Technical refinements of the scapular tip-free flap for mandibular reconstruction.

Background: The use of scapular tip chimeric free flaps (STFFs) for reconstructing mandibular defects has recently become popular, but its utility relative to other bone-containing free flaps remains debatable. The aim of the report is to describe how technical modification of STFF impacted in its use for mandibular reconstruction also commenting results obtained in a unicentric series of patients.

Patients And Methods: Patients undergoing mandibular reconstruction using an STFF from January 1, 2014 to June 1, 2022 were retrospectively enrolled in this report.

Cognitive telerehabilitation: an expert consensus paper on current evidence and future perspective.

The progressive improvement of the living conditions and medical care of the population in industrialized countries has led to improvement in healthcare interventions, including rehabilitation. From this perspective, Telerehabilitation (TR) plays an important role. TR consists of the application of telemedicine to rehabilitation to offer remote rehabilitation services to the population unable to reach healthcare.

Skin Expander for Scalp Reconstruction: Reappraisal of a Reconstructive Procedure for Aplasia Cutis Congenita.

Purpose: Aplasia cutis congenita (ACC) is a heterogeneous group of congenital disorders characterized by the absence of epidermis, dermis, appendages, subcutaneous tissue, and bone. The aim of the study is to describe a clinical report of ACC of the scalp treated with skin expanders.

Clinical Report: In October 2019, a 16-year-old female patient underwent scalp expansion with 2 rectangular devices (150 and 250 cm3; Radovan Mentor-Johnson&Johnson).

Wessex Head Injury Matrix in Patients with Prolonged Disorders of Consciousness: A Reliability Study.

The Wessex Head Injury Matrix (WHIM) was developed to assess patients with disorders of consciousness (DOC) and was tested in terms of inter-rater reliability (IRR) and test-retest reliability (TRR) in the year 2000. The American Congress of Rehabilitation and Medicine reported that IRR and TRR were unproven. We aim to assess the reliability of the WHIM in prolonged DOC patients (PDOC).

Double Arterialized Scapular Tip Free Flap for Mandibular Reconstruction.

Introduction: Scapular tip free flap (STFF) has become today one of the workhorse flaps for maxillary reconstruction; recently, the possibility of extending the vascular supply by adding to the angular branch of the circumflex pedicle up to its periosteal entrance in the lateral border of the scapula has been proposed as a reliable technique to improve the length of perfused bone when STFF is used for mandibular reconstruction. The purpose of this study was to evaluate the patients who had received microvascular reconstruction of the mandible with STFF vascularized by both the circumflex scapular artery via the periosteal branch and the thoracodorsal artery via the angular artery.

Methods: A retrospective chart review was conducted for all patients who underwent reconstruction with an STFF for mandibular defect between January 2016 and December 2020 at the University Hospital of Parma.

Modified Preauricular Transparotid Approach for Treating Mandibular Condylar Fractures.

Aim Of The Study: We introduce a technical variant of the standard preauricular approach to treat intracapsular and condylar neck fractures: the modified preauricular transparotid approach (MPTA). The main modification, when compared with the conventional submandibular approach, is that the incision of the superficial musculoaponeurotic system is performed directly above the parotid gland, and the buccal branch of the facial nerve is dissected in a retrograde way within the parotid gland.

Case Series: Between January 2019 and December 2020 at the Maxillofacial Departments of "Ospedale Maggiore" of Parma and "Policlinico San Martino" of Genoa 6 patients affected by intracapsular and condylar neck fractures underwent open reduction and internal with MPTA.

Maxillomandibular Advancement for Obstructive Sleep Apnea Syndrome: Long-Term Results of Respiratory Function and Reverse Face-Lift.

Purpose: Scientific literature considers maxillomandibular advancement (MMA) as the most effective surgical treatment for the management of adult obstructive sleep apnea syndrome (OSAS). Maxillomandibular advancement enlarges the pharyngeal space by expanding the skeletal framework. Moreover, it projects the soft tissue of the cheeks, the mouth, and the nose in the aging face, which is characterized by multiple signs affecting the middle third and the lower third.

Behavioral scales variability in patients with prolonged disorders of consciousness.

Background: The principal conditions differentiating disorders of consciousness (DOC) patients are the unresponsive wakefulness syndrome/vegetative state (UWS/VS) and the minimally conscious state (MCS). Many individuals who suffer from sudden-onset severe brain injury move through stages of UWS/VS and MCS before regaining full awareness. In some patients, the DOC condition is protracted for years (PDOC).

Analysis of the High Submandibular Approach: A Critical Reapprasail of a Transfacial Access to the Mandibular Skeleton.

Aim: In 2006 following the development of dedicated osteosynthesis plates, Meyer and colleagues reported a successful clinical study of condylar fractures treated by a modified submandibular approach; it was called high submandibular approach or "Strasbourg approach." The aim of this study is to describe the high submandibular approach step by step.

Case Series: Between January 2010 and December 2015 at the Maxillofacial Unit of the Hospital "Policlinico San Martino" 13 patients affected by subcondylar fracture underwent open reduction and internal with high submandibular approach.

Mediating Mindfulness-Based Interventions with Virtual Reality in Non-Clinical Populations: The State-of-the-Art.

Mindfulness is one of the most popular psychotherapeutic techniques that help to promote good mental and physical health. Combining mindfulness with immersive virtual reality (VR) has been proven to be especially effective for a wide range of mood disorders for which traditional mindfulness has proven valuable. However, the vast majority of immersive VR-enhanced mindfulness applications have focused on clinical settings, with little evidence on healthy subjects.

Fully Digitalized Workflow for One-Stage Mandibular Contouring and Orthognathic Surgery to Correct Severe Facial Asymmetry.

Introduction: Surgical correction of facial asymmetry is commonly performed in at least two stages. Recently, because of the long duration of a two-step procedure, the demand for a one-step procedure has increased. Our study aims to present a fully digitalized workflow for one-stage mandibular contouring (MC) and bimaxillary surgery to correct severe facial asymmetry using 3D technology.

Gender Influences Virtual Reality-Based Recovery of Cognitive Functions in Patients with Traumatic Brain Injury: A Secondary Analysis of a Randomized Clinical Trial.

The rehabilitation of cognitive deficits in individuals with traumatic brain injury is essential for promoting patients' recovery and autonomy. Virtual reality (VR) training is a powerful tool for reaching this target, although the effectiveness of this intervention could be interfered with by several factors. In this study, we evaluated if demographical and clinical variables could be related to the recovery of cognitive function in TBI patients after a well-validated VR training.

Stroke Telerehabilitation in Calabria: A Health Technology Assessment.

Telerehabilitation (TR) is defined as a model of home service for motor and cognitive rehabilitation, ensuring continuity of care over time. TR can replace the traditional face-to-face approach as an alternative method of delivering conventional rehabilitation and applies to situations where the patient is unable to reach rehabilitation facilities or for low-income countries where outcomes are particularly poor. For this reason, in this study, we sought to demonstrate the feasibility and utility of a well-known TR intervention on post-stroke patients living in one of the poorest indebted regions of Italy, where the delivery of rehabilitation services is inconsistent and not uniform.

Nociceptive Response Is a Possible Marker of Evolution in the Level of Consciousness in Unresponsive Wakefulness Syndrome Patients.

The Nociception Coma Scale (NCS) and its revised version (NCS-R) were used to evaluate behavioral responses to pain in non-communicative patients. We hypothesized that if patients demonstrate changes to their NCS(-R) scores over time, their evolving behavioral abilities could indicate a forthcoming diagnostic improvement with the Coma Recovery Scale-Revised (CRS-R). Forty-three Vegetative State/Unresponsive Wakefulness Syndrome (VS/UWS) patients were enrolled in the study.

Algorithm to the treatment of Crouzon syndrome.

Clinical reports regarding the entire surgical sequence in Crouzon syndrome from the neonatal period to the adult age are rare. The purpose of this study is to trace an operative algorithm with a long term follow up in a homogenous group of patients affected by Crouzon syndrome. A retrospective review was conducted for all patients affected by Crouzon syndrome who completed the entire surgical sequence.

Advanced Facial Rejuvenation After Bimaxillary Surgery in Three Different Facial Types.

Purpose: Facial aging is the consequence of many mechanisms involving the bones and the "soft tissue" (skin, fat, ligaments, muscles, and periosteum) of the face such as downward migration of the soft tissue, adipose and muscular tissue atrophy, and skeletal resorption. The potential of orthognathic surgery (double jaw surgical advancement) of expanding the skeletal foundation to increase the facial drape support is now recognized and widely popularized by several authors. The aim of this study was to analyze the rejuvenation change of the face after bimaxillary advancement for orthognathic surgery, focusing on the previously mentioned stigmata of the middle and the lower third of the aging face.

Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study.

Telehealth systems have shown success in the remote management of several neurological disorders, but there is a paucity of evidence in disorders of consciousness (DOC). In this study, we explore the effectiveness of a new telemonitoring system, for monitoring Vegetative State (VS) and Minimally Conscious State (MCS) patients. This was a prospective, mono-center randomized controlled study.

Salvage transorbital approach for the endovascular treatment of carotid cavernous fistulas.

Purpose: Carotid cavernous fistulas (CCFs) are abnormal connections between the cavernous sinus (CS) and carotid arteries. In direct CCFs, a transarterial route is often the preferred vascular access; in case of indirect CCFs, the complex anatomy of the feeder vessels and their extra-intracranial anastomosis makes the transarterial embolization challenging and often ineffective. The aim of this study was to review our experience with the transorbital approach to treat patients affected by CCF who have already experienced an endovascular failure procedure, in order to assess this salvage technique feasibility, by analyzing possible risks and complications.

The Trace Conditional Learning of the Noxious Stimulus in UWS Patients and Its Prognostic Value in a GSR and HRV Entropy Study.

The assessment of the consciousness level of Unresponsive Wakefulness Syndrome (UWS) patients often depends on a subjective interpretation of the observed spontaneous and volitional behavior. To date, the misdiagnosis level is around 30%. The aim of this study was to observe the behavior of UWS patients, during the administration of noxious stimulation by a Trace Conditioning protocol, assessed by the Galvanic Skin Response (GSR) and Heart Rate Variability (HRV) entropy.

Data on a new neurorehabilitation approach targeting functional recovery in stroke patients.

Robotic-assisted devices are known to positively affect the recovery of one specific motor effector after stroke. However, it has widely been reported that the functional status of patients is only partially ameliorated after application of this kind of advanced treatment. Here, data about the effect of a new rehabilitation approach has been described in a large population of stroke patients.

Subclavicular flap: A valid reconstructive option among anterior chest flaps in oral cancer patients.

Background: The subclavicular pedicled flap is based on the thoracic branch of the supraclavicular artery, and it represents a versatile reconstructive option for low-middle third face defects. Since its use in head and neck surgical oncology has not been popularized yet, we propose its application for oral cavity reconstruction after cancer resection by showing favorable results.

Methods: Eighteen subclavicular pedicled flaps were used to treat intraoral defects after oral squamous-cell cancer resection between June 2015 and December 2018.

The Reliability of the Progression of Autonomies Scale Applied on Acquired Brain Injured Patients.

The Progression of Autonomies Scale (PAS) is a behavioral scale useful to assess the autonomy levels in acquired brain-injured patients. It provides a broad profile, assessing different domains of human activities ranging from personal, domestic, and extradomestic autonomies. This cross-sectional study is aimed at evaluating the reliability of this scale on a large cohort of acquired brain injury (ABI) patients.

Respiratory and volumetric changes of the upper airways in craniofacial synostosis patients.

To assess postoperative changes of the upper airway in a pediatric syndromic cranial-synostosis (SCS) population who underwent Le Fort III (LFIII) or frontofacial advancement by distraction osteogenesis (DO). Charts' review of 25 SCS infants presented at our tertiary-care children's hospital between January 2005 and December 2016 was performed. Preoperative (T0) and postoperative (T1) three-dimensional computed tomography (3D-CT) and polysomnography (PSG) were recorded.

Buccal Fat Pad: Report of 24 Cases and Literature Review of 1,635 Cases of Oral Defect Reconstruction.

Objective: The buccal fat pad (BFP) has been progressively introduced into clinical practice for oral defect reconstruction. This study describes our experience with this technique and compares indications in the literature and outcomes.

Methods: We prospectively enrolled 24 patients presenting oral surgical defects and treated between January 2012 and January 2015 at our institution.