RESUMEN
The purpose of this study was to evaluate patient-reported outcome measures of quality of life (QoL) for patients with end-stage temporomandibular joint (TMJ) disease who have undergone TMJ prosthetic replacement. The records of 36 patients who had undergone alloplastic total joint replacement procedures were analyzed. Patients were treated using either TMJ Concepts or Biomet/Lorenz prosthetics. Patients were asked to complete a 12-item TMJ-S-QoL survey, which encompassed questions pertaining to pain, speech, chewing function, and various aspects of social life and mental health. The questions were answered on a 5-point scale. Data were analyzed using the Wilcoxon signed-rank test. Among the 36 patients (six male and 30 female), 18 responded to the survey. Markers of QoL after surgery were compared to the preoperative period. Significant improvements were reported for pain (94.4% of patients), chewing (83.3% of patients), speech (55.6% of patients), anxiety (72.2% of patients), activity (66.7% of patients), recreation (61.1% of patients), and mood (66.7% of patients) (all P<0.05). TMJ prosthetic replacement significantly enhanced QoL among patients suffering from chronic pain, limited range of motion, anxiety, impaired speech, and chewing due to end-stage TMJ disease in this sample of surgical patients.
Asunto(s)
Artroplastia de Reemplazo/métodos , Prótesis Articulares , Calidad de Vida , Trastornos de la Articulación Temporomandibular/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
Ameloblastic carcinoma and ghost cell odontogenic carcinoma are rare malignancies arising in odontogenic epithelium within the jaws. Gardner syndrome is a multifaceted autosomal dominant condition, which results in multiple dentofacial anomalies along with premalignant colon polyp formation and tumor formation in the skin and other organs. We report a case of ameloblastic carcinoma with features of ghost cell odontogenic carcinoma and extensive clear cell change and melanin pigmentation in a patient with clinical features of Gardner syndrome. To the best of our knowledge, odontogenic carcinoma arising in a patient with features of Gardner syndrome has not been reported previously. The clinical, radiographic, and histologic features of the case are discussed along with a review of the relevant literature.
Asunto(s)
Ameloblastoma/diagnóstico , Síndrome de Gardner/diagnóstico , Neoplasias Maxilares/diagnóstico , Tumores Odontogénicos/diagnóstico , Adulto , Ameloblastoma/patología , Ameloblastoma/cirugía , Biopsia , Diagnóstico Diferencial , Síndrome de Gardner/patología , Síndrome de Gardner/cirugía , Humanos , Masculino , Neoplasias Maxilares/patología , Neoplasias Maxilares/cirugía , Tumores Odontogénicos/patología , Tumores Odontogénicos/cirugía , Radiografía Panorámica , Tomografía Computarizada por Rayos XRESUMEN
Acute dislocation of the temporomandibular joint (TMJ) is a relatively common occurrence; chronic long-term dislocation is rare. Variance in the duration of dislocation and anatomical considerations make the treatment for long-standing dislocation complex and controversial. This paper attempts to review the literature associated with chronic TMJ dislocation treatment options and presents the authors' experience with a particularly long term dislocation.
Asunto(s)
Luxaciones Articulares/cirugía , Trastornos de la Articulación Temporomandibular/cirugía , Anciano , Artroplastia de Reemplazo/métodos , Enfermedad Crónica , Femenino , Fibrosis , Estudios de Seguimiento , Humanos , Luxaciones Articulares/diagnóstico por imagen , Prótesis Articulares , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/cirugía , Radiografía , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Cigoma/diagnóstico por imagenRESUMEN
Arterial pseudoaneurysms are rare in oral and maxillofacial surgery, but when they occur, quick recognition and management is necessary to avoid devastating consequences. The authors report a case of a pseudoaneurysm of the external carotid artery that developed after open reduction and internal fixation of a mandibular condyle fracture.
Asunto(s)
Traumatismos de las Arterias Carótidas/etiología , Arteria Carótida Externa/patología , Cóndilo Mandibular/lesiones , Fracturas Mandibulares/complicaciones , Angiografía , Embolización Terapéutica/métodos , Estudios de Seguimiento , Fijación Interna de Fracturas , Humanos , Masculino , Arteria Maxilar/patología , Arterias Temporales/patología , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
The risk of fire in the airway associated with laser surgery is well known, but there are reports of endotracheal tube fires ignited by electrocautery, particularly during pharyngeal surgery or tracheostomy or both. This uncommon complication has potentially devastating consequences. Surgeons undertaking these procedures should be aware of this complication and be familiar with measures to avoid them. We present a case report of an electrocautery-ignited endotracheal tube fire during an elective tracheostomy, which resulted in the patient's death.
Asunto(s)
Quemaduras por Inhalación/etiología , Electrocoagulación/efectos adversos , Incendios , Intubación Intratraqueal/efectos adversos , Traqueostomía , Anciano , Electrocoagulación/instrumentación , Seguridad de Equipos , Resultado Fatal , Femenino , Humanos , Intubación Intratraqueal/instrumentación , MasculinoRESUMEN
OBJECTIVE: Telemedicine technology has the ability to project highly specialized medical and dental expertise anywhere in the world. This is particularly important to many small, isolated communities that do not have access to medical and dental specialists. Telemedicine also has the potential to reduce unnecessary travel, time away from work, and unneeded hospital admissions. For this technology to be successful, however, clinicians need to have confidence in its capabilities. This study was conducted to determine the accuracy of an orthognathic evaluation using telemedicine. MATERIALS AND METHODS: Thirteen patients were randomly selected for review by two surgeons each using telemedicine and clinical examinations. Clinically acceptable differences were established, and the results of the two examination methods were compared. RESULTS: A main effect of the examination method was observed in 7 of the 18 continuous measurements taken. Examination of the absolute value of the within-subject difference between the two examination methods demonstrated that the mean absolute difference was statistically different from zero for 13 of 18 measurements taken. CONCLUSIONS: These data demonstrate that a relatively accurate orthognathic examination can be performed with this technology. With this in mind, clinicians may feel comfortable using this technology for other clinical applications.