Acute myeloid leukaemia (AML) is an aggressive haematological malignancy accounting for 25% of paediatric leukaemia. Extramedullary localisation of AML is termed Myeloid Sarcoma (MS) and occurs in 3-5% of patients with AML. It may precede, occur concurrently with, or signal relapse of AML. MS presentation in the maxillofacial region is extremely rare, with exact prevalence unknown.We report on two unrelated paediatric patients presenting within a three-month period to St John's Hospital Maxillofacial Unit, with maxillofacial MS as the initial presentation of AML.
Objective To describe the diagnosis and surgical management of a rare intramuscular myxolipoma arising within the masseter muscle. Case A 28-year-old woman presented with a slowly enlarging right facial swelling associated with discomfort during mastication. Clinical examination demonstrated a soft, mobile, well-circumscribed mass. Magnetic resonance imaging identified a well-defined lesion within the masseter muscle. Complete excision was performed through a transoral approach, preserving the facial nerve branches and Stensen's duct. Histopathological examination demonstrated mature adipose tissue within abundant myxoid stroma infiltrating skeletal muscle, confirming myxolipoma. Recovery was uneventful, and no clinical evidence of recurrence was observed at 6-month follow-up. Conclusion Myxolipoma of the masseter muscle is exceptionally uncommon and may resemble other benign soft-tissue lesions clinically and radiologically. Correlation of clinical findings, imaging, and histopathology is essential for diagnosis. Complete surgical excision can provide satisfactory functional and aesthetic outcomes, with no recurrence observed at 6-month follow-up in the present case.
Background As cannabis legalization expands, dental and oral and maxillofacial surgery providers increasingly encounter patients with recent or chronic cannabis use. Cannabis affects the central nervous and cardiopulmonary systems and may alter patient responses to intravenous (IV) sedative agents. Methods A retrospective cohort study was conducted at the University of Michigan School of Dentistry, including patients aged ≥16 years who underwent deep sedation for mandibular third molar extraction between June 2022 and December 2024. Patients were stratified by self-reported cannabis use. Primary outcomes were weight-adjusted dosages of propofol, ketamine, fentanyl, and midazolam; secondary outcomes were intraoperative complications, including oxygen desaturation and inadequate ventilation. Multivariable linear regression evaluated the association between cannabis use and weight-adjusted dose for each medication separately, adjusting for the number of inadequate ventilation instances, desaturation occurrence, and sedation time. Group comparisons used t-tests or Mann-Whitney U tests for continuous variables and chi-square or Fisher's exact tests for categorical variables; significance was set at P < 0.05. Results Of 589 patients, 175 (29.7%) reported cannabis use. In unadjusted comparisons, cannabis users had significantly higher weight-adjusted doses of propofol, ketamine, and midazolam than non-users (all P < 0.05); fentanyl dose did not differ significantly (P = 0.38). After adjustment, cannabis use remained independently associated with higher weight-adjusted propofol (β = 0.74; 95% CI, 0.47 to 1.0; P < 0.001) and ketamine (β = 0.07; 95% CI, 0.03 to 0.12; P < 0.001) dosing, but was not independently associated with fentanyl (β = 0.02; 95% CI, −0.07 to 0.10; P = 0.736) or midazolam (β = 0.00; 95% CI, 0.00 to 0.01; P = 0.080) dosing. Cannabis users had significantly more instances of inadequate ventilation than non-users (mean 3.0 vs 2.5; P = 0.002); rates of desaturation, airway adjunct use, bag-mask ventilation, and other adverse events did not differ significantly between groups. No significant differences were found between groups in age, sex, or BMI. Conclusion Cannabis use was independently associated with higher weight-adjusted propofol and ketamine requirements and with more frequent inadequate ventilation during deep sedation; the association with midazolam dosing did not persist after adjustment, and fentanyl dosing was unaffected. Given the retrospective, observational design, these findings support an association rather than a causal relationship. They suggest cannabis use may be a relevant factor in preoperative sedation planning, though prospective studies with objective exposure confirmation are needed before specific practice changes can be recommended.
Statement of problem Snoring is a common issue that affects couples' lives. Purpose This study aims to gather as much information as possible on the real-life impact of laser treatment for snoring. Materials and methods A retrospective analysis was conducted. Data obtained from patients who underwent the treatment were analyzed. Results from an app that records snoring, a questionnaire, and visual tissue assessment were evaluated. Results Patients reported improved sleep, with a reduction in daytime fatigue. Conclusions The results confirmed the efficacy of the therapy. The most objective way to assess a reduction in snoring is through questionnaires that record opinions from both the snorer and the partner. Improvements in the conditions of all patients were identified by the app and the Friedman and Mallampati scales. However, to achieve good results, laser therapy must be accompanied by changes in habits and lifestyle.
This study evaluated the functional agreement between magnetic resonance imaging (MRI) descriptions of the temporomandibular joint (TMJ) generated by GPT-4 with vision capabilities and reports issued by human radiologists, in an observational, retrospective, cross-sectional, analytical and comparative design. Twenty-nine examinations and 58 joints made up the final sample, treated as a single, unstratified group. Composite static images built from selected slices were submitted to the model using a standardized prompt covering ten anatomical-functional items, and each response was compared item by item with the human report and classified as agreement, disagreement, or not described. Among 432 evaluable comparisons, overall agreement was 70.83%, but the central finding was the wide variability across cases: mean 68.5%, median 80%, standard deviation 30.87%, range 0% to 100%, with 41.4% of examinations excellent and 31.0% poor. Agreement was highest for retrodiscal tissues (80.6%), disc recapture (79.2%) and osseous changes of the fossa/eminence (76.7%), and lowest for joint effusion (63.8%). No difference emerged between right and left sides (p = 0.9817), while a positive correlation linked report completeness to agreement (r = 0.4949; p = 0.0063). The tool shows potential as a support resource, but its inconsistent, case-dependent performance means specialist supervision is required at every stage.
