Velopharyngeal insufficiency

Disease class: Pharyngeal diseases

Cherubism

Disease class: Jaw diseases [Musculoskeletal diseases]
Disease class: Jaw diseases [Stomatognathic diseases]

Leukoplakia

Disease class: Precancerous conditions

Definition

White plaques of questionable risk having excluded (other) known diseases or disorders that carry no increased risk for cancer.

 

Features

• Firmly attached to an underlying mucous membrane. 
• Associated with a significant risk of malignant transformation.
• White or grey coloured.
• Flat.

 

Etymology

• leuko- = white
• -plakia  = plate  

 

Risk factors

• Tobacco smoking  
• Excessive alcohol consumption
• HIV infection / AIDS

[Maxillofacial surgery] Introduction

Maxillofacial surgeons specialise in diseases of the face and jaws.
There is significant overlap with dentistry, neurosurgery, orthopaedics, otorhinolaryngology, and plastic surgery.

 

Etymology

Latin maxilla, maxillae = jaw
Latin faciēs, faciēī = face

 

Stomatognathic diseases

 

Relevant diseases:

•  Impaction
• Wisdom teeth impaction
• Pericoronitis
• Temporomandibular joint dysfunction
• Tooth decay (dental caries)
• Dental abscess
• Tooth injuries
• Prognathism
• Cleft lip 
• Cleft palate
• Osteomyelitis
• Osteonecrosis of the jaw 
• Ludwig's angina 
• Alveolar bone loss

Alveolar bone loss

Disease class: Bone resorption

Management

Referral

• Maxillofacial surgery

Surgical

• Bone graft

Bone resorption

Disease class: Bone diseases

Types

• Ainhum
• Alveolar bone loss
• Osteolysis

Sleep bruxism

Disease class: Parasomnias

This is a syndrome characterised by bruxism (jaw clenching, teeth grinding) during sleep.

Stomatitis

Disease class: Mouth diseases

This refers to inflammation of the mouth, particularly the lips. 

See also

• Cheilitis

Cleft lip

Disease class: Lip diseases

Disease class: Mouth abnormalities

Also known as

• Orofacial cleft

Subtypes

• Microform cleft

 

See also

• Cleft palate

Bell palsy

Disease class: Facial nerve diseases
Disease class: Mouth diseases

Lemierre's syndrome

Disease class: Pharyngeal diseases

Also known as

• Septic phlebitis of the internal jugular vein
• Postanginal sepsis secondary to oropharyngeal infection
• Postanginal shock including sepsis
• Lemierre's disease
• Human necrobacillosis

 

Pathogens

• Fusobacterium necrophorum

 

Ankyloglossia

Disease class: Stomatognathic diseases

Also known as

Tongue tie

A congenital deformity in which the tongue is connected to the floor of the oral cavity by an unusually short lingual frenulum. The tongue range of motion is reduced.

Management

• Lingual frenectomy
• Lingual frenuloplasty

Temporomandibular joint disorders

Disease class: Joint diseases
Disease class: Stomatognathic diseases

Types 

• Temporomandibular joint dysfunction syndrome

Osteonecrosis

Disease class: Bone diseases

Also known as 

• Avascular necrosis 
• AVN

 

Pathophysiology

• Disruption of the normal vascular supply to bones can cause ischaemia and necrosis.

 

Causes

• Trauma (particularly bone fracture)
• Cancer
• Lupus
• Sickle cell disease
• HIV infection
• Gaucher’s disease
• Decompression sickness
• Heavy metal poisoning (e.g. lead and cadmium)
• Adverse drug reactions (e.g. corticosteroids, bevacizumab)

Types

• Osteonecrosis of the Jaw (associated with bisphosphonate treatment)
• Avascular necrosis of the femoral head
• Avascular necrosis of the knee
• Avascular necrosis of the ankle
• Avascular necrosis of the humeral head
• Avascular necrosis of the shoulder
• Avascular necrosis of the scaphoid
• Preiser's Disease: Avascular necrosis of the scaphoid without fracture
• Avascular necrosis of the spine 

Management 

• Arthroplasty
• Arthrodesis
• Revascularisation procedures (emerging field)

Secondary headache disorders

This is a category of headache disorder.
A headache can be secondary to various pathologies, both inside the head, and outside the head. The pain is a useful warning sign, heralding a potentially harmful pathology. Correction of the cause would alleviate the pain signals.

The pain is a useful warning sign, heralding a potentially harmful pathology. Correction of the cause would alleviate the pain signals.

The most common type of secondary headache is medication overuse headache.

 

Types

Headache attributed to trauma or injury to the head and/or neck

• Acute headache secondary to traumatic head injury
• Persistent headache secondary to traumatic head injury
• Acute headache secondary to whiplash
• Persistent headache secondary to whiplash
• Acute headache secondary to craniotomy
• Persistent headache secondary to craniotomy

Headache attributed to cranial or cervical vascular disorder

• Cerebral ischaemic event
• Non-traumatic intracranial haemorrhage
• Unruptured vascular malformation

Headache attributed to non-vascular intracranial disorder

• Increased CSF pressure
• Low CSF pressure

Headache attributed to a substance or its withdrawal

• Use of a substance
• Exposure to a substance
• Medication overuse headache
• Substance withdrawal

Headache attributed to infection

• Intracranial infection
• Systemic infection

Headache attributed to disorder of homoeostasis

• Hypothyroidism

Headache or facial pain attributed to disorder of the cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cervical structure

• Refractive error
• Glaucoma
• Dental caries

Headache attributed to psychiatric disorder

• Somatisation disorder
• Psychotic disorder

Ludwig’s angina

Disease class: Infection

Disease class: Mouth diseases

This refers to a type of cellulitis affecting the floor of the mouth.
This is a surgical emergency.

 

Etymology

From the Greek word ankhone = choke
From the Latin word angere = strangle

Angina refers to a feeling of strangling and choking.
In severe Ludwig's angina there is signficiant airway obstruction.

 

Causes

• Dental infections (75% to 90%)

Halitosis

Definition

Bad breath.

Source: Black's Medical Dictionary (42nd ed, 2010, ISBN 978-1-4081-0419-4)