Browsing by Author "Guamán Roldan, Hugo Xavier"

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Nasoangiofibroma juvenil - reporte de caso clínico y revisión literaria
(Universidad de Cuenca, 2024-09-13) Verdugo Parra, John Esteban; Orellana Barros, Kevin Fabricio; Guamán Roldan, Hugo Xavier
Juvenile nasoangiofibroma is a benign tumor with locally aggressive behavior, given the significant epistaxis it causes, frequent complications, and therapeutic complexity presented by this condition, diagnosis and treatment should be thorough; it occurs exclusively in adolescent males and accounts for 0.5%-0.05% of all head and neck tumors. This case corresponds to an 18-year-old patient with progressive respiratory difficulty over 2 years, nasal obstruction, and epistaxis. Clinical and imaging studies revealed a diagnosis of juvenile nasoangiofibroma at stage IIb according to Radkowski's classification. A Degloving approach was performed, and the tumor was completely removed. One year after resection, no tumor recurrence has been recorded. Conclusion: Juvenile nasoangiofibroma predominantly affects adolescent males and is primarily characterized by recurrent episodes of epistaxis. Surgical management remains the cornerstone of treatment, with various effective approaches available. The local recurrence rate is low, underscoring the effectiveness of current interventions in most cases.
Nasoangiofibroma juvenil: reporte de un caso mediante abordaje de Lefort I
(Universidad de Cuenca, 2024-05-17) Cantos Vera, Arturo Fernando; Guazhambo Arias, Juan Fernando; Guamán Roldan, Hugo Xavier
Juvenile nasopharyngeal angiofibroma is a rare and highly vascularized benign neoplasm. It represents 0.05% to 0.5% of head and neck neoplasms. In more advanced stages, it presents intracranial involvement with facial deformity and ocular proptosis. Histopathologically, they are non-encapsulated and well-circumscribed polypoid masses formed by vascular and fibrous stromal tissue. Evaluation is based on diagnostic imaging, mainly with computed tomography (CT) or magnetic resonance imaging (MRI). The Le Fort I osteotomy approach has been used for the treatment of midface deformities. This procedure has the advantage of offering excellent exposure of difficult-to-access sites, it does not generate facial scars, and pre-surgical biopsy is not recommended. The prognosis is good. The objective of this article is to present the case of a patient diagnosed with juvenile nasofibroangioma, according to the Radkowski classification system, corresponding to III according to Chandler and II according to Fish. A Le Fort I approach is performed, the tumor is resected and osteosynthesis is performed with titanium plates and screws to restore the patient's dental occlusion. Go for periodic check-ups to verify the absence of mass in the nasal passages.
Odontogenic maxillary sinusitis: a clinical case report
(Universidad de Cuenca, 2024-09-12) Vega Novillo, Mónica Salomé; Peña Benavidez, Patricio Geovanny; Guamán Roldan, Hugo Xavier
Odontogenic maxillary sinusitis (OMS) is a subtype of sinusitis that originates from dental infections and is often underdiagnosed due to its nonspecific clinical presentation, which overlaps with other types of rhinosinusitis. The etiopathogenesis involves a complex interplay of factors including iatrogenic causes, periodontal infections, and traumatic events, leading to a persistent inflammatory response in the maxillary sinus. This case report details a clinical case involving a 19-year-old male patient presenting with exacerbated sinusitis symptoms linked to a carious upper right first molar. Clinical manifestations included blurred vision, facial pain, and nasal regurgitation of liquids. Radiographic analysis revealed a radiolucent area indicative of sinus involvement, confirming the diagnosis of OMS.Surgical intervention comprised the extraction of the infected molar and the debridement of the maxillary sinus, followed by the application of Bichat’s fat pad to repair the resulting oroantral communication. This technique demonstrated effective closure of the defect, promoting tissue healing and reducing postoperative complications. The postoperative regimen included antibiotics, anti-inflammatories, and antihistamines, which facilitated recovery. This case underscores the necessity of a multidisciplinary approach in the diagnosis and management of OMS, integrating dental and surgical expertise to optimize patient outcomes. Imaging plays a crucial role in the diagnostic process, enabling precise identification of odontogenic lesions and their extent. The successful use of Bichat’s fat pad highlights its utility in oralmaxillofacial surgery for managing oroantral fistulas. This report contributes to the growing body of evidence supporting the importance of tailored surgical and medical strategies in managing complex cases of odontogenic maxillary sinusitis.
Tratamiento quirúrgico para la liberación de anquilosis de la articulación témporomandibular. Reporte de un caso clínico y revisión de la literatura
(Universidad de Cuenca, 2020) Guamán Roldan, Hugo Xavier; Lopez Nugra, Antonella Nicole; Ron, Juan Carlos