Biomedical subjects
Publications and source records attributed to J I Iriarte Ortabe.
This is the case of a young woman, 16-year-old, calling to our Department because of the appearance, in the floor of the mouth, of a mass progressively growing until about 5 cm diameter. Through fine needle biopsy was diagnosed of epidermoid cyst. Despite its size and infrahyoid site was removed successfully. Perusal review of last years bibliography and its variants.
Neurinomata developed from extracranial portion of hypoglossal nerve are very scarce. We report one case of neurinoma originated in the descending branch of hypoglossal nerve and not having found after careful perusal of the literature of this subject another case we consider the ours as the first portraying this type of pathology and its localization.
Pilomatrixial carcinoma is the malignant variety of pilomatrixoma. It is a malignant lesion, locally aggressive that can reappear, specially if not completely removed. Scanty are the number of cases listed in the literature (2). Although metastases are uncommon one or twice references can be found in the writings (1). We report 2 cases of pilomatrixial carcinoma located in the middle canthal and malar zones, which were treated surgically: excision of the tumor and reconstruction by means of a local rotation flap.
Having on base a wide and selective review of the literature, it has seemed to us interesting to detail the infective pathology on this location or sometimes occurring. This region is, as well will see, the seat of a rich pathology. We pretend on the other hand to reassess the importance of the meticulous examination of the oral cavity in "systemic problems". We describe the palatal infections divided in four groups: bacterial, viral, fungal and parasitory, according to the causal agent. We review the palatine manifestations of other fewer current syndromes as well.
The myomucosal flap from buccinator muscle is a versatile flap useful on reconstruction of defects located in the palatine region. We report the case of a vascular tumor located in the left palate which was removed and rebuilt with a myomucosal flap taken from buccinator muscle. We proceed previously to the embolization of its nutritional artery (a. palatina major).
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Three cases of adenoid cyst carcinoma of the palate are reported. In this study clinical features, pathological findings, treatment and prognosis are analyzed. In the 1st and 2nd cases we unfortunately verified that the course of the tumors based in a slow-continuous infiltrating spread. Moreover, in our first patient a late diagnosis of it made the prognosis become worse. In the 1st one, radical surgery is proposed for the adenoid cyst carcinoma diagnosed at an early stage without tumoral dissemination.
The authors report their experience of microsurgical reconstruction of the maxillofacial region with the radial forearm flap in 40 patients. After a brief historical and anatomical description, the cases are presented and specific considerations on the author's operative technique are detailed. The discussion on the advantages and the disadvantages of this flap ends the paper.
Diffuse sclerosing chronic osteomyelitis is a lasting pathological entity characterized for recurrent outbreaks of intensive pain referred to the mandible, escorted with inflammatory phenomena, trismus, paresthesia of the nervus alveolaris inferior and progressive deformity of the lower jaw. The differential diagnosis with other facial neuralgies of the face must be very carefully get up and its treatment is disappointing. The etio-pathology of the illness remains uncertain. The AA. report one clinic case with typical course, which offer them the opportunity to review and discuss the literature of the subject.
Reconstruction of oncological defects in the maxillofacial region still remains a real surgical challenge due to the complexity and the tridimensional aspect of these defects responsible for heavy functional impairment. Microsurgery allowing the transfer of free flaps gives the surgeon the opportunity to adapt a specific reconstruction to each defect and to reinsert the patient in a quasi normal social life. These reconstruction technics are routinely used in many centers; they must be integrated in our therapeutic arsenal and in the training of the maxillofacial surgeon. Seven years ago, we incorporated microsurgical reconstruction in our therapeutical concepts and today, it seems to us important to share our experience of microsurgical reconstruction in the field of soft tissues defects in the maxillofacial region.
We report a case of maxillary sitting of a calcifying odontogenic epithelial tumor (Pindborg's tumor). It is a benign tumor with similar microscopical findings with the ameloblastoma although its natural evolution is different. The tumor has an actodermal odontogenic origin. The stem cell from which it develops and its growth stimulus are unknown. Although the intermediary stratum of the enamel producing organ has been incriminated. A swelling of the maxillae or a casual finding--as the case reported--are the most common manifestations at beginning of these cases. The differential diagnosis depends on the radiological pattern we may find. Various surgical procedures may be considered optional. It could vary from enucleation to complete resection of the affected structure. Aggressive surgery is not indicated.
The authors detail the anatomical, physiological, and clinical considerations of the free forearm flap. These characteristics determine the many indications of this flap in the maxillofacial surgical reconstruction. Contraindications are quasi inexistent. The second part of this work analyse the surgical and microsurgical operative technique use for the authors. All different parts of this work are discussed upon a deep review of the recent literature.
The authors describe the technique of mobilization of the osseous orbito-zygomatico-malar complex pedicled to the masseter muscle. In some affections it is justiciable to use this approach which provides an excellent view of the lateral region of the medial cranial fossa and orbit and permits the access to the base of the tumor by a intra- and extracranial approach without traumatic injury for the brain and easy reconstruction.
Odontogenic fibroma is an infrequent benign tumor, originating in the mesenchyma and including an inactive odontogenic epithelial component. The central form, of which one case is reported here, is expressed by a relatively well-delineated radiolucent area, whose interest and difficulty lie in the differential diagnosis. On the basis of a review of the literature, details are given on the clinical, clinicopathologic, diagnostic and therapeutic data.
The solitary plasmocytoma of the mandible is a rare affection. This article describes the case of a man, 42 years old. A short review of the pathology is done. The treatment (surgery and radiotherapy) with their failures and complications is exposed.
The authors report their experience with the free osseous and osteocutaneous fibular flap used in the complex mandibular reconstruction. After a short review of the mandibular reconstruction possibilities and description of the fibular flap characteristics, the clinical cases are reported and the operative technique used by these authors is detailed. The discussion of the advantages and the disadvantages of this flap in the complex mandibular reconstruction ends the paper.
This paper present 2 different cases of extra-articular ankylosis of the temporo-mandibular joint by a maxillo-facial presentation of localized and generalized ossifying myositis. A review of the literature about this subject allow the AA, to describe the clinical, diagnostical and therapeutic features of this unusual pathology.
The AA. report their experience about 42 of latissimus dorsi flaps, used in the maxillofacial reconstruction of 40 patients, during the last 4 years. After a brief historic and anatomic descriptions, the operative technique used for them is detailed with the solution for the encountered problems. The discussion of the advantages and drawbacks of this flap which should deserve a preferential place in the reconstructive surgery of large losses of the maxillofacial sphere (besides the microsurgical methods) ends the paper.