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The reconstruction of large mandibular defect with combined distraction osteogenesis 联合牵张成骨修复下颌骨大面积缺损
Pub Date : 2025-03-01 Epub Date: 2024-11-29 DOI: 10.1016/j.adoms.2024.100508
Xue-gang Niu
We describe one case of the rehabilitation for large mandibular defect by the combined application of internal curvilinear and linear distraction osteogenesis. In the first operation, the transport discs were produced on both sides of the defect. The internal curvilinear and linear distraction were then performed Three months later, the defect was reduced by half, then in the second operation, the internal linear distraction osteogenesis bilateral to the residual defect was started. Another three months later, the newly-formed bone was evident in the distraction gaps, then in the third operation, the distracted transport bony discs were connected by a small local bone graft. By the steps, the 70 mm defect was reconstructed. This might be a practical way for the synchronous reconstruction of bony and soft tissue for large mandibular defects that do not require bone grafts from other anatomic areas.
本文报道了一种内曲线图和线性牵张成骨术联合应用于下颌大面积缺损的康复。在第一次手术中,在缺陷的两侧制作传输盘。3个月后行内曲线形牵张和内直线形牵张,缺损缩小一半,然后在第二次手术中,开始对残余缺损双侧进行内直线形牵张成骨。又过了3个月,在牵张间隙中出现明显的新骨形成,然后在第三次手术中,通过局部小骨移植物连接分散的运输椎间盘。通过这些步骤,重建了70 mm的缺陷。这可能是一种实用的方法,同时重建骨和软组织的大下颌骨缺损,不需要从其他解剖区域的骨移植。
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引用次数: 0
A Method to evaluate the efficacy of conservative treatment of intraosseous mandibular ameloblastoma 目的:评价下颌骨内成釉细胞瘤的保守治疗效果
Pub Date : 2025-03-01 Epub Date: 2024-12-04 DOI: 10.1016/j.adoms.2024.100509
Federico Stolbizer , María Luisa Paparella , María Magdalena Andrada , Diego Vázquez , María Elina Itoiz , Krissya María Villegas
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引用次数: 0
The association between head and neck radiotherapy, and osteoradionecrosis: A retrospective analysis of risk factors 头颈部放疗与骨放射性坏死之间的关系:危险因素的回顾性分析
Pub Date : 2025-03-01 Epub Date: 2025-01-04 DOI: 10.1016/j.adoms.2025.100514
Jaymit Patel, Mehmet Sen
Head and neck cancer is the fastest accelerating cancer. Radiotherapy is commonly used to treat head and neck cancer. Whilst radiotherapy is an effective treatment modality for head and neck cancer, it is associated with significant early and late side effects which impact on the quality of life of patients. The late side effects of radiotherapy (depending on the volume and dose) may cause irreversible problems such as dysphagia, xerostomia, dental decay, and osteoradionecrosis.
We performed a retrospective analysis of head and neck cancer cases treated with radiotherapy at Leeds Teaching Hospitals Trust, UK. The aim of this process was to perform an exploratory analysis into the potential risk factors for osteoradionecrosis, focussing on risk factors that would be identifiable at a pre-radiotherapy dental screening appointments. This methodology was not utilised to determine statistically significant correlations, but to inform future studies which may involve regression analysis, and subsequent risk prediction.
Our study confirms findings from previous studies suggesting that variables such as the timing of pre-radiotherapy extractions, the number of pre-radiotherapy extractions, and the smoking status of the patient may increase the risk of osteoradionecrosis. We found new potential risk factors which require further investigation, including the presence of dental pathology on the pre-treatment PET-CT. This novel finding may provide further indication of the patient specific risk for osteoradionecrosis.
头颈癌是发展最快的癌症。放射治疗通常用于治疗头颈癌。虽然放疗是头颈癌的一种有效治疗方式,但其早期和晚期副作用显著,影响患者的生活质量。放射治疗的后期副作用(取决于体积和剂量)可能导致不可逆的问题,如吞咽困难、口干、蛀牙和放射性骨坏死。我们对在英国利兹教学医院接受放射治疗的头颈癌病例进行了回顾性分析。这个过程的目的是对放射性骨坏死的潜在危险因素进行探索性分析,重点是在放射治疗前牙科筛查预约时可识别的危险因素。该方法不用于确定统计上显著的相关性,但为可能涉及回归分析和随后的风险预测的未来研究提供信息。我们的研究证实了先前的研究结果,即放疗前拔牙的时间、拔牙次数和患者的吸烟状况等变量可能会增加放射性骨坏死的风险。我们发现了新的潜在危险因素,需要进一步调查,包括治疗前PET-CT上是否存在牙科病理。这一新发现可能为患者放射性骨坏死的特异性风险提供进一步的指示。
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引用次数: 0
Surgical approaches for condylar fractures: An analysis of the advantages of transmeatal retroauricular access 髁突骨折的手术入路:经颅耳后入路的优势分析
Pub Date : 2025-03-01 Epub Date: 2024-12-28 DOI: 10.1016/j.adoms.2024.100500
Bianca Pulino , Jéssica Freitas de Andrade , Thiago Felippe Oliveira de Macedo , Geraldo Prestes de Camargo Filho , Andreas Neff , Raphael Capelli Guerra
Since the beginning of the 20th century, surgical techniques have greatly improved to provide more effective surgical treatment, minimise transoperative time, and restore function. When it comes to facial fractures, it is extremely important to minimise complications, such as facial nerve damage and scarring. The aim of this article was to address the main analyses of the types of condylar fractures and surgical approaches, providing the reader with existing possibilities to help them choose an approach which is effective and reduces the risk of complications.
自20世纪初以来,外科技术有了很大的进步,可以提供更有效的手术治疗,减少手术时间,恢复功能。当面部骨折时,尽量减少并发症是非常重要的,比如面神经损伤和疤痕。本文的目的是针对髁突骨折类型和手术入路的主要分析,为读者提供现有的可能性,以帮助他们选择有效且降低并发症风险的入路。
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引用次数: 0
Inferior alveolar nerve bypass during tilted implant insertion: A 3-year retrospective cohort study 倾斜种植体植入过程中的下牙槽神经旁路:一项为期 3 年的回顾性队列研究
Pub Date : 2025-03-01 Epub Date: 2024-11-22 DOI: 10.1016/j.adoms.2024.100502
Nadim Sleman

Objective

Implant placement in atrophic mandibles can be challenging due to insufficient bone volume. To overcome this problem, bone grafts are often required to increase bone volume and provide a stable base for the implant. However, bone grafting procedures can be invasive, time-consuming, and costly. Tilted implants are a viable option to bypass the inferior alveolar nerve (IAN) and increase the contact surface and primary stability.
The aim of this study was to evaluate the survival rate of tilted implants in posterior atrophic mandible and complications related to injury of the inferior alveolar nerve (IAN).

Methods

Accepted patients in this study were only those who suffered from teeth loss in the posterior atrophic mandible. The analysis of this study focused on tilted implants to investigate the survival rate following insertion and during the loading stage. Clinical assessment was conducted to analyze any occurrences of IAN injury.

Results

A total of 31 implants were placed in the posterior mandible of 26 patients with insufficient bone volume. Over a 36-month observation period, all implants exhibited a 100 % survival rate. Three patients experienced temporary neurosensory disturbances.

Conclusions

The use of tilted implants is a viable option for patients with atrophic edentulous mandible that lack the required alveolar height for traditional dental implants. Despite limited study observation time, bypassing the IAN during implant placement presents a predictable option for atrophic posterior mandible treatment.
目的由于骨量不足,在萎缩的下颌骨中植入种植体可能具有挑战性。为了解决这个问题,通常需要植骨来增加骨量,为种植体提供一个稳定的基底。然而,植骨手术可能是侵入性的、耗时的、昂贵的。本研究的目的是评估倾斜种植体在后萎缩下颌骨中的存活率以及与下牙槽神经损伤(IAN)相关的并发症。本研究的分析重点是倾斜种植体,以调查插入后和加载阶段的存活率。结果 在骨量不足的 26 位患者的下颌后部共植入了 31 个种植体。在 36 个月的观察期内,所有种植体的存活率均为 100%。结论对于下颌骨萎缩无牙颌、牙槽高度达不到传统种植体要求的患者来说,使用倾斜种植体是一种可行的选择。尽管研究观察时间有限,但在种植体植入过程中绕过 IAN 为萎缩性下颌后牙治疗提供了一种可预测的选择。
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引用次数: 0
A true malignant mixed tumour of the parotid gland 腮腺的一种真正的恶性混合瘤
Pub Date : 2025-03-01 Epub Date: 2025-02-03 DOI: 10.1016/j.adoms.2025.100521
Ayesha McLennan-Dalal , Efstathia Kyrodimou , Sarah L. Saunders , Syed Ali Khurram , Andrew S. McLennan
Salivary gland carcinosarcomas contain both malignant epithelial and mesenchymal elements making them a true malignant mixed tumour. They may arise ‘de novo’ or from an existing pleomorphic adenoma and are often difficult to diagnose histologically. Management is by means of radical surgery, but prognosis remains poor. We present a case of this rare tumour seen in a young patient to highlight its aggressive potential.
唾液腺癌肉瘤含有恶性上皮和间质成分,是一种真正的恶性混合性肿瘤。它们可能是“新生的”,也可能是由现有的多形性腺瘤引起的,通常难以在组织学上诊断。治疗手段是根治性手术,但预后仍然很差。我们提出一个罕见的肿瘤的情况下,看到一个年轻的病人,以突出其侵略性的潜力。
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引用次数: 0
A systematic review of social impacts of treatment and rehabilitation of head and neck cancer patients 头颈癌患者治疗和康复的社会影响的系统综述
Pub Date : 2025-03-01 Epub Date: 2025-01-06 DOI: 10.1016/j.adoms.2024.100513
Rebecca T. Bernstein, Aphra Garner-Purkis, Jennifer E. Gallagher, Sasha Scambler
The objective was to examine the social impacts of treatment and rehabilitation on patients with head and neck cancer (HNC). Following a comprehensive search of OVID (Embase, Medline, Pubmed, PsycINFO) and Web of Science, the Mixed Methods Appraisal Tool (MMAT) was used to assess the methodological quality of all included studies. The findings were reported using Preferred Reporting Items of Systematic review and Meta-Analyses (PRISMA) checklist. From 14,661 papers identified, 46 were eligible for inclusion of which 25 were quantitative, 14 qualitative and 7 mixed methods. Most papers focussed on the theme of eating and swallowing impacts (n = 16), with the next most frequent group using general quality-of-life measures (n = 11). Methodological inadequacy concerned small sample sizes and relatively short follow-up times. Qualitative studies revealed a wide range of social impacts which affect patients relating to the cancer, therapeutic education, and the negative impact of treatment side effects over time. The literature suggests that HNC patients experience a range of social impacts linked to identity, relationships, activities undertaken, and cultural issues. This review concludes that more in-depth larger scale prospective research as well as qualitative research is urgently needed to ascertain how to optimize care for HNC patients.
目的是研究治疗和康复对头颈癌(HNC)患者的社会影响。综合检索OVID (Embase, Medline, Pubmed, PsycINFO)和Web of Science后,使用混合方法评估工具(MMAT)评估所有纳入研究的方法学质量。使用系统评价和荟萃分析首选报告项目(PRISMA)清单报告研究结果。从14661篇文献中筛选出46篇符合纳入标准,其中定量方法25篇,定性方法14篇,混合方法7篇。大多数论文集中在饮食和吞咽影响的主题上(n = 16),其次是使用一般生活质量测量的组(n = 11)。方法上的不足涉及样本量小和随访时间相对较短。定性研究揭示了广泛的社会影响,这些影响与癌症、治疗教育以及治疗副作用的负面影响有关。文献表明,HNC患者经历了一系列与身份、关系、所从事的活动和文化问题相关的社会影响。本综述认为,如何优化HNC患者的护理,迫切需要更深入、更大规模的前瞻性研究和定性研究。
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引用次数: 0
Horizontally impacted second and third mandibular molars. A rare case, review of the literature and description of the surgical technique for removal 水平阻生第二和第三下颌磨牙。一个罕见的病例,回顾文献和手术技术的描述去除
Pub Date : 2025-03-01 Epub Date: 2025-01-27 DOI: 10.1016/j.adoms.2025.100517
Amit Dattani , Flora Menzies , Ayesha Hammad , Luis Bruzual
Horizontally impacted mandibular molars are not uncommon. However, we report a rare case of a horizontally impacted stacked second and third mandibular molar. This paper presents adaption of the principles of surgical exodontia to account for rare variations in abnormal anatomy and a review of the literature, weighing up the balance between orthodontic intervention and surgical removal. Successful removal depends on careful surgical planning and respect for the surrounding anatomical structures whilst following the principles of surgical exodontia.
水平阻生的下颌磨牙并不少见。然而,我们报告一个罕见的情况下,水平阻生堆叠第二和第三下颌磨牙。本文提出了适应的原则,手术外牙,以解释罕见的变异在异常解剖和文献回顾,权衡正畸干预和手术切除之间的平衡。成功的移除取决于仔细的手术计划和尊重周围的解剖结构,同时遵循外科外牙的原则。
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引用次数: 0
Navigating the nasopharyngeal maze: Balanced surgical approach for advanced juvenile angiofibromas 导航鼻咽迷宫:晚期青少年血管纤维瘤的平衡手术入路
Pub Date : 2025-03-01 Epub Date: 2025-01-25 DOI: 10.1016/j.adoms.2025.100518
Sowrabh Kumar Arora, Sumanth Bollu, Bhavya Mishra
Juvenile nasopharyngeal angiofibroma (JNA) are fibrovascular tumors of the nasopharynx. These tumors are very vascular and non-encapsulated and predominantly affect young males aged 14–25 years. Clinically, JNA presents with unilateral nasal obstruction and recurrent epistaxis. Advanced instances may result in proptosis, cranial neuropathy, facial edema, and potentially fatal bleeding. The tumors exhibit local invasiveness which can extend intracranially. In this study, we reviewed two cases of extensive nasopharyngeal angiofibroma treated at our institute using the maxillary swing technique. The surgical approach was chosen based on tumor extent, blood supply, and the presence or absence of intracranial extension. Preoperatively, patients underwent tracheostomy and embolization. Both patients underwent successful surgical excision via the maxillary swing approach. We report the anticipated complications, their management, and the outcomes of these cases. Long-term follow-up revealed no recurrence, and both patients regained normal nasal function.
幼年鼻咽部血管纤维瘤是发生在鼻咽部的纤维血管肿瘤。这些肿瘤血管密布,无包膜,主要影响14-25岁的年轻男性。临床表现为单侧鼻塞和复发性鼻出血。晚期病例可能导致突出、颅神经病变、面部水肿和潜在的致命出血。肿瘤表现为局部侵袭性,可向颅内扩展。在本研究中,我们回顾了在我们研究所使用上颌摆动技术治疗的两例广泛的鼻咽血管纤维瘤。手术入路的选择是基于肿瘤的范围,血液供应和有无颅内延伸。术前,患者行气管切开术和栓塞术。两例患者均通过上颌摆动入路成功切除。我们报告预期的并发症,他们的管理,以及这些病例的结果。长期随访无复发,两例患者鼻部功能均恢复正常。
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引用次数: 0
Comprehensive five-year study on salivary gland tumors: Demographic, clinical, and histopathological insights 唾液腺肿瘤的综合五年研究:人口学、临床和组织病理学见解
Pub Date : 2025-03-01 Epub Date: 2025-02-03 DOI: 10.1016/j.adoms.2025.100523
Rahul Rajbhar , Dhanashri Ekatpure , Ashvini Kolhe

Background

Salivary gland tumors account for 3 %–10 % of head and neck neoplasms. The aim of the study is to analyze demographic, clinical, and histopathological characteristics of salivary gland tumors.

Materials and methods

A five year retrospective analysis of surgically excised salivary gland tumor specimens was conducted. Data on demographics, clinical features, and histopathology were reviewed and statistically analyzed using descriptive and inferential methods.

Results

A total of 55,000 specimens were received; of these, 0.12 % was diagnosed as salivary gland tumors, with a male to female ratio of 1.1:1. Of the tumors, 85.1 % were benign and 14.9 % were malignant neoplasms, with the most common tumors being pleomorphic adenoma and mucoepidermoid carcinoma respectively. Benign tumors generally had a slower onset and were more encapsulated, while malignant tumors showed faster growth and were less encapsulated.

Conclusion

This study enhances understanding of salivary gland tumors, highlighting benign predominance, gender disparities, and key histopathological features for diagnosis and treatment.
背景唾液腺肿瘤占头颈部肿瘤的3% - 10%。本研究的目的是分析唾液腺肿瘤的人口学、临床和组织病理学特征。材料与方法对5年手术切除的涎腺肿瘤标本进行回顾性分析。对人口统计学、临床特征和组织病理学的数据进行回顾,并使用描述性和推断性方法进行统计分析。结果共收到标本5.5万份;其中,0.12%诊断为唾液腺肿瘤,男女比例为1.1:1。良性肿瘤占85.1%,恶性肿瘤占14.9%,以多形性腺瘤和黏液表皮样癌最为常见。良性肿瘤一般发病较慢,包膜较多,恶性肿瘤生长较快,包膜较少。结论本研究提高了对唾液腺肿瘤的认识,突出了良性优势、性别差异和诊断和治疗的关键组织病理学特征。
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引用次数: 0
期刊
Advances in Oral and Maxillofacial Surgery
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