Teresa González

Three-dimensional reconstruction after removal of zygomatic intraosseous hemangioma

IntroductionIntraosseous hemangioma, especially in the zygomatic area, is a very rare pathologic condition among the osseous tumors of the head and neck area. Clinical presentation includes a painless mass with progressive growth and hard consistence. Diagnosis is performed by means of computed tomography (CT). Treatment includes radical en bloc surgical excision with healthy bone margins in order to avoid blood loss. Previous embolization is not necessary. Bony defect reconstruction must be performed to avoid secondary deformities.Case reportWe present a case report of a 30-year-old female presenting a progressive painless swelling in the malar and zygomatic regions. CT scan demonstrated a right zygomatic lesion that extended into the orbital floor and lateral orbital wall, affecting also the zygomatic arch. The biopsy revealed an intraosseous hemangioma. Treatment was performed including an en bloc resection with healthy bony margins and primary reconstruction with calvarian bone graft in association with galea–pericranium flap.

RASSF1A methylation and cyclin D1 expression in vestibular schwannomas

Inactivation of the neuroWbromatosis type 2 tumor suppres-sor gene is the best known alteration in vestibular schwan-nomas (VS). In recent years aberrant promoter methylationof tumor-related genes, as well as alterations in growth reg-ulatory genes have been described as possible mechanismsof VS development and progression [ 2, 5, 8].

Anastomosis hipoglosofacial intratemporal hemiterminoterminal

La anastomosis hipoglosofacial directa y la anastomosis con interposicion de nervio auricular mayor son las tecnicas de reconstruccion facial mas utilizadas cuando el extremo proximal del nervio facial no es accesible. Presentamos una modificacion de la tecnica, la anastomosis hipoglosofacial intratemporal hemiterminoterminal, que soluciona muchos inconvenientes de las tecnicas previas. La porcion intratemporal del nervio facial se libera y anastomosa al nervio hipogloso, seccionado parcialmente. La tecnica esta especialmente indicada en pacientes con multiples deficit de pares craneales.

Hemi-Hypoglossal-Facial Intratemporal Side to Side Anastomosis

Conventional hypoglossal-facial anastomosis and the interposition jump graft variation are the most popular techniques for facial nerve reconstruction resulting from proximal facial nerve injury. We present a modification of this technique, the hemi-hypoglossal facial intratemporal side to side anastomosis, which overcomes many of the failings of previous techniques. The method involves mobilization of the intratemporal facial nerve, which is anastomosed to a partially incised hypoglossal nerve. It is especially indicated in patients with multiple cranial nerve palsies.

Técnicas reconstructivas del nervio facial

Objetivo Analizar la funcion facial postoperatoria de 14 pacientes sometidos a diferentes tecnicas reconstructivas del nervio facial. Pacientes y metodo Las etiologias de las paralisis facials incluian schwannomas vestibulares, schwannomas faciales, traumatismo craneoencefalico y lesiones iatrogenicas. Resultados El intervalo medio entre la lesion y la cirugia reconstructiva fue de 6 meses, excepto en 2 pacientes en que supero los 12 meses. En todos los casos los movimientos faciales aparecieron en torno a los 6 meses. Todos ellos obtuvieron una funcion facial de grados III o IV en la escala de House-Brackmann, lo que equivale a un resultado bueno o excelente en la escala de May. No hubo diferencias al comparar las tecnicas quirurgicas empleadas, tanto las anastomosis terminoterminales como las hipoglosofaciales. Conclusiones Los procedimientos reconstructivos del nervio facial deben ser conocidos por todos los otorrinolaringologos, ya que realizados a tiempo permiten como minimo restablecer la simetria facial en reposo y el cierre palpebral en la gran mayoria de los pacientes.

Facial nerve repair techniques

OBJECTIVE Post-operative facial function was analyzed in 14 patients undergoing different techniques for facial nerve repair. MATERIAL AND METHOD The aetiology of facial paralysis included vestibular schwannomas, facial schwannomas, cranioencephalic trauma, and iatrogenic lesions. RESULTS The mean interval between paralysis and reconstruction surgery was 6 months, although in 2 cases it exceeded 12 months. The first facial signs of recovery were achieved around the sixth month post-operatively, in every patient. All patients achieved a facial function graded III or IV in the House-Brackmann scale, equivalent to a grade II or III on the May scale. There were no differences between the surgical techniques compared, both termino-terminal anastomosis and hypoglossal-facial anastomosis. CONCLUSIONS The surgical reconstruction techniques for facial nerve repair should be known by all ENT surgeons. At least facial symmetry at rest and complete eye closure are achieved in almost every patient when the procedure is carried out at the proper time.

Estudio morfométrico de las malformaciones craneofaciales experimentales inducidas por ácido retinoico

espanolResumen: Objetivo: El acido retinoico es un metabolito activo de la vitamina A que administrado en grandes cantidades tiene efecto teratogeno sobre la embriogenesis de los mamiferos. Hemos investigado los efectos de la exposicion temprana de embriones de rata sobre las estructuras craneofaciales. Diseno: Cuarenta y cinco ratas Sprague-Dawley gestantes fueron tratadas con 125 mg/kg de acido all-trans-retinoico el dia 10 de gestacion. Las 20 ratas controles fueron tratadas con aceite. Los fetos de ambos grupos se extrajeron el dia antes de llegar a termino y fueron sometidos a un estudio morfologico y otro estudio morfometrico, analizando las malformaciones craneofaciales. Resultados: Ninguno de los fetos controles presento malformaciones. El 100% de los embriones tratados con retinoico presentaron defectos craneofaciales, incluyendo fisuras faciales, exoftalmos, malformaciones e insercion baja de los pabellones auriculares, apendices faciales y anomalias nasales. El analisis morfometrico revelo un incremento de la distancia entre los poros nasales (p Conclusiones: Tanto el estudio morfologico como el estudio morfometrico confirman la hipotesis segun la cual el acido retinoico altera el desarrollo craneofacial cuando se administra durante un momento critico del desarrollo embrionario. Una alteracion en la migracion de las celulas de la cresta neural craneal podria ser la razon que explicaria estas anomalias. EnglishAbstract: Objective: Retinoic acid is an active metabolite of Vitamin A that is teratogenic when present in excess during mammalian embriogenesis. We have investigated the effects of early exposure of rat embryos to retinoic acid on craniofacial structures. Design: Treatment of 45 pregnant Sprague-Dawley rats with 125mg./Kg all-trans-retinoic acid on pregnancy day 10 was performed. Twenty controls were treated only with oil. The fetuses were recovered the day before term, and both morphologic and morphometric analyses of the craniofacial structures were performed. Results: None of the control fetuses had malformations. Craniofacial defects were observed in 100% of the retinoic embryos including facial clefts, proptosis, abnormalities and inferior placement of the pinnae, skin tags, and nasal anomalies. Morphometric analyses revealed an increased distance between nasal pores (p Conclusions: Morphologic and morphometric studies confirm the hypothesis that retinoic acid disturbs normal craniofacial development when administered during a critical period. Hindrance of migration of the cranial neural crest cells may be a main reason to explain these events.

Recidiva cervical en el cuello patológicamente negativo (pN0):buscando una aguja en un pajar

Recurrence in the pathologically negative neck (pN0) is one of the most striking events occurring in head and neck tumors. It is not even mentioned in many neck dissection studies. The presence of micrometastases has been suggested as an explanation for this event. In accordance to a recent study performed in our institution, we bring up this controversial issue. A definitive explanation for recurrence in the pN0 has not yet been proposed.