Les algies oro-faciales chroniques idiopathiques (étiopathogénie, diagnostic, prise en charge thérapeutique)

TOULOUSE3-BU Santé-Centrale (315552105) / SudocTOULOUSE3-BU Sciences (315552104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Melanotic neuroectodermal tumour of infancy: a case report and review of the aetiopathogenic hypotheses.

The case of a 2-month-old healthy infant without relevant medical history. The patient was referred due to the aggravation of a swelling occupying the left half of the anterior maxilla. This lesion became visible approximately one month ago; it involved the buccal gingiva and alveolar bone, including the deciduous tooth germs 6.1 and 6.2. The swelling had dimensions of 20 mm x 20 mm. The surgical excision was performed under general anesthesia. The tooth buds of 6.1 and 6.2 were closely related to the tumour and so were removed. The lesion was entirely enucleated. The pathology of the lesion confirmed a melanotic neuroectodermal tumour of infancy. The melanotic neuroectodermal tumour of infancy (MNTI) has been described as a rare benign pigmented painless swelling that usually occurs in the anterior region of the maxilla and in the incisor region. The histological examination showed small basophilic cells, many containing melanin pigmentation within the cytoplasm, with a second population of larger cubical cells with abundant cytoplasm, arranged in alveolar or adenoid clusters. According to Krompecher this tumour derives from epithelial nests evolved at the time of embryonic fusion of the facial processes. It has also been suggested that the tumour arises from the retinal anlage by a pinching-off process of neuroepithelium during the formation of embryonic eye. More recently, the presence of high levels of vanillylmandelic acid suggest a neural origin of the tumour

Carie du biberon : un marqueur d’inégalités

La carie précoce de l’enfance affecte la dentition primaire avant l’éruption des dents permanentes. Elle est attribuée à l’utilisation prolongée d’un biberon contenant des hydrates de carbone fermentables. La carie précoce de l’enfance n’est pas seulement une maladie dentaire : c’est une affection sociale, culturelle et comportementale qui reflète les pratiques et les croyances autour de l’enfant. Les données suisses font penser qu’un enfant de 2 ans sur quatre est atteint de cette maladie dévastatrice, principalement dans les populations vulnérables. Le médecin de premier recours a un rôle dans le dépistage des enfants préscolaires. Il peut déterminer le niveau de risque de l’enfant. Il peut conseiller les familles et donner aux mères pendant leur grossesse des informations détaillées sur la carie précoce de l’enfance et sa prévention

Mandibular osteoradionecrosis in squamous cell carcinoma of the oral cavity and oropharynx: incidence and risk factors.

Objective. Mandibular osteoradionecrosis (ORN) is a serious complication of radiotherapy (RT) in head and neck cancer patients. The aim of this study was to analyze the incidence of and risk factors for mandibular ORN in squamous cell carcinoma (SCC) of the oral cavity and oropharynx.Study Design. Case series with chart review.Setting. University tertiary care center for head and neck oncology.Subjects and Methods. Seventy-three patients treated for stage I to IV SCC of the oral cavity and oropharynx between 2000 and 2007, with a minimum follow-up of 2 years, were included in the study. Treatment modalities included both RT with curative intent and adjuvant RT following tumor surgery. The log-rank test and Cox model were used for univariate and multivariate analyses.Results. The incidence of mandibular ORN was 40% at 5 years. Using univariate analysis, the following risk factors were identified: oral cavity tumors (P < .01), bone invasion (P < .02), any surgery prior to RT (P < .04), and bone surgery (P < .0001). By multivariate analysis, mandibular surgery proved to be the most important risk factor and the only one reaching statistical significance (P < .0002).Conclusion. Mandibular ORN is a frequent long-term complication of RT for oral cavity and oropharynx cancers. Mandibular surgery before irradiation is the only independent risk factor. These aspects must be considered when planning treatment for these tumors