Vitiligo, autoimmune thyroiditis: a rare thyroid cancer arising with bone metastates on maxillofacial area.

An association between vitiligo and autoimmune thyroid disorders had previously been postulated. Thyroid disorders were found in 18.5% of 15,126 patients with vitiligo, on the basis of the anamnestic data. Then, we investigated 255 healthy relatives in whom we tested only T3, T4 and TSH. With the immunological investigation we detected a higher incidence of TMA in vitiligo patients and in the family members. Therefore, on the basis of the immunologic and thyroid pathology functional data, we observed a thyroid pathology in 25% of the 890 vitiligo patients and in 21.1% of their first degree relatives. Then, clinical observation enabled to discover that 3 of 15,126 patients had undergone exeresis for a thyroid carcinoma and in the 890 vitiligo patients, who had undergone particular investigations, we found a thyroid carcinoma in 3 subjects. In one case lymphnodal involvement and bone metastases in the maxillary district were found. The purpose of this work is to evaluate the incidence of thyrosis and of thyroid carcinoma in vitiligo patients observed for 20 years.

Surgical planning and correction of medial craniofacial cleft.

In the framework of malformations that concerns the craniofacial area, the orbit is often involved because it represents the border structure between the neurocranium and the splanchnocranium. In these malformations it is very easy to find hypertelorism. Tessier classified clefts rising from the anterior skullbase and involving the maxilla and the alveolar process, as medial or 0 = 14 clefts. We report on a 2-year-old patient, treated with cranial decompression at an early age, suffering from this kind of malformation. To correct it, the surgical technique of facial bipartition was used. This technique, used for the first time by Tessier and then modified by Stricker and colleagues, allows the simultaneous correction of the orbits and maxilla. It is very important to make a correct diagnosis, to plan for surgery carefully for patients suffering from this kind of pathology, and to prescribe the most effective therapy. A computerized analysis system, based on the study of teleradiographic images and on three-dimensional computed tomography, to quantify the extent of the malformation and to define surgical planning was developed.

[Simultaneous surgical correction of temporomandibular ankylosis and facial symmetry. Presentation of a case]. / Correzione chirurgica contemporanea della anchilosi TM e della asimmetria facciale. Presentazione di un caso.

The authors stress the fact that the clinical course of a monolateral TMJ ankylosis tends to be more severe in young people. In this paper we analyze the diagnostic procedure for a tridimensional observation of any morphological and spatial alteration. The surgical procedure that permits the simultaneous correction of ankylosis and associated facial deformities is discussed.

Firearm injuries in maxillofacial region reconstructive surgery.

Firearms induce severe morphological and structural alterations on both soft and bony tissues of the face. It is therefore essential to restore their previous functionality. In our experience, maxillofacial lesions due to firearm shooting must be divided, from a locational point of view, into those lesions involving the upper third, those involving the medium third, and those involving the lower third of the face. Lesions of soft and bony tissues must be evaluated precisely through instrumental diagnostic examinations and axial and coronal computed tomographic projection, preferably with a three-dimensional construction, to be able to restore the previous functional integrity of the maxillofacial region. At a subsequent surgical time, it may be necessary to plan aesthetic corrections for recovery of the previous facial harmony.

Aesthetic and functional reconstruction in intraosseus hemangiomas of the zygoma.

The incidence of intraosseus hemangiomas is very low. The mandible, the zygoma, the maxilla, and the frontal bone are the most frequent areas of localization in the craniomaxillofacial region. Surgery, without preoperative embolization, is always the best treatment for intraosseus hemangiomas of the zygoma. The radical removal of the tumor frequently causes a contour defect that has to be corrected. Calvarial grafts provide a good solution to the problem of reconstruction of bone loss. They are easy to prepare, near to the implant zone, and they do not require changes in the patient's position during the operation. The implants fixed by micro- and minifixation systems provide a good functional and aesthetic result. We, after a review of the literature on intraosseus hemangiomas of the craniomaxillofacial region, report two cases of intraosseus hemangiomas of the zygoma in which removal of the tumor and reconstruction with calvarial grafts have been performed.