1,720,967 research outputs found
[Rhino-sinusal endoscopy as a diagnostic and therapeutic treatment in patients undergoing a bone marrow transplantation].
No full textImmunodepressed subjects appear to present as a common adverse event the infections complication of paranasal sinuses which can lead to an unfavourable clinical evolution spreading the infection to encephalic and endo-orbital tissues. The patients described by the authors present a common clinical history of neoplastic disorders concerning the haemopoietic tissue with an indication for bone marrow transplantation. These patients also demonstrated clinical-radiological evidence of rhino-sinusal impairment with specific maxillary sinus involvement. The clinical condition obliged us to reach a final diagnosis of the origin of rhino-sinusal involvement which clearly appeared by performing imaging diagnostic examinations in order to rapidly establish the correct therapy. The resolution of the rhino-sinus complication allows these patients to follow on the treatment for their own initial pathology. In fact, in order to resume the treatment against haemoblastic disorders, an essential step is to approach the paranasal sinus affection. Endoscopy, in the cases reported, permitted us to obtain a correct diagnosis and to develop a correct antimicrobic therapy, achieving the drainage of the maxillary sinus as well. Endoscopy achieved the same results as radical surgery of the maxillary sinus by the Caldwell-Luc approach, proving less aggressive and reducing operative timing, postoperative recovery timing and intra and post operative haemorrhagic complications. Moreover, endoscopy characteristics present a specific validity in patients with severe general conditions, which are described in the examined group, reducing time for diagnosis and therapy resulting specific to solve the rhino-sinus complication and also particularly important in order to interfere less with the delicate medical therapy for the primary pathology by the sample examined
Orthodontic-surgical treatment after posttraumatic bilateral condylectomy of the mandible in an adult patient.
No full textA posttraumatic open bite associated with a bird face is reported. Condylectomy was indicated in relation to the plurifragmentary fracture of the condyles with limitation of mandibular movement. Condylectomies were mandatory as a result of delayed maxillofacial surgical treatment, which was related to the poor general condition of the patient after trauma. Functional disorder recovery and aesthetic deformity correction were planned by a team approach between orthodontists and maxillofacial surgeons with the support of a logopedist for the postural-related muscle problems. The main practical and theoretical problems presented by the clinical case were a result of the need to restore the occlusal relations and to avoid recurrence of open bite in this patient. The patient presented a wide alteration of muscular function and a strength fibrotic retraction with alteration in the relationship between upper and lower jaws and retrusion of the mandible associated to open bite. Orthodontic treatment was carried with no impact on the upper and lower axis, avoiding orthodontic correction of the open bite. Surgery corrected both the open bite and the bird face by means of bilateral sagittal split osteotomies. Wiring of the mandibular osteotomies and intermaxillary fixation allowed positioning of the mandibular ramus bilaterally because of the fibrosis and muscular action-related forces without resulting in a similar rotation of the mandible with the risk of recurrence. Myotherapy and logopedic support minimized the risk of recurrence, improved reduction of muscular tension with the resolution of the lip incompetence, and allowed functional recovery of mandibular movements
Problematiche ricostruttive nel trattamento di neoplasie del distretto orbito-mascellare estendentisi alla base cranica
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Could transcranial endoscopy represent an alternative to craniotomy in skull base surgery?
No full textCraniofacial malformations and upper third facial tumor surgical management is currently performed by skull base osteotomies to allow skeleton mobilization or tumor removal. Craniotomies and retraction of frontal lobes allow wide exposure of anterior skull base.In the last decades, in keeping with the trend to perform less invasive surgical approaches, several authors reported endoscopic approaches for selected cases of skull base surgery, such as closure of cerebrospinal fluid leaks and transethmoidal and trans-sphenoidal approaches for pituitary surgery. Recent experience with transnasal endoscopic procedures improved both techniques and outcomes and became more common.The authors present a cadaver study of combined transfacial transcranial endoscopic approach to skull base. Such an approach used with minimally invasive surgery principles could represent, in selected cases (both for neoplastic lesions and malformations), an alternative to traditional anterior cranial fossa surgical approaches by wide craniotomies
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