Contribuição da ultrassonografia como exame complementar no estabelecimento do diagnóstico de lesões nodulares submucosas e subcutâneas da região bucomaxilofacial

• Autor(a) principal: Martins, Felipe Leal
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_RS
• Texto Completo: http://tede2.pucrs.br/tede2/handle/tede/1245
• topic: ODONTOLOGIA; PATOLOGIA BUCOMAXILOFACIAL; ULTRASSONOGRAFIA; DIAGNÓSTICO POR IMAGEM; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA

Ultrasonography is an innocuous noninvasive diagnostic tool, which is easy to perform and low-cost, and it is widely used in the medical field, indicated especially in the exam of soft tissues. Despite this, it is not usually requested by dental surgeons in the diagnostic investigation of intraoral lesions. The aim of this study was to determine how much this resource contributes to establishing the final diagnosis of nodules located in the oral and maxillofacial region. Accordingly, we evaluated the indication of use and reliability of the procedure in Dentistry, considering the usefulness to reach the definitive diagnosis of these alterations. Sixty-five patients with submucosal or subcutaneous nodules were recruited for the study. They had been indicated for and subjected to regional ultrasonography, since it was not possible to establish a conclusive diagnosis of the lesions only by clinical examination. Ultrasonography was carried out in an imaging diagnostic center utilizing the same apparatus Toshiba Aplio 80 Japan. The imaging reports were prepared by a single examiner, with wide experience in the interpretation of images of the oral and maxillofacial region. Of the total patients, 43 had a biopsy for histopathologic confirmation of the final diagnosis. In 22 individuals, it was not necessary to perform surgery, since imaging allowed the establishment of the diagnosis and management of the patient. Two investigators evaluated the results obtained with ultrasonography and estimated the scores, which were zero (ultrasonographic diagnosis differed from the final), 1 (contributed to the management of the patient) and 2 (defined the definitive diagnosis). The zero score accounted for 12.3% of the examinations performed, while 41.5 and 46,1% of patients had scores of 1 and 2, respectively, totaling 87.6% of cases where imaging was helpful. The procedure facilitated the diagnosis of vascular lesions in 93.3%, helped with the management of 87.5% of patients with both malignant and benign neoplasms, and had a role in establishing the final diagnosis in 76.5% of cases of mucus retention phenomena. The results obtained were in accordance to findings in the literature, which demonstrated that ultrasonography is an effective resource in determining the final diagnosis or in the management of patients with nonspecific nodular lesions in the soft tissues of the oral and maxillofacial region