Anterior mandibulotomy (mandibular swing) is an essentialsurgicalapproachto tumors of the oral cavity, oropharynx and parapharyngeal space. Objectives: to evaluate the feasibility of the technique, to determine frequency of complications and outcomes.This study consisted of 11 patients surgically treated for primary tumors in oral cavity, oropharynx and parapharyngeal space which included 7 females (64%) and 4 males(36%) with a mean age of 41.3 years, range from 40-65 years; lesion size range was 4-8 cm in greatest dimension. All patients underwent planned mandibular swing approach as part of the ablative surgery for different lesion in oral cavity, oropharynx and parapharyngeal space. Preoperative work-up included mandible evaluation with panoramicradiography that provided information on the dental anatomy and the mental foramen position. The mandibular swing approach that performed for patients has been evaluated regarding the surgical exposure which was obtained and achievement of these procedures.Paramedianmandibulotomy was used in 9 cases (82%) which used for exposure of lesions in oropharynx and parapharyngeal space, while median mandibulotomy was used in 2 cases (18%) which used for lesions in oral cavity. monocortical plate and screws were used in ten cases (91%), while transosseous wiring used in one case (9%) which result in subsequent nonunion mandibular osteotomy site. In ten cases (91%) the exposure was good, while in one case (9%) the exposure was limited. these procedures allow total removal of lesion in ten cases(91%) and it alloweddebulking of one case (9%). Only three patients (27%) have been received postoperative radiotherapy as adjuvant treatment for malignant lesion. The complication related to mandibular swing approach has been assessed and it was found that complication rate through the following up period that range from 6 -18 months was 36%. One patient had lost one of the incisors adjacent to the mandibulotomy site during the operation. One patient suffered from bony nonunion, one patient suffered from facial neuroparesis due to marginal mandibular nerve injury. The complication rate related to osteotomy was 18%.The lower lip splitting with paramedianmandibulotomy with miniplate fixation, is a safe, simple and reliable technique for providing excellent access to tumor of the oral cavity, oropharynx and parapharyngial space.
Background: Temporomandibular joint disorders (TMD) refer to a group of heterogeneous pain and dysfunction conditions involving the masticatory system, reducing life quality of the sufferers. Aim of study: The aim of the study was to evaluate the effectiveness of arthrocentesis with corticosteroid (betamethasone) injection and with sodium hyaluronate injection in treatment temporomandibular joint disorders, in conjunction with a stabilizing splint, for improving function and reducing pain, for preventing further deterioration of the TMJ dysfunction, to maintain improvements over time, and compare between them. Patients and methods: Fifty -four patients with TMJ disorders with age limit between 18 and 55 years of age, 9 males and 36 females, were enrolled in this study. Patients were randomly divided into two groups, in which one group received arthrocentesis with intra-articular corticosteroid (betamethasone) injection (1 ml), and another group received arthrocentesis with intra-articular sodium hyaluronate injection (1 ml) in superior joint space ,in single puncture. Patients were followed at regular interval of 7th day, one month, 3, 6, 9, 12 months (follow up) after last injection. Results: The mean age of patients was 8.873 ± 34.112 years in Group-A treat by betamethasone and10.973± 33.27 years in Group-A treat by sodium hyaluronate (ranged from 18.2 to 55.0 years).
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