• Title/Summary/Keyword: Maxillary cancer

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Maxillary resection for cancer, zygomatic implants insertion, and palatal repair as single-stage procedure: report of three cases

  • Salvatori, Pietro;Mincione, Antonio;Rizzi, Lucio;Costantini, Fabrizio;Bianchi, Alessandro;Grecchi, Emma;Garagiola, Umberto;Grecchi, Francesco
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.13.1-13.8
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    • 2017
  • Background: Oronasal/antral communication, loss of teeth and/or tooth-supporting bone, and facial contour deformity may occur as a consequence of maxillectomy for cancer. As a result, speaking, chewing, swallowing, and appearance are variably affected. The restoration is focused on rebuilding the oronasal wall, using either flaps (local or free) for primary closure, either prosthetic obturator. Postoperative radiotherapy surely postpones every dental procedure aimed to set fixed devices, often makes it difficult and risky, even unfeasible. Regular prosthesis, tooth-bearing obturator, and endosseous implants (in native and/or transplanted bone) are used in order to complete dental rehabilitation. Zygomatic implantology (ZI) is a valid, usually delayed, multi-staged procedure, either after having primarily closed the oronasal/antral communication or after left it untreated or amended with obturator. The present paper is an early report of a relatively new, one-stage approach for rehabilitation of patients after tumour resection, with palatal repair with loco-regional flaps and zygomatic implant insertion: supposed advantages are concentration of surgical procedures, reduced time of rehabilitation, and lowered patient discomfort. Cases presentation: We report three patients who underwent alveolo-maxillary resection for cancer and had the resulting oroantral communication directly closed with loco-regional flaps. Simultaneous zygomatic implant insertion was added, in view of granting the optimal dental rehabilitation. Conclusions: All surgical procedures were successful in terms of oroantral separation and implant survival. One patient had the fixed dental restoration just after 3 months, and the others had to receive postoperative radiotherapy; thus, rehabilitation timing was longer, as expected. We think this approach could improve the outcome in selected patients.

CLOSURE OF ORO-ANTRAL FISTULA USING SINUS LIFTING AND SKIN GRAFT IN MAXILLARY MALIGNANT CASES : CASE REPORT (상악골 악성종양환자에서 상악동점막거상술과 피부이식술을 이용한 구강-상악동누공의 폐쇄 : 증례보고)

  • Kim, Il-Kyu;Kang, Ho-Sik;Choi, Jin-Ho;Ryu, Seong-Hyun;Oh, Nam-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.86-90
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    • 2002
  • Sinus lifting was introduced for prosthetic reconstruction in 1960 decades by Boyne and is specifically used for implant surgery in maxillary posterior region with insufficient bony height and has been indicated for reconstruction of oro- antral and palato-alveolar cleft. We report that subtotal maxillectomy using sinus lifting and skin graft in mild maxillary cancer cases results in good prevention of oro-antral and oro-nasal fistula by preserving intact maxillary sinus mucosa and improves better functional outcome after maxillectomy.

Squamous cell carcinoma occurring with aspergillosis in the maxillary sinus: a case report and histological study (상악동내 국균증과 편평상피세포암의 동시발생 증례: 조직학적 연구 및 문헌고찰)

  • Byun, June-Ho;Lee, Jeong-Hee;Rho, Gyu-Jin;Park, Bong-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.125-127
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    • 2010
  • The coexistence of aspergillosis and squamous cell carcinoma (SCC) in the maxillary sinus was very rare. To our knowledge, this is the second report of coexistent SCC and aspergillosis in the maxillary sinus. A 58-year-old man underwent surgery for unilateral maxillary sinus infection with oroantral fistula. In the surgical specimen, SCC and aspergillosis were co-detected with routine and immunohistochemical stainings. Moreover, human papillomavirus 18 (HPV-18) was detected by polymerase chain reaction in the sinus specimen. The patient was re-operated with subtotal maxillectomy and has been followed up for two years without any evidence of recurrence or metastasis. Although it is not understood how aspergillosis could induce carcinoma formation, the chronic inflammation caused by prolonged fungal infection might be carcinogenic. Moreover, HPV-16 and -18 were another causative pathogens of SCC in the head and neck region. We recommend careful examination, including preoperative cytology, in patients with maxillary sinus fungal infections because of the potential for cancer development.

Prosthetic treatment for patient with upper lip cancer and severe periodontitis: Maxillary complete denture with denture adhesive and mandibular double crown-retained removable partial denture (구순암 환자에서의 의치접착제를 이용한 상악 총의치와 심한 치주 상태에서의 하악 이중관의치를 이용한 수복 증례)

  • Choi, Hyun-Suk;Lee, Cheong-Hee;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.1
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    • pp.74-80
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    • 2015
  • When oral cancer is occured, one may experience problems such as lip defect, necrosis of periodontal tissue and cervical caries caused by radiotherapy. According to ADI (Association of dental implantology), recent radiotherapy on jaw bone could be a relative contraindication of implant treatment. Due to this controversy, in most cases, treatment is done with removable dentures rather than implants. Especially, lip defect caused by an oral cancer operation have a serious repercussion on the retention of the denture. In this case report, patient with upper lip cancer had undergone resection primarily and secondary radiotherapy was done periodically. As a result, upper teeth of patient were extracted gradually and lower teeth showed very poor periodontal status. Therefore, Polident$^{(R)}$ denture adhesive cream (GlaxoSmithKline, London, England) was applied on maxillary complete denture to overcome reduced retention due to the lip defect and double crown RPD with friction pin was applied on the mandible successfully for two years.

Cerebellar Hemorrhage due to a Direct Carotid-Cavernous Fistula after Surgery for Maxillary Cancer

  • Kamio, Yoshinobu;Hiramatsu, Hisaya;Kamiya, Mika;Yamashita, Shuhei;Namba, Hiroki
    • Journal of Korean Neurosurgical Society
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    • v.60 no.1
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    • pp.89-93
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    • 2017
  • Infratentorial cerebral hemorrhage due to a direct carotid-cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus.

A Study of Radiation Dose Evaluation and Optimization Methods for Intra Oral Dental X-ray in Pediatric Patient (소아 구내촬영 시 방사선량 평가 및 최적화 방안에 대한 연구)

  • Lee, Hyun-Yong;Cho, Yong-In
    • Journal of radiological science and technology
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    • v.44 no.3
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    • pp.195-203
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    • 2021
  • Although intra oral dental x-ray is a lower dose than other radiological examinations, pediatric patients are known to have a higher risk of radiation damage than adults. For this reason, pediatric dental x-ray requires management of dose evaluation and imaging conditions during the examination. In this study, the dose calculation program ALARA-Dental(child/adult) was used to evaluate the organ dose and effective dose exposed to each examination site during intra oral imaging of children during dental radiographic examination, and dose analysis according to the imaging conditions was performed. As a result, the highest organ dose distribution was shown at 0.044 ~ 0.097 mGy in all are as of the mucous membrane of oral cavity except for the maxillary incisors and canines. Also, in the case of the thyroid gland, the maxillary canine and maxillary premolar examination showed 0.027 and 0.020 mGy, respectively, and the dose distribution was 15.4% to 70.0% higher than that of the mandibular examination. As for the effective dose calculated during intra oral imaging, the maxillary anterior and canine examinations showed the highest effective doses of 0.005 and 0.004 mSv, respectively, and the maxillary area examination showed a higher dose distribution on average than the mandible.

Central Venous Access for Chemoterapy in Patients with Malignant Disease (항암 화학요법을 받는 환자들에서의 중심정맥삽관술)

  • Kim, Uk-Seong;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.483-487
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    • 1993
  • From July 1990 to August 1992,78 Hickman catheters and 22 chemoports were inserted in 98 patients for chemotherapy.We analyzed the clinical data of these patients. The results were as follows: 1]Mean age of patients was 42.8$\pm$1.6[SE] years 2]Male to female ratio was 1.09:1 3]The diseases of the cases were leukemia[66] ,lymphoma[8], stomach cancer[8],uterine cervix cancer[5],ovarian cancer[4],lung cancer[3],aplastic anemia[2],maxillary gland cancer[1],pancreas cancer[1],malignant mesothelioma[1] and multiple myeloma[1] 4]Mean values of preoperative WBC counts,platelet counts,PT and APTT were 31,500$\pm$ 8,132[SE]/mm,104,000$\pm$ 12,200 [SE]/mm,82$\pm$ 1.9[SE]% and 32$\pm$ 0.8[SE] sec,respectively. 5]The average duration of catheter uses was 121.7$\pm$ 17.3[SE]days. 6]The complications were subcutaneous tunnel bleeding or hematoma[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1]. 7]The causes of catheter removal were patient`s death or hopeless discharge[22],completion of treatment[6],subcutaneus hematoma or bleeding[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1].So,we concluded that Hickman catheter and chemoport were useful vascular access for chemotherapy in patients with malignant diseases, with low rate of complication and longterm duration.

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A CASE REPORT OF OPEN TYPE HOLLOW OBTURATOR (개방형 Hollow 폐색장치의 임상 증례)

  • Chung, Moon-Kyu;Bae, Jeoung-Sik
    • The Journal of Korean Academy of Prosthodontics
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    • v.26 no.1
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    • pp.207-212
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    • 1988
  • Maxillary defects are a result of necessary cancer surgery, congenital anomaly or trauma. Ideally the patient with the aquired maxillary defect should be provided with an obturator prosthesis that is comfortable, restores adequate speech, deglutition, and mastication, and is acceptable cosmetically. This is a case report of open type hollow obturator delivered in the partial maxillectomy treated patient. The satisfied result obtained as follows: The open type hollow obturator has the advantage of easy fabrication, lightness, easy cleaning and restores adquate speech.

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