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At least 433 records · Page 24Linked to original sources
PubMed1984

Free jejunal graft for reconstruction of oral, oropharyngeal, and pharyngoesophageal defects.

A free jejunal graft was used either as a patch or as a conduit in 40 cases of reconstruction of the oral cavity, hypopharynx, and upper esophagus. Compared with previous intraoral reconstructive techniques using skin or myocutaneous flaps, one-stage free jejunal grafts result in low morbidity, rapid postoperative recovery, and no additional head and neck scars. Because of secure vascularization, the retention of temporary mandible implants is made safer. In addition to tongue reconstruction, facial contouring can also be achieved by the use of mesenteric fatty tissue. The well-vascularized physiologic lining created by utilizing the jejunal graft is highly resistant to mechanical stress and postoperative radiation therapy.

Adolescent↗
PubMed2001

Osteosarcoma metastatic to the mandible: a case report.

A case of osteosarcoma that metastasized to the mandibular ramus from the femur in a 36-year-old man is presented. The patient was referred to us for the diagnosis and treatment of swelling of the left cheek. Radiologic examination showed a radiolucent lesion containing radiopaque areas within the left mandibular ramus. The patient previously suffered from a femoral small cell osteosarcoma, which was resected 71 months before our first examination. After induction of general anesthesia, a unilateral mandibulectomy and a simultaneous reconstruction using a titanium plate and an artificial condyle were performed. The postoperative course was uneventful, with satisfactory facial appearance and jaw function. The histopathologic features of the mandibular tumor were identical to those of the femoral tumor. Thus the mandibular lesion was diagnosed as a metastatic small cell osteosarcoma. At 27 months after the operation there had been no recurrence.

Adult↗
PubMed2003

Prosthetic management of a total glossectomy defect after free flap reconstruction in an edentulous patient: a clinical report.

Total glossectomy with surgical reconstruction can result in a significantly altered mandibular arch anatomy. In edentulous patients, lingual vestibules along with the mandibular alveolar ridge can be obliterated. With the absence of lower anterior dentition, support of the lower lip is lost and traction from surgical closure can cause the lower lip to collapse into the oral cavity. This report describes the prosthetic treatment of an edentulous total glossectomy patient with an unconventional custom impression procedure to develop and record proper lower lip and cheek support. It also discusses some issues involved in the prosthetic management of the total glossectomy patient.

Carcinoma, Squamous Cell↗
PubMed2000

Does the oral device Noiselezz prevent sleep apnoea?

Both snoring and apnoea are caused by the collapse of soft tissue in the upper airways during sleep. Increasing the cross-sectional area of the airways in these segments by moving the mandible and/or the tongue forward stabilizes the upper airways in obstructive sleep apnoea syndrome (OSAS) patients. The aim of this study was to determine the effect of Noiselezz, which is an oral appliance of the mandibular advancing type, designed for easy use. Twenty-one patients, all men (aged 50.6 +/- 10.4, body mass index 26.5 +/- 3.3) were included in the study. Polysomnography (PSG) was performed before the patients started using Noiselezz. After a period of 2 weeks accustomizing to the oral device, the patients had another PSG performed with Noiselezz inserted. We found no significant differences in total sleep time, percentage of time spent snoring, duration of rapid eye movement (REM) sleep, slow-wave sleep, inter-sleep wake and sleep efficiency, apnoea/hypopnoea index (AHI) or lowest measured oxygen saturation after apnoea (minSaO2). No significant differences were found in the localization of obstructions or intrathoracal inspiratory pressure with and without the use of the Noiselezz oral device. Three patients (14%) reported satisfaction with treatment by the oral device. All three continued to use Noiselezz as treatment. The rest of the patients (86%) either did not tolerate the device at all or tried it for a period and then requested alternative treatment (n = 12). Most patients found the oral device "Noiselezz" inconvenient to use, and our results show that the device has little or no effect on snoring and sleep apnoea.

Adult↗
PubMed1998

Osseointegration of dental implants in patients with and without radiotherapy.

Between 1987 and 1997, 275 dental implants were inserted in the mandibles of 63 patients with squamous cell carcinoma of the lower oropharyngeal level following a radical surgical procedure. Thirty-five of these patients had been preirradiated with a complete dose of 60 Gy. In a retrospective analysis we have reviewed the data of these patients for age, sex, localization of the implants, irradiation, interval of implantation and interval of the abutment operation. Thus far, the median follow-up time is 65 months. The 5-year success rate for all implants was 97.9%. We found that radiotherapy, age, sex, localization of implantation or the interval between the end of the tumor therapy and the time of implantation did not have any significant influence on osseointegration or loss of osseointegration. Only the time interval between implantation and the abutment operation was recorded to be of any great significance (p = 0.0001). No augmentation in the osteoradionecrosis rate could be recorded after dental implantation (1.6%), which leads us to conclude that radiotherapy (60 Gy) in patients with head and neck cancers should not be regarded as a contraindication for dental implantation.

Adult↗
PubMed1999

Dental side effects of an oral device to treat snoring and obstructive sleep apnea.

STUDY OBJECTIVES: Snoring and obstructive sleep apnea (OSA) are common and related conditions--with major social and health implications--which can be treated successfully with dental devices that reposition the mandible. Despite wide use, side effects of these devices have not yet been systematically evaluated. The purpose of the study was to evaluate side effects of a mandibular advancement splint (MAS) previously described by the authors. DESIGN: Questionnaire survey and dental examination of a consecutive case series of patients treated with the MAS SETTING: Dental outpatient clinic PATIENTS: Attempts were made to contact all 191 patients treated over a 5-year period. All had snored loudly and habitually with or without OSA prior to treatment. MEASUREMENTS AND RESULTS: Of 191 patients treated, 132 agreed to complete the questionnaire. All were scheduled to attend for dental examination and 106 underwent examination. Of the 132 interviewed, patient and partner report indicated that the device was well tolerated and controlled snoring satisfactorily in 100 after 31 +/- 18 (mean +/- SD) months of use. Dental side effects were reported in 107 patients, although these were mostly minor, and only 10 patients ceased using the device because of them. Side effects included excess salivation (in 40), xerostomia (in 30), temporomandibular joint pain (in 35), dental discomfort (in 35), myofacial discomfort (in 33) and bite changes (in 16). Of 106 patients examined, 30 had increased maximal opening and 76 had no change compared with pretreatment records. Temporomandibular joint noises were found in 9 patients, and occlusal changes (12 m mylar strip and wax bite, relative to pretreatment) in 15. None of these effects could be related to degree of opening or protrusion produced by the MAS. CONCLUSION: Dental side effects occur in a significant proportion of patients using the MAS. In most cases these are minor and their importance must be balanced against the efficacy of the MAS in treating snoring and OSA.

Adult↗
PubMed1982

Chin augmentation--a restrospective study.

A retrospective study of 480 Silastic chin implants is summarized and analyzed. The surgeon's own variations on the operative procedure are detailed, including the staging of the simultaneous nose-chin operation in which the chin work is started first, with a temporary interval for hump removal, followed by termination of the chin work and a return to the nose operation. A variation in the handling of the Silastic implant is described in which parallel incisions are made on its inner side to avoid dead space and undesired tension. The results of the 480 cases are presented. The overall complications rate was 2.3%, though the total percentage of implants removed was only 1.46.

Chin↗
PubMed1990

The use of cryopreserved venous allografts in free tissue transfers--practical and aesthetic considerations.

A case in which multiple cryopreserved allograft saphenous veins were used as vein grafts for a difficult mandible reconstruction with a free tissue transfer is reviewed. Use of allograft veins was recently reported for lower limb vascular reconstruction but not for free tissue transfers. Such grafts may represent a viable alternative to the use of autologous vein grafts and have the potential to decrease operating time and avoid necessary scars.

Adult↗
PubMed1993

Osseointegrated titanium implants for the attachment of facial prostheses.

The ability to penetrate skin permanently with posts of pure titanium has led to a dramatic breakthrough in the attachment of facial prostheses. The posts are attached to screws of titanium that are completely integrated in the underlying bone, without any intervening soft tissue. This precise and rigid fixation permits rehabilitation of patients with complex defects that would be otherwise untreatable.

Adolescent↗
PubMed1998

Staged sequential reconstruction of a total lower lip, chin, and anterior mandibular defect.

The combination of a total lower lip, chin, and anterior mandibular defect following cancer resection is an extremely complex problem that requires a sequence of operations to optimize functional and aesthetic results. One patient is presented in whom the defect was reconstructed with a free fibular flap followed by a series of ancillary procedures using both modern and traditional techniques. At the time of tumor ablation, the through-and-through oromandibular defect was reconstructed with a fibular osteocutaneous flap. The lower lip and gingivolabial sulcus was reconstructed later with a tongue flap. Tissue expansion was subsequently used to replace the fibular skin with expanded submental hair-bearing skin. A polyethylene implant was added later to the fibular bone for chin augmentation. Subsequently the lower lip was supported with a tendinous graft suspended to the anterior masseter bilaterally. Lastly, the vermilion border was elevated by removing a rim of the tongue flap and covering the secondary wound with a full-thickness skin graft. At the end of the reconstructive procedures, lip seal and oral aperture were good with no drooling and excellent speech.

Carcinoma, Squamous Cell↗
PubMed1998

Computer-generated patient models for reconstruction of cranial and facial deformities.

The use of three-dimensional, computer-generated anatomic models can be used in the diagnosis and reconstruction of a variety of craniofacial problems. They are readily manufactured from computed tomography scans at a reasonable cost with only several weeks of preparation and delivery time. Their contemporary value is in the preoperative treatment planning, intraoperative implant fashioning, and preoperative implant fabrication in appropriately selected patients.

Adolescent↗
PubMed2006

Giant hemangiopericytoma of mandible: a propos of a case: a variant of the surgical technique for protection of the articular fosse.

The hemangiopericytoma is a tumor of the pericytes. It represents 1% of vascular tumors. It is frequently located in inferior limbs, the pelvis, and the retroperitoneum. A painless mass of slow growth is main presentation. Imaging is not specific. Only microscopic and immunohistochemical findings can verify the lesion. The surgical treatment is elective. The search of the world medical literature revealed the publication of only four cases of hemangiopericytoma of the jaw. We present the case of a patient with a giant hemangiopericytoma that originated in the jaw. Studies showed an enormous mass and destruction of the right jaw. A right hemimandibulectomy including the condyle was performed. Mandibular reconstruction was performed with titanium plates with condyle and bone graft of the iliac crest; a piece of silastic with titanium mesh was placed in the temporomandibular articular fossa. Two years after surgery, good aesthetic and functional results were evident, and tumor recurrence was not observed.

Adult↗