New Classification System and Defect-Oriented Algorithm for Functional Soft-Palate Reconstruction with Buccinator Myomucosal Flaps.

: Currently, there is a lack of a comprehensive classification system for soft-palate defects that provides synthetic information to guide functional reconstructive treatment. Our awareness, shaped by extensive experience, of the superiority of myomucosal flaps to fasciocutaneous flaps in functional palate reconstruction has driven us to introduce a new defect-based classification system and propose a new algorithm for reconstructing soft-palate defects using buccinator myomucosal flaps. : Soft-palate defects were classified into five classes.

Exoscope and Supermicrosurgery: Pros and Cons of 3D Innovation in Lymphatic Surgery.

The surgical treatment of lymphedema has seen advancements in recent years, with supramicrosurgical lymphaticovenular anastomosis (sLVA) gaining global acceptance. The integration of 3D exoscopes into microsurgery offers potential ergonomic and educational benefits. However, systematic evaluation of their efficacy in sLVA remains limited.

Combination of Supramicrosurgical Lymphatico-Venular Anastomosis (sLVA) and Lymph-Sparing Liposuction in Treating Cancer-Related Lymphedema: Rationale for a Regional One-Stage Approach.

Cancer-related lymphedema represents a potential complication of cancer treatment. The aim of this study is to evaluate the effectiveness of the combination of lymphatico-venular anastomosis and liposuction in the treatment of secondary lymphedema. We present a retrospective analysis of patients affected by cancer-related unilateral limb lymphedema.

Tongue Reconstruction with Buccinator Myomucosal Island Flaps: Technical Considerations, Oncologic Safety, Functional Outcomes and QoL Assessment-A Retrospective Observational Study.

The objective of this study was to investigate the effectiveness of buccinator myomucosal island flaps for tongue reconstruction following malignant tumor resections. A retrospective study was performed on 52 patients who underwent tongue reconstructions with buccinator myomucosal island flaps between 2012 and 2020. We reviewed the flap type and size, harvesting time, recipient- and donor-site complications, postoperative oncologic outcomes, functional recovery and QoL assessment.

A Single-Center Retrospective Analysis of 14 Head and Neck AVMs Cases Treated with a Single-Day Combined Endovascular and Surgical Approach.

Arteriovenous malformations (AVMs) are rare congenital defects of vascular development whose treatment remains challenging. The paper presents a retrospective single-center study of 14 patients with AVMs of the head and neck region undergoing combined endovascular and surgical treatment in a single day. AVM architecture and therapeutic strategies were determined on the basis of angiographic studies, while the psychological involvement of each patient was assessed by means of a questionnaire.

The "Kite-t-FAMMIF": A Novel Technique for Reconstruction of Extensive Soft Palate Resection.

Total soft palate reconstruction is a challenge for the head and neck surgeon. Velopharyngeal incompetence resulting from soft palate resection impairs both speech and swallowing and significantly affects the quality of life of the patients. Radial forearm free flap is the reconstructive technique most used worldwide, but it requires microsurgical skills, is associated with high donor site morbidity, and shrinks during the healing process, especially after adjuvant radiotherapy.

The Temporal Subcutaneous Brow Lift with Orbicularis Oculi Muscle Elastic Flap: Technical Considerations, Systematic Review, and Terminology Standardization.

Objectives:  As the face ages, cosmetic changes in the periorbital region including eyebrow ptosis, sagging in the lateral temporo-orbital region with superior eyelid hooding, ptosis of orbicularis oculi muscle associated with drooping of the malar area with multiple "crow feets", a deeper lid-cheek junction, and malar festoons also occur. All these periorbital structures should be considered as a single anatomical entity.

Methods:  Numerous techniques have been described to correct brow aesthetics in facial rejuvenation.

"Functional trapezius muscle reconstruction after resection of a desmoid tumor using an innervated gracilis free flap".

Desmoid tumors are characterized by indolent growth, progressive invasion of surrounding tissues and a high rate of relapse. We present the case of a desmoid tumor rising from the trapezius of a young woman. Following resection, we performed a functional reconstruction using an innervated gracilis free flap.

Recommendations for a safe restart of elective aerosol-generating oral surgery procedures following the COVID-19 pandemic outbreak: An Italian multicenter study.

Among healthcare workers, oral and maxillofacial surgeons are some of the most exposed to coronavirus disease (COVID-19). The aim of this retrospective study was to develop suggestions for continuing the work of oral and maxillofacial surgeons using a safe protocol for elective and urgent aerosol-generating procedures that could prevent the onset of new clusters. Based on the results obtained and a guidelines review of those Asian countries that had promptly managed the current pandemic, the following safety protocol was developed.

Chimeric LSMAP Double-barrel Fibula Free Flap: Goal-oriented Surgical Technique and Tips for One-stage Mandibular Reconstruction.

Composite oromandibular defects involving jaw bones, intraoral and skin/soft tissues, or dynamic structures such as the tongue, soft palate, and pharynx are real reconstructive challenges even today. Despite improvements in oral dental rehabilitation, another complex task to deal with in young patients with dentate or nonatrophic mandible is correcting a too large vertical occlusal dimension, which makes the prosthodontic rehabilitation very challenging. Instead of using more complex and time-consuming methods such as simultaneous free flaps and to avoid further bone graft and second-stage revision procedures, an innovative double-barrel shaped chimeric fibula free flap with lateral supramalleolar artery perforator flap is used to fulfill all of the reconstructive requisites in one-stage.

A new aesthetic pretrichial approach for upper third-facial fractures and pathologies: The "Crown incision".

Background: The coronal incision represents the cornerstone for the treatment of upper-third maxillofacial pathologies. However, this approach leaves long scars that in numerous patients, it can cause extensive surrounding alopecia and sensory skin deficits. This clinical evidence prompted the authors to propose a full pretrichial incision, the crown incision, in order to overcome these drawbacks.

Accuracy of Fibula Reconstruction Using Patient-Specific Cad/Cam Plates: A Multicenter Study on 47 Patients.

Objectives: 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.

Neck dissection with harmonic instruments and electrocautery: a prospective comparative study.

Background: Harmonic instruments are becoming popular in head and neck surgeries. In this prospective, randomized study, the efficacy of the harmonic instruments and electrosurgical technique is compared.

Materials And Methods: A total of 48 patients undergoing unilateral neck dissection were divided into two groups.

Platform switching versus regular platform single implants: 5-year post-loading results from a randomised controlled trial.

Purpose: To compare the clinical and radiographic outcomes of platform switching (PS) and regular platform (RP) implants.

Materials And Methods: This study was designed as a randomised controlled split-mouth trial. Eighteen patients, with bilaterally missing single premolars or molars to be restored with implant-supported single crowns, were consecutively enrolled.

Fibula free flap pedicle ossification: Experience of two centres and a review of the literature.

Purpose: The osteogenic potential of vascularized periosteum has been described in a few cases in the literature, and many different factors have been pointed out as plausible. Our aim was to review the literature in order to give a complete overview of this topic and to report on our clinical experience.

Patients & Methods: Our experience includes three patients who underwent maxillectomy and FFF reconstruction.

Aesthetic and Functional Evaluation of Total Nasal Reconstructions.

The loss of a portion or the totality of the nose has great relevance on the perception of the beauty of a face and can result in a catastrophic quality of life impairment. Several surgical techniques are currently available for the reconstruction of the nasal pyramid. However, there are very few nasal reconstruction quality evaluation protocols that allow the surgeon to choose objectively the best technique for each kind of defects.

Tactile recovery assessment with shortened Semmes-Weinstein monofilaments in patients with buccinator myomucosal flap oral cavity reconstructions.

Background: The sensitive restoration is a primary aim of oral reconstructive surgery. The Semmes-Weinstein monofilament test is the "Gold Standard" to assess the threshold of tactile sensitivity on the skin but its use in the oral cavity is limited due to the size of the tools. We adopted half-cut Semmes-Weinstein monofilaments to evaluate the threshold of tactile sensitivity in oral reconstructions with buccinator myomucosal flaps.

Reconstruction of full-thickness cheek defect with chimeric facial artery free flap: A case report.

Full-thickness cheek defects represent a difficult challenge for reconstructive surgeons. Multiple techniques have been described, including local, regional, and free flaps. In this report, the reconstruction of a through and through left cheek defect, resulting from a self-inflicted gunshot injury, with a chimeric facial artery free flap is presented.

Sensory recovery of myomucosal flap oral cavity reconstructions.

Background: Sensory restoration of the oral cavity is a primary aim of reconstructive surgery in posttraumatic or postablative defects. Sensitivity plays a key role in oral function, whose impairment strongly affects the patient's quality of life. Cheek myomucosal flaps provide a reliable and tissue-like reconstruction of these regions but their sensitive recovery, which we still know little about, deserves thorough assessment.

Rational and simplified nomenclature for buccinator myomucosal flaps.

Background: Reconstruction of moderate-sized mucosal defects of the oral cavity or oropharynx represents a surgical challenge. Buccinator myomucosal flaps seem to provide "ideal reconstruction" of oral/oropharyngeal defects because they carry a thin, mobile, well-vascularized, and sensitive tissue, like that excised or lost. Nevertheless, these flaps are not immediately popular because of confusion surrounding the complex terminology used to name them.

Perivascular Epithelioid Cell Tumour with Intraorbital Location: Report of a Case and Review of the Literature.

The Perivascular Epithelioid Cell tumours (PEComas) are rare mesenchymal neoplasms recognized as entity by the World Health Organization. The tumour cells have an uncertain origin and are characterized by distinctive histological and immunohistochemical features. We report a case of PEComa occurring as intraorbital lesion in a 47-year-old man.

Guided implant surgery after free-flap reconstruction: Four-year results from a prospective clinical trial.

Aim: The aim of this prospective clinical study is to assess the 4-year outcomes of implant-supported restorations performed using a computer-guided template-assisted flapless implant surgery approach in patients reconstructed with fibula or iliac crest free flaps.

Materials And Methods: Twelve jaws in 10 patients were reconstructed with osteomyocutaneous free flap after tumour resection or gunshot wound, after complete healing computer-assisted template-based flapless implant placement, based on prosthetic and aesthetic analysis, was performed using a customized protocol. Treatment success was evaluated using the following parameters: survival of implants/prostheses, prosthetic and biologic complications, marginal bone remodelling, soft tissue parameters and patient satisfaction.