Márta Ujpál

Comparison of postoperative complications following bone harvesting from two different donor sites for autologous bone replacement (hipbone and proximal epiphysis of the tibia)

Whereas autologous bone replacement was earlier applied in maxillofacial surgery virtually only for the restoration of mandibular defects and for the osteoplasty of patients with cleft alveolar process, the free transplantation of autologous bone (spongiosa or cortical bone or both) is nowadays primarily used for implantation purposes. Autologous bone is still the gold standard for bone replacement. This is the case even though a wide selection of bone substitutes is currently available, with which new bone equivalent to autologous bone can be produced in certain cases. Autologous bone is often obtained from intraoral sources, but if a larger quantity of spongiosa is required, these sites (the chin, the retromolar area of the mandible, the muscular process, etc.) are not suitable. Of the extraoral donor sites, the most frequently used site is the iliac crest, but the proximal epiphysis of the tibia is also appropriate for this purpose since we have recently performed bone transplantations on appreciable numbers of patients, we decided to compare the morbidity data relating to the two donor sites. In the 9 months between March and November 2007, sinus elevations were carried out on 14 patients with bone taken from the tibia, while in 38 patients bone was taken from the iliac crest for osteoplasty on clefted alveolar process. The comparison was based on postoperative clinical examinations, the complaints of the patients and objective study of the morbidity relating to the two donor sites. Clinically the patients tolerated both interventions well. Mobilization took place on the day of intervention. There were no major complications; one minor haematoma was observed after each type of surgery. The postoperative complaints of the patients did not reveal any essential difference. Following bone harvesting from the iliac crest, the gait of the patients slightly hampered for up to 10 to 14 days. In the tibia cases, the patients experienced no pain on walking by the second day. As regards donor site morbidity, protracted (1-2 weeks) oedema was observed after hip surgery, with paraesthesia of the area of innervation of the n. cutaneous femoris lateralis in 1 case, while there was a minor seroma following tibia surgery in 1 case. Our clinical experience suggests that, if 10-15 cm(3) spongiosa is required for augmentation purposes and there is no need for cortical bone, the patient is exposed to less stress when bone is taken from the proximal epiphysis of the tibia.

A 2-es típusú diabetes mellitus prevalenciájának változása szájüregi carcinomás betegek körében

INTRODUCTION Data proves that Hungary has a leading role in the statistics of oral cancer and patients living with type 2 diabetes. AIM Our aim was to understand the statistical correlation between oral cancer and metabolic disorder (diabetes mellitus and impaired fasting glucose) due to the valuable data from the Semmelweis University. METHOD We analyzed the data of 835 patients diagnosed with malignant oral cancer and 587 tumor-free control patients. We investigated the incidence and location of oral cancer among patients living with diabetes, and compared these datasets with our previous data from 14 years earlier. RESULTS We found that in oral cancer patients, 26.1% had diabetes and 20.8% had impaired fasting glucose; in the control group these ratios were 10.8% and 11.1%. This difference is significant (p<0.05). 14 years ago in the tumor group 14.6%, in the control group 5.6% had diabetes, while 9.7% and 5.5% had impaired fasting glucose. Lip cancer had the biggest incidence. CONCLUSIONS The rise of type 2 diabetes in the tumor group was significant. This could be a burden for the health care system. We want to highlight the importance of interdisciplinary cooperation between health care professionals. Orv Hetil. 2018; 159(20): 803-807.Absztrakt: Bevezetes: Ma mar szamos irodalmi adat bizonyitja, hogy a diabetes mellitus elősegiti a rosszindulatu daganatok kialakulasat es terjedeset, kedvezőtlenul befolyasolja a daganatos tulelest. Munkacsoportunk az elsők kozott vizsgalta a szajuregi malignus tumorok es a diabetes mellitus epidemiologiai osszefuggeseit. A diabetes szeles korű rapid terjedese miatt hosszu tavu osszehasonlito vizsgalatokat vegeztunk szajuregi daganatos betegek koreben. Eredmenyeinket a korabbi adatokkal osszevetve elemeztuk. Celkitűzes: Megvizsgalni a szajuregi daganatos betegek koreben a diabetes mellitus előfordulasi gyakorisagat es a kulonboző tumorlokalizaciok incidenciajat. Modszer: Retrospektiv diabetes- es emelkedett ehomi vercukorszintszűrest vegeztunk 835 hisztologiailag igazolt szajuregi daganatos beteg koreben. Vizsgaltuk a tumorok lokalizaciojat is. A kontrollcsoportot 587 tumormentes felnőtt kepezte. Az adatokat osszehasonlitottuk a 14 evvel ezelőtti eredmenyekkel. Eredmenyek: A szajuregi tumoros betegeknel ...