The authors prospectively analysed 50 patients with chronic anterior disc displacement without reduction, who underwent arthroscopic lysis and lavage of the temporomandibular joint (TMJ). Patients with symptoms lasting less than 1 year were assigned to Group A (n=28) and patients with symptoms lasting more than 1 year to Group B (n=22). The most common problems were inflammatory changes of synovial and retrodiscal tissue (Group A, 71%; Group B, 82%). Fibrous adhesions were present in 14% of Group A patients and 45% of Group B patients. Degenerative changes of the disc and articular surface were present in 4% of Group A patients and 32% of Group B patients. Mouth opening increased 123% from baseline in Group A, and 112% in Group B (P<0.05). Pain decreased significantly in both groups (Group A, 2.5 points; Group B, 1.68 points; P<0.05). In conclusion, almost all patients with chronic anterior disc displacement without reduction benefited from arthroscopic lysis and lavage of the TMJ. Patients with a shorter duration of symptoms problems benefited more than those with a longer duration. Arthroscopic lysis and lavage of the TMJ is safe and beneficial in chronic anterior disc displacement without reduction.
- MeSH
- Tissue Adhesions surgery MeSH
- Arthroscopy methods MeSH
- Time Factors MeSH
- Chronic Disease MeSH
- Temporomandibular Joint Disc surgery MeSH
- Joint Dislocations surgery MeSH
- Therapeutic Irrigation methods MeSH
- Humans MeSH
- Pain Measurement MeSH
- Temporomandibular Joint Disorders surgery MeSH
- Facial Pain surgery MeSH
- Osteoarthritis surgery MeSH
- Prospective Studies MeSH
- Range of Motion, Articular physiology MeSH
- Synovitis surgery MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
Piezosurgery is a promising meticulous system for bone cutting, based on ultrasound microvibrations. It is thought that the impact of piezosurgery on the integrity of soft tissue is generally low, but it has not been examined critically. The authors undertook an experimental study to evaluate the brain tissue response to skull bone removal using piezosurgery compared with a conventional drilling method. In Wistar male rats, a circular bone window was drilled to the parietal bone using piezosurgery on one side and a conventional bone drill on the other side. The behavioural performance of animals was evaluated using the motor BBB test and sensory plantar test. The brains of animals were evaluated by magnetic resonance imaging (MRI) and histology. The results of MRI showed significantly increased depth and width of the brain lesion in the region of conventional drilling compared with the region where piezosurgery was used. Cresylviolet and NF 160 staining confirmed these findings. There was no significant difference in any of the behavioural tests between the two groups. In conclusion, piezosurgery is a safe method for the performance of osteotomy in close relation to soft tissue, including an extremely injury-sensitive tissue such as brain.
- MeSH
- Astrocytes pathology MeSH
- Coloring Agents diagnostic use MeSH
- Time Factors MeSH
- Behavior, Animal physiology MeSH
- Rats MeSH
- Locomotion physiology MeSH
- Magnetic Resonance Imaging MeSH
- Brain pathology MeSH
- Random Allocation MeSH
- Neurofilament Proteins analysis MeSH
- Osteotomy instrumentation methods MeSH
- Oxazines diagnostic use MeSH
- Intraoperative Complications prevention & control MeSH
- Piezosurgery instrumentation methods MeSH
- Motor Activity physiology MeSH
- Brain Injuries prevention & control MeSH
- Rats, Wistar MeSH
- Parietal Bone surgery MeSH
- Thermosensing physiology MeSH
- Hindlimb physiology MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Male MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
This retrospective non-randomized 10-year follow-up study compared 147 patients with squamous cell carcinoma (SCC) of the oral cavity requiring hemimandibulectomy, treated by surgical resection, therapeutic neck dissection and radiotherapy. The 5-year survival rates were compared related to localization, size of the tumour, infiltration of locoregional lymph nodes, distant metastases, histopathological grading, radicality of surgery, and invasion of tumour into the mandible. Occurrence of tumour relapse and its localization was studied. The mean 5-year survival rate was 26%. Patients with SCC of the mandibular alveolar process had higher rates; the lowest rates occurred in SCC of the buccal mucosa. Survival rate was significantly lower with insufficient resection of the tumour (85% relapse). An important number of patients with radical resection died within 3 months of surgery. In almost 55% of the mandibles tumour was not present. In 5% of infiltrated mandibles, dissemination into inferior alveolar nerve was proven. Decreasing survival rate was seen with increasing size of tumour and higher histological grade. Therapeutic neck dissection significantly reduces survival rate and increases the percentage of lymph node relapse. Elective neck dissection should be performed in SCC requiring hemimandibulectomy. Primary reconstruction should reverse the high percentage of postoperative complication arising from increased radicality.
- MeSH
- Radiotherapy, Adjuvant MeSH
- Radiotherapy Dosage MeSH
- Adult MeSH
- Neoplasm Invasiveness MeSH
- Kaplan-Meier Estimate MeSH
- Clinical Protocols MeSH
- Neck Dissection MeSH
- Middle Aged MeSH
- Humans MeSH
- Logistic Models MeSH
- Neoplasm Recurrence, Local MeSH
- Lymphatic Metastasis MeSH
- Mandible surgery MeSH
- Survival Rate MeSH
- Mandibular Neoplasms mortality pathology radiotherapy surgery MeSH
- Retrospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Carcinoma, Squamous Cell mortality pathology radiotherapy surgery MeSH
- Neoplasm Staging MeSH
- Mouth Mucosa pathology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
We introduce a hypothesis that obstructive sleep apnea syndrome (OSAS) is primarily caused by an inherited reduced adaptability of upper airway striated muscles such that they cannot maintain patency when there is reduced consciousness (sleep). This reduced ability is caused by a deficiency of the genes for specific myosin heavy chain (MHC) proteins, which are the primary source of muscle adaptability in adults and were initially described in the chewing muscles. The development of OSAS must be linked to problems with striated muscle because affected patients are capable of normal breathing when awake but their respiratory parameters deteriorate during sleep; OSAS must, therefore, be caused by a factor that is voluntarily active during waking but inactive during sleep, and this can only be striated muscle. Congenital or acquired anatomical abnormalities are involved only partially, because OSAS patients with anatomical abnormalities do not begin to snore or to have apneas or hypopneas when lying in bed awake, but begin to do so only when sleeping.
- MeSH
- Humans MeSH
- Nerve Fibers physiology classification MeSH
- Penis anatomy & histology MeSH
- Plastic Surgery Procedures methods MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Congress MeSH
- MeSH
- Data Interpretation, Statistical MeSH
- Humans MeSH
- Nervous System pathology MeSH
- Pelvis surgery MeSH
- Transsexualism surgery MeSH
- Plastic Surgery Procedures utilization MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comparative Study MeSH
- MeSH
- Pelvis anatomy & histology MeSH
- Penis anatomy & histology innervation MeSH
- Transsexualism surgery MeSH
- Publication type
- Congress MeSH
