scholarly journals Prosthodontic rehabilitation of residual mandibular defect with Fixed removable Hybrid prosthesis- A case report

2021 ◽  
Vol 7 (2) ◽  
pp. 97-100
Author(s):  
Poonam Prakash ◽  
Mahesh Gowda ◽  
NK Sahoo
Keyword(s):  
Surgical Resection ◽  
Definitive Treatment ◽  
Biomechanical Stress ◽  
Long Span ◽  
Rare Benign Tumor ◽  
Hybrid Prosthesis ◽  
Removable Prosthesis ◽  
Mandibular Defect ◽  
Frequent Site ◽  
Maxilla And Mandible

Ameloblastoma is a rare, benign tumor of odontogenic epithelium  that was recognized in 1827 by Cusack and renamed ameloblastoma in 1930 by Ivey and Churchill. Ameloblastomas can be found both in the maxilla and mandible with a greater predilection of about 80% in the mandible with the posterior ramus area being the most frequent site. While chemotherapy, radiation therapy, curettage and liquid nitrogen have been effective in some cases of ameloblastoma, surgical resection  remains the most definitive treatment for this condition. Rehabilitation of residual mandibular defect post resection is a challenge due to long span compromised ridge condition and the absence of dentition. In such scenario, a fixed-removable prosthesis allows rapid return to excellent function by providing favorable biomechanical stress distribution along with restoration of esthetics, phonetics and ease of postoperative care and maintenance.This paper presents successful Prosthodontic rehabilitation of a patient with a large residual mandibular defect secondary to surgical resection for ameloblastoma using fixed-removable hybrid prosthesis.

scholarly journals Benign Osteoblastoma Involving Maxilla: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
K. Bokhari ◽  
M. S. Hameed ◽  
M. Ajmal ◽  
Rafi A. Togoo
Keyword(s):  
Case Report ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Histopathological Diagnosis ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Long Term Follow Up ◽  
Rare Benign Tumor ◽  
Benign Osteoblastoma ◽  
Maxilla And Mandible

Background. Osteoblastoma is a rare benign tumor. This tumor is characterized by osteoid and bone formation with the presence of numerous osteoblasts. The lesion is more frequently seen in long bones and rarely involves maxilla and mandible. Due to its clinical and histological similarity with other bone tumors such as osteoid osteoma and fibro-osseous lesions, osteoblastoma presents a diagnostic dilemma.Case Report. Very few cases of osteoblastomas involving maxillofacial region have been reported in the literature. This case report involves osteoblastoma involving right maxilla in an 18-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, surgical excision was performed. The patient was followed up for a period of 3 years and was disease free.Summary and Conclusion. Benign osteoblastoma involving jaw bones is a rare tumor. There is a close resemblance of this tumor with other lesions such as fibro-osseous lesions and odontogenic tumors and thus faces a diagnostic challenge. Surgical excision with a long-term follow-up gives good prognosis to this lesion—Benign Osteoblastoma.

scholarly journals Neurointerventional management of carotid webs associated with recurrent and acute cerebral ischemic syndromes

2016 ◽  
Vol 22 (4) ◽  
pp. 432-437 ◽  
Author(s):  
AH Elmokadem ◽  
SA Ansari ◽  
R Sangha ◽  
S Prabhakaran ◽  
A Shaibani ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Surgical Resection ◽  
Mechanical Thrombectomy ◽  
Carotid Stenting ◽  
Large Vessel ◽  
Definitive Treatment ◽  
Atheromatous Plaque ◽  
Left Middle Cerebral Artery ◽  
Computed Tomographic

Background A carotid web can be defined as an endoluminal shelf-like projection often noted at the origin of the internal carotid artery (ICA) just beyond the bifurcation. Diagnosis of a carotid web as an underlying cause of recurrent ischemic stroke is infrequent and easily misdiagnosed as an atheromatous plaque. Surgery has traditionally been used to resect symptomatic lesions while there is no enough evidence supporting medical therapy as the sole management. To our knowledge there is only one report about carotid artery stenting (CAS) as a definite management of carotid web and no previous reports of acute large-vessel occlusions undergoing mechanical thrombectomy in the setting of carotid web as the etiology. Case report We report two cases: The first presented with recurrent ischemic stroke in the same arterial territory and the other with an emergent left middle cerebral artery (MCA) occlusion that underwent endovascular mechanical thrombectomy in which initial computed tomographic angiograms (CTA) suggested carotid web etiologies. Following confirmation with digital subtraction angiography (DSA), both patients ultimately underwent endovascular carotid stenting instead of surgical resection for definitive carotid web treatment. Conclusions Carotid webs are a rare cause of ischemic stroke in young and middle-aged adults that can readily be identified by CTA. Endovascular management may include emergent mechanical thrombectomy for large-vessel thromboembolic complications, and for definitive treatment with carotid stenting across the carotid web as an alternative to surgical resection and medical management for secondary stroke prevention.

Surveillance imaging following colon cancer resection: Universal or risk-based?

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 307-307
Author(s):  
Christina Edwards Bailey ◽  
Chung-Yuan Hu ◽  
Amanda Cuddy ◽  
Y. Nancy You ◽  
George J. Chang
Keyword(s):  
Colon Cancer ◽  
Surgical Resection ◽  
Clinical Decision Making ◽  
Stage I ◽  
Definitive Treatment ◽  
Cancer Resection ◽  
Colon Cancer Resection ◽  
Surveillance Imaging ◽  
The Mean

307 Background: Current colon cancer surveillance guidelines recommend annual imaging for all patients following curative resection. The primary aim of this study is to evaluate variation in surveillance practices following colon cancer resection. Methods: A retrospective cohort study of patients ≥ 66 years old with stage I-III colon cancer that underwent surgical resection in the Surveillance, Epidemiology, and End Results-Medicare linked database (July 2001 through December 2007) with at least 3 years of follow-up was performed. Medicare claims for PET and CT scan of the chest, abdomen and pelvis performed after surgical resection were recorded and analyzed. In order to evaluate the use of definitive treatment (DT) for presumed recurrent disease, we identified patients who had undergone lung, liver, or colorectal resection during follow-up. Results: Of 22,544 patients who underwent primary resection of colon cancer, 13,753 (61.0%) underwent PET and/or CT after resection and 1,109 (4.52%) underwent at least 1 DT. The mean number of imaging performed for patients who did not undergo DT was 1.68. Within this group, the utilization of PET and/or CT varied by stage, with 14.1%, 22.4%, and 42.2% of patients with stage I, II, and III disease undergoing imaging, respectively. The most significant factor associated with PET and/or CT was tumor stage with an odds ratio of 1.86 (95% CI 1.70-2.02, P<0.001) for stage II disease and 4.56 (95% CI 4.17-4.99, P<0.001) for stage III disease compared to stage I disease. Additional factors significantly associated with PET and/or CT included year of diagnosis and SEER region. Among patients who did undergo DT, the mean number of PET and/or CT performed was 5.37 but the majority of imaging studies were performed 4 months prior to DT (mean 2.95). Conclusions: There is a high degree of variation in the use of surveillance imaging among elderly patients with localized colon cancer although some of this variation appears to be associated with stage at presentation. Our findings highlight discordance between clinical practice and surveillance guidelines. Further study is needed to understand the basis and appropriateness of clinical decision making that departs from guideline-based care.

scholarly journals Spinal osteoid osteoma: Surgical resection and review of literature

2020 ◽  
Vol 11 ◽  
pp. 308
Author(s):  
Abhinandan Reddy Mallepally ◽  
Rajat Mahajan ◽  
Sandesh Pacha ◽  
Tarush Rustagi ◽  
Nandan Marathe ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Osteoid Osteoma ◽  
Surgical Excision ◽  
Presenting Symptoms ◽  
Complete Surgical Excision ◽  
Rare Benign Tumor ◽  
The Common ◽  
Optimal Approach ◽  
Posterior Elements

Background: Osteoid osteoma (OO) is a rare benign tumor of the spine that involves the posterior elements with 75% tumors involving the neural arch. The common presenting symptoms include back pain, deformity like scoliosis, and rarely radiculopathy. Methods: From 2011 to 2017, we evaluated cases of OO managed by posterior surgical resection while also reviewing the appropriate literature. Results: We assessed five patients (three males and two females) averaging 36.60 years of age diagnosed with spinal OOs. Two involved the lumbar posterior elements, two were thoracic, and one was in the C3 lateral mass. All patients underwent histopathological confirmation of OO. They were managed by posterior surgical resection with/without stabilization. No lesions recurred over the minimum follow-up period of 24 months. Conclusion: Surgical excision is the optimal treatment modality for treating spinal OOs. The five patients in this study demonstrated good functional outcomes without recurrences. Further, the literature confirms that the optimal approach to these tumors is complete surgical excision with/without radiofrequency ablation.

scholarly journals Central neurogenic hyperventilation in conscious patients due to CNS neoplasm: a case report and review of the literature on treatment

2020 ◽  
Vol 7 (5) ◽  
pp. 559-568
Author(s):  
Joel Neves Briard ◽  
Marie-Claude Beaulieu ◽  
Émile Lemoine ◽  
Camille Beaulieu ◽  
Bruno-Pierre Dubé ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Resection ◽  
Short Duration ◽  
Selection Criteria ◽  
Symptom Relief ◽  
Definitive Treatment ◽  
Review Of The Literature ◽  
Other Neoplasms ◽  
Cns Neoplasm

Abstract Background Central neurogenic hyperventilation (CNH) is increasingly reported in conscious patients with a CNS neoplasm. We aimed to synthesize the available data on the treatment of this condition to guide clinicians in their approach. Methods We describe the case of a 39-year-old conscious woman with CNH secondary to glioma brainstem infiltration for whom hyperventilation was aborted with hydromorphone, dexamethasone, and brainstem radiotherapy. We then performed a review of the literature on the treatment of CNH in conscious patients due to a CNS neoplasm. Results A total of 31 studies reporting 33 cases fulfilled the selection criteria. The underlying neoplasm was lymphoma in 15 (45%) and glioma in 13 (39%) patients. Overall, CNH was aborted in 70% of cases. Opioids and sedatives overall seemed useful for symptom relief, but the benefit was often of short duration when the medication was administered orally or subcutaneously. Methadone and fentanyl were successful but rarely used. Chemotherapy was most effective in patients with lymphoma (89%), but not glioma (0%) or other neoplasms (0%). Patients with lymphoma (80%) and other tumors (100%) responded to radiotherapy more frequently than patients with glioma (43%). Corticosteroids were moderately effective. Subtotal surgical resection was successful in the 3 cases for which it was attempted. Conclusion Definitive treatment of the underlying neoplasm may be more successful in aborting hyperventilation. Variable rates of palliation have been observed with opioids and sedatives. Treatment of CNH is challenging but successful in a majority of cases.

Liver resection and outcome of hepatocellular carcinoma (HCC) in a transplant center.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 350-350
Author(s):  
Afsaneh Barzi ◽  
Shu Cao ◽  
Yuri Genyk ◽  
Jeffrey Kahn ◽  
Melissa A Wallman ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Resection ◽  
Surgical Resection ◽  
Treatment Options ◽  
Definitive Treatment ◽  
Vascular Involvement ◽  
Survival Outcomes ◽  
P Value ◽  
Incidence And Mortality ◽  
Transplant Candidates

350 Background: HCC has rising incidence and mortality in the US. Liver transplantation and surgery are the definitive treatment options. The median time to liver transplant in California is longer than many other regions. Given the expertise of our surgeons in liver resection we investigated the outcome of HCC at our institution. Methods: We extracted Norris Cancer registry data for patients (pt) with diagnosis of HCC from 2000 to 2010 who received their initial treatment at our facility. Overall survival (OS) is the primary end point of this study. We classified pt into transplant candidates (TC) vs. non-transplant candidates (NTC) based on the combination of T stage and vascular involvement. Results: We identified a total of 497 pts with HCC (Table). 98 pts had incomplete staging and 20 had metastatic disease and excluded from the analysis. We classified 221 pts as TC and 158 pts as NTC. The median OS for the TC was 2.9 years (yr) (95% CI 2.1-3.9) and in the NTC was 1.4 yr (95% CI 1.1 – 1.6). Amongst TC, 44 received transplant, 33 had surgical resection, and 144 had loco-regional treatment. Transplant recipients had an OS of 9.7 yr versus 4.3 yr (95% CI 1.9-9.1) in surgical patients, those with no definitive treatment had a OS of 1.8 yr (95%CI 1.6 -2.3). Among TC Hispanics had the best OS 4.3 yr (95% CI 1.9 – 9.7), followed by Asians 4.0 (95% CI 2.4-5.8), and Whites 2.0 (95% CI 1.4 -2.7) (p-value 0.0125). Among NTC Hispanics had the best OS 1.8 yr (95% CI 1.3 – 2.6), Asians 1.5 (95% CI 1.0 -2.1), and Whites 1.0 (95% CI 0.7 -1.4) (p-value 0.079). Conclusions: Liver transplantation continues to offer the best survival outcomes; however, in a region with long wait times, surgical resection offers a reasonable alternative with favorable survival outcomes. The trend of superior survival amongst Hispanics is noteworthy and subject of further investigation at our center. [Table: see text]

Synchronous esophageal cancer impact on survival of head and neck squamous cell carcinoma (HNSCC) patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17513-e17513
Author(s):  
Paulo Henrique Amor Divino ◽  
Gustavo Duarte Ramos Matos ◽  
Karolina Lima ◽  
Gilberto Castro ◽  
Gustavo Nader Marta ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Early Stage ◽  
Locally Advanced ◽  
Definitive Treatment ◽  
Tobacco Exposure ◽  
Drinking Habits ◽  
Treatment Information ◽  
Impact On Survival ◽  
Frequent Site ◽  
Worse Prognosis

e17513 Background: Optimal treatment of synchronous tumors (ST) of the aerodigestive tract is debatable and care is often individualized. Our goal was to characterize patients with HNSCC and esophageal cancer (EC) ST and to establish prognostic factors that could aid therapeutic decision. Methods: In this retrospective observational study, we evaluated data from 1650 consecutive patients diagnosed with HNSCC from 2008 to 2016. Patients with ST of HNSCC and esophagus with an interval of ≤ 6 months between both diagnoses were included. Patients ≥ 6 months between both diagnoses, incomplete treatment information and presence of another tumor site were excluded. Results: 52 patients were eligible. Median age was 57 years (39-91). Most were male (98%), with smoking and drinking habits (98%) and ECOG 0-1 (73%). HNSCCs were mainly in oropharynx (54%) and locally advanced disease (LA, III-IVB) (88%). In contrast, EC was early stage (I-II, 62%), located in the thorax (94%) and squamous histology (96%). 14 (27%) had LA in both primaries. Most LA HNSCCs (85%) were treated with radiotherapy (RT) with a median dose of 70Gy (5-70Gy). 50% received platinum and taxane induction chemotherapy. 81% of initial EC received at least surgery, mucosectomy or RT (median 50.4Gy). Hospitalization due to toxicity occurred in 12 (23%) and 7 (14%) of HNSCC and EC treatments, respectively. 16 patients (31%) had no definitive treatment directed to EC, without apparent impact on survival. Median time to progression was 13.8 months, being HNSCC the most frequent site of progression/relapse (40%). Median survival was 23.9 months (IC 95% 9.2-38.6). Early HNSCC survival was comparable to LA HNSCC (17.3 vs. 23.9 mo, p = 0.98). In LA HNSCC, LA vs. initial EC carried a worse prognosis (16 vs. 36.3 mo, p = 0.008). Anemia, BMI, tobacco exposure had no impact on survival. Conclusions: The occurrence of EC and HNSCC ST leads to a dismal survival, even in patients with early stage HNSCC. The presentation of LA in both sites is particularly challenging and associated with worse prognosis. Given the rate of treatment-related toxicity in this population, cautious efforts should be employed when planning definitive treatment in ST pts.

Patient Selection, Resection, and Outcomes for Hepatocellular Carcinoma

2012 ◽  
pp. 265-269
Author(s):  
Claudius Conrad ◽  
Kenneth K. Tanabe
Keyword(s):  
Hepatocellular Carcinoma ◽  
Surgical Resection ◽  
Patient Selection ◽  
Laboratory Data ◽  
Intraoperative Ultrasound ◽  
Definitive Treatment ◽  
Transfusion Requirements ◽  
Staging Systems ◽  
Selection Of Patients ◽  
Selection Of

Overview: Hepatocellular carcinoma (HCC) is an aggressive malignancy of the liver that most often arises in patients with cirrhosis and other chronic liver diseases. Worldwide, it is the sixth most common cancer and the third most common cause of cancer-related death. Median survival is poor, ranging from 6 to 20 months. Definitive treatment options for HCC are surgical resection, ablation, or transplantation. The selection of patients for surgical resection is based on clinical findings, laboratory data, and imaging. Although a number of staging systems exist, all have their limitations. A multidisciplinary approach to patient selection for surgery that includes the input of an experienced liver surgeon assures optimal outcomes. Sound understanding of liver segmentation, modern surgical techniques, and the use of intraoperative ultrasound have led to a reported perioperative mortality rate below 3%, blood transfusion requirements of less than 10%, and 5-year survival rates of at least 50%. Advances in laparoscopic technique and technology have expanded the indications for a safe and oncologically appropriate minimally invasive resection. Deciding which treatment option to employ depends on tumor resectability and the degree of underlying liver disease, which is present in 80% to 85% of patients with HCC; however, despite these surgical advances, a high recurrence rate of 70% in patients with cirrhosis and a survival rate of 65% to 80% in well-selected transplant patients are expected. This article will focus on the evaluation and selection of patients for surgical intervention, considerations in selecting the appropriate type of resection, and expected outcomes following liver resection.

Hidden Overdenture Bar in Fixed Implant-retained Hybrid Prosthesis: Report of a Novel Technique

2016 ◽  
Vol 17 (9) ◽  
pp. 780-782
Author(s):  
Prajna P Shetty ◽  
Makam Gangaiah
Keyword(s):  
Clinical Significance ◽  
Comprehensive Treatment ◽  
Patient Needs ◽  
Clinical Consideration ◽  
Advantages And Disadvantages ◽  
Novel Technique ◽  
Implant Abutments ◽  
Hybrid Prosthesis ◽  
Removable Prosthesis ◽  
Fixed Prosthesis

ABSTRACT Introduction Every patient needs a comprehensive treatment planning. Dentists must consider the advantages and disadvantages of the available implant prosthetic options and match them to patient's expectations. Hybrid denture prosthesis is one, i.e., fabricated and retained by screw threaded into implant abutments, most of the time on four implants. Sometimes due to failure of an implant, the prosthesis needs to be replaced with a newer casting to accommodate the existing implants. Clinical consideration This article presents a novel technique, wherein the existing framework of the fixed prosthesis can be used to convert the fixed prosthesis to removable prosthesis on the existing implants, without recasting. Clinical significance The implant is economical and easily convertible from a fixed-fixed to a fixed-removable prosthesis. Hence, there is reduced morbidity, reduced cost, and an increased psychological comfort for the patient. How to cite this article Shetty PP, Gangaiah M, Chowdhary R. Hidden Overdenture Bar in Fixed Implant-retained Hybrid Prosthesis: Report of a Novel Technique. J Contemp Dent Pract 2016;17(9):780-782.

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