Postoperative infections associated with microvascular free flaps in head and neck reconstruction: Analysis of risk factors and results with a standardized prophylaxis protocol.

Currently, large defects of the head and neck regions are mainly reconstructed using microvascular free flap. Postoperative infections, including surgical site infections (SSIs) and medical postoperative infections (MPI), are important causes of morbidity and worsening of surgical outcomes. The authors aimed to analyze the results obtained using a standardized prophylaxis protocol in a series of 100 consecutive patients who underwent microvascular reconstruction surgery between 2016 and 2021 at a single institution, to identify the risk factors, which could be overcome, to minimize the incidence of infectious complications.

Implant Dental Rehabilitation of Fibula-Free Flap Reconstructed Jaws.

Background: The possibility of placing dental fixtures in the reconstructed regions allows us to overcome the problems related to dental rehabilitation with removable prosthesis. The aim of this study was to assess the clinic-radiological outcome in a series of patients who underwent fibula flap jaws reconstruction and rehabilitation with implant-supported prosthesis with a minimum follow-up of 24 months.

Material And Methods: The study included 10 patients who underwent reconstruction with fibula free flap between 2010 and 2018.

The Shape of Things to Come: In-Hospital Three-Dimensional Printing for Mandibular Reconstruction Using Fibula Free Flap.

Objectives/hypothesis: The aim of this study was to explore whether the production of in-hospital, low-cost surgical cutting guides would be possible and to assess different cutting guide shapes to facilitate the surgery and the application with instruments.

Study Design: Cohort study.

Methods: Using free computer-aided design software, surgical cutting guides for the mandible and fibula were designed and used to perform virtual segmental osteotomies and fibula transplants in seven patients.

Prospective assessment of taste impairment and nausea during radiotherapy for head and neck cancer.

Dysgeusia and nausea are common side effects observed in head and neck cancer patients treated with either exclusive radiotherapy or combined modality treatment. The aim of the present study was to prospectively evaluate dysgeusia, during treatment and follow-up, using the chemotherapy-induced taste alteration scale (CiTAS), a metrics based on 18-items exploring three dimensions (quantitative and qualitative changes in taste perception, and diet-related issues) identified through a four-factor analysis: decline in basic taste, discomfort, phantogeusia-parageusia, and general taste alterations. Moreover, we scored, according to Common Toxicity Criteria Adverse Events, nausea and other treatment-related toxicities.

Prospective assessment of oral mucositis and its impact on quality of life and patient-reported outcomes during radiotherapy for head and neck cancer.

Oral mucositis (OM) is a common acute side effect during radiotherapy treatments for head and neck cancer (HNC), with a potential impact on patient's compliance to therapy, quality of life (QoL) and clinical outcomes. Its timely and appropriate management is of paramount importance. Several quantitative scoring scales are available to properly assess OM and its influence on patient-reported outcomes (PROs) and QoL.

Management of acute skin toxicity with Hypericum perforatum and neem oil during platinum-based concurrent chemo-radiation in head and neck cancer patients.

Acute skin toxicity is a frequent finding during combined radiotherapy and chemotherapy in head and neck cancer patients. Its timely and appropriate management is crucial for both oncological results and patient's global quality of life. We herein report clinical data on the use of Hypericum perforatum and neem oil in the treatment of acute skin toxicity during concurrent chemo-radiation for head and neck cancer.

Parameters and outcomes in 525 patients operated on for oral squamous cell carcinoma.

Purpose: This report analyzed the outcomes of patients undergoing surgery for oral squamous cell carcinoma (OSCC) to identify the value of prognostic factors.

Material And Methods: A total of 525 patients were studied who had undergone surgery for oral squamous cell carcinoma (OSCC) between 2000 and 2011, of whom 222 had received postoperative radiation-therapy (PORT) and or chemoradiation-therapy (PORTC). For each patient, personal data, histological findings, treatment and outcome were recorded and analyzed statistically.

Induction Chemotherapy and Sequential Concomitant Chemo-radiation in Locally Advanced Head and Neck Cancers: How Induction-phase Intensity and Treatment Breaks May Impact on Clinical Outcomes.

Aim: The purpose of the study was to assess outcomes of locally advanced head and neck (LAHNC) treated with induction chemotherapy (ICT) and subsequent concurrent chemo-radiation.

Patients And Methods: A total of 71 LAHNC patients were treated with 2-3 cycles of docetaxel, cisplatin and 5-fluorouracil as induction chemotherapy and subsequent concurrent chemoradiation with weekly cisplatin or carboplatin. Definitive radiotherapy was delivered with intensity-modulated radiation and a simultaneous integrated boost approach up to a total dose of 70 Gy in 35 fractions to the macroscopic primary and nodal disease.

To computer-aided design and manufacturing or not to computer-aided design and manufacturing? Free fibula flap with computer-aided technique for mandibular reconstruction.

Aim: The purpose of this study was to analyze the accuracy of computer-assisted free fibula flap for reconstruction of large mandibular defects for benign tumors.

Materials And Methods: Between December 2012 and January 2014, a total of 4 free osteocutaneous computer-assisted fibula flaps have been used in an equal number of patients for reconstruction of the mandible at the Division of Maxillofacial Surgery, Città della Scienza e della Salute Hospital, University of Turin. Inclusion criteria were large mandibular defects due to benign tumors.

Oral mucosa harvest for urologic reconstruction: role of maxillofacial surgeon and donor-site morbidity evaluation.

Purpose: The aim of this study was to present retrospective analysis of our experience regarding complications associated with the donor site after oral mucosa harvest for urethral reconstruction.

Materials And Methods: Between May 2010 and January 2013, a total of 18 patients with recurrent urethral strictures received a buccal mucosal graft for urethral reconstruction at the San Giovanni Battista Hospital, University of Turin, Turin. All operations were performed in a 2-team approach.

Evaluation of plate-related complications and efficacy in fibula free flap mandibular reconstruction.

Aim: The objective of this study was to evaluate the incidence of plate-related complications after vascularized bony reconstruction of the mandible, comparing the plate type used.

Patients And Methods: Between 2004 and December 2012, a total of 41 free osteocutaneous fibula flaps have been used in an equal number of patients for reconstruction of the mandible, at the Division of Maxillofacial surgery, San Giovanni Battista Hospital, University of Turin. Malignant pathology was the most common indication for segmental mandibulectomy.

Surgical management of synchronous central giant cell granuloma and ossifying fibroma of the mandible.

We describe the surgical management of an uncommon case of synchronous presentation of central giant cell granuloma and ossifying fibroma in the mandible. A mandibular resection was performed and a fibula-free flap was harvested to reconstruct the defect.

Dermofat graft after superficial parotidectomy to prevent Frey syndrome and depressed deformity.

Adequate tumor resection and preservation of facial nerve function are the primary goals of the parotidectomy. However, this technique may lead to undesirable effects, including a concave facial effect, Frey syndrome, and prominent scar.The aim of this study is evaluate the outcomes of facial symmetry and symptomatic Frey syndrome in patients having dermofat graft during superficial parotidectomy.

Double consecutive retrobulbar hemorrhage in a high-risk patient in treatment with aspirin and warfarin.

Retrobulbar hemorrhage is a vision-threatening emergency that may occur spontaneously or following facial trauma, orbital surgery, endoscopic sinus surgery, and retrobulbar injections. It may determine visual loss because of central retinal artery occlusion, optic neuropathy from direct compression, or compression of the circulation from mechanical tamponade. In addition to a deterioration in visual acuity with total blindness in the most severe cases, several symptoms and signs can be found, such as a sudden onset of severe pain, proptosis, and ophthalmoplegia.

Morbidity associated with anterior iliac crest bone graft.

Objective: The aim of this retrospective study was to assess the morbidity of the harvest of the anterior iliac bone graft and the overall satisfaction rates in a group of patients who underwent harvesting of iliac crest bone graft.

Patients And Methods: Patients who underwent iliac crest bone graft procedures from January 2002 to August 2009 were recalled and invited to answer a questionnaire about postoperative pain, sensory disturbance, functional limitations, and cosmetic appearance.

Results: A total of 61 patients were included in this retrospective study.

Management and outcomes of three cases of rhinocerebral mucormycosis.

Mucormycosis is a rare opportunistic infection caused by fungi belonging to Mucorales order. The infection usually starts in the middle or inferior nasal meatus and then spreads to the paranasal sinuses and the orbit. Then it reaches the brain through the ethmoid and the orbit apex and can lead to lethargy, paralysis, and death.

Surgical treatment and reconstruction for central giant cell granuloma of the jaws: a review of 18 cases.

Central giant cell granuloma (CGCG) is an uncommon benign bony lesion that occurs in the mandible and maxilla. The clinical behaviour of CGCG ranges from a slow-growing asymptomatic swelling to an aggressive lesion that presents pain, local bone destruction, root resorption and tooth displacement. Therapeutic options have varied greatly over the years.

Induction chemotherapy followed by concurrent chemoradiotherapy in advanced head and neck squamous cell carcinoma.

Background: A phase II study was carried out to investigate an induction regimen with cisplatin, paclitaxel followed by radiotherapy concurrent with weekly cisplatin for locally advanced squamous cell carcinoma of the head and neck.

Patients And Methods: Stage III-IV disease patients were eligible. Two cisplatin (100 mg/m2) and paclitaxel (175 mg/m2) courses were administered every 21 days followed by standard fractionated external beam radiotherapy (approximately 70 Gy), concomitant to weekly cisplatin (30 mg/m2).

Composite hemangioendothelioma of the oral cavity: case report and review of the literature.

Background: Composite hemangioendothelioma is a rare histopathologic feature, which is part of the hemangioendothelioma family. This is a heterogeneous group of vascular neoplasia with a high tendency to local relapse but a rare predisposition to metastatic spread. Composite hemangioendothelioma mainly affects adults and is usually localized in the distal extremity of the limbs.

Clinicopathological parameters and outcome of 245 patients operated for oral squamous cell carcinoma.

Introduction: This report analysed the outcome of patients undergoing surgery for oral squamous cell carcinoma in order to identify the prognostic value of several factors.

Patients: A total of 245 patients were studied who had undergone surgery for oral squamous cell carcinoma between 1989 and 2002, of whom 109 had received postoperative radiation therapy.

Methods: For each patient, personal data, alcohol and tobacco consumption, symptoms, histological findings, treatment, and outcome were recorded and analysed statistically.

An audit of mandibular fractures treated by intermaxillary fixation using intraoral cortical bone screws.

Introduction: During the last 10 years, intermaxillary fixation using intraoral cortical bone screws has been introduced for the treatment of mandibular fractures. The aim of this work was to evaluate the indications and possible complications of this method.

Materials And Methods: Sixty-two patients with mandibular fractures, treated by intermaxillary fixation using these screws, were evaluated by preoperative and postoperative panoramic radiographs.

Oral mucosal melanoma: a series of case reports.

Introduction: Due to the rarity of oral malignant melanomas case reports are a necessary source of information. Ten new cases are reported with a minimum follow-up of 3 years.

Patients And Methods: Patients were treated during a period of 10 years.

[Evaluation of tegumental changes after skeletal repositioning in orthodontic surgery].

One of the main problems of orthognathodontic surgery is to evaluate the effects on soft tissue of bone positioning performed following surgical programming. A method which is of particular interest, easy to perform and reproduce was proposed by Jensen in 1992. It evaluates the correspondence of soft tissues on the basis of surgical programming and allows percentage values of soft tissue movement to be calculated in relation to bone tissue, thus performing a surgical VTO which corresponds as closely as possible to the postoperative result.