Papers by JORGE LOLAS MILLARD
International journal of odontostomatology, 2019
RESUMEN: La condromatosis sinovial (CS), es una lesión benigna poco frecuente y de clínica bastan... more RESUMEN: La condromatosis sinovial (CS), es una lesión benigna poco frecuente y de clínica bastante inespecífica. Suele afectar articulaciones de huesos largos como la rodilla, el codo y la cadera, presentándose generalmente de manera unilateral. Se cree que solo un 3 % de los casos de CS afecta la articulación temporomandibular. Esta condición se caracteriza por ser un trastorno metaplásico del tejido conectivo sinovial que suele manifestarse con la formación de pequeños y múltiples nódulos de cartílago que posteriormente pueden desprenderse, calcificarse y formar cuerpos libres dentro del espacio articular. Presentamos el caso de una mujer de 55 años con condromatosis sinovial de la articulación temporomandibular, tratada desde hace 3 años bajo el diagnóstico de desórdenes temporomandibulares. A pesar de ser considerada una lesión de tipo benigna, esta puede llegar a ser localmente agresiva, extendiéndose como en nuestro reporte hacia la fosa craneal media, adelgazando parte del hueso temporal. PALABRAS CLAVE: condromatosis sinovial, articulación temporomandibular, fosa craneal media, hueso temporal.
Revista Española de Cirugía Oral y Maxilofacial, Sep 1, 2021
Neuropathic pain is originated as a direct consequence of an injury or disease that affects the s... more Neuropathic pain is originated as a direct consequence of an injury or disease that affects the somatosensory system, which is a chronic, debilitating condition that affects a significant number of patients. The causes of neuropathic pain are diverse, and trauma is one of them. In this article the Painful Traumatic Trigeminal Neuropathy (PTTN) is reviewed. Two clinical cases are presented. The first is a 43-year-old female with PTTN, who was diagnosed nine months after reduction and osteosynthesis of a left zygomatomaxillary fracture. The second case corresponds to a 62-year-old male who presented with a left suborbital PTTN also after a zygomatomaxillary fracture and its reduction and osteosynthesis surgery. In the first case, the patient achieved a 70 % of reduction in pain after 6 months of treatment using multimodal analgesia with pregabalin, carbamazepine and amitriptyline. The second patient achieved complete resolution of pain with multimodal therapy using carbamazepine, amitriptyline, and lidocaine patches after two months of treatment. Therapy through multimodal analgesic scheme provides a favorable prognosis, however achieving a total resolution of the patient's pain is a difficult objective to achieve, and a significant reduction of 30% or more in the patient´s VAS is considered a success of the effectiveness of the therapy.
Introduction: The use of external reference points (ERP) like the nasal pin (NP) and eye’s medial... more Introduction: The use of external reference points (ERP) like the nasal pin (NP) and eye’s medial canthus (EMC) provides a stable and reproductible landmarks for maxillary repositioning. ERP are widely used, for its practicality to achieve the desired aesthetic result in orthognathic surgery (OS). Objectives: The purpose of this study is to compare the ERPs: NP and EMC, to define which is the most accurate, and also define its limitations, in the intraoperative phase for vertical repositioning of the maxilla. Patients and methods: We performed a retrospective study on 26 patients who underwent OS from December 2015 to August 2018. Previous to the Le Fort I osteotomy, the vertical measurements were made. The most accurate ERP was considered to be the one that obtained the least average difference between the vertical measurement of the pre-surgical planning and that obtained in the intraoperative period. Results: The planned vertical movement was an average of -1.73 mm ± 1.97 SD, wit...
Revista Española de Cirugía Oral y Maxilofacial, 2021
El dolor neuropático es originado como consecuencia directa de una lesión o enfermedad que afecta... more El dolor neuropático es originado como consecuencia directa de una lesión o enfermedad que afecta al sistema somatosensorial, lo cual es una condición crónica, debilitante, que afecta a un número significativo de pacientes. Las causas de dolor neuropático son diversas y el trauma es una de ellas. En este artículo se revisa la neuropatía trigeminal traumática dolorosa (PTTN). Se presentan dos casos clínicos. La primera es una mujer de 43 años con PTTN que fue diagnosticada nueve meses después de la reducción y osteosíntesis de una fractura cigomatomaxilar izquierda. El segundo caso corresponde a un varón de 62 años que consultó con una PTTN suborbitaria izquierda también tras una fractura cigomatomaxilar y su cirugía de reducción y osteosíntesis. En el primer caso clínico la paciente logró una reducción de un 70 % de su sintomatología a los 6 meses de tratamiento mediante terapia farmacológica multimodal con pregabalina, carbamazepina y amitriptilina. El segundo paciente logró una resolución completa del dolor con carbamazepina, amitriptilina y parches de lidocaína, después de 2 meses. La terapia mediante esquema analgésico multimodal proporciona un pronóstico favorable, sin embargo, lograr una resolución total del dolor del paciente es un objetivo difícil de lograr, y una reducción significativa del 30 % o más en la EVA del paciente se considera un éxito de la efectividad de la terapia.
Neuropathic pain is originated as a direct consequence of an injury or disease that affects the s... more Neuropathic pain is originated as a direct consequence of an injury or disease that affects the somatosensory system, which is a chronic, debilitating condition that affects a significant number of patients. The causes of neuropathic pain are diverse, and trauma is one of them. In this article the Painful Traumatic Trigeminal Neuropathy (PTTN) is reviewed. Two clinical cases are presented. The first is a 43-year-old female with PTTN, who was diagnosed nine months after reduction and osteosynthesis of a left zygomatomaxillary fracture. The second case corresponds to a 62-year-old male who presented with a left suborbital PTTN also after a zygomatomaxillary fracture and its reduction and osteosynthesis surgery. In the first case, the patient achieved a 70 % of reduction in pain after 6 months of treatment using multimodal analgesia with pregabalin, carbamazepine and amitriptyline. The second patient achieved complete resolution of pain with multimodal therapy using carbamazepine, amit...
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Papers by JORGE LOLAS MILLARD