Microsurgical Reconstruction of the Nose: The Aesthetic Approach to Total Defects.

Background:  Reconstruction of complex defects involving nose and close facial units represents an aesthetic and functional challenge. Restoring satisfactory nasal shape, combining aesthetic, nasal function and patent airways is mandatory. In this paper, we describe our approach to total nose defects and we report our 20-year experience in microvascular nose reconstruction.

Navigation-guided resection of maxillary tumours: The accuracy of computer-assisted surgery in terms of control of resection margins - A feasibility study.

Introduction: Surgical treatment of maxillary tumours is often highly complex. The three-dimensional anatomy of the mid-face renders both correct intraoperative orientation and adequate oncological safety difficult to obtain. Recently, computer-assisted techniques and intraoperative navigation have been applied to oncological surgery treating head and neck cancer.

Orbital Reconstruction: Patient-Specific Orbital Floor Reconstruction Using a Mirroring Technique and a Customized Titanium Mesh.

Objective: Enophthalmos is a severe complication of primary reconstruction of orbital floor fractures. The goal of secondary reconstruction procedures is to restore symmetrical globe positions to recover function and aesthetics. The authors propose a new method of orbital floor reconstruction using a mirroring technique and a customized titanium mesh, printed using a direct metal laser-sintering method.

Giant pleomorphic adenoma of the parotid gland: an unusual case presentation and literature review.

Pleomorphic adenoma is the most common type of all salivary gland tumours. Although uncommon, cases of giant pleomorphic adenomas have been described in the medical literature, the majority involving the parotid gland. This paper describes an unusual case of a giant adenoma arising in the parotid gland.

Computer-Aided Rehabilitation of Maxillary Oncological Defects Using Zygomatic Implants: A Defect-Based Classification.

Purpose: A complete maxillectomy for neoplastic lesions leads to serious oral dysfunction. Zygomatic implants for fixed bridge support are considered beneficial for maxillary defects after tumor resection.

Materials And Methods: This clinical study examined the management of patients with different maxillary defect types who underwent delayed rehabilitation using zygomatic implants and immediate prosthetic loading.

Aggressive Central Giant Cell Granuloma of the Mandible Treated With Conservative Surgical Enucleation and Interferon-α-2a: Complete Remission With Long-Term Follow-Up.

Central giant cell granuloma (CGCG) is a benign tumor of the jaws. Aggressive lesions present a strong tendency toward recurrence after surgical enucleation; thus, en bloc resection and microvascular bone free flap transfer are usually performed. However, in young patients, aggressive surgical treatment is a not always suitable solution.

Head and neck cancer in elderly patients: is microsurgical free-tissue transfer a safe procedure?

The safety and success of microvascular transfer have been well documented in the general population, but the good results achieved with the use of free flaps in elderly patients have received little attention. This study sought to identify differences in complications, morbidity and functional outcomes between elderly (≥ 75 years) and younger (< 75 years) patients treated surgically for advanced head and neck cancer using the Head and Neck 35 module of the European Organisation for Research and Treatment of Cancer quality of life questionnaire. Patient treatment consisted of composite resection, including excision of the primary tumour with ipsilateral or bilateral neck dissection and microvascular reconstruction.

Health-related quality of life as a survival predictor for patients with oral cancer: is quality of life associated with long-term overall survival?

Objective: The aim of the present prospective study was to obtain further insight into health-related quality of life (HR-QoL) as a predictor of survival in a selected cohort of patients with oral cancer.

Study Design: A total of 124 patients were treated with surgery or combined therapy. All of the recruited patients completed the European Organization for Research and Treatment of Cancer questionnaires QLQC30 and H&N35 on 4 occasions.

Intraoperative biopsy of the major cranial nerves in the surgical strategy for adenoid cystic carcinoma close to the skull base.

Objective: Adenoid cystic carcinoma of the salivary glands has a propensity for perineural invasion, which could favor spread along the major cranial nerves, sometimes to the skull base and through the foramina to the brain parenchyma. This study evaluated the relationship between neural spread and relapse in the skull base.

Study Design: During surgery, we performed multiple biopsies with extemporaneous examination of the major nerves close to the tumor to guide the surgical resection.

Does microvascular free flap reconstruction in oral squamous cell carcinoma improve patient survival?

Objective: We analyzed our experiences with microvascular reconstruction after oncologic resections for oral squamous cell carcinoma. Has microvascular surgery changed the survival rate of these patients?

Design: Retrospective study.

Subjects And Methods: Forty-two consecutive patients enrolled from March 1999 to December 2004.

Periodontitis and cytokine patterns in HIV positive patients.

Objective: Oral and dental problems are common among human immunodeficiency virus (HIV) infected individuals, particularly the periodontitis is common in HIV-infected subjects.

Aim: To evaluate the cytokine patterns in HIV+ patients with periodontitis.

Material And Methods: In this study we analysed: HIV+ patients with and without periodontitis and HIV negative patients with and without periodontitis.

Biphosphonate-associated osteonecrosis can be controlled by nonsurgical management.

Sixteen patients with jaw biphosphonate-osteonecrosis and with exposed bone areas were subdivided into 2 treatment groups. The first group (7 patients) underwent superficial or radical surgical therapy, while the second (9 patients) underwent antibiotic treatment. A slight reduction of the necrotic areas was observed in 5 of 7 patients in the first group, whereas no change was observed in the remaining 2 patients at 22- and 24-month follow-up.

Histology and stability study of cortical bone graft influence on titanium implants.

Objective: The mechanisms for integrating titanium implants in recipient bone are still not well defined, and it is not known whether the process of bone formation around implants inserted into grafts is the same as that described for titanium implants in nongrafted cortical bone. This study compared the histology, stability, and osseointegration of titanium implants inserted in cortical bone with and without a simultaneous autologous cortical bone graft in an experimental animal model.

Methods: Thirty titanium implants were inserted in 3 sheep.

The joint use of LCA and emergy evaluation for the analysis of two Italian wine farms.

The aim of this paper is to evaluate two agroindustrial productive processes in their entirety (one organic and one semi-industrial), focusing on the comparison of impacts derived from the inputs and outputs of the system (life cycle assessment, LCA), integrated with a physical evaluation of the resources and natural services, on a common basis (emergy). Methods based on the joint use of LCA and emergy evaluation are useful, as they measure the contribution of environmental services and products to the productive process thus focusing primarily on the environmental impact of emissions and non-renewable energy inputs. The complementarity of the methods used in this paper contributes important elements and information useful for the comprehension of the organization of agriculture within Siena's territory.

Computed tomography and magnetic resonance features of carcinoma of the tongue.

Computed tomography (CT) and magnetic resonance (MR) imaging allow more accurate staging of the carcinoma of the tongue than the clinical examination alone. The complex anatomy and the tumour margins make the interpretation of CT and MR images challenging. The aim of this paper is to review the technique and semiotic criteria for CT and MR evaluation and staging of carcinoma of the tongue.

Synovial cell sarcoma of the neck. Case report and review of the literature.

Synovial sarcoma is an uncommon neoplasm accounting between 8 and 10% of all soft tissue malignancies. Involvement of the head and neck region is rare. So far, fewer than 100 cases have been reported in the literature and only a few originated in the soft palate, tongue, larynx, hypopharynx, and cervical oesophagus.

Human herpesvirus-6 reactivation in a longitudinal study of two HIV-1 infected patients.

After primary infection, human herpesvirus-6 (HHV-6) persists in latent form and can be reactivated in immunocompromised subjects. A longitudinal study of HHV-6 infection was carried out in two HIV-1 seropositive patients to provide in vivo evidence of HHV-6 reactivation. Concomitant with a significant rise of anti-HHV-6 IgG detected by IFA, a transient increase of HHV-6 viral load was shown in PBLs by PCR.

Quantitation of HCV viraemia by branched DNA signal amplification in patients treated with alpha-interferon--a longitudinal study.

Using bDNA, the plasma viral load trend of HCV-infected patients undergoing IFN therapy was analyzed. Nine patients were enrolled, each assigned to one of three groups, based on IFN response as determined by ALT and AST level trend. HCV was genotyped using DEIA.

Prolonged bedtime treatment with H2-receptor antagonists (ranitidine and famotidine) does not affect blood alcohol levels after ethanol ingestion in male patients with duodenal ulcer.

Objective: To verify whether a prolonged (therapeutic) treatment with ranitidine or famotidine may affect blood alcohol concentrations (BAC) in patients with duodenal ulcer (DU).

Methods: Sixteen male patients with DU were studied. Subjects with Helicobacter pylori-associated DU did not enter the study.