206 research outputs found
One-Stage Reconstruction of a Defect of the Oral Commissure and of the Cheek With a Radial Forearm Free Flap
No full textSeveral reconstructive methods have been proposed for complex clinical cases. These methods are based on composite graft tissue flaps which allow to obtain modest aesthetic-functional results. Only recently, revascularized flaps (fasciocutaneous free flap of radial) have been used. In this work, the authors present a clinical report of cheek mucosal carcinoma extended to the omolateral lip commissure, which has required the full thickness removal of the cheek, the lip commissure, and part of both lips; the use of a bileft free fasciocutaneous flap of radial (to reconstruct with a single flap both the cutaneous and mucosal deficits) has allowed for adequate reconstruction with good aesthetic and functional results
Prosthetic rehabilitation in post-oncological patients: report of two cases
No full textProsthetic rehabilitation in post-oncologic patients after bone reconstruction are not substantially different than those of patients affected by severe atrophia of upper or lower jaw after bone reconstruction.
Aim of this paper is to evaluate the possibilities of prosthetic rehabilitation on these patients and to present our method. Prosthesis-based oral rehabilitation of such tumor cases rapresents a challenge.
The report analyses two cases of patients who underwent ablative oral surgery. Both have received a fibula free vascularised flap. The first was rehabilitated with a removable prosthesis fixed on the residual teeth, while the second with an implant supported prosthesis. In case of carcinoma resection of the oral mucosa, the removable prosthesis guarantees a simplification in dental care operations. On the other hand, irradiated mucosa is frequentely unable to tolerate the friction created by the acrylic base. However, the fixed prosthesis can limit the view during follow-up controls. In our school, according to all exposed reasons, we consider the implant supported overdenture prosthesis to be the best choice for those patients
sj-pdf-1-cmt-10.1177_19433875211067010 – Supplemental Material‐ The ‘Maxillary Pull-through’ Technique: A Minimally Invasive Endoscopic- Assisted Approach to Nasal Septum Neoformations with Maxillary Bone Infiltration
No full textSupplemental Material for The ‘Maxillary Pull-through’ Technique: A Minimally Invasive Endoscopic-Assisted Approach to Nasal Septum Neoformations with Maxillary Bone Infiltration by Paolo Priore, MD, PhD, Filippo Giovanetti, MD, PhD, Andrea Battisti, MD, Danilo Di Giorgio, MD, Marco Della Monaca, MD, PhD, Ingrid Raponi, MD, Andrea Cassoni, MD, PhD, Valentino Valentini, MD, DMD in Craniomaxillofacial Trauma </p
Pleomorphic adenoma of the lachrymal gland: Presentation of a clinical case of relapse
No full textPleomorphic adenoma affecting the lachrymal gland requires a well-grounded clinical and therapeutic protocol to avoid the risk of malignant transformation or disease recurrence, which is quite dangerous at this site. The authors present a clinical case of pleomorphic adenoma recurrence affecting the right lachrymal gland in a patient who first underwent a biopsy, with subsequent resection of the neoplasm. The authors also review the clinical and radiological features enabling a differential diagnosis and describe the radical "exenteratio orbitae" surgery for pleomorphic adenoma recurrence 7 years after the first operation, which was performed because of total derangement of the orbital cavity. The patient remains disease-free 5 years after this surgical treatment. Therefore, it turns out that an incisional biopsy carries a higher biological cost for the patient
Orbital floor restoration
No full textOrbital blow-out fractures reconstruction aims to restore the continuity of the orbital floor, to provide support of orbital contents and prevent soft tissues' fibrosis. Different materials have been tested over the years to reach this purpose. Traditionally, autogenous grafts have been used as the material of choice; in recent years alloplastic materials have gained popularity because of their availability and ease of use. The purpose of this study was to review materials used in orbital floor reconstructive surgery at the Department of Maxillo-Facial Surgery of University of Rome '' La Sapienza '', with emphasis on their biocompatibility, their shaping features, and mechanical properties. This report presents the results obtained by the application of these products on 379 patients who underwent surgical treatment for blow-out fractures from 1995 to 2003: the diagnosis of fracture of the orbital floor was based on clinical symptoms and CT axial scanning through coronal reconstruction. Followup period spanned from 1 to 8 years
Stability Analysis of Nonlinear Rotating Systems Using Lyapunov Characteristic Exponents Estimated From Multibody Dynamics
No full textThe use of Lyapunov characteristic exponents to assess the stability of nonlinear, time-dependent mechanical systems is discussed. Specific attention is dedicated to methods capable of estimating the largest exponent without requiring the Jacobian matrix of the problem, which can be applied to time histories resulting from simulations performed with existing multibody solvers. Helicopter ground resonance is analyzed as the reference application. Improvements over the available literature are: the problem is formulated in physical coordinates, without eliminating periodicity through multiblade coordinates; the rotation of the blades is not linearized; the problem is modeled considering absolute positions and orientations of parts. The dynamic instability that arises at some angular velocities when the isotropy of the rotor is broken (e.g., caused by the failure of one lead-lag damper, a design test condition) is observed to evolve into a large amplitude limit cycle, where the usual Floquet–Lyapunov analysis of the linearized time-periodic simply predicts instability
Transmandibular Approaches
No full textLesions involving the middle cranial base, its underlying volumes, and the first cervical vertebrae can be adequately managed surgically by means of a series of different approaches. These have the following basic prerequisites: to supply adequate surgical light, to identify and preserve the neurovascular structures adjacent to the lesion, to restore an adequate barrier between the neurocranium and the upper aerodigestive tracts, and to preserve both the functionality and the appearance of the patient. © 2010 Springer-Verlag Milan
Cranial, craniofacial and skull base surgery
No full textLesions involving the middle cranial base, its underlying volumes, and the first cervical vertebrae can be adequately managed surgically by means of a series of
different approaches. These have the following basic
prerequisites: to supply adequate surgical light, to identify and preserve the neurovascular structures adjacent
to the lesion, to restore an adequate barrier between the
neurocranium and the upper aerodigestive tracts, and
to preserve both the functionality and the appearance
of the patient.
The approaches comprise a heterogeneous set of surgical techniques. No clear classification has yet been
established. As a consequence, the terminology used to
describe them is often confusing.
Despite this complexity, there are basically four
ways by which the lesions (of the lateral sectors of the
infratemporal fossa and/or the middle cranial base) can
be resected: transtemporal, infratemporal, intracranial,
and transfacial. These approaches, depending on the
size and location of the lesion, may be used jointly resulting in so-called combined approaches.
Transmandibular approaches, the main topic of
this chapter, tend to merge substantially with each of
the four above approaches, although transmandibular
means literally an approach involving exposure of the
lesion by more or less substantial mobilization of the
mandible portions, and consequently a transfacial approach.
However, in surgery, when the middle cranial base
is entered laterally, it is impossible to obtain complete
exposure only by mobilizing the mandible. Therefore,
it is necessary to osteotomize and remove other bone
structures such as, for example, the zygomatic arch
and/or the temporal squama. Therefore, in the literature,
approaches that should be indicated as transmandibular,
are identified by their authors with the most varied
names, sometimes creating confusion.
As mentioned above, transmandibular approaches
can be classified as single approaches (when the approach obtained by mobilizing the mandible is exclusively transfacial) or as combined approaches (if the lesion is approached by combining mobilization of the
mandible with that of other bone structures such as the
zygoma or the temporal squama).
In addition, approaches can also be categorized as
anterior or lateral, depending on whether the initial incision is carried out anteriorly in the mental region or
submandibular region or laterally in the preauricular region and extended below along the anterior margin of
the sternocleidomastoid muscle
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