Leopoldo Nizam Pfeilsticker

Odontogenic Myxoma in Children: A Case Report and Literature Review

Benign odontogenic lesions are rare entities but are very important due to their locally aggressive nature. Odontogenic myxoma is even rarer in children than in adults. There is no evidence in the literature in regard to the best treatment approach, in terms of conservative or aggressive surgery, for this type of tumor. This paper reports a case of odontogenic myxoma in a child treated with a compromised approach through bone osteotomies and a review of the literature about this disease, especially in pediatric patients.

Exostosis del conducto auditivo interno: 10 años de seguimiento

A 45-year-old female patient was attended with a right pulsatile tinnitus that had appeared two years ago. The tinnitus gets better when the patient turns the head/neck to the right or perform a hand compression of the neck in the right carotid. The tinnitus follows the cardiac rhythm and gets worse when she practices exercises. There was no other symptoms, such as hypoacusis, dizziness, or pain, and the patient had no previous medical history. Physical examination had no abnormalities. Audiogram showed a normal response with normal pure tones scores, speech recognition in 10 dB in both sides and good sound discrimination (96% of correct answer at 50 dB). Normal tympanometry on both sides (type A). The temporal and skull base CT (02/06/2002) showed a bone lesion in the left IAC, narrowing the canal, as the MRI (28/06/2001) that appointed out the same lesion. There is also a finding in the MRI of an empty sella (Fig. 1) The cervical Doppler of carotid and vertebral vessels (01/09/2000) was normal.

Avaliação de um protocolo da reabilitação orofacial na paralisia facial periférica: evaluation of an orofacial rehabilitation protocol

PURPOSE: to evaluate a proposed protocol of orofacial neuromuscular rehabilitation for peripheral facial paralysis. METHODS: clinical observation of 20 patients with fourth-degree paralysis, sent to orofacial rehabilitation in the Facial Paralysis Ambulatory from Hospital das Clinicas at UNICAMP: prospective longitudinal study. The verification of functional evolution or not, in the rehabilitation, was based on the improvement of muscular tonus, whose variation was measured by the modification in the labial commissure angle. The study was done with images from photographical documentation prior to (fifteen days after the installation of facial paralysis) and post one-year treatment. As proof of the effect concerning rehabilitation, the pre and post rehabilitation labial commissure angle was measured. The studied group was compared to a control group composed of nine subjects with fourth-degree orofacial paralysis, who did not undergo orofacial rehabilitation. The data were statistically analyzed by the two tail paired sample test (Students T test). RESULTS: the average of labial commissure angle was 7.9o after treatment, with statistically significant difference (p<0.001). For the control group the average of the angular measurement was 100.9o + 1.9. This value did no differ from the values initially measured in the studied group (p=0.723). They were significantly higher when compared to the average of the values of the final angles of the studied group with treated patients (p=0.001). CONCLUSION: the rehabilitation protocol used in the sample promoted significantly increment of muscular tonus, with functional improvement and in the facial rest.

Peripheral facial paralysis

PURPOSE: to evaluate a proposed protocol of orofacial neuromuscular rehabilitation for peripheral facial paralysis. METHODS: clinical observation of 20 patients with fourth-degree paralysis, sent to orofacial rehabilitation in the Facial Paralysis Ambulatory from Hospital das Clinicas at UNICAMP: prospective longitudinal study. The verification of functional evolution or not, in the rehabilitation, was based on the improvement of muscular tonus, whose variation was measured by the modification in the labial commissure angle. The study was done with images from photographical documentation prior to (fifteen days after the installation of facial paralysis) and post one-year treatment. As proof of the effect concerning rehabilitation, the pre and post rehabilitation labial commissure angle was measured. The studied group was compared to a control group composed of nine subjects with fourth-degree orofacial paralysis, who did not undergo orofacial rehabilitation. The data were statistically analyzed by the two tail paired sample test (Students T test). RESULTS: the average of labial commissure angle was 7.9o after treatment, with statistically significant difference (p<0.001). For the control group the average of the angular measurement was 100.9o + 1.9. This value did no differ from the values initially measured in the studied group (p=0.723). They were significantly higher when compared to the average of the values of the final angles of the studied group with treated patients (p=0.001). CONCLUSION: the rehabilitation protocol used in the sample promoted significantly increment of muscular tonus, with functional improvement and in the facial rest.