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Biomedical subjects

R Brusati

Publications and source records attributed to R Brusati.

At least 19 recordsLinked to original sources
PubMed2007

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.

Adult↗
PubMed2006

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.

Adult↗
PubMed2005

Anterior mandibular apical base augmentation in the surgical orthodontic treatment of mandibular retrusion.

The authors describe a surgical technique alternative to traditional pre-surgical orthodontics in order to increase the apical base in mandibular retrusion (class II, division I). This subapical osteotomy, optimizing inferior incisal axis without dental extractions and a long orthodontic treatment, associated to genioplasty permits to obtain an ideal labio-dento-mental morphology. This procedure avoids in some cases the need of a mandibular advancement and, if necessary, it reduces his entity with obvious advantages.

Chin↗
PubMed2001

Treatment of carcinoma of the parotid gland: the results of a multicenter study.

PURPOSE: This study analyzed the prognostic factors for carcinoma of the parotid gland and the role of surgery alone or with radiotherapy in treating these lesions. METHODS: Forty-five patients with malignant parotid tumors were studied retrospectively. Patients were treated by combined surgery and radiation therapy between 1984 and 1995 at the Maxillo-Facial Departments of the General Hospitals of Bologna and Parma. Resection was conservative when possible, depending on the extent of the tumor. The median follow-up time was 54 months. Data regarding incidence, tumor stage and grade, local control, distant metastases (calculated with the Kaplan-Meier method), and survival were analyzed. Cox's multiple linear regression was used to identify patient and tumor characteristics with the greatest prognostic significance. RESULTS: The actuarial 5- and 8-year disease-free survival rates were 81% and 62%, respectively. Multivariate analysis showed that tumor stage was a more prognostic variable than tumor grade. Residual microscopic disease at the excision margins was also an important prognostic variable. Laterocervical metastases affected 4 patients (9%), and distant metastases appeared in 8 patients (18%). CONCLUSIONS: Postoperative irradiation is indicated for patients with stage III and IV disease, patients with positive excision margins, and for patients with lymph node metastases.

Actuarial Analysis↗
PubMed2001

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.

Adolescent↗
PubMed2000

Losses of heterozygosity in oral and oropharyngeal epithelial carcinomas.

We analyzed 25 oral and oropharyngeal epithelial carcinomas for loss of heterozygosity (LOH) and microsatellite instability by using 55 oligonucleotide repeat markers located in 45 chromosomal regions. The aim was to identify which chromosomal regions and tumor-suppressor genes (TSGs) are preferentially lost in these tumors and to relate LOH at specific loci to clinicopathologic data. The analysis was performed on tumor tissue and on a corresponding normal tissue (blood lymphocytes) with the use of the polymerase chain reaction technique followed by microsatellite allele separation with denaturing gel electrophoresis. Thirty-two of 45 chromosomal regions demonstrated a significant (>/=20%) incidence of LOH. An allelic loss of >/=50% was found in 9p21 (77.8%), 8p22-23 (70%), 3p12 (61.5%), 1p36.1 and 12q22 (60%), 3q28 (57.1%), 5q23.3 (54.5%), 3p25-26, 3p24, and 7q35 (50%). We did not find any microsatellite instability. Our results suggest that in addition to a group of TSGs, pleiotropic for several tumor types, other suppressor genes are specifically involved in oral and oropharyngeal carcinogenesis.

Adult↗
PubMed2000

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.

Adolescent↗
PubMed1999

Technical refinements in surgical treatment of benign parotid tumours.

Over the last 15 years, a number of techniques have been developed that make it possible to treat benign parotid tumours surgically with virtually no morphofunctional sequelae. Given that the main objectives of the intervention are the complete removal of the lesion as well as isolation and preservation of the facial nerve and its branches, the authors recommend the following procedure: a face-lifting type of incision in order to disguise the cutaneous scar better; preservation of the posterior branch of the great auricular nerve, in order to maintain the sensitivity of the ear lobe; coverage of the residual defect by means of a flap composed of superficial and deep temporalis fascia in order to reduce the postoperative depression in the parotid region and the onset of Frey's syndrome.

Adenolymphoma↗
PubMed1996

Analysis on photographs of the growth of the cleft lip following a rotation-advancement flap repair: preliminary report.

A preliminary report is submitted on the growth of the lip after repair of a unilateral complete cleft (with a modified rotation-advancement flap) in 20 patients. In half of these cases an additional small Z-plasty was performed. The patients were photographed by a standardized method immediately after surgery and again after 18 months. Lip length on the operated side was measured and compared with the opposite side; possible results were: equal, long and short. After 18 months, 65% of all cases remained unchanged, 25% had lengthened and 10% shortened. Among cases treated with an additional small Z-plasty, unchanged and lengthened cases had an almost equal distribution, while the majority (8 out of 10) of the cases treated without Z-plasty remained unchanged. Consequently, the authors emphasize the benefits of reconstructing the cleft lip as symmetrical to the opposite side as possible or, at the most, moderately shorter only in cases treated with an additional Z-plasty.

Calibration↗
PubMed1995

Recovery of infraorbital nerve function after zygomaticomaxillary cheek pedicled flap.

The zygomaticomaxillary cheek pedicled flap (ZMCF) involves the intentional section of the infraorbital nerve to reflect the flap laterally in order to give access to the rhinopharynx, clivus and upper cervical spine. The aim of this trial was to examine the recovery of sensation of the infraorbital nerve, both quantitatively (touch sensation, localisation test, two-point discrimination) and qualitatively (sharp/blunt test, temperature sensation, pain sensitivity, dental sensitivity) in 7 patients, at least 12 months after surgery. In each patient, four cutaneous areas (lower eyelid, nose ala, upper lip, cheek) and the upper vestibulum were tested. Results of each test in all the examined areas were evaluated and compared with the data obtained on the nonoperated side (control side). Results of neurosensory tests indicated good recovery of sensation with little difference in comparison with the control side, showing that the functional consequence of ZMCF should actually be considered only as a transitory event.

Adolescent↗
PubMed1994

Repair of the cleft palate without lateral release incisions: results concerning 124 cases.

The authors report their experience in the treatment of cleft palate patients, with or without cleft lip, carried out without lateral release incisions. The surgical approach was as follows: the cleft palate only was closed in one step at the age of 10 to 12 months, while the cleft of lip and palate was closed in two steps: at 6 months of age the soft palate together with lip and nose repair and at 18 to 24 months the hard palate with gingivo-alveoloplasty. Out of the 147 patients treated from 1984 until 1992, 124 (73 cleft palate, 51 cleft lip and palate) were treated without lateral release incisions, allowing first intention healing in 122 cases. The failures observed involved 2 cases: in the first (a bilateral case with a wide cleft) an almost total dehiscence of the suture at the level of the hard palate occurred, while in the second (a cleft palate case) a small oronasal fistula developed (healed spontaneously in 2 weeks). Our results confirm that by performing the described surgical technique without lateral release incisions, a 98% success rate for closure of a cleft palate could be obtained. Of course, in very large clefts the lateral release incision should be considered however.

Alveoloplasty↗
PubMed1993

Maxillo-malar osteotomy as an approach to the clivus.

Among various approaches to the clivus and upper cervical spine, transmaxillary access gives the neurosurgeon optimal visibility. Maxillo-malar osteotomy permitting the reflection of the osteotomized segment pedicled to the cheek after a Weber-Fergusson type cutaneous incision is the method that for the authors gives the best visibility. A wide operating field from upper clivus to C4 can be obtained by performing a maxillo-malar osteotomy associated with a midline splitting of hard and soft palate. The authors have performed this kind of access in five cases for neurosurgical purposes. Healing was always uneventful and no complications were observed. Occlusion was always restored without intermaxillary fixation, facial scars were of good quality and the only drawback was the section of infraorbital nerve.

Cranial Fossa, Posterior↗
PubMed1993

[Transoral approaches to the skull base. An attempt of systematization].

This is a technical note concerning the classifications of the various operations possible via the buccal route towards the base of the skull and the first vertebrae. A part from the Hardy vestibulo-septal approach, mention must be made of the buccal and transpalatine approach, the direct buccal approach, the buccal approach widened downwards by transmandibular osteotomy, and finally the transmandibular and transcervical approach. These different technique enable the ablation of extradural and even intradural lesions at the level of the clivus, but are limited on the side by the pterygoid process and the large vessels.

Humans↗
PubMed1992

The early gingivoalveoloplasty. Preliminary results.

To try and achieve good alveolar structure without the need for later bone grafting, we have carried out secondary gingivoalveoloplasties in 19 consecutive patients with cleft lip and palate at a mean age of 36 months (range 19-68). The lip and soft palate had been repaired at a mean age of 6 months. Preliminary results suggest that simultaneous closure of the hard palate and reconstruction of the alveolomaxillary cleft results in good formation of new bone and good or reasonable alveolar structure, so obviating the necessity for bone grafting at the age of 9-10 years. Long term follow up is needed to confirm these results.

Age Factors↗