Mandible Metastasis As The First Sign From Primary Adenocarcinoma Of The Lung

Adenocarcinoma of the lung that metastasizes to the mandible is very uncommon; only a few cases have been described in the English-language literature. This article presents a metastasis from adenocarcinoma of the lung affecting the mandible of a 64-year-old woman, in which the first discovered metastatic lesion was detected before the primary tumor. The immunoreactivity for human thyroid transcription factor-1 (TTF-1) in the oral lesion was essential for determining the site and type of the primary tumor, as the patient showed no clinical or radiographic evidence of a tumor in the thyroid gland. After the primary tumor in the lung was diagnosed, radiotherapy and chemotherapy were initiated; unfortunately, the patient died two months after the start of treatment. This article emphasizes the importance of a well-conducted examination for diagnosing metastatic oral lesions.553224227Zachariades, N., Neoplasms metastatic to the mouth, jaws and surrounding tissues (1989) J Craniomaxillofac Surg, 17, pp. 283-290Zachariades, N., Koumoura, F., Vairaktaris, E., Mezitis, M., Metastatic tumors to the jaws: A report of seven cases (1989) J Oral Maxillofac Surg, 47, pp. 991-996Meyer, I., Shklar, G., Malignant tumors metastatic to the mouth and jaws (1965) Oral Surg Oral Med Oral Pathol, 20, pp. 350-362Ellis, G.L., Jensen, J.L., Reingold, I.M., Barr, R.J., Malignant neoplasms metastatic to gingivae (1977) Oral Surg Oral Med Oral Pathol, 44, pp. 238-245Hirshberg, A., Leibovich, P., Buchner, A., Metastases to the oral mucosa: Analysis of 157 cases (1993) J Oral Pathol Med, 22, pp. 385-390Ordonez, N.G., Value of thyroid transcription factor-1, E-cadherin, BG8, WT1, and CD44S immunostaining in distinguishing epithelial pleural mesothelioma from pulmonary and nonpulmonary adenocarcinoma (2000) Am J Surg Pathol, 24, pp. 598-606Solomon, M.P., Gormley, M., Jarrett, W., Rosen, Y., Metastatic lesions to the oral soft tissues (1975) J Oral Surg, 33, pp. 53-56Barr, C.E., Dym, H., Weingarten, L.A., Metastatic mucous-producing adenocarcinoma of thegingiva (1980) J Am Dent Assoc, 101, pp. 53-54Go, C.S., Farish, S.E., DeBoom, G.W., Lip paresthesia associated with a jaw mass (1990) J Am Dent Assoc, 121, pp. 662-663Kadokura, M., Yamamoto, S., Kataoka, D., Nonaka, M., Tanio, N., Kawada, T., Takaba, T., Pulmonary adenocarcinoma metastatic to the gingival (1999) Int J Clin Oncol, 4, p. 253Staalsen, N.H., Nielsen, J.S., Bronchogenic metastasis to the gingiva (1992) Oral Surg Oral Med Oral Pathol, 74, pp. 561-562Vieira, B.J., Aarestrup, F.M., da Fonseca, E.C., Dias, E.P., Bilateral gingival metastasis of lung adeocarcinoma: Report of a case (2001) J Oral Maxillofac Surg, 59, pp. 1224-1225Hirshberg, A., Buchner, A., Metastatic tumors to the oral region (1995) An overview. Eur J Cancer B Oral Oncol, 31 B, pp. 355-36

Orthognathic Surgery With Or Without Induced Hypotension

This study involved a retrospective evaluation of patients subjected to surgery for dentofacial deformities treated without induced controlled hypotension (group I, n = 50) and a prospective evaluation of patients who were subjected to surgery under hypotensive general anaesthesia (group II, n = 50). No statistical differences were found between the study groups with regard to the duration of surgery. However, there were statistically significant differences in the need for blood transfusion and the occurrence of bradycardia during the maxillary down-fracture. Hypotensive anaesthesia decreased the need for a blood transfusion and the occurrence of bradycardia, and is therefore considered highly beneficial for patients undergoing orthognathic surgery. © 2013 Published by Elsevier Ltd on behalf of International Association of Oral and Maxillofacial Surgeons. All rights reserved.435577580Farah, G.J., Moraes, M., Filho, L.I., Pavan, A.J., Camarini, E.T., Previdelli, I.T., Coelho, L., Induced hypotension in orthognathic surgery: A comparative study of 2 pharmacological protocols (2008) J. Oral Maxillofac. Surg., 66, pp. 2261-2269Rodrigo, C., Induced hypotension during anesthesia, with special reference to orthognathic surgery (1995) Anesth. Prog., 42, pp. 41-58Schaberg, S.J., Kelly, J.F., Terry, B.C., Posner, M.A., Anderson, E.F., Blood loss and hypotensive anesthesia in oral-facial corrective surgery (1976) J. Oral Surg., 34, pp. 147-156Bernard, J.M., Passuti, N., Pinaud, M., Long-term hypotensive technique with nicardipine and nitroprusside during isoflurane anesthesia for spinal surgery (1992) Anesth. Analg., 75, pp. 179-185Bloor, B.C., Ward, D.S., Belleville, J.P., Maze, M., Effects of intravenous dexmedetomidine in humans: II - Hemodynamic changes (1992) Anesthesiology, 77, pp. 1134-1142Boehm, D.F., Salat, A., Kinstner, C., Fleck, T., Felferning, M., Kimberger, O., Influence of hypotensive and normotensive anesthesia on platelet aggregability and hemostatic markers in orthognathic surgery (2001) Thromb. Res., 103, pp. 185-192Lanigan, D.T., West, R.A., Management of postoperative hemorrhage following the le Fort i maxillary osteotomy (1994) J. Oral Maxillofac. Surg., 42, pp. 367-375Lanigan, D.T., Hey, J., West, R.A., Hemorrhage following mandibular osteotomies: A report of 21 cases (1991) J. Oral Maxillofac. Surg., 49, pp. 713-724Campbell, R., Rodrigo, C., Cheung, L., Asystole and bradycardia during maxillofacial surgery (1994) Anesth. Prog., 41, pp. 13-16Lang, S., Lanigan, D.T., Van Der Wal, M., Trigeminocardiac reflexes: Maxillary and mandibular variants of the oculocardiac reflex (1991) Can J Anesth, 38, pp. 757-760Ragon, J.R., Marcool, R.M., Taylor, S.E., Asystole during le Fort i osteotomy (1989) J. Oral Maxillofac. Surg., 47, pp. 1082-1083Dolman, R.M., Bentley, K.C., Head, T.W., English, M., The effect of hypotensive anesthesia on blood loss and operative time during le Fort i osteotomies (2000) J. Oral Maxillofac. Surg., 58, pp. 834-839. , discussion 840Praveen, K., Narayanan, V., Muthusekhar, M.R., Baig, M.F., Hypotensive anaesthesia and blood loss in orthognathic surgery: A clinical study (2001) Br. J. Oral Maxillofac. Surg., 39, pp. 138-140Precious, D.S., Splinter, W., Bosco, D., Induced hypotensive anesthesia for adolescent orthognathic surgery patients (1996) J. Oral Maxillofac. Surg., 54, pp. 680-683. , discussion 683-684Sanders, G.M., Sim, K.M., Is it feasible to use magnesium sulphate as a hypotensive agent in oral and maxillofacial surgery (1998) Ann. Acad. Med. Singapore, 27, pp. 780-785Suttner, S.W., Piper, S.N., Lang, K., Huttner, I., Kumle, B., Boldt, J., Cerebral effects and blood sparing efficiency of sodium nitroprusside-induced hypotension alone and in combination with acute normovolaemic haemodilution (2001) Br. J. Anaesth., 87, pp. 699-705Enlund, M.G., Ahlstedt, B.L., Andersson, L.G., Krekmanov, L.I., Induced hypotension may influence blood loss in orthognathic surgery, but it is not crucial (1997) Scand. J. Plast. Reconstr. Surg. Hand Surg., 31, pp. 311-317Felfernig-Boehm, D., Salat, A., Kinstner, C., Fleck, T., Felfernig, M., Kimberger, O., Andel, H., Mueller, M.R., Influence of hypotensive and normotensive anesthesia on platelet aggregability and hemostatic markers in orthognathic surgery (2001) Thromb. Res., 103, pp. 185-192Enlund, M., Mentell, O., Engstrom, C., Horneman, G., Ronquist, G., Occurrence of adenylate kinase in cerebrospinal fluid after isoflurane anaesthesia and orthognathic surgery (1996) Ups. J. Med. Sci., 101, pp. 97-111Nishimura, S., Suzuki, A., Hatazawa, J., Nishimura, H., Shirane, R., Yasui, N., Yoshimoto, T., Cerebral blood-flow responses to induced hypotension and to CO 2 inhalation in patients with major cerebral artery occlusive disease: A positron-emission tomography study (1999) Neuroradiology, 41, pp. 73-79Choi, W.S., Samman, N., Risks and benefits of deliberate hypotension in anaesthesia: A systematic review (2008) Int. J. Oral Maxillofac. Surg., 37, pp. 687-703Nkenke, E., Kessler, P., Wiltfang, J., Neukam, F.W., Weisbch, V., Hemoglobin value reduction and necessity of transfusion in bimaxillary orthognathic surgery (2005) J. Oral Maxillofac. Surg., 63, pp. 623-628Gong, S.G., Krishnan, V., Waack, D., Blood transfusions in bimaxillary orthognathic surgery: Are they necessary (2002) Int J Adult Orthod Orthognath Surg, 17, pp. 314-317Dhariwal, D.K., Gibbons, A.J., Kittur, M.A., Sugar, A.W., Blood transfusion requirements in bimaxillary osteotomies (2004) Br. J. Oral Maxillofac. Surg., 42, pp. 231-235Zellin, G., Rasmusson, L., Palsson, J., Kahnberg, K.E., Evaluation of hemorrhage depressors on blood loss during orthognathic surgery: A retrospective study (2004) J. Oral Maxillofac. Surg., 62, pp. 662-666Rohling, R.G., Zimmermann, A.P., Biro, P., Haers, P.E., Saller, H.F., Alternative methods for reduction of blood loss during elective orthognathic surgery (1999) Int. J. Adult Orthodon. Orthognath. Surg., 14, pp. 77-82Golparvar, M., Naddafnia, H., Saghaei, M., Evaluating the relationship between arterial blood pressure changes and indices of pulse oximetric plethysmography (2002) Anesth. Analg., 95, pp. 1686-1690Ervens, J., Marks, C., Hechler, M., Plath, T., Hansen, D., Hoffmeister, B., Effect of induced hypotensive anaesthesia vs isovolaemic haemodilution on blood loss and transfusion requirements in orthognathic surgery: A prospective, single-blinded, randomized, controlled clinical study (2010) Int. J. Oral Maxillofac. Surg., 39, pp. 1168-1174Simpson, P., Bellamy, D., Cole, P., Electrocardiographic studies during hypotension anaesthesia using sodium nitroprusside (1976) Anaesthesia, 31, pp. 1172-1178McNulty, S., Sharifi-Azad, S., Farole, A., Induced hypotension with labetalol for orthognathic surgery (1987) J. Oral Maxillofac. Surg., 45, pp. 309-31

Anatomic study of the mandibular foramen, lingula and antilingula in dry mandibles, and its statistical relationship between the true lingula and the antilingula

The authors verified the anatomical location of the mandibular foramen, lingula and antilingula in dry mandibles, aiming to obtain information that could be used when performing mandibular osteotomies. Forty-four mandibles (88 sides) were evaluated. The distances were measured using a sliding calliper, with the mandibles fixed in a reproducible position. Results showed that the mandibular foramen is on average 5.82 mm below the lingula. Regarding the statistical comparison between the mandibular foramen entrance and the antilingula position, there is no correlation between the position of those two structures in the studied sample. The mandibular foramen is slightly posterior in relation to the centre of the ramus. The lingula is an important anatomic landmark for ramus surgery, and for determining the distance to the mandibular foramen entrance. The use of the antilingula as a landmark for the position of the vertical ramus osteotomy is not recommended411747