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Surgical access to condylar fractures in panfacial traumas
No full textSurgical access to the condyle in panfacial fractures is a delicate and debated issue. The aim of the study was to propose a protocol which would apply in the treatment of panfacial fractures requiring access to the condyles. A case series of 10 patients (8 males and 2 females) with panfacial fractures consisting of 16 extracapsular mandibular condylar fractures associated with 3 symphyseal, 7 parasymphyseal, 1 mandibular angle, 6 Le Fort II, 3 orbitomaxillomalar, 5 zygomatic arch fractures were included in this study. Reduction and fixation were achieved using the mini-retromandibular access in 6 patients with 10 extracapsular condylar fractures while in 4 patients with 6 extracapsular condylar fractures access to the condyles consisted in a face-lift-type preauricular access, as a caudal extension of a coronal or hemicoronal incision required for the reduction and fixation of other fractures of the upper and middle thirds. A good morphological and functional outcome was achieved in all patients. No surgical complication associated with access to the condyles or treatment of the condylar fractures was registered. The proposed protocol could be used as a guide in choosing access to the condyles in panfacial traumas
Surgical access to condylar fractures in panfacial traumas. [L’accesso chirurgico al condilo nei fracassi facciali]
No full textObiettivo. L’accesso al condilo nel contesto delle fratture panfacciali è un argomento particolarmente complesso e dibattuto. Il presente lavoro propone un protocollo applicabile nei fracassi facciali dove è necessario accedere al condilo.
Metodi. Lo studio comprende 10 pazienti (8 maschi e 2 femmine) con fratture panfacciali comprendenti 16 fratture extracapsulari di condilo associate a 3 fratture sinfisarie, 7 parasinfisarie, 1 frattura di angolo mandibolare, 6 fratture mascellari tipo LeFortII, 3 fratture orbito-maxillo-zigomatiche e 5 fratture zigomatiche. La riduzione e sintesi delle fratture di condilo veniva effettuata mediante accesso mini-retromandibolare in 6 pazienti per un totale di 10 fratture di condilo mentre in 4 pazienti per un totale di 6 fratture extracapsulari veniva effettuato attraverso un accesso tipo lifting come estensione caudale di un accesso emicoronale o coronale necessario per il trattamento delle fratture coesistenti.
Risultati. In tutti i pazienti venivano ottenuti buoni risultati morfo-funzionali. Nessuna complicanza relativa agli accessi ed al trattamento delle fratture di condilo.
Conclusioni. Il protocollo che proponiamo potrebbe guidare nella scelta dell’accesso chirurgico al condilo mandibolare nelle fratture panfacciali.AIM:
Surgical access to the condyle in panfacial fractures is a delicate and debated issue. The aim of the study was to propose a protocol which would apply in the treatment of panfacial fractures requiring access to the condyles.
METHODS:
A case series of 10 patients (8 males and 2 females) with panfacial fractures consisting of 16 extracapsular mandibular condylar fractures associated with 3 symphyseal, 7 parasymphyseal, 1 mandibular angle, 6 Le Fort II, 3 orbitomaxillomalar, 5 zygomatic arch fractures were included in this study. Reduction and fixation were achieved using the mini-retromandibular access in 6 patients with 10 extracapsular condylar fractures while in 4 patients with 6 extracapsular condylar fractures access to the condyles consisted in a face-lift-type preauricular access, as a caudal extension of a coronal or hemicoronal incision required for the reduction and fixation of other fractures of the upper and middle thirds.
RESULTS:
A good morphological and functional outcome was achieved in all patients. No surgical complication associated with access to the condyles or treatment of the condylar fractures was registered.
CONCLUSION:
The proposed protocol could be used as a guide in choosing access to the condyles in panfacial traumas
Microsurgical treatment of frontal mucocele sequelae
No full textSkull base surgery has undergone a revolution in recent decades with the introduction and development of new surgical approaches correlated with many modifications in this anatomically and functionally complex area. The most important progress has been possible with the advent of microsurgical flaps, which allow for the movement of large masses and different tissue components, providing effective separation and coverage of the endocranial content, replacement of the composite craniofacial defects, and reconstruction of poorly vascularized areas. To reduce the incidence of complications in the treatment of frontal recurrent mucoceles, accurate planning of reconstruction is mandatory.
We introduce 2 cases involving anterior cranial base repair after radical resection of chronically infected tissues in patients affected by frontal recurrent mucoceles. Reconstruction was accomplished through a forearm flap and a frontal bone reconstruction with custommade prosthesis
Pericranium graft in reconstructive surgery of atrophied maxillary bones
No full textIn preprosthetic surgery the autologous bone is universally considered the gold standard. Calvaria is, among many options, one of the preferred for its unique characteristics of hardness, easy of harvest and very low morbidity at donor site. Moreover, it gives the possibility of harvesting the pericranium. This technique, recently introduced in common practice in Milan, allows to harvest a large quantity of periosteum to cover bone grafts perioperativly. Periosteal tissue is used to cover bone grafts for two reasons. First, it would provide a layer of tissue that, thanks to its osteogenic potential, would prevent bone resorption. Second, this would interpose a layer of soft tissue to act as a cushion between the bone and mucosal flap to minimize the risk of wound dehiscence, that would bring to bone exposure and consequent failure of reconstruction. Five jaw reconstructions were performed with autologous bone and pericranium. In all cases the outcome was good, the grafts took with correct bone volume preservation. Implants were positioned according to prosthetic needs. In one case a vascular necrosis of a mucosal flap occurred. Bone exposure was prevented by the periosteum, which was revascularized after few days, allowing bone integration. Considering its potential protective capability towards bone grafts and the lack of donor site morbidity, this technique should be considered as a standard procedure in preprosthetic reconstructive surgery
GVHD orale post-trapianto allogenico per mieloma multiplo = Oral GVHD post allogeneic transplantation for multiple myeloma
No full text
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
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