RESUMEN
This study investigates the management of patients with obstructive sleep apnea (OSA) who have previously undergone palatal surgery and subsequently undergo maxillomandibular advancement (MMA). The research entails a retrospective analysis of phase II MMA cases from 2017 to 2022. Data encompassing demographics, clinical profiles, pre- and post-operative polysomnographic and radiological findings, surgical techniques, and complications were collected. Out of the 14 patients studied, conservative vestibular approaches were applied universally, with four cases necessitating the sectioning of descending palatine arteries. Results indicate an average maxillary sagittal advancement of 10.07 mm, a mean counterclockwise rotation of the maxillary occlusal plane at 9.35°, and a decline in apnea-hypopnea index from 45.5 to 4.5 events per hour. Surgical success and cure rates were 93.3% and 40%, respectively, with no major complications observed throughout the 45-month follow-up. This study underscores the safe and efficacious application of MMA in OSA patients with prior palatal surgery, offering valuable insights into their management.
RESUMEN
Traumatic dental injuries in elderly patients are a rising trend due to demographic and social changes of the population. Older dentulous patients in good health have become increasingly common. The development of a post-traumatic malocclusion is a common sequela resulting from mandibular condyle fracture, as in the case reported in this paper. The decision-making process led the authors to rule out conservative treatment options and to perform orthognathic surgery on an 81-year-old patient, an unprecedented report in the literature. At one-year follow-up, prophylactic therapy, a specific surgical technique, and osteotomy fixation have restored the occlusion to the pre-traumatic condition.
Asunto(s)
Maloclusión , Fracturas Mandibulares , Anciano , Anciano de 80 o más Años , Oclusión Dental , Humanos , Maloclusión/etiología , Mandíbula , Cóndilo Mandibular , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/cirugía , OsteotomíaRESUMEN
BACKGROUND: Chainsaw and circular-saw injuries represent a rare condition within the maxillofacial region. The purpose of this clinical report is to describe the injuries and the clinical and surgical management of these rare traumas. METHODS: In this clinical report, 11 patients presenting themselves to the emergency room in the hospital "Policlinico Le Scotte," Siena, from March 2016 to September 2017 with severe chainsaw and circular-saw injuries, were included. All of the patients underwent general anesthesia and surgical treatment. This study describes 3 of the 11 patients with saw injuries. RESULTS: No complications occurred during surgeries and a good primary closure of the wound margins were achieved in all patients. However, after surgery, the authors experienced some complications in 2 patients: the 1st one displayed chewing problems due to extensive local edema; the 2nd one developed a total loss of vision in his left eye, even though there was no damage inflected to the eye ball during the trauma or surgery. CONCLUSION: All the patients were followed during the 1st year after surgery. The authors evaluated the patients at 3 months, 6 months, and after 1 year, and none of them developed complications or alterations related to the trauma. However, 1 patient is still experiencing loss of vision and he is under constant specialized follow-up.
Asunto(s)
Traumatismos Maxilofaciales/cirugía , Heridas Penetrantes/cirugía , Accidentes , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Merkel cell carcinoma (MCC) is a rare malignant tumor with a neuroendocrine phenotype. The authors report a case of MCC of the left cheek region in an 85-year-old Caucasian woman who also received sentinel node biopsy using both Technectium-99m-labeled (99mTc) lymphoscintigraphy and indocyanine green lymphography.