Biomedical subjects
Publications and source records attributed to P J Medeiros.
This article discusses an orthodontic-surgical approach to a patient with a severe openbite associated with relative macroglossia. Phonoaudiologic therapy had been used for 2 years without success. Glossectomy was used as an aid for orthodontic surgery. Various treatment stages are described, and information is given on diagnosis and macroglossia correction.
This article presents a case of an ankylosed upper central incisor that did not respond to orthodontic mechanics alone or to surgical luxation followed by orthodontic traction. We performed an osteotomy involving the dento-osseous segment in one surgical stage to allow its inferior displacement. The patient was followed for 18 months and the result was considered satisfactory from both the occlusal and periodontal standpoints.
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OBJECTIVE: To evaluate the results of the laparoscopic technique in the treatment of adrenal pheochromocytoma. METHOD: Ten patients, 7 men and 3 women, between 10 and 67 years of age (mean 48) with pheochromocytoma underwent transperitoneal laparoscopic adrenalectomy and were evaluated retrospectively, based on clinical, laboratory, and pathological diagnosis. In all cases there was a solid unilateral adrenal tumor, 5 on the left side and 5 on the right side, whose greater diameter varied from 7 to 80 mm (mean 32). Nine of the 10 patients were chronically hypertensive or had already had hypertensive crises. One patient was normotensive, but presented metabolic alterations suggestive of adrenergic hyperfunction. RESULTS: No deaths occurred in this series. There were two (20%) conversions to open surgery, one due to venous bleeding and one due to the difficulty of dissection behind the vena cava in a patient presenting a partially retro-caval tumor. Surgical time in the 8 non-converted cases ranged from 70 to 215 minutes (mean 136). One patient (10%) received blood transfusion, and another (10%) presented two complications - acute renal failure and a subcutaneous infection. Both had been converted to open surgery. None of the non-converted cases was transfused or presented complications. Hospital discharge occurred between the 2nd and 11th post-operative day (mean 3). The pathological exam of the surgical specimens confirmed the diagnoses of pheochromocytoma in all 10 cases, one of them associated with an aldosterone-producing cortical tumor. CONCLUSIONS: Laparoscopic adrenalectomy for selected patients presenting pheochromocytoma is feasible and provides good results.