criteria. Regardless of the type of treatment, most studies reported over 40% improvement in pain as measured by Visual Analog Scale or Numeric rating Scale score. Regardless of the type of treatment, most studies reported over 20% improvement in functionality. Most complications were reported in the surgical studies. Conclusion: Surgical fusion and therapeutic injections can likely provide pain relief, improve quality of life, and improve work status. The comparative effectiveness of these interventions cannot be evaluated with the current literature. PMID:23526911

Retrospective analysis of factors affecting the efficacy of surgical treatment of the scar.

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Yang, Z; Shi, X; Zhang, Y; Wang, S; Lei, Z; Liu, X; Fan, D

2014-04-01

The scar is a major problem in the medical profession. Its timely treatment is very important for the better outcome of the scar treatment and for the improvement of the life quality of the patients. The aim of this study was retrospectively analyzed the epidemiological characteristics affecting the efficacy of the scar surgical treatment of the people in the western part of China. Total 414 scar cases were retrospectively analyzed to clarify the epidemiological characteristics and the factors affecting the scar surgical treatment efficacy. The factors included were sex, age, area distribution, treatment seasons, injury sites, injury causes, and the time from scarring to the surgical treatment. All scar cases were surgically treated with the repairing technology including skin graft, flap and soft tissue dilation. There were 206 males and 208 females with the average age 20.53±12.9 years (age range 1-68 years). The patient proportions in the age groups of 0-20, 21-40 and >40 years were 61.4% (254 cases), 29.2% (121 cases), and 9.4% (39 cases) respectively. The patient's attendance rate reached the highest during the summer and winter. Most patients were from the rural areas with an increasing tendency each year. The burn scars were the most abundant and the injury sites were mostly the head and face. Univariate analysis showed that the time from scarring to the surgical treatment and the injury sites were significantly influenced the scar surgical treatment efficacy. Logistic regression analysis demonstrated that the injured sites of the head and face significantly influenced the scar surgical treatment efficacy. With the development of economy in China, more scar patients especially younger and children visit doctors predominantely from the rural areas. Usually, they get their scars in the exposed area of their bodies (head and face) which seriously affect the patient's appearance and function. Factors influencing the scar surgical treatment efficacy has

Occurrence of the Retromolar Foramen in Dry Mandibles of South-Eastern Part of India: A Morphological Study with Review of the Literature

Science.gov (United States)

Potu, Bhagath Kumar; Kumar, Vinod; Salem, Abdel-Halim; Abu-Hijleh, Marwan

2014-01-01

The retromolar foramen (RMF) is a rare anatomical structure situated in the retromolar fossa behind the third molar tooth. When it is present, the foramen is connected with the mandibular canal and is believed to transmit neurovascular structures that provide accessory source to the mandibular molars and the buccal area. Reports from the literature show that the presence of RMF could pose a challenge in complete blockage of the inferior alveolar nerve during mandibular surgeries. We report the incidence of retromolar foramen from ninety-four dry mandibles of south-eastern part of Karnataka State, India. The foramen was observed in 11 mandibles out of 94 included in the study (11.7%). In three mandibles, the foramen was present bilaterally (3.2%) and in three it was on the left side (3.2%) and in five it was on the right side (5.3%). For the first time, we also measured the dimensions of the retromolar area and distance of the foramen from third molar tooth to understand its risks during the surgical extraction of the lower third molar tooth. A thorough review of the literature has also been done to compare the present findings with the studies reported from the various populations. PMID:25489487

The state of the vegetative nervous system in patients with gonarthrosis for surgical treatment before and after surgical treatment

Directory of Open Access Journals (Sweden)

Karaseva T.lu.

2012-12-01

Full Text Available Aim. Analyzing the vegetative tensity of organism» functional systems before and after surgical treatment of elderly patients with metabolic-and-dystrophic gonarthrosis. Methods. The evaluation of vegetative homeostasis, reactivity of the vegetative nervous system by the data of variation pulsometry («REAN-POLY» RGPA-6/12, Taganrog in 60 patients with gonarthrosis at the age of 50-72 years and the disease duration — 9+1.5 years before and after surgical treatment: total tunnelization (Group I, tunnelization with osteotomy of leg bones for correction of limb biomechanical axis (Group II, treatment-and-diagnostic arthroscopy (Group III. Results. The reduction of the level of hypoxia tolerance and the decrease of the processes of general adaptation one month after surgery in Group I was registered in 40% of patients. As for patients of Group II, by the end of the period of fixation with the llizarov device — in 50%. As for those of Group III after arthroscopy — in 10% of patients. Among the patients whose 1С / 1С calculated parameter after surgical treatment was registered <1.0, its values were >10.0 before treatment in 70% of cases. At rest, marked vagotonia was registered with hypersympathicotonic reaction to orthotest, as well as with sharp decrease of the proportion of second-order slow waves while transition to standing position (VLF proportion <10.0%, thereby reflecting organism»s energy deficiency state. Conclusion. Preoperative examination. When VLF proportion after orthotest is registered <10.0%, such patients should be referred to risk group and prescribed in-depth examination. The index of centralization (1С dynamics for orthotest (1С test/1С rest is one of the criteria of functional recovery level for the particular patient: its increase points to the positive dynamics of restorative rehabilitative process, and the values <1.0 —to the negative one.

Value of PET/CT 3D visualization of head and neck squamous cell carcinoma extended to mandible.

Science.gov (United States)

Lopez, R; Gantet, P; Julian, A; Hitzel, A; Herbault-Barres, B; Alshehri, S; Payoux, P

2018-05-01

To study an original 3D visualization of head and neck squamous cell carcinoma extending to the mandible by using [18F]-NaF PET/CT and [18F]-FDG PET/CT imaging along with a new innovative FDG and NaF image analysis using dedicated software. The main interest of the 3D evaluation is to have a better visualization of bone extension in such cancers and that could also avoid unsatisfying surgical treatment later on. A prospective study was carried out from November 2016 to September 2017. Twenty patients with head and neck squamous cell carcinoma extending to the mandible (stage 4 in the UICC classification) underwent [18F]-NaF and [18F]-FDG PET/CT. We compared the delineation of 3D quantification obtained with [18F]-NaF and [18F]-FDG PET/CT. In order to carry out this comparison, a method of visualisation and quantification of PET images was developed. This new approach was based on a process of quantification of radioactive activity within the mandibular bone that objectively defined the significant limits of this activity on PET images and on a 3D visualization. Furthermore, the spatial limits obtained by analysis of the PET/CT 3D images were compared to those obtained by histopathological examination of mandibular resection which confirmed intraosseous extension to the mandible. The [18F]-NaF PET/CT imaging confirmed the mandibular extension in 85% of cases and was not shown in [18F]-FDG PET/CT imaging. The [18F]-NaF PET/CT was significantly more accurate than [18F]-FDG PET/CT in 3D assessment of intraosseous extension of head and neck squamous cell carcinoma. This new 3D information shows the importance in the imaging approach of cancers. All cases of mandibular extension suspected on [18F]-NaF PET/CT imaging were confirmed based on histopathological results as a reference. The [18F]-NaF PET/CT 3D visualization should be included in the pre-treatment workups of head and neck cancers. With the use of a dedicated software which enables objective delineation of

Effect of x-ray irradiated rat fetus mandible

International Nuclear Information System (INIS)

Han, Chang Gun; You, Dong Soo

1978-01-01

The effect of irradiation of x-ray to developing rat mandible in the gestation stage was focused on the study of mandible development and the side effect of x-ray irradiation. The author studied the effect of x-ray irradiation with the gestated rat and their offsprings. 100 rads, 200 rads, 300 rads and 400 rads of x-ray was irradiated in regular order schematically at the lower left abdomen of gestated rat. 18 1/2 days after conception, their offsprings were sacrificed and examined their developing mandible with histological findings. The results were as followed. 1. In the 100-200 rads irradiated rat offsprings, bony trabeclulation was revealed irregular shape. In combine with this finding, osteoblast and fibroblast were appeared shrunken of their nucleus and location of eccentric position. 2. In the 300-400 rads irradiated rat offsprings, decrease of fibroblast and osteoblast appearance in the periosteum were prominently observed and empty lacunae were frequently appeared in their bone matrix. 3. The advent of osteoclast and resorption of cortical bone were appeared in proportion to increasing of x-ray irradiation.

Rare Case of a Chondrosarcoma of the Mandible in a Child

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Hendryk Vieweg

2013-01-01

Full Text Available Chondrosarcoma of the mandible is rare, especially in children. The available literature consists mostly of a few case reports which are partly integrated in small studies. Growing this small pool of literature is helpful in solidifying knowledge about this disease and facilitating appropriate treatment for children. Therefore, we present such a case in a 12-year-old boy, exhibit comprehensive and relevant information concerning this entity, and discuss our findings in the context of other publications.

Surgical treatment of endometriosis before gamete intrafallopian ...

African Journals Online (AJOL)

Abstract. Objective. To determine whether active pelvic endometriosis impairs the efficacy of GIFT (gamete intrafallopian transfer) and whether prior surgical treatment of endometriosis improves the efficacy of GIFT. Design. Matched controlled retrospective study. Setting. University-based assisted reproduction programme.

Surgical-Orthodontic Treatment of Gummy Smile with Vertical Maxillary Excess

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Sumit Kumar Yadav

2014-01-01

Full Text Available Vertical maxillary excess is a well-defined clinical entity with several treatment options available. Treatment of the condition requires extremely well-coordinated orthodontic and surgical treatment planning and execution. This case report describes a multidisciplinary approach in the successful management of a patient with severe vertical maxillary excess. Careful selection and good execution of a surgical-orthodontic treatment plan in the management of vertical maxillary excess provided the superior esthetic and functional results in this case. Maxillary Le Forte 1 procedure was performed for vertical maxillary impaction along with anterior segmental setback. The presented technique was unique as it shortened the treatment time and esthetic results in smile and vertical proportions were achieved.

Use of the 3D surgical modelling technique with open-source software for mandibular fibula free flap reconstruction and its surgical guides.

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Ganry, L; Hersant, B; Quilichini, J; Leyder, P; Meningaud, J P

2017-06-01

Tridimensional (3D) surgical modelling is a necessary step to create 3D-printed surgical tools, and expensive professional software is generally needed. Open-source software are functional, reliable, updated, may be downloaded for free and used to produce 3D models. Few surgical teams have used free solutions for mastering 3D surgical modelling for reconstructive surgery with osseous free flaps. We described an Open-source software 3D surgical modelling protocol to perform a fast and nearly free mandibular reconstruction with microvascular fibula free flap and its surgical guides, with no need for engineering support. Four successive specialised Open-source software were used to perform our 3D modelling: OsiriX ® , Meshlab ® , Netfabb ® and Blender ® . Digital Imaging and Communications in Medicine (DICOM) data on patient skull and fibula, obtained with a computerised tomography (CT) scan, were needed. The 3D modelling of the reconstructed mandible and its surgical guides were created. This new strategy may improve surgical management in Oral and Craniomaxillofacial surgery. Further clinical studies are needed to demonstrate the feasibility, reproducibility, transfer of know how and benefits of this technique. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Etiopathogenesis, diagnostics and history of surgical treatment of stress urinary incontinence.

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Jovan, Hadži-Djokić; Uroš, Babić; Aleksandar, Argirović; Miodrag, Aćimović; Milan, Radovanović; Bogomir, Milojević; Tomisla, Pejčić; Zoran, Džamić

2014-01-01

Urinary incontinence represents involuntary urine leakage into the urethra. This pathological condition represents a major medical, social and hygienic problem. The paper presents risk factors for development of the disorder, as well as diagnostic methods applied in evaluation of the female patients. Chronological review of diverse surgical techniques used in treatment of stress urinary incontinence reported in the published scientific papers is also presented. Review of the literature data was also performed. Sling procedures with application of suburethral loops have been used since the beginning of the last century in treatment of this disorder. Surgical treatment of stress urinary incontinence is applied when conservative treatment fails to give any effects according to strictly defined indications. During the last 100 years, surgical techniques have undergone different improvements and the results have also been significantly improved.

The surgical treatment of chronic pancreatitis: a clinical series of 17 cases.

Science.gov (United States)

Vasile, D; Ilco, A; Popa, D; Belega, A; Pana, S

2013-01-01

Despite the fact that in the last few years, new invasive non-surgical therapies were introduced, surgical treatment of chronic pancreatitis still plays an important part.The aim of the study is to evaluate pain remission and quality of life after surgical approach. We present 17 cases of chronic pancreatitis that were operated between 2007-2011. Surgical treatment was decided for after the failure of pain control therapy (14 cases)and by the suspicion of cancer in the head of the pancreas (3 cases). Imaging data for all the cases, CT-CE and ERCP, guided us in choosing the right therapy. Surgical techniques performed were pancreatico-jejunostomy (PJ) in eleven cases and duodenopancreatectomy(DP) in six cases. Good pain control was achieved in 10 patients: 6-PJ and 4-DP. Moderate results were observed in 4 cases: 2-PJ and 2-DP. In 3 patients symptoms remained the same. There is no consensus over the surgical treatment in chronic pancreatitis. Surgical approach, strongly motivated and personalised for each patient is followed by good results. It is possible that in the future, limited resections become the therapy of choice, replacing classic ones. Celsius.

Effect of non-surgical periodontal treatment on chronic kidney disease patients

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Hilana Paula Carillo Artese

2010-12-01

Full Text Available Chronic kidney disease (CKD is a debilitating systemic condition. Our working hypothesis is that CKD predialysis patients with periodontitis would respond poorly to periodontal treatment owing to immunologic compromise. Twenty-one predialysis patients (group 1 and 19 individuals without clinical evidence of kidney disease (group 2 with chronic periodontitis were subjected to non-surgical periodontal treatment with no antibiotics. Clinical periodontal and systemic parameters were evaluated at baseline and 3 months after treatment. Both groups showed significant and similar post-treatment improvements in all periodontal parameters examined. Most interestingly, periodontal treatment had a statistically significant positive effect on the glomerular filtration rate of each individual (group 1, p = 0.04; group 2, p = 0.002. Our results indicate that chronic periodontitis in predialysis kidney disease patients improved similarly in patients with chronic periodontitis and no history of CKD after receiving non-surgical periodontal therapy. This study demonstrates that CKD predialysis patients show a good response to non-surgical periodontal treatment.

Orthodontic-surgical treatment of bilateral maxillary canine impaction

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Sumitra

2012-01-01

Full Text Available A 13-year-old female patient reported with the chief complaint of irregular front teeth. She had a skeletal Class III and Angle′s Class I malocclusion with hyperdivergent growth pattern and bilateral impaction of maxillary canines. Surgical exposure of the impacted teeth and orthodontic alignment was planned. The surgical exposure was done by a minimally invasive modified window technique. Orthodontic treatment of impacted canines without causing significant morbidity to the adjacent teeth and periodontium is a challenge. The bilaterally impacted maxillary canines were successfully aligned and leveled. The depth of the gingival sulcus and clinical crown heights of disimpacted teeth were normal post-treatment and after 1 year of retention.

SURGICAL TREATMENT OF HEMORRHOIDS: A CRITICAL APPRAISAL OF THE CURRENT OPTIONS

Science.gov (United States)

CERATO, Marlise Mello; CERATO, Nilo Luiz; PASSOS, Patrícia; TREIGUE, Alberto; DAMIN, Daniel C.

2014-01-01

Introduction Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. Aim To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. Methods A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Results Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conclusion Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results. PMID:24676303

Orthodontic-surgical treatment of bilateral maxillary canine impaction

OpenAIRE

Sumitra

2012-01-01

A 13-year-old female patient reported with the chief complaint of irregular front teeth. She had a skeletal Class III and Angle's Class I malocclusion with hyperdivergent growth pattern and bilateral impaction of maxillary canines. Surgical exposure of the impacted teeth and orthodontic alignment was planned. The surgical exposure was done by a minimally invasive modified window technique. Orthodontic treatment of impacted canines without causing significant morbidity to the adjacent teeth an...

Surgical Treatment for Achalasia of the Esophagus: Laparoscopic Heller Myotomy

Science.gov (United States)

Torres-Villalobos, Gonzalo; Martin-del-Campo, Luis Alfonso

2013-01-01

Achalasia is an esophageal motility disorder that leads to dysphagia, chest pain, and weight loss. Its diagnosis is clinically suspected and is confirmed with esophageal manometry. Although pneumatic dilation has a role in the treatment of patients with achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed achalasia. This review will focus on the surgical treatment of achalasia, with special emphasis on laparoscopic Heller myotomy. We will also present a brief discussion of the evaluation of patients with persistent or recurrent symptoms after surgical treatment for achalasia and emerging technologies such as LESS, robot-assisted myotomy, and POEM. PMID:24348542

Higher rate of compensation after surgical treatment versus conservative treatment for acute Achilles tendon rupture

DEFF Research Database (Denmark)

Sveen, Thor-Magnus; Troelsen, Anders; Barfod, Kristoffer Weisskirchner

2015-01-01

in the period from 1992 to 2010 in the DPIA database were identified and patient records were reviewed manually. RESULTS: The compensation awarded for the 18-year period totalled 18,147,202 DKK with 41% of patient claims being recognised. Out of 180 surgically treated patients, 79 received a total compensation...... of 14,051,377 DKK, median 47,637 (range: 5,000-3,577,043). Of 114 non-surgically treated patients, 40 received 3,715,224 DKK in compensation, with a median amount of 35,788 DKK (range: 5,000-830,073). CONCLUSION: Compensation after surgical treatment was 3.8 times higher than compensation after non......-surgical treatment. It is noteworthy that 34.5% of patients had an overlooked diagnosis which underlines the importance of a correct primary diagnosis. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

The mandible and its foramen: anatomy, anthropology, embryology and resulting clinical implications.

Science.gov (United States)

Lipski, M; Tomaszewska, I M; Lipska, W; Lis, G J; Tomaszewski, K A

2013-11-01

The aim of this paper is to summarise the knowledge about the anatomy, embryology and anthropology of the mandible and the mandibular foramen and also to highlight the most important clinical implications of the current studies regarding anaesthesia performed in the region of the mandible. An electronic journal search was undertaken to identify all the relevant studies published in English. The search included MEDLINE and EMBASE databases and years from 1950 to 2012. The subject search used a combination of controlled vocabulary and free text based on the search strategy for MEDLINE using key words: 'mandible', 'mandibular', 'foramen', 'anatomy', 'embryology', 'anthropology', and 'mental'. The reference lists of all the relevant studies and existing reviews were screened for additional relevant publications. Basing on relevant manuscripts, this short review about the anatomy, embryology and anthropology of the mandible and the mandibular foramen was written.

Surgical stent for dental implant using cone beam CT images

International Nuclear Information System (INIS)

Choi, Hyung Soo; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan

2010-01-01

The purpose of this study is to develop a surgical stent for dental implant procedure that can be easily applied and affordable by using cone beam computerized tomography (CBCT). Aluminum, Teflon-PFA (perfluoroalkoxy), and acetal (polyoxymethylene plastic) were selected as materials for the surgical stent. Among these three materials, the appropriate material was chosen using the CBCT images. The surgical stent, which could be easily placed into an oral cavity, was designed with chosen material. CBCT images of the new surgical stent on mandible were obtained using Alphard-3030 dental CT system (Asahi Roentgen Co., Ltd., Kyoto, Japan). The point of insertion was prescribed on the surgical stent with the multiplanar reconstruction software of OnDemand3D (CyberMed Inc., Seoul, Korea). Guide holes were made at the point of insertion on the surgical stent using newly designed guide jig. CBCT scans was taken for the second time to verify the accuracy of the newly designed surgical stent. Teflon-PFA showed radiologically excellent image characteristics for the surgical stent. High accuracy and reproducibility of implantation were confirmed with the surgical stent. The newly designed surgical stent can lead to the accurate implantation and achieve the clinically predictable result.

Adjacent segment infection after surgical treatment of spondylodiscitis.

Science.gov (United States)

Siam, Ahmed Ezzat; El Saghir, Hesham; Boehm, Heinrich

2016-03-01

This is the first case series to describe adjacent segment infection (ASI) after surgical treatment of spondylodiscitis (SD). Patients with SD, spondylitis who were surgically treated between 1994 and 2012 were included. Out of 1187 cases, 23 (1.94 %) returned to our institution (Zentralklinik Bad Berka) with ASI: 10 males, 13 females, with a mean age of 65.1 years and a mean follow-up of 69 months. ASI most commonly involved L3-4 (seven patients), T12-L1 (five) and L2-3 (four). The mean interval between operations of primary infection and ASI was 36.9 months. All cases needed surgical intervention, debridement, reconstruction and fusion with longer instrumentation, with culture and sensitivity-based postoperative antimicrobial therapy. At last follow-up, six patients (26.1 %) were mobilized in a wheelchair with a varying degree of paraplegia (three had pre-existing paralysis). Three patients died within 2 months after the ASI operation (13 %). Excellent outcomes were achieved in five patients, and good in eight. Adjacent segment infection after surgical treatment of spondylodiscitis is a rare complication (1.94 %). It is associated with multimorbidity and shows a high mortality rate and a high neurological affection rate. Possible explanations are: haematomas of repeated micro-fractures around screw loosening, haematogenous spread, direct inoculation or a combination of these factors. ASI may also lead to proximal junctional kyphosis, as found in this series. We suggest early surgical intervention with anterior debridement, reconstruction and fusion with posterior instrumentation, followed by antimicrobial therapy for 12 weeks. Level IV retrospective uncontrolled case series.

Open and Arthroscopic Surgical Treatment of Femoroacetabular Impingement

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Benjamin D. Kuhns

2015-12-01

Full Text Available Femoroacetabular impingement (FAI is a common cause of hip pain, and when indicated, can be successfully managed through open surgery or hip arthroscopy. The goal of this review is to describe the different approaches to the surgical treatment of FAI. We present the indications, surgical technique, rehabilitation, and complications associated with (1 open hip dislocation, (2 reverse peri-acetabular osteotomy, (3 the direct anterior mini-open approach, and (4 arthroscopic surgery for femoroacetabular impingement.

Imaging in the Evaluation of Endoscopic or Surgical Treatment for Achalasia

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Diego Palladino

2016-01-01

Full Text Available Purpose. Aim of the study is to evaluate the efficacy of the endoscopic (pneumatic dilation versus surgical (Heller myotomy treatment in patients affected by esophageal achalasia using barium X-ray examination of the digestive tract performed before and after the treatment. Materials and Methods. 19 patients (10 males and 9 females were enrolled in this study; each patient underwent a barium X-ray examination to evaluate the esophageal diameter and the height of the barium column before and after endoscopic or surgical treatment. Results. The mean variation of oesophageal diameter before and after treatment is −2.1 mm for surgery and 1.74 mm for pneumatic dilation (OR 0.167, CI 95% 0.02–1.419, and P: 0.10. The variations of all variables, with the exception of the oesophageal diameter variation, are strongly related to the treatment performed. Conclusions. The barium X-ray study of the digestive tract, performed before and after different treatment approaches, demonstrates that the surgical treatment has to be considered as the treatment of choice of achalasia, reserving endoscopic treatment to patients with high operative risk and refusing surgery.

[High complication rate after surgical treatment of ankle fractures].

Science.gov (United States)

Bjørslev, Naja; Ebskov, Lars; Lind, Marianne; Mersø, Camilla

2014-08-04

The purpose of this study was to determine the quality and re-operation rate of the surgical treatment of ankle fractures at a large university hospital. X-rays and patient records of 137 patients surgically treated for ankle fractures were analyzed for: 1) correct classification according to Lauge-Hansen, 2) if congruity of the ankle joint was achieved, 3) selection and placement of the hardware, and 4) the surgeon's level of education. Totally 32 of 137 did not receive an optimal treatment, 11 were re-operated. There was no clear correlation between incorrect operation and the surgeon's level of education.

Salivary duct carcinoma in the mandible: a case report.

Science.gov (United States)

Kikuchi, Yoshinao; Hirota, Makoto; Iwai, Toshinori; Aoki, Shinjiro; Chikumaru, Hiroshi; Kawabe, Ryoichi; Matsui, Yoshiro

2007-03-01

Salivary duct carcinoma (SDC) is a distinctive and aggressive neoplasm. The most frequent site of origin is the parotid gland, followed by the submandibular gland. SDC originating in the minor salivary glands, particularly in the ectopic glands within the mandible, is extremely rare. We describe a 62-year-old man with SDC in the mandible, who presented with a painless lump in the right submandibular region (later identified as lymph node metastasis) and ipsilateral mental nerve palsy. Histologic examination after ablative surgery revealed SDC originating in the mandible and cervical nodal metastases spreading to levels I-III. The patient remains alive 59 months after presentation as a result of postoperative full-dose irradiation and regular intensive chemotherapy using TXT, 5-FU, and CDDP. However, the patient has local recurrence and distant metastases to the lung and brain. In this report, we also discuss the specific diagnostic criteria and developmental theories of intraosseous salivary gland tumors.

Condition-specific Quality of Life Assessment at Each Stage of Class III Surgical Orthodontic Treatment -A Prospective Study.

Science.gov (United States)

Tachiki, Chie; Nishii, Yasushi; Takaki, Takashi; Sueishi, Kenji

2018-01-01

Surgical orthodontic treatment has been reported to improve oral health-related quality of life (OHRQL). Such treatment comprises three stages: pre-surgical orthodontic treatment; orthognathic surgery; and post-surgical orthodontic treatment. Most studies have focused on change in OHRQL between before and after surgery. However, it is also necessary to evaluate OHRQL at the pre-surgical orthodontic treatment stage, as it may be negatively affected by dental decompensation compared with at pre-treatment. The purpose of this prospective study was to investigate the influence of surgical orthodontic treatment on QOL by assessing change in condition-specific QOL at each stage of treatment in skeletal class III cases. Twenty skeletal class III patients requiring surgical orthodontic treatment were enrolled in the study. Each patient completed the Orthognathic Quality of Life Questionnaire (OQLQ), which was developed for patients with dentofacial deformity. Its items are grouped into 4 domains: "social aspects of dentofacial deformity"; "facial esthetics"; "oral function"; and "awareness of dentofacial esthetics". The questionnaire was completed at the pre-treatment, pre-surgical orthodontic treatment, and post-surgical orthodontic treatment stages. The results revealed a significant worsening in scores between at pre-treatment and pre-surgical orthodontic treatment in the domains of facial esthetics and oral function (ppre-surgical orthodontic and post-surgical orthodontic treatment in all domains except awareness of dentofacial esthetics (ppre-surgical orthodontic treatment stage. Significant correlations were also observed between improvement in upper and lower lip difference, soft tissue pogonion protrusion, and ANB angle and improvement in OQLQ scores at the post-surgical orthodontic treatment stage. These results indicate that morphologic change influences OHRQL in patients undergoing surgical orthodontic treatment not only after surgery, but also during pre-surgical

Medical versus surgical treatment for refractory or recurrent peptic ulcer.

Science.gov (United States)

Gurusamy, Kurinchi Selvan; Pallari, Elena

2016-03-29

Refractory peptic ulcers are ulcers in the stomach or duodenum that do not heal after eight to 12 weeks of medical treatment or those that are associated with complications despite medical treatment. Recurrent peptic ulcers are peptic ulcers that recur after healing of the ulcer. Given the number of deaths due to peptic ulcer-related complications and the long-term complications of medical treatment (increased incidence of fracture), it is unclear whether medical or surgical intervention is the better treatment option in people with recurrent or refractory peptic ulcers. To assess the benefits and harms of medical versus surgical treatment for people with recurrent or refractory peptic ulcer. We searched the specialised register of the Cochrane Upper GI and Pancreatic Diseases group, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and trials registers until September 2015 to identify randomised trials and non-randomised studies, using search strategies. We also searched the references of included studies to identify further studies. We considered randomised controlled trials and non-randomised studies comparing medical treatment with surgical treatment in people with refractory or recurrent peptic ulcer, irrespective of language, blinding, or publication status for inclusion in the review. Two review authors independently identified trials and extracted data. We planned to calculate the risk ratio, mean difference, standardised mean difference, or hazard ratio with 95% confidence intervals using both fixed-effect and random-effects models with Review Manager 5 based on intention-to-treat analysis. We included only one non-randomised study published 30 years ago in the review. This study included 77 participants who had gastric ulcer and in whom medical therapy (histamine H2 receptor blockers, antacids, and diet) had failed after an average duration of treatment of 29 months. The

Surgical Treatment for Achalasia of the Esophagus: Laparoscopic Heller Myotomy

Directory of Open Access Journals (Sweden)

Gonzalo Torres-Villalobos

2013-01-01

Full Text Available Achalasia is an esophageal motility disorder that leads to dysphagia, chest pain, and weight loss. Its diagnosis is clinically suspected and is confirmed with esophageal manometry. Although pneumatic dilation has a role in the treatment of patients with achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed achalasia. This review will focus on the surgical treatment of achalasia, with special emphasis on laparoscopic Heller myotomy. We will also present a brief discussion of the evaluation of patients with persistent or recurrent symptoms after surgical treatment for achalasia and emerging technologies such as LESS, robot-assisted myotomy, and POEM.

Surgical treatment of craniofacial haemangioma in children

African Journals Online (AJOL)

Keywords: craniofacial area, haemangioma, surgical treatment ... Correspondence to Kamal Abdel-Elah Aly, Pediatric Surgery Unit, ..... Adverse effects of systemic glucocorticosteroid therapy in infants with hemangiomas. Arch Dermatol 2004; 140:963–969. 23 Siegfried EC, Keenan WJ, Al Jureidini S. More on propranolol ...

[Surgical treatment of Marfan syndrome; analysis of the patients required multiple surgical interventions].

Science.gov (United States)

Yamazaki, F; Shimamoto, M; Fujita, S; Nakai, M; Aoyama, A; Chen, F; Nakata, T; Yamada, T

2002-07-01

Without treatment, the life expectancy of patients with Marfan syndrome is reduced by the associated cardiovascular abnormalities. In this study, we reviewed our experience of the patients with Marfan syndrome who required multiple surgical interventions to identify the optimal treatment for these patients. Between January 1986 and December 2000, 44 patients with Marfan syndrome were operated on at Shizuoka City Hospital (SCH). Among them, 10 patients (22.7%) underwent multiple surgical interventions. There were 5 male and 5 female patients with a mean age of 40.6 +/- 16.1 years at the initial surgery. Only one patient was operated on at another hospital for his first, second, and third operations. His fourth operation was carried out at SCH. The remaining 9 patients underwent a total of 14 additional surgical procedures at SCH. Computed tomography (CT) scans were taken every 6 months postoperatively, and aortic diameter greater than 60 mm was considered as the indication for the additional surgery. There were no early death and one late death. The causes of additional surgery were enlargement of true aneurysm in 6, enlargement of residual dissection in 4, new dissection in 4, false aneurysm at the coronary anastomosis of Bentall procedure in 1. In 9 patients, both ascending and descending aorta were replaced. Among these 9 patients, only 3 patients underwent total arch replacement, and remaining 6 patients had their arch left in place with or without dissection. Our current strategy of the treatment of Marfan patients with acute type A dissection is total arch replacement with an elephant trunk at the initial emergent surgery.

Erythritol-Enriched Air-Polishing Powder for the Surgical Treatment of Peri-Implantitis

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Silvio Taschieri

2015-01-01

Full Text Available Peri-implantitis represents a major complication that can compromise the success and survival of implant-supported rehabilitations. Both surgical and nonsurgical treatment protocols were proposed to improve clinical parameters and to treat implants affected by peri-implantitis. A systematic review of the literature was performed on electronic databases. The use of air-polishing powder in surgical treatment of peri-implantitis was investigated. A total of five articles, of different study designs, were included in the review. A meta-analysis could not be performed. The data from included studies reported a substantial benefit of the use of air-polishing powders for the decontamination of implant surface in surgical protocols. A case report of guided bone regeneration in sites with implants affected by peri-implantitis was presented. Surgical treatment of peri-implantitis, though demanding and not supported by a wide scientific literature, could be considered a viable treatment option if an adequate decontamination of infected surfaces could be obtained.

Surgical treatment of gross posttraumatic deformations in thoracic spine

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Aleksei E. Shul’ga

2017-10-01

Full Text Available Rigid severe post-traumatic thoracic spine deformities result from frequent, recent high-energy trauma in children with an increasing frequency due to a variety of reasons. These types of injuries are commonly followed by spinal cord anatomic injury; therefore, the treatment of these patients warrants special attention from the ethical viewpoint. Generally, the only indication for surgical intervention is spinal dysfunction. Considering this and the patients’ ordinary severe somatic state, surgical trauma should be minimized as much as possible. However, for adequate deformity correction, effective spine stabilization and restoration of liquorodynamics is necessary. Recent studies have reported the successful use of different methods of dorsal interventions (P/VCR in cases with unstable damages in children. Here, we present the case of a 15-year-old boy who underwent surgical treatment for coarse post-traumatic thoracic spine deformity with chronic fracture-dislocation of Th7 vertebra.

Surgical Non-Regenerative Treatments for Peri-Implantitis: a Systematic Review

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Ausra Ramanauskaite

2016-09-01

Full Text Available Objectives: The purposes of the present study were 1 to systematically review the literature on the surgical non-regenerative treatments of peri-implantitis and 2 to determine a predictable therapeutic option for the clinical management of peri-implantitis lesions. Material and Methods: The study search was performed on primary database MEDLINE and EMBASE from 2005 until 2016. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported changes in probing depth (PD and/or bleeding on probing (BOP and/or radiologic marginal bone level changes after peri-implantitis surgical non-regenerative treatment at 6-month follow-up or longer were included accordingly PRISMA guidelines. Results: The first electronic and hand search resulted in 765 citations. From 16 full-text articles reviewed, 6 were included in this systematic review. Surgical non-regenerative methods were found to be efficient in reducing clinical parameters. BOP and PD values were significantly decreased following implantoplasty and systematic administration of antibacterials, but not after local application of chemical compounds or diode laser. Similarly, significant improvement in clinical and radiographic parameters was found only after implantoplasty compared with resective surgery alone. We found significant heterogeneity in study designs and treatments provided among the pooled studies. All of the studies revealed an unclear or high risk of bias. Conclusions: Surgical non-regenerative treatment of peri-implantitis was found to be effective to reduce the soft tissue inflammation and decrease probing depth. More randomized controlled clinical trials are needed to assess the efficacy of surgical non-regenerative therapy of peri-implantitis.

[Surgical treatment of gynecomastia: an algorithm].

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Wolter, A; Scholz, T; Diedrichson, J; Liebau, J

2013-04-01

Gynecomastia is a persistent benign uni- or bilateral enlargement of the male breast ranging from small to excessive findings with marked skin redundancy. In this paper we introduce an algorithm to facilitate the selection of the appropriate surgical technique according to the presented morphological aspects. The records of 118 patients (217 breasts) with gynecomastia from 01/2009 to 08/2012 were retrospectively reviewed. The authors conducted three different surgical techniques depending on four severity grades. The outcome parameters complication rate, patient satisfaction with the aesthetic result, nipple sensitivity and the need to re-operate were observed and related to the employed technique. In 167 (77%) breasts with moderate breast enlargement without skin redundancy (Grade I-IIa by Simon's classification) a subcutaneous semicircular periareolar mastectomy was performed in combination with water-jet assisted liposuction. In 40 (18%) breasts with skin redundancy (Grade IIb) a circumferential mastopexy was performed additionally. An inferior pedicled mammaplasty was used in 10 (5%) severe cases (Grade III). Complication rate was 4.1%. Surgical corrections were necessary in 17 breasts (7.8%). The patient survey revealed a high satisfaction level: 88% of the patients rated the aesthetic results as "very good" or "good", nipple sensitivity was rated as "very good" or "good" by 83%. Surgical treatment of gynecomastia should ensure minimal scarring while respecting the aesthetic unit. The selection of the appropriate surgical method depends on the severity grade, the presence of skin redundancy and the volume of the male breast glandular tissue. The presented algorithm rarely leads to complications, is simple to perform and shows a high satisfaction rate and a preservation of the nipple sensitivity. © Georg Thieme Verlag KG Stuttgart · New York.

Surgical tools and medical devices

CERN Document Server

Jackson, Mark

2016-01-01

This new edition presents information and knowledge on the field of biomedical devices and surgical tools. The authors look at the interactions between nanotechnology, nanomaterials, design, modeling, and tools for surgical and dental applications, as well as how nanostructured surfaces can be created for the purposes of improving cell adhesion between medical devices and the human body. Each original chapter is revised in this second edition and describes developments in coatings for heart valves, stents, hip and knee joints, cardiovascular devices, orthodontic applications, and regenerative materials such as bone substitutes. There are also 8 new chapters that address: Microvascular anastomoses Inhaler devices used for pulmonary delivery of medical aerosols Surface modification of interference screws Biomechanics of the mandible (a detailed case study) Safety and medical devices The synthesis of nanostructured material Delivery of anticancer molecules using carbon nanotubes Nano and micro coatings for medic...

Tongue-mandible coupling movements during saliva swallowing.

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Bourdiol, P; Mishellany-Dutour, A; Peyron, M-A; Woda, A

2014-03-01

The purpose of this study was to measure the tongue and mandible positions and displacements in relation to the maxilla in the midsagittal plane to characterize the different saliva swallowing patterns by recording their kinematics. A 2D electromagnetic articulograph using four transducer coils, three attached to the upper surface of the tongue midline plus one attached to the chin anterior part allowed continuous evaluation of tongue and chin movements in twelve young adults in good general health. During 170 s sequences recorded at a frequency of 100 Hz, subjects were at rest, silently reading a text they had chosen. The subjects were free to swallow during the sequence. Deglutition of accumulated saliva was analysed after averaging all values obtained during successive 250 ms periods. We identified three elementary swallowing patterns. Mean duration of tongue-mandible movements were 1·51 ± 0·17 s, 1·63 ± 0·14 s and 2·00 ± 0·08 s for the first, second and third patterns respectively. In the light of other studies based on intra-oral pressure recordings, our results help to understand the tongue-mandible coupling behaviours involved in managing an in-mouth saliva bolus during the three elementary swallowing patterns identified. © 2014 John Wiley & Sons Ltd.

History of surgical treatments for hallux valgus.

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Galois, Laurent

2018-05-31

In the nineteenth century, the prevalent understanding of the hallux valgus was that it was purely an enlargement of the soft tissue, first metatarsal head, or both, most commonly caused by ill-fitting footwear. Thus, treatment had varying results, with controversy over whether to remove the overlying bursa alone or in combination with an exostectomy of the medial head. Since 1871, when the surgical technique was first described, many surgical treatments for the correction of hallux valgus have been proposed. A number of these techniques have come into fashion, and others have fallen into oblivion. Progress in biomechanical knowledge, and improvements in materials and supports have allowed new techniques to be developed over the years. We have developed techniques that sacrifice the metatarsophalangeal joint (arthrodesis, arthroplasties), as well as conservative procedures, and one can distinguish those which only involve the soft tissues from those that are linked with a first ray osteotomy.

Surgical treatment of rib fracture nonunion: A single center experience.

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de Jong, M B; Houwert, R M; van Heerde, S; de Steenwinkel, M; Hietbrink, F; Leenen, L P H

2018-03-01

In contrast to the emerging evidence on the operative treatment of flail chest, there is a paucity of literature on the surgical treatment of rib fracture nonunion. The purpose of this study was to describe our standardized approach and report the outcome (e.g. patient satisfaction, pain and complications) after surgical treatment of a rib fracture nonunion. A single centre retrospective cohort study was performed at a level 1 trauma centre. Symptomatic rib nonunion was defined as a severe persistent localized pain associated with the nonunion of one or more rib fractures on a chest CT scan at least 3 months after the initial trauma. Patients after initial operative treatment of rib fractures were excluded. Nineteen patients (11 men, 8 women), with symptomatic nonunions were included. Fourteen patients were referred from other hospitals and 8 patients received treatment from a pain medicine specialist. The mean follow-up was 36 months. No in-hospital complications were observed. In 2 patients, new fractures adjacent to the implant, without new trauma were observed. Furthermore 3 patients requested implant removal with a persistent nonunion in one patient. There was a mean follow-up of 36 months, the majority of patients (n = 13) were satisfied with the results of their surgical treatment and all patients experienced a reduction in the number of complaints. Persisting pain was a common complaint. Three patients reporting severe pain used opioid analgesics on a daily or weekly basis. Only 1 patient needed ongoing treatment by a pain medicine specialist. Surgical fixation of symptomatic rib nonunion is a safe and feasible procedure, with a low perioperative complication rate, and might be beneficial in selected symptomatic patients in the future. In our study, although the majority of patients were satisfied and the pain level subjectively decreases, complaints of persistent pain were common. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Surgical treatment of pediatric pulmonary metastases].

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Costa Borrás, E; Ferrís i Tortajada, J; Jovaní Casano, C; Segarra Llido, V; Bermúdez Cortés, M; Cañete Nieto, A; Velázquez Terrón, J

1998-07-01

We comment and update the surgical treatment for pulmonary metastases (PM) within a multidisciplinary approach for paediatric cancer. We analyse patients with PM who have been operated between 1976-1996. Scientific literature published in the last 25 years (Cancerlit and Medline) was reviewed. PM from 13 patients were removed. Seven were males and 6 females with a mean age 5 4/12 years (range: 11 months- 12 3/12 years). Diagnoses were Wilms' tumour (7), osteosarcoma (3), Ewing sarcoma (1), rabdomiosarcoma (1), Yolk sac tumour (1). PM were unilateral in 7 cases and bilateral in six cases. PM appeared synchronically in four patients and metacronically in nine cases (3 of these after chemotherapy). All patients received chemotherapy and four of them local radiotherapy. Surgery consisted on radical segmentectomy and only one patient needed lobectomy due to a local relapse. Nowadays five patients (38%) are in complete remission with a mean follow-up from surgery of 11 11/12 years (range: 6 3/12-20 years). Metastasectomy is an important surgical technique in global treatment of children with PM and for a selected group of patients it can offer the only opportunity for curation.

Autologous fat graft as treatment of post short stature surgical correction scars.

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Maione, Luca; Memeo, Antonio; Pedretti, Leopoldo; Verdoni, Fabio; Lisa, Andrea; Bandi, Valeria; Giannasi, Silvia; Vinci, Valeriano; Mambretti, Andrea; Klinger, Marco

2014-12-01

Surgical limb lengthening is undertaken to correct pathological short stature. Among the possible complications related to this procedure, painful and retractile scars are a cause for both functional and cosmetic concern. Our team has already shown the efficacy of autologous fat grafting in the treatment of scars with varying aetiology, so we decided to apply this technique to scars related to surgical correction of dwarfism. A prospective study was conducted to evaluate the efficacy of autologous fat grafting in the treatment of post-surgical scars in patients with short-limb dwarfism using durometer measurements and a modified patient and observer scar assessment scale (POSAS), to which was added a parameter to evaluate movement impairment. Between January 2009 and September 2012, 36 children (28 female and 8 male) who presented retractile and painful post-surgical scars came to our unit and were treated with autologous fat grafting. Preoperative and postoperative mean durometer measurements were analysed using the analysis of variance (ANOVA) test and POSAS parameters were studied using the Wilcoxon rank sum test. There was a statistically significant reduction in all durometer measurements (p-value treatment with autologous fat grafting. Surgical procedures to camouflage scars on lower limbs are not often used as a first approach and non-surgical treatments often lead to unsatisfactory results. In contrast, our autologous fat grafting technique in the treatment of post-surgical scars has been shown to be a valuable option in patients with short-limb dwarfism. There was a reduction of skin hardness and a clinical improvement of all POSAS parameters in all patients treated. Moreover, the newly introduced POSAS parameter appears to be reliable and we recommend that it is included to give a more complete evaluation of patient perception. Copyright © 2014 Elsevier Ltd. All rights reserved.

Open, Arthroscopic, and Percutaneous Surgical Treatment of Lateral Epicondylitis: A Systematic Review.

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Burn, Matthew B; Mitchell, Ronald J; Liberman, Shari R; Lintner, David M; Harris, Joshua D; McCulloch, Patrick C

2017-03-01

Approximately 10% of patients with lateral epicondylitis go on to have surgical treatment; however, multiple surgical treatment options exist. The purpose of this study was to review the literature for the clinical outcomes of open, arthroscopic, and percutaneous treatment of lateral epicondylitis. The authors hypothesized that the clinical outcome of all 3 analyzed surgical treatments would be equivalent. A systematic review was performed using PubMed, Cochrane Central Register of Controlled Trials, and Google Scholar in July 2016 to compare the functional outcome, pain, grip strength, patient satisfaction, and return to work at 1-year follow-up for open, arthroscopic, and percutaneous treatment of lateral epicondylitis. Six studies (2 Level I and 4 Level II) including 179 elbows (83 treated open, 14 arthroscopic, 82 percutaneous) were analyzed. Three outcome measures (Disabilities of the Arm, Shoulder, and Hand [DASH] score, visual analog scale [VAS], and patient satisfaction) were reported for more than one category of surgical technique. Of these, the authors noted no clinically significant differences between the techniques. This is the first systematic review looking at high-level evidence to compare open, percutaneous, and arthroscopic techniques for treating lateral epicondylitis. There are no clinically significant differences between the 3 surgical techniques (open, arthroscopic, and percutaneous) in terms of functional outcome (DASH), pain intensity (VAS), and patient satisfaction at 1-year follow-up.

Surgical Treatment of Hepatocellular Carcinoma

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Zamora-Valdes, Daniel; Taner, Timucin; Nagorney, David M.

2017-01-01

Hepatocellular carcinoma (HCC) is a major cause of cancer-related death worldwide. In select patients, surgical treatment in the form of either resection or transplantation offers a curative option. The aims of this review are to (1) review the current American Association for the Study of Liver Diseases/European Association for the Study of the Liver guidelines on the surgical management of HCC and (2) review the proposed changes to these guidelines and analyze the strength of evidence underlying these proposals. Three authors identified the most relevant publications in the literature on liver resection and transplantation for HCC and analyzed the strength of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification. In the United States, the liver allocation system provides priority for liver transplantation to patients with HCC within the Milan criteria. Current evidence suggests that liver transplantation may also be indicated in certain patient groups beyond Milan criteria, such as pediatric patients with large tumor burden or adult patients who are successfully downstaged. Patients with no underlying liver disease may also benefit from liver transplantation if the HCC is unresectable. In patients with no or minimal (compensated) liver disease and solitary HCC ≥2 cm, liver resection is warranted. If liver transplantation is not available or contraindicated, liver resection can be offered to patients with multinodular HCC, provided that the underlying liver disease is not decompensated. Many patients may benefit from surgical strategies adapted to local resources and policies (hepatitis B prevalence, organ availability, etc). Although current low-quality evidence shows better overall survival with aggressive surgical strategies, this approach is limited to select patients. Larger and well-designed prospective studies are needed to better define the benefits and limits of such approach. PMID:28975836

Surgical treatment of bronchiectasis: A review of 20 years of experience

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D. Coutinho

2016-03-01

Full Text Available Background: Bronchiectasis is defined as an abnormal and irreversible dilation and distortion of the bronchi, which has numerous causes. Surgical treatment of this disease is usually reserved for focal disease and when the medical treatment is no longer effective. We report our center experience and outcomes in bronchiectasis surgery during the last 20 years. Methods: Between 1994 and 2014, sixty-nine patients underwent surgical resection for bronchiectasis. Patient demographics, presenting symptoms, indications for surgical treatment, type of lung resection, morbidity and mortality, as well as clinical follow-up and outcomes were analyzed. Results: From the 69 patients included, 31 (44.9% were male and 38 (55.1% were female. Surgery was indicated because of unsuccessful medical therapy in 33 patients (47.8%, haemoptysis in 22 patients (31.9%, nondiagnostic lung mass in 9 patients (13.0% and lung abscess in 5 patients (7.3%. The surgical procedures were lobectomy in 45 (65.2% patients, pneumonectomy in 10 (14.5% patients, bilobectomy in 8 (11.6% patients, lobectomy plus segmentectomy in 3 (4.3% patients and only segmentectomy in 3 (4.3% patients. Morbidity rate was 14.5% and there was no perioperative mortality. The follow-up was possible in 60 patients, with an outcome reported as excellent in 44 (73.3% patients, as improved in 11 (18.3% and as unchanged in 5 (8.3%. Conclusion: Although the number of patients with bronchiectasis referred for surgical treatment has decreased, pulmonary resection still plays a significant role. Surgical resection of localized bronchiectasis is a safe procedure with proven improvement of quality of life for the majority of patients. Keywords: Bronchiectasis, Thoracic surgery

[Surgical treatment of esophageal achalasia--20 years experience].

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Yaramov, N; Sokolov, M; Angelov, K; Toshev, S; Petrov, B

2009-01-01

Achalasia comes from a Greek word that means "failure to relax." Cardiospasm and achalasia refer to the same condition. This report addresses esophageal achalasia--its history, diagnosis, pathophysiology, and treatment options. We report our experience in treating this disorder surgically using modified Heller myotomy combined or not with partial gastric fundoplication. 47 patients with achalasia surgically operated in 20-years period are reported by authors. These features make it reasonable to reasses the relative indications for surgery and nonsurgical therapy in achalasia of the esophagus.

Outcomes of Surgical Treatment for Anterior Tibial Stress Fractures in Athletes: A Systematic Review.

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Chaudhry, Zaira S; Raikin, Steven M; Harwood, Marc I; Bishop, Meghan E; Ciccotti, Michael G; Hammoud, Sommer

2017-12-01

Although most anterior tibial stress fractures heal with nonoperative treatment, some may require surgical management. To our knowledge, no systematic review has been conducted regarding surgical treatment strategies for the management of chronic anterior tibial stress fractures from which general conclusions can be drawn regarding optimal treatment in high-performance athletes. This systematic review was conducted to evaluate the surgical outcomes of anterior tibial stress fractures in high-performance athletes. Systematic review; Level of evidence, 4. In February 2017, a systematic review of the PubMed, MEDLINE, Cochrane, SPORTDiscus, and CINAHL databases was performed to identify studies that reported surgical outcomes for anterior tibial stress fractures. Articles meeting the inclusion criteria were screened, and reported outcome measures were documented. A total of 12 studies, published between 1984 and 2015, reporting outcomes for the surgical treatment of anterior tibial stress fractures were included in this review. All studies were retrospective case series. Collectively, surgical outcomes for 115 patients (74 males; 41 females) with 123 fractures were evaluated in this review. The overall mean follow-up was 23.3 months. The most common surgical treatment method reported in the literature was compression plating (n = 52) followed by drilling (n = 33). Symptom resolution was achieved in 108 of 123 surgically treated fractures (87.8%). There were 32 reports of complications, resulting in an overall complication rate of 27.8%. Subsequent tibial fractures were reported in 8 patients (7.0%). Moreover, a total of 17 patients (14.8%) underwent a subsequent procedure after their initial surgery. Following surgical treatment for anterior tibial stress fracture, 94.7% of patients were able to return to sports. The available literature indicates that surgical treatment of anterior tibial stress fractures is associated with a high rate of symptom resolution and return

Thin-plate spline (TPS) graphical analysis of the mandible on cephalometric radiographs.

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Chang, H P; Liu, P H; Chang, H F; Chang, C H

2002-03-01

We describe two cases of Class III malocclusion with and without orthodontic treatment. A thin-plate spline (TPS) analysis of lateral cephalometric radiographs was used to visualize transformations of the mandible. The actual sites of mandibular skeletal change are not detectable with conventional cephalometric analysis. These case analyses indicate that specific patterns of mandibular transformation are associated with Class III malocclusion with or without orthopaedic therapy, and visualization of these deformations is feasible using TPS graphical analysis.

[Mandible function in taking construction bite for activator].

Science.gov (United States)

Irie, M

1989-06-01

Functional effects of construction bite for activator (Andresen type) especially on lateral pterygoid muscle, as well as the positional changes of the mandible, hyoid bone and surface EMGs from bilateral anterior temporal (TA) and masseter (MM) muscle, were studied on the electric force scale, MKG, EMG and cephalometric radiographs in 14 subjects with anterior cross bite in mixed dentition. The cephalometric radiographs were taken at the start of each patient's treatment. One was taken with the mandible in the intercuspal position and one was also taken with the activator in the mouth at the overjet improvement. The activator patients were divided into two groups because of differences in the direction of movement of the hyoid bone in the FH plane. In group O (7 patients), the movement of the hyoid bone was at an oblique angle to the FH plane, while in group D (7 patients) the movement ot the hyoid bone with nearly direct below angle to FH plane. The patients were further divided into three types because of differences in the distance between the hyoid bone and mental spine, and combined with the groups OA (3 patients), OB (2 patients), OC (2 patients), DA (5 patients), DB (2 patients) and DC (Naught). The results obtained were as follows: The forces for the construction bite for groups O and D were 2.71 Kg and 2.72 kg, respectively. Type OC required significantly heavier force. (p less than 0.05) In the condylar test, O group was significantly smaller at the start of treatment, but not after overjet improvement. Type OA and OB were also significantly smaller at the start of treatment. (p less than 0.05) Velocity of opening for group D was significantly (p less than 0.05) faster at the start of treatment, but not after that. There was no significant difference in EMGs between the groups, with activator in the mouse D group much increased as it EMGs. The EMGs M/T ratio for both groups was approximately 100% at the start of treatment for overjet improvement. In cases

Brown Tumour in the Mandible and Skull Osteosclerosis Associated with Primary Hyperparathyroidism – A Case Report

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Danica Popovik-Monevska

2018-02-01

Full Text Available BACKGROUND: The hyperparathyroidism (HPT is a condition in which the parathyroid hormone (PTH levels in the blood are increased. HPT is categorised into primary, secondary and tertiary. A rare entity that occurs in the lower jaw in association with HPT is the so-called brown tumour, which an osteolytic lesion is predominantly occurring in the lower jaw. It is usually a manifestation of the late stage of the disease. Osteosclerotic changes in other bones are almost always associated with renal osteodystrophy in secondary HPT and are extremely rare in primary HPT. This article reports a rare case of a brown tumour in the mandible as the first sign of a severe primary HPT, associated with osteosclerotic changes on the skull. CASE REPORT: A brown tumour in the mandible was diagnosed in 60 - year old female patient with no previous history of systemic disease. The x - rays showed radiolucent osteolytic lesion in the frontal area of the mandible affecting the lamina dura of the frontal teeth, and skull osteosclerosis in the form of salt and pepper sign. The blood analyses revealed increased values of PTH, calcitonin and β – cross-laps, indicating a primary HPT. The scintigraphy of the parathyroid glands showed a presence of adenoma in the left lower lobe. The tumour lesion was surgically removed together with the lower frontal teeth, and this was followed by total parathyroidectomy. The follow - up of one year did not reveal any signs of recurrence. CONCLUSION: It is critical to ensure that every osteolytic lesion in the maxillofacial region is examined thoroughly. Moreover, a proper and detailed systemic investigation should be performed. Patients should undergo regular check-ups to prevent late complications of HPT.

Surgical Anatomy of the Cervical Part of the Hypoglossal Nerve.

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Kariuki, Brian Ngure; Butt, Fawzia; Mandela, Pamela; Odula, Paul

2018-03-01

Iatrogenic injuries to cranial nerves, half of which affect the hypoglossal nerve, occur in up to 20% of surgical procedures involving the neck. The risk of injury could be minimized by in-depth knowledge of its positional and relational anatomy. Forty-one hypoglossal nerves were dissected from cadaveric specimens and positions described in relation to the internal carotid artery (ICA), external carotid artery (ECA), carotid bifurcation, mandible, hyoid bone, mastoid process, and the digastric tendon. The distance of the nerve from where it crossed the ICA and ECA to the carotid bifurcation was 29.93 (±5.99) mm and 15.19 (±6.68) mm, respectively. The point where it crossed the ICA was 12.24 (±3.71) mm superior to the greater horn of hyoid, 17.16 (±4.40) mm inferior to the angle of the mandible, and 39.08 (±5.69) mm from tip of the mastoid. The hypoglossal nerve loop was inferior to the digastric tendon in 73% of the cases. The hypoglossal nerves formed high loops in this study population. Caution should be exercised during surgical procedures in the neck. The study also revealed that the mastoid process is a reliable fixed landmark to locate the hypoglossal nerve.

[Surgical treatment of anal fistula].

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Zeng, Xiandong; Zhang, Yong

2014-12-01

Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

An Analysis of Surgical Treatment for the Spontaneous Rupture of Hepatocellular Carcinoma.

Science.gov (United States)

Sada, Haruki; Ohira, Masahiro; Kobayashi, Tsuyoshi; Tashiro, Hirotaka; Chayama, Kazuaki; Ohdan, Hideki

2016-01-01

The prognosis of spontaneous rupture of hepatocellular carcinoma (HCC) remains unclear. We investigated the prognosis of patients with ruptured HCC based on the treatments and prognostic factors associated with long-term survival. The prognoses of 64 consecutive patients treated for ruptured HCC from 1986 to 2013 were analyzed according to their methods of treatment. The prognostic factors of 16 surgical patients were identified, and their overall survival (OS) and recurrence rates were compared to 1,157 surgical patients who underwent surgery for non-ruptured HCC. The surgical outcomes were also compared using a propensity score matching method. Surgery was associated with a better OS. Curative resection was the only independent prognostic factor in surgical patients with ruptured HCC (p = 0.040). Although the OS of surgical patients with non-ruptured HCC was found to be significantly better than that of the patients with ruptured HCC, no significant difference in OS was observed after propensity score matching. A curative resection should be the objective of treatment, assuming the suitability of the patient's clinical condition. When the liver function reserve and tumor extension of patients with ruptured and non-ruptured HCC are similar, then their surgical outcomes may not be significantly different. © 2015 S. Karger AG, Basel.

Longitudinal study of relative growth rates of the maxilla and the mandible according to quantitative cervical vertebral maturation.

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Chen, Lili; Liu, Jiarong; Xu, Tianmin; Lin, Jiuxiang

2010-06-01

The purpose of this study was to investigate the relative growth rates (RGR) of the maxilla and the mandible according to quantitative cervical vertebral maturation (QCVM) of adolescents with normal occlusion. Mixed longitudinal data were used. The sample included 87 adolescents (32 boys, 55 girls) from 8 to 18 years of age with normal occlusion, selected from 901 candidates. Sequential lateral cephalograms and hand-wrist films were taken once a year for 6 consecutive years. The growth magnitude (GM) and RGR of the maxilla and the mandible were measured and analyzed. GM and RGR were not always consistent, because subjects had different periods of time between the QCVM stages. GM was not as reliable as RGR. RGR had no significant sex differences in the maxilla and the mandible, in spite of different decelerating curves. However, statistically significant sex differences were found in the GM of mandibular measurements. The greatest growth potentials were not synchronized between the maxilla and the mandible. For both sexes, the greatest RGR of maxillary length and height was in QCVM stage I; then, deceleration occurred. The greatest RGR of mandibular length and height was in QCVM stage II, and the next largest was in QCVM stage I. Understanding the RGR can provide references for orthodontic treatment and orthognathic surgery. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Pattern of surgical periodontal treatment in a Nigerian Teaching Hospital: A 37 month review

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Clement Chinedu Azodo

2016-01-01

Conclusion: Periodontal abscess and gingival enlargement constituted the main indications for surgical periodontal treatment while incision and drainage and gingivectomy were the main surgical periodontal treatments in this study.

Medical and surgical treatment of primary divergent strabismus.

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Noguera, H; Castiella Acha, J C; Anguiano Jimenez, M

2014-11-01

To evaluate the long-term effectiveness of different therapies applied in the past 30 years, both medical and surgical, and results, with the ultimate aim of determining which are the most appropriate criteria to indicate when and how to perform medical and surgical treatment in these patients. A retrospective randomized study was conducted on 198 patients with primary divergent strabismus first seen in our clinic (IOC) in the last 36 years (1976-2012), with a mean follow-up of 8.38 years. Demographic and clinical characteristics, as well as the various treatments performed, and motor and sensory outcome were collected. They were finally divided into 3 groups of 70, 71 and 56 patients, respectively, according to their first visit, in order to compare the therapies applied. Half (50%) of our patients debuted before 2 years of age (P50=24 months), and 26.3% had optimal binocular vision at the beginning of the study. Medical treatment was used as exclusive therapy in 29.3% of cases (occlusion therapy, applying negative lenses, botulinum toxin), and 70.7% required surgery (61.2% by double retro-insertion of lateral rectus, and 38.8% monolateral retro-resection). There was a recurrence in 26.7% of patients, and 40 re-interventions were performed (70% due to recurrence of divergent strabismus, 12.5% due to surgical over-correction, and 17.5% for other reasons). In the end, 61.1% of patients had perfect binocular vision (TNO=60"), and the proportion was higher in patients who showed proper control of their strabismus at the beginning (P=.003). However, no differences were found in the other variables studied. When the patients were divided into 3 groups (which are demographically comparable), an increased number of patients in Group 3 were found to be treated using negative lenses and botulinum toxin (P<.001 and P=.003). This group was found to have had a higher proportion of bilateral surgery (P=.032), seeking greater immediate postoperative over-correction, thus

Surgical treatment of oral leukoplakia

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Yuliia Kolenko

2017-04-01

Full Text Available Background: The effectiveness of care for patients with leukoplakia depends on how timely and accurately the disease was diagnosed and also by the subsequent choice of the optimal method of treatment. In recent decades, surgery is increasingly using methods that are alternative to standard surgical methods. Purpose: to justify, develop and evaluate treatment algorithm of verrucous and erosive-ulcerative forms of oral leukoplakia with a SIN2 histological structure. Materials and Methods: to achieve this goal, a comprehensive clinical and laboratory examination of 155 patients with oral leukoplakia was performed, which appealed to the Department of Therapeutic Dentistry of the  Bogomolets National Medical University in the period from 2011 to 2015. All patients underwent clinical and laboratory tests. Results: after removal of the affected area of the mucosa by radiation of an erbium laser, wound healing under fibrinous plaque was observed at 7.0 ± 0.5 days. When excision of the mucous membrane with a scalpel, the healing took place under the iodinine swab through the granulation phase for 14.0 ± 1.5 days. In patients after the operation of excision of the area of verrucous or erosive-ulcerative oral mucosa leukoplakia with laser radiation without antimicrobial and anti-inflammatory therapy on the third day, in 95% of cases there is no pain syndrome and collateral edema in the postoperative area. After traditional treatment, despite the use of antibiotics and non-steroidal anti-inflammatory drugs, 56% of patients complained of pain, and 62% had collateral edema. Conclusions: the use of ErrYAG laser laser radiation in the surgical treatment of patients with verrucous and erosive-ulcerative forms of leukoplakia promotes acceleration of healing processes of a postoperative wound twice as fast as in the control group. The use of laser technology reduces the risk of inflammatory purulent complications and helps to prevent the recurrence of the

[Surgical treatment of diffuse adult orbital lymphangioma: two case studies].

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Berthout, A; Jacomet, P V; Putterman, M; Galatoire, O; Morax, S

2008-12-01

Orbital lymphangioma is a rare vascular malformation; it is a benign but severe anomaly because of its infiltrative, diffuse, and hemorrhagic nature, and its high morbidity rate. Surgical resection is a real challenge on account of the intricate architecture of the lesion. The authors report their surgical experience concerning two cases of diffuse orbital lymphangioma whose diagnosis was established in adulthood and whose surgical treatment was successful. Two patients presented with adult orbital lymphangioma. Progression was slow during the first decade and then was quickly followed by complications: major exorbitism, compressive optic neuropathy, and corneal exposure. Neuroimaging showed a diffuse and cystic orbital malformation. Surgical resection was performed as completely as possible, in one case with a Krönlein orbitotomy and in the other case only via a conjunctive route. An aspirate drain was put in the orbit for 48 h so as to prevent dead spaces forming after resection, an essential risk factor of hemorrhagic or cystic recurrence. Systemic corticotherapy was administered for the 5 days following surgery. The resection was total in one case and subtotal in the other. The surgical follow-up was uneventful with an excellent aesthetic result and an improvement in visual acuity. After 12 months, no tumoral or hemorrhagic recurrence was noted. The surgical treatment of orbital lymphangiomas is challenging because of their infiltrative nature. In diffuse forms, a complete resection is rarely possible because of the risk of sacrificing visual function. In the two cases reported herein, the resection of the extraconal portion was complete, but the intraconal portion was completely removed only in one case. Using the aspirate drain, negative pressure was maintained in the orbital cavity, preventing the formation of chocolate cysts induced by surgery. Although the clinical result was very satisfying, long-term follow-up is necessary to evaluate recurrence

[Surgical issues and outcomes in ischial pressure sores treatment].

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Voulliaume, D; Grecea, M; Viard, R; Brun, A; Comparin, J-P; Foyatier, J-L

2011-12-01

Ischiatic pressure sores are frequent in spinal cord injury patients, associated with bad prognosis and high recurrence rate. Many surgical techniques were described, including surgical debridement followed by pedicled flap coverage. We aim to propose a practical decision tree for primary or secondary ischial pressure sore treatment. Our series of 48 operated ischial sores with an average follow up of 4 years (range 2 to 8years) is analyzed and compared to previously published reports. Surgical techniques are discussed according to their specific indications. The optimal recurrence rate in published reports about pressure sore treatment is 20%; a rate inferior to 19% is found in our series, showing the equal importance of flap selection and postoperative care and education. Depending on each situation, various available flaps are described and compared: gluteus maximus flap, biceps femoris flap, gracilis flap, tensor fascia lata flap, fasciocutaneous thigh flaps, rectus femoris and vastus lateralis flap, rectus abdominis flap. Specific surgical indications for more extensive wounds are studied: resection arthroplasty of the hip, hip disarticulation, fillet flaps from the leg, microsurgery. Based upon our experience, a decision tree summarizes our proposition of flap selection, depending on the wound size and the patient background. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Comparison of three surgical treatment options for unicameral bone cysts in humerus.

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Mavčič, Blaž; Saraph, Vinay; Gilg, Magdalena M; Bergovec, Marko; Brecelj, Janez; Leithner, Andreas

2018-04-23

Treatment of unicameral bone cysts (UBC) in the humerus with drainage screws is scarcely reported in the literature. The aim of this retrospective study was to compare drainage screws and alternative treatment methods with respect to the number of required surgical procedures to achieve sufficient UBC healing, postoperative fractures/recurrences/complications, and radiological outcome. Medical archives of two tertiary orthopedic referral centers were screened for all patients who were treated surgically for humeral UBC in the period 1991-2015 with a histologically/cytologically confirmed diagnosis. Sex, age, all surgical procedures, fractures, complications, recurrences, and the final radiological outcome were compared between patients treated with drainage screws, elastic intramedullary nails, or curettage with optional grafting. The study included 106 operated patients with a mean age of 10.3 years, with a mean follow-up of 5.7 years. The average number of UBC-related surgical procedures in sex-matched and age-matched treatment groups was 2.7 with drainage screws, 2.8 with intramedullary nails, and 3.5 with curettage/grafting (P=0.54). Intramedullary nails (odds ratio 0.20) and older age (odds ratio for each year 0.83) predicted a lower risk of postoperative UBC recurrence. Patients with drainage screws had the highest UBC recurrence rates and the lowest rates of changed initial treatment method. There was no difference between the treatment groups in the postoperative fracture rate, complications, or the final radiological outcome. UBC treatment in the humerus therefore requires approximately three surgical procedures, irrespective of the treatment modality chosen. Adding an elastic intramedullary nail to a humeral UBC cyst may reduce recurrence risk and prevent further fractures. Level III - therapeutic retrospective comparative study.

Epilepsy with dual pathology: surgical treatment of cortical dysplasia accompanied by hippocampal sclerosis.

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Kim, Dong W; Lee, Sang K; Nam, Hyunwoo; Chu, Kon; Chung, Chun K; Lee, Seo-Young; Choe, Geeyoung; Kim, Hyun K

2010-08-01

The presence of two or more epileptogenic pathologies in patients with epilepsy is often observed, and the coexistence of focal cortical dysplasia (FCD) with hippocampal sclerosis (HS) is one of the most frequent clinical presentations. Although surgical resection has been an important treatment for patients with refractory epilepsy associated with FCD, there are few studies on the surgical treatment of FCD accompanied by HS, and treatment by resection of both neocortical dysplastic tissue and hippocampus is still controversial. We retrospectively recruited epilepsy patients who had undergone surgical treatment for refractory epilepsy with the pathologic diagnosis of FCD and the radiologic evidence of HS. We evaluated the prognostic roles of clinical factors, various diagnostic modalities, surgical procedures, and the severity of pathology. A total of 40 patients were included, and only 35.0% of patients became seizure free. Complete resection of the epileptogenic area (p = 0.02), and the presence of dysmorphic neurons or balloon cells on histopathology (p = 0.01) were associated with favorable surgical outcomes. Patients who underwent hippocampal resection were more likely to have a favorable surgical outcome (p = 0.02). We show that patients with complete resection of epileptogenic area, the presence of dysmorphic neurons or balloon cells on histopathology, or resection of hippocampus have a higher chance of a favorable surgical outcome. We believe that this observation is useful in planning of surgical procedures and predicting the prognoses of individual patients with FCD patients accompanied by HS. Wiley Periodicals, Inc. © 2009 International League Against Epilepsy.

[Class III surgical patients facilitated by accelerated osteogenic orthodontic treatment].

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Wu, Jia-qi; Xu, Li; Liang, Cheng; Zou, Wei; Bai, Yun-yang; Jiang, Jiu-hui

2013-10-01

To evaluate the treatment time and the anterior and posterior teeth movement pattern as closing extraction space for the Class III surgical patients facilitated by accelerated osteogenic orthodontic treatment. There were 10 skeletal Class III patients in accelerated osteogenic orthodontic group (AOO) and 10 patients in control group. Upper first premolars were extracted in all patients. After leveling and alignment (T2), corticotomy was performed in the area of maxillary anterior teeth to accelerate space closing.Study models of upper dentition were taken before orthodontic treatment (T1) and after space closing (T3). All the casts were laser scanned, and the distances of the movement of incisors and molars were digitally measured. The distances of tooth movement in two groups were recorded and analyzed. The alignment time between two groups was not statistically significant. The treatment time in AOO group from T2 to T3 was less than that in the control group (less than 9.1 ± 4.1 months). The treatment time in AOO group from T1 to T3 was less than that in the control group (less than 6.3 ± 4.8 months), and the differences were significant (P 0.05). Accelerated osteogenic orthodontic treatment could accelerate space closing in Class III surgical patients and shorten preoperative orthodontic time. There were no influence on the movement pattern of anterior and posterior teeth during pre-surgical orthodontic treatment.

A Rare Large Residual Cyst of the Mandible

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Setareh Shojaei

2016-02-01

Full Text Available Introduction: A residual cyst is a periapical cyst persisted after its associated tooth had been extracted. Case Presentation: A 59-year-old Iranian man complaining of a dull pain in his left side of the mandible after falling down one month ago was referred to the department of oral and maxillofacial pathology, Hamadan University of Medical Sciences, Iran. Panoramic film revealed a radiolucent lesion and fracture of the mandible at the right side. An excisional biopsy was obtained. Based on the histopathologic findings, residual cyst was diagnosed. Conclusions: We reported a rare case of large residual cyst. Dental practitioners should consider this lesion in the differential diagnosis of radiolucent lesions of the jaw bone.

Results of surgical treatment for juvenile myasthenia gravis.

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Vázquez-Roque, F J; Hernández-Oliver, M O; Medrano Plana, Y; Castillo Vitlloch, A; Fuentes Herrera, L; Rivero-Valerón, D

2017-04-01

Radical or extended thymectomy is an effective treatment for myasthenia gravis in the adult population. There are few reports to demonstrate the effectiveness of this treatment in patients with juvenile myasthenia gravis. The main objective of this study was to show that extended transsternal thymectomy is a valid option for treating this disease in paediatric patients. Twenty-three patients with juvenile myasthenia gravis underwent this surgical treatment in the period between April 2003 and April 2014; mean age was 12.13 years and the sample was predominantly female. The main indication for surgery, in 22 patients, was the generalised form of the disease (Osserman stage II) together with no response to 6 months of medical treatment. The histological diagnosis was thymic hyperplasia in 22 patients and thymoma in one patient. There were no deaths and no major complications in the postoperative period. After a mean follow-up period of 58.87 months, 22 patients are taking no medication or need less medication to manage myasthenic symptoms. Extended (radical) transsternal thymectomy is a safe and effective surgical treatment for juvenile myasthenia gravis. Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Surgical treatment of primitive gastro-intestinal lymphomas: a systematic review

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Cirocchi Roberto

2011-11-01

Full Text Available Abstract Primitive Gastrointestinal Lymphomas (PGIL are uncommon tumours, although time-trend analyses have demonstrated an increase. The role of surgery in the management of lymphoproliferative diseases has changed over the past 40 years. Nowadays their management is centred on systemic treatments as chemo-/radio- therapy. Surgery is restricted to very selected indications, always discussed in a multidisciplinary setting. The aim of this systematic review is to evaluate the actual role of surgery in the treatment of PGIL. A systematic review of literature was conducted according to the recommendations of The Cochrane Collaboration. Main outcomes analysed were overall survival (OS and disease free survival (DFS. There are currently 1 RCT and 4 non-randomised prospective controlled studies comparing surgical versus medical treatment for PGIL. Seven hundred and one patients were analysed, divided into two groups: 318 who underwent to surgery alone or associated with chemotherapy and/or radiotherapy (surgical group versus 383 who were treated with chemotherapy and/or radiotherapy (medical group. Despite the OS at 10 years between surgical and medical groups did not show relevant differences, the DFS was significantly better in the medical group (P = 0.00001. Accordingly a trend was noticed in the recurrence rate, which was lower in the medical group (6.06 vs. 8.57%; and an higher mortality was revealed in the surgical group (4.51% vs. 1.50%. The chemotherapy confirms its primary role in the management of PGIL as part of systemic treatment in the medical group. Surgery remains the treatment of choice in case of PGIL acutely complicated, although there is no evidence in literature regarding the utility of preventive surgery.

Sexual dimorphism of the mandible in a contemporary Chinese Han population.

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Dong, Hongmei; Deng, Mohong; Wang, WenPeng; Zhang, Ji; Mu, Jiao; Zhu, Guanghui

2015-10-01

A present limitation of forensic anthropology practice in China is the lack of population-specific criteria on contemporary human skeletons. In this study, a sample of 203 maxillofacial Cone beam computed tomography (CBCT) images, including 96 male and 107 female cases (20-65 years old), was analyzed to explore mandible sexual dimorphism in a population of contemporary adult Han Chinese to investigate the potential use of the mandible as sex indicator. A three-dimensional image from mandible CBCT scans was reconstructed using the SimPlant Pro 11.40 software. Nine linear and two angular parameters were measured. Discriminant function analysis (DFA) and logistic regression analysis (LRA) were used to develop the mathematics models for sex determination. All of the linear measurements studied and one angular measurement were found to be sexually dimorphic, with the maximum mandibular length and bi-condylar breadth being the most dimorphic by univariate DFA and LRA respectively. The cross-validated sex allocation accuracies on multivariate were ranged from 84.2% (direct DFA), 83.5% (direct LRA), 83.3% (stepwise DFA) to 80.5% (stepwise LRA). In general, multivariate DFA yielded a higher accuracy and LRA obtained a lower sex bias, and therefore both DFA and LRA had their own advantages for sex determination by the mandible in this sample. These results suggest that the mandible expresses sexual dimorphism in the contemporary adult Han Chinese population, indicating an excellent sexual discriminatory ability. Cone beam computed tomography scanning can be used as alternative source for contemporary osteometric techniques. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Four surgical tips in the treatment of epicondylitis].

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Jiménez, I; Marcos-García, A; Muratore-Moreno, G; Medina, J

2016-01-01

Lateral epicondylitis is a common injury in the population. Most patients improve with conservative treatment, but in a small percentage surgery is necessary. The aim of this study is to analyse the clinical results obtained by a «4 surgical tips» technique. This is a retrospective study of 35 operated elbows, with a mean follow-up of 5.3 years. In all cases epicondylar denervation, removal of the angiofibroblastic degeneration core, epicondylectomy, and release of posterior interosseous nerve, was performed. Each patient was evaluated using the Broberg and Morrey Rating System (BMRS), Mayo Elbow Performance Score (MEPS), Visual Analogue Scale (VAS), DASH questionnaire, and a survey of subjective assessment. BMRS mean score was 97.2 points, with 95.71 points with the MEPS. The mean decrease in VAS was 8.12 points, and the mean score on the DASH was 1.68 points. The results were rated as excellent or very good by 94.3% of patients. There was one recurrence, which resolved with further surgery. Two neuropraxia of the posterior interosseous nerve occurred, which completely recovered in 10 weeks. Using the «4 surgical tips» technique, clinical resolution of symptoms in 97.1% was achieved at the first operation. Therefore, it appears to be an effective, reproducible technique with few complications, in the surgical treatment of lateral epicondylitis resistant to conservative treatment. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

Surgical treatment of an unusual case of pelvic extramedullary hematopoiesis.

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Khen-Dunlop, Naziha; Girot, Robert; Brunelle, Francis; Révillon, Yann; Nihoul-Fékété, Claire; Sarnacki, Sabine

2006-07-01

Extramedullary hematopoiesis affects about 15% of the patients treated for thalassemia intermedia. Usually seen in adulthood, the most common location is the paraspinal region. Diagnosis and treatment of extramedullary hematopoiesis located in the pelvis of a young 15-year-old girl is discussed. The young age of the patient and the uncommon site of the mass first lead to the diagnosis of an ovarian dermoid cyst. Because of the clinical history and the typical feature on computed tomography scan, extramedullary hematopoiesis was concluded. A specific treatment based on blood transfusion and hydroxyurea was first proposed but remained inefficient. Surgical excision was thus successfully performed. Whereas surgery is limited to spinal cord compression in paraspinal extramedullary hematopoiesis, this observation argues for surgical treatment in symptomatic intraabdominal extramedullary hematopoiesis when medical treatment fails.

An experimental study on the radiation hazard of the mandible

International Nuclear Information System (INIS)

Sakurai, Tohru

1987-01-01

The purpose of this study is to investigate the influence of the tooth extraction after irradiation to the mandible experimentally. The following results were obtained. 1. In a group whose teeth were extracted immediately after irradiation, healing of the extraction wound was delayed. However, severe radiation hazard was not recognized macroscopically. 2. In a group whose teeth were extracted after 2 weeks following irradiation, radiation osteomyelitis was recognized macroscopically. All of these cases showed disturbances of healing of the extraction wound. 3. The early radiographical finding on the mandible, in which the teeth had been extracted after irradiation, was osteoporosis and it was accelerated by infection. 4. Bone resorption caused by osteoclast was observed microscopically in a group whose teeth were extracted after irradiation. Osteoporotic bone resorption was accelerated by infection, and was decreased by subsidings of infection and blood vessel hazard. 5. Sequestration was one of the results of radiation osteomyelitis, which was caused by the disturbance of blood circulation due to periosteum detachment. Sequestrum was caused by invasion of the healthy gingiva. 6. Though healing of the extraction wound was delayed by irradiation, new bone was formed in the alveolar socket if the blood clot occupied the alveolar socket. 7. Radiation hazard of the mandible became more severe when the mandible was accompanied by infection. (J.P.N.)

Primary Diffuse Large B-Cell Lymphoma of the Mandible: Case Report and Review of the Literature

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Amr Bugshan

2015-10-01

Full Text Available In the oral cavity, extranodal non-Hodgkin's lymphoma can occur in the periapical region either in the maxilla or mandible. Also, it can mimic inflammatory lesions that arise around the teeth apices such as periapical granuloma, radicular cyst and osteomyelitis. Misdiagnosis of lymphomas in the jaws may reduce the chance of successful treatment and worsen the prognosis. Therefore, any growth of periapical tissue must be submitted for histopathological evaluation to avoid a delay in the diagnosis. We present a case of extranodal non-Hodgkin's lymphoma of a 53-year-old male in the right posterior mandible that was initially misdiagnosed as a reactive periapical lesion. This case illustrates the importance for both the pathologist and the clinician of considering malignant lesions such as lymphoma in the differential diagnosis of periapical radiolucency.

Evaluation of bone scan by scintigraphy to detect subclinical invasion of the mandible by squamous cell carcinoma of the oral cavity

International Nuclear Information System (INIS)

Baker, H.L.; Woodbury, D.H.; Krause, C.J.; Saxon, K.G.; Stewart, R.C.

1982-01-01

A prospective study using scintigraphy was performed to compare the sensitivity of the Panorex roentgenogram and the bone scan in detecting subclinical invasion of the mandible by squamous cell carcinoma of the oral cavity and floor of the mouth. Twenty-five patients with squamous cell carcinoma of the floor of the mouth were evaluated preoperatively by both the Panorex and scintigraphic techniques and the results compared with postoperative pathologic findings. In 13 (52%) of the cases, Panorex and scintigraphic techniques were comparable in detecting tumor involvement in bone. In eight cases (32%) all three modalities had normal pathologic indications of the mandible. However, in four cases (16%) results of the scintigraphic techniques were abnormal and the Panorex, normal. In four separate cases, the extent of lesion demonstrable by scintiscanning was greater than delineated by Panorex; surgical specimen confirmed this finding. Pathologic examination of operative specimens confirmed tumor involvement. These data lead us to believe that the scintigraphic techniques may be more sensitive in detecting early mandibular involvement with squamous cell carcinoma than the Panorex technique and may help alter the therapeutic approach

A New Method for Surgical Treatment of Subcondylar Fractures: A Case Report

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Gholamreza Shirani

2017-12-01

Full Text Available AbstractSubcondylar fractures are common in the maxillofacial region following direct trauma to the mandibular ramus. The literature is replete with articles written on the treatment of subcondylar fractures, encompassing a plethora of various surgical approaches; however, the best treatment procedure has remained controversial. Such fractures are either treated by open reduction with internal fixation or closed reduction with maxillomandibular fixation. In this article, we describe a new surgical method for treatment of subcondylar fractures.

Clinical aspects of a multicenter clinical trial of implant-retained mandibular overdentures in patients with severely resorbed mandibles

NARCIS (Netherlands)

Geertman, ME; Boerrigter, EM; VanWaas, MAJ; vanOort, RP

In a multicenter clinical trial treatment, the effects of overdentures on different implant systems in patients with severely resorbed mandibles were compared 1 year after the insertion of new dentures. The implant systems used were the transmandibular implant (TMI), the IMZ (IMZ), and the Branemark

Minimally Invasive Surgical Treatment of Acute Epidural Hematoma: Case Series

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Weijun Wang

2016-01-01

Full Text Available Background and Objective. Although minimally invasive surgical treatment of acute epidural hematoma attracts increasing attention, no generalized indications for the surgery have been adopted. This study aimed to evaluate the effects of minimally invasive surgery in acute epidural hematoma with various hematoma volumes. Methods. Minimally invasive puncture and aspiration surgery were performed in 59 cases of acute epidural hematoma with various hematoma volumes (13–145 mL; postoperative follow-up was 3 months. Clinical data, including surgical trauma, surgery time, complications, and outcome of hematoma drainage, recovery, and Barthel index scores, were assessed, as well as treatment outcome. Results. Surgical trauma was minimal and surgery time was short (10–20 minutes; no anesthesia accidents or surgical complications occurred. Two patients died. Drainage was completed within 7 days in the remaining 57 cases. Barthel index scores of ADL were ≤40 (n=1, 41–60 (n=1, and >60 (n=55; scores of 100 were obtained in 48 cases, with no dysfunctions. Conclusion. Satisfactory results can be achieved with minimally invasive surgery in treating acute epidural hematoma with hematoma volumes ranging from 13 to 145 mL. For patients with hematoma volume >50 mL and even cerebral herniation, flexible application of minimally invasive surgery would help improve treatment efficacy.

[Evaluating an effectiveness of surgical treatment of gastroesophageal reflux disease combined with hiatal hernia].

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Mozharovskiy, V V; Tsyganov, A A; Mozharovskiy, K V; Tarasov, A A

To assess an effectiveness of surgical treatment of gastroesophageal reflux disease (GERD) combined with hiatal hernia (HH). The trial included 96 patients with GERD and HH who were divided into 2 groups. The principal difference between groups was the use of surgery in the main group and therapeutic treatment in the comparison group. The effectiveness of surgical treatment is superior to therapeutic treatment of GERD by more than 2.5 times. HH combined with GERD is an indication for surgical treatment. Fundoplication cuff should not lead to angular and rotational esophageal deformation. Nissen procedure in Donahue modification (Short Floppy Nissen) simulates optimally the geometry of esophago-gastric junction and His angle.

Experience in the diagnostic and surgical treatment of pancreatic pseudocysts

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N. G. Golovko

2015-10-01

Full Text Available Actuality. Problem of surgical treatment of pancreatic pseudocysts is actual and debatable. The incidence of pancreatic pseudocysts is 0.5–1 per 100 000 adults per year, and in the overall incidence it reaches 1.6% –4.5%. Aim. Surgical treatment results of 34 patients with pancreatic pseudocysts were analyzed to improve results of diagnostic and surgical management of pancreatic pseudocests. Methods and results. Ultrasound scan combined with computer tomography were used for pancreatic pseudocysts diagnostic. Pancreatic pseudocysts surgical treatment was performed by minimally invasive percutaneous techniques and laparotomic surgery. Laparotomy operations were performed in 27 patients. The structure of operations was follow: external drainage of pseudocysts - 11 patients, 2 of them by minilaparotomy access, pseudocyst jejunostomy by Roux – 9 patients, pseudocyst jejunostomy with entero-enteroanastamosis by Brown – 3 patients, pseudocyst gastrostomy and pseudocyst duodenostomy – in 2 patients. Percutaneous external drainage of pancreatic pseudocysts under ultrasound control was performed in 7 patients. Indications for external percutaneous needle drainage of pancreatic pseudocysts under ultrasound control were: presence of a secure acoustic windows, lack of communication with the pancreatic pseudocysts ductal system, pseudocyst cavity diameter greater than 60 mm with wall thickness more than 3–4 mm, presence of the severe comorbidity and high operational and anesthetic risk (III–IV class ASA. Conclusions. Analysis of early treatment results (3–6 months found that pancreatic pseudocysts minimally invasive percutaneous puncture external drainage use in combination with ultrasound control, in addition to laparotomic operation, allows to achieve excellent and good results in 91.1% of patients.

The management of esophageal achalasia: from diagnosis to surgical treatment.

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Dobrowolsky, Adrian; Fisichella, P Marco

2014-03-01

The goal of this review is to illustrate our approach to patients with achalasia in terms of preoperative evaluation and surgical technique. Indications, patient selection and management are herein discussed. Specifically, we illustrate the pathogenetic theories and diagnostic algorithm with current up-to-date techniques to diagnose achalasia and its manometric variants. Finally, we focus on the therapeutic approaches available today: medical and surgical. A special emphasis is given on the surgical treatment of achalasia and we provide the reader with a detailed description of our pre and postoperative management.

De Qeurvian Tenosynovitis: Clinical Outcomes of Surgical Treatment with Longitudinal and Transverse Incision

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Arefah Dehghani Tafti

2011-03-01

Full Text Available AbstractObjectives: De Quervain disease is a mechanical tenosynovitis due to inadequacy volume between abductor pollicis longus, extensor pollicis brevis and their tunnel. Treatment methods include immobilization, steroid injections, and operation. For the first time Fritz De Quervain described surgical treatment of this disease. Since then, various ways of treatment have been reported. The purpose of this study is to compare the clinical outcomes of a longitudinal incision with a transverse incision in De Quervain disease.Methods: This was a randomized controlled clinical trial conducted in three hospitals in Iran, Yazd from March 2003 to September 2008. One hundred-twenty patients with De Quervain disease who did not respond to conservative treatment were operated with two different incisions. The patients were followed for three months to compare the surgical outcomes.Results: During a three month follow-up, a significant difference was shown between the two methods (p=0.03. Results of surgical treatment with longitudinal incision were excellent (only 5 hypertrophic scars, but there were 13 postoperative complaints with transverse incision.Conclusion: According to our findings, longitudinal incision in surgical treatment of De Quervain disease is better than transverse incision.

Minimally invasive surgical treatment of valvular heart disease.

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Goldstone, Andrew B; Joseph Woo, Y

2014-01-01

Cardiac surgery is in the midst of a practice revolution. Traditionally, surgery for valvular heart disease consisted of valve replacement via conventional sternotomy using cardiopulmonary bypass. However, over the past 20 years, the increasing popularity of less-invasive procedures, accompanied by advancements in imaging, surgical instrumentation, and robotic technology, has motivated and enabled surgeons to develop and perform complex cardiac surgical procedures through small incisions, often eliminating the need for sternotomy or cardiopulmonary bypass. In addition to the benefits of improved cosmesis, minimally invasive mitral valve surgery was pioneered with the intent of reducing morbidity, postoperative pain, blood loss, hospital length of stay, and time to return to normal activity. This article reviews the current state-of-the-art of minimally invasive approaches to the surgical treatment of valvular heart disease. Copyright © 2014 Elsevier Inc. All rights reserved.

Selection of treatment and surgical approach for vestibular schwannomas

International Nuclear Information System (INIS)

Eguchi, Kuniki; Yamaguchi, Satoshi; Sakoda, Eiichiro

2007-01-01

Described are the present state of selection of stereotactic radiotherapy or surgical treatment and their combination for schwannomas in the title, and authors' policy of surgery as a first choice treatment. The policy stands on the concept that surgery is useful for the controllability thereafter of the tumor, of which size is at first larger than 25 mm diameter, and radiotherapy like a gamma-knife is applicable to the residual tissue grown after operation and to the tissue with less than the size before surgery because the smaller the size, the better is thought the control by the knife (reportedly 100% for the tissue of <14 mm diameter). The basis of authors' selection of two surgical approaches of through-lower lateral occiput and trans-labyrinthine, and their outcomes like hearing loss are described and discussed in details for 24 patients (two underwent radiotherapy before surgery) during the period Sep. 2003-Aug. 2006 of authors' hospital. Radiotherapy is thought essentially useful for the control of the tumor with a small or surgically reduced size. (R.T.)

Failure location prediction by finite element analysis for an additive manufactured mandible implant.

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Huo, Jinxing; Dérand, Per; Rännar, Lars-Erik; Hirsch, Jan-Michaél; Gamstedt, E Kristofer

2015-09-01

In order to reconstruct a patient with a bone defect in the mandible, a porous scaffold attached to a plate, both in a titanium alloy, was designed and manufactured using additive manufacturing. Regrettably, the implant fractured in vivo several months after surgery. The aim of this study was to investigate the failure of the implant and show a way of predicting the mechanical properties of the implant before surgery. All computed tomography data of the patient were preprocessed to remove metallic artefacts with metal deletion technique before mandible geometry reconstruction. The three-dimensional geometry of the patient's mandible was also reconstructed, and the implant was fixed to the bone model with screws in Mimics medical imaging software. A finite element model was established from the assembly of the mandible and the implant to study stresses developed during mastication. The stress distribution in the load-bearing plate was computed, and the location of main stress concentration in the plate was determined. Comparison between the fracture region and the location of the stress concentration shows that finite element analysis could serve as a tool for optimizing the design of mandible implants. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Treatment of Mandibular Prognathism

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Hong-Po Chang

2006-01-01

Full Text Available Mandibular prognathism (MP or skeletal Class III malocclusion with a prognathic mandible is one of the most severe maxillofacial deformities. Facial growth modification can be an effective method of resolving skeletal Class III jaw discrepancies in growing children with dentofacial orthopedic appliances including the chincup, face mask, maxillary protraction combined with chincup traction and the Fränkel functional regulator III appliance. Orthognathic surgery in conjunction with orthodontic treatment is required for the correction of adult MP. The two most commonly applied surgical procedures to correct MP are sagittal split ramus osteotomy (SSRO and intraoral vertical ramus osteotomy. Both procedures are suitable for patients in whom a desirable occlusal relationship can be obtained with a setback of the mandible, and each has its own advantages and disadvantages. In bilateral SSRO, the intentional ostectomy of the posterior part of the distal segment can offer long-term positioned stability. This may be attributable to reduction of tension in the pterygomasseteric sling that applies force in the posterior mandible. While various environmental factors have been found to contribute to the development of MP, heredity plays a substantial role. The relative contributions of genetic and environmental components in the etiology of MP are unclear. The recent identification of the genetic susceptibilities to MP constitutes the first step toward understanding the molecular pathogenesis of MP. Further studies in molecular biology are needed to identify the gene-environment interactions associated with the phenotypic diversity of MP and the heterogenic developmental mechanisms thought to be responsible for them.

Investigation of clinical and histopathological effects of Rofecoxib after surgical trauma of the gum in rabbit

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Ali Rezaie

2007-05-01

Full Text Available In this study, clinical and histopathological effects of Rofecoxib, which is usually used in surgery as an analgesic and anti inflammatory drug is evaluated on the process of healing following surgical trauma. 15 New Zealand white rabbits with the same condition were selected and after numbering, divided to three different groups so that there were 5 rabbits per group. Then in each group after anesthesia  with Xylazine and Ketamine a circular surgical trauma was created in the right lateral region of mandible using punch biopsy and after 12 days, clinical and histopathological effects of treatment with low dose (6 mg/kg/day and high dose (12 mg/kg/day Rofecoxib was compared with control group that received placebo. It was evident that use of this drug had positive effects on healing which was obvious from clinical findings and comparison of photomicrographs of the healing site in both low dose and high dose treatment groups compared with control group. Also it was determined that use of high dose of Rofecoxib had better effects on healing process compared to low dose of this drug.

Longterm results and their prognosis in surgical treatment of Grave's disease

OpenAIRE

I V Makarov; R A Galkin; M M Andreev

2013-01-01

This study focuses on improving the results of surgical treatment of patients with diffuse toxic goiter way jus tify the selection of thyroid residue and thyroid status in predicting longterm periods. The basis of the study is the immediate and longterm results of surgical treatment of 138 patients suffering from diffuse toxic goi ter. As a result of the research, with a modern point of clinical and statistical analysis proved the effective ness of fascial subtotal resection of the thyroid gl...

Using laser irradiation for the surgical treatment of periodontal disease

Science.gov (United States)

Vieru, Rozana D.; Lefter, Agafita; Herman, Sonia

2002-10-01

In the marginal pr ogressive profound periodontities, we associated low level laser therapy (LLLT) to the classical surgical treatment with implant of biovitroceramics. From a total of 50 patients, 37 where irradiated with the laser. We used a diode laser, =830 nm, energy density up to 2 J cm2, in Nogier pulsed mode. The laser treatment is used in a complex of therapeutic procedures: odontal, local anti-inflammatory -- as well as in the cabinet and at home --, prosthetic, and for the morphologic and functional rebalancing. The immediate effects where: an evolution without bleeding and without post-surgical complications, as can appear at the patients who didn't benefit of laser irradiation (hematom, pain, functional alteration in the first post-surgical week). Operated tissue is recovering faster. The percentage of recurrences decreases and the success depends less on the biological potential and the immunity of each individual.

Surgical treatment of distal biceps tendon rupture: a case report

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Cristina N. Cozma

2017-11-01

Full Text Available Objectives. Distal biceps tendon rupture affects the functional upperextremity movement, impairing supination and flexion strength. According to age, profession and additional risks treatment might be nonoperative or surgical. Methods. We describe the case of a 43 years old male patient who sustained an injury to his right distal biceps and was diagnosed with acute right distal biceps rupture. Surgical treatment was decided and biceps tendon was reinserted to the radius tuberosity using a combination of a cortical button fixation associated with an interference screw. Results. Postoperative functional result was favorable with no complications and with no movement limitation after one month. Conclusions. When possible, distal biceps tendon repair should be realized surgically because this permits restoring of the muscle strength to near normal levels with no loss of motion. Nerve complications are common; therefore the surgery should be realized by experienced upper extremity surgeons.

Reduced somatosensory impairment by piezosurgery during orthognathic surgery of the mandible.

Science.gov (United States)

Brockmeyer, Phillipp; Hahn, Wolfram; Fenge, Stefan; Moser, Norman; Schliephake, Henning; Gruber, Rudolf Matthias

2015-09-01

This clinical trial aimed to test the hypothesis that piezosurgery causes reduced nerval irritations and, thus, reduced somatosensory impairment when used in orthognathic surgery of the mandible. To this end, 37 consecutive patients with Angle Class II and III malocclusion were treated using bilateral sagittal split osteotomies (BSSO) of the mandible. In a split mouth design, randomized one side of the mandible was operated using a conventional saw, while a piezosurgery device was used on the contralateral side. In order to test the individual qualities of somatosensory function, quantitative sensory testings (QSTs) were performed 1 month, 6 months and 1 year after surgery. A comparison of the data using a two-way analysis of variance (ANOVA) revealed a significant reduction in postoperative impairment in warm detection threshold (WDT) (P = 0.046), a decreased dynamic mechanical allodynia (ALL) (P = 0.002) and a decreased vibration detection threshold (VDT) (P = 0.030) on the piezosurgery side of the mandible as opposed to the conventionally operated control side. In the remaining QSTs, minor deviations from the preoperative baseline conditions and a more rapid regression could be observed. Piezosurgery caused reduced somatosensory impairment and a faster recovery of somatosensory functions in the present investigation.

Postnatal mandible growth in wild and laboratory mice: Differences revealed from bone remodeling patterns and geometric morphometrics.

Science.gov (United States)

Martínez-Vargas, Jessica; Muñoz-Muñoz, Francesc; Martinez-Maza, Cayetana; Molinero, Amalia; Ventura, Jacint

2017-08-01

Comparative information on the variation in the temporospatial patterning of mandible growth in wild and laboratory mice during early postnatal ontogeny is scarce but important to understand variation among wild rodent populations. Here, we compare mandible growth between two ontogenetic series from the second to the eighth week of postnatal life, corresponding to two different groups of mice reared under the same conditions: the classical inbred strain C57BL/6J, and Mus musculus domesticus. We characterize the ontogenetic patterns of bone remodeling of the mandibles belonging to these laboratory and wild mice by analyzing bone surface, as well as examine their ontogenetic form changes and bimodular organization using geometric morphometrics. Through ontogeny, the two mouse groups display similar directions of mandible growth, according to the temporospatial distribution of bone remodeling fields. The allometric shape variation of the mandibles of these mice entails the relative enlargement of the ascending ramus. The organization of the mandible into two modules is confirmed in both groups during the last postnatal weeks. However, especially after weaning, the mandibles of wild and laboratory mice differ in the timing and localization of several remodeling fields, in addition to exhibiting different patterns of shape variation and differences in size. The stimulation of dentary bone growth derived from the harder post-weaning diet might account for some features of postnatal mandible growth common to both groups. Nonetheless, a large component of the postnatal growth of the mouse mandible appears to be driven by the inherent genetic programs, which might explain between-group differences. © 2017 Wiley Periodicals, Inc.

Surgical treatment of hepatic Echinococcus granulosus

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Waldemar Patkowski

2017-09-01

Full Text Available Introduction : Infections caused by metacestode stage of the Echinococcus granulosus in humans result in disease named cystic echinococcosis. Aim: To present the outcomes of patients treated surgically for cystic echinococcosis of the liver. Material and methods : One hundred and nineteen patients treated in the period between 1989 and 2014 due to E. granulosus infection in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw were selected for this retrospective study. Diagnostic protocol included imaging examinations, i.e. ultrasonography and computed tomography of the abdomen. Blood samples where used to proceed sequential enzyme-linked immunosorbent assay (ELISA using Em2plus antigen as well as polymerase chain reaction (PCR to detect E. granulosus . Results : Surgery was the choice for treatment for almost all of the patients (98.3%. In 40 (34.2% patients right hemihepatectomy, in 19 (16.2% patients left hemihepatectomy, and in 21 (17.9% patients bisegementectomy were performed. Postoperative complications occurred in 4 (3.4% patients. In 3 patients biliary fistula requiring endoscopic treatment was observed, and 1 patient had subdiaphragmatic abscess successfully treated with drainage under ultrasound guidance. None of the patients died in the postoperative period, and the 1-, 5-, and 10-year survival rates were 100.0%, 90.9%, and 87.9%, respectively. Conclusions : Surgical treatment of the symptomatic cystic echinococcosis is the modality of choice for E. granulosus infection of the liver. Despite substantial development of diagnostic methods and new management opportunities, echinococcal infection still presents a challenge for epidemiologists, pharmacologists, and clinicists.

Eagle syndrome surgical treatment with piezosurgery.

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Bertossi, Dario; Albanese, Massimo; Chiarini, Luigi; Corega, Claudia; Mortellaro, Carmen; Nocini, Pierfrancesco

2014-05-01

Eagle syndrome (ES) is an uncommon complication of styloid process elongation with stylohyoideal complex symptomatic calcification. It is an uncommon condition (4% of the population) that is symptomatic in only 4% of the cases. Eagle syndrome is usually an acquired condition that can be related to tonsillectomy or to a neck trauma. A type of ES is the styloid-carotid syndrome, a consequence of the irritation of pericarotid sympathetic fibers and compression on the carotid artery. Clinical manifestations are found most frequently after head turning and neck compression. Although conservative treatment (analgesics, anticonvulsants, antidepressants, local infiltration with steroids, or anesthetic agents) have been used, surgical treatment is often the only effective treatment in symptomatic cases. We present the case of a 55-year-old patient, successfully treated under endotracheal anesthesia. The cranial portion of the calcified styloid process was shortened through an external approach, using a piezoelectric cutting device (Piezosurgery Medical II; Mectron Medical Technology, Carasco, Italy) with MT1-10 insert, pump level 4, vibration level 7. No major postoperative complications such as nerve damage, hematoma, or wound dehiscence occurred. After 6 months, the patient was completely recovered. Two years after the surgery, the patient did not refer any symptoms related to ES. The transcervical surgical approach in patients with ES seems to be safe and effective, despite the remarkable risk for transient marginal mandibular nerve palsy. This risk can be decreased by the use of the piezoelectric device for its distinctive characteristics--such as precision, selective cut action, and bloodless cut.

Oral and masticatory rehabilitation using osseointegrated dental implants after resective treatment of multicystic ameloblastoma in the lower jaw with a fibula graft

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João Ricardo Almeida Grossi

2018-01-01

Full Text Available Ameloblastoma is an aggressive odontogenic tumor which typically occurs between third and fourth decade of life that often needs resective approach. Immediate reconstruction may show better results. The treatment of multicystic ameloblastoma in the mandible being a rare case that occurred in the late second decade of life, which was surgically removed along with the affected teeth with safety margins, and the region was immediately reconstructed using a vascularized graft, removed from the fibula. Its integration, in combination with osseointegrated dental implants and fixed implant-supported prostheses, restored chewing function and esthetics. After 6 years from fibular graft and 24 months of dental implants, an excellent outcome was observed, with oral health and normal functions properly restored, and the immediate reconstruction of the mandible in resective cases, associated with oral rehabilitation with dental implants, may be considered a suitable treatment option.

Surgical Treatment of Complication of Female Genital Mutilation in ...

African Journals Online (AJOL)

Surgical Treatment of Complication of Female Genital Mutilation in Pikine Hospital, Senegal. Abdoul A Diouf, Moussa Diallo, Aissatou Mbodj, Omar Gassama, Mamour Guèye, Jean C Moreau, Alassane Diouf ...

Non-surgical treatments for hidradenitis suppurativa: A systematic review.

Science.gov (United States)

Robert, E; Bodin, F; Paul, C; Konstantinou, M-P; Gall, Y; Grolleau, J-L; Laloze, J; Chaput, B

2017-08-01

The management of hidradenitis suppurativa is multidisciplinary, involving general measures, medical treatment and surgery. Non-surgical treatments, often first-line procedures, mainly concern forms of low-to-moderate severity or, conversely, very severe forms in non-operable patients or those refusing surgery. While many treatments have been attempted, few randomized controlled trials have been conducted, so the choice of treatments is most often based on the personal experience of the clinicians. The objective of this systematic review is to propose a synthetic analysis of the currently available non-surgical procedures. This systematic review of the literature was conducted in accordance with the PRISMA criteria. We searched for articles in the Medline ® , PubMed Central, Embase and Cochrane databases published between January 2005 and September 2015. Sixty-four articles were included. They generally had a low level of evidence; indeed, the majority of them were retrospective observational studies. They involved biotherapy (44%), dynamic phototherapy (16%), antibiotics (11%), Laser (8%), retinoids (6%) and immunosuppressive therapies, anti-inflammatory drugs, zinc, metformin, gammaglobulins and fumarates. None of the non-surgical treatments can treat all stages of the disease and offer long-term remission. Antibiotics and biotherapy seem to have real effectiveness but their effect remains suspensive and the disease is almost certain to reappear once they are stopped. As regards antibiotics, no association has shown their superiority in a study with a high level of evidence. And while some biotherapies seem quite effective, due to their side effects they should be reserved for moderate-to-severe, resistant or inoperable forms of the disease. Randomized controlled studies are needed before valid conclusions can be drawn. In the resistant or disabling forms, it is consequently advisable to orientate to the greatest possible extent towards radical surgery, which

Gastric cancer : staging, treatment, and surgical quality assurance

NARCIS (Netherlands)

Dikken, Johannes Leen

2012-01-01

Research described in this thesis focuses on several aspects of gastric cancer care: staging and prognostication, multimodality treatment, and surgical quality assurance. PART I - STAGING AND PROGNOSTICATION Cancer staging is one of the fundamental activities in oncology.6,7 For over 50 years, the

Evidence-Based Surgical Treatments for Chronic Pancreatitis.

Science.gov (United States)

Kleeff, Jörg; Stöß, Christian; Mayerle, Julia; Stecher, Lynne; Maak, Matthias; Simon, Peter; Nitsche, Ulrich; Friess, Helmut

2016-07-25

If conservative treatment of chronic pancreatitis is unsuccessful, surgery is an option. The choice of the most suitable surgical method can be difficult, as the indications, advantages, and disadvantages of the available methods have not yet been fully documented with scientific evidence. In April 2015, we carried out a temporally unlimited systematic search for publications on surgery for chronic pancreatitis. The target parameters were morbidity, mortality, pain, endocrine and exocrine insuffi - ciency, weight gain, quality of life, length of hospital stay, and duration of urgery. Differences between surgical methods were studied with network meta-analysis, and duodenum-preserving operations were compared with partial duodenopancreatectomy with standard meta-analysis. Among the 326 articles initially identified, 8 randomized controlled trials on a total of 423 patients were included in the meta-analysis. The trials were markedly heterogeneous in some respects. There was no significant difference among surgical methods with respect to perioperative morbidity, pain, endocrine and exocrine insufficiency, or quality of life. Duodenumpreserving procedures, compared to duodenopancreatectomy, were associated with a long-term weight gain that was 3 kg higher (p chronic pancreatitis is superior to partial duodenopancreatectomy in multiple respects. Only limited recommendations can be given, however, on the basis of present data. The question of the best surgical method for the individual patient, in view of the clinical manifestations, anatomy, and diagnostic criteria, remains open.

Mood-induced variations of mandible and tongue postures.

Science.gov (United States)

Bourdiol, P; Mishellany-Dutour, A; Peyron, M-A; Woda, A

2013-06-01

Twelve young adults in a good general health were observed during habitual posture of tongue and jaw in different emotional conditions induced by watching three video sequences. The position of the mandible was tracked by the displacements of an electromagnetic sensor glued to the chin. The tongue-to-palate distance was obtained by 2-D location of three electromagnetic sensors placed on the tongue upper midline surface. Head displacements were evaluated with a sensor fixed to an upper central incisor and were subtracted from corresponding displacements of tongue and chin sensors to obtain the real tongue and mandible positions during continuous recording sequences. Emotional conditioning by a fear movie influenced the vertical position of the mandible: the mean interarch distances during the fear movie (2·34 ± 0·24 mm) were significantly different from those measured during the tender (3·13 ± 0·35) and neutral (3·42 ± 0·80) movies, respectively (anova repeated measure, SNK; P < 0·05). anova repeated measure indicated that the tongue-to-palate distance differed significantly when the subjects were watching the conditioning movies (P = 0·003), the tip of the tongue taking a lower position during the fear movie than during the tender and neutral movies. © 2013 John Wiley & Sons Ltd.

Infected primary knee arthroplasty: Risk factors for surgical treatment failure

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Joao Gabriel Duarte Paes Pradella

2013-09-01

Full Text Available OBJECTIVE: To present epidemiological data and risk factors associated with surgical out-comes favorable or unfavorable for the treatment of infection in infected total knee arthroplasty. METHODS: We reviewed medical records of 48 patients who underwent treatment of primary total knee arthroplasty for infection between January 1994 and December 2008, in the Orthopedics and Traumatology Department of the Santa Casa de Misericórdia de São Paulo. The variables associated with favorable outcome of surgical treatment (debridement and retention or exchange arthroplasty in two days or unfavorable (arthrodesis or death infection. RESULTS: A total of 39 cases of infection after primary total knee arthroplasty, 22 progressed to 17 for a favorable outcome and unfavorable outcome. Early infections (OR: 14.0, 95% CI 1.5-133.2, p = 0.016 and diabetes (OR: 11.3, 95% CI 1.4-89.3, p = 0.032 were associated with arthrodesis joint and death respectively. CONCLUSION: Patients with early infection had a higher risk of developing surgical procedure with unfavorable outcome (arthrodesis and diabetics had higher odds of death after infection of primary knee arthroplasties.

Endodontic, surgical and periodontal treatment of dens invaginatus. Case report.

Science.gov (United States)

Castellarin, M; Demitri, V; Politi, M

2001-01-01

The aim of this paper is to propose a single stage global treatment of endodontic, periapical and periodontal lesions in a lateral maxillary incisor with dens invaginatus. A 24 year-old woman presenting a lateral maxillary incisor with dens invaginatus in association with periapica1 and periodontal lesions underwent simultaneous surgical, endodontic and periodontal regenerative procedures. At 2, 6, 12, 18 months follow-up the radiographic healing appeared to be improved and the periapical lesion healed completely 1 year after surgical intervention. Surgery in association with endodontic and periodontal procedures represents the treatment of choice to maximize long term prognosis in cases of dens invaginatus with chronic periapical and periodontal lesions.

78 FR 11207 - Clinical Study Designs for Surgical Ablation Devices for Treatment of Atrial Fibrillation...

Science.gov (United States)

2013-02-15

...] Clinical Study Designs for Surgical Ablation Devices for Treatment of Atrial Fibrillation; Guidance for... devices intended for the treatment of atrial fibrillation. DATES: Submit either electronic or written... Study Designs for Surgical Ablation Devices for Treatment of Atrial Fibrillation'' to the Division of...

Custom-Machined Miniplates and Bone-Supported Guides for Orthognathic Surgery: A New Surgical Procedure.

Science.gov (United States)

Brunso, Joan; Franco, Maria; Constantinescu, Thomas; Barbier, Luis; Santamaría, Joseba Andoni; Alvarez, Julio

2016-05-01

Several surgical strategies exist to improve accuracy in orthognathic surgery, but ideal planning and treatment have yet to be described. The purpose of this study was to present and assess the accuracy of a virtual orthognathic positioning system (OPS), based on the use of bone-supported guides for placement of custom, highly rigid, machined titanium miniplates produced using computer-aided design and computer-aided manufacturing technology. An institutional review board-approved prospective observational study was designed to evaluate our early experience with the OPS. The inclusion criteria were as follows: adult patients who were classified as skeletal Class II or III patients and as candidates for orthognathic surgery or who were candidates for maxillomandibular advancement as a treatment for obstructive sleep apnea. Reverse planning with computed tomography and modeling software was performed. Our OPS was designed to avoid the use of intermaxillary fixation and occlusal splints. The minimum follow-up period was 1 year. Six patients were enrolled in the study. The custom OPS miniplates fit perfectly with the anterior buttress of the maxilla and the mandible body surface intraoperatively. To evaluate accuracy, the postoperative 3-dimensional reconstructed computed tomography image and the presurgical plan were compared. In the maxillary fragments that underwent less than 6 mm of advancement, the OPS enabled an SD of 0.14 mm (92% within 1 mm) at the upper maxilla and 0.34 mm (86% within 1 mm) at the mandible. In the case of great advancements of more than 10 mm, the SD was 1.33 mm (66% within 1 mm) at the upper maxilla and 0.67 mm (73% within 1 mm) at the mandibular level. Our novel OPS was safe and well tolerated, providing positional control with considerable surgical accuracy. The OPS simplified surgery by being independent of support from the opposite maxilla and obviating the need for classic intermaxillary occlusal splints. Copyright © 2016

Impact on sexual function of surgical treatment in rectal cancer

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Pedro Costa

Full Text Available ABSTRACT Introduction The development of new surgical techniques and medical devices, like therapeutical multimodal approaches has allowed for better outcomes on patients with rectal cancer (RCa. Owing to that, an increased awareness and investment towards better outcomes regarding patients’ sexual and urinary function has been recently observed. Aim Evaluate and characterize the sexual dysfunction of patients submitted to surgical treatment for RCa. Materials and Methods An observational retrospective study including all male patients who underwent a surgical treatment for RCa between January 2011 December 2014 (n=43 was performed, complemented with an inquiry questionnaire to every patient about its sexual habits and level of function before and after surgery. Discussion All patients were male, with an average of 64yo. (range 42-83yo.. The surgical procedure was a rectum anterior resection (RAR in 22 patients (56% and an abdominoperineal resection (APR in 19(44%. Sixty three percent described their sexual life as important/very important. Sexual function worsening was observed in 76% (65% with complains on erectile function, and 27% on ejaculation. Fourteen patients (38% didn't resume sexual activity after surgery. Increased age (p=0.007, surgery performed (APR (p=0.03 and the presence of a stoma (p=0.03 were predictors of ED after surgery. A secondary analysis found that the type of surgery (APR (p=0.04, lower third tumor's location (p=0.03 and presence of comorbidities (p=0.013 (namely, smokers and diabetic patients were predictors of de novo ED after surgery. Conclusions This study demonstrated the clear negative impact in sexual function of patients submitted to a surgical treatment for RCa. Since it is a valued feature for patients, it becomes essential to correctly evaluate/identify these cases in order to offer an adequate therapeutical option.

Chronic suppurative osteomyelitis of the mandible

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K Mallikarjun

2011-01-01

Full Text Available Osteomyelitis is an infection of the bone or bone marrow, usually caused by pyogenic bacteria or mycobacterium. Osteomyelitis, inflammatory process of the bone and its structures, can be acute or chronic. Taking a journey from a nonsurgical approach to a surgical one, it appeared to be one osteomyelitis revenge against all our efforts. The pain, the pus, the new bone formation, and all the trouble, this case showed it all. The injudicious use of antibiotics and delay in providing the requisite treatment can cause devastating effects as in the case of an 11-year-old child. A case report on treating osteomyelitis through medication and realizing that surgical excision remains the only realistic approach, the report talks about the investigations and treatment planning done to deal with it.

Mandible reconstruction: History, state of the art and persistent problems.

Science.gov (United States)

Ferreira, José J; Zagalo, Carlos M; Oliveira, Marta L; Correia, André M; Reis, Ana R

2015-06-01

Mandibular reconstruction has been experiencing an amazing evolution. Several different approaches are used to reconstruct this bone and therefore have a fundamental role in the recovery of oral functions. This review aims to highlight the persistent problems associated with the approaches identified, whether bone grafts or prosthetic devices are used. A brief summary of the historical evolution of the surgical procedures is presented, as well as an insight into possible future pathways. A literature review was conducted from September to December 2012 using the PubMed database. The keyword used was "mandible reconstruction." Articles published in the last three years were included as well as the relevant references from those articles and the "historical articles" were referred. This research resulted in a monograph that this article aims to summarize. Titanium plates, bone grafts, pediculate flaps, free osteomyocutaneous flaps, rapid prototyping, and tissue engineering strategies are some of the identified possibilities. The classical approaches present considerable associated morbidity donor-site-related problems. Research that results in the development of new prosthetics devices is needed. A new prosthetic approach could minimize the identified problems and offer the patients more predictable, affordable, and comfortable solutions. This review, while affirming the evolution and the good results found with the actual approaches, emphasizes the negative aspects that still subsist. Thus, it shows that mandible reconstruction is not a closed issue. On the contrary, it remains as a research field where new findings could have a direct positive impact on patients' life quality. The identification of the persistent problems reveals the characteristics to be considered in a new prosthetic device. This could overcome the current difficulties and result in more comfortable solutions. Medical teams have the responsibility to keep patients informed about the predictable

Dynamic simulation and finite element analysis of the human mandible injury protected by polyvinyl alcohol sponge

Energy Technology Data Exchange (ETDEWEB)

Karimi, Alireza; Navidbakhsh, Mahdi, E-mail: mnavid@iust.ac.ir; Razaghi, Reza

2014-09-01

There have been intensive efforts to find a suitable kinetic energy absorbing material for helmet and bulletproof vest design. Polyvinyl alcohol (PVA) sponge is currently in extensive use as scaffolding material for tissue engineering applications. PVA can also be employed instead of commonly use kinetic energy absorbing materials to increase the kinetic energy absorption capacity of current helmet and bulletproof vest materials owing to its excellent mechanical properties. In this study, a combined hexahedral finite element (FE) model is established to determine the potential protection ability of PVA sponge in controlling the level of injury for gunshot wounds to the human mandible. Digital computed tomography data for the human mandible are used to establish a three-dimensional FE model of the human mandible. The mechanism by which a gunshot injures the protected mandible by PVA sponge is dynamically simulated using the LS-DYNA code under two different shot angles. The stress distributions in different parts of the mandible and sponge after injury are also simulated. The modeling results regardless of shot angle reveal that the substantial amount of kinetic energy of the steel ball (67%) is absorbed by the PVA sponge and, consequently, injury severity of the mandible is significantly decreased. The highest energy loss (170 J) is observed for the impact at entry angle of 70°. The results suggest the application of the PVA sponge as an alternative reinforcement material in helmet and bulletproof vest design to absorb most of the impact energy and reduce the transmitted load. - Highlights: • The ability of PVA sponge to control the injury to the human mandible is computed. • A hexahedral FE model for gunshot wounds to the human mandible is established. • The kinetic energy and injury severity of the mandible is minimized by the sponge. • The highest energy loss (170 J) is observed for the impact at entry angle of 70°. • PVA suggests as an alternative

Surgical treatment of acute pulmonary embolism--a 12-year retrospective analysis

DEFF Research Database (Denmark)

Lehnert, Per; Møller, Christian H; Carlsen, Jørn

2012-01-01

Surgical embolectomy for acute pulmonary embolism (PE) is considered to be a high risk procedure and therefore a last treatment option. We wanted to evaluate the procedures role in modern treatment of acute PE....

Outcome and treatment of postoperative spine surgical site infections: predictors of treatment success and failure.

Science.gov (United States)

Maruo, Keishi; Berven, Sigurd H

2014-05-01

Surgical site infection (SSI) is an important complication after spine surgery. The management of SSI is characterized by significant variability, and there is little guidance regarding an evidence-based approach. The objective of this study was to identify risk factors associated with treatment failure of SSI after spine surgery. A total of 225 consecutive patients with SSI after spine surgery between July 2005 and July 2010 were studied retrospectively. Patients were treated with aggressive surgical debridement and prolonged antibiotic therapy. Outcome and risk factors were analyzed in 197 patients having 1 year of follow-up. Treatment success was defined as resolution within 90 days. A total of 126 (76 %) cases were treated with retention of implants. Forty-three (22 %) cases had treatment failure with five (2.5 %) cases resulting in death. Lower rates of treatment success were observed with late infection (38 %), fusion with fixation to the ilium (67 %), Propionibacterium acnes (43 %), poly microbial infection (68 %), >6 operated spinal levels (67 %), and instrumented cases (73 %). Higher rates of early resolution were observed with superficial infection (93 %), methicillin-sensitive Staphylococcus aureus (95 %), and failure. Superficial infection and methicillin-sensitive Staphylococcus aureus were predictors of early resolution. Postoperative spine infections were treated with aggressive surgical debridement and antibiotic therapy. High rates of treatment failure occurred in cases with late infection, long instrumented fusions, polymicrobial infections, and Propionibacterium acnes. Removal of implants and direct or staged re-implantation may be a useful strategy in cases with high risk of treatment failure.

Diode-Pumped Laser for Lung-Sparing Surgical Treatment of Malignant Pleural Mesothelioma.

Science.gov (United States)

Bölükbas, Servet; Biancosino, Christian; Redwan, Bassam; Eberlein, Michael

2017-06-01

Surgical resection represents one of the essential cornerstones in multimodal treatment of malignant pleural mesothelioma. In cases of tumor infiltration of the lung, lung-scarifying procedures such as lobectomies or pneumonectomies might be necessary to achieve macroscopic complete resection. However, this increases the morbidity of the patients because it leads to possible delay of the planned chemotherapy or radiotherapy. Innovative surgical techniques are therefore required to enable salvage of the lung parenchyma and optimization of surgical treatment. Here we report our first experience with a diode-pumped neodymium-doped yttrium aluminium garnet laser for parenchyma-sparing lung resection during surgery for malignant pleural mesothelioma. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Surgical Versus Nonsurgical Management of Rotator Cuff Tears: Predictors of Treatment Allocation.

Science.gov (United States)

Kweon, Christopher; Gagnier, Joel J; Robbins, Christopher B; Bedi, Asheesh; Carpenter, James E; Miller, Bruce S

2015-10-01

Rotator cuff tears are a common shoulder disorder resulting in significant disability to patients and financial burden on the health care system. While both surgical and nonsurgical management are accepted treatment options, there is a paucity of data to support a treatment algorithm for care providers. Defining variables to guide treatment allocation may be important for patient education and counseling, as well as to deliver the most efficient care plan at the time of presentation. To identify independent variables at the time of initial clinical presentation that are associated with preferred allocation to surgical versus nonsurgical management for patients with known full-thickness rotator cuff tears. Case control study; Level of evidence, 3. A total of 196 consecutive adult patients with known full-thickness rotator cuff tears were enrolled into a prospective cohort study. Robust data were collected for each subject at baseline, including age, sex, body mass index (BMI), shoulder activity score, smoking status, size of cuff tear, duration of symptoms, functional comorbidity index, the American Shoulder and Elbow Surgeons (ASES) score, the Western Ontario Rotator Cuff index (WORC), and the Veterans Rand 12-Item Health Survey (VR-12). Logistic regression was performed to identify variables associated with treatment allocation, and the corresponding odds ratios were calculated. Of the 196 patients enrolled, 112 underwent surgical intervention and 84 nonoperative management. With covariates controlled for, significant baseline patient characteristics predictive of eventual allocation to surgical treatment included younger age, lower BMI, and durations of symptoms less than 1 year. Increasing age, higher BMI, and duration of symptoms longer than 1 year were predictive of nonsurgical treatment. Factors that were not associated with treatment allocation included sex, tear size, functional comorbidity score, or any of the patient-derived outcome scores at presentation

ANALYSIS OF EFFECT AND COMPLICATION ON SURGICAL TREATMENT OF CAROTID BODY TUMORS IN 46 CASES

Institute of Scientific and Technical Information of China (English)

郑月宏; 刘暴; 李拥军; 刘昌伟; 管珩

2003-01-01

Objective. To describe the effects of surgical treatment and complications in 46 patients with carotid body tumor (CBT). Method. Retrospective study on surgical treatment and complications was carried out in 46 cases of CBT which were surgically treated with different kind of procedures. Result. All procedures performed successfully except that the CBT was not excised in 4 cases. No operative mortality was observed. There were 2 postoperative hemiplegia, 4 hypoglossal nerve impairment,2 glossopharyngeal nerve impairment, 1 vagus nerve impairment, and 1 accessory nerve impairment. One patient presented postoperative cranial nerve impairment in glossopharyngeal, vagus and hypoglossal nerves. Two patients developed local recurrence during the long-term follow-up. Conclusion. Complete surgical excision was possible in each patient if the diagnosis had been correctly made through selective preoperative angiography, vessel ultrasound Doppler and other examinations.Reasonable surgical procedure and Matas training were necessary to the successful surgical treatment and thus decrease the complicative incidence rate of carotid chemodectomas.

Perioperative blood transfusion does not decrease survival after surgical treatment of spinal metastases

DEFF Research Database (Denmark)

Clausen, Caroline; Lönn, Lars; Morgen, Søren Schmidt

2014-01-01

PURPOSE: To assess whether perioperative allogenic blood transfusions in patients undergoing surgical treatment for spinal metastases independently influence patient survival. METHODS: A retrospective study including 170 consecutive patients undergoing surgical treatment for spinal metastases in ...... 12-month survival. Future studies should assess if a liberal transfusion regime can be applied to this group of patients; thereby, prioritizing early postoperative mobilization....

Clinical characteristics and outcome of surgical treatment of ...

African Journals Online (AJOL)

There were 12 patients with alveolar disease while six had embryonal type of rhabdomyosarcoma. Treatment was by combination chemotherapy, and surgical excision which was done primarily in 11, after chemotherapy in four, and after radiotherapy in one. Two had biopsy only. Five patients are alive, two of them without ...

Cap’n’collar differentiates the mandible from the maxilla in the beetle Tribolium castaneum

Science.gov (United States)

2012-01-01

Background The biting mandible of the arthropods is thought to have evolved in the ancestor of the insects, crustaceans and myriapods: the Mandibulata. A unique origin suggests a common set of developmental genes will be required to pattern the mandible in different arthropods. To date we have functional studies on patterning of the mandibular segment of Drosophila melanogaster showing in particular the effects of the gene cap’n’collar (cnc), however, the dipteran head is far from representative of insects or of more distantly related mandibulates; Drosophila does not even possess a mandibular appendage. To study the development of a more representative insect mandible, we chose the red flour beetle Tribolium castaneum and investigated the function of the Tribolium orthologs of cap’n’collar (Tc-cnc) and the Hox gene Deformed (Tc-Dfd). In order to determine the function of Tc-cnc and Tc-Dfd, transcripts were knocked down by maternal RNA interference (RNAi). The effects of gene knockdown were examined in the developing embryos and larvae. The effect of Tc-cnc and Tc-Dfd knockdown on the expression of other genes was determined by using in situ hybridization on Tribolium embryos. Results Our analyses show that Tc-cnc is required for specification of the identity of the mandibular segment of Tribolium and differentiates the mandible from maxillary identity. Loss of Tc-cnc function results in a transformation of the mandible to maxillary identity as well as deletion of the labrum. Tc-Dfd and the Tribolium homolog of proboscipedia (Tc-mxp = maxillopedia), Hox genes that are required to pattern the maxillary appendage, are expressed in a maxilla-like manner in the transformed mandible. Tribolium homologs of paired (Tc-prd) and Distal-less (Tc-Dll) that are expressed in the endites and telopodites of embryonic appendages are also expressed in a maxilla-like manner in the transformed mandible. We also show that Tc-Dfd is required to activate the collar of Tc

BRUCELLA ENDOCARDITIS IN IRANIAN PATIENTS: COMBINED MEDICAL AND SURGICAL TREATMENT

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Ebrahim Nematipour

1995-06-01

Full Text Available Brucella endocarditis is a Tare but serious complication ofbrucellosis and is the main cause of death reuuedto thisdisease: Itis not rare in the endemic areas and aaualiy accounts for up to 8~lO% ofendocarditis infections: We report seven adult cases of brucella endocarditis in lmam-Khorneini Hospual: Contrary to previous independent reports, female patients were not rare in this study and accountedfor three out ofseven. Four patients were cared for by combined medical and surgical treatment and were recovered Three of the patients that did not receive the combined theraPl could not he saved This report confirms the necessity of prompt combined medical and surgical treatment ofbrucella endocarditis.

OUTCOMES OF SURGICAL TREATMENT OF HIATAL HERNIA

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Zhurbenko G. A.

2018-05-01

Full Text Available Background: In traditionally performed fundoplications during the treatment of sliding diaphragmatic hernias, the improvement of surgical techniques to restore acute angle of His remains topical. Aim: To develop a method of surgical treatment of hiatus hernias to restore acute angle of His. Material and methods: Patients (n = 74 were divided into two groups: the main group (I (n = 45, in which the developed operation method was applied and the control group (II (n = 29, in which Toupet method was applied to 26 patients, Nissen method – to 3 patients. GERD-Q and GERD-HRQL questionnaires were applied to all patients of the first group before the operation, during discharge from hospital and 6-12 12-18 18-24 months after surgical intervention. Patients of the second group were surveyed 6-12 months after the operation. Results: According to the results of the survey after 6-12 months statistically significant differences were not revealed in the groups: GERD-Q, p<0,386; GERD-HRQL, p<0,1089. In the main group there was a tendency to decrease the points in the GERD-Q survey when compared before and after surgery, p <0.0001. Out of 16 (55% patients of the second group hospitalized after the operation the relapse was revealed in 9 patients, 7 of them were re-operated. 20(43,3% patients of group I underwent inpatient examination, 2 relapsed and no one was re-operated. Conclusion: The efficiency of the suggested operation technique is comparable to Toupet method in the early stages, although when assessing the remote results there are a less number of relapses.

Evaluation of surgical treatment for cerebral amyloid angiopathy

International Nuclear Information System (INIS)

Ohta, Masaru; Takeshita, Iwao; Samoto, Ken

2007-01-01

Treatment of cerebral hemorrhage in the elderly is often difficult and a growing concern due to Japan's aging population. We retrospectively evaluated radiological images of intracerebral hemorrhages associated with cerebral amyloid angiopathy (CAA) and surgical efficacy for performance status of patients. From January 2000 to December 2005, 240 patients with intracerebral hemorrhage and 49 patients with cerebral subcortical hemorrhage were reported. Of these, 41 cases fulfilled the Boston criteria for CAA. Diagnosis by autopsy was 0, surgical biopsy histopathology 9, multiple hemorrhagic lesions 8 and single lesion in 24 patients. Involved lobes were frontal: 6, temporal: 1, fronto-parietal: 3, temporo-parietal: 8, parietal: 12, parieto-occipital: 6 and occipital: 5. CAA-related subcortical hemorrhages were commonly distributed in 2 lobes, with the parietal lobe the most commonly affected area. Radiological characteristics of CAA-related subcortical hemorrhages were irregular borders: 30/41 (73%) intraventricular ruptures: 15/41 (37%), and subarachnoid hemorrhage and/or acute subdural hematoma: 37/41 (90%). Surgery was indicated if consciousness level (Japan Coma Scale) was greater than II-20 and hematoma volume greater than 40 ml. Craniotomy was performed on 18 patients with modified Rankin Scale (mRS) with 60% improving postoperatively and the remainder maintaining the same mRS as before surgery. Two patients underwent emergency craniotomy due to a rapidly growing hematoma producing a comatose state. Of the 18 surgical cases, 1 had further bleeding in a different area postoperatively at 3 months. Of the 23 nonsurgical cases, 4 had further bleeding after conservative treatment at 1.5 to 3.5 months with 1 case affected on 3 separate occasions. Surgical removal of hematomas caused by CAA is safe and unlikely to accelerate the rate of further bleeding, but rather contribute to improvement of mRS in selected patients. (author)

Surgical Management of Severe Spontaneous Hemorrhage of the Abdominal Wall Complicating Acenocoumarol Treatment

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Orestis Ioannidis

2012-01-01

Full Text Available Acenocoumarol is a vitamin K antagonist that is used for the treatment of acquired and congenital, both arterial and venous, thrombotic diseases. Its use is complicated by the narrow therapeutic range. Bleeding following oral anticoagulation, despite rare, remains the major complication. Most cases of hemorrhagic episodes usually require short hospitalization and transfusion, while surgical drainage of the hematoma is not recommended. However, in cases that conservative treatment isn’t successful, surgical intervention remains an option. We present a case of severe spontaneous bleeding of the rectus abdominis muscle which was successfully managed surgically.

Surgical orthodontics.

Science.gov (United States)

Strohl, Alexis M; Vitkus, Lauren

2017-08-01

The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

Relationship between preoperative breast MRI and surgical treatment of non-metastatic breast cancer.

Science.gov (United States)

Onega, Tracy; Weiss, Julie E; Goodrich, Martha E; Zhu, Weiwei; DeMartini, Wendy B; Kerlikowske, Karla; Ozanne, Elissa; Tosteson, Anna N A; Henderson, Louise M; Buist, Diana S M; Wernli, Karen J; Herschorn, Sally D; Hotaling, Elise; O'Donoghue, Cristina; Hubbard, Rebecca

2017-12-01

More extensive surgical treatments for early stage breast cancer are increasing. The patterns of preoperative MRI overall and by stage for this trend has not been well established. Using Breast Cancer Surveillance Consortium registry data from 2010 through 2014, we identified women with an incident non-metastatic breast cancer and determined use of preoperative MRI and initial surgical treatment (mastectomy, with or without contralateral prophylactic mastectomy (CPM), reconstruction, and breast conserving surgery ± radiation). Clinical and sociodemographic covariates were included in multivariable logistic regression models to estimate adjusted odds ratios and 95% confidence intervals. Of the 13 097 women, 2217 (16.9%) had a preoperative MRI. Among the women with MRI, results indicated 32% higher odds of unilateral mastectomy compared to breast conserving surgery and of mastectomy with CPM compared to unilateral mastectomy. Women with preoperative MRI also had 56% higher odds of reconstruction. Preoperative MRI in women with DCIS and early stage invasive breast cancer is associated with more frequent mastectomy, CPM, and reconstruction surgical treatment. Use of more extensive surgical treatment and reconstruction among women with DCIS and early stage invasive cancer whom undergo MRI warrants further investigation. © 2017 Wiley Periodicals, Inc.

Big Keratocystic Odontogenic Tumor of the Mandible

African Journals Online (AJOL)

GB

KCOT originates as an extension of the basal epithelial cells or the dental organ due to degeneration of the stellate reticulum, or odontogenic epithelial remnants in the mandible or ... transformation into a squamous cell carcinoma. (3). CASE PRESENTATION. A 30 years old male patient came from the southern part of ...

Bodypacking - An increasing problem in the Netherlands: Conservative or surgical treatment?

NARCIS (Netherlands)

van Geloven, A. A. W.; van Lienden, K. P.; Gouma, D. J.

2002-01-01

Objective: Evaluation of diagnostic work-up and treatment of bodypackers. Identification of predictive factors for surgical treatment. Design: Retrospective descriptive study. Setting: Teaching hospital, The Netherlands. Patients: All 40 consecutive patients, admitted during the period 1995-99

New developments for the surgical treatment of shoulder problems

International Nuclear Information System (INIS)

Anderl, W.

2004-01-01

Tremendous advancement has been made in the surgical treatment of the shoulder within the last years. Arthroscopic techniques for treatment of rotator cuff lesions, instability problems and biceps tendon lesions are today established because of significant improvement of instruments, suture materials and anchor techniques. The 4th generation of shoulder prosthesis systems guarantee today anatomical and biomechanical advantages with significant functional improvement for the patient. (orig.) [de

EVALUATION OF TWO SURGICAL TREATMENTS OF PRIMARY VESICOURETERAL REFLUX AMONG CHILDREN: A 15 YEARS EXPERIENCE

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Memeti Shaban

2016-07-01

Full Text Available Aim: aim of the study was to evaluate the efficiency of two different surgical treatments of vesicoureteral reflux (VUR on succesfull rate and patient outcome. Methods: Retrospective study on children with primary VUR and their surgical treatment from 1999 to 2014 in the University Clinic for Pediatric Surgery in Skopje. A total of 76 children (114 ureters with VUR ranging from second to fifth grade were treated surgically, 44 patients (67 ureters with an open surgical technique and 32 patients (47 ureters with endoscopic treatment ”STING” procedure. The following parameters were analyzed: duration of the intervention, duration of the hospitalization, the need for antibiotics and analgesic therapy and the need for blood and blood derivatives transfusion. The result of the surgical treatment was also validated. A good result was considered when reduction of VUR by 2 degrees with the endoscopic method or by 3 degrees in the open surgical technique was noticed. Results: Using open surgical technique, patients were hospitalized for an average of 9 days (range from 5 to 13 days. All children received double antibiotic therapy. The need for analgesics lasted for 3 to 4 days. 90% of treated children needed blood and/or blood derivatives transfusion. Success rate with this method was 93.8%. Endoscopic procedure was performed as a one-day surgical procedure. The average duration was 15 minutes. Single, prophylactic dose of antibiotic was ordinated. There was no need for blood and/or blood derivatives transfusion. The overall success of the treatment was about 70%. Conclusion: Open surgical procedure is used for more complicated cases, VUR grade IV-V or by previously failed. Endoscopic, “STING” procedure was commonly used for patients with VUR grade greater than 2, after previously failed conservative treatment, febrile urinary infection despite antibiotic prophylaxis and/or emergence of new scarring in the renal parenchyma. Patient assessment and

ADVANTAGES OF SURGICAL TREATMENT OF ACHILLES TENDON RUPTURE BY PERCUTANEOUS SUTURE AS OPPOSED TO NONSURGICAL TREATMENT

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Goran Vidić

2010-06-01

Full Text Available The Achilles tendon is the strongest tendon in the body, and its rupture appears to be the most common injury of the tendomuscular apparatus. This type of injury is more frequent in sportsmen, especially those who play tennis, gymnastics, skiing, handball, football, basketball and athletics. Also, the ruptures are common in people who engage in sports activities for recreation. They appear more often in males, in proportion of 3:1. It appears reciprocally in 25- 30% of the cases. The rupture is easily diagnosed by means of clinical examination (Thompson's test and ultrasonography.The aim of the analysis was to point to the advantages of surgical treatment of a fresh Achilles tendon rupture as opposed to non-surgical treatment by plaster immobilization.The examination was performed on 35 patients, of which 16 (45,71% were treated operatively and 19 (54,29% were treated nonoperatively. The average age of the patients was 38.8 years, that is 37.1 for those treated operatively and 40.2 for those treated nonoperatively. Among the examinees, there were 29(82,86% men and 6 (17,14% women. The operative treatment method consisted of percutaneous suturing, whereas the nonoperative treatment involved the circular above the knee plaster immobilization. All operatively treated patients underwent the surgical treatment in the first 48 hours from the time when the injury had occured. Anesthesia was local and infiltrative.The obtained results showed that there were no unhealed ruptures or re-ruptures. In the group of patients who did not undergo the surgery, there was 1 re-rupture and 1 unhealed rupture, after which the surgical treatment had to be performed in both cases. In the group of operated patients there were no infections, however, 1 thromboembolism occured. Recovery of muscular strenght of the tendon and the realization of the full range of movement required less time in the operated patients. The ultrasonographic findings in the operated patients

Changes in craniofacial development due to modifications of the treatment of unilateral cleft lip and palate.

Science.gov (United States)

Smahel, Z; Müllerova, Z; Nejedly, A; Horak, I

1998-05-01

The objective of this study was to evaluate the craniofacial morphology of children with unilateral cleft lip and palate (UCLP) resulting from differing management protocols practiced in Prague from 1945 to 1976. The craniofacial morphologies of four groups of patients were compared. Two groups were assessed retrospectively (individuals born from 1945 to 1963), and two groups were followed on a longitudinal basis (individuals born from 1966 to 1976). The study was conducted at the Cleft Lip and Palate Center at the Department of Plastic Surgery, Prague, which has a catchment area population of 6 million. The subjects were a consecutive series of adult males (n = 84) who had complete UCLP without associated malformations. Patients born from 1945 to 1955 did not receive centralized orthodontic therapy. From 1945 to 1965, the alveolar process in the area of the cleft was not surgically repaired. Primary bone grafting was used for the group born from 1965 to 1972, and primary periosteoplasty was used in the subsequent period. Throughout the period covered by the study, the palate was operated on by pushback and pharyngeal flap surgery. From 1945 to 1965, the lip was repaired initially according to Veau, and later according to Tennison and Randall, and during this time, fixed appliances were used for orthodontic treatment. The results for the period from 1945 to 1955 are characterized by mandibular overclosure with anterior crossbite. Centralized orthodontic treatment in the later period improved sagittal jaw relations due to the posterior displacement of the mandible and an edge-to-edge bite was attained, but maxillary retrusion was unchanged. Primary bone grafting increased retrusion of the maxilla, which was compensated by further posterior displacement of the mandible. An edge-to-edge bite was also obtained. Primary periosteoplasty reduced maxillary retrusion, and the marked proclination of the upper dentoalveolar component with fixed appliances resulted in a

[Current status and expectations in the surgical treatment of recurrent lateral patellar dislocation].

Science.gov (United States)

Zhao, Zhi-Dong; Li, Peng-Cui; Wei, Xiao-Chun

2017-11-25

Up to now, surgical treatment of recurrent lateral patellar dislocation mainly includes: medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, trochleoplasty, lateral retinacular release, derotation osteotomy and so on . Clinical reports show that: the use of a single or combined with several methods have achieved ideal short to mid-term clinical outcomes. However, there is no consolidate criterion concerning the choices of different kinds of surgical ways for the treatment of individual recurrent lateral patellar dislocation. Meanwhile, with the wide use of MPFL reconstruction and other surgical options, there are more and more complications and failures that are worthy and necessary for us to pay attention to, even though its high success rate. The aim of this article is to make a systematic review of the application status of different surgical methods, collecting the positive results we have achieved, illuminating application keys of surgical techniques, guiding patient-specific therapy more precisely. Copyright© 2017 by the China Journal of Orthopaedics and Traumatology Press.

Ameloblastic fibro-odontoma of the anterior mandible in a 22-month-old boy

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Wewel John

2010-01-01

Full Text Available We report an ameloblastic fibro-odontoma (AFO presenting in the anterior mandible as a "bump on his gums" in a 22-month-old boy. An occlusal radiograph revealed a well-circumscribed radiolucency with scattered radiopaque foci. The tumor was enucleated under general anesthesia. The histologic findings were characteristic of an AFO, a mixed odontogenic tumor most common in the posterior jaws, primarily affecting individuals with an average age of 10 years. The clinical presentation, microscopic findings, differential diagnoses, and treatment are discussed.

Management of cannabis-induced periodontitis via resective surgical therapy: A clinical report.

Science.gov (United States)

Momen-Heravi, Fatemeh; Kang, Philip

2017-03-01

There is a lack of clinical research on the potential effect of cannabis use on the periodontium as well as its effect on treatment outcomes. The aim of this case report is to illustrate the clinical presentation of periodontal disease in a young woman who was a chronic cannabis user, as well as successful treatment involving motivating the patient to quit cannabis use and undergo nonsurgical and surgical therapy. A 23-year-old woman sought care at the dental clinic for periodontal treatment. During a review of her medical history, the patient reported using cannabis frequently during a 3-year period, which coincided with the occurrence of gingival inflammation. She used cannabis in the form of cigarettes that were placed at the mandibular anterior region of her mouth for prolonged periods. Localized prominent papillary and marginal gingival enlargement of the anterior mandible were present. The mandibular anterior teeth showed localized severe chronic periodontitis. The clinicians informed the patient about the potentially detrimental consequences of continued cannabis use; she was encouraged to quit, which she did. The clinicians performed nonsurgical therapy (scaling and root planing) and osseous surgery. The treatment outcome was evaluated over 6 months; improved radiographic and clinical results were observed throughout the follow-up period. Substantial availability and usage of cannabis, specifically among young adults, requires dentists to be vigilant about clinical indications of cannabis use and to provide appropriate treatments. Behavioral modification, nonsurgical therapy, and surgical therapy offer the potential for successful management of cannabis-related periodontitis. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

SURGICAL TREATMENT OF CHRONIC CYSTIC PANCREATITIS

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O. N. Sled

2016-01-01

Full Text Available Increasing the number of patients with complicated forms of chronic pancreatitis and pancreatic cysts observed in recent decades. Mostly people of working age are susceptible to disease. This makes the issue a social importance.The article presents a modern view of the choice of method of surgical treatment of chronic pancreatitis and cystic optimal terms of therapy, depending on the degree of “maturity” of pancreatic cysts. A detailed analysis of both traditional surgery and advanced minimally invasive treatment for pancreatic cysts is performed in this review of the literature.Emphasis is placed on radical methods of treatment, particularly in the duodenum-preserving operations. Pathogenic study is carried out. The problem of choosing the most radical and at the same time the organ-preserving technique, helping to improve the immediate and long-term results, the quality of life and social and labor rehabilitation, has not lost its relevance. Studies carried out in this area are currently important.

Surgical treatment of parastomal hernia

International Nuclear Information System (INIS)

Basti, Z.; Mayer, A.

2013-01-01

Stoma construction is among standard surgical skills and is performed for many indications. Every stoma means huge impact on quality of life for patients even with great improvement in surgical technique and ostomy devices. All patients are very sensitive to complication of stoma and the most frequent complication is parastomal hernia. Incidence reported in literature is very high and unacceptable, it is 30-70%. Surgical approach is very demanding on technical equipment and experiences of surgeon. Authors focus on each surgical approach for treating this complication weather it´s using mesh or laparoscopic or open approach. (author)

Surgical Treatment with Locoregional Flaps for the Eyelid: A Review

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Federico Lo Torto

2017-01-01

Full Text Available Reconstruction of the eyelids after skin cancer excision can be challenging. Surgical treatment options are multiple; deep anatomy knowledge of lamellar components is mandatory to choose the most adequate surgical planning. Eyelids’ role in vision and social relationship is critical; both function and aesthetics are tough to restore. Using a flap provides a satisfying texture and colour match with adjacent tissues and ensures short contraction during healing; furthermore, grafts are sometimes necessary to achieve pleasing results. Hundreds of surgical techniques have been described aiming for eyelid reconstruction; in our paper, we want to provide for our audience the most reliable and useful procedures for subtotal and total eyelid reconstruction following NMSC full-thickness excision.

Treatment of Osteomyelitis: A Case for Disruption of the Affected Adjacent Periosteum.

Science.gov (United States)

Hudson, John W; Daly, Austin P; Foster, Michael

2017-10-01

To evaluate the response of mandibular osteomyelitis treated by surgical decortication with disruption of the affected adjacent periosteum in concert with long-term targeted antibiotic therapy. The hypothesis is that, by removing the buccal cortical plate and disrupting the hypertrophically inflamed adjacent periosteum, the medullary bone will be brought in contact with bleeding tissue and circulating immunologic factors and antibiotics, which will promote definitive resolution. A retrospective review was conducted of 7 patient charts with associated radiographs from November 2010 to August 2016 treated by the first author at the University of Tennessee Medical Center (Knoxville, TN). Patients with chronic suppurative or nonsuppurative osteomyelitis of the mandible without condylar involvement or pathologic fracture were selected and treated with decortication with periosteal disruption in combination with long-term targeted antibiotic therapy. Seven patients (3 women and 4 men; mean age, 60 yr) underwent decortication with periosteal disruption of the affected area and received at least 6 weeks of targeted intravenous antibiotics. Computed tomography was performed preoperatively and a repeat study was performed after completion of antibiotics. In each case, post-treatment imaging showed definitive resolution after treatment with decortication in concert with disruption of the inflamed hypertrophic periosteum and intravenous antibiotics. Debridement of the infected cortical bone with restoration of the blood supply through disruption of the adjacent periosteum provided definitive resolution of mandibular osteomyelitis in the 7 patients treated. The hypothesis is that disruption of the affected adjacent periosteum reintroduces an immune-mediated response in concert with improved antibiotic delivery to and penetrance of the diseased mandible, aiding in definitive resolution. Decortication with periosteal disruption allows for preservation of the inferior alveolar

Morphometric variability of mandible linear characteristics depending on level of teeth alveolus position

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Olga Yu. Aleshkina

2017-05-01

Results and Conclusion ― The highest altitude was marked at levels of incisors and 3rd molar, the smallest one – at level of 1st and 2nd molars; maximum mandible thickness was defined at level of 2nd molar, minimum – at levels of canine and 1st – 2nd premolars on both sides of mandible; average thickness was revealed at levels of incisors, 1st and 2nd molars and had the same statistical values. Bilateral variability of thickness was significantly dominating on the right side and only at levels of 1st – 2nd premolars and 1st molar. Average values of altitude and thickness from both sides of mandible and at all levels had medium degree of variability.

[The 3D-printed dental splint: a valuable tool in the surgical treatment of malocclusion after polytrauma].

Science.gov (United States)

van de Velde, W L; Schepers, R H; van Minnen, B

2016-01-01

A 22-year old male was referred to the Department of Oral and Maxillofacial Surgery of a university clinic 2 months after he had sustained multiple traumatic injuries abroad because of an anterior malocclusion. The malocclusion was the sequel of an unrecognised, untreated, already consolidated paramedian mandibular fracture on the right and a fracture of the contralateral mandibular angle on the left. Preoperatively, a cobalt-chrome 3D-printed dental splint was prepared. Surgical correction of the malocclusion was carried out by segmental osteotomies of the mandible at the original fracture sites. This involved a vertical paramedian osteotomy on the right side and a unilateral sagittal split osteotomy on the left mandibular angle side. The mandibular segment was mobilised in the correct occlusion with the aid of the 3D-printed dental splint. The splint was fixed to the teeth with dental composite. The custom made 3D-printed dental splint is considered a promising procedural innovation in oral and maxillofacial surgery.

Comparing surgical repair with conservative treatment for degenerative rotator cuff tears : a randomized controlled trial

NARCIS (Netherlands)

Lambers Heerspink, Okke; van Raay, Jos J. A. M.; Koorevaar, Rinco C. T.; van Eerden, Pepijn J. M.; Westerbeek, Robin E.; van 't Riet, Esther; van den Akker-Scheek, Inge; Diercks, Ronald L.

Background: Good clinical results have been reported for both surgical and conservative treatment of rotator cuff tears. The primary aim of this randomized controlled trial was to compare functional and radiologic improvement after surgical and conservative treatment of degenerative rotator cuff

Heterochrony in mandible development of larval shrimp (Decapoda: Caridea)--a comparative morphological SEM study of two carideans.

Science.gov (United States)

Batel, Annika; Melzer, Roland R; Anger, Klaus; Geiselbrecht, Hannes

2014-11-01

Mandible development in the larval stages I-V of two palaemonid shrimp species, Palaemon elegans and Macrobrachium amazonicum, was analyzed using scanning electron microscopy, light microscopy, and confocal laser scanning microscopy. In contrast to the zoea I of P. elegans, first-stage larvae of M. amazonicum are nonfeeding. At hatching, the morphology of the mandibles is fully expressed in P. elegans, while it appears underdeveloped in M. amazonicum, presenting only small precursors of typical caridean features. In successive zoeal stages, both species show similar developmental changes, but the mandibular characters of the larvae in M. amazonicum were delayed compared to the equivalent stages in P. elegans, especially in the development of submarginal setae and mandible size. In conclusion, our results indicate heterochrony (postdisplacement) of mandible development in M. amazonicum compared to that in P. elegans, which is related to initial lack of mandible functionality or planktivorous feeding at hatching, respectively. This conclusion is supported by comparison with other palaemonid zoeae exhibiting different feeding modes. Our data suggest that an evolutionary ground pattern of mandible morphology is present even in species with nonfeeding first-stage larvae. © 2014 Wiley Periodicals, Inc.

Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol

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Corina Marilena Cristache

2017-01-01

Full Text Available The aim of this study was to evaluate the accuracy of a stereolithographic template, with sleeve structure incorporated into the design, for computer-guided dental implant insertion in partially edentulous patients. Materials and Methods. Sixty-five implants were placed in twenty-five consecutive patients with a stereolithographic surgical template. After surgery, digital impression was taken and 3D inaccuracy of implants position at entry point, apex, and angle deviation was measured using an inspection tool software. Mann–Whitney U test was used to compare accuracy between maxillary and mandibular surgical guides. A p value < .05 was considered significant. Results. Mean (and standard deviation of 3D error at the entry point was 0.798 mm (±0.52, at the implant apex it was 1.17 mm (±0.63, and mean angular deviation was 2.34 (±0.85. A statistically significant reduced 3D error was observed at entry point p=.037, at implant apex p=.008, and also in angular deviation p=.030 in mandible when comparing to maxilla. Conclusions. The surgical template used has proved high accuracy for implant insertion. Within the limitations of the present study, the protocol for comparing a digital file (treatment plan with postinsertion digital impression may be considered a useful procedure for assessing surgical template accuracy, avoiding radiation exposure, during postoperative CBCT scanning.

Combined and surgical treatment of cervix uteri cancer

International Nuclear Information System (INIS)

Shuvaeva, N.I.; Kundukhova, E.M.; Vekhova, L.I.; Volkova, M.A.; Falileeva, E.P.; Troitskaya, I.B.

1980-01-01

The many-year experience with the treatment of the cervix uteri cancer has indicated that a combined method in case of the appropriate indications provides for high and persistant delayed results. The five-year recovery of patients at all stages was noted in 78.7% (1 stage-87.3%; 2 stage-71.6 %, 3 stage-41.7%). Improvement of therapeutic and diagnostic methods, strict adherence to the principles of a differential approach to selecting the type of therapy enabled increasing the per cent of a five-year cure from 68.9%' (1945-46) to 91.8% in 1965-69. The clinical features of microinvasive cervix uteri canner (stage 1a) made it possible to reduce the extent of the treatment applied on account of excluding a radiation component and lessening the extent of surgical intervention. A five-year cure by the surgical method in patients with cancer of stage 1a made up 97%. The results of the combined therapy in patients cervix uteri with stage 1b within the same period yielded 94%

Surgical Treatment Results of Acute Acromioclavicular Injuries

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Mahmoud Jabalameli

2010-02-01

Full Text Available Background Different methods of surgical treatment for acromioclavicular(ACjoint injury were considered in the literature. The purpose of the study was to compare intra- articular AC repair technique with the extra-articular coracoclavicular repair technique for the patients with Rockwood type III and VAC joint injury when indicated.Methods: Nineteen consecutive patients with Rockwood type III and VAC joint injury  were treated with intra-articular (Group I - 12 cases and extra-articular (Group II - 7cases repair technique between 1380 - 1386, and the results reviewed. When the diagnosis was established, the mean age of the patients was 32.5 years (Range, 18 - 60; group I and II 31.8 years (Range, 18 - 60 and 34 years (Range, 22 - 58 respectively. The mean duration of postoperative follow - up was 24 months. The Constant shoulder scoring system was applied to obtain clinical results.   Results: Only in group I, the post-surgical complication was associated with fiber allergy, wound infection and pin site infection in two patients respectively. No pain was detected in fourteen cases. Four patients in group I had occasional mild pain during sport activity, while one case in this group reported severe pain during resting which prevented the patient from activity. Also, there was an ossification in thirteen patients particularly in group I. Clinical results showed the mean constant shoulder score was 93.4 in group I and 97.1 in group II.Conclusion: At the time of the follow - up, there was a clear difference between both groups regarding to postoperative pain and discomfort.Therefore, it seemed that potential cause of pain was due to postoperative complications. An interesting postoperative complication without interfere in the functional outcome was coracoclavicular space ossification in most cases. This was probably because of soft tissue injury during the operation.It seemed that surgical treatment of Rockwood type III and VAC joint injuries

Early reconstruction of bone defect created after initial surgery of a large keratocystic odontogenic tumor: A case report

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Matijević Stevo

2013-01-01

Full Text Available Introduction. Keratocystic odontogenic tumor (KCOT is defined as a benign cystic neoplasm of the jaws of odontogenic origin with a high rate of recurrence. The most lesions occur in the posterior part of the mandible. Treatment of KCOT remains controversial, but the goals of treatment should involve eliminating the potential for recurrence while minimizing surgical morbidity. However, another significant therapeutic problem related to the management of KCOT is an adequate and early reconstruction of the existing jaw defect, as well as appropriate aesthetic and functional rehabilitation of a patient, especially in cases of a very large destruction of the jaws bone. Case report. We presented a 65-year-old female patient with very large KCOT of the mandible. Orthopantomographic radiography showed a very large elliptical multilocular radiolucency, located on the right side of the mandible body and the ascending ramus of the mandible, with radiographic evidence of cortical perforation at the anterior border of the mandibular ramus and the superior border of the alveolar part of the mandible. The surgical treatment included two phases. In the first phase, the tumor was removed by enucleation and additional use of Carnoy solution, performing peripheral ostectomy and excision of the affected overlying mucosa, while in the second phase, restorative surgery of the existing mandibular defect was performed 6 months later. Postoperatively, we did not register any of postoperative complications, nor recurrence within 2 years of the follow-up. Conclusion. Adequate and early reconstruction of the existing jaw defect and appropriate aesthetic and functional rehabilitation of the patient should be the primary goal in the treatment of KCOT, having in mind the need for a long-term post-surgical follow-up.

Massive keratocystic odontogenic tumor of mandible crossing the midline in 11-year child: An unusual case report and its management

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A N Sulabha

2013-01-01

Full Text Available Introduction: Odontogenic keratocyst (OKC is now designated by World Health Organization (WHO as keratocystic odontogenic tumor (KCOT. The OKC involves approximately 11% of all the cysts in jaws. OKC possesses tumor-like characteristics because of its clinical behavior. Incidence of occurrence of this lesion in nonnevoid basal cell carcinoma syndrome patients before ten is low. Case Report: We report a massive OKC in the anterior region of mandible in a child. Combination of age, sex, size of the lesion, its location, and rapid growth in the present case makes it different from other KCOTs. Our management plan aimed to preserve the natural dentition, shape, function, and continuity of mandible. Discussion: An aggressive treatment modality like enucleation in combination with Carnoy′s solution application, as done in the present case might be considered as a viable treatment modality for massive KCOT. The present paper also highlights brief discussion concerning the management of OKC.

Emergency percutaneous treatment in surgical bile duct injury.

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Carrafiello, Gianpaolo; Laganà, Domenico; Dizonno, Massimiliano; Ianniello, Andrea; Cotta, Elisa; Dionigi, Gianlorenzo; Dionigi, Renzo; Fugazzola, Carlo

2008-09-01

The aim of this study is to evaluate the efficacy of emergency percutaneous treatment in patients with surgical bile duct injury (SBDI). From May 2004 to May 2007, 11 patients (five men, six women; age range 26-80 years; mean age 58 years) with a critical clinical picture (severe jaundice, bile peritonitis, septic state) due to SBDI secondary to surgical or laparoscopic procedures were treated by percutaneous procedures. We performed four ultrasound-guided percutaneous drainages, four external-internal biliary drainages, one bilioplasty, and two plastic biliary stenting after 2 weeks of external-internal biliary drainage placement. All procedures had 100% technical success with no complications. The clinical emergencies resolved in 3-4 days in 100% of cases. All patients had a benign clinical course, and reoperation was avoided in 100% of cases. Interventional radiological procedures are effective in the emergency management of SBDI since they are minimally invasive and have a high success rate and a low incidence of complications compared to the more complex and dangerous surgical or laparoscopic options.

Surgical-prosthetic treatment of large mandibular cysts

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Džambas Ljubiša D.

2003-01-01

Full Text Available This paper presents a combined surgical-prosthetic procedure of reconstructing mandibular bone defect in a 53 year old patient, following enucleation of a mandibular cyst (Cystectomy Partsch II. After a thorough diagnostic evaluation, a surgical procedure was planned with the particular attention to the nature of the disease, patient’s condition, size and extension of the cyst, tissue loss, and the possibilities of prosthetic management of a mandibular bone defect with partial postresection dental prosthesis. It is of great importance to point to the significance of teamwork of a maxillofacial surgeon and a specialist in prosthodontics. This kind of cooperation provided very effective and less risky soft tissue, as well as bone tissue regeneration (osteogenesis. The patient’s recovery was fast, and he could return to his daily activities and work without significant changes regarding quality of life after surgery and prosthetic treatment.

Solitary plasmacytoma of the mandible - a rare entity.

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Baad, Rajendra; Kapse, Sonam C; Rathod, Nanita; Sonawane, Kishor; Thete, Sanjay Gangadhar; Kumar, M Naveen

2013-06-01

Plasma cell dyscrasias (multiple myeloma, solitary plasmocytoma of bone and extra medullary plasmocytoma) are cha¬racterized by a monoclonal neoplastic proliferation of plasma cells of which Solitary plasmocytoma of bone (SPB) is a localized form. SPB is most frequently seen in vertebrae and secondarily in long bones. Its presence in jaws is extremely rare. The malignant plasma cells express monotypic cytoplasmic immunoglobulins and plasma cell-associated antigens, with an absence of immature B-cell antigens. Here we report a unique case of plasmacytoma in the right side of mandible, a chronology for diagnosis of the lesion is also reviewed along with clinical, radiographic, histopathological and immunohistochemical evidence. How to cite this article: Baad R, Kapse S C, Rathod N, Sonawane K, Thete S G, Naveen M K. Solitary Plasmacytoma of the Mandible - A Rare Entity. J Int Oral Health 2013; 5(3):97-101.

Detection surgical treatment and its results in children's thyroid gland

International Nuclear Information System (INIS)

Polyakov, V.G.; Lebedev, V.I.; Belkina, B.M.; Shishkov, R.V.; Makarova, I.S.; Durnov, L.A.

1995-01-01

208 patients with thyroid gland cancer were observed in 1975-1993 . The morphological investigations point to an absolute prevalence of highly differentiated forms of thyroid gland cancer in children. The radiation diagnostic techniques included ultrasound investigations of neck organs, chest roentgenography, thyroid gland scintigraphy. It is shown that the surgical method is the basic technique of treating thyroid gland cancer in children. 5-year survival rate of patients depending on the stage of disease development and scope of surgical treatment is analysed

Association Between Changes in the Angle of Mandible and Reduced Bone Mineral Density

International Nuclear Information System (INIS)

Rehman, D.; Sarwath, S.; Nigar, N.

2015-01-01

Objective: To establish an association between the angle of mandible on an orthopantomogram (OPG) with reduced bone mineral density of femoral neck and spine on Dual Energy X-ray Absorptiometry (DXA) scan. Study Design: Cross-sectional study. Place and Duration of Study: Institute of Basic Medical Sciences (IBMS), Dow University of Health Sciences (DUHS), Karachi, from December 2011 to July 2012. Methodology: Female subjects between 25 and 85 years of age were divided into premenopausal (Group-I) and postmenopausal (Group II) groups. Dual Energy X-ray Absorptiometry (DXA) scan was done to divide Group-I and Group-II into normal (pre A, post A), osteopenic (pre B, post B) and osteoporotic (pre C, post C) groups. Changes seen in angle of mandible on orthopantomogram (OPG) in subgroups of Group-I were compared with each other and with subgroups of Group-II. SPSS version 16 was used to carry out the statistical analysis. Intragroup significance was evaluated through One Way Analysis Of Variance (ANOVA). For intergroup significance independent samples t-test was applied. Results: The angle of mandible (A) was significantly decreased in Intragroup comparison of Group-II (0.035) between Post normal (Post A) vs. Post osteopenic (Post B) groups. Intergroup comparison between Group-I and Group-II (0.005) showed a significant decrease in angle of mandible between Pre osteopenic (Pre B) vs. Post osteopenic (Post B). Conclusion: As decrease in angle of mandible was observed at stage of osteopenia, it can be conveniently used for early detection of osteoporosis. (author)

Morphometric analysis of the mandible in the Durban Metropolitan population of South Africa.

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Ishwarkumar, S; Pillay, P; Haffajee, M R; Satyapal, K S

2017-01-01

The identification of an individual from skeletal remains plays a vital role in forensic investigation as it is essential for the identification of the individual's age, sex, and/or race and further analysis. Skeletal characteristics differ from one population group to another since population-specific osteometric standards exist for sex determination. Since the mandible is the largest, strongest and most durable compact facial bone, it is the best preserved after death. While sexual dimorphism of the mandible is indicated by its shape and size, morphometric analysis is more accurate in the determination of sex from the skull. The aim of this study was to evaluate the morphometric parameters of the mandible in the Durban Metropolitan population. Various morphometric parameters of the mandible were measured and assessed in 265 digital panoramic radiographs aged between 16 and 30 years (n = 530). Each parameter recorded was statistically analysed using SPSS to determine if a relationship existed between the parameter, and sex and age. In this study the morphometric parameters of the male mandibles were greater than that of the females. This concurred with the findings of previous studies. The length of the mandibular ramus on the right and left sides was statistically significant with sex. This correlated with previous studies, indicating that the length of the mandibular ramus generally has higher sexual dimorphism than any other morphometric mandibular parameter (p = 0.000). However, only the length of the right mandibular body was statistically significant when compared with sex (p = 0.040). The findings of this study may assist forensic investigators, anatomists, anthropologists and maxillo-facial surgeons.

Surgical Treatment of Severe Traumatic Brain Injury in Switzerland: Results from a Multicenter Study.

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Rossi-Mossuti, Frédéric; Fisch, Urs; Schoettker, Patrick; Gugliotta, Marinella; Morard, Marc; Schucht, Philippe; Schatlo, Bawarjan; Levivier, Marc; Walder, Bernhard; Fandino, Javier

2016-01-01

Since the introduction of modern surgical techniques and monitoring tools for the treatment of severe traumatic brain injury (TBI) in Switzerland, standardized nationwide operative procedures are still lacking. This study aimed to assess surgical management and monitoring strategies in patients admitted throughout Switzerland with severe TBI. Demographic, clinical, and radiologic data from a prospective national cohort study on severe brain-injured patients (Patient-relevant Endpoints after Brain Injury from Traumatic Accidents [PEBITA]) were collected during a 3-year period. This study evaluated patients admitted to 7 of the 11 trauma centers included in PEBITA. We retrospectively analyzed surgery-related computed tomography (CT) findings prior to and after treatment, intracranial pressure (ICP) monitoring, size and technical features of craniotomy, as well as surgical complications. ResULTS: This study included 353 of the 921 patients enrolled in PEBITA who underwent surgical treatment for severe TBI. At admission, acute subdural hematoma was the most frequent focal lesion diagnosed (n = 154 [44%]), followed by epidural hematoma (n = 96 [27%]) and intracerebral hematoma (n = 84 [24%]). A total of 198 patients (61%) presented with midline shift. Clinical deterioration in terms of Glasgow Coma Scale scores or intractable ICP values as an indication for surgical evacuation or decompression were documented in 20% and 6%, respectively. A total of 97 (27.5%) only received a catheter/probe for ICP monitoring. Surgical procedures to treat a focal lesion or decompress the cerebrum were performed in 256 patients (72.5%). Of the 290 surgical procedures (excluding ICP probe implantation), craniotomy (137 [47.2%]) or decompressive craniectomy (133 [45.9%]) were performed most frequently. The mean size of craniectomy in terms of maximal linear width on the CT axial slice was 8.4 ± 2.9 cm. Intraoperative ICP monitoring was reported in 61% of the interventions. Significant

Morphologic and Morphometric Analysis of Lingula in Localizing Mandibular Foramen with its Surgical Importance

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Phalguni Srimani

2017-10-01

Full Text Available Introduction: Morphologic and morphometric evaluation of mandible is clinically important. Considering the close relationship of lingula with neurovascular structures entering through mandibular foramen, lingula is often used as an important bony landmark during oral and maxillofacial surgical approach and inferior alveolar nerve block anaesthesia. Inadequate anatomical knowledge may result various intra operative complications like haemorrhge, fractures and nerve injury. Also, structural variations of lingula followed by inaccurate localization of mandibular foramen have been implicated as causative factor for unsuccessful inferior alveolar nerve block anaesthesia. Aim: To determine morphological and morphometric variations related to lingula of mandible in localizing mandibular foramen and to compare the results with similar type of osteological studies performed earlier on different population group. Materials and Methods: The study was performed on 36 adult dry human mandibles on both sides to categorize lingula according to its various shapes and determine the location of lingula based on surrounding mandibular landmarks by using Vernier caliper as 5 distances from tip of lingula as follows: i to anterior border of ramus of mandible; ii to posterior border of ramus of mandible; iii to centre of mandibular notch; iv to the alveolar socket of second molar tooth; and v to the base of mandible. The present study also indicated bilingual distance between tips of lingula of both sides. Data collected were analyzed statistically. Results: The most common shape of lingula was observed as triangular (51.39% followed by truncated (23.61%, then nodular (20.83% and assimilated (4.17% as least prevalent type. The average distances of tip of lingula from anterior and posterior borders of ramus of mandible were 18.21±1.50 mm and 16.33±1.21 mm respectively. On average, the tip of lingula was situated at 18.17±1.51 mm, 33.40±2.11 mm and 32.07±2.68 mm

Glucocorticoid-induced osteoporosis in the lumbar spine, forearm, and mandible of nephrotic patients

DEFF Research Database (Denmark)

Olgaard, K; Storm, Tina; van Wowern, N

1992-01-01

/day and tapered down to 20 mg/day for 1 year and DFZ was given in an equipotent dosage. Twenty-three patients completed 6 months of treatment, and 18 patients completed 12 months of treatment. Beside laboratory parameters to ensure the effect of treatment on the nephrotic syndrome, all had measurements......The long-term effects of high dose steroid treatment with either prednisone (PDN) or deflazacort (DFZ) were examined on various parts of the skeleton in 29 patients with nephrotic syndrome. All had normal skeleton at the start of the steroid treatment. At the beginning, PDN was given as 80 mg...... of the bone mineral content (BMC) at 0, 6, and 12 months of treatment. BMC was measured by single photon absorptiometry of both forearms and by dual photon absorptiometry of the mandible, forearms, and lumbar spine. The effect of DFZ was compared to that of PDN due to a potential "calcium sparing" effect...

[APPLICATION OF COMPUTER-ASSISTED SURGICAL PLANNING IN SURGICAL TREATMENT OF ANKLE FRACTURES].

Science.gov (United States)

Xia, Shengli; Wang, Xiuhui; Fu, Beigang; Lu, Yaogang; Wang, Minghui

2015-12-01

To explore the clinical value of computer-assisted surgical planning in the treatment of ankle fractures. Between January 2012 and January 2014, open reduction and internal fixation were performed on 42 patients with ankle fractures. There were 22 males and 20 females with an average age of 52 years (range, 19-72 years). The causes were spraining injury (20 cases), traffic accident injury (14 cases), and falling from height injury (8 cases). The time from injury to operation was 5 hours to 12 days (mean, 2.5 days). All fractures were closed trimalleolar fractures. According to Lauge-Hansen classification, 25 cases were rated as supination extorsion type IV, 13 as pronation extorsion type IV, and 4 as pronation abduction type III. The preoperative planning was made by virtual reduction and internal fixation using Superimage software. The mean operation time was 93.7 minutes (range, 76-120 minutes). Delayed wound healing occurred in 1 case, and secondary healing was obtained after treatment; primary healing of incision was achieved in the other patients. Postoperative X-ray films and CT images showed anatomic reduction of fracture and good position of internal fixation. All patients were followed up 14.6 months on average (range, 9-27 months). The range of motion of the affected ankle was close to the normal side at 6-8 weeks. The mean fracture healing time was 13.1 weeks (range, 11-17 weeks). Degenerative change of the ankle joint was observed in 3 cases (7.1%) with manifestation of mild narrowing of joint space on the X-ray films at last follow-up. According to Baird-Jackson score system, the results were excellent in 24 cases, good in 13 cases, and fair in 5 cases, with an excellent and good rate of 88%. Computer-assisted surgical planning for ankle fractures can help surgeons identify type of ankle fractures and improve surgical scheme for guiding fracture reduction and selecting and placing implants, so good effectiveness can be obtained.

An atypical case of craniometaphyseal dysplasia. Case report and surgical treatment.

Science.gov (United States)

Novelli, Giorgio; Ardito, Emanuela; Mazzoleni, Fabio; Bozzetti, Alberto; Sozzi, Davide

2017-01-01

Craniometaphyseal dysplasia is a rare hereditary bone disease presenting metaphyseal widening of the tubular bones, sclerosis of craniofacial bones and bony overgrowth of the facial and skull bones. Craniometaphyseal dysplasia occurs in an autosomal dominant (AD) and an autosomal recessive (AR) form. We present a 32-year-old patient arrived at our unit in May 2009. His main discomfort was a major limitation of the mouth opening, in the context of a craniofacial deformity. Relying on patient's medical history and the performed diagnostic tests, the diagnosis of craniometaphyseal dysplasia was made. After careful evaluation of the clinical case, in accordance with the requirements of the patient, we opted for a surgical treatment aimed at correction of functional limitation of temporomandibular joint and aesthetic improvement of the facial bones. The stability of the clinical results led us to suggest and to undertake the surgical path, also due to the lack of safe and consolidated non-surgical treatments for the specific case.

Sublingual misoprostol versus standard surgical care for treatment of incomplete abortion in five sub-Saharan African countries

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Shochet Tara

2012-11-01

Full Text Available Abstract Background In low-resource settings, where abortion is highly restricted and self-induced abortions are common, access to post-abortion care (PAC services, especially treatment of incomplete terminations, is a priority. Standard post-abortion care has involved surgical intervention but can be hard to access in these areas. Misoprostol provides an alternative to surgical intervention that could increase access to abortion care. We sought to gather additional evidence regarding the efficacy of 400 mcg of sublingual misoprostol vs. standard surgical care for treatment of incomplete abortion in the environments where need for economical non-surgical treatments may be most useful. Methods A total of 860 women received either sublingual misoprostol or standard surgical care for treatment of incomplete abortion in a multi-site randomized trial. Women with confirmed incomplete abortion, defined as past or present history of vaginal bleeding during pregnancy and an open cervical os, were eligible to participate. Participants returned for follow-up one week later to confirm clinical status. If abortion was incomplete at that time, women were offered an additional follow-up visit or immediate surgical evacuation. Results Both misoprostol and surgical evacuation are highly effective treatments for incomplete abortion (misoprostol: 94.4%, surgical: 100.0%. Misoprostol treatment resulted in a somewhat lower chance of success than standard surgical practice (RR = 0.90; 95% CI: 0.89-0.92. Both tolerability of side effects and women’s satisfaction were similar in the two study arms. Conclusion Misoprostol, much easier to provide than surgery in low-resource environments, can be used safely, successfully, and satisfactorily for treatment of incomplete abortion. Focus should shift to program implementation, including task-shifting the provision of post-abortion care to mid- and low- level providers, training and assurance of drug availability. Trial

Asymmetry quantization and application to human mandibles

DEFF Research Database (Denmark)

Glerup, Nanna; Nielsen, Mads; Sporring, Jon

2004-01-01

of asymmetry, the statistics on asymmetry for normal and pathological anatomical structures can be compared. Symmetry is a well-known mathematical group theoretical concept. In this paper, we will mathematically define the concept of weak symmetry, including topological symmetry, which serves as a basis...... of pathological assumed non-symmetric mandibles exhibiting a statistically significant increase of asymmetry....

Aggressive fibromatosis of the mandible in childhood

International Nuclear Information System (INIS)

Sartoris, D.J.; Parker, B.R.; Arkoff, R.S.

1983-01-01

Aggressive fibromatosis, or infantile fibrosarcoma, is an uncommon form of juvenile fibromatosis which rarely involves the head and neck. Skeletal involvement is infrequently demonstrated by radiography in this condition. Two unusual cases with similar radiographic changes in the mandible are presented, a situation not previously described. Clinical, pathologic, and radiographic features of aggressive fibromatosis are discussed. (orig.)

Increased incidence of bowel cancer after non-surgical treatment of appendicitis.

Science.gov (United States)

Enblad, Malin; Birgisson, Helgi; Ekbom, Anders; Sandin, Fredrik; Graf, Wilhelm

2017-11-01

There is an ongoing debate on the use of antibiotics instead of appendectomy for treating appendicitis but diagnostic difficulties and longstanding inflammation might lead to increased incidence of bowel cancer in these patients. The aim of this population-based study was to investigate the incidence of bowel cancer after non-surgical treatment of appendicitis. Patients diagnosed with appendicitis but lacking the surgical procedure code for appendix removal were retrieved from the Swedish National Inpatient Register 1987-2013. The cohort was matched with the Swedish Cancer Registry and the standardised incidence ratios (SIR) with 95% confidence interval (95% CI) for appendiceal, colorectal and small bowel cancers were calculated. Of 13 595 patients with non-surgical treatment of appendicitis, 352 (2.6%) were diagnosed with appendiceal, colorectal or small bowel cancer (SIR 4.1, 95% CI 3.7-4.6). The largest incidence increase was found for appendiceal (SIR 35, 95% CI 26-46) and right-sided colon cancer (SIR 7.5, 95% CI 6.6-8.6). SIR was still elevated when excluding patients with less than 12 months since appendicitis and the incidence of right-sided colon cancer was elevated five years after appendicitis (SIR 3.5, 95% CI 2.1-5.4). An increased incidence of bowel cancer was found after appendicitis with abscess (SIR 4.6, 95% CI 4.0-5.2), and without abscess (SIR 3.5, 95% CI 2.9-4.1). Patients with non-surgical treatment of appendicitis have an increased short and long-term incidence of bowel cancer. This should be considered in the discussion about optimal management of patients with appendicitis. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Surgical versus nonsurgical treatment in first traumatic anterior dislocation of the shoulder in athletes

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Gustavo Gonçalves Arliani

2011-03-01

Full Text Available Gustavo Gonçalves Arliani, Diego da Costa Astur, Carina Cohen, Benno Ejnisman, Carlos Vicente Andreoli, Alberto Castro Pochini, Moises CohenCentro de Traumatologia do Esporte (CETE, Departamento de Ortopedia e Traumatologia da Universidade Federal de São Paulo, São Paulo, BrazilAbstract: Anterior traumatic dislocation is a common problem faced by orthopedic surgeons. After the first episode of shoulder dislocation, a combination of lesions can lead to chronic instability. The management in treatment of young athletes after the first acute anterior shoulder dislocation is controversial. The available literature supports early surgical treatment for young male athletes engaged in highly demanding physical activities after the first episode of traumatic dislocation of the shoulder. This is because of the best functional results and lower recurrence rates obtained with this treatment in this population. However, further clinical trials of good quality comparing surgical versus nonsurgical treatment for well-defined lesions are needed, especially for categories of patients who have a lower risk of recurrence.Keywords: athlete, conservative treatment, surgical treatment, immobilization, stabilization, primary treatment, shoulder dislocation

Surgical and endoscopic treatment of pain in chronic pancreatitis: a multidisciplinary update.

Science.gov (United States)

Issa, Y; van Santvoort, H C; van Goor, H; Cahen, D L; Bruno, M J; Boermeester, M A

2013-01-01

Chronic pancreatitis is an inflammatory disease of the pancreas with abdominal pain as the most prominent symptom. Adequate treatment of patients with chronic pancreatitis remains a major challenge, mainly because of the lack of evidence-based treatment protocols. The primary goal of treatment is to achieve long-term pain relief, control of the complications associated with the disease, and to restore the quality of life. Currently, a conservative step-up approach is often used for the treatment of pain; progression to severe and intractable pain is considered necessary before invasive treatment is considered. Recent studies, however, suggest that surgical intervention should not be considered only as last-resort treatment, since it can mitigate disease progression, achieve excellent pain control, and preserve pancreatic function. In this review, we present a state-of-the art overview of endoscopic and surgical treatment options for patients with painful chronic pancreatitis, and elaborate on the timing of surgery. Copyright © 2013 S. Karger AG, Basel.

Alterations of regional pulmonary function in patients with mitral stenosis studied with xenon-133 following surgical treatment

International Nuclear Information System (INIS)

Kurata, Naohiko

1983-01-01

The purpose of this study is to investigate the regional pulmonary function in mitral stenosis using Xenon-133 before and after surgical treatment. Twenty-seven patients with mitral stenosis have been studied. There were four types of distribution of pulmonary perfusion. According to the increase of pulmonary capillary wedge pressure, the distribution of pulmonary perfusion showed a vertical distribution different from that of normal man, as well known according to the many past reports. But Type IV(PCWP > 30mmHg) showed the distribution uniform throughout the lung. The patients with Type IV had severe pulmonary vascular resistance and abnormal distribution of ventilation. They showed decreased %VC, SaO 2 and increased FRV in the tests of total lung functions. Postoperatively, the distribution of pulmonary perfusion in Type II and Type III returned to normal after 6 - 12 months of surgical treatment, but in the Type IV never returned to normal even after 12 months of surgical treatment. The hemodynamic data in the Type IV after 3 - 6 months of surgical treatment showed the moderate pulmonary hypertension and pulmonary vascular resistance. In total lung function tests, %VC, SaO 2 and FRV were recognized the improvement after surgical treatment, but they retained under normal range even after 12 months of sutgical treatment. The abnormal distribution of ventilation improved to normal distribution after 12 months of surgical treatment. The regional pulmonary function test using Xenon-133 is very beneficial to estimate the severity of mitral stenosis and to expect the effects of surgical treatment on the pulmonary circulation and ventilation. (J.P.N.)

Piezosurgery an Asset in Treatment of Pierre Robin Sequence.

Science.gov (United States)

Singh, Divya; Gadre, Pushkar; Gadre, Kiran; Ramanojam, Shandilya

2017-03-01

Pierre Robin sequence (formerly a syndrome) is named after the French stomatologist who, in 1923 and 1934, described the problems associated with micrognathia in newborn. It comprises mandibular micrognathia, U-shaped cleft palate, and glossoptosis. The typical symptoms are hypoxaemia, noisy breathing, snoring, stridor, cyanosis, bradycardia, feeding difficulties, and failure to thrive. Distraction osteogenesis has recently been considered as a surgical option for early intervention to lengthen the mandible and relieve respiratory problems. Piezosurgery offers a modality to make precise bone cuts preserving vital structures, minimizing the invasiveness of the surgical procedure, and offering bloodless field. We present case of 1-year-old male malnourished child with Pierre Robin sequence and tracheostomy in situ since day 11 of his birth. The staged treatment plan involving mandibular lengthening in which mandibular osteotomies were performed with the piezoelectric scalpel followed by decannulation of tracheostomy, which has been described in detail in this article.

Anterior vaginal wall repair (surgical treatment of urinary incontinence) - slideshow

Science.gov (United States)

... page: //medlineplus.gov/ency/presentations/100110.htm Anterior vaginal wall repair (surgical treatment of urinary incontinence) - series— ... to slide 4 out of 4 Overview The vaginal opening lies just below the urethral opening, and ...

Surgical management of failed endoscopic treatment of pancreatic disease.

Science.gov (United States)

Evans, Kimberly A; Clark, Colby W; Vogel, Stephen B; Behrns, Kevin E

2008-11-01

Endoscopic therapy of acute and chronic pancreatitis has decreased the need for operative intervention. However, a significant proportion of patients treated endoscopically require definitive surgical management for persistent symptoms. Our aim was to determine which patients are likely to fail with endoscopic therapy, and to assess the clinical outcome of surgical management. Patients were identified using ICD-9 codes for pancreatic disease as well as CPT codes for endoscopic therapy followed by surgery. Patients with documented acute or chronic pancreatitis treated endoscopically prior to surgical therapy were included (N = 88). The majority of patients (65%) exhibited chronic pancreatitis due to alcohol abuse. Common indicators for surgery were: persistent symptoms, anatomy not amenable to endoscopic treatment and unresolved common bile duct or pancreatic duct strictures. Surgical salvage procedures included internal drainage of a pseudocyst or an obstructed pancreatic duct (46%), debridement of peripancreatic fluid collections (25%), and pancreatic resection (31%). Death occurred in 3% of patients. The most common complications were hemorrhage (16%), wound infection (13%), and pulmonary complications (11%). Chronic pancreatitis with persistent symptoms is the most common reason for pancreatic surgery following endoscopic therapy. Surgical salvage therapy can largely be accomplished by drainage procedures, but pancreatic resection is common. These complex procedures can be performed with acceptable mortality but also with significant risk for morbidity.

Surgical treatment in Osteogenesis Imperfecta - 10 years experience.

Science.gov (United States)

Georgescu, I; Vlad, C; Gavriliu, T Ş; Dan, S; Pârvan, A A

2013-06-15

Osteogenesis imperfecta (OI) is a very rare disease compared to other afflictions, running the risk of social isolation for children and their parents, due to the problems specific to the disease. All the social, psychological and physical disadvantages must be removed or at least mitigated, all within the society's limited resources. In Romania, this situation has led in the last couple of years to the selection of a number of extremely severe cases, which could not be solved by orthopedic and classic surgical treatment methods. These patients exhibit gracile long bones, which are distorted, often with cystic degeneration at the level of the extremities, pseudarthroses, limb length discrepancies, most of them being unable to walk, being condemned to sitting in a wheelchair. This paper deals with the experience of the Orthopedics Department of "Maria Sklodowska Curie" Clinical Emergency Hospital for Children, in Bucharest, in the field of surgical treatment for moderate and severe forms of OI, within the time frame of May 2002-May 2012. For the first time in Romania, on May 20, 2002, the team led by Professor Gh. Burnei, MD, has implanted telescopic rods in the femur and tibia of a patient with OI. One of the most important themes, of great interest in the orthopedic surgery, is the osteoarticular regularization and reconstruction in severe forms of OI, which should allow the patients to stand and walk. These cases are a challenge for the surgeon, who is in the position of applying new, complex procedures, or perfecting, modifying and adapting techniques that have already been established. The aim of the surgical treatment is the increase of the quality of life of these children and adolescents and of their social integration. In the above-mentioned period, from the OI patients who are in the evidence of our clinic, 32 were operated on, totaling 81 surgeries. Out of these, 28 patients, aged 2-27 years, have benefited from reconstructive surgery of the pelvic limbs

Surgical Treatment for Achalasia of the Esophagus: Laparoscopic Heller Myotomy

OpenAIRE

Gonzalo Torres-Villalobos; Luis Alfonso Martin-del-Campo

2013-01-01

Achalasia is an esophageal motility disorder that leads to dysphagia, chest pain, and weight loss. Its diagnosis is clinically suspected and is confirmed with esophageal manometry. Although pneumatic dilation has a role in the treatment of patients with achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed achalasia. This review will focus on the surgical treatment of achalasia, with special emphasis on lapar...

Surgical treatment and a unique management of rostral mandibular fracture with cerclage wire in a horse.

Science.gov (United States)

Naddaf, Hadi; Sabiza, Soroush; Kavosi, Narges

2015-01-01

A 3-year-old Arabian colt was presented for a major gingiva wound at the right rostral part of mandible. After clinical assessments, rostral mandibular fracture was determined. Stabilization of fractured region was achieved via cerclage wire application under general anesthesia. Fixation wires were left in place for 6 weeks. A 3 -month follow up revealed complete fracture healing. The purpose of this case report was to give clinical information about rostral mandibular fractures and treatment of these fractures and nutrition protocol in a horse, as this fracture is of the most common type of jaw fracture sustained by young horses.

Micro-surgical endodontics.

Science.gov (United States)

Eliyas, S; Vere, J; Ali, Z; Harris, I

2014-02-01

Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

A Quick Surgical Treatment of Conjunctivochalasis Using Radiofrequencies

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Alexandra Trivli

2018-02-01

Full Text Available The purpose of our study is to present a quick surgical procedure for the treatment of Conjunctivochalasis (CCH and to evaluate its effectiveness. Thirty consecutive patients, in whom CCH was diagnosed on clinical examination, were investigated for the presence of symptoms of dry eye. The 60 eyes were evaluated according to their symptomatology and the 40 symptomatic eyes were grouped in two stages using the LIPCOF (stage 1, one small fold; stage 2, more than two folds but not higher than the tear meniscus classification and included in the study. After a subconjunctival injection of lidocaine 20 mg/mL, a medium frequency alternating current (RF was used, adjusted in low power. With a wide tip, redundant conjunctiva was ablated leaving space between the ablations. Postoperative treatment included eye oint.gentamicin 0.3% with dexamethasone 0.03% three times a day for 5 days. At postoperative day 10, conjunctival edema had subsided and conjunctival epithelium was intact after fluorescein staining. Symptoms had improved in all patients. During follow-up, no complication was detected. Mild conjunctival hyperemia was present in all cases but resolved with standard postoperative medications. To conclude, CCh treatment with RF appears to be a safe, quick, and effective surgical technique. Operation time is less than 10 min and can be performed in an outpatient clinic.

Epidemiology and treatment outcome of surgically treated mandibular condyle fractures. A five years retrospective study.

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Zrounba, Hugues; Lutz, Jean-Christophe; Zink, Simone; Wilk, Astrid

2014-09-01

Surgical management of mandibular condyle fractures is still controversial. Although it provides better outcome than closed treatment questions still remain about the surgical approach and the osteosynthesis devices to be used. Between 2005 and 2010, we managed 168 mandibular condyle fractures with open treatment. Two surgical approaches were used in this study, a pre-auricular and a high submandibular approach (one or the other or as a combined approach). Internal fixation was performed using TCP(®) plates (Medartis, Basel, Switzerland) or with two lag screws (15 and 17 mm). Delta plates were used in 15 cases (8.9%). We report the epidemiology of these fractures and the outcomes of the surgical treatment. We assessed the complications related to the surgical procedure and those related to the osteosynthesis material. The facial nerve related complication rate was very low and the osteosynthesis materials used proved to be strong enough to realize a stable fixation. The two approaches used in this study appeared to be safe with good aesthetic results. Most of the surgical procedure failures occurred in high subcondylar fractures especially when bilateral. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

General Anesthesia in the Surgical Treatment of Coronary Heart Disease

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N. A. Karpun

2012-01-01

Full Text Available The paper deals with the problem of anesthetic maintenance during surgical correction of coronary blood flow. The basis for this is the results of the investigations conducted at the V. A. Negovsky Research Institute of General Reanimatology, the objective of which was to improve the results of surgical treatment in patients with different forms of coronary heart disease (CHD, by optimizing the anesthetic maintenance of open heart surgery. Clinical and special examinations were made in 367 patients who had undergone surgical treatment (aortocoronary bypass surgery; formation of a mammary coronary anastomosis; resection and plastic repair of left ventricular aneurysms; thrombectomy from the heart chambers for CHD and its complications. The main methodological approach to this study is to personalize intensive therapy and general anesthesia, which are relied on both evidence-based medicine and an individual pathophysiological approach. The paper details how to choose the basic mode of general anesthesia depending on the form of CHD and myocardial contractile function. Furthermore, the authors propose methods for optimizing the perioperative period: postoperative analgesia; correction of the aggregate state of blood; operative hemodilution; prevention and correction of critically reduced blood oxygen capacity 

Bilateral aneurysmal bone cyst of the mandible: A case report

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Gopal HK Sharma

2015-01-01

Full Text Available An aneurysmal bone cyst (ABC, usually considered a reactive lesion of bone rather than a cyst or true neoplasm, is believed to represent an exaggerated, localized, proliferative response of vascular tissue in bone. The case described here is of a 40-year-old female patient presenting with gradually increasing bilateral mandibular swelling of more than 1 year duration. The radiographic and cone beam computed tomography (CBCT images showed bilateral, multilocular expansile radiolucent lesions in the mandible in the premolar-molar region. On considering the blood aspirate obtained and the histopathologic findings, the patient was diagnosed with bilateral aneurysmal bone cysts in the mandible, with probable pre-existing bone lesion.

Giant Keratocystic Odontogenic Tumor of the Mandible – A Case Report

International Nuclear Information System (INIS)

Kornafel, Olga; Jaźwiec, Przemysław; Pakulski, Krzysztof

2014-01-01

The keratocystic odontogenic tumor (KCOT) is a relatively rare, benign neoplasm which develops in the maxilla or mandible, arising from the dental lamina or basal cells of the oral epithelium. It is often found incidentally and brings about late symptoms as it does not cause bone distension for a long time. The presented case is of a young woman with a giant keratocystic odontogenic tumor of the mandible. Despite its rare occurrence, it must be taken into consideration in radiological and clinical diagnostics. Due to the frequent recurrence of KCOT, patients are recommended to be kept under long-term and close radiological supervision

A Surgery-first approach in surgical-orthodontic treatment of mandibular prognathism--a case report.

Science.gov (United States)

Yu, Chung-Chih; Chen, Po-Hsun; Liou, Eric J W; Huang, Chiung-Shing; Chen, Yu-Ray

2010-01-01

The conventional approach in orthodontic surgery treatment of dentofacial anomalies requires a varied period of pre-surgical orthodontic treatment. This presurgical period is considered to be important for adequate surgical treatment and stable results. This period is usually long bothersome for patients because dental decompensation is required and there is consequent deterioration of aesthetics and function, especially in cases of skeletal Class III occlusion. At Chang Gung Craniofacial Center, a surgery-first approach (SFA), i.e. minimal pre-surgical orthodontics, is one of the treatment choices for Class III patients. In this report, we present a 19-year-old man with mandibular prognathism, an anterior open bite and severe dental crowding treated with SFA. The patient received orthognathic surgery a week after bracing of the teeth. The operation and recovery were uneventful as well as the following orthodontic treatment. The total treatment time was only four months, much shorter than with the conventional approach. The patient benefitted from immediate improvement of the facial profile after surgery, and a much shorter total treatment, and the results were not compromised. We believe in selected cases, SFA is a good and effective treatment alternative.

Surgical Treatment of A Dissecting Aneurysm of the Superior Cerebellar Artery: Case Report

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Stefanescu Florin

2014-10-01

Full Text Available Dissecting aneurysm located in the peripheral region of the superior cerebellar artery is very rare. There is little experience regarding their surgical or endovascular treatment. We present the case of a peripheral dissecting superior cerebellar artery aneurysm treated by surgical clipping.

SURGICAL TREATMENT OF POLYCYSTIC OVARIES IN INFERTILE PATIENTS

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Martina Ribič Pucelj

2003-12-01

Full Text Available Background. Polycystic ovaries (PCO are manifested either independently or as a syndrome (PCOS. They are one of the commonest endocrinopathy in women of reproductive age. Despite a variable clinical picture one of the leading symptoms is infertility for anovulation. Surgical treatment of the disease witnessed a revival after the introduction of minimally invasive operative laparoscopy. Various techniques of ovarian tissue destruction have been applied, the most common being laparoscopic electrocoagulation of the ovaries (LECO. The aim of this retrospective study was to assess the pregnancy rates and pregnancy outcomes following LECO.Patients and methods. From 1993 and 2000 inclusive LECO was performed at the Reproductive Unit, Department of Obstetrics and Gynecology Ljubljana in 222 infertile patients with PCO(S, in whom previous medical ovulation induction failed or in whom overreaction of the ovaries to gonadotropin treatment occurred. To the questionnaire, mailed to the patients, 185 (83.3% responded. The evaluation of the outcome of LECO treatment involved 157 patients, since the patients who underwent in vitro fertilization (IVF-ET treatment for other causes of infertility prior to LECO, were exclude from the analysis. LECO was performed under general endotracheal anesthesia using a 3-puncture technique. On each ovary 5– 15 (mean 10 punctures were made with a monopolar electric needle, energy of 300 W, and duration of 4 seconds. Statistical analysis was done using Chi-square test and odds ratios.Results. After LECO 99 (63.3% of the 157 patients conceived, 56 (54.6% spontaneously and 43 (45.4% after additional postoperative ovarian stimulation. Pregnancy was registered in 58 (59.0% patients with primary, and in 41 (41% patients with secondary infertility, in 20 (57% patients with PCO, 79 (65% with PCOS, in 71 (64.1% patients with a normal partner’s spermiogram, and in 28 (46.1% patients with the partner’s oligoasthenoteratospermia of

Recurrence and Mortality after Surgical Treatment of Soft Tissue ...

African Journals Online (AJOL)

In Africa, patients with soft tissue sarcomas generally present late and have to travel long distances to treatment centers. Many do not benefit from radiotherapy and chemotherapy after the surgical procedure due to inadequate resources. As such recurrence rates may be much higher than those reported elsewhere (11).

The Patterns Of Surgical Thyroid Diseases And Operative Treatment ...

African Journals Online (AJOL)

The Patterns Of Surgical Thyroid Diseases And Operative Treatment. In Gondar College of Medical sciences, North-western Ethiopia. Abebe B. M.D. Lecturer and General practitioner,. Girmaye T. M.D. Assistant professor of surgery,. Mensur 0. M.D. Assistant professor of surgery,. Sentayehu T. M.D. General practitioner,.

Rhegmatogenous retinal detachment and conventional surgical treatment.

Science.gov (United States)

Golubovic, M

2013-01-01

The aim of the paper was to present the efficacy and indications for application of conventional surgical treatment of retinal detachment by using external implants, that is,application of encircling band and buckle. This study comprised patients from the University Eye Clinic in Skopje. A total of 33 patients were diagnosed and surgically treated in the period between May 2010 and August 2011. Conventional surgery was applied in smaller number of patients whose changes of the vitreous body were manifested by detachment of posterior hyaloid membrane, syneresis, with appearance of a small number of pigment cells in the vitreous body and synchysis, and the very retina was with fresh detachment without folds or epiretinal changes (that is, PVR A grade). There were a larger number of patients with more distinct proliferative changes of the vitreous body and of the retina, grades PVR B to C1-C2, and who also underwent the same surgical approach. Routine ophthalmologic examinations were performed, including: determination of visual acuity by Snellen's optotypes, determination of eye pressure with Schiotz's tonometer, examination of anterior segment on biomicroscopy, indirect biomicroscopy of posterior eye segment (vitreous body and retina) and examination on biomicroscopy with Goldmann prism, B scan echography of the eyes before and after surgical treatment. Conventional treatment was used by external application of buckle or application of buckle and encircling band. In case of one break, radial buckle was applied and in case of multiple breaks in one quadrant limbus parallel buckle was applied. Besides buckle, encircling band was applied in patients with total or subtotal retinal detachment with already present distinct changes in the vitreous body (PVR B or C1-C2) and degenerative changes in the vitreous body. Breaks were closed with cryopexy. The results obtained have shown that male gender was predominant and that the disease was manifested in younger male adults

Surgical treatment of advanced stage Freiberg disease

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Emin Özkul

2014-09-01

Full Text Available Objective: Freiberg disesase is an avascular necrosis of the 2nd and 3rd metatarsal head and which kind of surgical option to be used is controversial in symptomatic patients. In this study the results of the advanced stage Freiberg’s disease patients, who were treated with surgery were evaluated. Methods: 12 patients (8 female, 4 male whose pain could not be solved with conservative method and underwent surgery (6 debridement, 3 osteotomy, 3 excision of the metatarsal head were included in this study. Themean age of the patients 19.1 (range 13- 31 and the mean follow-up 30.8(range 25-94 months. According to the Smillie classification 3 patients had type 5, 8 patients had type 4 and 1 patient had type 3 osteonecrosis. The results of the patients were evaluated according to Lesser Metatarsophalangeal-Interphalangeal Scale. Results: According to Lesser MetatarsophalangealInterphalangeal Scale 3 patients (%25 had excellent, 6 patients (%50 had good and 3 patients had poor results were obtained. 2 of 3 patients with poor results were type 5, and 1 patient was type 4 and all three patients underwent joint debridement. Conclusion:The method of surgical treatment of Freiberg disease determined according to the stage of the disease. Debridement alone in the treatment of patients with late stage is not enough, it should be combined with other methods.

[Surgical Treatment of Bronchial Stricture due to Endobronchial Tuberculosis: 
Results in 36 Consecutive Cases].

Science.gov (United States)

Ruan, Junzhong; Zhang, Tianhui; Li, Fugen; Duan, Yong; Han, Ming; Wang, Zitong

2018-04-20

Bronchial tuberculosis is a common complication of pulmonary tuberculosis. The present report is to investigate and analyze the indication and efficacy of surgical treatment of bronchial stricture due to severe endobronchial tuberculosis, when the drug and endoscopic treatment were no effect. Reviewed the clinical-pathological records documenting the surgical outcomes in 36 bronchial stricture due to severe endobronchial tuberculosis who underwent lobectomy or pneumonectomy enrolled in our hospital between January 2000 and February 2016. Pneumonectomy in 8 cases, lobectomy in 23 cases, sleeve resection in 5 cases. No intraoperative or early postoperative death occurred. Six patients developed complications. All 6 cases recovered well after treatment. Surgical treatment is still the recommended treatment modatity for bronchial stricture caused by endobronchial tuberculosis due to its good results. It should be performed in time when the drug and intraluninal treatment were no effect for avoiding of being progeressed.

Treatment experience of surgical repair for long-term skull defect

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Shou-cheng FAN

2015-12-01

Full Text Available Retrospective analysis was performed on 30 patients of skull defect who underwent surgical repair. Intraoperative and postoperative curative effect was evaluated on those patients, and the results showed that the incidence rate of intraoperative dura mater defect (P = 0.001, early postoperative complications [new epilepsy (P = 0.035 and effusion (P = 0.021] and late postoperative complications [foreign body sensation (P = 0.035 and dizziness and headache (P = 0.050] in long-term skull defect group were all higher than those in control group. In conclusion, surgical repair of long-term skull defect incurring high risk and various complications will not be an ideal management. Therefore, early surgical treatment for skull defect is suggested. DOI: 10.3969/j.issn.1672-6731.2015.12.016

Priority of surgical treatment techniques of full cartilage defects of knee joint

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Андрій Вікторович Літовченко

2015-10-01

Full Text Available Aim. Surgical treatment of chondromalacia of knee joint cartilage is an actual problem of the modern orthopedics because the means of conservative therapy can be realized at an initial stage only and almost exhausted at the further ones. Imperfections of palliative surgical techniques are the short-term clinical effect and pathogenetic baselessness because surgical procedure is not directed on reparation of cartilaginous tissue. For today there are a lot of transplantation techniques that are used for biological renewal of articular surface with formation of hyaline or at least hyaline-like cartilage. The deep forage of cartilage defect bottom to the medullary canal is a perspective and priority technique.Methods. The results of treatment of 61 patients with chondromalacia of knee joint of 3-4 degree according to R. Outerbridge are the base of the work. 20 patients of every group underwent microfracturization of cartilage defect bottom and subchondral forage of defect zone. 21 patients underwent the deep forage of defect zone of knee joint according to an offered technique.Result. The results of treatment with microfracturization, subchondral forage and deep forage of defect zone indicate the more strong clinical effect especially in the last clinical group where good and satisfactory results ratios in the term of observation 18 and 24 month remain stable.Conclusions. Deep forage of cartilage defects zone is the most adequate reparative technique of the surgical treatment of local knee joint cartilage defects. Owing to this procedure the number of cells of reparative chondrogenesis predecessors is realized

Surface-bounded growth modeling applied to human mandibles

DEFF Research Database (Denmark)

Andresen, Per Rønsholt; Brookstein, F. L.; Conradsen, Knut

2000-01-01

From a set of longitudinal three-dimensional scans of the same anatomical structure, the authors have accurately modeled the temporal shape and size changes using a linear shape model. On a total of 31 computed tomography scans of the mandible from six patients, 14,851 semilandmarks are found...

Open treatment of unilateral mandibular condyle fractures in adults: a systematic review.

Science.gov (United States)

Rozeboom, A; Dubois, L; Bos, R; Spijker, R; de Lange, J

2017-10-01

Since the introduction of rigid internal fixation devices, more and more surgeons favour an open approach to treating condylar fractures of the mandible in adult patients. Different indications for open treatment have been published. Open treatment is associated with surgical complications because of the technique employed. The aim of this systematic review was to provide an overview of the studies published exclusively on open treatment, and to summarize the existing open treatment modalities and their clinical outcomes. A total of seventy studies were selected for detailed analysis. Most studies reported good results with regard to the outcome measures of open treatment. Surgical complications including hematoma, wound infection, weakness of the facial nerve, sialocele, salivary fistula, sensory disturbance of the great auricular nerve, unsatisfactory scarring, and fixation failure were reported in the studies. This review suggests that because of the high level of methodological variance in the relevant studies published to date, among other factors, there are currently no evidence-based conclusions or guidelines that can be formulated with regard to the most appropriate open treatment. Establishment of such standards could potentially improve treatment outcomes. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Combination of Surgical Drainage and Renal Artery Embolization: An Alternative Treatment for Xanthogranulomatous Pyelonephritis

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Upasani, Anand, E-mail: anand.upasani@gosh.nhs.uk [Great Ormond Street Hospital, Department of Paediatric Urology (United Kingdom); Barnacle, Alex, E-mail: alex.barnacle@gosh.nhs.uk; Roebuck, Derek, E-mail: derek.roebuck@gosh.nhs.uk; Cherian, Abraham, E-mail: abraham.cherian@gosh.nhs.uk [Great Ormond Street Hospital (United Kingdom)

2017-03-15

Conventionally, xanthogranulomatous pyelonephritis is treated with antibiotics and drainage of abscess followed by nephrectomy for definitive treatment. Surgical excision of the affected kidney carries risk of significant complications. An alternative treatment modality is described in the form of embolization of the renal artery to devascularise the renal parenchyma and ablate the renal tissue, thus avoiding a major surgical procedure and the significant risks involved.

Combination of Surgical Drainage and Renal Artery Embolization: An Alternative Treatment for Xanthogranulomatous Pyelonephritis

International Nuclear Information System (INIS)

Upasani, Anand; Barnacle, Alex; Roebuck, Derek; Cherian, Abraham

2017-01-01

Conventionally, xanthogranulomatous pyelonephritis is treated with antibiotics and drainage of abscess followed by nephrectomy for definitive treatment. Surgical excision of the affected kidney carries risk of significant complications. An alternative treatment modality is described in the form of embolization of the renal artery to devascularise the renal parenchyma and ablate the renal tissue, thus avoiding a major surgical procedure and the significant risks involved.

Treatment in Borderline Class III Malocclusion: Orthodontic Camouflage (Extraction) Versus Orthognathic Surgery.

Science.gov (United States)

Rabie, A-Bakr M; Wong, Ricky W K; Min, G U

2008-01-01

To investigate the differences in morphological characteristics of borderline class III patients who had undergone camouflage orthodontic treatment or orthognathic surgery, and to compare the treatment effects between these two modalities. Cephalograms of 25 patients (13 orthodontic, 12 surgical) with class III malocclusion were analyzed. All had a pretreatment ANB angle greater than -5 masculine. Using discriminant analysis, only Holdaway angle was selected to differentiate patients in the pretreatment stage. Seventy-two per cent patients were correctly classified. In the orthodontic group, reverse overjet was corrected by retraction of the lower incisors and downward and backward rotation of the mandible. The surgical group was corrected by setback of the lower anterior dentoalveolus and uprighting of the lower incisors. No difference was found in posttreatment soft tissue measurements between the two groups. Twelve degree for the Holdaway angle can be a guideline in determining the treatment modalities for borderline class III patients, but the preferences of operators and patients are also important. (2) Both therapeutic options should highlight changes in the lower dentoalveolus and lower incisors. (3) Both treatment modalities can achieve satisfactory improvements to the people.

The medical and surgical treatment in secondary and tertiary hyperparathyroidism. Review.

Science.gov (United States)

Cocchiara, G; Fazzotta, S; Palumbo, V D; Damiano, G; Cajozzo, M; Maione, C; Buscemi, S; Spinelli, G; Ficarella, S; Maffongelli, A; Caternicchia, F; Ignazio Lo Monte, A; Buscemi, G

2017-01-01

Hyperparathyroidism is an alteration of the pathophysiological parathyroid hormone (PTH) secretion due or an independent and abnormal release (primary or tertiary hyperparathyroidism) by the parathyroid or an alteration of calcium homeostasis that stimulates the excessive production of parathyroid hormone (secondary hyperparathyroidism). There is not a standard, clinical or surgical, treatment for hyperparathyroidism. We review current diagnostic and therapeutic methods. In secondary hyperparathyroidism (2HPT) there is a progressive hyperplasia of the parathyroid glands and an increased production of parathyroid hormone. Several causes are proposed: chronic renal insufficiency, vitamin D deficiency, malabsorption syndrome. The tertiary hyperparathyroidism (3HPT) is considered a state of excessive autonomous secretion of PTH due to long-standing 2HPT and it's usually the result of a lack of suppression in the production of PTH. The pathophysiological implications are both skeletal and extraskeletal: it damages the cardiovascular system, nervous system, immune, hematopoietic and endocrine system. The introduction of new drugs has improved the survival of these patients, allowing the inhibition of the synthesis of PTH. Indication for surgical treatment is unresponsive medical therapy. There are no large prospective studies that comparing the medical and surgical treatment. The choice is not unique and we have to consider the singolar case and the clinical condition of the patient.

[ANALYSIS OF CLINICAL EFFECT IN SURGICAL TREATMENT OF Maisonneuve FRACTURE].

Science.gov (United States)

Zhang, Zhiwen; Cai, Xianhua; Wei, Shijun; Liu, Ximing

2015-03-01

To investigate the operative method and short-term effectiveness in the surgical treatment of Maisonneuve fracture. Between January 2010 and February 2013, 23 patients with Maisonneuve fracture were treated. There were 14 males and 9 females with an average age of 40.3 years (range, 30-68 years). The causes of injuries were falling injury in 11 patients, sports related injury in 5 patients, traffic accident injury in 4 patients, and falling injury from height in 3 patients. The interval between injury and operation was 7-10 days (mean, 8.5 days). All of fractures were closed. Three patients had combined injury of deltoid ligament. The surgical procedures included surgical reduction and fixation of medial malleolus fracture and posterior malleolus fracture, repair of the deltoid ligament with ground anchor suture, and fixation of the disrupted distal tibiofibular syndesmosis. All incisions achieved primary healing, no postoperative complications such as infection occurred. Twenty-one patients were followed up 24-36 months (mean, 26.5 months). No patients complained of pain, tenderness, and obvious swelling of the ankle. At 3-6 months (mean, 4.6 months) after operation, X-ray films showed bony union of fractures and normal mortises in 21 patients. And no traumatic arthritis was observed with reliable fixation. The range of motion of ankle dorsi flexion and plantar flexion was 30-40 degrees) (mean, 34.5 degrees) Baird-Jackson anide functional score was 85-100 (mean, 94); 16 cases were rated as excellent, 4 as good, and 1 as fair with an excellent and good rate of 95.2%. Surgical treatments of Maisonneuve fracture include surgical reduction and fixation of the medial malleolus and posterior malleolus, repair of the deltoid ligament and fixation of the disrupted distal tibiofibular syndesmosis, and good effectiveness can be achieved.

Orthodontic treatment in cherubism: an overview and a case report.

Science.gov (United States)

Abela, Stefan; Cameron, Malcolm; Bister, Dirk

2014-11-01

Cherubism is a rare hereditary disease that frequently manifests as a painless enlargement of the mandible and/or maxilla. The disease usually progresses rapidly during the first and second decades of life but it is self-limiting and often regresses. Although few orthodontic case reports describing cherubic patients exist, the timing and extent of surgical intervention is controversial. This present paper aims to review the treatment literature and provide a case report of a patient who underwent orthodontic/surgical management. The patient presented with severe cherubism in her late teenage years; her main complaint was poor facial and dental appearance. Multiple teeth were missing and those present demonstrated significant preoperative root resorption. Treatment consisted of orthodontic alignment of the upper anterior teeth and a recontouring osteotomy. Confirmed by the patient, the combination approach led to a significant improvement in facial aesthetics and better self-esteem. Tooth movement through the osseous lesions was uneventful and no further root resoption was observed. Orthodontic treatment may be undertaken in those affected by Cherubism even with pre-existing idiopathic root resorption, but patients need to be appropriately informed and consented.

Transfer of surgical competences in the treatment of intersex ...

African Journals Online (AJOL)

Transfer of surgical competences in the treatment of intersex disorders in Togo. ... Background: To evaluate the impact of scientific seminar on the sexual ambiguity on patients and paediatric surgeons in French-speaking African countries. Materials and Methods: This was a report of the proceeding of a teaching seminar on ...

Using vacuum in the treatment of surgical wounds complications

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Drašković Miroljub

2011-01-01

Full Text Available Background/Aim. Using vacuum in medicine has been known from long ago, however, it has not been used for the treatment of wounds. The first experiments in this field were performed by Wagner Fleischmann, University of Ulm, Ulm, West Germany, in 1993. The aim of this study was to present our clinical experience with the treatment of surgical wounds complications in vascular patients by the use of controled vacuum. Method. In a period October 2006 - December 2009 a total of 18 patients with infection and surgical wound dehiscence were treated by the use of vacuum. Vacuum was applied to wounds by placing a polyurethane sponge on them and by fixing a polyurethane foil and a sponge to the surrounding healthy skin so to completely airtight wounds. Over a foil vacuum of - 150 mmHg was applied for a 5-day period, and on the day 6 a foil and a sponge were removed. Results. In all the 18 wounds treated by the use of vacuum secondary wound closing was achieved with no complications and with a significantly shortened time period treatment. Wound infections were healed using this method and only in 2 patients antibiotics were used at the same time. Conclusion. The use of vacuum in the treatment of operative wounds complications is an easy and reliable method contributing significantly to wounds better healing.

Growth Modeling of Human Mandibles using Non-Euclidean Metrics

DEFF Research Database (Denmark)

Hilger, Klaus Baggesen; Larsen, Rasmus; Wrobel, Mark

2003-01-01

From a set of 31 three-dimensional CT scans we model the temporal shape and size of the human mandible. Each anatomical structure is represented using 14851 semi-landmarks, and mapped into Procrustes tangent space. Exploratory subspace analyses are performed leading to linear models of mandible...... shape evolution in Procrustes space. The traditional variance analysis results in a one-dimensional growth model. However, working in a non-Euclidean metric results in a multimodal model with uncorrelated modes of biological variation. The applied non-Euclidean metric is governed by the correlation...... structure of the estimated noise in the data. The generative models are compared, and evaluated on the basis of a cross validation study. The new non-Euclidean analysis is completely data driven. It not only gives comparable results w.r.t. to previous studies of the mean modelling error, but in addition...

TOT versus TVT – mesh surgical treatment in stress urinary incontinence

Directory of Open Access Journals (Sweden)

Ovidiu Bratu

2015-12-01

Full Text Available Introduction: Stress urinary incontinence is a highly debilitating condition, with an important impact over the quality of life. When the conservative treatment fails, the surgical treatment is a viable solution. Minimally invasive sling procedures have become the gold standard of surgical management for stress urinary incontinence (SUI in women. Material and methods: The study was conducted on 68 patients with stress urinary incontinence, 52 have undergone the retropubic tension-free vaginal tape and 16 patients were operated using the transobturator tape procedure. All the patients were evaluated before the operation and the indication of the surgical treatment was established on the basis of physical examination (all the patients had positive cough test, abdominal ultrasound (to determine postvoid residual urine volume, urinalysis and urine culture (the majority of the patients have had before the operation recurrent urinary tract infections. Results: The satisfaction was similar in both groups of patients, with an average satisfaction rate of 91% for TVT and 86% for the patients who have undergone TOT procedure. The patients were in a proportion of 78,9% at menopause, with an average number of natural births of 1.9 and a mean BMI of 28.2. Regarding the surgical duration, this has varied between 20 and 40 minutes, being higher in the TVT cases (up to 5-7 minutes longer than TOT, because cystoscopy was performed during the operation to verify if the bladder was perforated or not. The urethral catheter was removed immediately after the operation in the case of the TOT procedure and in the day after the operation for the patients who have undergone TVT procedures (all of these patients associated genital prolapse. The hospitalization time was 3 days. We haven’t encountered significant intraoperative and postoperative complications. Conclusions: The TOT and TVT procedures have proven to be highly effective and safe methods in the treatment of

COMPARATIVE ANALYSIS OF THE TREATMENT OF THE EOSINOPHILIC GRANULOMA WITH VERTEBRAL INVOLVEMENT USING ORTHOPEDIC CORSET AND SURGICAL OPERATION

Directory of Open Access Journals (Sweden)

A. I. Snetkov

2010-01-01

Full Text Available The results of treatment of 72 patients with pathological fracture of vertebra bodies against eosinophilic granuloma a spine are analysed. Orthopedic corset technologies are used in treatment of 42 patients, surgical treatment was applied. Orthopedic corset may be used in patients with eosinophilic granuloma of backbone. This method of treatment was used in a case of the absence of spine secondary deformations and neurologic semiology. Orthopedic corset treatment is associated with long immobilization on the average within 1,5-2 years and never leads to a complete recovery of the damaged spine. Surgical treatment consists in use only at loss of height of a body to 30-40%, when destruction of spine more severe it is necessary to use operative treatment in two stages. Absolute indications to surgical treatment are the neurologic deficit and secondary deformations of a spine. Surgical treatment allows to reduce terms of treatment till 3-4 months and quickly to return the patient to an active life.

Is sternal rewiring mandatory in surgical treatment of deep sternal wound infections?