Rafael Martín-Granizo

Cemento-ossifying fibroma of the upper gingivae:

enlarged for 4 months. It was painful and interfered with mastication. Her medical history was noncontributory, and she denied alcohol and tobacco use. Physical examination revealed a rounded, lobulated mass, 30 × 40 mm (Fig 1). It was exophytic and pedicled on the vestibular surface of the upper gingivae. On palpation, it was elastic and covered by healthy mucosa. She had advanced generalized periodontitis with mobile teeth but no cervical adenopathy. Dental panoramic radiographs showed no intraosseous cyst or bony tumor. An excisional biopsy was performed with the patient under local anesthesia resecting the attached gingivae. In addition, both extraction of the upper left second premolar and the upper left first molar and curettage of the underlying bone were done. The recovery was uneventful, and no recurrence was detected at a 6-month follow-up.

Epithelioid hemangiomas of the maxillofacial area: A report of three cases and a review of the literature

Epithelioid hemangioma, also named angiolymphoid hyperplasia with eosinophilia, is a very rare tumor that arises from vascular structures. The relative incidence in the skin of the head and neck area is rather high as compared to other parts of the body. Three cases are reported in an atypical location and the differential diagnosis with other similar vascular lesions and their pathologic features is presented.

Mandibular sclerosing osteomyelitis of Garré

Since 1893, when Carl Garréa 1 described the features of the sclerosing osteomyelitis, few reports have been published. This is a rather rare disease also named periostitis ossificans, nonsuppurative chronic osteomyelitis, and chronic osteomyelitis with proliferative periostitis. It is defined as an intense proliferation of periosteum with reactive peripheral bone formation caused by a slight irritation or infection without necrosis or purulent exudate. 2

Tratamiento quirúrgico de la impresión basilar mediante osteotomía tipo Le Fort I segmentada: a propósito de un caso

Resumen La patologia de caracter expansivo, tumoral o no, originada a nivel de la region anatomica de la base del craneo (BC), presenta una gran diversidad histologica; desde un punto de vista clinico provoca una disfuncion neurologica cronica de mayor o menor gravedad. El tratamiento quirurgico representa la opcion terapeutica mas empleada. Un conocimiento exhaustivo de la anatomia topografica de esta area es prioritario para un correcto diseno de la estrategia operatoria. En muchos casos se requiere una estrecha colaboracion multidisciplinar. Como en cualquier actividad quirurgica, la exeresis lesional completa y una correcta rehabilitacion funcional y estetica, en ausencia de complicaciones, es el reto del equipo quirurgico. El abordaje a la encrucijada anatomica que constituye la BC no es unico, si no que se sustenta en un gran abanico de posibilidades; ninguna via se puede considerar la mejor, ni ninguna esta exenta de dificultad tecnica, ni de posibles complicaciones. Dentro del grupo de las vias transorales, la osteotomia maxilar tipo Le Fort I (OMLF I) segmentado, es aceptada por distintos autores como una excelente posibilidad de abordaje a la region del clivus y de la charnela occipito-vertebral. Presentamos el caso de un paciente, tratado de forma conjunta con el Servicio de Neurocirugia de nuestro hospital. Fue diagnosticado clinica y radiologicamente de impresion basilar con compresion bulbar. El estudio de imagen mediante Resonancia Magnetica (RM) ponia de manifiesto la presencia de un lesion fibrosa extradural localizada alrededor de la apofisis odontoides. En sesion clinica conjunta se decidio emplear un abordaje mediante OMLF I segmentado para abordar dicha lesion. La exposicion del lecho quirurgico fue optima, obteniendose una reseccion completa. Los resultados postoperatorios fueron altamente satisfactorios.

TWO PIECES OF OVERLAPPING GENIOPLASTY

The long-term mental outcome of 76 children operated on for trigonocephaly was assessed, and the factors influencing the prognosis were studied. Final assessment of mental development was made on children who were more than 3 years old and was based on the occurrence of behavioral disturbances, learning disability, and school difficulties, and on intellectual efficiency. Children were graded into three groups: no abnormality, mild abnormalities but with normal social function, and grossly abnormal. Preoperative computed tomography scans were used to measure the severity of the frontal stenosis and to identify associated intracranial abnormalities, such as agenesis of the corpus callosum, dilatation of the subdural spaces, or hydrocephalus. Associated extracranial malformations and associated family cases were also noted. Lastly, the family setting was studied. Overall, 31.6 percent of patients had evidence of some degree of trouble Several correlations were identified: mental development was worse when the frontal stenosis was severe, when cranial reconstruction was performed after I year of age, and when there were associated extracranial malformations. In addition, the family environment was found to have a major influence, but the presence of intracranial abnormalities did not correlat ith mental development.