Maxillofacial rehabilitation after rhinectomy using two different treatment options: clinical reports.

The aim of these clinical reports was to describe two different approaches to prosthetic rehabilitation after facial disfigurement because of a total rhinectomy. A man with a total rhinectomy was scheduled for craniofacial implants in the nasal residual defect. Three oral implants were used instead of craniofacial ones. A conventional framework was designed to connect the prosthesis to the implant abutments in the anterior nasal floor, and a custom-made ball attachment was positioned in the glabella abutment. A woman with a free rectum abdomis flap covering the defect of the middle face was scheduled for a nasal prosthesis. A titanium framework with a novel connection between the eyeglasses and the prosthesis was manufactured. The two clinical reports presented in this article illustrate favourable clinical treatment outcomes in the rehabilitation of disfigurement.

Intraosseous mucoepidermoid carcinoma. Report of a long-term evolution case.

Primary central mucoepidermoid carcinoma (CMC) of the jaws accounts only for 2-3% of all mucoepidermoid carcinomas reported. Bhaskar in 1963 first analysed the criteria for his central origin, histology and pathogenesis. The authors report a long-term evolution case of CMC of the mandible with peculiar clinical features observed at the Department of Maxillo-Facial Surgery of the School of Medicine and Surgery of the "Federico II" University of Naples (Naples, Italy) examining histopathologic and clinical features and problems related to the treatment.

[Benign parotid lymphoepithelial cysts associated with HIV infection]. / Cisti linfoepiteliali benigne parotidee correlate ad infezione da HIV.

HIV infections are often related with lymphoepithelial benign cysts of the parotid gland; these lesions are uncommon and other salivary glands are rarely involved. The diagnosis, often difficult, is based on imaging techniques, like computed tomography, and pathologic techniques, like fine needle aspiration biopsy. The therapeutic approach can be performed by simple aspiration, surgical resection, pharmacotherapy, or radiotherapy. Three cases of HIV-related lymphoepithelial benign cysts of the parotid gland observed at the Department of Maxillofacial Surgery of the "Federico II" University of Naples and at the Department of Oral and Maxillofacial Surgery of "La Paz" Hospital of the Universitad Autonoma of Madrid are described.

[Pathological fracture of the mandible: a report of a clinical case treated with clodronate]. / Frattura patologica della mandibola: descrizione di un caso clinico trattato con clodronato.

Oral squamous cell carcinoma often invades the mandible. However, the incidence of pathological fractures of the maxillofacial bones is low and their treatment is rarely satisfactory. A patient, too weak to undergo surgery, affected by squamous cell carcinoma of the mandibular region with bone involvement and pathological fracture of the mandible, underwent chemotherapy with carboplatin associated with diphosphonate.

Detection of latero-cervical metastases from oral cancer.

In squamous cell carcinoma of the oral cavity, the presence of nodal metastases greatly influences prognosis. The evaluation of regional lymph nodal involvement is crucial in the correct management of these neoplasms. The records of 45 patients with oral cancer were reviewed retrospectively to evaluate the accuracy and prognostic value of the techniques used to detect lymph node metastasis in the neck (clinical examination, echo-colour-Doppler, computed tomography and magnetic resonance imaging). Echo-colour-Doppler was the most accurate procedure with a predictive positive value of 95.6% and the lowest false-negative rate. Therefore, a diagnostic preoperative study must include echo-colour-Doppler preferably associated with computed tomography to achieve the greatest diagnostic accuracy.

Cervical metastases from pulmonary epidermoid carcinoma.

A patient with a right latero-cervical swelling of three-months history was observed. Fine needle aspiration biopsy showed the presence of metastases of epidermoid carcinoma moderately differentiated. No signs or symptoms of head and neck neoplasm were presents. After instrumental evaluation the primary neoplasm was localised at the left lung and metastases were also localised in the right submandibular gland. Although metastases from pulmonary epidermoid carcinoma are normally bloodborne, in this case lymphatic metastases involving cervical areas were present, probably secondarily the submandibular involvement.

[Pathological fractures of the mandible caused by cancer of the oral cavity]. / Fractures pathologiques de la mandibule causées par le cancer de la cavité buccale.

The pathological fracture of the mandible is a rare and undesirable consequence of cancerous bone invasion. This study investigates the retrospective incidence of this phenomenon in diagnosed cases of squamous cell carcinoma of the mandibular region, and reviews the methods of treatment used. A total of 194 patients with squamous cell carcinoma of the mandibular region were observed. Only six cases of pathological fractures were found. The treatment was conditioned by the need to eliminate the tumor, and was carried out in different methods according to the individual cases. This study underlines the importance of both knowing various techniques and collaborating with other specialists in treating the fracture.

Accuracy in the diagnosis of mandibular involvement by oral cancer.

Cancer of the mandibular region usually has a poor prognosis; this is particularly correlated to invasion of the mandible. To reduce the consequences of poor therapeutic planning, careful preoperative assessment of bone infiltration is necessary. We have examined the records of 50 patients evaluated by clinical examination, conventional radiography, computed tomography (CT), bone scintigraphy with 99mTc and magnetic resonance imaging (MRI). The highest sensitivity (100%) was attained by scintigraphy; the highest values of specificity (96.3%) were reached by CT scan and MRI. A CT scan showed the highest predictive positive value (95.4%) and efficiency (94%), this plus MRI have good values and the associated sensitivity and efficiency are higher than when these techniques are used alone.

Peripheral ameloblastoma: report of a case with malignant aspect.

Peripheral ameloblastoma is a very rare tumour with histological characteristics similar to those of the centrally located ameloblastoma. It appears in the gum and in the alveolar process of the jaws. We report a case of tumour of the left maxillary region, near the canine area. Histologically it presented itself with follicles and nests of cells with a trabecular architectural pattern. High mitotic index and clear images of perineural infiltration were present. The diagnosis was peripheral ameloblastoma with malignant aspects. At 12-month follow-up no local recurrence was noted.

[Fractures of maxillo-facial bones in children. Our experience]. / Le fratture dello scheletro maxillo-facciale in età pediatrica. Nostra esperienza.

A clinic-statistical study of maxillo-facial fractures in a series of 52 children is reported. This group presents a higher involvement of mandibular body and a low rate M:F than in the literature. Factors responsible for increasing of maxillo-facial traumas in little girls and in school age are analyzed.