Orthognathic surgery: a randomized study comparing Piezosurgery and Saw techniques.

Introduction: The purpose of this study was to evaluate specific parameters: intra-operative time, facial swelling, degree of pain (VAS scale), recovery time and neurosensory disturbance in patients who underwent orthognathic surgery either using piezo or saw devices.

Material And Methods: We designed a retrospective study, which included 100 patients who underwent bilateral sagittal split osteotomy (BSSO) surgery combined with maxillary Le Fort I. They were separated into 2 groups of 50 patients each.

Maxillary fungus ball in a diabetic patient. An odontogenic origin.

Introduction: Fungus ball (FB) represents a granulomatous mass due to a fungal colonization which may disseminate and potentially lead to a systemic infection. Maxillary fungus ball is considered to be a complication of dental treatment and, according to relevant literature, it often stems from improper endodontic therapies.

Material And Methods: The authors report the case of a 69-year-old caucasian woman with nasal respiratory distress and frequent sinusitis symptoms.

Our Experience Managing Difficult Accidental Chainsaw Trauma.

Background: Chainsaw and circular-saw injuries represent a rare condition within the maxillofacial region. The purpose of this clinical report is to describe the injuries and the clinical and surgical management of these rare traumas.

Methods: In this clinical report, 11 patients presenting themselves to the emergency room in the hospital "Policlinico Le Scotte," Siena, from March 2016 to September 2017 with severe chainsaw and circular-saw injuries, were included.

The Second Division of Trigeminal Nerve for Corneal Neurotization: A Novel One-Stage Technique in Combination With Facial Reanimation.

Corneal neurotization represents an effective surgical strategy to restore corneal sensibility in patients affected by neurotrophic keratopathy.Corneal sensibility is essential in preserving structure and function of the eye. Loss of corneal sensibility can lead to a degenerative condition of the cornea known as neurotrophic keratopathy.

Indocyanine Green Sentinel Node in Merkel Cell Carcinoma of the Cheek.

Merkel cell carcinoma (MCC) is a rare malignant tumor with a neuroendocrine phenotype. The authors report a case of MCC of the left cheek region in an 85-year-old Caucasian woman who also received sentinel node biopsy using both Technectium-99m-labeled (99mTc) lymphoscintigraphy and indocyanine green lymphography.

Relationship Between the Quantity of Nerve Exposure During Bilateral Sagittal Split Osteotomy Surgery and Sensitive Recovery.

Aim And Objectives: The purpose of this study was to evaluate how different exposures of the V3 nerves during orthognathic surgery impact neurosensory disturbances.

Methods: The study included 127 patients who underwent either bilateral sagittal split osteotomy (BSSO) or BSSO with maxillary le Fort 1. They were divided into 6 groups, identified by the quantity of V3 nerve exposure.

Giant palatal schwannoma.

Schwannoma is a benign tumor that arises from nerves that contain Schwann cells. We report a case of giant schwannoma of the hard palate, which originated from the greater palatine nerve and is interesting for its large dimensions.

LEOPARD syndrome: maxillofacial care.

This article reports a case of a boy with LEOPARD syndrome with unusual mandibular osteolytic osteoclastic-like lesions and eruption disorder. The patient was referred to our department for bilateral facial swelling: systemic examinations, diagnosis, and dental and maxillofacial care are reported.

"Naked microvascular bone flap" in oral reconstruction.

Since the 1980s, bone free flaps have been used to reconstruct the maxilla and the mandible. The vascular pedicle, through the supply of nutritional substances and drugs from the bloodstream, ensures the vitality of the flap, rapid bone integration, and reduced risk of infection.However, due to many surgeons' concerns about orocervical and orosinusal fistulas and infections, bone flaps are usually buried and protected by mucosal flaps or a second skin flap whenever it is not possible to harvest a skin paddle together with the bone flap.

Calvarial onlay graft and submental incision in treatment of atrophic edentulous mandibles: an approach to reduce postoperative complications.

Purpose: The aim of this study was to test our approach based on the use of calvarial graft and extraoral approach, in treatment of severe mandibular atrophies with implant surgery and prosthetic rehabilitation.

Methods: We selected 6 patients, 4 females and 2 males, completely edentulous with a severe mandibular atrophy (class VI Cawood and Howell classification). Mean age of patients was 63 years, ranging from 60 to 67 years.

Management of a bulky capillary hemangioma in the parapharyngeal space with minimally invasive surgery.

In this article, the authors report their management with minimally invasive surgery of a bulky capillary hemangioma in the parapharyngeal space. Parapharyngeal space capillary hemangioma is a rare tumor in adults. Because of its rarity and difficulty to treat, we suggest a multidisciplinary approach in choosing the best treatment, with an accurate follow-up.

Complications of orbital floor repair with silastic sheet: the skin fistula.

Treatment of orbital floor fracture is a subject of great interest in maxillofacial surgery. Many materials have been described for its reconstruction.In this article, the authors report a case of a patient who, 7 years from a previous orbital floor fracture and treatment with silastic sheet, presented herself to their clinic for the failure of the material used for its reconstruction and a skin fistula.

Postsurgical predictive theoretical thickness (PTT) of frontal sinus anterior wall as key point in surgical management of frontal bossing: proposal of a new analytic method.

Background: Frontal bossing is a malformation characterized by peculiar prominent forehead, and commonly it can be associated with cranial synostosis and endocrine disorder; however, nonsyndromic conditions are described as well.Literature controversies on proper frontal bossing surgical treatment showed evidence of 2 main surgical procedures: frontal bone reshaping and bone en bloc mobilization.A decision-making criterion between these 2 techniques has never been described in literature.

Single-step nasal reconstruction with osteocutaneous forearm flap after total rhinectomy.

Purpose: Nasal defects resulting from tumor excision can be classified according to tissues involved, such as skin, cartilage, and bone. Although in the case of "simple" defects, reconstruction with loco-regional flap eventually associated with cartilage grafts can lead to satisfactory results; in the case of total or partial rhinectomy, a minimum of 3 and a maximum of 7 operations have to be performed in the current series to achieve an acceptable end result. We present the case of a total rhinectomy reconstruction in a single-step procedure with an osteocutaneous forearm free flap (RFOFF).

Surgery for malignant maxillary tumors involving the middle cranial fossa.

The purpose of this study was to evaluate the disease-free survival (DFS) of patients with maxillary malignant tumors invading the middle cranial fossa (MCF) who underwent a lateral or anterolateral skull base resection. This study was a retrospective analysis in a tertiary referral center and included 62 patients with maxillary malignant tumors invading the MCF (stage T4b) treated with surgery with or without postoperative radiotherapy. All patients had sharp pain and involvement of at least one branch of the trigeminal nerve.

Role of a new orthognathic surgery in maxillomandibular reconstruction by free flaps.

Purpose: The objective of this study was to describe the orthognathic surgery techniques for the treatment of occlusal anomalies in those patients who underwent complex maxillomandibular reconstruction with bony free flap.

Materials And Methods: The authors describe their personal technique developed over years of experience with reconstruction of mandibular defects with bony free flaps.

Results: The outcomes in these patients who were treated according to our surgical planning were completely satisfying, with a 100% stability of the treated bones.

Iliac crest flap: donor site morbidity.

Introduction: Starting from the 1980s, with the advent of microsurgery, microvascular flaps are used for the reconstruction of wide and complex bone defects of the maxillomandibular district. Compared with conventional and implant-supported prostheses, the free flaps allow aesthetic-functional rehabilitations more adapt to answer to problems that these wide disablements involve. The anatomic characteristics of the crest flap make it one of the best available flap in the maxillomandibular bone reconstruction.

Scapula free flap for complex maxillofacial reconstruction.

Introduction: Composite tissue defects of the mandible and maxilla, after resection of head and neck malignancies, osteoradionecrosis, malformations, or traumas, cause functional and aesthetic problems. Nowadays, microvascular free flaps represent the main choice for the reconstruction of these defects. Among the various flaps proposed, the scapula flap has favorable characteristics that make it suitable for bone, soft tissue, or combined defects.

Intraosseous hemangiomas.

Intraosseous hemangiomas are classified as benign tumors of vascular nature. Some authors describe them as hamartomas. They originate and expand inside bone structures.

Microvascular reconstruction of the mandible in irradiated patients.

This work focuses on the use of revascularized free flaps for the reconstruction of the major defects of the mandible after the removal of advanced-stage tumors in irradiated patients. It uses three representative cases to study the problems of complex patients and the possible reconstructive options. The cases, all three young patients (two females and one male), had undergone a mandibulectomy and adjuvant radiotherapy for malignant neoplasms.