Bilateral and multifocal Warthin's tumor of parotid gland: two case reports and review of literature.

Warthin's tumor is the second most common benign neoplasm of the parotid. Most of cases are represented by a single localization, while only a small percentage of patients presents bilateral lesions or unilateral multifocal pattern. Warthin's tumor has an excellent prognosis due to the low rate of recurrence after surgical treatment. Malignant transformation occurs in less than 1% of cases. The aim of this article is to present two unusual cases of Warthin's tumor and an updated review of the latest scientific literature.

A complication following tooth extraction: chronic suppurative osteomyelitis.

UNLABELLED: A complication following tooth extraction: a case report of chronic suppurative osteomyelitis. OBJECTIVE: This article presents a case report about the surgery treatment of chronic suppurative osteomyelitis following a tooth extraction. METHODS: Cone beam computed tomography revealed a sequestrum bone formation that required the sequestrectomy and the debridement of the involved area. The prescription of oral penicillin and metronidazole were necessary after and before the surgery. Also 20 sessions of hyperbaric oxygen therapy were important for the healing of the marrow space. RESULTS: The histologic test confirmed the diagnosis of "Chronic suppurative osteomyelitis". Clinically the post-operative course showed no complications but a good healing of the bone tissue. Culture reports revealed two microorganisms, streptococcus viridans and staphylococcus, that are sensitive to penicillin. CONCLUSIONS: Clinical results confirmed the validity of the sequestrectomy and the debridement of the involved area for the treatment of chronic suppurative osteomyelitis. Such approach has always to be preferred because it guarantees the healing of bone tissue.

[Distraction osteogenesis of the cranio-maxillo-facial bones]. / Osteogenesi distrazionale dello scheletro cranio-maxillo-facciale.

Distraction osteogenesis is a surgical technique: its main purpose is to induce a mechanically stimulated bone tissue augmentation. A controlled tension, developed by a slow and gradual separation of the corticotomized/osteotomized bone segments, induces new bone formation and related soft tissue augmentation. In this way, we can observe a more harmonious tissue augmentation, better than with traditional techniques as osteotomies with grafts. This procedure, initially applied in orthopedic field for limb lengthening, is now also applied in the cranio-facial field. The most important features of distraction osteogenesis consist in the simplicity of execution, the lack of donor site morbidity and the simultaneous expansion of bone and related soft tissue. Besides, the technique is still at the beginning and requires further acknowledgements, before being widespread used to treat cranio-facial malformations. Disadvantages in bone distraction are related to the external device and consist in esthetic discomfort during treatment, and cutaneous scars. Recently, to solve these problems an intraoral distraction device was proposed. Distraction osteogenesis has now an expanding role in cranio-facial surgery.

[Van Buchem disease. Maxillofacial changes, diagnostic classification and general principles of treatment]. / Malattia di Van Buchem. Alterazioni maxillo facciali, inquadramento diagnostico e principi generali di trattamento chirurgico.

Van Buchem's disease is a rare pathology with recessive transmission and variable expressivity characterised by a progressive cortical bone deposition. There are two types of this disease: Type I (Van Buchem's disease) progressive form for all life and with high level of PA (alkaline phosphate); Type II (Worth disease) the pathologic bone deposition stops at 20 years of age and the level of PA in the adult is normal. The most important histological feature is the bone hypertrophy with preservation of the lamellar frame. The bones interested are: skull vault, mandible, ribs, clavicle and diaphyseal portion of long bones. The first clinical manifestation became evident in childhood with progressive course. The narrowing of the cranial foramen is responsible of the progressive cranial nerves compression and the subsequent neurological signs. The disease is incurable; surgical treatment aims to reduce the intracranial pressure and to correct bones deformity. A clinical case in which the patient treated has esthetic problems but not neurological signs is presented.