The Use of Ivermectin in the Adjunct Treatment of Oral Cavity Myiasis

Oralna mijaza općenito je povezana s lošom higijenom usta, alkoholizmom, senilnošću te gnojnim lezijama i neoplazmama. Gotovo je redovita kod starijih pacijenata, posebice onih s mentalnim poremećajima i posebnim potrebama. U literaturi su opisane različite metode liječenja te oralne patologije, no ni jedna nije potpuno učinkovita. U ovom prikazu slučaja ističe se uporaba ivermectina kao alternativne terapije u liječenju mijaze. Ovaj lijek praktičan je u primjeni, dobro se apsorbira i razmjerno brzo postiže visoku koncentraciju u krvi. U ovom su članku predstavljena dva slučaja pacijenata iz doma za umirovljenike primljenih u hitnu službu bolnice Passo Fundo u São Vicente de Paulu u Brazilu s kritičnim stanjem oralne mijaze i apscesom zuba. Osim što su se uklanjale rukom, ličinke su isprane oksigeniranom vodom (10 vol.) i 0,12-postotnim klorheksadin-glukonatom (CHX). Kao pomoćna terapija tri je dana ordiniran ivermectin u dozi od 6 mg. Taj se lijek pokazao kao jednostavna pomoćna terapija u liječenju ove oralne patologije.Oral myiasis is generally associated to poor oral hygiene, alcoholism, senility, suppurative lesions, and neoplasia and has been constantly reported in elderly patients and/or patients with mental disorders and special needs. Different methods have been described for the clinical treatment of human myiasis, however, none of them were completely effective. This paper suggests that oral Ivermectin is considered an alternative therapy for myiasis. This medication is practical to administrate and presents quick absorption with high blood concentration in relatively little time. The present article reports two cases of elderly patients who were residents of geriatric homes and were referred to the emergency unit of the Hospital São Vicente de Paulo of Passo Fundo – RS, Brazil, with a critical condition of oral myiasis and septic teeth. For treating the larvae present in the oral cavity, washing procedures with 10 vol. oxygenated water and 0.12% Chlorhexidine gluconate (CHX) were performed, plus manual removal of the larvae. As adjunct systemic treatment, Ivermectin 6 mg was administered for 3 days, which proved to be quite a viable and easy implementation, serving as a good option in the adjunct treatment of this kind of pathology

Quiste óseo aneurismático Aneurysmal bone cyst

El quiste óseo aneurismático (QOA) es una lesión benigna rara en huesos maxilares, su mayor frecuencia es en huesos largos del esqueleto y columna vertebral. Algunos autores especulan que el origen sea por trauma, mala formación o un neoplasma. El aspecto radiográfico puede mostrar desde una imagen difusa hasta una imagen bien definida, muy semejante a las otras lesiones de los maxilares volviendo el diagnóstico diferencial amplio. Con la destrucción del córtex óseo puede todavía formar una imagen reaccional del periostio en forma de rayos de sol, característico de una lesión maligna. En este estudio, se presenta caso de paciente femenino, 17 años de edad, que buscó el Servicio de Cirugía y Traumatología Buco maxilofacial del Hospital São Vicente de Paulo-RS, que presentó dolor y aumento de volumen en la mandíbula. Informó que hace cerca de un año empezó a sentir malestar en la región junto al ángulo mandibular derecho, lo cual fue progresivamente aumentando de volumen. El aspecto radiográfico acordaba una lesión maligna. Después de la confirmación histopatológica de QOA, el tratamiento seleccionado para el caso fue quirúrgico conservador, con legrado de la cavidad ósea, y fue mantenido en control posoperatorio de rutina con 6 y 18 meses. En las radiografías panorámicas realizadas se verifica la neoformación ósea y cura del caso.<br>The aneurysmal bone cyst (ABC) is a benign and rare lesion in maxillary bones, is more frequent in largo bones of skeletal and spinal column. Some authors speculate about that its origin be traumatic, malformation of neoplasm. The radiographic appearance may to show from a diffuse image up to a well defined image very similar to the other maxillary lesions turning wide the differential diagnosis. With destruction of the bon cortex it is possible to create a reaction image of periosteum in sunbeams characteristic of malignant lesion. This is the case of a female patient aged 17 seeking help in the Bucco-maxillofacial Surgery and Traumatology Service of the São Vicente de Paulo Hospital _ RS, presenting with pain and an increased mandibular volume. She manifested that around one year she began to feel a discomfort next to he right mandibular angle, which was progressively increasing the volume. The radiographic appearance resembled a malignant lesion. After the histopathology verification of ABC, treatment choosed for this case was of type conservative surgical with bone cavity curettage and was maintained under systemic postoperative control for 6 and 18 months. In the taken panoramic radiographies is verified the bone neoformation and the cure of case

Associated Injuries in Patients with Maxillofacial Trauma at the Hospital São Vicente de Paulo, Passo Fundo, Brazil

Objectives: This study aimed to identify the occurrence, type and severity of body injuries associated in patients with facial trauma, referred to the Hospital São Vicente de Paulo (HSVP) in the city of Passo Fundo - RS, Brazil.Material and Methods: The study analyzed medical records of 1385 patients who were treated in the Department of Oral and Maxillofacial Surgery at HSVP during the period from 1991 to 2010.Results: According to the results of this study we observed that 35% of cases of facial fractures were associated with a body injury. It was recorded a higher incidence of facial fractures in the male population (82.6%), aged between 20 and 39 years. The main etiologic factors for this association were car accidents, falls and assaults. Most fractures were recorded in the mandible and the main body injury found was the abrasion associated in some region of the body, however, when considering fractures of the face middle third the main body injury was more associated with cranioencephalic trauma.Conclusions: Concomitant injuries in areas other than the face should be expected first and foremost after high-speed trauma mechanisms and in association with severe facial fractures. The results underscore the importance of multiprofessional collaboration in diagnosis and sequencing of treatment who have sustained facial fractures