1/42. Tracheal intubation in a child with trismus pseudocamptodactyly (Hecht) syndrome.Tracheal intubation of a child with trismus pseudocamptodactyly (Hecht) syndrome is described. This disorder is characterized by progressive trismus and the need for repeated surgeries. Children intubated orally on a prior occasion may require an alternative approach subsequently due to progressive inability to open the mouth. An antegrade fiberoptic-guided nasotracheal technique initially was chosen due to extremely limited mouth opening. After this approach was unsuccessful, a retrograde guidewire-assisted fiberoptic intubation was performed. The manifestations of Hecht syndrome, as well as both techniques for tracheal intubation employed, are reviewed.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
2/42. Anaesthetic management of two paediatric patients with Hecht-Beals syndrome.We undertook the anaesthetic management of two children with Hecht-Beals syndrome for orthopaedic surgery under general anaesthesia. Both patients had arachnodactyly, kyphoscoliosis, and multiple congenital joint contractures, but limited mandible excursion was not obvious preoperatively in either, although mental retardation made it difficult for them to cooperate with mouth examination. They had no apparent difficulties with their mouths in daily activities. The anaesthesia records of one patient showed that intubation had been difficult in an earlier procedure. The other patient also had a history of difficult intubation, with slight tearing of the corners of her mouth during an intubation procedure. During slow induction of general anaesthesia with sevoflurane, face mask ventilation was easily performed. We attempted to visualize the larynx under anaesthesia with muscle relaxation, but we were unsuccessful because of the limited mouth opening. After several trials, blind oral intubations were fortunately successful in both patients. There were no postoperative problems with the airway.- - - - - - - - - - ranking = 2keywords = mouth (Clic here for more details about this article) |
3/42. Synovial chondromatosis of the left temporomandibular joint superficially resembling chondrosarcoma: a case report.A 25 year-old woman was referred to the clinic complaining of pain in the left temporomandibular joint (TMJ) and trismus. According to the x-ray images, a solitary mass was observed in the anterior pouch of the lower joint cavity. The mass was removed by means of a synovectomy and a diskectomy. Upon light microscopic examination, the tissue removed showed high cellular activity. As a differential diagnosis, we had to consider the possibility of chondrosarcoma based on the histopathological features; however, since no invasive nor metastatic finding was recognized, we made a diagnosis of synovial chondromatosis despite its rare existence. Although there has been no sign of recurrence at present, we plan to carefully follow up with the patient.- - - - - - - - - - ranking = 0.0023378528342279keywords = cavity (Clic here for more details about this article) |
4/42. trismus due to bilateral mandibular coronoid hyperplasia.Bilateral mandibular coronoid hyperplasia is a rare cause of restricted mouth opening. diagnosis of the condition prior to general anaesthetic is essential, as oral intubation may be impossible. The reported case illustrates the role of computed tomography in assessment of the disorder and effective treatment by coronoidectomy.- - - - - - - - - - ranking = 0.5keywords = mouth (Clic here for more details about this article) |
5/42. Bilateral temporomandibular joint pseudogout.Pseudogout is an acute presentation of one type of crystal deposition disease in which calcium pyrophosphate dihydrate crystals are found in the joint spaces of synovial joints. In this case, a 56-year-old caucasian male presented with right sided preauricular swelling, temporomandibular joint arthralgia and restricted mouth opening; he developed identical symptoms on the left side two days later.- - - - - - - - - - ranking = 0.5keywords = mouth (Clic here for more details about this article) |
6/42. A pivoting appliance for intracavitary brachytherapy in patients with reduced mouth opening.PURPOSE: The risks of radiotherapy to normal tissues are well known. In many cases, a tumor patient suffering a relapse cannot undergo radiotherapy a second time. One exception may be the local application of brachytherapy. Afterloading devices allow the position of radiating materials near the site for treatment exactly according to three-dimensional treatment planning. This report shows the technical procedure for the fabrication of an intracavitary afterloading radiation device. MATERIALS AND methods: A 48-year-old woman who had received neutron radiotherapy and tumor surgery for adenoid cystic carcinoma had to be treated for relapse. The mouth opening was limited to 15 mm. The mixing tip of a silicone impression system was used as an axis for a pivoting appliance. RESULTS: Two years after reradiation, the patient was free of relapse symptoms, although an increased limitation of mouth opening was recorded. CONCLUSION: Even if the mouth opening is severely limited after tumor surgery and/or radiation, intracavitary brachytherapy still can be performed in edentulous patients using a pivoting device.- - - - - - - - - - ranking = 3.5keywords = mouth (Clic here for more details about this article) |
7/42. Surgical correction of trismus in a child with Hecht syndrome.Hecht syndrome is a rare condition that is also known as trismus pseudocamptodactyly syndrome. Short muscle and tendon units limiting the range of motion of upper and lower extremities and mouth characterize this disorder of muscle development. There is no consensus on the optimal treatment of temporomandibular joint (TMJ) ankylosis in this patient population. Endoscopic release in one patient resulted in early postoperative recurrence. The authors present a 28-month old boy who had a limited mouth opening of 6 mm. CT scan showed no bony ankylosis. The range of mouth opening did not to improve with physical therapy. The patient underwent extensive subperiosteal dissection of the mandible, bilateral coronoidectomy, and TMJ exploration. An intraoperative opening of 18 mm was achieved. The patient remained intubated until postoperative swelling resolved. He was extubated in the operating room 6 days later. The patient continued to improve with physical therapy. He had a 25-mm mouth opening at 12 months of follow-up.- - - - - - - - - - ranking = 2keywords = mouth (Clic here for more details about this article) |
8/42. trismus-pseudocamptodactyly syndrome: a case report.BACKGROUND: Hecht and Beals in 1969 described an autosomal dominant syndrome characterised by severe restriction of mouth opening, camptodactyly, shortness of leg muscles and, as a direct consequence, foot deformities. CASE REPORT: A case of a 4-year-old girl affected by this unusual syndrome is described. The patient underwent bilateral resection of coronoid processes by intraoral approach. An intraoral device was used in the immediate postoperative period in order to maintain mouth opening. Once at home, the patient has had, for six months, phisiokinesic therapy by means of a modified Darcissac device.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
9/42. osteoma of the condyle as the cause of limited-mouth opening: a case report.osteoma is a benign tumour consisting of mature bone tissue. It is an uncommon lesion that occurs mainly in the bones of the craniofacial complex. Only a few cases involving the condylar process have been reported. An osteoma of the left condyle causing limited mouth-opening in a 32-year-old Malaysian Chinese female is reported here to alert the practitioner to consider this lesion as a diagnostic possibility in instances of trismus or limited-mouth opening.- - - - - - - - - - ranking = 3keywords = mouth (Clic here for more details about this article) |
10/42. Removal of a deeply impacted mandibular third molar through a sagittal split ramus osteotomy approach.We describe the case of a 48-year-old man who, after a 5-year history of recurrent infection and intermittent trismus associated with a deeply impacted lower right third molar tooth, presented to the accident and emergency department with severely limited mouth opening, extensive facial swelling and pyrexia. The lower right third molar was later removed successfully through a sagittal split ramus osteotomy approach. This case shows that the sagittal split osteotomy continues to have a valuable role in the removal of deeply impacted lower third molars, particularly when they are in close proximity to the inferior alveolar nerve.- - - - - - - - - - ranking = 0.5keywords = mouth (Clic here for more details about this article) |
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