1 例肿瘤患者使用颧骨种植体进行颌面康复: 病例报告。
- 作者列表："Gómez-Pedraza A","González-Cardín V","Díez-Suárez L","Herrera-Villalva M
:Tumor ablation results in significant sequelae in the appearance, function, and esthetics of a patient with cancer, especially resection for head and neck cancer. Reconstruction with local and microvascular flaps is a workable option; however, the esthetic results will occasionally be unfulfilling and inadequate for the rehabilitation of lost structures. Prosthetic rehabilitation with conventional and zygomatic implants can provide favorable and predictable long-term results. We report the clinical case of a 53-year-old female patient with adenoid cystic carcinoma (ACC). The treatment protocol included radical surgery, radiotherapy, and maxillofacial rehabilitation with conventional and zygomatic implants. Management of an ACC case requires a timely, radical, and multidisciplinary approach. In our patient, rehabilitation of masticatory function was accomplished in the immediate postoperative period and before radiotherapy. The rehabilitation of masticatory function improved the patient's systemic and nutritional status and her speech, with coverage of the esthetic defect. These outcomes reduced the psychological and emotional effects of tumor ablation.
: 肿瘤消融导致癌症患者的外观、功能和美观方面出现显著后遗症，尤其是头颈癌切除术。局部和微血管皮瓣重建是可行的选择; 然而，美学结果偶尔会不令人满意，不足以修复丢失的结构。传统和颧骨植入物的假体康复可以提供有利和可预测的长期结果。我们报告 1 例 53 岁女性患者腺样囊性癌 (ACC) 的临床病例。治疗方案包括根治性手术、放疗和常规种植体和颧骨种植体的颌面康复。ACC 案件的管理需要及时、激进和多学科的方法。在我们的患者中，咀嚼功能的康复是在术后即刻和放疗前完成的。咀嚼功能的康复改善了患者的全身和营养状况以及她的言语，覆盖了美学缺陷。这些结果降低了肿瘤消融的心理和情绪影响。
METHODS:INTRODUCTION:Human papillomavirus (HPV) is the most common sexually transmitted infection and is associated with several types of cancer. The number of cases of HPV-associated head and neck squamous cell carcinomas (HNSCCs), especially oropharyngeal carcinomas, has increased significantly in recent years despite decreased tobacco smoking rates. Currently, no data concerning the risk factors and prevalence of HPV in HNSCC patients in all regions of Brazil are available, making it difficult to promote advances in this field of public health. Therefore, our goal is to determine the impact of infection by HPV, including HPVs with different genotypes, on head and neck cancer and the risk factors associated with the development of head and neck cancer in all regions of Brazil. METHODS AND ANALYSIS:This is a case-control study that will include 622 patients and 622 controls from all regions of Brazil. A questionnaire will be applied to gather information on sociodemographic, behavioural and health factors. Oral, cervical or penile/scrotal, and anal specimens and serum samples will be collected from all participants. Formalin-fixed paraffin-embedded tissue from tumour biopsies will be analysed only in the case group. Molecular and serological analyses will be performed to evaluate the presence and role of HPV in the development of head and neck cancer. ETHICS AND DISSEMINATION:This project was approved by the research ethical committee of the proposing institution (Hospital Moinhos de Vento, number 2.852.060). Ethical approval from the collaborators is currently under evaluation and is not yet complete. The results of this study will be presented at meetings with the Brazilian Ministry of Health through technical reports and to the scientific community at national and international events, with subsequent publication of scientific articles.
METHODS:BACKGROUND:Factors related to head and neck cancer and the treatment of the disease can affect quality of life. The aim of this study was to determine factors associated with the severity of impact on oral health-related quality of life (OHRQoL) in survivors of head and neck cancer using a multivariate analysis. METHODS:This cross-sectional study evaluated 90 volunteers who had completed radiotherapy at least 3 months earlier. OHRQoL was assessed using oral health impact profile (OHIP-14) and the data were analyzed using robust variance poisson regression models. RESULTS:The mean total OHIP-14 score was 23.98 ± 12.55. Patients with hyposalivation had 56% higher (worse) mean OHIP-14 total scores (CI:1.11-2.18) and patients with advanced stage tumors had 31% higher mean OHIP-14 total scores (CI:1.03-1.66) in multivariate analyses. CONCLUSION:OHRQoL of survivors of head and neck cancer experienced a negative impact following radiotherapy. The impact was associated with hyposalivation and advanced stage tumors.
METHODS:BACKGROUND:To immunohistochemically evaluate the association between the presence of cancer-associated fibroblasts (CAFs) and the tumour expression of podoplanin (PDPN) in head and neck squamous cell carcinoma (HNSCC) and their association with clinicopathological variables. MATERIAL AND METHODS:A tissue microarray (TMA) with biopsy sections from patients diagnosed with HNSCC was stained with antibodies against the CAFs marker, α-smooth muscle actin (α-SMA), and PDPN. We subsequently evaluated their expression to determine the association between them and with clinicopathological variables including age, primary tumour site, TNM stage, and tumour differentiation grade. RESULTS:Positive reaction to α-SMA was observed in the tumour stroma, revealing spindle-shaped cells compatible with CAFs, which showed a high expression in 62% of cases and a significant association with laryngeal carcinomas, advanced clinical stages, and lower tumour differentiation (P ≤ 0.05). PDPN staining on tumour cells showed low expression in 72% of cases, and it was not associated with any clinicopathological variable or with the presence of CAFs. CONCLUSIONS:The presence of CAFs in the tumour stroma is related to an aggressive phenotype and could increase as the disease progresses, although based on our findings, it would have no relationship, at least directly, with the expression of PDPN.