scholarly journals Mandibular Coronoid Fractures, How Rare?

2015 ◽  
Vol 16 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Tejraj Pundalik Kale ◽  
SM Kotrashetti ◽  
JB Lingaraj ◽  
Vipin Aggarwal
Keyword(s):  
Treatment Strategies ◽  
Mouth Opening ◽  
Objective Evaluation ◽  
Coronoid Process ◽  
Treatment Modalities ◽  
Mandibular Fractures ◽  
Lower Face ◽  
Limited Mouth Opening ◽  
Significant Difference ◽  
Coronoid Fractures

ABSTRACT Background To study the rarity of mandibular coronoid process fractures and treatment strategies based on the displacement of these fractures. Materials and methods A retrospective study of 11 cases of coronoid process fractures among 307 treated cases from 2008 to 2013 was conducted. Six patients were treated conservatively and 5 underwent ORIF with associated fractures. A statistical analysis of the data obtained after subjective and objective evaluation was done. Results The incidence of coronoid process fractures was 3.58% of all mandibular fractures analyzed. There was no statistically significant difference found between two treatment modalities, but differences in maximum interincisal opening (MIO) and pain in the postoperative period were significant. Conclusion We recommend that linear coronoid fractures with minimal displacement can be managed with conservative treatment. For patients with significant displacement of coronoid process, limited mouth opening or concomitant mid-face or lower-face fractures, rigid internal fixation is recommended. How to cite this article Kale TP, Aggarwal V, Kotrashetti SM, Lingaraj JB, Singh A. Mandibular Coronoid Fractures, How Rare? J Contemp Dent Pract 2015;16(3):222-226.

scholarly journals Bilateral Elongated Mandibular Coronoid Process and Restricted Mouth Opening: A Case Report

2017 ◽  
Vol 11 (1) ◽  
pp. 670-678 ◽  
Author(s):  
Thomas Starch-Jensen ◽  
Annette Dalgaard Kjellerup
Keyword(s):  
Case Report ◽  
Imaging Modality ◽  
Mouth Opening ◽  
Coronoid Process ◽  
Treatment Modalities ◽  
Mandibular Movement ◽  
Limited Mouth Opening ◽  
Joint Disorder ◽  
Surgically Induced

Introduction: Mandibular coronoid process hyperplasia is an uncommon congenital or developmental temporomandibular joint disorder, characterized by elongation of the coronoid process, which may cause limited mandibular movement as a consequence of interference between the hyperplastic coronoid process and the medial surface of the zygomatic arch. Methods: Mandibular coronoid process hyperplasia commonly affects males in the second decade of life and the exact aetiology and pathogenesis is unknown. The condition can be uni- or bilateral. Progressive painless reduction in mouth opening is the main clinical finding and computed tomography is the most reliable imaging modality for confirming the diagnosis. Results: Surgical intervention involving coronoidectomy and long-term intensive postoperative physiotherapy is the treatment of choice for mandibular coronoid process hyperplasia with impingement on the zygomatic bone and limited mouth opening. However, surgically induced fibrosis and the tendency for mandibular coronoid process regrowth may cause relapse and renewed limited mouth opening. Vigorous physical therapy should therefore be initiated shortly after surgery. Conclusion: The purpose of this case report is to present the clinical and radiographic features of elongated mandibular coronoid process in an 18-year-old male with limited mouth opening, and to discuss the various surgical treatment modalities.

Craniopharyngioma: a comparison of tumor control with various treatment strategies

2010 ◽  
Vol 28 (4) ◽  
pp. E5 ◽  
Author(s):  
Isaac Yang ◽  
Michael E. Sughrue ◽  
Martin J. Rutkowski ◽  
Rajwant Kaur ◽  
Michael E. Ivan ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Treatment Strategies ◽  
Group Versus ◽  
Outcome Data ◽  
Treatment Modalities ◽  
Rank Test ◽  
Tumor Control ◽  
Subtotal Resection ◽  
Log Rank Test ◽  
Significant Difference

Object Craniopharyngiomas have a propensity to recur after resection, potentially causing death through their aggressive local behavior in their critical site of origin. Recent data suggest that subtotal resection (STR) followed by adjuvant radiotherapy (XRT) may be an appealing substitute for gross-total resection (GTR), providing similar rates of tumor control without the morbidity associated with aggressive resection. Here, the authors summarize the published literature regarding rates of tumor control with various treatment modalities for craniopharyngiomas. Methods The authors performed a comprehensive search of the English language literature to identify studies publishing outcome data on patients undergoing surgery for craniopharyngioma. Rates of progression-free survival (PFS) and overall survival (OS) were determined through Kaplan-Meier analysis. Results There were 442 patients who underwent tumor resection. Among these patients, GTR was achieved in 256 cases (58%), STR in 101 cases (23%), and STR+XRT in 85 cases (19%). The 2- and 5-year PFS rates for the GTR group versus the STR+XRT group were 88 versus 91%, and 67 versus 69%, respectively. The 5- and 10-year OS rates for the GTR group versus the STR+XRT group were 98 versus 99%, and 98 versus 95%, respectively. There was no significant difference in PFS (log-rank test) or OS with GTR (log-rank test). Conclusions Given the relative rarity of craniopharyngioma, this study provides estimates of outcome for a variety of treatment combinations, as not all treatments are an option for all patients with these tumors.

scholarly journals A case of osteochondroma of the coronoid process with long-term limited mouth opening

2019 ◽  
Vol 65 (1) ◽  
pp. 22-28
Author(s):  
Takako KONO ◽  
Koji YAMADA ◽  
Shuji UENO ◽  
Yuki MATSUSHIMA ◽  
Tomio ISEKI ◽  
...  
Keyword(s):  
Mouth Opening ◽  
Coronoid Process ◽  
Limited Mouth Opening

scholarly journals GCT-23. MULTI-INSTITUTIONAL ANALYSIS OF TREATMENT MODALITIES IN BASAL GANGLIA AND THALAMIC GERMINOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii332-iii332
Author(s):  
Richard T Graham ◽  
Mohammad H Abu-Arja ◽  
Joseph Stanek ◽  
Ute Bartels ◽  
Andrea Cappellano ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Institutional Analysis ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Event Free Survival ◽  
Free Survival ◽  
Combine Chemotherapy ◽  
Imaging Characteristics ◽  
Significant Difference

Abstract BACKGROUND Central nervous system (CNS) germinomas are radiotherapy (RT)-sensitive tumors with excellent survival. Current treatment strategies combine chemotherapy with RT to reduce the field and dose of RT. There is no standard treatment for germinomas originating in the basal ganglia/thalami (BGTG) given their rarity and poorly-defined imaging characteristics. Craniospinal (CSI), whole brain (WBI), whole ventricle (WVI), and focal RT have been previously utilized; however, the optimal strategy remains unclear. METHODS Retrospective multi-institutional analysis was conducted across 18 institutions in four countries. RESULTS For 46 cases with non-metastatic BGTG, the event-free survival (EFS) was 86.9% at both 5 and 10 years, while overall survival (OS) was 100%, and 95.7% respectively at 5 and 10 years. Median RT dose and range for the various treatment volumes were as follows: CSI (n=10): 2340 cGy (1980–3060 cGy), WBI (n=8): 2340 (1800–3000 cGy), WVI (n=14): 2340 cGy (1800–2550 cGy), focal (n=9): 3600 cGy (3060–5400 cGy). There was no statistically significant difference in the EFS based on RT modality (p=0.57), but EFS for subjects with CSI and WBI were both 100%. The three subjects who received chemotherapy alone had significantly lower EFS than those who received chemotherapy and RT (p=0.001), but were salvageable with RT. CONCLUSION In the largest study to date for BGTG, there were no significant differences in outcomes between patients who received CSI, WBI, WVI or focal RT. This group of patients should be included in future prospective clinical trials, and a more limited RT field may be considered.

scholarly journals The Comparison of Duration Endotracheal Tube Insertion Using Aerosol Box And without Aerosol Box in Elective Surgery Patients in the Covid-19 Pandemic

2022 ◽  
Vol 2 (2) ◽  
pp. 212-221
Author(s):  
Zulkifli ◽  
Agustina Br Haloho ◽  
Legiran ◽  
Muhammad Ikhsan Kartawinata
Keyword(s):  
Endotracheal Tube ◽  
Elective Surgery ◽  
Mouth Opening ◽  
Tube Insertion ◽  
Operating Theater ◽  
Limited Mouth Opening ◽  
Mallampati Score ◽  
Significant Difference ◽  
Post Test ◽  
Mouth Movement

Introduction. The aerosol box can reduce the risk of droplet and aerosol transmission from the patient to the operator when performing intubation, but in practice, an aerosol box makes the glottis visualization less evident, and the operator moves less space with less space the aerosol box. This study aimed to compare ETT duration using an aerosol box and without an aerosol box using a video laryngoscope. Methods: This study was a clinical trial with a post-test-only control design. The study was carried out from February 2021 to May 2021 at the Central Operating Theater of dr. Mohammad Hoesin General Hospital Palembang. The sample in this study was all patients who underwent elective surgery under general anesthesia using intubation at the Central Surgical Installation of dr. Mohammad Hoesin Palembang. After the data is collected, it is analyzed using the SPSS 22.0 program with the appropriate test. Results. There were no differences in subject characteristics (age, sex, BMI, Mallampati score, TMD, Cormack Lehane, limited mouth opening, short neck, limited mouth movement) between the group using the aerosol box and the group without the aerosol box. The duration of intubation without an aerosol box is 30.67 + 2.63 seconds, and using an aerosol box is 44.53 + 2.89 seconds. There was a significant difference between the two groups in the duration of patient intubation (p < 0.001). However, there was no significant difference in complications in the two groups (p >0.05). Conclusion. The duration of the endotracheal tube insertion using an aerosol box is more extended than without an aerosol box in elective surgery patients.

scholarly journals Effect of arthrocentesis on the clinical outcome of various treatment methods for temporomandibular joint disorders

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Chang-Woo Kim ◽  
Sung-Jae Lee ◽  
Euy-Hyun Kim ◽  
Dong-Keon Lee ◽  
Mong-Hun Kang ◽  
...  
Keyword(s):  
Pain Relief ◽  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Temporomandibular Joint Disorders ◽  
Treatment Modalities ◽  
Disc Displacement ◽  
Significant Difference ◽  
Joint Disorder ◽  
Average Pain ◽  
Closed Lock

Abstract Background We evaluated the improvement of pain and the increase in mouth opening after temporomandibular joint arthrocentesis and the possible association with various factors such as previous splint treatment, medication, and diagnosis. Results We studied 57 temporomandibular joint disorder patients who underwent arthrocentesis at Korea University Anam Hospital. These patients (24 males and 33 females, aged between 15 and 76 years) underwent arthrocentesis that was performed by one surgeon. The degree of mouth opening (assessed using the maximum mouth opening: MMO) and pain (assessed using the visual analog scale: VAS) were assessed pre- and post-arthrocentesis. The study also investigated whether treatment modalities other than arthrocentesis (medication and appliance therapy) were performed. Statistical analysis revealed that there was a significant difference in mouth opening and pain after temporomandibular joint arthrocentesis. Preoperative appliance therapy affected the results of arthrocentesis, but it was not statistically significant. With regard to pain relief, preoperative diagnosis did not show a significant difference. However, with regard to maximum mouth opening, patients with disc displacement without reduction with limited mouth opening (closed lock) showed the highest recovery (11.13 mm). Conclusion The average of MMO increase after arthrocentesis was 9.10 mm, and patients with disc displacement without reduction with locking (closed lock) showed most recovery in maximum mouth opening and it was statistically significant. The average pain relief of patients after arthrocentesis was 3.03 in the VAS scale, and patients using anterior repositioning splint (ARS) preoperatively showed the most pain relief.

scholarly journals Implementation of a multidisciplinary infections conference improves the treatment of spondylodiscitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
D. Ntalos ◽  
B. Schoof ◽  
D. M. Thiesen ◽  
L. Viezens ◽  
H. Kleinertz ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Treatment Strategies ◽  
Autologous Bone Graft ◽  
Treatment Modalities ◽  
Post Intervention ◽  
Operative Revision ◽  
Significant Difference ◽  
Spinal Segments ◽  
Patient Groups ◽  
Single Discipline

AbstractEstablishing a multidisciplinary approach regarding the treatment of spondylodiscitis and analyzing its effect compared to a single discipline approach. 361 patients diagnosed with spondylodiscitis were included in this retrospective pre-post intervention study. The treatment strategy was either established by a single discipline approach (n = 149, year 2003–2011) or by a weekly multidisciplinary infections conference (n = 212, year 2013–2018) consisting of at least an orthopedic surgeon, medical microbiologist, infectious disease specialist and pathologist. Recorded data included the surgical and antibiotic strategy, complications leading to operative revision, recovered microorganisms, as well as the total length of hospital and intensive care unit stay. Compared to a single discipline approach, performing the multidisciplinary infections conference led to significant changes in anti-infective and surgical treatment strategies. Patients discussed in the conference showed significantly reduced days of total antibiotic treatment (66 ± 31 vs 104 ± 31, p < 0.001). Moreover, one stage procedures and open transpedicular screw placement were more frequently performed following multidisciplinary discussions, while there were less involved spinal segments in terms of internal fixation as well as an increased use of intervertebral cages instead of autologous bone graft (p < 0.001). Staphylococcus aureus and Staphylococcus epidermidis were the most frequently recovered organisms in both patient groups. No significant difference was found comparing inpatient complications between the two groups or the total in-hospital stay. Implementation of a weekly infections conference is an effective approach to introduce multidisciplinarity into spondylodiscitis management. These conferences significantly altered the treatment plan compared to a single discipline approach. Therefore, we highly recommend the implementation to optimize treatment modalities for patients.

scholarly journals Development of temporomandibular ankylosis after diagnosis of Jacob’s disease: clinical and tomographic assessment

2020 ◽  
Vol 9 (5) ◽  
pp. 426-428
Author(s):  
Rafael Linard Avelar ◽  
Roque Soares Martins Neto ◽  
Bruno da Silva Gaspar ◽  
Raimundo Antonio de Lima Praxedes Neto ◽  
Paulo Paulo Goberlânio Barros Silva
Keyword(s):  
Literature Review ◽  
Temporomandibular Joint ◽  
Delayed Diagnosis ◽  
Mouth Opening ◽  
Rare Condition ◽  
Temporomandibular Joint Disorders ◽  
Zygomatic Arch ◽  
Coronoid Process ◽  
Limited Mouth Opening ◽  
Joint Formation

Jacob's disease is a rare condition that consists of the formation of a pseudo joint structure between the mandibular coronoid process and the zygomatic bone, resulting in limited mouth opening. The disease is difficult to diagnose and etiology is uncertain. This article describes a clinical case of a 6-year-old child with limited mouth opening, which resulted in the formation of a temporomandibular ankylosis leading to complete immobility due to delayed diagnosis and treatment of the disease. A review of this pathology and the most precise imaging exams are discussed for the early and differential diagnosis of the disease. Descriptors: Ankylosis; Temporomandibular Joint; Temporomandibular Joint Disorders. Referências Wang WH, Xu B, Zhang BJ, Lou HQ. Temporomandibular joint ankylosis contributing to coronoid process hyperplasia. Int J Oral Maxillofac Surg. 2016;45(10):1229-33. Zhong SC, Xu ZJ, Zhang ZG, Zheng YH, Li TX, Su K. Bilateral coronoid hyperplasia (Jacob disease on right and elongation on left): report of a case and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Mar;107(3):e64-7. Coll-Anglada M, Acero-Sanz J, Vila-Masana I, Navarro-Cuéllar C, Ochandiano-Caycoia S, López de-Atalaya J, Navarro-Vila C. Jacob's disease secondary to coronoid process osteochondroma. A case report. Med Oral Patol Oral Cir Bucal. 2011;16(6):e708-10. Yesildag A, Yariktas M, Doner F, Aydin G, Munduz M, Topal U. Osteochondroma of the coronoid process and joint formation with zygomatic arch (jacob disease): report of a case. Eur J Dent. 2010;4(1):91-4.  Çorumlu U, Kopuz C, Demir MT, Pirzirenli ME. Bilateral elongated mandibular coronoid process in an Anatolian skull. Anat Cell Biol. 2016;49(3):217-20. Choi JG, Kim SY, Perez-Atayde AR, Padwa BL. Bilateral coronoid process hyperplasia with pseudocartilaginous joint formation: Jacob disease. J Oral Maxillofac Surg. 2013;71(2):316–21. Losa-Muñoz PM, Burgueño-García M, González-Martín-Moro J, Sánchez-Burgos R. Osteochondroma of coronoid process: a rare etiology of jacob disease. Craniomaxillofac Trauma Reconstr. 2014;7(4):306-9.  Escuder i de la Torre O, Vert Klok E, Marí i Roig A, Mommaerts MY, Pericot i Ayats J. Jacob's disease: report of two cases and review of the literature. J Craniomaxillofac Surg. 2001;29(6):372-76. Hernández-Alfaro F, Escuder O, Marco V. Joint formation between an osteochondroma of the coronoid process and the zygomatic arch (Jacob disease): report of case and review of literature. J Oral Maxillofac Surg. 2000;58(2):227-32. Sreeramaneni SK, Chakravarthi PS, Krishna Prasad L, Raja Satish P, Beeram RK. Jacob's disease: report of a rare case and literature review. Int J Oral Maxillofac Surg. 2011;40(7):753-57.  D'Ambrosio N, Kellman RM, Karimi S. Osteochondroma of the coronoid process (Jacob's disease): an unusual cause of restricted jaw motion. Am J Otolaryngol. 2011;32(1):52-4. Shackelford RT, Brown WH. Restricted jaw motion due to osteochondroma of the coronoid process. J Bone Joint Surg Am. 1949;31A(1):107-14.

Role of KTP-532 laser in management of oral submucous fibrosis

2008 ◽  
Vol 123 (4) ◽  
pp. 418-421 ◽  
Author(s):  
D R Nayak ◽  
S G Mahesh ◽  
D Aggarwal ◽  
P Pavithran ◽  
K Pujary ◽  
...  
Keyword(s):  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Neck Surgery ◽  
Treatment Modalities ◽  
Rank Test ◽  
Tertiary Centre ◽  
Significant Difference ◽  
Signed Rank Test ◽  
Submucous Fibrosis ◽  
Ktp 532 Laser

AbstractIntroduction:Oral submucous fibrosis is a chronic disease characterised by progressive inability to open the mouth. Various treatment modalities are available for its management, but these have largely been ineffective.Materials and methods:Nine cases of oral submucous fibrosis underwent a release procedure using a KTP-532 laser, from March 2005 to January 2006, within the ENT – head and neck surgery department of a tertiary centre.Results:Pre- and post-operative mouth-opening was compared using the Wilcoxon signed rank test, and a significant difference observed (Z = −2.690, p = 0.007). Follow up over an average period of 12 months showed encouraging results.Conclusion:This preliminary study indicated that adequate release of oral submucous fibrosis can be achieved by using a KTP-532 laser release procedure, with minimal morbidity and satisfactory results. These promising results should encourage more widespread use of this technique in the management of this condition.

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