Graves-Basedow ophthalmopathy surgical approaches: Open vs Endoscopic.

Graves-Basedow's disease (GBD) is an autoimmune pathology that affects the thyroid and is characterized by the presence of goiter, hyperthyroidism, ophthalmopathy, and dermopathy. Graves-Basedow ophthalmopathy (GBO) is a set of inflammatory and infiltrative alterations of the orbital tissue that affects 40-90% of subjects suffering from GBD. Our study aims to investigate the differences in the clinical outcomes of patients treated with two different techniques: the classic open and the more modern endoscopic.

Interscapular Pain after Anterior Cervical Discectomy and Fusion: Does Zygapophyseal Joints over Distraction Play a Role?

Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific post-operative complications include dysphagia, dysphonia, cervicalgia, adjacent segment disorder, cage subsidence, and infections. However, interscapular pain is commonly reported by these patients after surgery, although its mechanisms have not been clarified yet.

Synchronous Ipsilateral Pleomorphic Adenomas of Parotid and Submandibular Glands: An Unusual Finding.

A rare case of synchronous ipsilateral pleomorphic adenomas (PA) of the left parotid and submandibular glands is reported. Simultaneous multiple PA in major salivary glands are a very rare entity, and merely few cases of ipsilateral synchronous PA involving parotid and submandibular glands are reported in the literature. The case of a 40-year-old female with a six-year history of asymptomatic growing lesion in both left parotid and left submandibular regions is presented.

Complex Orbital Fractures: Three-Dimensional Planning and Combined Surgical Approach.

Nowadays the development of diagnostic imaging, surgical techniques, alloplastic materials, and surgical instruments has made possible a more accurate management of orbital fractures. The aim of the present study was the management of orbital fractures and the solution of particular cases. The use of high-resolution computed tomography makes possible to gain a better understanding of the complex orbit anatomical structure.

Fibrous Dysplasia: A Complex Maxillary Reconstruction.

Fibrous dysplasia is a benign tumor of the skeleton. Mostly 2 forms are described: a monostotic and a poliostotic form. The maxilla and the mandible are the most interested of the facial district.

Squamous cell carcinoma arising on a forearm free flap 21 years after hemiglossectomy.

Aim: Free and pedicled flap are methods of choice for reconstruction of post-surgical defects consequent to oral squamous cell carcinomas (SCCs), and missing intraoral mucosa is commonly reconstructed by the cutaneous component of the flap to guarantee an epithelial lining. Even if rare, cases of second tumors arising in the skin flap have been described. We present our experience reporting a clinical case.

Surgical evolution in the treatment of mandibular condyle fractures.

Background: In Literature fractures of the mandible that involve the condyle ranges from 20% to 35% and various possible surgical options are described according to the varying pathological situations. Up to the present, numerous techniques have been used for the surgical treatment of condylar fractures. In this article we are proposing the combination of two surgical techniques as therapy for extra-capsular condylar fractures with dislocation.

Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients.

Background: During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures.

Unusual complication of condrocostal implant in rhinoplasty.

A 67-year-old patient with a casual diagnosis of a foreign body within the frontal sinus outreaching the frontal cerebral parenchyma was treated. Results of anamnestic examination revealed that the patient underwent rhinoplasty with condrocostal implant of the nasal dorsum fixed to the anterior wall of the frontal sinus using a Kirschner wire 2 years ago. A combined transnasal endoscopic and transcranic approach was performed to remove the foreign body.

Wide excision and anterolateral thigh perforator flap reconstruction for dermatofibrosarcoma protuberans of the face.

Dermatofibrosarcoma protuberans is a rare cutaneous malignant tumor associated with a high cure rate but with a high incidence of local recurrence. Because of its tentacle-like subcutaneous infiltrating pattern that extends far beyond the clinically visible skin lesion, a wide resection margin is recommended. Hence, its localization to the head-and-neck regions, although rare, represents a real challenge for both the oncologic surgeon and the reconstructive surgeon, who aim to achieve a radical resection of the tumor with the best possible aesthetic outcome.

Bilobed skin paddle fibula flap for large oromandibular defects.

Although the fibula free flap (FFF) is a useful choice for mandible reconstruction, its application for large oromandibular defects is still debated upon. We report the use of FFF with a bilobed perforator-based skin paddle for combined hemiglossectomy, floor-of-the-mouth, tonsillar pillar, and mandibular body defect. A case of an 84-year-old woman with a 2.

Schwannoma of the facial nerve: indications for surgical treatment.

There is no preoperative diagnostic modality that can identify facial nerve schwannoma with certainty. Difficulty in locating the facial nerve intraoperatively raises suspicion of a neurogenous tumor of the facial nerve, and this may prevent unnecessary damage to the nerve. Not every facial nerve schwannoma should be resected.

Sagittal split osteotomy of the fibula for modeling the new mandibular angle.

Fibula modeling techniques for mandible reconstruction carry a high risk of bone perfusion impairment and low predictability of osteotomy angles. To restore the parabolic shape of the mandible, the number of osteotomies should be as small as possible to preserve both periosteal and endosteal perfusion. We report our approach with sagittal split osteotomy (SSO) technique for mandibular angle reconstruction.

Stensen duct relocation after cheek mucosa tumor resection.

Cheek mucosa cancer might surround Stensen meatus requiring preservation and relocation of the duct. Sialodochoplasty is necessary to avoid subsequent stricture, cheek swelling, and obstructive sequelae that could make following oncologic follow-up difficult. We report a simple successful technique of parotid duct cannulation and relocation in a 77-year-old woman who underwent cheek mucosa tumor resection for squamous cell carcinoma and free fasciocutaneous forearm reconstruction.

Sphenoidal-clival neoformation: an endoscopic approach.

The cranial base has distinct embryologic origins. The anterior cranial base is derived solely from the neural crest, similar to other facial bones, whereas the posterior cranial base is formed by the paraxial mesoderm. Both these parts also develop and grow with distinct features.

Osteosarcoma radioinduced after adenoid cystic tumor of the parotid gland.

Osteosarcoma can develop secondary to malignant transformation within a preexisting benign bone lesion, such as Paget disease, osteonecrosis, fibrous dysplasia, and chronic infection, or it can arise in previously irradiated areas. This article presents the case of a 36-year-old woman who was affected by a radioinduced osteosarcoma after radiotherapy for an adenoid cystic carcinoma of the left parotid gland treated when she was 24 years old.

Lip reconstruction with local m-shaped composite flap.

The primary management of lip malignancies is radiotherapy or complete surgical resection. Surgical resection brings a full-thickness defect of lip tissues, and management of the resulting lip defect needs a surgical technique that maximizes functional and cosmetic outcomes. The use of local tissue flaps forms the basic concept of lip reconstruction.

Malignant ethmoidal neoplasms: a cranionasal endoscopy approach.

Craniofacial resection has been adopted worldwide as the standard therapy for tumors of the paranasal sinuses involving the anterior skull base. Recent refinements in endoscopic techniques together with the development of related surgical instruments allow complete radical resection of complex anatomic structures through combined transcranial and endonasal approaches without compromising any oncological principles. We use a transcranial nasoendoscopic approach for ethmoid malignant tumors in stage I and II according to the Instituto Nazionale Tumori, Milano staging.

Ameloblastoma relapse after 50 years from resection treatment.

Ameloblastoma is a slow-growing, locally invasive, epithelial odontogenic tumor of the jaws with a high rate of recurrence if not removed adequately but with virtually no tendency to metastasize (World Health Organization Classification of Tumors: Pathology and Genetics of Head and Neck Tumours, 2005). This paper presents a case of a woman who was treated in 1961, when she was 25 years old, for an ameloblastoma in the right posterior region of the mandible. After 50 years, the ameloblastoma relapsed, and another surgical treatment was necessary.

Concha bullosa: endoscopic treatment.

Aim: To assess the frequency and the endoscopic treatment of the middle turbinate pneumatization or concha bullosa.

Materials And Methods: Forty-nine patients (26 males and 23 females) with sinusitis and headache symptoms and axial and coronal computed tomographic scans of the paranasal sinuses and who had an endoscopic examination visit in the outpatient department between January 2005 and July 2007 were included in this study. Functional endoscopic sinus surgery was performed.

Temporomandibular joint disorders and maxillomandibular malformations: role of condylar "repositionin" plate.

Even if the relationship between condylar position and/or temporomandibular disorders (TMDs) and dentofacial deformity is controversial in literature, several patients presenting malocclusion refer to pain and TMDs as the main trouble. There are also various opinions concerning the alterations or improvements of temporomandibular joint symptoms after orthognathic surgery. In agreement with the experience of Universität Würzburg, the purpose of this study was to evaluate the validity of splint technique to reproduce centric condyle positioning in bimaxillary osteotomy surgeries for the patients with skeletal-facial disorders and coexisting TMDs.

Cold therapy in maxillofacial surgery.

Background: Cryotherapy (the application of ice for therapeutic purposes) is one of the most common treatment modalities used in the immediate management of acute soft tissue injury. Despite its widespread clinical use, the precise physiological responses to therapeutic cooling have not been fully elucidated, and effective evidence-based treatment protocols are yet to be established (BMC Musculoskelet Disord 2007;8:125).

Patients And Methods: From January 2008 to July 2008, 10 patients (4 men and 6 women) affected by dental-skeletal classes II and III were treated.

Evolution in diagnosis and repairing of orbital medial wall fractures.

In the last decades, diagnostical imaging, surgical techniques, alloplastic materials, and surgical instruments development allowed a great progress in management of orbital fractures; the aim of the present study was to focus on the progress and changes in the management of orbital medial wall fractures. Isolated medial wall fractures are not a common clinical evidence, and those necessitating surgery is relatively rare. Diagnostical refinements allowed to detect such fractures more commonly than suspected, and the indications to surgical treatment had been increased by the progresses that minimized morbidity of patients and allowed better restoration of the functional anatomy.

Navigator system guided endoscopic intraoral approach for remodelling of mandibular condyle in Garré syndrome.

In recent years, surgical trends showed an interest for minimally invasive surgery. Endoscopically assisted techniques were developed and widely reported. Endoscopic approaches can sometimes represent an alternative to traditional surgery.