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PubMed1975

Hidradenomata of the external auditory meatus. (Review of the literature and report of a pleomorphic adenoma).

A case of hidradenoma of the external auditory meatus ('ceruminoma') is presented, with a review of the literature. The tumour has the appearances of a pleomorphic adenoma and is devoid of a capsule. It is suggested that the term hidradenoma be used for tumours of the ceruminous glands and that they be classified histologically as (1) adenoma, (2) pleomorphic adenoma, (3) adenoid cystic carcinoma and (4) adenocarcinoma. This classification aids treatment and prognosis. Attention is drawn to the high incidence of malignancy in hidradenomata of the external auditory meatus. The treatment of choice for pleomorphic adenomata is wide surgical excision with an adequate margin of normal skin. If there is doubt regarding complete removal, or a recurrence develops, a wider surgical excision is necessitated.

Adenoma, Sweat Gland↗
PubMed1992

The paranasal sinuses and other enigmas: an aquatic evolutionary theory.

The functional role of the paranasal sinuses in man has long been in dispute and as yet no satisfactory explanation has been offered for these 'unwanted' spaces. An answer may be found by study of the comparative evolutionary development of the sinuses in man and other higher primates. Several unique physical characteristics of man not seen elsewhere in the ape family, or indeed in other terrestrial mammals, including some relating to the upper aerodigestive tract, are not satisfactorily explained by the traditionally held theory of evolutionary development of early man directly from the arboreal ape. It is argued that these developmental differences are much more logically explained by a period of aquatic adaptation at a crucial period in the evolution of pre-hominid man. A new theory is proposed which might explain the importance of the sinus air cavities as buoyancy aids for protection of the upper airway tract in such an aquatic environment. Further evidence is offered relating to a pathological condition of the external ear canal which supports this theory that man at some stage in his early development acquired an affinity for an aquatic environment. Explanation of these unique hominid characteristics in terms of an aquatic evolutionary theory may help to resolve some of the enigmatic inconsistencies between man and other higher primates, and may account for man's eventual emergence as the dominant extant species, and perhaps an explanation for the 'missing link'.

Animals↗
PubMed2001

Familial case of Potocki-Shaffer syndrome associated with microdeletion of EXT2 and ALX4.

Multiple exostosis, biparietal foramina, minor craniofacial abnormalities, and mental retardation are characteristic of the syndrome associated with a proximal deletion of 11p (MIM # 601224), which has been shown to be a true contiguous gene deletion syndrome. The presence of multiple exostosis is associated with deletion of the EXT2 gene. Similarly, the presence of biparietal foramina has been shown to be associated with the deletion of ALX4 located proximally to EXT2. Specific genes related to mental retardation and craniofacial abnormalities, however, have yet to be identified. We report on a family with a microdeletion of 11(pll.2p11.2) with multiple exostosis and biparietal foramina without mental retardation or craniofacial abnormalities. Our results suggest that genes related to mental retardation and craniofacial development must be located outside of the D11S1785-D11S1385 region.

Child↗
PubMed1989

Cloning defined regions of the human genome by microdissection of banded chromosomes and enzymatic amplification.

The molecular analysis of many genetic diseases requires the isolation of probes for defined human chromosome regions. Existing techniques such as the screening of chromosome-specific libraries, subtractive DNA cloning and chromosome jumping are either tedious or not generally applicable. Microdissection and microcloning has successfully been applied to various chromosome regions in Drosophila and mouse, but conventional microtechniques are too coarse and inefficient for analysis of the human genome. Because microdissection has previously been used on unbanded chromosomes only, cell lines in which the chromosome of interest could be identified without banding had to be used. At least one hundred chromosomes were needed for dissection and lambda vectors used to achieve maximum cloning efficiency. Recombinant phage clones are, however, more difficult to characterize than plasmid clones. Here we describe the dissection of the Langer-Giedion syndrome region on chromosome 8 from GTG-banded metaphase chromosomes (G-banding with trypsin-Giemsa) and the universal enzymatic amplification of the dissected DNA. Eighty per cent of clones from this library (total yield 20,000) identify single-copy DNA sequences. Fifty per cent of clones detect deletions in two patients with Langer-Giedion syndrome. Although the other clones have not yet been mapped, this result demonstrates that thousands of region-specific probes can be isolated within ten days.

Base Sequence↗
PubMed2001

Ridge augmentation using mandibular tori.

A 19-year-old female was referred by her dental practitioner for the restoration of missing maxillary lateral incisors and canines. Ridge augmentation was required. This was undertaken using mandibular tori as the sites for harvesting bone. The grafting was successful and the spaces were subsequently restored using resin-bonded bridgework. The case reports that mandibular tori provide a local and convenient source of bone for ridge augmentation procedures.

Adult↗
PubMed2005

An extraction complicated by lateral and medial pterygoid tethering of a fractured maxillary tuberosity.

We report a case in which the extraction of an upper second molar was complicated by a maxillary tuberosity fracture. Delivery of the tooth and bone fragment under local anaesthesia was unable to be achieved because of pain, brisk bleeding and tethering by the lateral and medial pterygoid muscles. The eventual removal of the fragment under general anaesthetic required the control of haemorrhage deep within the infratemporal fossa. When this complication is recognised by the general dentist the maxillary tuberosity should not be removed and the patient referred to a specialist unit.

Exostoses↗
PubMed2005

Mutation screening of EXT1 and EXT2 by direct sequence analysis and MLPA in patients with multiple osteochondromas: splice site mutations and exonic deletions account for more than half of the mutations.

Multiple osteochondromas (MO) is an autosomal dominant condition, caused by mutations in either the EXT1 or the EXT2 gene. The DNA of a cohort of 35 patients, clinically suspected to be affected with MO, was screened for mutations by a combination of direct sequence analysis and multiplex ligation-dependent probe amplification (MLPA). In this cohort, 26 pathogenic gene alterations were found (74%). With sequence analysis mutations were detected in 22 patients (63%). In total, 10 mutations were detected in the EXT1 and 12 in the EXT2 gene. The number of the splice site mutations detected was larger than expected from the literature. In addition, with the MLPA four deletions of one or more exons were found in this cohort. Two patients, of whom one had a negative family history, showed deletions of exon 1 of the EXT1 gene, which is possibly a deletion hot spot. In patients suspected to be affected by MO, we recommend a quantitative analysis such as MLPA, followed by direct sequence analysis for the screening of the EXT1 and EXT2 genes.

Cohort Studies↗
PubMed2000

The prevalence of radiographically evident mandibular tori in the University of Iowa dental patients.

OBJECTIVES: To evaluate the radiographic prevalence of mandibular tori and to determine the attributes which make tori radiographically evident. METHODS: The prevalence of mandibular tori was determined from 1600 radiographic surveys of patients attending the College of Dentistry, University of Iowa, 200 for each decade of life from the first to the eighth. Dry skulls were evaluated at the National Museum of Natural History. Mandibular tori were measured, classified and radiographed to correlate the radiographic findings with the physical characteristics. RESULTS: Overall, 16.9% of the patient population had radiographically detectable mandibular tori with some cohorts within the population as high as 33%. Lobulated tori extending 4 mm or more mediolaterally were radiographically detectable. CONCLUSIONS: This study revealed one of the higher prevalence rates of mandibular tori in the literature for a population within the United States. Radiographic threshold analysis suggests that this group of Iowans has a high percentage of medium to large discretely lobulated tori.

Adolescent↗
PubMed2000

Magnetic resonance imaging of temporomandibular disorders: classification, prevalence and interpretation of disc displacement and deformation.

AIM: To analyse the prevalence of disc displacements and deformations from MRI of symptomatic temporomandibular disorders (TMD). METHODS: The study was conducted retrospectively on 192 joints of 98 patients (67 females, 31 males, mean age 29 years), who had undergone bilateral MRI (except for four who had unilateral) in the sagittal (both open and closed mouth) and coronal (closed mouth only) planes. These displacements were subdivided into static (complete anterior and posterior, partial anterolateral and anteromedial, sideways lateral and medial, anterolateral and anteromedial rotational) and dynamic (with reduction, without reduction, with incomplete reduction; non-determinable). Disc deformations were subdivided into: enlargement of the posterior band, reversed biconcave shape, biplanar (flattened) and biconvex shape. RESULTS: Eighty per cent of patients had bilateral displacement, 15% unilateral and 5% a normally positioned disc. Complete anterior displacement was the commonest and sideways the rarest. Reduction was present in 58% of disc displacements, no reduction in 26%, incomplete reduction in 4%, while in the remaining 12%, it could not be determined. Rotational displacement was the most likely to feature reduction and sideways the least. Temporomandibular joints with no reduction were closely correlated with bone lesions. The most frequent deformation was biplanar and the rarest enlargement of the posterior band. CONCLUSIONS: There was a high prevalence of displacements and deformations. While they do not appear to be significant in inducing pain, they can predispose to the onset of osteoarthrosis.

Adult↗
PubMed2002

Impact of JPEG lossy image compression on quantitative digital subtraction radiography.

OBJECTIVES: The aim of the study was to evaluate the impact of JPEG lossy image compression on the estimation of alveolar bone gain by quantitative digital subtraction radiography (DSR). METHODS: Nine dry domestic pig mandible posterior segments were radiographed three times ('Baseline', 'No change', and 'Gain') with standardized projection geometry. Bone gain was simulated by adding artificial bone chips (1, 4, and 15 mg). Images were either compressed before or after registration. No change areas in compressed and subtracted 'No change-Baseline' images and bone gain volumes in compressed and subtracted 'Gain-Baseline' images were calculated and compared to the corresponding measurements performed on original subtracted images. RESULTS: Measurements of no change areas ('No change-Baseline') were only slightly affected by compressions down to JPEG 50 (J50) applied either before or after registration. Simulated gain of alveolar bone ('Gain-Baseline') was underestimated when compression before registration was performed. The underestimation was bigger when small bone chips of 1 mg were measured and when higher compression rates were used. Bone chips of 4 and 15 mg were only slightly underestimated when using J90, J70, and J50 compressions before registration. CONCLUSIONS: Lossy JPEG compression does not affect the measurements of no change areas by DSR. Images undergoing subtraction should be registered before compression and if so, J90 compression with a compression ratio of 1:7 can be used to detect and measure 4 mg and larger bone gain.

Alveolar Process↗
PubMed1999

A clinical study of oral tori in southern Thailand: prevalence and the relation to parafunctional activity.

The objective of the present study was to investigate the relationship of oral tori and occlusal stress as indicated by parafunctional activity (clenching and grinding) and to report the prevalence of torus palatinus (TP) and torus mandibularis (TM) among patients attending a dental school hospital in southern Thailand. Six-hundred-nine individuals, 183 males and 426 females, were interviewed and examined for the presence of clenching and grinding habit. The presence of TP and TM was also examined in each individual and in the case of TM size was recorded. Tabulated analysis was carried out to find the crude relationships of the parafunction, age and sex to the presence of TP or TM. The relationships were then analyzed by logistic regression. Of these individuals, 376 (61.7%) had TP, whereas 182 (29.9%) had TM. The male:female prevalence ratios of TP and TM were 1:1.4 and 1:0.94, respectively. TP was, thus, more frequent in females. A strong association between clenching and grinding and the presence of TM was found. The presence of TM might be useful as a cue to look for signs of parafunction.

Adolescent↗
PubMed1997

Bilateral coronoid hyperplasia--a report with a view on its management.

Bilateral coronoid hyperplasia requires surgery (coronoidectomy) to improve mouth opening. An intra-oral approach is preferred with direct fibre-optic anaesthetic intubation. Myotomy of the masseter muscle is recommended in cases where fibrotic and calcifying effects have occurred. Pre-operative physiotherapy counselling and post-operative jaw exercises are important to the final success of the management.

Adolescent↗