Ewing's tumor of the jaw

Previous reports have focused on the fact that laminar periosteal new bone is a common radiologic sign of Ewing's sarcoma of the jaws. Critical analysis of the literature does not lead to this conclusion. A case is reported and radiologic appearances described. A review of the literature shows striking clinical and radiologic similarities to osteogenic sarcoma of the jaws. A differential radiologic interpretation of Ewing's sarcoma of the jaws is offered.

Pitfalls in the use of the flexible bronchoscope in pediatric patients

Flexible bronchoscopy is an important diagnostic technique for study of pediatric patients with pulmonary problems. Many pitfalls await the unwary, but with experience and care, most can be overcome or circumvented.

Model systems for learning pediatric flexible bronchoscopy

Considerable practice is necessary to develop the skills essential to successful and safe performance of flexible bronchoscopy, especially in pediatric patients. We review a number of model systems, both mechanical and living, for learning and maturing bronchoscopic skills. For each of the animal models (canine, feline, leporine, and simian), the relevant anatomy and anesthetic techniques as well as the relative advantages and disadvantages of each model are discussed.

Acquired symptomatic bronchial stenosis in infants: successful management using an argon laser

Acquired bronchial stenosis following prolonged endotracheal intubation is uncommon, but in infants it is associated with significant morbidity. A variety of endobronchial techniques including forceps or cautery resection and balloon dilatation have been used with inconsistent results. Laser therapy seems attractive, but pediatric applications have been very limited. We report the first series of infants with life-threatening acquired bronchial stenosis treated with an argon laser. Eight infants, age 3 weeks to 2 years, presented with symptomatic bronchial obstruction following prolonged intubation. Seven of these patients had at least 90% obstruction of a lobar or mainstem bronchus. Under general anesthesia a 300 or 600 micron quartz laser fiber was passed through the suction channel of a 3.5-mm flexible or 3-mm rigid bronchoscope. The laser was operated at 2.5 to 3.5 W in 0.5-second pulses, to ablate the obstructing tissue. Multiple procedures, spaced no closer than 10 days, were required in three of eight infants. Follow-up bronchoscopy after 2 to 30 months revealed normal findings in five of eight infants. All but one child, who has persistent collapse of the bronchus intermedius due to bronchomalacia at the site of the obstruction, had satisfactory results. The only complication was a pneumothorax in a 1,300 g infant, which developed eight hours after treatment. Our experience suggests that the argon laser is effective in the management of endobronchial lesions in infants and is superior to the CO2 and Neo-dymium-yttrium aluminum garnet (Nd-YAG) lasers for this purpose.(ABSTRACT TRUNCATED AT 250 WORDS)

The role of dentistry in patients undergoing bone marrow transplantation

It is imperative that a comprehensive dental examination should be performed in all patients who are to undergo a bone marrow transplantation. Such assessments should be carried out prior to and after the transplantation procedure. This paper addresses the implications of marrow transplantation and the impact on dental treatment. The side-effects of transplantation chemotherapy, radiation treatment and graft versus host disease and their impact on the oral cavity are also discussed in this paper.

The immediate role of the dentist in the maxillectomy patient

It is imperative that comprehensive planning takes place for the potential maxillectomy patient. Input from the dentist is required for all stages of the procedure, from initial consultation to placement of the final prosthesis. By utilizing an interim dental prosthesis (splint), the impact of tissue loss, wound fibrosis and neurological damage can be minimized. In this paper, the authors address the initial stage in the treatment sequence, the surgical splint.

Thyroid dose distribution in dental radiography

The anatomic position and proven radiosensitivity of the thyroid gland make it an organ of concern in dental radiography. A calibrated thermoluminescent dosimetry system was used to investigate the absorbed dose (microGy) to the thyroid gland resultant from a minimum irradiated volume, intraoral full-mouth radiography technique with the use of rectangular collimation with a lead-backed image receptor, and conventional panoramic radiography performed with front and rear lead aprons. Use of the minimum irradiated volume technique resulted in a significantly decreased absorbed dose over the entire thyroid region ranging from 100% to 350% (p less than 0.05). Because this intraoral technique results in radiographs with greater image quality and also exposes the thyroid gland to less radiation than the panoramic, this technique may be an alternative to the panoramic procedure.

African Burkitt's lymphoma in the Cape province of South Africa and in Namibia

The clinical features, incidence and pattern of jaw involvement, and seasonal occurrence in relation to 22 patients with Burkitt's lymphoma in the Cape province and Southwest Africa were analyzed. The mean age, male dominance, and pattern of organ involvement paralleled typical African Burkitt's lymphoma. Development of the patients' disease was more likely during the rainy season. The frequency and pattern of jaw involvement resembled typical African Burkitt's lymphoma. The frequency of jaw involvement was similar in white and nonwhite patients. Members of all racial groups had typical African Burkitt's lymphoma.

The role of dentistry in head and neck radiation therapy

In the adult patient, oral complications of cancer radiotherapy stem from the deleterious effects of radiation on salivary glands, oral mucosa, mandibular musculature and alveolar bone. Clinical consequences of such treatment include xerostomia, rampant dental decay, mucositis, taste loss, osteoradionecrosis, infection, trismus, and nutritional stomatitis. These alterations to the normal state occur both during and after completion of head and neck radiation. Fig. 1 outlines the time frame involved in the development of each particular problem. In the past 20 years, many changes have occurred in the management of patients receiving radiation therapy. The traditional regimen of dental care in these patients was one of extracting all teeth encompassed by the radiation field. However, 15 years ago, this concept was questioned due to the incidence of post radiation caries (PRC) outside the zone of irradiation. The purpose of this paper is to review the major consequences of radiation treatment to the head and neck as well as outline the role of the dentist in the management of these patients.

Suitability of the panoramic radiograph for assessment of mesiodistal angulation of teeth in the buccal segments of the mandible

A mandibular phantom was used to investigate the suitability of the panoramic radiograph for assessment of the mesiodistal angulation of teeth in the buccal segments of the mandible. This Plexiglas model, housing steel pins at known angulation, was radiographed with both panoramic and plane-film techniques. Results indicated that plane-film techniques were more accurate than the panoramic technique for assessing mesiodistal root angulation.

Periostitis ossificans versus Garrè's osteomyelitis. Part II: Radiologic analysis of 93 cases in the jaws

Ninety-three clinically and radiologically diagnosed cases of periostitis ossificans were gathered over a 13-year period. Histologic specimens were available in 19 cases. The predominant age, race, and gender were determined. The position of the periosteal reaction, its average length and width, and radiographs required to best demonstrate it were also established. Sequestra were present in two thirds of the cases. Radiographic features and associated clinical findings are described.

Periostitis ossificans versus Garrè's osteomyelitis. Part I. What did Garrè really say?

In 1893, C. Garrè published an article dealing with the manifestations of acute osteomyelitis. Since then, his name has been associated with diseases such as Garrè's osteomyelitis, chronic sclerosing osteomyelitis, and periostitis ossificans, among others. Scrutiny of a translated version of the original article reveals that Garrè was not responsible for the description of the disease that now bears his name.