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Biomedical subjects

C Riberti

Publications and source records attributed to C Riberti.

At least 37 records · Page 2Linked to original sources

[Anesthesia problems in children with cleft lip, maxilla and palate].

The technical and physiopathological problems associated with labiomaxillopalatine schisis in children are discussed. Personal experience, involving the choice of a type of anaesthesia based on the use of an analgesic (pentazocine), and the exclusion of halogenated anaesthetics in most cases, is reported. Stress is laid on the simplicity of the technique. Coupled with careful intraoperative monitoring, it has enabled this type of surgery to be handled both serenely and successfully.

Age Factors↗

[Tibial periostal graft in the repair of the primary cleft palate: preliminary report of a new technique (author's transl)].

Reconstruction of the oral plane of a primary cleft palate using tibial periostal graft at the primary repair stage seems a highly appealing technique: -- the osteogenic power of the periosteum used as a free transplant has been demonstrated long ago (Ollier, Axhausen); -- two requisites must be filled when primary palate repair is undertaken: maintainance of the nasal fossa size and maintenance of the palatal fibromucosa that must be not submitted to any traction whatsoever, otherwise endognathia will arise. A vast, tight and strong periostal plane will be obtained with the periostal graft, the latter bringing also bone to the cleft. Better still, such a periostal graft can be extended backwards over the entire length of the cleft bony palate which will subsequently create a situation requiring simple soft palate repair.

Child, Preschool↗

[Complete repair in one stage of the sequelae of unilateral total hare lip (author's transl)].

The sequelae of hare lip, of mixed origin, malformative and surgical, require careful analysis of the deformities present in order to ensure their correction. The basic concept is replacement of the cleft in its initial position, i.e.: --re-opening of the cleft, --exposure of the bony edges, --excision of scar tissue. Restoration is then performed starting deep and working upwards, with primary attention paid to the skeleton with the complex concern of: --normalisation of the underlying bone and of occlusion, --re-establishment of oro-nasal muscular equilibrium, --esnuring nasal ventilation. without neglecting the overall morphology. With this in mind, complete repair in one stage is most likely to result in a harmonious overall result.

Bone Transplantation↗

Myofasciocutaneous expansion in the tegumentary rehabilitation of the amputation stump.

In post-traumatic amputations, in particular in leg amputations, the presence of an unstable scar or of ulcerous areas that are difficult to heal in the site of the amputation stump constitutes a repair problem that is not easily solved. In this specific field of reconstruction skin expansion has earned significant agreement, and is even considered to be a safe and reliable method for the surgical rehabilitation of the amputation stump, allowing us to obtain high-quality tegumentary covering, with no excessive thickness, that adapts well to the prosthesis and to the underlying skeleton, and that is characterized by good sensitivity of protection. Tegumentary amplification may, in some cases, also become myocutaneous, allowing us to obtain more tissue thickness for protection in patients submitted to chronic loading that lasts longer and in those with thin teguments, in which traditional expansion could determine excessive narrowing of the tegumentary covering, following atrophy caused by compression of the subcutaneous adipose tissue.

Accidents, Traffic↗

[The postoperative expansion of a myocutaneous flap of the large dorsal muscle in postmastectomy breast reconstruction].

BACKGROUND: Reconstructive breast surgery using the myocutaneous flap of the latissimus dorsi muscle with simultaneous insertion of a prosthesis represents a very useful procedure from a clinical standpoint. METHODS: Twenty-one breast reconstructions were performed using this type of surgery at the Plastic Surgery Clinic of the University of Udine between December 1993 and December 1995. RESULTS: Good aesthetic results can be obtained due to the relatively moderate functional and scarring complications, as well as to the vitality of the transposed tissue. The percentage of capsular contractures observed frequently in the past was lowered through the use of technologically-advanced prosthetic materials with a texturized surface. CONCLUSIONS: In addition, since the reconstructed breast can be expanded postoperatively through definitive Becker expanders, aesthetically satisfactory results can be achieved even with contralateral ptosic and/or large breasts.

Adult↗

[Breast reconstruction].

The ideal goal of every post-mastectomy breast reconstruction is to achieve a breast that is as "identical" as possible to the contralateral one in shape, size, consistency, mobility and degree of naturalness. At the same time, however, it is essential to rely on the simplest and safest reconstruction technique as far as the patient is concerned. Mastectomy and restoration of the lost morphology should be performed in a single operation whenever the opportunity arises and there are two reasons for this. First of all, by working this way reconstruction can be performed on an area that is completely free of any scar tissue. Secondly, there are psychological considerations involved, since this makes it possible to avoid the trauma of letting the patient seeing herself, even for just an instant, without her breast. The numerous different techniques used for the morphological reconstruction of breast volume can be classified into two basic groups: reconstruction with insertion of a prosthesis and reconstruction without a prosthesis. Both of these techniques make it possible to personalize surgical choices based on the patient's unique characteristics, in order to achieve a complete symmetry in relation to the contralateral breast.

Breast Implantation↗

[Current therapeutic trends in the oto-mandibular syndrome].

The authors describe the characteristics of oto-mandibular syndrome (hemifacial microsomia), underlining that the knowledge of the craniofacial growth and the analysis of the deformities are necessary for a correct surgical approach. The skeletal abnormalities, and in particular the mandibular deformity, are the first step of treatment, which is begun more and more often before the age of six to minimize the skeletal distortion and to decrease the psychological problems of the child. Nevertheless, several surgical procedures are generally required up to the age of 12-16 to obtain a good symmetry. The reconstruction of the ear is deferred, whenever possible, until the mandibular and zygomatic osseous framework have been established to avoid a location in an unfavorable site. The earliest age of repair is six years. Early correction of macrostomia is needed in order to obtain a functioning and symmetric oral sphincter. The possible deficiency of soft tissues does not always require surgery and is the last step of treatment of hemifacial microsomia.

Child↗

[Hearing changes in patients with cleft lip and palate: clinico-statistical contribution].

The otological complications which may occur in subjects with cleft lip and palate due to middle ear and tubal impairment related to velopharyngeal musculature are discussed. Three groups of patients aged 3-15 years have been submitted to clinical examination, audiometry and impedance measurement. In 2/3 of cases there was hearing impairment between 20-40 dB and 72% out of children younger than 8 years a pathological tymponometric curve was observed. These results confirm the positive relationship between cleft palate and hearing impairment and suggest that these children must be followed-up very carefully in oder to prevent middle ear and tubal alterations.

Adolescent↗