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Biomedical subjects

Federico Biglioli

Publications and source records attributed to Federico Biglioli.

10 recordsLinked to original sources
PubMed2006

Function of the sensate free forearm flap after partial glossectomy.

AIMS: To compare functional recovery of sensitive free forearm flaps with non-sensitive free forearm flaps, following reconstruction for partial glossectomy. MATERIAL: Sixteen patients underwent partial glossectomy for oncological reasons, of whom: nine patients underwent repair with non-sensitive free forearm flaps (group A) and seven with sensitive free flaps (group B). METHODS: All patients underwent the following tests: (1) tactile sensitivity evaluation, localization of stimulus, sharp/blunt definition, discrimination between two points (static and dynamic), thermal sensitivity to heat/cold; (2) speech evaluation by means of the modified Fanzago test; (3) subjective evaluation concerning the degree of satisfaction of the following functions: swallowing, feeding and talking. RESULTS: The sensitivity and logopaedic evaluation tests and the subjective evaluation charts highlight an overall better functional recovery of the sensitive repair than the non-sensitive ones. CONCLUSION: In patients who have undergone partial glossectomy repair with free forearm neurofasciocutaneous flaps allow good recovery of oral functions and, therefore, a good quality of life.

Forearm↗
PubMed2006

Clinical outcome of dental implants placed in fibula-free flaps used for the reconstruction of maxillo-mandibular defects following ablation for tumors or osteoradionecrosis.

OBJECTIVES: (a) To evaluate the clinical outcome of fibula revascularized flaps used for the reconstruction of maxillary and mandibular defects due to resection for tumors or osteoradionecrosis and (b) to evaluate the survival and success rates of implants placed in the reconstructed areas. MATERIAL AND METHODS: In a 8-year period (1995-2002), 59 patients, 38 males and 21 females, aged from 13 years to 69 years (mean age: 48.7 years), presenting with maxillary and mandibular defects due to resection for tumors or osteoradionecrosis, were reconstructed with fibula-free flaps. Of the 59 patients, 16 received 71 implants for the prosthetic rehabilitation of the reconstructed edentulous areas. RESULTS: Out of 59 fibula-free flaps, three failed and had to be removed, nine underwent partial necrosis involving the bone segment and/or the skin paddle but survived, while the remaining 47 healed uneventfully. The mean follow-up of patients after the reconstruction was 55 months (range: 24-120 months). The cumulative survival rate of fibula-free flaps was 94.9%. The mean follow-up of the 16 patients treated with dental implants and implant-supported prostheses was 50.2 months (range: 24-96 months). The cumulative implant success and survival rates of implants were 98.6% and 93.1% respectively. CONCLUSION: The reconstruction of maxillo-mandibular defects following ablation for tumors or osteoradionecrosis with fibula-free flaps has been demonstrated to be a reliable technique with good long-term results. Implants placed in the reconstructed areas were demonstrated to integrate normally, with success and survival rates comparable to those obtained in case of implants placed in native bone.

Adolescent↗
PubMed2004

Kinking of pedicle vessels and its effect on blood flow and patency in free flaps: an experimental study in rats.

AIM: Head rotation may significantly alter the initial position of the vascular pedicle of free flaps in reconstructive surgery of the oral cavity. This may lead to kinking of venous and/or arterial vessels. In spite of some precautions as rotating the head contralaterally for the first few days postoperatively or shortening the pedicle, the problem is still not well understood and remains unsolved. In order to understand the matter better, an experimental study was devised to create intentional kinking of the pedicle of a free-flap. MATERIAL AND METHODS: Twenty CD-outbred rats were subdivided into two groups. All rats were operated on by harvesting a muscular free flap from the right-hind limb. Microvascular anastomoses were performed on the femoral artery and vein. In group A (kinking group), the free flap was twisted and placed within the abdomen just under the spleen; by this way the pedicle was rotated by 180 degrees creating a kink. In group B (no kinking, the control-group), the same microvascular flap was performed leaving the limb in the normal anatomical position. Rats were sacrificed 48 h postoperatively and patency of the vessels was established both clinically (Acland test) and microscopically. RESULTS: Only one vein of a rat of group B had preanastomotic thrombosis, so no statistically significant difference was found among the two groups. CONCLUSIONS: From this experimental protocol a 180 degrees narrow kinking with a curvature rather than acute angulation of the pedicle does not influence the survival rate of the free flap negatively. This, however, does not refute the possibility that a more acute angular kinking may reduce survival rates of microvascular flaps.

Anastomosis, Surgical↗
PubMed2003

Submental Orotracheal Intubation: An Alternative to Tracheotomy in Transfacial Cranial Base Surgery.

This retrospective study evaluated the safety and efficacy of submental intubation not only for trauma treatment but also for oncological cranial base surgery. The medical records of 24 patients who underwent submental intubation from 1996 to 2002 were reviewed. There were 6 procedures for craniofacial trauma, 12 transmaxillary approaches to the clivus for clivus chordomas, and 6 transmaxillary approaches to the cranial base for chondrosarcomas. Time required for intubation, accidental extubation, postoperative complications, and the healing of intraoral and submental scars were evaluated. The submental orotracheal intubation was completed successfully in all patients. No accidental extubations or tube injuries occurred. The mean time required for intubation was 5 minutes. The only complication was one case of superficial infection of the submental wound. The intraoral and submental accesses healed with minimal scarring in all patients. Submental orotracheal intubation is a useful and safe technique for airway management of craniomaxillofacial traumas and during transfacial approaches to the cranial base. It avoids the complications associated with tracheostomy. It also permits considerable downward retraction of the maxilla after a Le Fort I osteotomy and is associated with good clival exposure. Furthermore, it does not interfere with maxillomandibular fixation at the end of the surgery.

Journal Article↗
PubMed2002

Function of the great auricular nerve following surgery for benign parotid disorders.

INTRODUCTION: The main concern in benign parotid surgery is complete removal of the lesion whilst avoiding any harm to the facial nerve. Some time ago, surgeons also began to spare other structures including the great auricular nerve. The purpose of this paper was to study these procedures prospectively and to evaluate the sensory recovery of this nerve. MATERIAL: Fourteen patients undergoing parotid surgery with preservation of the great auricular nerve (group A) have been studied and compared with 10 patients whose operations involved sacrificing the nerve (group B). METHODS: The function of the great auricular nerve has been tested (qualitatively and quantitatively) before the operation, and postoperatively during the first few days and at 3, 6, 9 and 12 months. RESULTS: Twelve months postoperatively, no area of anaesthesia was found in group A, whilst all patients in group B had some degree of sensory loss. In group A, the qualitative and quantitative tests documented complete recovery of various types of surface sensitivity in 80% of cases, with the remaining 20% showing only a moderate reduction in comparison with the unoperated side. CONCLUSION: From this study, it seems reasonable to spare the great auricular nerve during parotid surgery for benign disease because the procedure takes very little time, but guarantees a major improvement of postoperative sensitivity of the region innervated by the great auricular nerve.

Adult↗
PubMed2002

Neurosensory alterations of the inferior alveolar and mental nerve after genioplasty alone or associated with sagittal osteotomy of the mandibular ramus.

AIMS: The purpose of our protocol is to study neurosensory disturbances following genioplasty, sagittal split mandibular osteotomy, or both procedures in combination. Many authors assessed the incidence and degree of neurosensory disturbances of the inferior alveolar nerve following orthognathic surgery but often results are difficult to interpret and compare due to a lack of standardization of methods. PATIENTS: Fifty patients (24 males and 26 females) were tested with qualitative (touch sensation, sharp/blunt test, cold sensation and hot sensation) and quantitative methods (localization test, two point static and dynamic test) at least 1 year after orthognathic surgery. The patients were divided into the following groups: 10 patients in group 1 (controls); 12 patients in group 2 (genioplasty alone or in association with maxillary osteotomy or vertical mandibular ramus osteotomy); 10 patients in group 3 (sagittal split osteotomy alone); 18 patients in group 4 (sagittal split osteotomy with concomitant genioplasty). METHOD: On both sides four areas were tested: centre of chin and lip (cutaneous and mucosal sides), 2 cm lateral to the chin centre (cutaneous and mucosal sides), 3 cm lateral to the chin centre i.e. approximately at the mental foramen (cutaneous and mucosal sides) and vermilion. Tests were always performed by the same person. All patients were also asked to indicate whether the altered sensation was considered subjectively as being disabling. RESULTS: None of the patients showed persistent anaesthesia in the tested areas according to the qualitative tests. In group 2 the quantitative sensory tests revealed normal or slight hypoaesthesia (17%) in all areas tested; in 30% of the patients of group 3, minimal quantitative sensory disturbances were noted, while the incidence of objective sensory deficits increased in patients who had undergone a concomitant genioplasty (40% among group 4). Among the tested areas the vermilion and oral commissure were affected most often in all groups. Statistical analysis (using STATA 6.0) revealed that these differences were significant (p<0.05). There were also significant differences between group 1 and groups 3 and 4 for tactile sensitivity, location tests and sharp-blunt discrimination, while two point discrimination (quantitative test) showed statistically significant differences between group 1 and all other groups (2-4). No statistically significant differences among the four groups were found for thermal sensation (hot and cold). CONCLUSIONS: The combination of genioplasty and sagittal split osteotomy seems to be more detrimental for the lip sensibility than genioplasty or sagittal split alone. Thermal sensation is less affected than tactile sensation, location and two point discrimination tests (static and dynamic). Despite that, sensory deficit was never considered as disabling by the patients subjectively.

Chin↗
PubMed2002

Access to the maxillary sinus using a bone flap on a mucosal pedicle: preliminary report.

INTRODUCTION: An alternative procedure to access the maxillary sinus is described. OBJECTIVE: To describe advantages and disadvantages of the suggested technique of harvesting a bone flap based on an antral mucosal pedicle. MATERIAL: Four patients have been operated on to remove foreign bodies or odontogenic cysts. RESULTS: In all four patients, removal of the lesions and foreign bodies was easily accomplished. CONCLUSION: The procedure described respects the morpho-functional integrity of the sinus, is easy, quick and may be performed under local anaesthesia.

Foreign Bodies↗
PubMed2002

Comparison of the effect of supraperiosteal versus subperiosteal dissection on the growing rabbit maxilla.

OBJECTIVE: To achieve closure of wide unilateral cleft lip repair without tension of the cleft lip margins, a large undermining, especially of the anterolateral surface of the maxilla, is needed. Two types of dissection are feasible: supraperiosteal or subperiosteal. The aim of this study was to investigate whether there are differences in maxillary growth between healthy rabbits after supraperiosteal or subperiosteal dissection. METHODS: Twenty-four male 7-week-old New Zealand white rabbits were divided randomly into three groups: eight control animals (untreated); eight animals undergoing supraperiosteal dissection of the left surface of the maxilla, and eight animals undergoing subperiosteal dissection of the left surface of the maxilla. All of the treated animals were operated on by the same surgeon at age of 7 weeks and sacrificed at 27 weeks together with control group animals. Seven cephalometric measures (representing aspects of maxillary length, width, and height), on the left side, were taken on the cleaned skull of the rabbits, and the results were analyzed statistically. RESULTS: No significant differences in maxillary growth were noted across the three study groups. CONCLUSIONS: The supraperiosteal or subperiosteal undermining of the anterolateral surface of the maxilla does not seem to interfere with the growth of the normal maxilla in the rabbit.

Alveolar Process↗
PubMedDate not supplied

Fibrous dysplasia of the orbital region: current clinical perspectives in ophthalmology and cranio-maxillofacial surgery.

PURPOSE: To describe the multidisciplinary diagnosis and treatment of patients with orbital fibrous dysplasia, a slowly progressive disease that may lead to asymmetry, disfigurement, and functional ocular problems. METHODS: Ten patients with orbital fibrous dysplasia underwent bifrontal craniotomy through a coronal flap, with the removal of the supraorbital arch and dysplastic process involving the anterior and middle base of the skull. Four patients underwent superior orbital fissure and optic nerve canal decompression. Reconstruction was performed by using an autologous bone graft for both the adults and children, in whom a rib graft was preferred. The mean follow-up was 53.2 +/- 18.3 months (range, 14 to 94 months). The patients' preoperative status and postoperative status were compared. RESULTS: The immediate and long-term morphologic and aesthetic results were good in all cases. All of the patients complained of some degree of diplopia during the immediate postoperative period, but the problem spontaneously resolved within 1 to 6 months in all but one case. No postoperative reduction in visual function was observed in the patients who underwent optic nerve decompression. The only reported complication was the irregular reabsorption of regrafted dysplastic bone in one patient. CONCLUSIONS: A multidisciplinary approach to orbital fibrous dysplasia is fundamental for treatment planning and execution.

Adolescent↗