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
- adheze tkání chirurgie MeSH
- artroskopie metody MeSH
- časové faktory MeSH
- chronická nemoc MeSH
- discus articularis čelistního kloubu chirurgie MeSH
- dislokace kloubu chirurgie MeSH
- léčebná irigace metody MeSH
- lidé MeSH
- měření bolesti MeSH
- nemoci temporomandibulárního kloubu chirurgie MeSH
- obličejová bolest chirurgie MeSH
- osteoartróza chirurgie MeSH
- prospektivní studie MeSH
- rozsah kloubních pohybů fyziologie MeSH
- synovitida chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie 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
- astrocyty patologie MeSH
- barvicí látky diagnostické užití MeSH
- časové faktory MeSH
- chování zvířat fyziologie MeSH
- krysa rodu rattus MeSH
- lokomoce fyziologie MeSH
- magnetická rezonanční tomografie MeSH
- mozek patologie MeSH
- náhodné rozdělení MeSH
- neurofilamentové proteiny analýza MeSH
- osteotomie přístrojové vybavení metody MeSH
- oxaziny diagnostické užití MeSH
- peroperační komplikace prevence a kontrola MeSH
- piezochirurgie přístrojové vybavení metody MeSH
- pohybová aktivita fyziologie MeSH
- poranění mozku prevence a kontrola MeSH
- potkani Wistar MeSH
- temenní kost chirurgie MeSH
- vnímání teploty fyziologie MeSH
- zadní končetina fyziologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie 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
- adjuvantní radioterapie MeSH
- celková dávka radioterapie MeSH
- dospělí MeSH
- invazivní růst nádoru MeSH
- Kaplanův-Meierův odhad MeSH
- klinické protokoly MeSH
- krční disekce MeSH
- lidé středního věku MeSH
- lidé MeSH
- logistické modely MeSH
- lokální recidiva nádoru MeSH
- lymfatické metastázy MeSH
- mandibula chirurgie MeSH
- míra přežití MeSH
- nádory mandibuly mortalita patologie radioterapie chirurgie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- spinocelulární karcinom mortalita patologie radioterapie chirurgie MeSH
- staging nádorů MeSH
- ústní sliznice patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články 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
- interpretace statistických dat MeSH
- lidé MeSH
- nervový systém patologie MeSH
- pánev chirurgie MeSH
- transsexualismus chirurgie MeSH
- zákroky plastické chirurgie využití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
- MeSH
- lidé MeSH
- nervová vlákna fyziologie klasifikace MeSH
- penis anatomie a histologie MeSH
- zákroky plastické chirurgie metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kongresy MeSH
- MeSH
- pánev anatomie a histologie MeSH
- penis anatomie a histologie inervace MeSH
- transsexualismus chirurgie MeSH
- Publikační typ
- kongresy MeSH
