Carlos Augusto Pereira do Lago

Expansão rápida da maxila cirurgicamente assistida: estudo preliminar

A expansao rapida da maxila cirurgicamente assistida e eficiente para o tratamento de deficiencias transversais da maxila em pacientes adultos. OBJETIVO: Estudar duas tecnicas de expansao rapida da maxila cirurgicamente assistida - com separacao ou nao dos processos pterigoides. MATERIAL E METODOS: O estudo de coorte contemporânea longitudinal foi composto de 10 pacientes, com 18-40 anos de idade e com discrepância transversa da maxila de mais de 4mm. Dois grupos foram estabelecidos de forma aleatoria, cinco pacientes em cada grupo, de acordo com a separacao ou nao dos processos pterigoides. Alem disso, em ambos os grupos, foram realizadas as osteotomias dos pilares zigomaticos e da sutura intermaxilar. A discrepância transversal foi medida em modelos de estudo, uma radiografia cefalometrica postero-anterior avaliou os planos zigomaticos superior e inferior e a distância inter-tuberes e uma radiografia oclusal avaliou a disjuncao intermaxilar no periodo pre-operatorio e 30 dias de pos-operatorio. Um periodo de 7 dias foi aguardado apos as osteotomias, antes de iniciar a expansao de um quarto de volta por dia. RESULTADOS: Nao houve diferenca estatistica entre as medidas pre e pos-operatorias. CONCLUSAO: Ha poucos estudos controlados na literatura comparando as duas tecnicas de expansao cirurgica da maxila. Estudos com amostras maiores devem ser realizados.

Mandibular fracture in a premature infant: a case report and review of the literature.

This study describes a case of a lymphoepithelial cyst ith uncommon localization anterior to the anterior aucial pillar but not into the tonsil fossa. The proximity f the lesion to the area of the second branchial cleft and he existence of a duct to the anterior faucial pillar onstitute a very rare finding. The histologic examinaion and the anatomic relations of the cyst support the ypothesis of second branchial cleft origin.

Cervical-thoracic facial necrotizing fasciitis of odontogenic origin

Doctoral de gree in oral and maxillofacial surgery and trauma, Pernambuco Dentistry School (FOP), UPE. Staff of the Oral and Maxillofacial Surgery and Trauma Unit, Hospital da Restauracao, Recife, PE.Restauracao Hospital (Hospital da Restauracao).Send correspondence to: Rua Dr. Geraldo de Andrade, 101, apto. 104. Espinheiro, Recife - PE. CEP: 52021-220.Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on May 17, 2010; and accepted on July 12, 2010. cod. 7090

Surgically assisted rapid maxillary expasion: a preliminar study

UNLABELLED Surgically assisted rapid maxillary expansion is efficient for the treatment of transverse maxillary deficiencies in skeletally mature patients. AIM To study two techniques for surgically assisted rapid maxillary expansion: with or without pterygoid plate detachment. MATERIAL AND METHODS A longitudinal cohort study sample including ten patients aged 18-40 years, with a skeletal transverse discrepancy in the maxilla of more than 4 mm. Two groups were established on a randomized basis, five patients in each group, according to the detachment or absence of detachment of the pterygoid plate. Furthermore, osteotomies of the bilateral zygomatic buttress and the intermaxillary suture were done in both groups. The transverse discrepancy was measured in study models, a posterior-anterior cephalometric radiograph evaluated the superior and inferior zygomatic plane and the inter-tuber distance and an occlusal radiograph evaluated the intermaxillary disjunction in the pre-operative period and 30 days post-operatively. A 7-day period of rest was given after corticotomy before starting expansion with quarter turns once a day. RESULTS There were no statistically significant differences between pre- and post-operative measurements. CONCLUSION There are few randomized control trials in literature comparing the two techniques for surgically maxillary expansion. Further studies with a larger sample are required.

Case ReportCervical-thoracic facial necrotizing fasciitis of odontogenic origin

Doctoral de gree in oral and maxillofacial surgery and trauma, Pernambuco Dentistry School (FOP), UPE. Staff of the Oral and Maxillofacial Surgery and Trauma Unit, Hospital da Restauracao, Recife, PE.Restauracao Hospital (Hospital da Restauracao).Send correspondence to: Rua Dr. Geraldo de Andrade, 101, apto. 104. Espinheiro, Recife - PE. CEP: 52021-220.Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on May 17, 2010; and accepted on July 12, 2010. cod. 7090

Conservative Treatment of Comminuted Mandibular Fracture Involving Maxillomandibular Fixation With Miniplates

Bars and steel wires are the most commonly used methods to achieve maxillomandibular fixation, although there are numerous alternatives described for this same purpose. In cases of edentulous candidates for the conservative treatment of facial fractures, none of the conventional methods can be instituted for maxillomandibular fixation. Fixation in such cases is achieved with the aid of the total dentures of the patient or the confection of splints, but these methods lead to eating and oral hygiene problems. This article reports the case of an edentulous patient with a comminuted mandible fracture treated with a rarely described technique in which intermaxillary fixation was achieved with titanium miniplates.

Transmaxillary approach to the cranial base: an evaluation of 11 cases

UNLABELLED Surgical access to the skull base is always difficult, especially because of the noble anatomic structures present there. Maxillary osteotomy provides direct view to the clivus region and the neck spine, and it also bears less morbidity when compared to the many other accesses described in the literature. AIM to assess 11 patients submitted to transmaxillary osteotomy, describing the surgical technique and postoperative results and complications. MATERIALS AND METHODS A retrospective study involving eleven patients submitted to transmaxillary approach to the brainstem. We studied dental occlusion, trans and postoperative bleeding, bone necrosis and soft tissue alterations. All followed the same surgical protocol and were followed up for two years. RESULTS after treatment, all the patients improved in their clinical status and had no neurological complication, trans and postoperative hemorrhage or major complications were seen. Among the complications, two patients had incomplete maxilla fracture, two had laceration of their nasal mucosa and one had, as late complication, an oral-sinusal fistula. CONCLUSION Transmaxillary osteotomy provided proper access to the clivus for brainstem decompression with low rate of complications in this series.

Acesso transmaxilar à base do crânio: avaliação de 11 casos

Surgical access to the skull base is always difficult, especially because of the noble anatomic structures present there. Maxillary osteotomy provides direct view to the clivus region and the neck spine, and it also bears less morbidity when compared to the many other accesses described in the literature. AIM: to assess 11 patients submitted to transmaxillary osteotomy, describing the surgical technique and postoperative results and complications. MATERIALS AND METHODS: A retrospective study involving eleven patients submitted to transmaxillary approach to the brainstem. We studied dental occlusion, trans and postoperative bleeding, bone necrosis and soft tissue alterations. All followed the same surgical protocol and were followed up for two years. RESULTS: after treatment, all the patients improved in their clinical status and had no neurological complication, trans and postoperative hemorrhage or major complications were seen. Among the complications, two patients had incomplete maxilla fracture, two had laceration of their nasal mucosa and one had, as late complication, an oral-sinusal fistula. CONCLUSION: Transmaxillary osteotomy provided proper access to the clivus for brainstem decompression with low rate of complications in this series.