Mucosal necrosis of the palate after embolization for labial arterioveinous malformation

Objective: Cervico-facial arteriovenous malformations (AVMs) are complex and rare vascular lesions, and present in 0.1% of the population. Of traumatic or congenital origin, they are characterized by variable growth, and their complications can be disfiguring and potentially fatal. The treatment of choice is embolization followed by surgery if necessary. The main complications are recurrence and postoperative bleeding. Case report: We report the rare case of a 59-year-old female patient who underwent embolization of a right upper labial and jugal AVM, followed by complete necrosis of the right hemi-palatal mucosa associated with dental mobility and pain. Follow-up at 6 months showed complete reepithelialisation of the palate.  Conclusions: Soft tissue necrosis after AVM embolization is a rare event and is more commonly described after embolization for epistaxis. The evolution is generally favourable within a few weeks.    Objective: Cervico-facial arteriovenous malformations (AVMs) are complex and rare vascular lesions, and present in 0.1% of the population. Of traumatic or congenital origin, they are characterized by variable growth, and their complications can be disfiguring and potentially fatal. The treatment of choice is embolization followed by surgery if necessary. The main complications are recurrence and postoperative bleeding. Case report: We report the rare case of a 59-year-old female patient who underwent embolization of a right upper labial and jugal AVM, followed by complete necrosis of the right hemi-palatal mucosa associated with dental mobility and pain. Follow-up at 6 months showed complete reepithelialisation of the palate. Conclusions: Soft tissue necrosis after AVM embolization is a rare event and is more commonly described after embolization for epistaxis. The evolution is generally favourable within a few weeks.   &nbsp

CURRENT THERAPEUTIC APPROACH OF THE WHITE SPONGE NAEVUS OF THE ORAL CAVITY.

We report a case of White Sponge Naevus of the tongue in a 50 years-old man. White Sponge Naevus of the oral cavity is a rare, benign and dominant autosomic inherited disorder, which presents in the form of a white, hyperplasic and verrucous or spongious lesion of the oral mucosa. Differential diagnosis is clinically difficult with more common white lesions of the oral cavity. Various therapeutic approaches have been proposed. Systemic antibiotics or local applications of retinoic acid provide limited benefits but are poorly effective. To our knowledge, CO2 Laser has never been tried to treat a White Sponge Naevus of the oral cavity. We performed a complete removal of the lesion with CO2 Laser, but complete recurrence occurred. Finally, a surgical resection was realized, which proved to be effective. Two years later, the patient is free of recurrence. This article proposes a review of the literature on what is known on White Sponge Naevus of the oral mucosa. We stress the importance of confrontation between anamnesis, clinical examination and pathologic findings to lead to the proper diagnosis of this rare disease

Rôle du microbiome dans la transformation maligne des lésions/affections potentiellement malignes de la muqueuse buccale

Rôle du microbiome dans la transformation maligne des lésions/affections potentiellement malignes de la muqueuse buccal

Successful treatment of grade III osteoradionecrosis with mandibular fracture with pentoxifylline, tocopherol and clodronate.

Osteoradionecrosis (ORN) is one of the most severe complications after head and neck radiotherapy. Once established, ORN is difficult to manage and is traditionally considered to be irreversible. Since the recent understanding of the pathophysiology of ORN is based on the concept of radiation-induced fibrosis, a new therapeutic medical regimen has been proposed comprising the combination of pentoxifylline, tocopherol and clodronate (PENTOCLO). A 55-year-old woman presented with grade III ORN with large intraoral bone exposure, a fracture of the left posterior horizontal branch and an orocutaneous fistula. Because she refused surgery, medical treatment with PENTOCLO was proposed. After 55months of treatment, there was complete mucosal coverage and complete consolidation of the fracture site around the orocutaneous fistula. PENTOCLO treatment can help some patients with grade III disease, as in this case. Further prospective randomized controlled trials are needed to confirm this result

ostéochimionécroses des mâchoires

Définition, mécanismes, traitements en cause, facteurs de risque, préventio

Ostéonécrose des mâchoires secondaire à un traitement par ustekinumab pour une maladie de Crohn

Les ostéonécroses des mâchoires (ONM) sont décrites depuis 2003, d’abord après prise de bisphosphonates, puis de dénosumab, autre anti-résorbeur osseux (ARD). Récemment, d’autres molécules telles les agents antiangiogéniques, les thérapies ciblées et les immunomodulateurs ont été mises en cause dans l’apparition d’ONM. Toutefois, l’ONM liée à l’immunothérapie est rarement décrite. Quelques rares cas sont décrits après traitement par anti-TNF-α (infliximab, adalimumab) et plus rarement après anti-PDL1 (pembrolizumab). Nous décrivons le premier cas en relation avec un anti-IL-12/IL-23 (ustékinumab) dans le cadre du traitement d’une maladie de Crohn, sans antécédant de traitement par ARD

Medication related osteonecrosis of the jaw around previously osseointegrated implants: about 5 cases

Medication related osteonecrosis of the jaw around previously osseointegrated implants: about 5 case

Mélanome de la muqueuse buccale

Introduction: The oral melanoma (OM) account for 1% of all melanomas. The prognosis is poor despite an adequate locoregional control of the disease. Clinical case: A 45-year-old woman presented with submandibular lymph nodes, having metastised from a melanoma. Oral cavity examination revealed a pigmented lesion of the gingiva in front of tooth 12, with satellite spots. Surgical treatment, radiotherapy, chemotherapy, and immunotherapy failed and the patient died 16 months after diagnosis. Discussion: Oral melanomas have a poor prognosis probably because they are generally detected late. The most common sites for oral melanomas are the palate and maxillary gingiva. About 30% of OM is preceded by areas of oral pigmentation for several months or years. The prognosis is poor with a 5% to 20% five-year survival rate. © 2008 Elsevier Masson SAS. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

UTILISATION DE PRF DANS UN RETARD DE CICATRISATION PROFONDE DE PLAIES DE TRACHEOTOMIE ET CERVICOTOMIE POST-EVIDEMENT GANGLIONNAIRE DANS LE CADRE D’UN CARCINOME EPIDERMOÏDE DE LA LANGUE

Matériel et méthode : Le PRF est utilisé pour sa capacité à délivrer d’importantes concentrations de facteurs de croissance autologues aux tissus hôtes favorisant la réparation tissulaire. Nous rapportons un cas d’utilisation de PRF au niveau des tissus profonds (plaie de trachéotomie et cervicotomie) chez une patiente de 48 ans atteinte d’un carcinome épidermoïde de langue, traitée par glossectomie, évidement cervical, trachéotomie et reconstruction par lambeau radial. La cicatrisation était lente avec une déhiscence des sutures cervicales et de trachéotomie. La patiente ne présentait pas d’hypoprotéinémie ni autre facteur de risque de retard de cicatrisation hormis un tabagisme actif. Plusieurs avivements des deux plaies ont été réalisés afin de stimuler le saignement et la fermeture des berges sans résultat concluant. Un mois après l’intervention, les plaies présentant toujours un aspect sec et atone, des membranes de PRF ont été placées dans les deux sites. Résultats : Cinq jours après le placement de PRF, les tissus sous-cutanés adhéraient aux plans profonds au niveau des deux sites. Un suivi rapproché pendant quinze jours montrait une cicatrisation complète permettant le traitement de radiothérapie post-opératoire. Conclusion : Nous rapportons le cas de comblement de plaies de trachéotomie et cervicotomie par du PRF dans un retard de cicatrisation profonde un mois après évidement cervical et trachéotomie. La fermeture des deux sites était acquise en quinze jours permettant la suite du traitement oncologique