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Biomedical subjects

M Politi

Publications and source records attributed to M Politi.

At least 19 recordsLinked to original sources
PubMed2006

Ultrasonic bone cutting for surgically assisted rapid maxillary expansion (SARME) under local anaesthesia.

Ultrasonic bone-cutting surgery has been recently introduced as a feasible alternative to the conventional tools of cranio-maxillo-facial surgery, due to its technical characteristics of precision and safety. The device used is unique in that the cutting action occurs when the tool is employed on mineralized tissues, but stops on soft tissues. This technical note illustrates the use of Piezosurgery for all osteotomies of surgically assisted rapid maxillary expansion (SARME). The procedure, including pterygo-maxillary detachment, can be completed under local anaesthesia. Other advantages include minimal risk of jeopardizing critical anatomic structures (e.g. palatine artery), minimal intraoperative bleeding and postoperative swelling, and minimal thermal damage to bone surfaces. Narrow and rectilinear osteotomies can be easily performed with varying vibrating scalpels, at the cost of a longer operative time.

Anesthesia, Dental↗
PubMed2006

Femoral nerve palsy after mandibular reconstruction with microvascular iliac flap: a complication under anticoagulation therapy.

Pharmacological prophylaxis and intervention are used extensively in head and neck reconstructions with microvascular flaps. There is no universally accepted protocol, but the microvascular surgery literature recommends intraoperative anticoagulation with heparin. Here is reported a case of iliacus haematoma with subsequent femoral nerve palsy after the harvest of a microvascular iliac flap for mandibular reconstruction in a patient who had been treated with heparin. The association between femoral nerve palsy and anticoagulant therapy has been well described. It remains unclear as to why the iliacus muscle is particularly vulnerable to intramuscular haemorrhage. Femoral nerve neuropathy is also an uncommon but recognized complication after abdominopelvic surgery. Iliacus haematoma secondary to microvascular surgery has not been previously reported. This case illustrates the need to be aware of this type of complication and its clinical manifestations for patients under anticoagulant therapy in the perioperative period during microvascular reconstructions.

Adult↗
PubMed2006

Cognitive changes after carotid artery stenting.

INTRODUCTION: We aimed to test changes in cognitive performance after carotid artery stenting (CAS). METHOD: Ten patients were neuropsychologically tested at least 24 h before and 48 h after CAS. To diminish thromboembolic events, we used a proximal protection device. The following neuropsychological tests were selected: The Mini Mental State Examination (MMSE), symbol digit test and subtests of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) battery (verbal fluency, constructional practice, word list memory and delayed recall). Affective state was determined by the Beck Depression Score (BDS). RESULTS: No patient suffered from depression (BDS <1) or dementia (MMSE 29.9+/-1.5). Nine of the ten patients (P=0.12) showed increased speed in the Number Connection Test (NCT) (corresponding to trail making test). Most patients showed better or similar results concerning delayed recall (P=0.31). No change was observed in the symbol digit test, word list memory, verbal fluency or constructional practice. Better results concerning NCT and delayed recall after carotid stenting might be due to improved brain perfusion. CONCLUSION: After CAS, cognitive and memory performance seem to improve. Further studies with different time intervals and more refined testing, as well as perfusion-weighted imaging, are needed.

Aged↗
PubMed2006

[Vascular anomalies of the cerebellopontine angle].

Vascular anomalies of the cerebellopontine angle are rare compared to tumors in this area. Irritation of the trigeminal, facial, or vestibulocochlear nerve may cause trigeminal neuralgia, hemifacial spasm and vertigo, or tinnitus accordingly. Vessel loops in the cerebellopontine cisterns may cause compression at the root entry or exit zone of the cranial nerves V, VII, and VIII, a phenomenon which is called "vascular loop syndrome." Megadolichobasilar artery and aneurysms of the vertebrobasilar system can also lead to dislocation and compression of the cranial nerves and brain stem. Three-dimensional CISS MR imaging and MR angiography are useful in the detection of neurovascular compression. Microvascular decompression is an effective surgical procedure in the management of compression syndromes of the cranial nerves V, VII, and VIII.

Aged↗
PubMed2006

[Anatomy of the cerebellopontine angle].

The cerebellopontine angle (CPA) is an anatomically complex region of the brain. In this article we describe the anatomy of the CPA cisterns, of the internal auditory canal, the topography of the cerebellum and brainstem, and the neurovascular structures of this area.

Brain Stem↗
PubMed2006

[Spinal infections].

Regardless of the compartment involved, imaging of spinal infections and other spinal inflammatory diseases must be performed by magnetic resonance imaging (MRI). This allows early detection of changes in disk space or vertebral bodies. Associated paraspinal and epidural masses are depicted. However, in spinal cord inflammation MRI has a very limited specificity and cannot usually differentiate between the wide array of possible causes of intramedullary lesions. This article covers a spectrum of inflammatory lesions of the spinal cord.

Adult↗
PubMed2006

[Imaging of spinal tumors].

Spinal tumors are often categorized into extradural, intradural extramedullary, or intramedullary. Although this classification represents somewhat of an overgeneralization as a lesion may reside in two compartments, it still helps to characterize spinal tumors. In the intradural, extramedullary space, primary tumors, such as neurofibroma and meningioma, are relatively common. Secondary tumors or leptomeningeal enhancement also occur. In the intramedullary space, primary tumors are far more common than secondary tumors or metastases.

Contrast Media↗
PubMed2006

Arthroscopic laser surgery in temporomandibular functional joint disorders.

AIM: The authors present the 1-year results of combined use of arthroscopic lysis and lavage procedure, capsular stretch and holmium:yttrium-aluminium-garnet (Ho:YAG) laser techniques for the treatment of chronic closed lock of the temporomandibular joint. METHODS: Twelve joints were treated in 10 patients (9 females and 1 male) affected by anterior disk displacement without reduction not responsive to conservative treatment. All the patients were studied with preoperative magnetic resonance immaging (MRI). Surgical procedures included lysis and lavage, capsular stretch and Ho:YAG laser techniques with anterior release, posterior scarification and debridment of cartilage surface. The individual outcome was evaluated with the clinical examination, a visual analogue scale (VAS) for pain and a questionnaire concerning mandibular functional impairment. Patients were followed-up for 1 year. RESULTS: One-year results show that 9 patients (success rate 90%) achieved improvement of mandibular function and reduction of pain. The clinical recordings at the 1-year follow-up indicated good outcomes. Nine patients could masticate a regular diet at 1-year follow-up. CONCLUSIONS: These findings seem to justify the use of Ho:YAG laser techniques together with the lysis and lavage procedure and capsular stretch for the treatment of chronic closed lock of the temporomandibular joint. These arthroscopic procedures represent the first choice and an effective approach in the surgical treatment of this condition.

Arthroscopy↗
PubMed2006

Advanced giant cell reparative granuloma of the mandible: radiological features and surgical treatment.

Giant cell reparative granuloma accounts for 1%-7% of all benign lesions of the jaw. Giant cell reparative granuloma often arises in the mandible and in the maxilla and affects children and young adults. It is usually a slow-growing lesion, fast-growing lesions having rarely been reported. The latter, despite the innocent histological appearance, has an aggressive behaviour mimicking a malignant lesion. In the present report the clinical features of an aggressive variety of giant cell reparative granuloma in a 21-year-old female are described focusing on the dental findings at computed tomography and surgical treatment.

Adult↗
PubMed2005

[Moyamoya disease].

Moyamoya disease is an idiopathic progressive vasculopathy characterized by slowly progressive narrowing involving the distal internal carotid artery and the proximal circle of Willis. Collateral vessels develop to compensate for the slowly progressive stenosis. These enlarged collaterals appear as a "puff of smoke" on angiography, which gives the disease its name. This review discusses the clinical manifestation, imaging findings, and angiographic features.

Cerebral Angiography↗
PubMed2005

[Imaging of the temporal bone. An overview].

Diseases of the temporal bone should be diagnosed by high resolution computed tomography (CT) and magnetic resonance imaging (MRI). Because of the excellent imaging of bony structures, CT is the method of choice for diagnosing pathologies of the external auditory channel, middle ear, and mastoid. Imaging of trauma is performed with CT. For examining the labyrinth system and interior auditory channel, MRI is the method of choice. This article gives an overview of the anatomy of the temporal bone and describes the most important pathologies.

Diagnosis, Differential↗
PubMed2005

Extracts and constituents of Lavandula multifida with topical anti-inflammatory activity.

The topical anti-inflammatory activity of the ethanol and aqueous extracts from the aerial parts of Lavandula multifida L. (Lamiaceae), used in the Moroccan traditional medicine, was investigated by inhibition of the Croton oil-induced ear edema in mice. The biological assay revealed a dose-dependent anti-inflammatory activity for the ethanol extract, while the aqueous one was less active. Bioassay-guided fractionation of the ethanol extract led to identify four triterpenic acids of oleanane series, four pimarane and one iso-pimarane diterpenes, as well as the phenolic monoterpene carvacrol and its glucoside. Some of these compounds revealed an anti-inflammatory activity comparable to that of indomethacin.

Administration, Cutaneous↗
PubMed2005

Resorbable plates in maxillary fixation. A 5-year experience.

AIM: Metallic plates and screws have become the routine way of stabilizing the facial skeleton; however, there are many disadvantages in the use of metallic devices. Fixation systems made of biocompatible absorbable material, with appropriate load-bearing properties and sufficient degradation rate can overcome these disadvantages. Recently, resorbable materials were tested in maxillary, mandibular and chin osteotomies. Despite a lot of reports on the use of resorbable bone fixation devices in cranio-maxillo-facial application are now available, their use in preprosthetic surgery has yet to be adequately documented. The Authors report their 5-year experience in the employment of resorbable fixation in surgery of the superior maxilla, involving orthognathic and preprosthetic procedures of the upper jaws. The surgical technique is described and usefulness and advantages are discussed. METHODS: Plates and screws were composed of an 82% poly-L-lactic acid/18% polyglycolic acid copolymer (PLLA-PGA); 50 orthognathic and 5 preprosthetic procedures of upper jaws were involved, performing Le Fort I osteotomies in all cases. RESULTS: Our operations were were carried out without complications. Follow-up ranged from 6 months to 5 years. One patient developed a localized buccal space infection which resolved after a course of antibiotics given orally. CONCLUSIONS: Resorbable fixation should be considered adequate for fixation in maxillary surgery.

Biocompatible Materials↗
PubMed2005

Bone biological plate for stabilization of maxillary inferior repositioning.

AIM: Inferior repositioning of the maxilla to correct vertical maxillary deficiency has been one of the more unstable orthognathic procedures performed. Different surgical techniques have been proposed to stabilize downward movement of the maxilla. The aim of this study was to evaluate the skeletal stability of maxillary anterior downgrafting using bone biological plates in association to bone plates and bone graft for skeletal stabilization. METHODS: The records of 6 patients were evaluated cephalometrically, analyzing the presurgical, immediate postsurgical and long-term follow-up radiographs. All patients had one-piece Le Fort I osteotomy with anterior downgraft of at least 2 mm at point A. Any horizontal movement of the maxilla concomitant with the downgraft was no more than 5 mm. Rigid fixation with titanium miniplates and screws and with bone biological plate was used to stabilize the maxilla. In the sample of 6 patients, 3 underwent one-jaw (maxilla only) surgery and 3 two-jaw surgery. RESULTS: The mean surgical inferior downgrafting at point A was 5+/-1.4 mm (P<0.001) with a relapse of 0.16+/-1. 63 mm (3.2% of surgical movement). The mean surgical inferior downgrafting at the anterior nasal spine (ANS) was 5.66+/-1.36 mm (P<0.001) with a relapse of 0.41+/-1.56 mm (7.32% of surgical movement). Relapse in the vertical dimension failed to reach any statistical significance for all maxillary landmarks. CONCLUSIONS: Anterior downgrafting of the maxilla with this fixation method seems to be a stable and predictable procedure. The use of bone biological plates seems to substantially improve skeletal stability even if further investigations with a more consistent sample of patients is required.

Biocompatible Materials↗