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Nelke K, Morawska-Kochman M, Kowalski P, Dobrzyński M, Guziński M. A proposed protocol for correlation between bone density in hemimandibular hyperplasia radiography and histopathological findings - A retrospective study. J Craniomaxillofac Surg 2024; 52:196-202. [PMID: 38195296 DOI: 10.1016/j.jcms.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 09/07/2023] [Accepted: 11/23/2023] [Indexed: 01/11/2024] Open
Abstract
The role of low-dose computed tomography (LDCT) in surgical planning can be assessed based on the correlation among bone density (BD/HU), radiographic values, and the histopathological appearance of hyperplastic overgrowth in mandibular condyles (hemimandibular hyperplasia/osteochondroma). The aim of this study was to evaluate the correlation between LDCT indices of bone-density measurements in surgical planning and histopathological specimens. The patients incuded in this study underwent detailed radiological evaluation as preparation for further clinical procedures. Excised condyles were evaluated in terms of bone density index using LDCT, and then histopathologically to investigate the accuracy of surgical procedures and set the basis for future surgical planning. An index value between both condyles' bone densities represented the relative difference between the healthy condyle and the side with hemimandibular hyperplasia (HH). Patients with unilateral condylar hyperplasia (UCH) showed a statistical correlation between condyle heads with increased bone density (BD) and scintigraphic (SCI) values (p < 0.001). On the other hand, correlation between BD and histopathological studies alone was significant (p < 0.001). With the increase in BD measured in HU in UCH condyles, the overall value of fibrous cartilage layer thickness decreased (p < 0.001). Furthermore, histopathological evaluation indicated that increased bone density on the UCH side resulted in increased total thickness (p > 0.001). The proposed index measurements in the mandibular condyles based on LDCT/BD can be used to estimate the degree of required surgical resection. Results from LDCT radiographic studies correlate with histopathological specimens more than scintigraphy.
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Affiliation(s)
- Kamil Nelke
- Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland; Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland.
| | - Monika Morawska-Kochman
- Department of Otolaryngology, Head and Neck Surgery, Wrocław Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Przemysław Kowalski
- Department of Clinical and Experimental Pathology, Wrocław Medical University, 50-556 Wrocław, Poland
| | - Maciej Dobrzyński
- Department of Pediatric Dentistry and Preclinical Dentistry, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland
| | - Maciej Guziński
- Department of Radiology, Wrocław Medical University, Borowska 213, 50-556 Wrocław, Poland/
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Orabona GD, Abbate V, Maffia F, Romano A, Bonavolontà P, Valletta A, Iaconetta G, Califano L. Piezoelectric Condylectomy Through Transoral Endoscopic Approach: A Cadaveric Study. Indian J Otolaryngol Head Neck Surg 2023; 75:963-966. [PMID: 37275105 PMCID: PMC10235273 DOI: 10.1007/s12070-022-03168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/09/2022] [Indexed: 11/08/2022] Open
Abstract
Surgical approaches in the treatment of TMJ pathologies are a much-debated topic in literature. We propose a new surgical approach performed by intraoral access and completed by endoscopic magnification and long-tip piezosurgery assistance. A piezosurgery (Piezosurgery Plus, Mectron s.p.a. 2014) with a long angled tip (MT5-10 L) was used to perform an endoscopically assisted condylectomy. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03168-0.
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Affiliation(s)
- Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Francesco Maffia
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Alessandra Valletta
- Dentistry Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Giorgio Iaconetta
- Neurosurgery Unit Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano Salerno, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
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