Submental

Submental
  • 文章类型: Case Reports
    (1)背景:舌下间隙皮样囊肿并不常见,通常表现为无痛,群众逐渐扩大,通常直径不超过3厘米。由于其临床表现,这些囊肿可能类似于各种疾病,在口腔中的发生率相对较低,约占所有皮样囊肿的1.6%。(2)方法:我们介绍了一例17岁的女性,患有累及下颌的巨大皮样囊肿,舌下,和语言区域,几年来未确诊。通过MRI和细针穿刺获得诊断,导致通过子宫颈入路手术切除的决定。(3)结果:愈合过程顺利。手术后的第一天,病人开始了肌功能疗法,成功地恢复了适当的舌头功能。在24个月的随访中,患者保持无症状。(4)结论:宫颈入路可成功治疗累及颌下的巨大口腔皮样囊肿,舌下,和语言空间。手术治疗后,通过肌功能疗法可以成功恢复舌功能。
    (1) Background: Dermoid cysts occurring in the sublingual space are uncommon, typically manifesting as painless, gradually enlarging masses, usually not exceeding 3 cm in diameter. These cysts can resemble various conditions due to their clinical presentation, with a relatively low occurrence rate in the oral cavity, accounting for about 1.6% of all dermoid cysts. (2) Methods: We present the case of a 17-year-old female with a giant dermoid cyst involving the submental, sublingual, and lingual areas, undiagnosed for several years. Diagnosis was achieved through MRI and fine-needle aspiration, leading to the decision for surgical removal through a cervical approach. (3) Results: The healing process was uneventful. From the first day post-surgery, the patient began myofunctional therapy, successfully regaining proper tongue functions. Throughout a 24-month follow-up, the patient remained symptom-free. (4) Conclusions: A cervical approach can successfully treat giant oral dermoid cysts involving submental, sublingual, and lingual spaces. Tongue function can be successfully regained through myofunctional therapy after surgical treatment.
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  • 文章类型: Case Reports
    颌面部骨折伴鼻/颅底骨折可能会排除鼻气管插管,口气管插管可能会阻碍手术进入。在这些情况下,蛛网膜下插管是一种安全且广为接受的替代方案,与低发病率和并发症发生率相关。我们报告了一例这种罕见的并发症,其中在下下插管后,患者出现舌下唾液膨出,与周围纤维化的下颌下管扩张有关。我们遇到的继发性舌下唾液腺膨出可能是由于mental下插管技术的错误所致。因此,全面了解颌下区和颌下区的解剖结构对避免并发症很重要。
    Maxillofacial fractures with the nasal/skull base fractures may preclude nasotracheal intubation, and oro-tracheal intubation may obstruct surgical access. In these cases, submental intubation is a safe and well-accepted alternative, associated with low morbidity and complication rate. We report a case of one such rare complication, wherein following submental intubation, the patient presented with a sublingual sialocele, associated with dilatation of the submandibular duct with surrounding fibrosis. The secondary sublingual sialocele we encountered could have been due to errors in the technique of submental intubation. Hence, thorough knowledge of the submental and submandibular region\'s anatomy is important to avoid complications.
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  • 文章类型: Case Reports
    皮样囊肿是口腔颌面部最不常见的发育性囊肿。它们可能是先天性或获得性的,被视为缓慢和进行性的无症状肿胀。很难区分插入的ranulas和插入的皮样囊肿,因为它们都具有非常相似的临床特征。然而,由于两个实体都有不同的治疗策略,区分开来是很重要的。一名57岁的男性患者向口腔医学和放射科报告,精神下区域有很大的肿胀。据我们所知,本病例报告是首例显示如此广泛的皮样囊肿的病变,类似于老年男性患者的ranula。该报告主要关注达到最终诊断所面临的诊断挑战。
    Dermoid cysts are the least commonly occurring developmental cysts in the oral and maxillofacial region. They may be congenital or acquired and are seen as asymptomatic swellings that are slow and progressive. It is very difficult to differentiate plunging ranulas from plunging dermoid cysts as both of them have very similar clinical features. However, since both entities have different treatment strategies, it is important to differentiate one from the other. A 57-year-old male patient reported to the Department of Oral Medicine and Radiology with a large swelling in the submental region. To the best of our knowledge, the present case report is the first one showing such an extensive lesion of plunging dermoid cyst mimicking plunging ranula in an elderly male patient. The report mainly focuses on the diagnostic challenges faced to reach the final diagnosis.
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    文章类型: Journal Article
    目的:分析克氏针悬吊术在甲状腺乳头状癌(PTC)中的临床疗效。
    方法:回顾,我们纳入了2020年12月至2021年12月在南昌大学第二附属医院接受治疗的112例PTC患者。其中,60例(腹腔镜组)采用克氏针悬吊术进行无气腹经口下ETE,另外52例(开放组)采用传统甲状腺切除术。手术指标(手术时间(OT),术中失血(IBL),和术后引流量(DV)),中央淋巴结(CLN)的数量,住院时间(LOS),视觉模拟评分(VAS)评分,审美满意度得分,观察并比较两组患者的并发症。
    结果:两组的OT差异无统计学意义(55.73±5.49分钟vs.55.00±7.79分钟),IBL(20.67±7.75mLvs.23.08±6.24mL),术后DV(33.17±15.09mLvs.39.52±19.22mL),解剖的CLN数量(5.54±2.75vs.5.43±3.15),LOS(3.63±0.69dvs.3.68±0.57d),术后VAS评分(3.19±1.07分vs.3.38±1.09分),和总并发症发生率(3.85%vs.8.33%;全体P>0.05)。然而,腹腔镜组的美学满意度评分明显高于开腹组(7.10±1.46分vs.6.42±1.46分;P<0.05)。此外,两组患者均随访至少3个月,未观察到复发或转移。
    结论:采用克氏针悬吊术的无气体经口下ETE可提供与传统甲状腺切除术相当的疗效和安全性,但它提供了优越的美学效果,使其成为PTC患者的可行治疗选择。
    OBJECTIVE: To analyze the clinical efficacy of gasless submental-transoral endoscopic thyroidectomy (ETE) with Kirschner wire suspension in patients with papillary thyroid carcinoma (PTC).
    METHODS: Retrospectively, we enrolled 112 patients with PTC who received treatment in The Second Affiliated Hospital of Nanchang University between December 2020 and December 2021. Among them, 60 cases (laparoscopic group) received gasless submental-transoral ETE with Kirschner wire suspension, and the other 52 cases (open group) were treated by traditional thyroidectomy. Surgical indicators (operative time (OT), intraoperative blood loss (IBL), and postoperative drainage volume (DV)), number of central lymph node (CLN) dissected, length of hospital stay (LOS), Visual Analogue Scale (VAS) score, aesthetic satisfaction score, and complications were observed and compared between the two groups.
    RESULTS: There was no significant difference between the two groups in OT (55.73±5.49 min vs. 55.00±7.79 min), IBL (20.67±7.75 mL vs. 23.08±6.24 mL), postoperative DV (33.17±15.09 mL vs. 39.52±19.22 mL), number of CLN dissected (5.54±2.75 vs. 5.43±3.15), LOS (3.63±0.69 d vs. 3.68±0.57 d), postoperative VAS score (3.19±1.07 points vs. 3.38±1.09 points), and total complication rate (3.85% vs. 8.33%; all P>0.05). However, the laparoscopic group exhibited a significantly higher aesthetic satisfaction score than the open group (7.10±1.46 points vs. 6.42±1.46 points; P<0.05). In addition, patients in both groups were followed up for at least 3 months, and no recurrence or metastasis was observed.
    CONCLUSIONS: Gasless submental-transoral ETE with Kirschner wire suspension offers comparable curative effect as traditional thyroidectomy and safety, but it provides superior esthetic results, making it a viable treatment option for patients with PTC.
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  • 文章类型: Case Reports
    此儿科病例报告描述了并发的精神下和舌状皮样囊肿的新发现,据我们所知,以前在文献中没有报道过。囊肿累及舌头的病因,嘴巴的地板,下颈部是多种多样的,代表先天性,炎症,和肿瘤来源。涉及这些区域的皮样囊肿并不常见,最常见的是在下巴下,舌下,和语言空间。表现出的症状随囊肿的大小和位置而变化。MRI是区分皮样囊肿与其他病因的首选方式。虽然介入技术已被用于治疗其他头颈部的皮样囊肿,对于涉及口腔和口底结构的患者,手术切除仍然是首选治疗方法。
    This pediatric case report describes the novel finding of concurrent submental and lingual dermoid cysts, which to our knowledge, has not been previously reported in the literature. The etiology of cysts involving the tongue, floor of the mouth, and submental neck is varied, representing congenital, inflammatory, and neoplastic sources. Dermoid cysts involving these regions are uncommon and are most frequently reported in the submental, sublingual, and lingual spaces. Presenting symptoms vary with cyst size and position relative to the mylohyoid muscle. MRI is the preferred modality to differentiate dermoid cysts from other etiologies. While interventional techniques have been utilized to treat dermoid cysts in other head and neck locations, surgical excision remains the preferred treatment for those involving oral and floor-of-mouth structures.
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  • 文章类型: Case Reports
    猴痘病毒感染的特征是前驱疾病伴发烧,剧烈头痛,淋巴结病,背痛,肌痛,和虚弱,其次是皮肤损伤的爆发。一个病例系列报告了猴痘病毒感染与原发性肛门生殖器和面部蜂窝织炎。此外,在一些病例报告中已经报道了叠加的细菌感染。我们介绍了一例猴痘病毒感染病例,该患者表现为颌骨肿胀,最初被认为是蜂窝织炎/脓肿聚集所致。一名接受艾滋病毒暴露前预防的25岁同性恋男性因痛苦而被送往紧急护理中心,破裂,下巴结痂病变。鉴于最近与猴痘病毒感染患者的接触,收集了猴痘拭子。然后他发烧了,下巴/颈部肿胀,吞咽困难,这促使他来到我们的急诊室.他在演讲中发热和心动过速。实验室并不引人注目。颈部CT扫描显示两侧颌下和颌下区软组织增厚,与蜂窝织炎一致,没有脓肿形成的证据。它还显示了突出的双侧颌下和左侧IIA淋巴结肿大。我们开始给病人静脉注射氨苄西林-舒巴坦,但他的肿胀加重了.我们怀疑脓肿形成临床;然而,经皮引流尝试产生干水龙头。我们加了万古霉素来增加保险,但是病人仍然发热,他的肿胀继续恶化。同时,他的猴痘病毒聚合酶链反应(PCR)拭子结果为阳性,还有其他皮肤损伤.这两个发现以及抗生素治疗缺乏改善使我们相信他的发烧是猴痘继发的,而肿胀是真正的蜂窝织炎的反应性淋巴结病继发的。我们停止了他的抗生素,随着下巴肿胀的完全消退,他的症状有所改善。由于最初认为患者的肿胀继发于蜂窝织炎和脓肿收集,因此该病例难以处理,但结果是淋巴结肿大继发的。此病例说明了猴痘病毒感染中淋巴结病的重要性和严重程度,最初可能会被误诊为蜂窝织炎。
    Monkeypox virus infection is characterized by a prodromal illness with fever, intense headache, lymphadenopathy, back pain, myalgias, and asthenia, followed by the eruption of skin lesions. A case series has reported monkeypox virus infection with primary anogenital and facial cellulitis. In addition, superimposed bacterial infections have been reported in several case reports. We present a monkeypox virus infection case of a patient presenting with jaw swelling initially thought to be secondary to cellulitis/abscess collection. A 25-year-old homosexual male on HIV pre-exposure prophylaxis presented to an urgent care center with a painful, ruptured, crusted chin lesion. Given recent contact with monkeypox virus-infected patients, a monkeypox swab was collected. He then developed a fever, jaw/neck swelling, and difficulty swallowing, which prompted him to come to our emergency department. He was febrile and tachycardic on presentation. The labs were unremarkable. A CT scan of the neck showed soft tissue thickening within the submental and submandibular regions bilaterally, consistent with cellulitis without evidence of abscess formation. It also showed prominent bilateral submandibular and left station IIA lymphadenopathy. We started the patient on intravenous ampicillin-sulbactam, but his swelling worsened. We suspected abscess formation clinically; however, a percutaneous drainage attempt yielded a dry tap. We added vancomycin for extra coverage, but the patient remained febrile, and his swelling continued to worsen. In the meantime, his monkeypox virus polymerase chain reaction (PCR) swab result returned positive, and he developed other skin lesions. These two findings and the lack of improvement with antibiotic therapy led us to believe that his fever was secondary to monkeypox and the swelling was secondary to reactive lymphadenopathy over true cellulitis. We stopped his antibiotics, and his symptoms improved with a complete resolution of the jaw swelling. This case was challenging to manage as the patient\'s swelling was initially thought to be secondary to cellulitis and abscess collection, but it turned out to be secondary to lymphadenopathy. This case illustrates the significance and severity of lymphadenopathy in monkeypox virus infection, which can be initially misdiagnosed as cellulitis.
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  • 文章类型: Case Reports
    化脓性汗腺炎(HS)是一种慢性炎症性疾病,其特征是深层疼痛结节,经典的是在身体的三齿间的皮肤和大汗腺丰富的区域,如肛门生殖器,腋窝,乳房下和腹股沟区。这是一个35岁女性的案例,谁是已知的臀部HS,她接受了颈部抽脂手术,然后由于颈前HS而变得复杂,这被认为是一个非典型的位置。患者接受了抗生素治疗,并表现出巨大的改善。此外,在对药物治疗没有反应的患者中,手术治疗通常是通过切开受影响的区域,并使伤口开放以通过次要意图治愈,或者如果该区域广泛,则用皮肤移植物覆盖。
    Hidradenitis suppurativa (HS) is a chronic inflammatory disorder that is characterized by deep-seated painful nodules, classically in the intertriginous skin and apocrine gland-rich areas of the body such as the anogenital, axillary, inframammary and inguinal regions. This is a case of a 35-year-old female, who is known to have gluteal HS, she underwent neck liposuction procedure that was then complicated by anterior neck HS, which is considered as an atypical location. The patient received medical treatment with antibiotics and showed huge improvement. In addition, in patients who do not show response to medical therapy, surgical treatment is usually carried out by incising the area affected and leaving the wound open to be healed by secondary intention or covering it with a skin graft if the area is extensive.
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  • 文章类型: Journal Article
    本研究旨在研究使用达芬奇SP系统通过胸骨前和下入路进行远程访问甲状腺切除术的可行性。
    在五个尸体模型中进行了双侧甲状腺切除术。在两个尸体中使用了胸骨前区的单个切口,在三具尸体中使用了the下整容切口方法。
    在一具尸体中进行胸骨前入路,在三具尸体中进行下入路,完成了远程访问甲状腺切除术。所需的皮瓣发育很少,对于所有程序,SP系统的对接时间都很快。胸骨前入路皮肤切口后甲状腺完全暴露的时间少于30分钟,而下手术少于27分钟。在胸骨前入路中完成全甲状腺切除术需要83分钟,在下入路中需要67至127分钟。不需要额外的端口来暴露腺体并完成双侧切除。
    使用达芬奇SP系统在单切口胸骨前和下入路中进行甲状腺全切除术是可行的,与其他目前应用的机器人方法相比是有希望的。需要进一步的研究来评估使用daVinciSP系统进行胸骨前或下甲状腺切除术是否在实际患者中提供临床益处。
    UNASSIGNED: This study aims to study the feasibility of a remote-access thyroidectomy through presternal and submental approaches with the da Vinci SP system.
    UNASSIGNED: Bilateral thyroidectomies were performed in five cadaveric models. A single incision in the presternal area was used in two cadavers, and a submental facelift incision approach was used in three cadavers.
    UNASSIGNED: Performing remote-access thyroidectomy was completed with a presternal approach in one cadaver and with the submental approach in three cadavers. The required skin flap development was minimal, and the docking time for the SP system was quick for all procedures. Time to full exposure of the thyroid gland after skin incision was less than 30 min for the presternal approach and less than 27 min for the submental procedure. Completing total thyroidectomies took 83 min in the presternal approach and between 67 and 127 min in the submental access. No additional ports were required to expose the gland and complete the bilateral resection.
    UNASSIGNED: Total thyroidectomy was feasible with the da Vinci SP system in single incision presternal and submental approaches comparing promisingly with other currently applied robotic methods. Further studies will be required to assess whether a presternal or submental thyroidectomy with the da Vinci SP system provides clinical benefits in real patients.
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  • 文章类型: Journal Article
    经口内窥镜前庭入路甲状腺切除术(TOETVA)的发展受到固有缺陷的限制,如精神神经损伤和二氧化碳(CO2)相关并发症。在这里,我们提出了一种无CO2的新技术,称为无气体经口下联合入路内镜甲状腺切除术(STET),以解决TOETVA中的问题。
    我们回顾了从2020年11月至2021年11月在我们机构使用新型仪器成功接受无气体STET的75名患者。在自然的the下折痕线中形成约2cm的主切口,然后与两个前庭切口结合以完成该过程。人口统计数据,回顾性记录手术技术和围手术期结果.
    本研究招募了13名男性和62名女性患者,平均年龄为34.0±8.1岁。68例患者患有甲状腺乳头状癌,7例患有良性结节。我们成功地进行了所有无气体STET,而没有转换为开放手术。术后平均住院时间为4.2±1.8天。观察到1例短暂性喉返神经损伤和2例短暂性甲状旁腺功能低下。三名患者在术后第一天抱怨下唇麻木。淋巴瘘1例,皮下积液,每个都发生切口肿胀,所有这些都被保守地治愈了。一名患者在手术后六个月复发。
    使用我们自己设计的悬架系统的无汽油STET在技术上是安全且可行的,具有合理的手术和肿瘤学结果。
    UNASSIGNED: The development of transoral endoscopic vestibular approach thyroidectomy (TOETVA) has been limited by inherent defects, such as mental nerve injury and carbon dioxide (CO2)-related complications. Herein, we proposed a new technique without CO2 called gasless submental-transoral combined approach endoscopic thyroidectomy (STET) to solve the problems in TOETVA.
    UNASSIGNED: We reviewed 75 patients who successfully underwent gasless STET using novel instruments at our institution from November 2020 to November 2021. A main incision of approximately 2 cm was made in the natural submental crease line and then combined with two vestibule incisions to complete the procedure. Demographic data, surgical technique and perioperative outcomes were retrospectively recorded.
    UNASSIGNED: Thirteen male and sixty-two female patients with a mean age of 34.0 ± 8.1 years were enrolled in this study. Sixty-eight patients had papillary thyroid carcinomas and seven had benign nodules. We successfully performed all gasless STET without conversion to open surgery. The average postoperative hospital stay was 4.2 ± 1.8 days. One transient recurrent laryngeal nerve injury and two transient hypoparathyroidisms were observed. Three patients complained of slight lower lip numbness on the first postoperative day. One case of lymphatic fistula, subcutaneous effusion, and incision swelling occurred each, all of which were conservatively cured. One patient developed a recurrence six months after surgery.
    UNASSIGNED: Gasless STET using our own designed suspension system is technically safe and feasible with reasonable operative and oncologic results.
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  • 文章类型: Randomized Controlled Trial
    目的:本前瞻性研究旨在探讨内镜下甲状腺切除术与常规甲状腺切除术的临床疗效及炎症反应。
    方法:我们前瞻性招募了2021年1月至2022年7月在上海交通大学医学院附属上海第六人民医院接受常规开放甲状腺切除术或内镜下甲状腺切除术的45例患者(共90例)。使用以下指标对这些患者进行评估:解剖的淋巴结数量,并发症,疼痛严重程度,炎症指标,化妆品满意度,和经济成本。所有数据采用t检验或卡方检验进行分析。
    结果:纳入90例患者。两组在基线特征方面没有显着差异。所有接受甲状腺切除术的患者的创伤指数相似,炎症水平升高。开腹甲状腺切除术组和腔镜下甲状腺切除术组的淋巴结清扫总数差异无统计学意义,阳性淋巴结数,排水量,和并发症。在温哥华瘢痕评分和美容满意度评分方面,髁下内镜甲状腺切除术组明显优于开放甲状腺切除术组。在术后第1天和第2天,下网膜内镜甲状腺切除术组的疼痛评分明显降低,停机时间更短,与开放式甲状腺切除术组相比,医疗和美容费用更便宜。
    结论:与传统的开放性甲状腺切除术相比,下内镜甲状腺切除术并没有增加创伤的程度,具有优越的临床疗效,减少疼痛,需要更短的停机时间,达到了更好的美容效果,并与较低的医疗保健成本有关。
    This prospective study aimed to explore the clinical efficacy and inflammatory reaction of submental endoscopic thyroidectomy versus conventional thyroidectomy.
    We prospectively recruited 45 patients (total 90 patients) who met the eligibility criteria to undergo conventional open thyroidectomy or submental endoscopic thyroidectomy from January 2021 to July 2022 in the Shanghai Sixth People\'s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. These patients were evaluated using the following indices: number of lymph nodes dissected, complications, pain severity, inflammatory indicators, cosmetic satisfaction, and economic cost. All data were analyzed by the t-test or chi-squared test.
    Ninety patients were enrolled. The two groups did not significantly differ regarding baseline characteristics. All patients who underwent thyroidectomy had a similar trauma index and increased level of inflammation. There were no significant differences between the open thyroidectomy and submental endoscopic thyroidectomy groups in the total number of lymph nodes dissected, number of positive lymph nodes, drainage volume, and complications. The Vancouver scar score and cosmetic satisfaction score were significantly better in the submental endoscopic thyroidectomy group than the open thyroidectomy group. The submental endoscopic thyroidectomy group had a significantly lower pain scores on postoperative days 1 and 2, less downtime, and cheaper medical and esthetic costs than the open thyroidectomy group.
    Compared with conventional open thyroidectomy, submental endoscopic thyroidectomy did not increase the degree of trauma, had superior clinical efficacy, caused less pain, required a shorter downtime, achieved a better cosmetic effect, and was associated with lower healthcare costs.
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