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La Sindrome di Eagle
No full textLa Sindrome di Eagle è una possibile, anche se infrequente, causa di dolore facciale
atipico. Essa è causata dalla presenza di un processo stiloideo allungato. La diagnosi
di tale alterazione anatomica è agevole se ne viene sospettata la presenza sulla base
dell’esame obiettivo e della storia clinica. Il trattamento è più frequentemente di
tipo chirurgico e prevede la rimozione dell’apice del processo stiloideo mediante
un accesso intraorale. Viene qui presentato il protocollo diagnostico e terapeutico
utilizzato presso la nostra Unità OperativaEagle Syndrome
Eagle Syndrome is a potential, although quite rare, source of atypical facial pain. It is
caused by an elongated styloid process. Syndrome is an unusual source of atypical facial
pain. This anatomic feature is easily diagnosed if its presence is suspected. Treatment is
more often by means of surgery by removal of styloid process apex trough an intraoral
approach. We present the diagnostic and therapeutic protocol used in our department
Cisti del pavimento orale come causa di ostruzione respiratoria. Presentazione di un caso clinico
No full textUna tumefazione a livello del pavimento orale può essere dovuta a 3 principali gruppi di lesioni: infettive, neoplastiche e infiammatorie. Presentiamo il caso di una paziente portatrice di cisti infiammatoria che, in breve tempo, ha raggiunto grandi dimensioni. L'agoaspirazione della lesione è stata alla base del processo infettivo che ha portato all'aumento dimensionale della cisti con l'insorgenza di progressive difficoltà respiratorie. Il trattamento ha previsto l'esecuzione di una tracheotomia d'urgenza e l'enucleazione della lesione attraverso un approccio intraorale. L'enucleazione è avvenuta tramite accesso lungo la linea mediana del pavimento della bocca iniziando appena dietro alla piega linguale e continuando lungo la superficie ventrale della lingua.Three major groups of lesions can cause swelling in the floor of the mouth: infectious, neoplastic, and cystic. We present the case of a patient with inflammatory cyst in the floor of the mouth that reached, in a little while, huge dimensions. Needle aspiration of the lesion caused an infectious process that enlarged the cyst and led to progressive difficulties in breathing. Treatment was by emergency tracheostomy and enucleation of the lesion using an intraoral approach. The enucleation was performed through a mucosal incision along the midline of the floor of the mouth, starting just behind the lingual fold, and extending along the ventral surface of the tongue
Pericranium graft in preprosthetic maxillary reconstruction.
No full textCases presentation: The necessary requirements for bone graft reconstruction success are: appropriate vascular support in the recipient site, adequate rigid fixation and graft protection
from external infecting agents. The senior author has developed a new technique consisting in the positioning of a pericranium layer, harvested from the parietal area of the cranium, over
the rigidly fixed bone grafts. The advantages are: prevention from bone exposure and resorption due to the presence of a layer physically interposed between graft and mucosa and
with osteogenic potential; thickening of the alveolar mucosa which is helpful in soft tissue conditioning during the prosthodontic phase. In this study, we enrolled 18 patients affected
by maxillary and mandibular bone atrophy and treated using the above-mentioned technique. Twelve cases underwent calvarial graft, 6 iliac bone graft; All patients underwent pericranium
graft overlapping. After a healing period of 6 months for calvaria and 4 months for iliac crest, implants were positioned.
Results: No donor site complications were reported. Bone graft survival and maintenance of morphology was observed in all cases. Two patients, during the second postoperative week,
presented vascular damage of the mucosal flap with exposure of the underlying periosteum, which appeared still vital at that time protecting the underlying bone. The damage healed
spontaneously by second intention, and the presence of the periosteal tissue prevented from bone contamination.
Conclusion: Because of protective capability towards bone grafts and lack of donor site morbidity, the pericranium graft could become a standard procedure in preprosthetic
reconstructive surgery
Ossification of vascular pedicle in fibular free flaps : a report of four cases
No full textThe fibular free flap is the most widely used flap for jaw reconstruction. Flap contouring requires removal of bone excess in the proximal segment by a subperiosteal dissection, preserving vascular connections between the pedicle and the bone and leaving well vascularized periosteum attached to the vascular pedicle. Among about 100 reconstructions with fibular flaps, 4 cases were observed of abnormal ossification along the vascular pedicle. Periosteum preserves its osteogenic capability after transposition, especially in a revascularized flap; this characteristic, together with the direct contact with the bone, allows the possibility of new bone formation along the pedicle. It would appear necessary to change the technique of reducing fibular excess, with removal of periosteum together with the bone, in order to avoid the complication described
Reconstruction of severe maxillary or mandibular defects with fresh frozen bone
No full textCases presentation: Implant placement requires an adequate quantity and quality of alveolar bone. In case of severe maxillary or mandibular atrophy, several options are available to fill the alveolar defect: autologous, homologous or heterologous grafts or synthetic products. Each of these materials has advantages and disadvantages; currently homologous bone, provided by bone banks, is often used because of its immunological and viral safety. A total of 25 patients had been treated with fresh-frozen bone (FFB): 15 patients underwent reconstruction through tricortical iliac crest, while 10 through femoral bone. After a mean post-grafting period of 6 months for the ilaiac bone and 9 months for the femur, 20 patients underwent implant surgery. After an additional month, 16 of these have also delivered the final prosthetic restoration. Patients, who completed the implant loading time, were followed in a standardized clinical method for up to 9,25 months (range, 2-18 months).
Results: All surgical phases were carried out following the standard protocols used for bone augmentation. Endosseous implants were placed adequately and bone biopsies were performed. In our sample we reported 1 post-operative tissue necrosis, 1 graft resorption, because of the delayed implant insertion time, and 23 positive results.
Conclusion: Our experience, although limited in term of number of patients and follow up period, is certainly positive. This surgical procedure has been shown to be a predictable and reliable method for rehabilitation of patients with extreme resorption of the alveolar ridge. The use of homologous bone presents several potential advantages: cheap, available in unlimited amount, reduced surgical procedures and safe
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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