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Correzione estetico-funzionale delle asimmetrie del 1/3 inferiore del viso
No full textVedasi l'allegat
Tens,electroacupuncture and EMG in TMJ disorders. Preliminary report
No full textIn a correct management of facial pain and TMJ disorders, we have to consider at least 3 pathologies: myofacial pain syndromes, temporomandibular joint disorders, internal derangement. Many times these 3 pathologies are tightly joined each other. According to the disease the chosen treatment is different: myophysiotherapy, orthopedic surgery, meniscectomy, etc. but many times pain is the main problem for the patient. Besides pharmacological treatment (non-narcotic analgesics, sedatives, carbamazepine, etc.), electical currents and acupuncture are used to relieve the pain. We are elevating the effects of TENS and electroacupuncture on the pain and on 2 muscles of mastication (masseter and temporalis). To assess the intensity of the pain before and after treatment the VAS (visual analogue scale) is used; to cheeck the changes in the muscular activity we are using an EMG. Our preliminary results show the effectiveness of these methods in the antalgic response and muscular balance but with different characteristics
Griesel's syndrome
No full textGriesel’s syndrome is a rare pathology characterised by a rotatory atlo-axial subluxation, secondary to oro-rhino-pharingeal inflammatory processes diffused in the prevertebral region by the lymphatic way. Similar cases have also been observed after adeno-tonsillar surgery. The maximum incidence is placed between 6 and 12 years old.
Fielding and coll. in 1977 elaborated a classification, still used actually, that defines, according to an increasing gravity criterion, 4 types of atlo-occipital subluxation. The primary treatment is based on a specific antibiotic therapy. The subluxation is also reduced with physiotherapy.
The interest for this syndrome is due to the fact that constitutes, in chronic cases mostly, a real model of study for the integrated system cranio-cervical-mandibular apparatus, and offers the possibility to valuate the repercussions on this system, of primary alterations appeared at the cervical column.
The Authors report 4 cases (2 males and 2 females), between 8 and 12 years old, affected from Grisel`s syndrome. Three patients have been previously treated in neurosurgery department .In the fourth cases , the patient was affected by a cronic form and hasn’t been previously treated. In the last case, a detailed, aimed diagnostic study has been executed, in order to estimate the repercussions of the severe atlo-occipital alteration on the muscular and skeletal cranio-cervical-maxillo-mandibular system.
In the first three cases the effects of the atlo-occipital alterations on the muscular and skeletal cranio-facial system appeared during infancy. The analysis of the clinical elements of these three cases demonstrated in an unquestionable way that the whole muscular and skeletal structures of the cranio-maxillo-mandibular-joid-cervical-vertebral region is an integrate system.
From the study of the fourth case, where the alterations were chronic, the Authors can observe how the stabilization of the process, and so the atlo-occipital asymmetry of the skull-base, can evolve exciting muscular and skeletal asymmetries and occlusal alterations. In this specific case there was a mandibular asymmetry with cross-bite and unilateral subluxation of the temporomandibular joint
Valutazioni diagnostico-terapeutiche nella iperplasia linfonodale angiofollicolare (malattia di Castleman) della parotide
No full textL’iperplasia linfonodale ngiofollicolare o Malattia di Castleman è una rara affezione linfoproliferativa, a manifestazione uni o policentrica, pressocchè sconosciuta nel distretto maxillo-facciale, di cui esistono tre varianti istopatologiche: jalinovascolare (a prognosi favorevole), plasmacellulare (sovente sistemica, con possibilità di trasformazione linfomatosa o sarcomatosa) e mista. Rarissimi i casi della forma jalinovascolare a localizzazione unicentrica parotidea. In tutto 6 casi, di cui 1 descritto dagli stessi AA.. Dopo aver sottolineato gli aspetti clinici ed istopatologici della malattia, oggetto di due precedenti note, gli AA si soffermano più estesamente sulle problematiche diagnostiche della rara linfopatìa, quale contributo di elementi semeiologici specifici, differenziali rispetto ad adenopatìe di altra natura. In questo senso riportano lo studio della lesione eseguito con la RM. Esso ha mostrato di peculiare una corrispondenza fra le caratteristiche macroscopiche ed istologiche della adenopatia e gli aspetti documentativi ottenuti nelle varie sequenze, fornendo quindi aspetti di indubbio interesse clinico
Pain relief and Electromyographic evaluation in patients suffering from pain dysfunction syndrome of the temporomandibular joint
No full textAims: To evaluate the effectiveness of the analgesic response to two electric physiotherapy techniques: electroacupuncture (E.A.) and transcutaneus electrical nerve stimulation (T.E.N.S.), in patients suffering from the pain dysfunction syndrome. Moreover, we checked the effects of E.A. and T.E.N.S. on the masseter and temporalis anterior muscles of the same patients.
Method: Fourteen patients, (8 females and 6 males, aged 18-51), suffering from TMJ pain dysfunction syndrome were divided into two groups and treated 7 with E.A. and 7 with T.E.N.S.; we used continous waves at 10-50 Hz for each 20 minutes treatment; the Scott-Huskisson Visual Analogue Scale (V.A.S.) was used to assess the intensity of pain both before and after the treatments. We have investigated the changes in activity of two masticatory muscles, the masseter and temporalis anterior, using superficial electromyography.
Results: Our results show that, in relation to the changes in the masseter and temporalis muscle activity, both E.A. and T.E.N.S. have a good affect on the balance of the muscle; meanwhile, using the Signed Ranked Test, the E.A. is more effective than T.E.N.S. in relieving the pain, with a significant statistical difference (p=0.03).
Conclusions: The results indicate that E.A. and T.E.N.S. are effective physiotherapy techniques and suggest their use to relieve pain and to balance masticatory muscles in patients suffering from T.M.J. pain dysfunction syndrome
Patologia oncologica rara del massiccio facciale: "Inverted Papilloma"
No full textL’ “Inverted Papilloma” del massiccio facciale costituisce una patologia di raro riscontro e di particolare interesse clinico terapeutico. La lesione epiteliale è rara, benigna, ma dotata di notevole aggressività locoregionale, elevata tendenza alla recidiva e, nel 5%-15% dei casi, alla trasformazione maligna. Gli AA sottolineano: 1) la necessità di un accurato studio diagnostico preoperatorio specie se il processo sia esteso ai seni paranasali con polisinusiti consensuali anche maxillo-sfeno-frontali, come in un caso venuto alla loro osservazione. In tal senso, per la definizione dei processi otseitici, ritengono opportuno verificare con TC la densitometria dell’impalcatura ossea interessata. 2) La opportunità di eseguire interventi estesi finalizzati all’asportazione totale della lesione, dei processi osteitici, e delle aree di ipodensità ossea limitrofe alla lesione papillomatosa documentate alla consolle TC. Ciò ai fini di una completa bonifica delle aree interessate che permette: a9 di scongiurare la esposizione alle recidive da parte di questo tipo di neoformazione particolarmente aggressiva; b) di bonificare i processi flogistici concomitanti, talora gravi; c) laddove siano presenti comunicazioni oro-antrali, di assicurare un terreno adatto all’attecchimento dei lembi per la loro chiusura.
In tal senso viene preconizzato il ricorso ad interventi del tipo Pietrantoni-De Lima finalizzati alla bonifica di tutte le cavità sinusali per via transmascellare
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