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O.119 Hyperbaric oxygen therapy in osteomyelitis of the jaws
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Journal of Cranio-Maxillofacial Surgery 36(2008) Suppl. 1
Conclusions: These results suggest that treatment of DSO with bisphosphonates may be a good option in patients with therapyresistant symptoms. O.116 Eagle’s syndrome – report of four rare cases P. Arkuszewski, M. Tyndorf, T. Hilt, A. Przygoski. Department of Cranio-Maxillofacial Surgery Medicla University of Lodz, Lodz, Poland Eagle’s syndrome is defined as elongation of the styloid process or stylohyoid ligament mineralization complex which consist of: styloid process, stylohyoid ligament and lesser horn of the hyoid bone. It is a rare entity, which is not commonly suspected in clinical practice. It is characterized by recurrent facial and throat pain, dysphagia, odynophagia, parapharyngeal foreign body sensation, otalgia and neck pain. Eagle’s syndrome can be treated conservatively (placing local anesthetic into the styloid process and the stylomandibular ligament attachment) or surgically. The aim of this study is to discuss four clinical cases of symptomatic patients. In three cases (two female and one male aged from 50 to 59) styloid process elongation was unilateral and once (60 year-old male) it appeared as a very uncommon bilateral mineralization of stylohyoid ligament complex. All patients presented severe throat pain, odynophagia and dysphagia. In addition to clinical examination (to palpate the elongated styloid process, the gloved finger was inserted along the occlusal line posteriorly to the to the tonsillar fossa region) the use of plain radiographs, orthopantomograms or computed tomography scan allowed accurate preoperative diagnosis of Eagle’s syndrome. Surgical treatment (the intraoral, trans pharyngeal approach) was conducted in all cases. The patients have been observed and until now no signs of recurrence have been noted. O.117 Epithelioid hemangioendothelioma of the mandible D. Ventorre, G. Bettini, G. Corrocher, A. Baltieri. Maxillo-Facial Surgery Department, University of Verona, Verona, Italy Objective: Epithelioid Hemangioendothelioma is a rare vascular tumour with locally aggressive growth and biological behaviour intermediate between hemangioma and angiosarcoma. Its most frequent localization is liver, soft tissues and lung. It rarely occurs in the oral cavity. We present a case of epithelioid hemangioendothelioma of the retromolar region spreaded to the mandible ramus. Methods: A 63 years old man came to our department referring pain associated with paraesthesia of perimandibular soft tissues. Panorex didn’t show any bone lesion. A TC scan was performed and it showed a 1 cm × 1 cm osteolytic area, involving the right mandibular ramus without any other simultaneous body localization. The patient underwent a probing excision and the specimen was assessed for histological examination. Histological findings were Epithelioid Hemangioendothelioma with indications for radical resection of both the bone affected area and the soft tissues surrounding. A reconstruction of the local oral mucosa was also performed with skin graft. No complications occurred in the postoperative. Results: After 12 months, the patient maintains a satisfactory masticatory function without any local or distant recurrences. Conclusions: Epithelioid Hemangioendothelioma has a more aggressive biological behaviour when occurs in hard tissue and when it presents a multiple localization. This case of monostotic lesion was treated with radical surgery. Given the high incidence of recurrence even after several years, it needs a long clinical and radiological follow up.
Abstracts, EACMFS XIX Congress O.118 Familial cherubinism: review of 33 cases from Moscow R. Khonsari, Ia. Ovitchinnikov, Mv. Korolenkova, Vv. Roginsky. CHU de Nantes, Nantes, France Objectives. Familial cherubism is an uncommon disease. By reviewing 33 cases from the Central Institute of Stomatology in Moscow, we show examples of misleading clinical courses, pinpoint the minor signs of the disease and discuss the different treatment strategies. Methods. Retrospective study of 33 cases treated in Moscow in the last three decades. Clinical and radiological follow-up. Severity rating according to the von Wowern classification. Pre- and post-surgical evaluation in the operated cases. Results. Despite a stereotyped evolution profile, some cases can exhibit highly unsual characteristics. Furthermore, the minor signs of the disease are exposed, as found predominantly in parents of affected children. The different treatment plans are discussed. Finally, the first case of Ramon syndrome without neurological symptoms is exposed. Conclusion. Familial cherubism can be a tricky diagnosis in unsual cases. This large series allows to expose poorly known aspects of this affection. O.119 Hyperbaric oxygen therapy in osteomyelitis of the jaws A. Zimmermann, R. Depprich, N.R. K¨ubler, C. Sproll, J. Handschel. Clinic for Maxillofacial and Facial Plastic Surgery, D¨usseldorf, Germany The aim of this investigation was to evaluate the effectivity of hyperbaric oxygen therapy (HBO) in the treatment of patients with osteomyelitis of the jaws. 27 patients, treated for osteomyelitis of the jaws using HBO therapy between 2000 and 2006 were evaluated. 8 patients were younger than 30 years of age. The clinical absence of complaints was regarded as the main success parameter of the therapy. The patients were subdivided in three groups. 1. Initial manifestation of osteomyelitis. 2. Recurrent manifestation after combined surgical and antibiotic treatment. 3. Recurrent manifestation after antibiotic treatment allone. From 13 patients with initial manifestation, 7 were without complaints after 40 sessions of HBO and without recurrece till this day. From 9 Patients in the second group, 4 were without complaints and recurrence after 40 sessions, whereas the two younger Patients had several episodes of complaints. In comparrison to that, especially the younger patients from the third group responded well to the HBO therapy. HBO therapy is a beneficial addition to the surgical and drug treatment of osteomyelitis of the jaws. O.120 Keratocystic odontogenic tumor: a follow up of 60 patients M. Riha, S. Skrabl, R. Ewers, C. Klug. University of Vienna, Vienna, Austria Objective: The purpose of this analysis was to evaluate four different surgical treatment methods for keratocystic odontogenic tumors (KCOT) and the outcome of those treatments over a 10year period. A retrospective review was performed of 60 patients, treated from 1996 to 2006. Patients and Methods: The four groups of different surgical treatment were: (1) Enucleation with Carnoy’s solution, used for small unicystic lesions without certainty of histology. (2) Enucleation without Carnoy’s solution, also applied for small unicystic lesions after previous histological confirmation of KOCT. (3) Decompression followed by enucleation implemented for large often
Journal of Cranio-Maxillofacial Surgery 36(2008) Suppl. 1
Conclusions: These results suggest that treatment of DSO with bisphosphonates may be a good option in patients with therapyresistant symptoms. O.116 Eagle’s syndrome – report of four rare cases P. Arkuszewski, M. Tyndorf, T. Hilt, A. Przygoski. Department of Cranio-Maxillofacial Surgery Medicla University of Lodz, Lodz, Poland Eagle’s syndrome is defined as elongation of the styloid process or stylohyoid ligament mineralization complex which consist of: styloid process, stylohyoid ligament and lesser horn of the hyoid bone. It is a rare entity, which is not commonly suspected in clinical practice. It is characterized by recurrent facial and throat pain, dysphagia, odynophagia, parapharyngeal foreign body sensation, otalgia and neck pain. Eagle’s syndrome can be treated conservatively (placing local anesthetic into the styloid process and the stylomandibular ligament attachment) or surgically. The aim of this study is to discuss four clinical cases of symptomatic patients. In three cases (two female and one male aged from 50 to 59) styloid process elongation was unilateral and once (60 year-old male) it appeared as a very uncommon bilateral mineralization of stylohyoid ligament complex. All patients presented severe throat pain, odynophagia and dysphagia. In addition to clinical examination (to palpate the elongated styloid process, the gloved finger was inserted along the occlusal line posteriorly to the to the tonsillar fossa region) the use of plain radiographs, orthopantomograms or computed tomography scan allowed accurate preoperative diagnosis of Eagle’s syndrome. Surgical treatment (the intraoral, trans pharyngeal approach) was conducted in all cases. The patients have been observed and until now no signs of recurrence have been noted. O.117 Epithelioid hemangioendothelioma of the mandible D. Ventorre, G. Bettini, G. Corrocher, A. Baltieri. Maxillo-Facial Surgery Department, University of Verona, Verona, Italy Objective: Epithelioid Hemangioendothelioma is a rare vascular tumour with locally aggressive growth and biological behaviour intermediate between hemangioma and angiosarcoma. Its most frequent localization is liver, soft tissues and lung. It rarely occurs in the oral cavity. We present a case of epithelioid hemangioendothelioma of the retromolar region spreaded to the mandible ramus. Methods: A 63 years old man came to our department referring pain associated with paraesthesia of perimandibular soft tissues. Panorex didn’t show any bone lesion. A TC scan was performed and it showed a 1 cm × 1 cm osteolytic area, involving the right mandibular ramus without any other simultaneous body localization. The patient underwent a probing excision and the specimen was assessed for histological examination. Histological findings were Epithelioid Hemangioendothelioma with indications for radical resection of both the bone affected area and the soft tissues surrounding. A reconstruction of the local oral mucosa was also performed with skin graft. No complications occurred in the postoperative. Results: After 12 months, the patient maintains a satisfactory masticatory function without any local or distant recurrences. Conclusions: Epithelioid Hemangioendothelioma has a more aggressive biological behaviour when occurs in hard tissue and when it presents a multiple localization. This case of monostotic lesion was treated with radical surgery. Given the high incidence of recurrence even after several years, it needs a long clinical and radiological follow up.
Abstracts, EACMFS XIX Congress O.118 Familial cherubinism: review of 33 cases from Moscow R. Khonsari, Ia. Ovitchinnikov, Mv. Korolenkova, Vv. Roginsky. CHU de Nantes, Nantes, France Objectives. Familial cherubism is an uncommon disease. By reviewing 33 cases from the Central Institute of Stomatology in Moscow, we show examples of misleading clinical courses, pinpoint the minor signs of the disease and discuss the different treatment strategies. Methods. Retrospective study of 33 cases treated in Moscow in the last three decades. Clinical and radiological follow-up. Severity rating according to the von Wowern classification. Pre- and post-surgical evaluation in the operated cases. Results. Despite a stereotyped evolution profile, some cases can exhibit highly unsual characteristics. Furthermore, the minor signs of the disease are exposed, as found predominantly in parents of affected children. The different treatment plans are discussed. Finally, the first case of Ramon syndrome without neurological symptoms is exposed. Conclusion. Familial cherubism can be a tricky diagnosis in unsual cases. This large series allows to expose poorly known aspects of this affection. O.119 Hyperbaric oxygen therapy in osteomyelitis of the jaws A. Zimmermann, R. Depprich, N.R. K¨ubler, C. Sproll, J. Handschel. Clinic for Maxillofacial and Facial Plastic Surgery, D¨usseldorf, Germany The aim of this investigation was to evaluate the effectivity of hyperbaric oxygen therapy (HBO) in the treatment of patients with osteomyelitis of the jaws. 27 patients, treated for osteomyelitis of the jaws using HBO therapy between 2000 and 2006 were evaluated. 8 patients were younger than 30 years of age. The clinical absence of complaints was regarded as the main success parameter of the therapy. The patients were subdivided in three groups. 1. Initial manifestation of osteomyelitis. 2. Recurrent manifestation after combined surgical and antibiotic treatment. 3. Recurrent manifestation after antibiotic treatment allone. From 13 patients with initial manifestation, 7 were without complaints after 40 sessions of HBO and without recurrece till this day. From 9 Patients in the second group, 4 were without complaints and recurrence after 40 sessions, whereas the two younger Patients had several episodes of complaints. In comparrison to that, especially the younger patients from the third group responded well to the HBO therapy. HBO therapy is a beneficial addition to the surgical and drug treatment of osteomyelitis of the jaws. O.120 Keratocystic odontogenic tumor: a follow up of 60 patients M. Riha, S. Skrabl, R. Ewers, C. Klug. University of Vienna, Vienna, Austria Objective: The purpose of this analysis was to evaluate four different surgical treatment methods for keratocystic odontogenic tumors (KCOT) and the outcome of those treatments over a 10year period. A retrospective review was performed of 60 patients, treated from 1996 to 2006. Patients and Methods: The four groups of different surgical treatment were: (1) Enucleation with Carnoy’s solution, used for small unicystic lesions without certainty of histology. (2) Enucleation without Carnoy’s solution, also applied for small unicystic lesions after previous histological confirmation of KOCT. (3) Decompression followed by enucleation implemented for large often