An Overview of Management Considerations for Mongolian Gerbils (Meriones unguiculatus), Cats (Felis catus), and Dogs (Canis familiaris) as Hosts for Brugia Infection.

Lymphatic filariasis is a mosquito-borne parasitic infection affecting an estimated 51.4 million people. Brugia malayi and Brugia pahangi are used in research because common nonprimate research species such as Mongolian gerbils (Meriones unguiculatus), cats (Felis catus), and dogs (Canis familiaris) can maintain the life cycle of these species of filarial nematodes. Although overall care and management of animals infected with Brugia spp. is relatively straightforward, there are some unique challenges and special considerations that must be addressed when managing a research colony infected with these parasites. In this review, we discuss our experience, share insight into biosafety and clinical management, and describe the expected clinical signs associated with Brugia infection in gerbils, cats, and dogs.

Evaluating the Safety and Efficacy of Capromorelin in Rhesus Macaques (Macaca mulatta).

Nonhuman primates used in biomedical research may experience clinically significant weight loss for a variety of reasons. Episodes of anorexia (complete loss of appetite) or hyporexia (decreased appetite) can result in significant weight loss, potentially altering animal welfare and scientific studies. The FDA has approved several appetite stimulants for use in domestic species, but currently none are approved for use in NHP. Treatment of inappetence and weight loss in NHP often relies on the extralabel use of these compounds. Capromorelin is a ghrelin receptor agonist. As a growth hormone secretagogue, capromorelin increases appetite, leading to weight gain. Studies in several species have shown a positive correlation between capromorelin administration and weight gain; in 2017, an oral solution of capromorelin received FDA approval for use in dogs. We tested this solution in healthy adult rhesus macaques (n = 3 males and 3 females) for its effects on body weight and insulin like growth factor-1 (IGF-1). A control group (n = 2 males and 2 females) was used for comparison. Treated macaques received a 3mg/kg oral dose daily for 7 d. Clinical signs were observed daily. Weights were collected before, during and at the end of treatment. Blood was drawn before, during and after treatment for measurement of IGF-1 levels and standard hematology and biochemistry parameters. Baseline-adjusted mean body weights and IGF-1 levels were significantly higher in treated as compared with control monkeys after 7 d of beginning treatment (body weight of 10.5±0.1kg (mean ± SEM) and 10.1±0.1kg, respectively; IGF-1 of 758±43ng/mL and 639±22ng/mL, respectively). Capromorelin administration was not associated with appreciable changes in hematologic and biochemical values in treated macaques. These findings suggest that capromorelin may be useful for treating inappetence and weight loss in NHP, and based on blood analysis, a 7-d course of treatment does not appear to cause acute toxicity.

Somatosensory tinnitus and temporomandibular disorders: A common association.

BACKGROUND: Although the association between tinnitus and temporo-mandibular disorders (TMD) has been frequently reported, their rate of association in the literature shows a great variability. OBJECTIVE: We aimed to investigate the prevalence of TMD in patients with somatosensory tinnitus and, vice versa, the occurrence of somatosensory tinnitus in patients with TMD. METHODS: The study included patients with somatosensory tinnitus (audiological group) and patients with TMD (stomatological group), evaluated at the audiologic and stomatologic clinics of the Policlinic Hospital of Milan, Italy. Common causes of tinnitus, such as hearing and neurological disorders, were excluded. A cervicogenic somatic tinnitus was also ruled out. Different TMD symptoms, including joint noise and joint pain, were considered. The collected data were analysed using descriptive statistical methods, and the Pearson's Chi-squared test was performed to study the prevalence of the different symptoms by clinical groups. RESULTS: Audiological group included 47 patients with somatosensory tinnitus. Overall, TMD was diagnosed in 46 patients (97.8%), including TMJ noise in 37 (78.7%), clenching in 41 (87.2%) and pain in 7 (14.8%) patients. Stomatological group included 50 patients with TMD, including joint noise in 32 (64.0%), clenching in 28 (56.0%) and TMJ pain in 42 (84.0%) patients. A somatosensory tinnitus was diagnosed in 12 (24.0%) patients. CONCLUSION: Our study showed a high prevalence of TMD in patients with tinnitus, as well as a not uncommon occurrence of tinnitus in patients presenting with TMD. The distribution of TMD symptoms, such as joint noise, and joint pain was different between the two groups.

Zygomatic implant guided rehabilitation based on inverted support technique: a pilot study.

OBJECTIVE: Zygomatic implant insertion surgery is a challenging operation. The primary aim of this pilot study was to assess the accuracy of EZgoma® "Inverted Support Technique" for the zygomatic implant-guided surgery. Secondly, any factors which may affect the surgical protocol results, such as implant-prosthetic virtual plan, surgical model matching, intra or post-operative complications, time rate between surgical procedure and prosthetic loading, zygomatic implant survival rate and implant success rate were analyzed. PATIENTS AND METHODS: A total of 20 zygomatic implants were placed in atrophic maxillae of 5 patients. The final position of zygomatic implants after surgery was compared with the pre-operative digitally planned position.  The analyzed parameters were zygomatic implants apex and base mean linear distance and zygomatic implants axis mean angular deviation. RESULTS: The comparison was provided by a tridimensional imaging elaboration platform, provided by Geomagic, which allows the overlay of virtual plan STL data with post-operative control CT scan DICOM data. As a result, all the mean values regarding the 20 placed zygomatic implants respected the universally agreed values in guided zygomatic implant surgery: the mean linear distance of the implant platform and of the implant apex were 1.59 mm and 1.62 mm respectively, while the mean angular deviation of the implant axis was equal to 1.74°. One of the patients had mucositis as a post-operative complication. In one patient the anterior wall of the maxillary sinus fractured, and in one zygomatic implant primary stabilization was not achieved. No other complications occurred. CONCLUSIONS: As a conclusion, data obtained from this study suggested that guided zygomatic implant rehabilitation may represent a reliable, efficient, rapid, ergonomic, and safe surgical protocol, however further investigations are needed.

A clustering metaheuristic for large orienteering problems.

The Orienteering Problem is a routing problem that commonly appears in mapping, transportation, distribution, and scheduling scenarios. The Orienteering Problem is a challenging NP-hard problem, such that obtaining optimal or near optimal solutions usually requires a significant amount of computation for large and even moderately large instances. As a result, existing algorithms cannot effectively be utilized for solving large Orienteering Problems in an online setting, which is often required in real-world applications where a plan has to be iteratively computed. For instance, a planner might need to adapt to changes in the scenario or in the environment (e.g., this is common in goods delivery, as well as in mobile robotic scenarios for coverage, monitoring, and surveillance). Motivated by these limitations, we propose a multi-stage clustering-based metaheuristic for tackling large Orienteering Problems in an effective, strategically controlled amount of computation time. The metaheuristic starts by decomposing the problem into smaller, independent sub-problems that are efficiently solved using an algorithm of choice, sequentially or in parallel. The obtained solutions are then merged to form a solution for the original problem, and then further optimized and processed to ensure feasibility. The metaheuristic aims to dramatically improve the computation time of a given Orienteering Problem algorithm without a significant decrease in the solution quality of that algorithm, especially for large Orienteering Problems. We have validated the effectiveness of the proposed metaheuristic design through a set of computational experiments. In particular, using a state-of-the-art heuristic and an exact algorithm, we have shown that it is significantly beneficial to use the Orienteering Problem algorithm plugged into our metaheuristic, as opposed to using it as a standalone algorithm. This was found to be especially true for large problems. As a result, large instances of Orienteering Problems can be effectively tackled within reasonable time bounds even for online application scenarios.

Oral rehabilitation of oncology patients with dental implants after reconstruction surgery with autogenous flaps.

OBJECTIVE: Reconstruction after radical cancer surgery in terms of function and esthetics can be quite demanding. The aim of this study was to evaluate oral rehabilitation with autogenous flaps and dental implants for maxillofacial reconstruction in oncologic patients after implant insertions. MATERIALS AND METHODS: The study consisted of 19 patients diagnosed with either squamous cell carcinoma, fusocellular carcinoma, or mucoepidermoid carcinoma. The reconstruction of the maxillofacial defects was done with autogenous flaps (free fibular flap, antero-lateral thigh flap, radial forearm flap, or rotational pedicled temporal muscle flap). Implants were inserted on the average 32.03±19.51 months after reconstructive operations. A total of 82 implants were inserted. Mean follow-up after maxillo-facial surgery was 7.2 years (mean 86.56±22.04 months). Mean follow-up after implant insertions was 4.5 years (mean 54.6±21.82). Primary outcome was implant survival. Secondary outcome was evaluation of post-surgical complications. RESULTS: There were surgical revisions in seven patients after reconstructive surgery with flaps, mainly due to tumor relapse. Complications were seen in 11 patients. There was one implant failure. Overall implant survival rate was 98.8%. No relations were found between implant survival rate and gender, type of tumor, type of microvascular free flap, radiation therapy, chemotherapy, and prosthesis type. CONCLUSIONS: According to the results of this study, oral rehabilitation with dental implants inserted in free flaps for maxillofacial reconstruction after ablative oncologic surgery can be considered as a safe treatment modality with successful outcomes.

Analysis and comparison of quality of life and patients' satisfaction between dental-skeletal dysmorphisms and Obstructive Sleep Apnea (OSA) patients following orthognathic surgery.

OBJECTIVE: The aim of this study was to evaluate the impact of orthognathic surgery on the patients' satisfaction and quality of life (QoL) in patients with dental skeletal dysmorphisms and Obstructive Sleep Apnea (OSA). SUBJECTS AND METHODS: Patients were grouped into two cohorts, patients with OSA (G1) and patients with dento-skeletal dysmorphisms (G2). SF-36 questionnaire was obtained from all subjects before interventions. A standardized follow-up protocol, including a second SF-36 questionnaire was planned as at least 6 months after surgery. The impact of surgery on satisfaction was evaluated by post-operative patient satisfaction-based survey. RESULTS: 61 patients were included as: 21 OSA (G1), 12 Class II (G2-a) and 28 Class III (G2-b) patients. The mean post-operative follow-up was 65.47±26.36 months. In the SF-36 results, when pre and post operative surveys were compared, the quality of life increased significantly for G1 in all items except for body pain. In G2, when pre and post operative surveys were compared, the quality of life increased significantly in items related to emotional well-being, health transition, role limitations due to emotional problems, while other parameters did not significantly change. When groups were compared, there was no difference among them except for physical functioning which was improved for OSA patients. According to the Rustemeyer results, overall post-operative satisfaction score was 84.92±14.72%. There was a significant difference for patient satisfaction considering facial aesthetics in both groups. For chewing function there was no difference for patient satisfaction in G1, but there was a significant difference in G2 patients. CONCLUSIONS: Orthognathic surgery seems to be beneficial in terms of patients' satisfaction and patients' satisfaction for both dental skeletal dysmorphism and OSA patients.

Custom made/patient specific alloplastic total temporomandibular joint replacement in immature patient: a case report and short review of literature.

OBJECTIVE: Temporomandibular joint reconstructive surgery in a growing patient represents a challenging situation. Autogenous and alloplastic reconstructive options are being studied in literature; however, there are still some limitations. The objective of this case report is to evaluate a novel custom-made prosthetic system in a 12-year-old TMJ ankylosis patient. CASE PRESENTATION: The patient had complaints of temporomandibular joint ankylosis and hypoplasia. The patient had already been operated two times with autogenous grafts. Swelling and tumefaction were apparent on the right side of the face. Mouth opening was 1.5 centimeters, with limitations in lateral and protrusive movements of the jaws. Hypertonic muscles and pain upon palpation were registered. There were no signs of luxation, fracture, or traumatic avulsion. After examination, unilateral TMJ ankylosis was apparent on TC scans. Revision surgery was planned with the use of true plastic temporomandibular joint customized prosthesis. The patient underwent a TMJ reconstruction surgery using CADCAM custom-made patient specific prosthesis. The follow up period of this patient was 46 months and showed successful healing with no complications. CONCLUSIONS: Replacement of TMJ with custom made alloplastic material that is reported can be considered as a safe and useful option for growing young individuals in selected cases.

Clinical outcomes of fully and partially threaded zygomatic implants in a cohort of patients with minimum 7.5-year follow-up.

OBJECTIVE: The aim of this retrospective case series report was to evaluate the results of oral rehabilitation with extra-sinus zygomatic implant surgery with a minimum follow-up of 7.5 years. PATIENTS AND METHODS: A total of 35 patients with 87 zygomatic implants were included. The mean follow-up period of the patients was 93 months. The zygomatic implant survival and complications were evaluated as criteria for success. RESULTS: There were no implant failures. Overall success rate without complications for zygomatic implant was 88.5%. Complications developed in 4 patients (1 cutaneous fistula and 3 mucositis). According to the results on an implant basis, patients with previously failed conventional implants had greater probability of complications. Patients with quad zygomatic implants had higher incidence of complications than those with two zygomatic implants. Fully threaded implant design was associated with higher incidence of mucositis than partially threaded design. No relation was found between implant success and smoking, prosthesis type, and antagonist dentition. When conducting the analysis using the patient as unit, only the antagonist dentition showed significant difference, the worst outcome being associated with the Toronto resin prosthesis. CONCLUSIONS: Zygomatic implants can be considered as a safe alternative to conventional implant insertions and bone grafting procedures in oral rehabilitation of patients with severely atrophic maxillary bone.

Solitary fibrous tumor of parotid gland: a case report and short review of literature.

OBJECTIVE: This case report represents a solitary fibrous tumor, which is a very rare neoplasm in the parotid gland. CASE PRESENTATION: 80-year-old Caucasian female patient with palpable, immobile, painless, slow growing, semi-rigid-elastic neoplasm in the left parotid gland, that was existing for four months. There were no signs of inflammation and facial paralysis. The tumor was initially interpreted as a salivary gland neoplasm of uncertain origin. Fine needle aspiration was performed 2 times; however, the precise diagnosis was challenging. The tumor was excised, regional lymphadenectomy was performed. Morphological and immunophenotypical findings were consistent with solitary fibrous tumor of parotid gland. Currently, the patient is under regular follow-up period at 9 months with no evidence of metastasis or recurrence. CONCLUSIONS: Although very rare, solitary fibrous tumor (SFT) should be suspected in cases of slow growing, solid, well-defined nodules of the parotid gland. The SFT of the parotid gland are usually benign tumors, however there is a low risk of recurrency and malignant behavior with metastatic potential. Complete resection of the tumor should be performed since it is crucial for management without any recurrence.

Evaluation of Arthrocentesis with hyaluronic acid injections for management of temporomandibular disorders: a systematic review and case series.

Although arthrocentesis is an accepted safe treatment modality for the management of temporomandibular disorders (TMD) in symptomatic patients, the benefit of hyaluronic acid (HA) injections remains uncertain. The aim of this study was to evaluate whether intra-articular HA injections adjunctive to arthrocentesis can be more effective than other medications for the improvement of TMD associated symptoms. Additionally, the impact of HA injections on quality of life of TMD patients was assessed with SF-36® questionnaire in a cohort of patients. An electronic search of Medline, Scopus and Cochrane databases was performed up to March 2020. The following search terms were used: "arthrocentesis", "hyaluronic acid", "intra-articular injections", "visco-supplementation", "temporomandibular disorders". Prospective and retrospective studies that reported the application of HA injections compared to other intra-articular drugs for the treatment of temporomandibular disorders were included. Systematic or narrative reviews and pre-clinical studies were excluded. Additionally, a retrospective clinical study was performed for evaluation of changes in quality of life before and after arthrocentesis with HA injections. In the systematic review, the initial search yielded 1327 articles. After screening of the titles, abstracts, and full texts, 29 studies were selected (26 randomized studies, 2 controlled clinical trials, 1 retrospective report). In the clinical study, 12 patients were included. Intra-articular injections of HA and other medications together with arthrocentesis seemed to be beneficial for improvement of functional symptoms of TMD and pain. The case series also supported the efficacy of HA injections showing an improvement of quality of life of these patients. However, from literature review, it was impossible to identify an optimum drug or a protocol for predictably improving the pain and/or functional symptoms of temporomandibular problems, due to different etiologies, diversity of treatment modalities and conflicting results. In conclusion, there is no consensus in the literature that HA injections shows better results in comparison with other treatment modalities. According to the results of the present clinical study, HA injections with/without arthrocentesis seems to be beneficial in terms of clinical symptoms and quality of life of the TMD patients.

Impacted post-traumatic maxillary central incisor: A multidisciplinary approach.

AIM: The aim of this paper is to provide clinicians useful information for the management of impacted central incisor due to early childhood trauma. CASE REPORT: It is reported the case of an impacted right maxillary central incisor in an 8-year-old male patient who had an intrusive luxation trauma of primary tooth at the age of 4. After clinical and radiographic evaluation, a multidisciplinary treatment plan was planned. Therapy involved a surgical and orthodontic approach in order to expose the tooth and move the incisor in the normal position with a self-ligating appliance system. RESULTS: Through a multidisciplinary approach it was possible to move the impacted incisor in the occlusal plane, preserving periodontal tissues and tooth vitality. CONCLUSION: When a permanent tooth is impacted, the multidisciplinary approach of surgery and orthodontic treatment is the best way to obtain a suitable outcome in terms of gingival contour, occlusal plane and aesthetics, when compared with other treatment options.

Impact of COVID-19 epidemic on maxillofacial surgery in Italy.

Maxillofacial departments in 23 surgical units in Italy have been increasingly involved in facing the COVID-19 emergency. Elective surgeries have been progressively postponed to free up beds and offer human and material resources to those infected. We compiled an inventory of 32 questions to evaluate the impact of the SARS-COV2 epidemic on maxillofacial surgery in 23 selected Italian maxillofacial departments. The questionnaire focused on three different aspects: the variation of the workload, showing both a reduction of the number of team members (-16% among specialists, -11% among residents) due to reallocation or contamination and a consistent reduction of elective activities (the number of outpatient visits cancelled during the first month of the COVID-19 epidemic was about 10 000 all over Italy), while only tumour surgery and trauma surgery has been widely guaranteed; the screening procedures on patients and physicians (22% of maxillofacial units found infected surgeons, which is 4% of all maxillofacial surgeons); and the availability of Personal Protective Equipment, is only considered to be partial in 48% of Maxillofacial departments. This emergency has forced those of us in the Italian health system to change the way we work, but only time will prove if these changes have been effective.

Predictive role of gnathological techniques for the treatment of persistent idiopathic facial pain (PIFP).

INTRODUCTION/BACKGROUND: Persistent idiopathic craniofacial pain (PIFP) is a heterogeneous group of pain syndromes whose main characteristic is the daily presence of persistent pain for at least 3 months. The pathophysiology of PIFP is still not entirely known and probably related to biological and psychological factors. Although PIFP has been attributed to the central neuron activity, the importance of masticatory muscles as a possible pathogenic mechanism was recently demonstrated. The main purpose of our paper was to identify the physiological rest position of the mandible with minimal tonus of both the elevator and depressor muscles and the neuromuscular trajectory of mouth closing obtained by transcutaneous electrical stimulation (TENS) and maintained with the use of an occlusal device, known as orthotic. MATERIALS AND METHODS: The VAS scale for facial pain and the migraine disability assessment score (MIDAS) index for patient quality of life were evaluated at the beginning of the study for the 38 subjects that came to our attention. Our research included two phases. The first phase consisted of kinesiographic and electromyographic (EMG) examinations of the masticatory muscles and a 45-min application of TENS in order to deprogram the muscular activity. Kinesio-electromyographic examinations were repeated in the second phase. The main evaluated parameter was jaw deflection or deviation on the sagittal and frontal planes before and after TENS during patient tooth occlusion. Patients that showed a significant modification of this parameter were treated with orthotics for 12 months. RESULTS: The results of a 12-month follow-up show a sharp reduction of the VAS (pre-orthotic 9.05, range 8-10, SD 0.8; post-orthotic 5.87, range 1-5, SD 0.7) and an improvement in the quality of life (MIDAS). CONCLUSIONS: Our study demonstrated the usefulness of TENS as a screening method for the application of orthotics. This non-invasive and/or non-painful procedure could be a useful complementary treatment in this patient population. The results of the study also confirm the role of masticatory muscle dynamics as a possible pathogenic mechanism in patients with PIFP.

Maxillomandibular advancement for the treatment of obstructive sleep apnoea syndrome: a long-term follow-up.

Obstructive sleep apnoea syndrome (OSAS), which is characterised by repetitive episodes of pharyngeal collapse during sleep, is gaining much attention because of the important deleterious consequences it might have on the patient's health. We therefore organised a retrospective longitudinal study to report the long-term follow-up of maxillomandibular advancement (MMA) as a treatment for OSAS. A total of 19 patients with severe OSAS was treated during the period 2007-2016. They were followed up six months postoperatively (T1) and after a mean follow up of 6.7 (range 4-10) years (T2, between November 2017 and February 2018) for the polysomnography variables, and the Epworth sleeping scale (ESS) and body mass index (BMI) were recorded. All polysomnographic variables improved significantly from baseline to T1 and from baseline to T2. The ESS significantly improved from baseline to T2. Nearly all patients at T1 and over two-thirds at T2 had a 50% reduction of the apnoea/hypopnoea index when compared with baseline, and a value lower than 20 of the same index. The BMI did not change significantly from T0 to T2. Our long-term follow-up has documented the stability of the outcomes of the MMA for the treatment OSAS.

Evaluation of factors influencing accuracy of virtual surgical planning in orthognatic surgery.

Three-dimensional virtual surgical planning has become routine practice in orthognatic and reconstructive surgery for the possibility to realize presurgical evaluation of intraoperative bones movements, the prediction of postoperative results and the high level of accuracy. Thanks to surface superimposition between 3D planned and 3D postoperative model of maxillo-facial skeleton, a medium discrepancy less than 1 mm was found in scientific literature, considering 15 different points of maxillofacial skeleton. In our study we decided to evaluate different factors that could invalidate that result in the same cohort of patients, such as sex, kind of dentofacial deformity, asymmetry, type of surgical approach and entity of maxillo-mandibular movements (more or less than 1 mm). We found out no significant differences among groups. We can state that virtual surgical planning and 3D surgical splints are a valid means of diagnosis, treatment and predictivity regardless factors that could influence post-operative results. In conclusion, virtual surgical planning and 3D surgical splints facilitated diagnosis, treatment planning and accuracy regardless of sex, dentofacial deformity class, surgery techniques, entity of advancement and asymmetry.

The role of electrophysiological investigations of masticatory muscles in patients with persistent idiopathic facial pain.

INTRODUCTION: The authors tried to establish whether there is any electrophysiological difference of masticatory muscle activity between patients with persistent idiopathic facial pain (PIFP) and healthy subjects. METHODS: Twenty-eight PIFP patients (6 men and 22 women, mean age 40 years) and 28 normal subjects (12 men and 16 women, mean age 40 years) underwent EMG of temporal and masseter muscles before and after transcutaneous electric nerve stimulation (TENS). RESULTS: After TENS stimulation, the mean amplitude difference was found to be smaller than the baseline before TENS in the PIFP patients compared with healthy subjects. CONCLUSIONS: The peculiar behavior of masticatory muscles after TENS could be relevant in order to explain the well-known improvement of pain reported by some PIFP patients after orthosis positioning.

Three-dimensional longitudinal evaluation of facial mimicry in orthognathic class III surgery.

The effect of bimaxillary orthognathic surgery on facial mimicry was assessed longitudinally in 15 patients with dentoskeletal class III facial dysmorphism (seven men, eight women, mean age 28 years). The patients were analysed pre-surgery and at 6, 12, and 24 months post-surgery while performing verbal (five vowels) and non-verbal (open and closed mouth smile, lip purse) soft tissue facial movements. The three-dimensional motions of right and left nasogenian, crista philtri, cheilion, and lower lip landmarks were detected by an optoelectronic instrument, and a total mobility index was obtained. Differences between the sides were quantified by the symmetry index. Patient values were compared to those collected previously from healthy volunteers by computing z-scores. On average, no significant differences were found in the mobility of the buccal soft tissues at 24 months after surgery (ANOVA P-value, range 0.075-0.808), with positive median z-scores (pooled mean value close to 0.6). Symmetry indices ranged around the control reference values, showing no stage-related differences (Friedman test P-value, range 0.252-0.937), and exceeding 90% for all movements at 24 months after surgery. Bimaxillary osteotomy does not compromise facial mimicry in either verbal or non-verbal facial movements.

Impact of reconstructive microsurgery on patients with cancer of the head and neck: a prospective study of quality of life, particularly in older patients.

Treatment of cancer of the head and neck often requires extended resection and major reconstructive surgery, both of which can have great functional and emotional impact. It is fundamental to evaluate the outcome with respect not only to the clinical aspects but also to the quality of life (QoL) perceived by the patients. In the light of the reported increasing incidence of oral cancer in older patients, we decided to see if there was an association between QoL and age. Between June 2015 and December 2016 we submitted the Italian version of the 36-item Short Form Health Survey (SF-36) to 30 patients (mean (range) age 65.5 (23-87) years) who had had resection and microsurgical reconstruction at the Ospedale Maggiore Policlinico of Milan. The questionnaires were completed before operation, and 12 months afterwards, and clinical and personal data were also collected. From the results of SF-36 we obtained the Short Form 12 (SF-12), Physical Health Composite Score (PCS), and Mental Health Composite Score (MCS) and looked at how age influences the variation in QoL scores. The variation between SF-36 and SF-12 results (preoperatively and postoperatively) did not seem to correlate with age. Our study confirmed that reconstructive microsurgery can be realistically proposed to older as well as younger patients because, according to the QoL index, older patients are able to manage (and therefore take advantage of) this complex surgical technique.