1,720,980 research outputs found
Sclerosing osteomyelitis of Garré periostitis ossificans.
No full textSclerosing osteomyelitis of Garré is a rare syndrome; the mandible is the most commonly affected bone segment in the cervicofacial region. This chronic disease is characterized by a nonsuppurative ossifying periostitis with subperiosteal bone formation, commonly reactive to a mild infection or irritation. The differential diagnosis must be made with similar clinical conditions with hard mandibular swelling associated with bony sclerosis. Presumptive diagnosis can be achieved by radiology, but such diagnosis must be confirmed by histology. The aim of therapy is to remove the cause when recognized, aided by an adequate antibiotic therapy. Clinical, radiographic, and histologic features are presented in this case report
Vie di diffusione dei tumori dei seni paranasali e pressupposti anatomici di asportazione complessa
No full textAn unusual case of sub-condylar bilateral fracture and bilateral post-traumatic temporomandibular ankylosis.
No full textA case of bilateral sub-condylar fracture with wide stump dislocation associated with a central facial trauma, fracture-intrusion of the rhino-orbital-maxillary complex and a parasymphyseal mandibular fracture, is reported. After surgery and inter-maxillary fixation an unusual temporo-mandibular ankylosis developed. Maximum mouth opening, lateral and protrusive movements were severely limited. Surgical treatment of ankylosis was requested and performed. The originality of this case lies in the atypical lateral dislocation of condylar neck fractured stumps to the zygomatic arches and in the later appearance of ankylosis between the glenoid fossa, zygomatic arch, condylar neck stump, and the condylar process displaced anteromedially. The ankylosed blocks were resected, displaced condyles were also removed due to the strong adhesion with the ankylotic tissue and the lack of any anatomical continuity or connection with the glenoid fossa. Functional therapy allowed the resolution of the functional limitation
[The role of SMAS in the prevention of Frey's syndrome].
No full textFrey's syndrome is the most common postoperative complication in the parotid gland surgery. The authors report their own experience with 80 patients who underwent surgical operation of superficial or total parotidectomy. In 45 of them was performed the SMAS flap, no SMAS flap performed in the remaining 35 patients. The follow-up was performed by interviewing the patients about their symptoms. The purpose of this work is to show the role of SMAS flap, that minimize the frequency and the intensity of symptoms of the Frey's syndrome
Dissection of the cranial base en bloc with the infratemporal fossa [Dissezione della base cranica in monoblocco con la fossa infratemporale.]
No full textA high incidence of morbidity and mortality was related with skull-base neoplasm surgery. Several advances have permitted, in recent years, the total excision of such neoplasms with minimal patient morbidity. Due to an improved understanding of the surgical anatomy of the skull-base and to the collaboration of the neurosurgeon and maxillofacial surgeon and, moreover, to the improvements of imaging (CT and MR) in the past decades new combined approaches were planned and performed to allow en bloc resections of extensive lesions. Extensive exposure of the tumor, improved management of the internal carotid artery, preservation of cranial nerves not involved by tumors and improved cranial base reconstruction techniques (by free flaps) have resulted from this progress. The aim of the present work is to show the main anatomical landmarks of infratemporal fossa and medium skull base that help the surgeon to achieve an en bloc resection
Evolution in diagnosis and repairing of orbital medial wall fractures.
No full textIn the last decades, diagnostical imaging, surgical techniques, alloplastic materials, and surgical instruments development allowed a great progress in management of orbital fractures; the aim of the present study was to focus on the progress and changes in the management of orbital medial wall fractures. Isolated medial wall fractures are not a common clinical evidence, and those necessitating surgery is relatively rare. Diagnostical refinements allowed to detect such fractures more commonly than suspected, and the indications to surgical treatment had been increased by the progresses that minimized morbidity of patients and allowed better restoration of the functional anatomy. Mainly, the endoscopic surgery as an alternative to open reduction allowed to manage such fractures with less unwanted sequelae; endoscopy decreases morbidity and improves the results with respect to open reductions. In literature, currently, it can be noticed that there is an increased trend in surgical treatment of the patients with orbital medial wall fracture because endoscopy decreased perisurgical morbidity and improved long-term results. Endoscopic repair of orbital blowout fractures represents an innovative and highly successful and safe alternative to external repairs owing to its introduction in orbital trauma management; actually, indications for surgical intervention are in the course of revision. New deal is important for the future treatment of patients sustaining orbital trauma. The authors present their experience
[Complications of reconstructive surgery using free flaps in the maxillofacial region].
No full textThe subject of our investigation was a group of twenty-nine patients with cervico-facial malignant neoplasms. The 29 patients, whose ages ranged from 12 to 68, with a mean age of 40, underwent surgery between January 1992 and January 1995. Cranial base and/or maxillo-facial defects were restored by free flap tissue transfer. Thirty-one micro-surgical free flaps were performed and post-operative monitoring was carried out for about 15-20 days. The aim of the present study is to show the importance of clinical semeiology which permits an early diagnosis of post-operative complications. Furthermore, post-operative monitoring of microsurgical free tissue transfer enables an etiological diagnosis and surgical vascular salvage of the flap to be made at the most opportune time. Many Authors report microsurgical transfer success at 95%-96% because timely detection and resolution of complication can minimize flap failure. We report our experience with 31 free flaps performed in 29 patients. Three of the patients needed a second transfer due to the failure of the first. Two underwent free flap transfers, while a pedicle flap was carried out on the other. In fourteen, latissimus dorsi free flaps were used (in 2 cases the procedure had to be performed twice), the forearm and the jejunum were employed in eight patients and the rectus abdominis in one
[Diagnostic and surgical problems in a case of post-traumatic retention of a foreign body in the submandibular gland].
No full textWe report a particular case of a traumatically introduced foreign body in the sub-mandibular gland. A breaking object (plastic pen) penetrated, through the anterior oral floor, the submandibular gland. Such foreign bodies should be removed before suturing the wounds, as they can disturb healing and cause problems long after the accident. An adequate history, clinical and imaging studies should reveal the possibility of foreign body penetration and its localization, when it isn't previously removed. We compare the use of ultrasound detection of foreign bodies in soft tissue and conventional plain radiography, computed tomography, and magnetic resonance imaging. The usefulness of US in this kind of research does not justify TC or RM studies and allows a less invasive surgical operation
Differential diagnosis in a case of brown tumor caused by primary hyperparathyroidism [Diagnosi differenziale in un caso di tumore bruno da iperparatiroidismo primitivo.]
No full textFibrous-cystic osteitis is a bone metabolic disorder related to hyperparathyroidism. This pathological condition shows a bone catabolism enhancement, due to increased level of PTH. Brown tumour is a uni- or multi-focal bone lesion, which represents the terminal stage of the hyperparathyroidism-dependent bone pathology. This focal lesion is not a real neoplasm showing itself as a cellular reparative process, mainly interesting the jaws, specially the mandible. Because of the similar radiological features (cyst-like radiolucency) showed by other lesions, the diagnosis can be difficult. Histology cannot guarantee a certain diagnosis, some lesions, such as giant cell tumour, giant cell granuloma, aneurysmal bone cyst and cherubism, show a similar macroscopical and microscopical features. Differential diagnosis is possible only by comparative evaluation of clinical, radiological and biochemical evidences. Personal experience with a patient affected by maxillary expansive lesion previously diagnosed as GCT is reported. Radiological examinations showed another cyst-like lesion involving the mandible. Clinical history and multifocality of lesions were suggestive for the presence of a systemic disease, laboratory data allowed a primary hyperparathyroidism diagnosis. Parathyroid scintigraphy was performed and detected a parathyroid adenoma. In first instance the patient underwent to surgical operation on the jaws in order to stop the rapid progression of bone lesions, and then another operation for the removal of parathyroid adenoma was performed
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