Surgical approaches to cavernous haemangiomas of the orbit.

Cavernous haemangiomas are the most common orbital masses and the second most common cause of unilateral proptosis after thyroid ophthalmopathy. We retrospectively analysed 19 patients with retrobulbar cavernous haemangiomas, 9 of whom had lateral orbitotomy to remove retrobulbar cavernous haemangiomas located superior (n=4), inferior (n=2) or lateral (n=3) to the optic nerve. Seven patients had lateral orbitotomy together with an anterior medial approach to gain access to retrobulbar cavernous haemangiomas located medially to the optic nerve in the posterior half of the orbit. An anterior approach was used in 3 patient with an anteriorly located cavernous haemangioma. We describe here the planning of surgical treatment based on the site of the lesion.

Primary intraosseous hemangiomas of the orbit.

INTRODUCTION: Primary intraosseus orbital hemangiomas are rare vascular anomalies, of which only 23 cases have been previously reported in the literature. We here describe a further two cases. MATERIALS AND METHODS: An anterior approach was used to remove a mass located in the inferior orbital rim in one case, and in the orbital floor in the other. RESULTS: Good restoration of the orbital walls with no signs of recurrence. DISCUSSION: Intraosseous hemangiomas of the orbit are usually located anteriorly, and can be removed by anterior surgical approaches. The main surgical problem is due to the removal of the involved areas of the orbital walls because resection without reconstruction may cause functional impairments and secondary deformities that are more damaging for the patient than the tumour itself. In order to avoid defects, the integrity of the orbital walls must be immediately restored by means of autologous bone or alloplastic grafts.

Conservative treatment of arteriovenous malformations of the mandible.

A modified technique is reported on the treatment of arteriovenous malformations in the mandibular body. The technique consists of highly selected embolization and piecemeal removal of the lesion through burred holes made in the cortex. This way the mandible and the teeth may be saved in selected patients.

Reconstruction of the orbital walls in surgery of the skull base for benign neoplasms.

Surgery for benign neoplasm extending into the orbital roof requires immediate reconstruction to avoid complications, which include transmission of the cerebral pulse to the globe, bulbar dystopia, diplopia, and fibrosis of the oculomotor muscles. Many alloplastic materials have been employed for such reconstruction, but currently most authors agree that autologous bone graft is the best option. Using calvarial bone in adults and split ribs in children, we have operated on eight patients for fibrous dysplasia (five cases), neurofibroma (two cases), or meningioma (one case). After a median follow-up period of two years and six months, good morphology of the orbit was maintained with no ocular symptoms.

[A new "light" maxillomandibular fixation system]. / Un nuovo sistema "leggero" di fissazione maxillo-mandibolare.

BACKGROUND: A new "light" maxillo-mandibular fixation system for treatment of mandibular fractures, based on use of special pins, is proposed. METHODS: Fifteen patients with non-displaced mandibular fractures (angle, body and symphysis), have been treated at the Department of Maxillofacial Surgery, S. Paolo University Hospital, Milan. The system is based on pins formed by a no. 1 metal wire and a bead. The free end of the pin is threaded around a tooth and then wound three or four times around the bead to fix it in place and, at the same time, separate it from the gingiva. One pin is usually positioned on each quadrant. Once the pins are in place they are tied to each other using a loop no. 0 to complete the maxillo-mandibular fixation. Particular attention was paid to maintain a correct individual occlusion. The time of maxillo-mandibular block was 10-15 days. RESULTS: Results were good with complete healing of all fractures, restoration of individual occlusion, minimal periodontal lesions and a good compliance for the treatment by the patients. CONCLUSIONS: It is suggested to use this system routinely because quick, economic, easy on periodontium and relatively comfortable for the patients. The contraindication include an unstable occlusion, the absence of a suitable pair of teeth on both sides of the jaws, avulsion or trauma or periodontopathy of one of the teeth needed for the fixation system.

[Dispersion of junctional tissue and its consequences in a case of sudden infant death]. / Dispersione del tessuto giunzionale e sue conseguenze in un caso di morte improvvisa del lattante.

This article reports a case of sudden infant death syndrome in a 1-month-old male. Some important abnormalities of the cardiac conduction system were found, consisting of persistent fetal dispersion of the atrioventricular node and His bundle, accessory atrioventricular pathways of Mahaim type and resorptive degeneration. These changes could be considered as a morphological substrate for cardiac arrhythmias.

Penetration of cefonicid into serum, salpinges, cervix and vaginal tissue.

Cefonicid is a new cephalosporin that, given in adequate concentrations is able to kill some pathogens such as Gram-positive cocci and many Enterobacteriaceae. In this study we have evaluated 40 patients receiving 1 g of cefonicid i.m. at various times before abdominal or vaginal hysterectomy. The results of the present study indicate that a single dose of 1 g of cefonicid given intramuscularly is useful as prophylaxis and treatment of gynecological infections.

Block of gonadotropic activity with a long-acting estroprogestogen.

PIP: 40 healthy, fertile women received an intramuscular injection of F1 6902 (100 mg of MAP-depot + 20 mg of estradiol valerianate) on Day 5 of menstrual cycle. Urinary luteinizing hormone (LH) determinations were made throughout the cycle. At both the 13th and 23rd day, in treated patients, the urinary LH diminished significantly (F .01) with respect to Day 5 of cycle. Patient age and LH value on Day 5 correlated (P .05) insignificantly. However, a negative correlation between age and the difference between LH on Day 5 and 13 was found (P .05); i.e., the lower the subject age, the greater the reduction in LH value. No significant variations in cervical pH were observed either at Day 13 or 23 with respect to Day 5 values. Of the 40 subjects treated, 25 had quantitatively regular menstrual flow from the 23rd-26th day after administration. Of the remaining 15, 2 had anticipated flows, 5 had spotting, and the remaining 8 had delayed menstruation. 3 spotting subjects were curettaged and the endometrium was atrophic with a stromal component of a decidual type prevailing on the glandular type.^ieng