Estevam Rubens Utumi

SAPHO syndrome with temporomandibular joint ankylosis: clinical, radiological, histopathological, and therapeutical correlations

The SAPHO syndrome is characterized by specific clinical manifestations of synovitis, acne pustulosis, hyperostosis, and osteitis. It is a rare disease with a combination of osseous and articular manifestations associated with skin lesions. We describe a patient with SAPHO syndrome of the mandible and involvement of the temporomandibular joint (TMJ ankylosis). The findings from orthopantomography, computed tomography (CT), and clinical and histopathological examinations are compared and analyzed to improve the final diagnosis. Our patient was submitted to a bilateral high condylectomy and coronoidectomy to correct the open mouth limitation. No previous report of SAPHO syndrome associated with secondary TMJ ankylosis was found in the literature.

Osteochondroma of the temporomandibular joint: a case report

Osteochondroma of the mandibular condyle has been found in the oral and maxillofacial region rarely. This paper describes a case of osteochondroma of the mandibular condyle in a 20-year-old woman, who was referred to our service with facial asymmetry, prognathic deviation of chin, cross-bite to the contralateral side, changes in condylar morphology, limited mouth opening, and malocclusion. Computed tomography (CT) was performed for better evaluation to the pathological conditions on the temporomandibular joint. Based on the clinical examination, patient history, and complementary exams, the hypothesis of osteochondroma was established. Condylectomy was performed using a preauricular approach with total removal of the lesion. After 3 years of postoperative follow up and orthodontic therapy, the patient is symptom-free, and has normal mouth opening with no deviation in the opening pattern.

Evaluation of simulated bone lesion in the head of the mandible by using multislice computed tomography

Conventional radiography has shown limitation in acquiring image of the ATM region, thus, computed tomography (CT) scanning has been the best option to the present date for diagnosis, surgical planning and treatment of bone lesions, owing to its specific properties. Objective: The aim of the study was to evaluate images of simulated bone lesions at the head of the mandible by multislice CT. Material and methods: Spherical lesions were made with dental spherical drills (sizes 1, 3, and 6) and were evaluated by using multislice CT (64 rows), by two observers in two different occasions, deploying two protocols: axial, coronal, and sagittal images, and parasagittal images for pole visualization (anterior, lateral, posterior, medial and superior). Acquired images were then compared with those lesions in the dry mandible (gold standard) to evaluate the specificity and sensibility of both protocols. Statistical methods included: Kappa statistics, validity test and chi-square test. Results demonstrated the advantage of associating axial, coronal, and sagittal slices with parasagittal slices for lesion detection at the head of the mandible. Results: There was no statistically significant difference between the types of protocols regarding a particular localization of lesions at the poles. Conclusions: Protocols for the assessment of the head of the mandible were established to improve the visualization of alterations of each of the poles of the mandibles head. The anterior and posterior poles were better visualized in lateral-medial planes while lateral, medial and superior poles were better visualized in the anterior-posterior plane.

Rare Occurrence of Myositis Ossificans Traumatica in a Patient With Rubinstein-Taybi Syndrome

n favor of a metastatic thyroid, a second-stage reoval of the thyroid primary followed by postoperaive radioiodine therapy is advocated. In those cases ith a definitive preoperative diagnosis, a better progosis has been reported with simultaneous resection f the solitary bony metastases along with total thyoidectomy followed by radioiodine therapy. This ay be because of the enhanced uptake and inreased effectiveness of postoperative radioiodine in ealing with other systemic micrometastases that are therwise undetectable. It is believed that skeletal etastases of thyroid carcinomas have a relatively oorer survival rate than lung metastases. In contrast to the majority of the published literature, his report is unique because the thyroid primary was ompletely asymptomatic with no prior history of thyoid disease and the metastatic mandibular lesion was asquerading as an arteriovenous malformation.

Extensive epidermoid cyst of the submental region.

Epidermoid cysts are malformations that are rarely observed in the submental region. Imaging has an important role in surgical planning according to the size and location of the cyst in relation to geniohyoid and mylohyoid muscles. This article reports the case of a 15-year-old female patient complaining of submental swelling. The differential diagnosis included infection, tumor, ranula, and abnormalities during embryonic development. The lesion was surgically excised using an extra-oral approach. The histopathological examination revealed a cyst wall lined with stratified squamous epithelium with the presence of several horny scales consistent with the diagnosis of an epidermoid cyst. No recurrences were found after 1 year of follow-up.

Recidiva de cisto dermoide congênito de localização paramediana

INTRODUCTION: The dermoid cyst is a cyst of unusual development in the face and more often involves the mouth floor. Most injuries occur in young adults with a slight predilection for males. Lesions in neonatal and children are extremely rare. It manifests as swelling floating asymptomatic and slow-growing and progressive, reaching dimensions. His capsule may contain one or more skin appendages such as sebaceous glands, hair or nails. The treatment is surgical, by enucleation, and its recurrence uncommon. The clinical appearance, histopathology, differential diagnosis and treatment of a case of congenital dermoid cyst, and its recurrence, are discussed by the authors.