Negative pressure wound therapy in complex cranio-maxillofacial and cervical wounds.

The care and the management of the healing of difficult wounds at the level of the skull-facial face many problems related to patient compliance and the need to perform multiple dressings, with long periods of healing and, occasionally, a very long hospitalisation period. The introduction and evolution of negative pressure wound therapy (NPWT) in the treatment of difficult wounds has resulted in better healing, with a drastic reduction in terms of time and biological costs to the patient and cost to the health care system. The main aim of this study is to describe and discuss, using out our experience, the usefulness of NPWT in the cranial-facial-cervical region.

Orbital Osteoblastoma: Technical Innovations in Resection and Reconstruction Using Virtual Surgery Simulation.

Osteoblastoma is a benign tumor of bone, representing less than 1% of bone tumors. Craniomaxillofacial localizations account for up to 15% of the total and frequently involve the posterior mandible. Endo-orbital localization is very rare, with most occurring in young patients.

Primary Intraosseous Squamous Cell Carcinoma of the Jaws: 6 New Cases, Experience, and Literature Comparison.

Purpose: To analyze the clinical, histologic, radiologic, therapeutic, and prognostic aspects of 6 cases of an uncommon head and neck malignancy and compare these results with data in the literature.

Materials And Methods: The medical histories of all patients treated in the Maxillofacial Surgery Unit in San Gerardo Hospital (Monza, Italy) for primitive intraosseous squamous cell carcinoma (PIOSCC) of the jaw were reviewed. All patients were considered suitable for inclusion in the study, specifically those whose oral mucosa had not been compromised and who did not have distant metastases.

The free anterolateral thigh musculocutaneous flap for head and neck reconstruction: one surgeon's experience in 92 cases.

Background: Applications of the free anterolateral thigh (ALT) musculocutaneous flap have been largely underestimated compared with indications for fasciocutaneous or perforator flaps. In this article, the authors critically review the experience of a single surgeon with the free ALT musculocutaneous flap for head and neck reconstruction, focusing on its applications in different cephalic areas and on advantages and disadvantages of this technique.

Patients And Methods: Ninety-two patients were treated using a free ALT musculocutaneous flap.

Reconstruction of lateral through and through oro-mandibular defects following oncological resections.

Background: Resections of oromandibular squamous cell carcinoma involving lateral mandible, oral cavity, and the skin, lead to composite oromandibular defects that can be approached in several ways depending on the extension of the bone defect, of the soft tissue and cutaneous resection, the patient's general status and the prognosis. Purpose of the study is to evaluate retrospectively functional and esthetic outcome obtained with different reconstructive technique employed.

Methods: A retrospective evaluation of 42 patients has been performed.

Donor site morbidity using the buccinator myomucosal island flap.

Objective: The objective of this study was to analyze our experience with donor site morbidity after harvesting a buccinator myomucosal island flap (BUMIF) for reconstructing surgical defects involving the tongue and floor of the mouth after oncological resections in 15 consecutive patients.

Study Design: Donor site morbidity was evaluated using 5 parameters: mouth opening, oral commissure symmetry, inner vestibule restoration, cheek mucosal lining, and the esthetic result. The clinical evaluation was performed by a blinded panel of 2 clinicians and the patient him- or herself, assessing each parameter with a score ranging from 0 to 3.

Iliac crest free flap for maxillary reconstruction.

Purpose: Reconstructing defects after maxillary resections presents a challenge for the reconstructive surgeon because of the critical role played by the maxillary skeleton in facial function and esthetics. Obturation, local or locoregional flaps, and soft tissue free flaps are good options for maxillary reconstruction; however, the lack of bone reconstruction often leads to ptosis of the facial tissues, particularly of the nasal base and columella, under the effects of gravity and makes it impossible to place osseous implants for dental rehabilitation. We present our experience with the iliac crest free flap for maxillary reconstruction, focusing on the advantages of this technique and particularly on flap positioning, which is dependent on defect site and size.

Fibro-osseous dysplasia localized to the zygomatic arch: case report.

Fibrous dysplasia is an osseous growth disorder, producing immature bone characterized by the replacement of normal bone with fibro-osseous connective tissue. The therapy is surgical, but the diagnosis of fibrous dysplasia of the craniofacial bones is not in itself an indication for treatment. The authors present a rare case of a zygomatic arch localization of fibrous dysplasia causing considerable facial asymmetry and social impairment.

Reconstruction of anterior through and through oromandibular defects following oncological resections.

Background: Resections of oromandibular squamous cell carcinoma involving anterior mandible, floor of the mouth, and the skin, lead to composite oromandibular defects that can be approached in several ways depending on the extension of the bone defect, of the soft tissue and cutaneous resection, the patient's general status, and the prognosis.

Methods: A retrospective evaluation of 27 patients has been performed. The techniques described included single osseous or soft tissues free flap reconstruction, two free flaps or free and locoregional flap association.