Oral and Maxillofacial Surgeon Master in higher education in health. Head of the Division of Maxillofacial Surgery of the National Cancer Institute (INCART) Head of the Maxillofacial Surgery Service of the San Vicente de Paúl Regional Hospital, Phone: 8097570913 Address: SAN FRANCISCO DE MACORIS, DOMINICAN REPUBLIC
Background: The yellow ligament of the chin or chin fat pad is poorly described in anatomic publi... more Background: The yellow ligament of the chin or chin fat pad is poorly described in anatomic publications, is a morphological structure not very well known, but constant, its relevance in facial physiognomy is currently recognized. its anatomy, histology and function. a change of terminology is proposed according to the anatomical terminology. Methods: The study observational of the population consisted of the 10 patiens who were going to perform procedures in the chin. A bibliographic review of the yellow ligament of the chin was carried out. Results: The yellow ligament of the chin is an constant anatomical structure described in the various anatomy texts and journal articles that were evaluated, of the 10 patients observed clinically in trans-surgical procedures on the mental region, the yellow ligament of the chin was present clinically in 8 patients. Conclusions: Based on the anatomy, location and histology of the yellow ligament of the chin, and to the descriptions of the yello...
Latinoamerican journal of oral and maxillofacial surgery, 2021
El colgajo en isla submental: una alternativa en la reconstrucción orofacial. Descripción de la t... more El colgajo en isla submental: una alternativa en la reconstrucción orofacial. Descripción de la técnica y reporte de casos The submental island flap as an alternative in orofacial reconstruction. Description of the technique and case report
Background: The yellow ligament of the chin or chin fat pad is poorly described in anatomic publi... more Background: The yellow ligament of the chin or chin fat pad is poorly described in anatomic publications, is a morphological structure not very well known, but constant, its relevance in facial physiognomy is currently recognized. its anatomy, histology and function. a change of terminology is proposed according to the anatomical terminology. Methods: The study observational of the population consisted of the 10 patiens who were going to perform procedures in the chin. A bibliographic review of the yellow ligament of the chin was carried out. Results: The yellow ligament of the chin is an constant anatomical structure described in the various anatomy texts and journal articles that were evaluated, of the 10 patients observed clinically in trans-surgical procedures on the mental region, the yellow ligament of the chin was present clinically in 8 patients. Conclusions: Based on the anatomy, location and histology of the yellow ligament of the chin, and to the descriptions of the yellow ligamments to chin this must be recognized is part of the retaining ligaments of the face, a new terminology is proposed for said ligament, septum dermis osseum menti (osteocutaneous mentalis septum, in english).
RESUMEN Lacirugía delmacizo facial esundesafío paracirujanos y anestesiólogos, debidoal reducidoe... more RESUMEN Lacirugía delmacizo facial esundesafío paracirujanos y anestesiólogos, debidoal reducidoespaciode trabajode ambosespecialistas. Se describela técnicade Hernández Altemirqueconsiste entúnelizar por víasubmentoniana el tubo orotraqueal parael mantenimiento de la anestesia general. Se realizoun estudioobservacional descriptivo retrospectivo de loscasos atendidos porel servicio de Cirugía Buco-Maxilofacíal delHospital Regional SanVicente DePaúl enla Ciudad deSan Francisco de MacorísentreDiciembre1997-Mayo2005 dondese utilizóintubaciónorotraqueal con exteriorización submentoniana. Eluniverso estuvo constituido por 19pacientes, 100%mascufinos, una edadmedia de 26.6 añosy pico etarioen la 2da décadade la vida.El 77.78%correspondió a fracturasmúltiplesfacialesy 22.22% a dificultadtécnica paraintubación nasotraqueal. Secomparo conla traqueotomía el tiempode ejecución y confort de ambastécnicas, el costo y las complicaciones, concluyéndose que la tunelizacion por víasubmental es máseconómica, duramenostiempoen su ejecución, y ofrecemasconfort y menoscomplicaciones a los pacientes quela traqueotomía. (Rev. odontol.dominico v. 11,P 29-33,Enero-Diciembre, 2005). Palabras claves: Inlubación anestésica. Trauma maxilofacial. Tunelizacion submandibular. CirujanoBuco-maxilo-facial Encargado del serviciode cirugíamaxilofacial del hospital san Vicente dePaúl, SanFrancisco deMacorís, R.O. Introducción La cirugía del macizo facial es un desafío tanto para cirujanos como para anestesiólogos. El diag-nóstico de grandes tumores de la boca extendidos a senos paranasales y a orofaringe, y los cada vez mas frecuentes traumatismos faciales que comprometen 2 a 3 tercios de la cara, crean verdaderos dilemas en el área de trabajo de los cirujanos y anestesiólogos. Por un lado, el cirujano se ve obligado a trabajar en la boca y estructuras óseas faciales, pero por otro lado el anestesiólogo se ve impedido de intubarlo tanto por vía oral o nasal. En algunas ocasiones, aunque esto sea posible, la exteriorización del tubo por vía bucal o nasal crea dificultades insalvables, por traba-jar en un espacio en común.. Históricamente la solución más rápida y segura, ha sido realizar una traqueotomía previa, Existe un número importante de complicaciones precoces y tardías asociadas a la traqueotomía. Dentro de las primeras se encuentra la mala colocación del tubo de traqueotomía, neumotórax, sangrado y enfisema local. En el segundo grupo podemos mencionar la distorsión, estenosis traqueal y alteraciones estéticas. Además de lo mencionado, la traqueotomía requiere de cuidados post-operatorios especiales como propor-cionar oxígeno humidificado, aspiración cuidadosa e intermitente de secreciones, precauciones de esterili-dad, ajustar la presión del cuff o manguito y cambio del tubo de traqueotomía al quinto día. En síntesis, Volúmen 11I 2005
We report a case of a giant monomorphic adenoma of the hard palate. Monomorphic adenomas are usua... more We report a case of a giant monomorphic adenoma of the hard palate. Monomorphic adenomas are usually encapsulated and frequently are partially cystic. Their histologic pattern may be confused with that of adenoid cystic carcinoma, but they grow in an expansile fashion and usually are monolobular.
Osteoma is a slow-growing, benign and uncommon neoplasm located primarily in the región of the ma... more Osteoma is a slow-growing, benign and uncommon neoplasm located primarily in the región of the maxillofacial skeleton. An osteoma on the coronoid process is exceedingly rare. Here, we report a case of osteoma occurring in the pterygomandibular space in a 35-year-old woman. Clinical examination reveal facial asymmetry and difficulty in mouth opening, and the regional lymph nodes were non-palpable. CT images revealed well-circumscribed dense, radiopaque masses located coronoid process.we present a Aesthetic facial correction for this cases.
The Internet Journal of Head and Neck Surgery., 2009
We report a case of a giant monomorphic adenoma of the hard palate. Monomorphic adenomas are usua... more We report a case of a giant monomorphic adenoma of the hard palate. Monomorphic adenomas are usually encapsulated and frequently are partially cystic. Their histologic pattern may be confused with that of adenoid cystic carcinoma, but they grow in an expansile fashion and usually are monolobular.
The Internet Journal of Third World Medicine., 2012
Worldwide maxillofacial injuries have become a social problem, since there has been an alarming i... more Worldwide maxillofacial injuries have become a social problem, since there has been an alarming increase of this type of injury. In the Northeast region of the Dominican Republic the facial trauma constitutes a significant proportion of all trauma, although epidemiological studies in the country are few. A retrospective study was undertaken to assess causes of maxillofacial trauma in the San Vicente de Paúl Regional University Hospital in the town of San Francisco de Macorís, Duarte State, Dominican Republic. Between July 2002 and July 2011, 786 cases of maxillofacial fractures were seen at the Oral and Maxillofacial Surgery Unit of this Hospital. Most fractures occurred in adults with ages ranging from 21 to 30 years (30.2%). Men (58.5%) were more affected than women (41.5%) and most patients treated were from the locality of San Francisco de Macorís (34.2%). Traffic accidents/motorcycles (39.7%) were the major cause of trauma, followed by automobile accidents (18.7%) and physical violence (16.4%). Hard tissue injuries (63.5%) were more common. The mandible (22.1%) was found to be the most commonly fractured bone in the facial skeleton, followed by the zygomatic complex (12.7%). Wounds or lacerations (24.0%), edema (4.6%) and hematoma (4.6%) were the most common types of soft injuries.
Background: The yellow ligament of the chin or chin fat pad is poorly described in anatomic publi... more Background: The yellow ligament of the chin or chin fat pad is poorly described in anatomic publications, is a morphological structure not very well known, but constant, its relevance in facial physiognomy is currently recognized. its anatomy, histology and function. a change of terminology is proposed according to the anatomical terminology. Methods: The study observational of the population consisted of the 10 patiens who were going to perform procedures in the chin. A bibliographic review of the yellow ligament of the chin was carried out. Results: The yellow ligament of the chin is an constant anatomical structure described in the various anatomy texts and journal articles that were evaluated, of the 10 patients observed clinically in trans-surgical procedures on the mental region, the yellow ligament of the chin was present clinically in 8 patients. Conclusions: Based on the anatomy, location and histology of the yellow ligament of the chin, and to the descriptions of the yello...
Latinoamerican journal of oral and maxillofacial surgery, 2021
El colgajo en isla submental: una alternativa en la reconstrucción orofacial. Descripción de la t... more El colgajo en isla submental: una alternativa en la reconstrucción orofacial. Descripción de la técnica y reporte de casos The submental island flap as an alternative in orofacial reconstruction. Description of the technique and case report
Background: The yellow ligament of the chin or chin fat pad is poorly described in anatomic publi... more Background: The yellow ligament of the chin or chin fat pad is poorly described in anatomic publications, is a morphological structure not very well known, but constant, its relevance in facial physiognomy is currently recognized. its anatomy, histology and function. a change of terminology is proposed according to the anatomical terminology. Methods: The study observational of the population consisted of the 10 patiens who were going to perform procedures in the chin. A bibliographic review of the yellow ligament of the chin was carried out. Results: The yellow ligament of the chin is an constant anatomical structure described in the various anatomy texts and journal articles that were evaluated, of the 10 patients observed clinically in trans-surgical procedures on the mental region, the yellow ligament of the chin was present clinically in 8 patients. Conclusions: Based on the anatomy, location and histology of the yellow ligament of the chin, and to the descriptions of the yellow ligamments to chin this must be recognized is part of the retaining ligaments of the face, a new terminology is proposed for said ligament, septum dermis osseum menti (osteocutaneous mentalis septum, in english).
RESUMEN Lacirugía delmacizo facial esundesafío paracirujanos y anestesiólogos, debidoal reducidoe... more RESUMEN Lacirugía delmacizo facial esundesafío paracirujanos y anestesiólogos, debidoal reducidoespaciode trabajode ambosespecialistas. Se describela técnicade Hernández Altemirqueconsiste entúnelizar por víasubmentoniana el tubo orotraqueal parael mantenimiento de la anestesia general. Se realizoun estudioobservacional descriptivo retrospectivo de loscasos atendidos porel servicio de Cirugía Buco-Maxilofacíal delHospital Regional SanVicente DePaúl enla Ciudad deSan Francisco de MacorísentreDiciembre1997-Mayo2005 dondese utilizóintubaciónorotraqueal con exteriorización submentoniana. Eluniverso estuvo constituido por 19pacientes, 100%mascufinos, una edadmedia de 26.6 añosy pico etarioen la 2da décadade la vida.El 77.78%correspondió a fracturasmúltiplesfacialesy 22.22% a dificultadtécnica paraintubación nasotraqueal. Secomparo conla traqueotomía el tiempode ejecución y confort de ambastécnicas, el costo y las complicaciones, concluyéndose que la tunelizacion por víasubmental es máseconómica, duramenostiempoen su ejecución, y ofrecemasconfort y menoscomplicaciones a los pacientes quela traqueotomía. (Rev. odontol.dominico v. 11,P 29-33,Enero-Diciembre, 2005). Palabras claves: Inlubación anestésica. Trauma maxilofacial. Tunelizacion submandibular. CirujanoBuco-maxilo-facial Encargado del serviciode cirugíamaxilofacial del hospital san Vicente dePaúl, SanFrancisco deMacorís, R.O. Introducción La cirugía del macizo facial es un desafío tanto para cirujanos como para anestesiólogos. El diag-nóstico de grandes tumores de la boca extendidos a senos paranasales y a orofaringe, y los cada vez mas frecuentes traumatismos faciales que comprometen 2 a 3 tercios de la cara, crean verdaderos dilemas en el área de trabajo de los cirujanos y anestesiólogos. Por un lado, el cirujano se ve obligado a trabajar en la boca y estructuras óseas faciales, pero por otro lado el anestesiólogo se ve impedido de intubarlo tanto por vía oral o nasal. En algunas ocasiones, aunque esto sea posible, la exteriorización del tubo por vía bucal o nasal crea dificultades insalvables, por traba-jar en un espacio en común.. Históricamente la solución más rápida y segura, ha sido realizar una traqueotomía previa, Existe un número importante de complicaciones precoces y tardías asociadas a la traqueotomía. Dentro de las primeras se encuentra la mala colocación del tubo de traqueotomía, neumotórax, sangrado y enfisema local. En el segundo grupo podemos mencionar la distorsión, estenosis traqueal y alteraciones estéticas. Además de lo mencionado, la traqueotomía requiere de cuidados post-operatorios especiales como propor-cionar oxígeno humidificado, aspiración cuidadosa e intermitente de secreciones, precauciones de esterili-dad, ajustar la presión del cuff o manguito y cambio del tubo de traqueotomía al quinto día. En síntesis, Volúmen 11I 2005
We report a case of a giant monomorphic adenoma of the hard palate. Monomorphic adenomas are usua... more We report a case of a giant monomorphic adenoma of the hard palate. Monomorphic adenomas are usually encapsulated and frequently are partially cystic. Their histologic pattern may be confused with that of adenoid cystic carcinoma, but they grow in an expansile fashion and usually are monolobular.
Osteoma is a slow-growing, benign and uncommon neoplasm located primarily in the región of the ma... more Osteoma is a slow-growing, benign and uncommon neoplasm located primarily in the región of the maxillofacial skeleton. An osteoma on the coronoid process is exceedingly rare. Here, we report a case of osteoma occurring in the pterygomandibular space in a 35-year-old woman. Clinical examination reveal facial asymmetry and difficulty in mouth opening, and the regional lymph nodes were non-palpable. CT images revealed well-circumscribed dense, radiopaque masses located coronoid process.we present a Aesthetic facial correction for this cases.
The Internet Journal of Head and Neck Surgery., 2009
We report a case of a giant monomorphic adenoma of the hard palate. Monomorphic adenomas are usua... more We report a case of a giant monomorphic adenoma of the hard palate. Monomorphic adenomas are usually encapsulated and frequently are partially cystic. Their histologic pattern may be confused with that of adenoid cystic carcinoma, but they grow in an expansile fashion and usually are monolobular.
The Internet Journal of Third World Medicine., 2012
Worldwide maxillofacial injuries have become a social problem, since there has been an alarming i... more Worldwide maxillofacial injuries have become a social problem, since there has been an alarming increase of this type of injury. In the Northeast region of the Dominican Republic the facial trauma constitutes a significant proportion of all trauma, although epidemiological studies in the country are few. A retrospective study was undertaken to assess causes of maxillofacial trauma in the San Vicente de Paúl Regional University Hospital in the town of San Francisco de Macorís, Duarte State, Dominican Republic. Between July 2002 and July 2011, 786 cases of maxillofacial fractures were seen at the Oral and Maxillofacial Surgery Unit of this Hospital. Most fractures occurred in adults with ages ranging from 21 to 30 years (30.2%). Men (58.5%) were more affected than women (41.5%) and most patients treated were from the locality of San Francisco de Macorís (34.2%). Traffic accidents/motorcycles (39.7%) were the major cause of trauma, followed by automobile accidents (18.7%) and physical violence (16.4%). Hard tissue injuries (63.5%) were more common. The mandible (22.1%) was found to be the most commonly fractured bone in the facial skeleton, followed by the zygomatic complex (12.7%). Wounds or lacerations (24.0%), edema (4.6%) and hematoma (4.6%) were the most common types of soft injuries.
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