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La salivación es un proceso fisiológico dependiente de las glándulas salivales. En reposo, el 70% de la saliva es secretada por las glándulas submaxilares. Sin embargo, bajo estimulación, el flujo salival aumenta, hasta cinco veces, siendo la glándula parótida la principal responsable. La sialorrea se define como un trastorno de la emisión de la saliva consistente en un exceso de producción o en la incapacidad de retención intraoral y deglución de la misma. Esta condición es normal en niños hasta los 15-18 meses de edad y se considera patológica cuando ocurre después de los cuatro años. La causa más frecuente de la sialorrea en los pacientes pediátricos es la disfunción neuromuscular, debido a problemas en la coordinación neuromuscular y en la deglución. Es especialmente prevalente en pacientes con parálisis cerebral infantil (PCI).Desde el punto de vista clínico, los pacientes pueden presentar alteraciones cutáneas peribucales y en la región mentoniana, pobre higiene oral con mayor incidencia de caries dentales y un mayor riesgo de aspiraciones con posibles neumonías asociadas. Así mismo, puede conducir a alteraciones psicológicas y sociales en la vida diaria de los enfermos y familiares. El impacto de la sialorrea en la calidad de vida del paciente es el factor más importante para definir la necesidad de tratamiento..., Salivation is a physiological process dependent on the salivary glands. At rest, 70% of saliva is secreted by the submaxillary glands. However, under stimulation, salivary flow increases, up to five times, with the parotid gland being primarily responsible.Sialorrhoea is defined as a saliva emission disorder consisting of excess saliva production or the inability to retain saliva intraorally and swallow it. This condition is normal in children up to 15-18 months of age and is considered pathological when it occurs after the age of four years.The most common cause of sialorrhoea in paediatric patients is neuromuscular dysfunction, due to problems in neuromuscular coordination and swallowing.It is especially prevalent in children with cerebral palsy (CP).From a clinical point of view, patients may present peribuccal and chin region skin alterations, poor oral hygiene with a higher incidence of dental caries and a higher risk of pneumonia associated with aspiration mechanisms. It can also lead to psychological and social disturbances in the daily lives of patients and their families. The impact of hypersalivation on the patient's quality of life is the most important factor in defining the need for treatment...

Microsurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic patients underwent scalp reconstruction with LD (10), ALT (11), and OM (9) flaps. The length of the vascular pedicle, the operation time, the possibility of a two-team approach, the length of hospital stays, the complications, and the aesthetic results were evaluated. The OM flap was the flap with the shortest vascular pedicle length with a mean of 6.26 ± 0.16 cm, compared to the LD flap, which was 12.34 ± 0.55 cm and the ALT flap with 13.20 ± 0.26 cm (p < 0.05). The average time of surgery was 6.6 ± 0.14 h in patients reconstructed with OM, compared to the LD flap, which was 8.91 ± 0.32 h and the ALT flap with 7.53 ± 0.22 h (p < 0.05). A two-team approach was performed in all patients for OM flaps and ALT flaps, but only in two patients reconstructed with the LD flap (p < 0.001). In patients reconstructed with the OM flap, a very satisfactory or satisfactory result was reported in seven patients (77.8%). Eight patients reported a very unsatisfactory or unsatisfactory result with LD flap (80%) and 10 patients with ALT flap (90.9%) (p = 0.002). The mean hospital stay after surgery was not statistically significant (p > 0.05). As for complications, two patients reconstructed with OM flap, five LT flaps, and two ALT flaps developed complications, not statistically significant (p = 0.235). Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. Regarding the aesthetic outcome, OM flap or LD flap should be consid, Depto. de Medicina, Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

Medication-related osteonecrosis of the jaw (MRONJ) has been associated with the use of different drugs administered in the treatment of malignant neoplasms or metastases and in antiresorptive therapies. Since 2010, denosumab, a monoclonal antibody whose mechanism of action is to prevent the activation of the RANK receptor on the surface of osteoclasts, has been associated with osteonecrosis of the jaw. Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare neoplasm characterised by the presence of squamous cells within the maxillary or mandibular bone without an initial clinical association with the oral mucosa. We present a case of a PIOSCC in an osteonecrosis of the jaw related to a patient who received antiresorptive treatment with denosumab outlining the clinical and histopathological features of MRONJ and PIOSCC., Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub