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Odontogenic keratocysts are benign lesions of the maxillomandibular region with high growth potential resulting in huge bone destruction. The presence of multiple Odontogenic keratocysts can be associated with the Gorlin-Goltz syndrome. There are two accepted theories of their origin: remnants of dental lamina and proliferation of cells from the basal layer of oral epithelium into the mandible or maxilla. Odontogenic keratocysts are usually asymptomatic and are diagnosed incidentally on routine periapical or panoramic radiographs. The type of treatment is related to their high recurrence rate. The objective of the present study is to report a clinical case of a surgical treatment of a parakeratinized odontogenic keratocyst by enucleation in a fourteen-year old girl. This technique was used since the complete removal of the cyst posed no risks of complications from a dental and/or anatomical point of view. Furthermore, it facilitated the comprehensive anatomohistopathological analysis of the lesion including its clinical, histopathological, and radiological aspects.

Os ceratocistos odontogênicos são apresentados como lesões benignas do complexo maxilomandibular, de grande potencial de crescimento e de grande destruiçäo óssea podendo, quando em múltiplas apresentações, serem associados à "Síndrome de Gorlin", existindo, para tanto, duas teorias para o seu desenvolvimento: uma delas a partir de remanescentes da lâmina dentária, e outra a partir da proliferação de células da camada basal ou do epitélio oral para a mandíbula ou maxila. Os ceratocistos odontogênicos são lesões de caráter geralmente assintomáticos, sendo comumente descobertos em exames radiográficos panorâmicos ou periapicais de rotina. Suas formas de tratamento estão relacionadas ao seu grande potencial recidivante. O presente trabalho tem como objetivo o relato de caso clínico de uma jovem de quatorze anos de idade, em que um ceratocisto odontogênico paraqueratinizado na maxila foi retirado cirurgicamente por enucleação. Tal técnica foi escolhida uma vez que a retirada completa do cisto em questão não representava complicações dos pontos de vista dental e/ou anatômico; e facilitava o estudo integral da lesão com relação ao exame anatomohistopatológico, analisando ainda seus aspectos clínicos, histopatológicos e radiográficos.

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Introduction: Inverted papilloma is a rare benign tumor of the nasal fossa, which usually originates from its lateral wall. Only 5% of cases demonstrate exclusive sinus involvement. Primary sphenoid sinus involvement is even rarer. Although considered a benign lesion, the tumor has a potentially invasive nature and has also been found to have an associated malignancy rate of 7 to 15%. Objectives: To report a case of inverted nasal papilloma originating in a rare location: the sphenoid sinus. Resumed: Report a 56-year-old woman, presented to our outpatient clinic complaining of frontal headache, occasional otalgia and recent forgetfulness. She was initially evaluated by a neurologist and then submitted to a head magnetic resonance imaging. A lesion was found to be filling both sphenoid sinuses. Sinus computed tomography showed an opacified sphenoid sinus with apparent bony integrity. The patient underwent sphenoidotomy through a transnasal endoscopic approach. A bleeding papillomatous lesion was identified. A biopsy was performed and histopathologic study suggested inverted papilloma. The lesion was then completely resected. The patient has been followed for 60 days after surgery; no signs of recurrence were found upon flexible nasofibroscope examination. Conclusion: Inverted Papilloma exclusively involving the sphenoid sinus is a rare entity. Non specific symptomatology and Clinical presentation make this kind of tumor a diagnostic and therapeutic challenge. The Endoscopic Sphenoidotomy has been the treatment of choice. Close follow-up is required in order to detect possible recurrences and malignant transformation...

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Introduction Inverted papilloma is a rare benign tumor of the nasal fossa, which usually originates from its lateral wall. Only 5% of cases demonstrate exclusive sinus involvement. Primary sphenoid sinus involvement is even rarer. Although considered a benign lesion, the tumor has a potentially invasive nature and has also been found to have an associated malignancy rate of 7 to 15%. Objectives To report a case of inverted nasal papilloma originating in a rare location: the sphenoid sinus. Resumed Report a 56-year-old woman, presented to our outpatient clinic complaining of frontal headache, occasional otalgia and recent forgetfulness. She was initially evaluated by a neurologist and then submitted to a head magnetic resonance imaging. A lesion was found to be filling both sphenoid sinuses. Sinus computed tomography showed an opacified sphenoid sinus with apparent bony integrity. The patient underwent sphenoidotomy through a transnasal endoscopic approach. A bleeding papillomatous lesion was identified. A biopsy was performed and histopathologic study suggested inverted papilloma. The lesion was then completely resected. The patient has been followed for 60 days after surgery; no signs of recurrence were found upon flexible nasofibroscope examination. Conclusion Inverted Papilloma exclusively involving the sphenoid sinus is a rare entity. Non specific symptomatology and Clinical presentation make this kind of tumor a diagnostic and therapeutic challenge. The Endoscopic Sphenoidotomy has been the treatment of choice. Close follow-up is required in order to detect possible recurrences and malignant transformation.

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Odontomas são hamartomas de origem odontogênica, compostos pelos mesmos tecidos que formam o dente. Reconhecem-se dois tipos histológicos: complexo e composto. No tipo composto, os tecidos dentais dispõem-se como no dente, apresentando radiopacidade aos raios-x. O tipo complexo é uma mescla de tecidos odontogênicos maduros, não organizados. Odontomas são usualmente assintomáticos e de lenta progressão. Esse é o relato de um caso em que um odontoma composto estava causando atraso na erupção de um canino permanente.

Odontomas are defined as hamartomas of odontogenic origin. They are composed of all structures that form the dental tissues. Histologically, two types of odontomas are recognized: complex and compound lesions. The compound type is composed of tooth-like structures that can be seen radiographically as opacities. The complex type comprises a mixture of odontogenic tissues without dental organization. The odontomas are usually asymptomatic and slow growing lesion. This is a case report of compound odontoma causing delayed eruption of a permanent canine in a young patient.

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Introdução: O trauma facial apresenta incidência crescente, principalmente devido ao aumento dos acidentes automobilísticos, que continuam sendo sua principal causa. Objetivo: Descrever o perfil dos traumas faciais e dos indivíduos traumatizados atendidos em 2006 e 2007. Métodos: Foram avaliadas as seguintes variáveis: gênero, faixa etária, localização da lesão, motivo do trauma, tipo de tratamento instituído, profissional que realizou o atendimento e a cidade de origem do paciente. Os dados foram coletados por meio de pesquisa em prontuários nos Hospitais Santa Casa de Misericórdia e Hospital Aroldo Tourinho. Uma análise descritiva foi realizada empregando o pacote SPSS v.12.0. Resultados: Observou-se que (81%) dos acidentados eram do gênero masculino. Os traumas mais comuns foram os mandibulares (45%), malar (22%) e maxila (16%). A maioria dos casos (73%) foi atendida pelo médico e o cirurgião-dentista atendeu (27%) dos acidentados. Os acidentes automobilísticos foram responsáveis pela maioria dos traumatismos (17%). Os pacientes eram, na sua maioria (49%), oriundos de Montes Claros/MG. Conclusão: O trauma facial acontece com freqüência e o acidente automobilístico é a principal causa.

Introduction: The facial trauma has presented an increasing occurrence, due especially to the growth of automobile accidents, which continue being its main cause. Objective: Tto describe the facial trauma and injured individual profile that were seen in 2006 and 2007. Methods: The following variables were assessed: gender, age, location of the lesion, the trauma reason, the kind of treatment, the professional who saw the patient and the city where the patient was from. The data were collected through a research in patients chats at Santa Casa de Misericórdia and Aroldo Tourinho Hospital. A descriptive analysis was carried out using the SPSS package v.12.0. Results: It was noticed that 81% of the injured were men. The most common trauma places were mandibular (45%), malar (22%) and maxilla (16%). A rate of 73% of the cases was seen by a doctor and 27% were seen by dental surgeon. The car accident was charged with the majority of the injuries (17%). Most patients were from Montes Claros/MG (49%). Conclusions: Facial trauma presented an increasing occurrence and automobile accidents was the main cause.

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Introdução: Descrição de caso clínico de rinosporidiose, doença granulomatosa crônica e rara, causada pelo Rhinosporidium seeberi. Objetivo: Incluir esta doença nos diagnósticos diferenciais de lesões polipoides das fossas nasais. Relato do Caso: Paciente do sexo masculino, proveniente do norte do Brasil, evoluiu por 3 anos, com lesão polipoide papilomatosa, da fossa nasal esquerda. Realizada sinusectomia com remoção de toda lesão, centrada em bula etmoidal e processo uncinado. Diagnóstico diferencial foi de papiloma invertido ou sinusite fúngica. O exame histopatológico revelou acentuada infestação por numerosas estruturas fúngicas com formas de esporângios repletas de esporangiósporos. Os microorganismos eram positivos para as colorações de Grocott, PAS e Mucicarmim; ao contrário do Coccidiodes immitis, que não se contrasta pelo mucicarmim. Não se optou por tratamento complementar e após 1 ano de seguimento não existem sinais de recidiva. Comentários Finais: A rinosporidiose deve ser considerada como diagnóstico diferencial das lesões polipoides nasais. No diagnóstico das lesões intranasais deve-se sempre considerar a procedência do paciente. É obrigatório o estudo anátomo-patológico para definir o diagnóstico. Na rinosporidiose, a exérese cirúrgica pode ser curativa.

Introduction: Clinical case report of rhinosporidiosis, a rare and chronic granulomatous disease, caused by Rhinosporidium seeberi. Objective: To include this disease in the differential diagnoses of polypoid lesions of the nasal mass. Report: A male patient from the North of Brazil evolved a three-year papilomatous polypoid lesion of the left nasal cavity. He was submitted to sinusectomy with resection of the entire lesion, located in ethmoid bulla and uncinated process. Inverted papilloma or fungal sinusitis were differential diagnoses. The histopathological examination revealed a strong infestation by numerous fungal structures with sporangia shape full of sporangiospores. The microorganisms were positive for colorations of Grocott, PAS and Mayer's Mucicarmin; opposite from Coccidioides immitis, which presents no contrast by the mucicarmin. We didn't choose complimentary treatment and after one year of follow-up he presents with no sign of recurrence. Final Comments: Rhinosporidiosis must be considered to be a nasal polypoid lesion differential diagnosis. In the intranasal lesions diagnosis we should keep in mind the patient's origin. The anatomopathological study is mandatory to set the diagnosis. In the rhinosporidiosis, the surgical exeresis can be a curative treatment.

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Penfigóide Cicatricial (Penfigóide Cicatricial de Membrana Mucosa) é uma doença auto-imune inflamatória crônica caracterizada pela presença de bolhas subepiteliais em membranas mucosas e, ocasionalmente na pele. Pode haver acometimento oral, nasal, faríngeo, laríngeo, ocular, esofágico, anogenital e de pele, predominantemente em pacientes na quinta e sexta décadas de vida. O tratamento preconizado inclui corticóides sistêmicos e agentes imunossupressores. Descrevemos neste trabalho dois casos com a doença em atividade, sendo que um evoluiu com complicação séptica pelo uso de imunossupressor e outro que apresentou estenose supraglótica exigindo traqueotomia.

Cicatricial pemphygoid (mucous membrane cicatricial pemphygoid) is a chronic autoimmune inflammatory disease characterized by subepithelial bubbles in mucous membranes and, occasionally on the skin. It may affect the mouth, the nose, pharynx, larynx, the eyes, esophagus, anus, genitals and skin; especially affecting patients between fifty and sixty years of life. Treatment includes systemic steroids and immunosuppressive agents. In the present paper we describe two cases with the active disease, and one of them had sepsis because of using immunosuppressive agents and another that presented supraglottic stenosis requiring tracheostomy.

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Introdução: Os traumas dentários podem causar injúria de vários tipos, que envolvem desde a fratura do esmalte até a fratura óssea. Dentre os vários tipos de traumatismos dentários, a avulsão dental, classificada como uma injúria dentária que consiste no deslocamento total de um dente de sua cavidade. É a mais freqüente nas escolas durante as práticas esportivas e recreativas. As crianças e adolescentes são os principais grupos de risco de avulsão dentária, que é mais freqüente entre os indivíduos do gênero masculino. O uso do protetor bucal é recomendado durante a prática de atividades físicas para evitar ou minimizar os traumas dentais. O reimplante é a conduta mais indicada em casos de avulsão dental. Objetivo: Avaliar o conhecimento e o nível de informação de acadêmicos de Educação Física sobre trauma alvéolo-dentário e uso de protetor bucal. Métodos: Foi aplicado um questionário a acadêmicos do último período do Curso de Educação Física, contendo 16 perguntas versando sobre traumatismo dentário e uso de protetor bucal. Foi realizada análise estatística descritiva a partir das respostas obtidas. Resultados: Oos acadêmicos apresentam baixo conhecimento sobre avulsão-reimplante dentário, o que em parte se deve ao fato de não terem tido a oportunidade de estudar o assunto durante a formação acadêmica. Os acadêmicos não atribuem ao protetor bucal a atenção que esse dispositivo merece, pois não incentivam ou exigem o uso do mesmo, por seus alunos, durante as práticas esportivas.

Introduction: Dental trauma can cause injuries of various types that involve the fracture of teeth enamel, and bone fracture. Among various types of dental traumatism, dental avulsion is classified as a dental injury that consists of the total dislocation of a tooth from its cavities. This type of trauma is the most frequent of the schools of sports and recreative practices. Children and teenagers are the principal risk group of dental avulsion, which is most frequent among men. The use of mouth protectors is recommended during the practice of physical activities in order to avoid or minimize dental trauma. The reimplantation is the most indicated conduct in cases dental avulsion. Objective: To evaluate the knowledge and level of information of the Physical Education academics about alveolous dental trauma and the use of mouth protector. Methods: It was applied a questionnaire to students of the last year of Physical Education, containing questions about dental traumatism and the use of mouth protectors. The statistical and descriptive analyses were done from the answers obtained. Results: the academics have insufficient knowledge of avulsion/dental-reimplantation, which is a partial result of not having the opportunity to study this subject during the academic formation. The students do not give the mouth protector the requested attention. Therefore, they do not suggest or demand the use of this devise to their students during sportive activities.

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Cicatricial pemphygoid (mucous membrane cicatricial pemphygoid) is a chronic autoimmune inflammatory disease characterized by subepithelial bubbles in mucous membranes and, occasionally on the skin. It may affect the mouth, the nose, pharynx, larynx, the eyes, esophagus, anus, genitals and skin; especially affecting patients between fifty and sixty years of life. Treatment includes systemic steroids and immunosuppressive agents. In the present paper we describe two cases with the active disease, and one of them had sepsis because of using immunosuppressive agents and another that presented supraglottic stenosis requiring tracheostomy.

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A proporção de pacientes com otosclerose estapediana em relação ao número de otorrinolaringologistas tem diminuído nos últimos anos. Questiona-se se a cirurgia de tratamento da otosclerose deve ou não continuar sendo ensinada para residentes. OBJETIVO: Avaliar os resultados e complicações das estapedotomias realizadas por residentes no período de janeiro de 1997 a janeiro de 2000; verificar a inclusão da estapedotomia no programa de residência médica. FORMA DE ESTUDO: Estudo de coorte histórica longitudinal. MATERIAIS E MÉTODOS: Avaliados 50 prontuários de pacientes submetidos a um total de 51 estapedotomias quanto às complicações e resultados audiológicos. RESULTADOS: Fechamento do gap aéreo-ósseo para menor ou igual a 10dB NA em 70,5 por cento das orelhas e menor ou igual a 20 dB NA em 86,3 por cento das orelhas. Ocorreu 1 caso de surdez total. Complicações: subluxação da bigorna (7,8 por cento), perfuração da membrana timpânica (5,8 por cento), vertigem incapacitante que se resolveu dentro de 3 semanas (5,8 por cento), otorréia (3,9 por cento), platina flutuante (1,95) e fístula perilinfática (1,9 por cento). CONCLUSÃO: A análise da literatura e os resultados e complicações obtidos neste estudo permitem concluir que a estapedotomia pode ser incluída no programa de residência médica, desde que haja disponibilidade de casos cirúrgicos para o treinamento dos residentes.

The number of patients with stapes otosclerosis compared to the number of otorhinolaryngologists has declined over the past several years. As a result a controversy has arisen in the literature, whether or not stapes surgery should be included in residency programs. AIM: the objective of the present study is to evaluate the results and complications of estapedotomies performed by residents between January, 1997 and January, 2000, and consequently study the feasibility of including estapedotomies in residency programs. STUD DESIGN: retrospective review of prospectively collected audiometric data. MATERIALS AND METHODS: fifty charts of patients that were submitted to a total of 51 primary stapedotomies were reviewed mainly for complications and audiological results. RESULTS: there was closure of the air-bone gap within 10 dB HL in 70.5 percent of ears and closure to within 20 dB HL in 86.3 percent of ears. There was one ear with total hearing loss (2 percent). CONCLUSION: From the results and complications seen in the present study, and analyzing papers from the literature, it is possible to conclude that stapedotomy is a procedure that can be included in residency programs, if there are surgical cases for the residents.

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UNLABELLED: The number of patients with stapes otosclerosis compared to the number of otorhinolaryngologists has declined over the past several years. As a result a controversy has arisen in the literature, whether or not stapes surgery should be included in residency programs. AIM: the objective of the present study is to evaluate the results and complications of estapedotomies performed by residents between January, 1997 and January, 2000, and consequently study the feasibility of including estapedotomies in residency programs. STUD DESIGN: retrospective review of prospectively collected audiometric data. MATERIALS AND METHODS: fifty charts of patients that were submitted to a total of 51 primary stapedotomies were reviewed mainly for complications and audiological results. RESULTS: there was closure of the air-bone gap within 10 dB HL in 70.5% of ears and closure to within 20 dB HL in 86.3% of ears. There was one ear with total hearing loss (2%). CONCLUSION: From the results and complications seen in the present study, and analyzing papers from the literature, it is possible to conclude that stapedotomy is a procedure that can be included in residency programs, if there are surgical cases for the residents.

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