Skin cancers affecting the concha and antihelix are quite common, because of anterior auricular projection from the head and subsequent actinic exposure, leading to the need for effective ear reconstruction post-surgery. Various methods such as skin grafts, free tissue transplantation, and local flaps have been used. This study introduces a refined technique for concha-antihelix defect reconstruction, based on a minimally invasive modification of the revolving-door flap procedure.
View Article and Find Full Text PDFCurrent concepts in orthognathic surgery focus on not just rectifying dentoskeletal irregularities but also improving facial aesthetic and function. In this respect, nasal reshaping holds extraordinary significance in determining surgery effectiveness and patient satisfaction. Facial preoperative evaluations emphasize the paramount functional and aesthetic impacts of caudal septum in tip reshaping.
View Article and Find Full Text PDFWith the increasing use of sustainable energy sources, the electric scooter has become a widely used vehicle. The aim of the study is to analyse the types of facial fracture related to road traffic accidents to outline the need for dedicated road rules. An observational, retrospective, multicentre study was carried out at the Maxillofacial Surgery Units of six Italian hospitals.
View Article and Find Full Text PDFDespite the progress made in multidisciplinary care, there has been little improvement in the oncologic outcomes of oral cavity squamous cell carcinomas (OSCCs). In the latest edition of the TNM staging, "depth of invasion" (DOI) has recently been introduced as one of the criteria for determining the T stage, alongside other factors. DOI is widely recognized as an independent risk factor for nodal metastases and is a crucial consideration in the preoperative staging of OSCCs, along with measurements of tumor thickness (TT).
View Article and Find Full Text PDFOral Potentially Malignant Disorder (OPMD) is a significant concern for clinicians due to the risk of malignant transformation. Oral Squamous Cell Carcinoma (OSCC) is a common type of cancer with a low survival rate, causing over 200,000 new cases globally each year. Despite advancements in diagnosis and treatment, the five-year survival rate for OSCC patients remains under 50%.
View Article and Find Full Text PDFFor decades, oral squamous cell carcinoma (OSCC) has been one of the most prevalent and mortal cancers worldwide. The gold standard for OSCC diagnosis is still histopathology but this narrative multidisciplinary review has the aim to explore the literature about conventional OSCC prognostic indicators related to the pTNM stage at the diagnosis such as the depth of invasion and the lymphovascular invasion associated with distant metastasis as indicators of poor life expectancy. Despite its multifactorial nature and recognizable precursors, its diagnosis at the early stages is still challenging.
View Article and Find Full Text PDF(1) Background: In surgical procedures for maxillofacial tumours, it is challenging to preserve functional and cosmetic properties in the affected patients. The use of fat grafting is considered as a valuable alternative to overcome postoperative aesthetic asymmetry problems. (2) Methods: In this study, we enrolled thirty patients with parotid gland tumours in which a partial or complete parotidectomy was performed with positioning in the parotid bed of autologous dermis-fat grafts.
View Article and Find Full Text PDF(1) Background: Medication-related osteonecrosis of the jaws (MRONJ) is an adverse drug reaction characterized by progressive bone disruption and necrosis in the mandibular and/or maxillary bones. It occurs in individuals who have received antiresorptive drugs without prior radiotherapy. Since its first reported cases in the USA in 2003, extensive literature has emerged worldwide, leading to significant advancements in understanding MRONJ's pathogenesis and management.
View Article and Find Full Text PDFBilateral sagittal split osteotomy for orthognathic surgery is the most used technique for mandible advancement or setback and has been well documented and modified over the years since Trauner and Obwegeser described it. The improvement brought by each technique allowed the surgeons to perform safer osteotomies, shorten the operative time, and increased the flexibility of the programmed mandibular movements. The authors present a modification of the bilateral sagittal osteotomy technique with the aim of making the technique easier to perform and more comfortable for the surgeon for the purpose of positioning the osteosynthesis plates and screws.
View Article and Find Full Text PDFTemporary facial nerve palsy after parotid tumor surgery ranges from 14 to 65%, depending on surgery, tumor type, and subsite. The study aimed to evaluate the role of Kabat physical rehabilitation in the outcomes of patients affected by severe facial nerve palsy following parotid gland surgery. The results and clinical data of two groups, Kabat and non-Kabat (control), were statistically compared.
View Article and Find Full Text PDFWhen occlusal alterations are not accompanied by paranasal deficiencies, mobilization of the maxilla via Le Fort I osteotomy should be made with a different design. In this preliminary report, a W-shaped osteotomy that doesn't change the position of the maxillary bone surrounding the pyriform aperture was presented for the first time. Advantages and indications of this new procedure are discussed.
View Article and Find Full Text PDFChest pain following a trans-thoracic biopsy often has multiple etiologies, especially in patients with lymphomas. Pathological neuronal mechanisms integrate with an overproduction of IL-6, TNF-α, IL1-β by macrophages and monocytes, which amplifies inflammation and pain. In consideration of this complex pathogenesis, international guidelines recommend diversified analgesia protocols: thoracic epidural, paravertebral block, and systemic administration of opioids.
View Article and Find Full Text PDFLymphomas usually involve lymph nodes and other lymphoid tissues, but sometimes occur in non-lymphoid organs, called extra-nodal sites. Primary diffuse extra-lymph node large B-cell lymphoma (DLBCL) of the thyroid and parotid gland have been observed rarely. According to the most accredited guidelines, primary extra-nodal DLBCL of the parotid and thyroid glands should be treated with three cycles of R-CHOP followed by radiotherapy of the involved site (ISRT).
View Article and Find Full Text PDFArthrocentesis in temporomandibular joint disorders can be associated with the intra-articular infiltration of various drugs with the objective of increase treatment efficacy. The aim of this study was to evaluate the clinical indexes variation in patients affected by temporomandibular joint disorders treated with arthrocentesis and sodium hyaluronate (SH) injections. A total of 28 patients suffering from temporomandibular joint disorders underwent one cycle of five arthrocentesis and infiltrations of sodium hyaluronate.
View Article and Find Full Text PDFObjectives: This prospective study evaluated the accuracy of mandibular reconstruction using free fibular flaps (by comparing virtual plans to the three-dimensional postoperative results), and the extent of bone-to-bone contact after computer-assisted surgery.
Methods: We included 65 patients who underwent partial-continuity mandibular resections from February 2013 to January 2017, and evaluated virtual planning, surgical techniques, and accuracy.
Results: Forty-seven patients were analysed.
The prevalence of chronic pain is between 33% to 64% and is due to cancer pain, but it has also been observed in non-cancer patients. Chronic pain is associated with lower quality of life and higher psychological distress and depressive/anxiety disorders in patients without a history of disorder. In this study we evaluated in clinical practice the effectiveness of the intrathecal pump in 140 patients who underwent pain therapy at our Center.
View Article and Find Full Text PDFBackground: Multi-phasic Computed Tomography (CT) evaluation allows to study the enhancement features of parotid gland masses. The aim of our study was to evaluate the role of delayed enhancement in the characterization of different histologic types of parotid tumours.
Methods: Forty-eight patients (22 male and 26 female) with at least one parotid gland tumor, were included in our study.
The oral tongue is the most common site for tumours within the oral cavity. Despite intense research, there has been no improvement in the survival rate for patients with oral tongue squamous cell carcinoma (OTSCC) during the last decades. Differences between oral cancer patients based on ethno-geographical distribution have been reported.
View Article and Find Full Text PDFBackground: The purpose of this study was to report the outcome of the management of both horizontal and vertical defects of alveolar crest using the bone slat technique approach in conjunction with third molar removal prior to implant placement in the aesthetic area.
Methods: We present a 20-year-old female patient who lost a maxillary lateral incisor. The objective of treatment was to replace the lateral incisor with an implant-supported crown restoration without interfering with the integrity and topography of the adjacent gingival tissues.
Squamous cell carcinoma of the head and neck, SCCHN, is a heterogeneous group of tumours not only concerning the site of origin but also regarding aetiology. The 5-year survival for the whole group of SCCHN tumours has not significantly improved over the last 20-25 years. Apart from tumour spread to lymph nodes, N status, gains and losses of specific chromosomes are the only factors shown to be independent prognostic markers for these tumours.
View Article and Find Full Text PDFBackground: The reconstruction of alveolar ridges for implant placement is still a challenging surgical procedure, especially in the case of extensive vertical and horizontal bone atrophy.
Objective: The objective of the present study was to evaluate the quantity and quality of newly regenerated bone; clinically by means of direct clinical measuring, ridges augmented by autogenous cortical bone associated with autogenous particulate bone graft in the posterior lower jaw defect.
Methods: For the preliminary study, a bone defects in partially edentulous in patient aged 52 years were selected to receive horizontal ridge augumentation prior autolougous bone block and particulate graft.
Background: A three-dimensionally favourable mandibular bone crest is desirable to be able to successfully implant placement to meet the aesthetic and functional criteria in the implant-prosthetic rehabilitation. Several surgical procedures have been advocated for bone augmentation of the atrophic mandible, and the sandwich osteotomy is one of these techniques. The aim of the present case report was to assess the suitability of segmental mandibular sandwich osteotomy combined with a tunnel technique of soft tissue.
View Article and Find Full Text PDFDescending Necrotizing Mediastinitis (DNM) is a polymicrobic, dangerous and often fatal process, arising from head or neck infections and spreading along the deep fascial cervical planes, descending into the mediastinum. It can rapidly progress to sepsis and can frequently lead to death. It has a high mortality rate, up to 40% in the different series, as described in the literature.
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