RESUMO
Craniofacial malformations (Pierre-Robin sequence, Treacher-Collins syndrome, Nager syndrome, etc.) are frequently associated to severe mandibular hypoplasia, which can cause upper airway obstruction by retroposition of the base of the tongue in the posterior pharyngeal space. Most of the patients respond to postural treatment. In prone decubitus position, it may be necessary to monitor oxygen saturation, insert a nasopharyngeal tube and even an endotracheal one. In more severe cases with prolonged and frequent pauses of apnea, tracheostomy may be necessary, but it is associated with high morbidity and sometimes mortality. In the last two years, in the Multidisciplinary Cleft Lip and Palate Unit of the Hospital Virgen de las Nieves, 4 children with severe obstructive apnea secondary to severe mandibular hypoplasia have been treated with mandibular distraction osteogenesis, this procedure being effective in the resolution of the condition. It has avoided tracheostomy, it has lengthened the jaw in a period of 2-3 weeks. During this time, the obstructive respiratory problems and also swallowing problems have disappeared. The esthetic results were excellent and the complications, for the moment, minimum.
Assuntos
Apneia/etiologia , Apneia/cirurgia , Anormalidades Craniofaciais/complicações , Anormalidades Craniofaciais/cirurgia , Mandíbula/cirurgia , Osteogênese por Distração , Feminino , Humanos , Recém-Nascido , MasculinoRESUMO
INTRODUCTION: A cervical tumoration is a frequent symptom presented by patients of different ages. OBJECTIVE: Analyse the clinical, diagnostical and treatment aspects of patients affected by cervical tumoration. METHOD: Retrospective study of a serie of cases during 10 years. RESULTS: A total of 182 patients, affected by cervical tumoration, were analysed. The 60% were men and the 40% women with 45 years average. The benign pathology more frequent was the branchial cyst and the malign were the metastasis of epidermoide carcinoma. The diagnostic and therapeutic procedures utilized are analysed. CONCLUSIONS: An anamnesis and a minoutious exploration diminish in great measure the diagnostic possibilities. The TAC and the PAAF are diagnostic methods of great value in the study of a cervical tumoration and facilitate an adequate scheme of treatment, that is essential for a good prognosis.