1,720,983 research outputs found
Dyskeratosis congenita and squamous cell carcinoma of the mandibular alveolar ridge
No full textDyskeratosis congenita is a rare disease caused by telomerase dysfunction classically characterised by the triad: skin pigmentation, nail dystrophy and mucosal leukoplakia. Few cases are described in literature regarding patients with head and neck squamous cell carcinoma affected by dyskeratosis congenita, and the therapeutic decisions are not yet well defined. A review of the literature of the last 20 years (2001-2021) was performed, and it was analysed the case of a 38-year-old male patient affected by dyskeratosis congenita diagnosed with a squamous cell carcinoma of the inferior alveolar ridge, treated with surgery. The absence of complications and the good postoperative recovery of the patient comfort in saying that resection and reconstructive surgery can be safely performed. The occurrence of disseminated disease 6 months after the treatment warns about the extreme aggressiveness of the pathology, its often systemic nature and the necessity of a multidisciplinary approach as well as further studies
Osteonecrosis of the maxilla with zygomatic bone exposure by zolendronic acid: A case report
No full textBisphosphonates are a class of drugs extremely important in the treatment of several pathologies such as bony metastases, malignant hypercalcaemia, multiple myeloma, osteoporosis, and Paget's disease. Since necrosis in the maxilla and jaw area is often associated to treatment with Bisphosphonates, the present study wants to assess any possible relation between Bisphosphonates therapy and osteonecrosis. Here, we report on a patient affected by multiple myeloma (MM) who developed necrosis of the maxilla and exposure of the zygomatic bone during bisphosphonates therapy (BT). In literature, to our knowledge no cases with so huge extension of necrosis have been reported to date. He refused any surgical treatment. After a 5-year follow-up, the disease is now well controlled without progression, with long term or intermittent courses of penicillin-type antibiotics. Bisphosphonates, such as pamidronate and zoledronate, play a determinant role in the treatment of several oncological diseases. Nevertheless, they could pose a risk for osteonecrosis in the maxilla and jaw region. Furthermore, the treatment of bisphosphonates-related osteonecrosis is still a challenge due to the extreme aggressiveness of the syndrome. Hence, the conservative or the aggressive approaches have to be carefully considered each time, case by case
Trismus and TMJ disorders as first clinical manifestations in an intracranial acquired cholesteatoma
Full text linkIntracranial extension of acquired cholesteatoma is a rare occurrence that can develop secondary to trauma, chronic otitis media or acquired aural cholesteatoma. The most commonly observed symptoms are headache and hearing loss. The authors report on a rare case of intracranial cholesteatoma presenting with atypic symptoms: swelling and temporomandibular joint disorders
Designing a Masterclass in free flap surgery for head and neck surgeons: Our experience
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Intraoperative navigation in complex head and neck resections: indications and limits
No full textPURPOSE: The surgical removal of head and neck tumors often represents a highly complex surgery. The three-dimensionality and the anatomy of the head and neck area make sometimes difficult a correct intraoperative orientation and the obtaining of an adequate oncological safety. In the present pilot study, the authors propose a protocol of application of intraoperative navigation in the resection of head and neck tumors. The purpose is to develop a methodology that can be helpful to ensure oncologic free margins of resection and to facilitate the orientation of the specimen by pathologists.MATERIALS AND METHODS: A sample of 16 patients with head and neck tumors was selected, and they were differentiated into two groups: a "study group" treated with CT computer-assisted surgery and a "control group" surgically treated without the use of technology. The following data were analyzed: operative and pre-surgical planning times, issues related to the use of the technologies, respect of the planned landmarks, description and orientation of the surgical specimen and distance of the tumor from the margins of resection.RESULTS: In the "study group" were noticed a reduced rate of errors in the specimen orientation and an increased distance of the tumor from the margins of resection. Similar operative times were observed in both groups.CONCLUSIONS: Intraoperative navigation resulted to be a reliable method to improve oncological safety in a selected group of patients
Anatomic landmarks for masseteric nerve identification: Anatomic study for a new reference point
No full textThe masseteric nerve is often used as a donor nerve in the treatment of facial paralysis. Even if several anatomical studies described landmarks for its identification, their main disadvantages are the anatomical variability and the changes due to surgery. Sixteen dissections were performed on cadaveric specimens. The masseteric muscle (MM), the zygomatic arch (ZA), the masseteric nerve (MN) and the zygomatic branch of the facial nerve (ZB) were identified and their relationships were measured. The relationships between MN and ZB resulted to be constant, with MN intersecting ZB at a depth of 0,78 cm in the muscle, 1,6 cm below ZA and 0,8 cm from the posterior border of MM. The measures obtained demonstrated as the main zygomatic branch of the facial nerve can be a suitable landmark for the identification of the masseteric nerve, with no variations due to the surgical procedure or patient characteristics
Recurrent squamous cell carcinoma of the lower lip: salvage surgery outcome
No full textSquamous cell carcinoma (SCC) of the lip is one of the most commonly occurring oral cancers, mainly involving the lower lip. Despite a good prognosis in cases of early detection, survival rates drop dramatically in the presence of recurrence. While there are many studies in the literature regarding the management of primary tumours, the rate of recurrence in lower lip SCC is low and therefore there are few data and articles about them. We retrospectively reviewed patients affected by recurrent SCC of the lower lip treated surgically from 2011 to 2019 in a single centre. Data and results were compared with those in the literature. A total of 16 patients (mean [range] age: 78.1 [62-93] years) were eligible for inclusion. The disease-free survival rate at 2 and 5 years was 29.6% and the overall survival rate at 2 and 5 years was 14.4%. A significantly higher rate of failure and a worse prognosis was observed in patients with neck involvement. The prognosis of recurrent lower lip SCC is unfavourable with extremely low survival rates. This issue is probably linked to the oncological pathology but also to the advanced age of most patients, the presence of several comorbidities and, consequently, the high risk of perioperative mortality. For this reason, the analysis of data sets reported in the literature may help the surgeon in the management of recurrences and selection of patients
Management of free flap failure in head and neck surgery
No full textFree flap surgery is overall considered the gold standard in head and neck reconstruction, with a success rate of 95%. The management of a total flap necrosis and which solution, between a pedicled or a second free flap, is safer for a salvage procedure is still controversial. Object of this study is to describe the authors’ management of total free flap loss in head and neck reconstruction and compare the choices and results to those reported in the literature. From January 2012 to January 2016, 149 consecutive free flaps were performed at the Maxillo- Facial Operative Unit of the Hospital Casa Sollievo della Sofferenza in San Giovanni Rotondo (Italy) for reconstruction of head and neck defects. Of these, 6 flaps were lost due to a total necrosis. In 5 cases it was decided to harvest a second free flap, and in the remaining patient a temporalis muscle flap was used. All the free salvage flaps were successful, without complications and with a good aesthetic and functional recovery. Analysing the data obtained, and comparing them with those reported in the literature, it can be concluded that a second subsequent free flap can be considered an ideal and safe procedure in salvage surgery
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