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Corvino S, Kassam A, Piazza A, Corrivetti F, Spiriev T, Colamaria A, Cirrottola G, Cavaliere C, Esposito F, Cavallo LM, Iaconetta G, de Notaris M. Open-door extended endoscopic transorbital technique to the paramedian anterior and middle cranial fossae: technical notes, anatomomorphometric quantitative analysis, and illustrative case. Neurosurg Focus 2024; 56:E7. [PMID: 38560942 DOI: 10.3171/2024.1.focus23838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/30/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE The superior eyelid endoscopic transorbital approach (SETOA) provides a direct and short minimally invasive route to the anterior and middle skull base. Nevertheless, it uses a narrow corridor that limits its angles of attack. The aim of this study was to evaluate the feasibility and potential benefits of an "extended" conservative variant of the "standard" endoscopic transorbital approach-termed "open-door"-to enhance the exposure of lesions affecting the paramedian aspect of the anterior and middle cranial fossae. METHODS First, the authors described the technical nuances of the open-door extended transorbital approach (ODETA). Next, they documented its morphometric advantages over standard SETOA. Finally, they provided a clinical-anatomical application to demonstrate enhanced exposure and better angles of attack to treat lesions occupying the paramedian anterior and middle cranial fossae. Five adult cadaveric specimens (10 sides) initially underwent standard SETOA and then extended open-door SETOA (ODETA to the paramedian anterior and middle fossae). The adjunct of hinge-orbitotomy, through three surgical steps and straddling the frontozygomatic suture, converted conventional SETOA to its extended open-door variant. CT scans were performed before dissection and uploaded to the neuronavigation system for quantitative analysis. The angles of attack on the axial plane that addressed four key landmarks, namely the tip of the anterior clinoid process (ACP), foramen rotundum (FR), foramen ovale (FO), and trigeminal impression (TI), were calculated for both operative techniques and compared. RESULTS Hinge-orbitotomy of the extended open-door SETOA resulted in several surgical, functional, and esthetic advantages: it provided wider axial angles of attack for each of the target points, with a gain angle of 26.68° ± 1.31° for addressing the ACP (p < 0.001), 29.50° ± 2.46° for addressing the FR (p < 0.001), 19.86° ± 1.98° for addressing the FO (p < 0.001), and 17.44° ± 2.21° for addressing the lateral aspect of the TI (p < 0.001), while hiding the skin scar, avoiding temporalis muscle dissection, preserving flap vascularization, and decreasing the rate of bone infection and degree of orbital content retraction. CONCLUSIONS The extended open-door technique may be specifically suited for selected patients affected by paramedian anterior and middle fossae lesions, with prevalent anteromedial extension toward the anterior clinoid, the foremost compartment of the cavernous sinus and FR and not completely controlled with the pure endoscopic transorbital approach.
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Affiliation(s)
- Sergio Corvino
- 1Department of Neuroscience and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli "Federico II," Naples, Italy
- 2Department of Neuroscience and Reproductive and Odontostomatological Sciences, PhD Program in Neuroscience, Università degli Studi di Napoli "Federico II," Naples, Italy
- 3Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Italy
| | - Amin Kassam
- 4Department of Neurosciences, Intent Medical Group, Northshore University Neurosciences Institute, Arlington Heights, Illinois
| | - Amedeo Piazza
- 3Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Italy
- 5Department of Neurosurgery, "Sapienza" University of Rome, Italy
| | - Francesco Corrivetti
- 3Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Italy
- 6Department of Neurosurgery, San Luca Hospital, Vallo della Lucania, Salerno, Italy
| | - Toma Spiriev
- 7Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, Bulgaria
| | | | | | | | - Felice Esposito
- 1Department of Neuroscience and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli "Federico II," Naples, Italy
| | - Luigi Maria Cavallo
- 1Department of Neuroscience and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli "Federico II," Naples, Italy
| | - Giorgio Iaconetta
- 10Neurosurgical Clinic A.O.U. "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Matteo de Notaris
- 3Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Italy
- 10Neurosurgical Clinic A.O.U. "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
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Piazza A, Spiriev T, Corvino S, Corrivetti F, Laleva L, Iaconetta G, de Notaris M. The Course of the Trochlear Nerve Presented via a 3-Dimensional Photorealistic Anatomic Model. World Neurosurg 2024:S1878-8750(24)00483-2. [PMID: 38548050 DOI: 10.1016/j.wneu.2024.03.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/16/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Several factors contribute to the anatomical complexity of the trochlear nerve, including small diameter, complex and longest intracranial course, deep location, and numerous neurovascular relationships. A 3-dimensional (3D) photorealistic model of the cranial nerves provides a detailed and immersive representation of the anatomy, enabling one to improve surgical planning, advanced surgical research, and training. The purpose of this work is to present a 3D photogrammetric study for a more intuitive and interactive way to explore and describe the entire course of trochlear nerve. METHODS Two injected-fixed head human specimens (4 sides) were examined. The dissection protocol was divided into the following steps: 1) brain hemisphere exposure; 2) hemispherectomy dissecting all cranial nerves and partial removal of the free edge of the tentorium; 3) middle fossa and lateral wall of cavernous sinus exposure; and 4) orbital exposure. A detailed 3D photogrammetric model was generated for each dissection step. RESULTS Four main volumetric models were generated during a step-by-step layered dissection of the entire nerve pathway highlighting its different segments. Finally, a full and integrated model of the entire course of the nerve was created. The models are available for visualization on monoscopic display, virtual, and augmented reality environment. CONCLUSIONS The present photogrammetric model provides a more comprehensive understanding of the nerve's anatomy in its different segments, allows for customizable views thus simulating different perspectives, and can be a valuable alternative to traditional dissections. It is an advanced tool for surgical planning and surgical simulation as well as virtual reality representation of the anatomy.
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Affiliation(s)
- Amedeo Piazza
- Department of Neurosurgery, Sapienza University, Rome, Italy; Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria
| | - Sergio Corvino
- Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy; Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - Francesco Corrivetti
- Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy; Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", Naples, Italy; Department of Neurosurgery, San Luca Hospital, Vallo della Lucania, Salerno, Italy.
| | - Lili Laleva
- Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria
| | - Giorgio Iaconetta
- Unit of Neurosurgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - Matteo de Notaris
- Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy; Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", Naples, Italy; Department of Neurosurgery, San Luca Hospital, Vallo della Lucania, Salerno, Italy; Unit of Neurosurgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy; Neuroanatomy Committee of the Italian Society of Neurosurgery, SINch, Italy
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Bonavolontà P, Germano C, Committeri U, Orabona GD, Piombino P, Abbate V, Maglitto F, Iaconetta G, Califano L. Surgical management of Warthin tumor: long-term follow-up of 224 patients from 2002 to 2018. Oral Maxillofac Surg 2024; 28:131-136. [PMID: 37191772 PMCID: PMC10914882 DOI: 10.1007/s10006-023-01156-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 05/07/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE Warthin tumors (WT) are the second most common benign parotid gland neoplasms. They can occur as synchronous or metachronous lesions in 6-10% of cases. This study aims to compare the complication rate in 224 patients who underwent extracapsular dissection (ECD) or superficial parotidectomy (SP) for the treatment of a WT. METHODS This retrospective study was conducted at the Department of Maxillo-Facial Surgery at the University of Naples "Federico II" from February 2002 to December 2018 on a group of patients who underwent surgical treatment for WT. The type of surgical technique was chosen based on Quer's classification. The complications evaluated were facial nerve palsy, hematoma, Frey's syndrome, and bleeding. RESULTS A total of 224 patients treated from 2002 to 2018 for Warthin tumor were included in the study. Two hundred elven had solitary tumors (94.1%) and 13 had multicentric lesions (5.8%), of which 9 cases presented synchronous lesions and 4 cases presented metachronous lesions. Extracapsular dissection (ECD) was performed in 130 patients (58.3% of cases) and superficial parotidectomy (SP) in the other 94 (41.7% of cases). CONCLUSIONS We consider both surgical techniques as valid. In our opinion, it is essential to study each case based on Quer's Classification to obtain the best surgical outcome. Based on a lower observed rate of complications such as facial nerve palsy, Frey's syndrome, and bleeding, ECD seems to be the best option for the surgical treatment of Quer Class I lesions.
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Affiliation(s)
- Paola Bonavolontà
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via pansini n. 5, 80100, Naples, Italy
| | - Cristiana Germano
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via pansini n. 5, 80100, Naples, Italy
| | - Umberto Committeri
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via pansini n. 5, 80100, Naples, Italy.
| | - Giovanni Dell'Aversana Orabona
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via pansini n. 5, 80100, Naples, Italy
| | - Pasquale Piombino
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via pansini n. 5, 80100, Naples, Italy
| | - Vincenzo Abbate
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via pansini n. 5, 80100, Naples, Italy
| | - Fabio Maglitto
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via pansini n. 5, 80100, Naples, Italy
| | | | - Luigi Califano
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via pansini n. 5, 80100, Naples, Italy
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Corrivetti F, Guizzardi G, Bove I, Enseñat J, Prats-Galino A, Solari D, Cavallo LM, Iaconetta G, Di Somma A, de Notaris M. Transorbital Exposure of the Internal Carotid Artery: A Detailed Anatomic and Quantitative Roadmap for Safe Successful Surgery. Oper Neurosurg (Hagerstown) 2024; 26:314-322. [PMID: 37815220 DOI: 10.1227/ons.0000000000000943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/15/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The superior eyelid endoscopic transorbital approach has rapidly gained popularity among neurosurgeons for its advantages in the treatment, in a minimally invasive fashion, of a large variety of skull base pathologies. In this study, an anatomic description of the internal carotid artery (ICA) is provided to identify risky zones related to lesions that may be approached using this technique. In this framework, a practical roadmap can help the surgeon to avoid potentially life-threatening iatrogenic vascular injuries. METHODS Eight embalmed adult cadaveric specimens (16 sides) injected with a mixture of red latex and iodinate contrast underwent superior eyelid transorbital endoscopic approach, followed by interdural dissection of the cavernous sinus, extradural anterior clinoidectomy, and anterior petrosectomy, to expose the entire "transorbital" pathway of the ICA. Furthermore, the distance of each segment of the ICA explored by means of the superior eyelid endoscopic transorbital approach was quantitatively analyzed using a neuronavigation system. RESULTS We exposed 4 distinct ICA segments and named the anatomic window in which they are displayed in accordance with the cavernous sinus triangles distribution of the middle cranial fossa: (1) clinoidal (Dolenc), (2) infratrochlear (Parkinson), (3) anteromedial (Mullan), and (4) petrous (Kawase). Critical anatomy and key surgical landmarks were defined to further identify the main danger zones during the different steps of the approach. CONCLUSION A detailed knowledge of the reliable surgical landmarks of the course of the ICA as seen through an endoscopic transorbital route and its relationship with the cranial nerves are essential to perform a safe and successful surgery.
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Affiliation(s)
- Francesco Corrivetti
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno , Italy
| | - Giulia Guizzardi
- Department of Neurosurgery, Hospital Clinic de Barcelona, Barcelona , Spain
- Laboratory of Surgical Neuroanatomy, Faculty of Medicine, Universitat de Barcelona, Barcelona , Spain
| | - Ilaria Bove
- Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples , Italy
| | - Joaquim Enseñat
- Department of Neurosurgery, Hospital Clinic de Barcelona, Barcelona , Spain
| | - Alberto Prats-Galino
- Laboratory of Surgical Neuroanatomy, Faculty of Medicine, Universitat de Barcelona, Barcelona , Spain
| | - Domenico Solari
- Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples , Italy
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples , Italy
| | - Giorgio Iaconetta
- Unit of Neurosurgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno , Italy
| | - Alberto Di Somma
- Department of Neurosurgery, Hospital Clinic de Barcelona, Barcelona , Spain
- Laboratory of Surgical Neuroanatomy, Faculty of Medicine, Universitat de Barcelona, Barcelona , Spain
| | - Matteo de Notaris
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno , Italy
- Department of Neurosurgery, Hospital Clinic de Barcelona, Barcelona , Spain
- Laboratory of Surgical Neuroanatomy, Faculty of Medicine, Universitat de Barcelona, Barcelona , Spain
- Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples , Italy
- Unit of Neurosurgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno , Italy
- Department of Neuroscience, Neurosurgery Operative Unit, "San Pio" Hospital, Benevento , Italy
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Corvino S, Piazza A, Spiriev T, Tafuto R, Corrivetti F, Solari D, Cavallo LM, Di Somma A, Enseñat J, de Notaris M, Iaconetta G. The Sellar Region as Seen from Transcranial and Endonasal Perspectives: Exploring Bony Landmarks Through New Surface Photorealistic Three-Dimensional Model Reconstruction for Neurosurgical Anatomy Training. World Neurosurg 2024:S1878-8750(24)00219-5. [PMID: 38342178 DOI: 10.1016/j.wneu.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/04/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Virtual reality-based learning of neuroanatomy is a new feasible method to explore, visualize, and dissect interactively complex anatomic regions. We provide a new interactive photorealistic three-dimensional (3D) model of sellar region microsurgical anatomy that allows side-by-side views of exocranial and endocranial surfaces to be explored, with the aim of assisting young neurosurgery residents in learning microsurgical anatomy of this complex region. METHODS Four head specimens underwent an endoscopic endonasal approach extended to the anterior and posterior skull base to expose the main bony anatomic landmarks of the sellar region. The same bony structures were exposed from a transcranial perspective. By using a photogrammetry method, multiple photographs from both endocranial and exocranial perspectives, different for angulations and depth, were captured, fused, and processed through dedicated software. RESULTS All relevant bony structures were clearly distinguishable in the 3D model reconstruction, which provides several benefits in neuroanatomy learning: first, it replicates bony structures with high degrees of realism, accuracy, and fidelity; in addition, it provides realistic spatial perception of the depth of the visualized structures and their anatomic relationships; again, the 3D model is interactive and allows a 360° self-guided tour of the reconstructed object, so that the learner can read the bones and their anatomic relationship from all desired points of view. CONCLUSIONS Detailed knowledge of key surgical landmarks representing keyholes and/or anatomic structures to not violate is mandatory for safer surgery, especially for a complex region such as the skull base. Highly accurate virtual and functional neurosurgical models, such as photogrammetry, can generate a realistic appearance to further improve surgical simulators and learn neuroanatomy.
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Affiliation(s)
- Sergio Corvino
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences, Program in Neuroscience, Università degli Studi di Napoli "Federico II", Naples, Italy; Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno, Italy
| | - Amedeo Piazza
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno, Italy; Division of Neurosurgery, "Sapienza" University of Rome, Rome, Italy
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria
| | - Roberto Tafuto
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy; Laboratory of Surgical Neuroanatomy, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Francesco Corrivetti
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno, Italy; Department of Neurosurgery, San Luca Hospital, Salerno, Italy
| | - Domenico Solari
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Alberto Di Somma
- Laboratory of Surgical Neuroanatomy, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain; Departments of Neurological Surgery, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Joaquim Enseñat
- Departments of Neurological Surgery, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Matteo de Notaris
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno, Italy; Neurosurgical Clinic A.O.U. "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
| | - Giorgio Iaconetta
- Neurosurgical Clinic A.O.U. "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
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Carbone F, Colamaria A, Corvino S, Sacco M, Iaconetta G, Corrivetti F, Di Maria D, Catapano G, Fochi NP, Leone A, Spetzger U, de Notaris M. Multimodal Use of Contact Endoscopy in Neurosurgery: Case Series with Technical Note and Literature Review. World Neurosurg 2024; 182:e657-e665. [PMID: 38070736 DOI: 10.1016/j.wneu.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Originally adopted for the cytological screening of cervical and uterine cancer, contact endoscopy (CE) is now widely used in several fields of oncological surgery. The CE method, with magnification power up to 150x, was designed to enhance visualization and identify microscopic changes indicative of precancerous and cancerous lesions at early stages. In this pilot study, we evaluated the multimodal applications of CE during different endoscopic intracranial neurosurgical procedures. METHODS Twenty patients with skull base lesions underwent surgery using different minimally invasive endoscopic approaches (endonasal, transorbital, and supraorbital). CE was used to distinguish the pathology from the surrounding healthy tissue by positioning the endoscope either in proximity or directly onto the target tissue. Special attention was given to the visualization of the margins of the lesion to differentiate compression/displacement from infiltration of the normal surrounding tissue. RESULTS With its unprecedented range of magnification, CE could clearly identify the microvascular pattern and cytological architecture of a tissue not detectable by simple white light endoscopy, with no reported damage due to heat transmission or iatrogenic injuries. All the lesions diagnosed as "presumed neoplastic tissue" by CE were confirmed by histopathology. The most promising results were observed in surgeries for meningioma and pituitary adenoma, as these lesions exhibit distinctive microvascular networks. CONCLUSIONS CE represents a new and effective technique for the in vivo identification of pathological microvascular and tissue features, allowing preservation of normal tissue during different endoscopic approaches. The use of CE could improve diagnostic accuracy and assist in intraoperative decision-making, becoming a key tool in various applications in neurosurgical field.
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Affiliation(s)
- Francesco Carbone
- Department of Neurosurgery - Karlsruher Neurozentrum, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany; Division of Neurosurgery, University of Foggia, Foggia, Italy
| | | | - Sergio Corvino
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University Federico II, Naples, Italy
| | - Matteo Sacco
- Division of Neurosurgery, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giorgio Iaconetta
- Division of Neurosurgery, School of Medicine "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy
| | - Francesco Corrivetti
- Division of Neurosurgery, Department of Surgical Specialties, San Filippo Neri Hospital/ASL 1, Roma, Italy
| | | | - Giuseppe Catapano
- Division of Neurosurgery, "Ospedale del Mare" Hospital, Naples, Italy
| | | | - Augusto Leone
- Department of Neurosurgery - Karlsruher Neurozentrum, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany; Faculty of Human Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
| | - Uwe Spetzger
- Department of Neurosurgery - Karlsruher Neurozentrum, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Matteo de Notaris
- Department of Neuroscience, Neurosurgery Operative Unit, "San Pio" Hospital, Benevento, Italy
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Romano A, Norino G, Dell’Aversana Orabona G, Barone S, Ordano D, Calvanese C, Troise S, Califano L, Iaconetta G. A Large Follicular Dentigerous Cyst: A New Multi-portal Access: Intraoral and Endoscopic Technique. J Maxillofac Oral Surg 2024; 23:189-192. [PMID: 38312981 PMCID: PMC10830927 DOI: 10.1007/s12663-023-01885-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023] Open
Abstract
Background The standard treatment for a dentigerous cyst of maxilla is a surgical enucleation, the extraction of the tooth. In the case of cysts involving the maxillary sinus, a Caldwell-Luc approach is used. In case of large cysts, its marsupialization is carried out in order to reduce the bone defect, followed by enucleation and extraction of the tooth. Methods This is a case of a large follicular dentigerous cyst of upper jaw with 18 ectopic tooth within the maxillary sinus, treated in our Unit. Results We decided to perform a multi-portal access, the intraoral endoscopic-assisted technique; an intraoral approach has been performed, but less demolishing than the routine intraoral approach, through the anterior wall of the maxillary sinus, already eroded by the lesion. The lesion was very large, occupying the entire maxillary cavity. For this reason, by means of the intraoral approach alone, it was extremely difficult to remove the lesion in its entirety. The endoscopic-assisted technique was combined with intraoral approach. The lesion extended to the maxillary ostium. This did not allow to reach the ostium through the classic endoscopic approach. Endonasal endoscopic access was used both to enucleate the cyst, that was adherent to the orbital floor and soft tissues of the OMC (osteomeatal complex), and to restore the physiological drainage of the maxillary sinus. Conclusions We decided to perform a combined intraoral and endoscopic approach to allow a complete excision of the cystic lesion, without being very demolishing and taking advantage of the bone erosion already caused by the large cyst.
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Affiliation(s)
- A. Romano
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - G. Norino
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - G. Dell’Aversana Orabona
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - S. Barone
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - D. Ordano
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - C. Calvanese
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - S. Troise
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - L. Califano
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - G. Iaconetta
- Department of Neurosurgery, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
- Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
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De Simone M, Conti V, Palermo G, De Maria L, Iaconetta G. Advancements in Glioma Care: Focus on Emerging Neurosurgical Techniques. Biomedicines 2023; 12:8. [PMID: 38275370 PMCID: PMC10813759 DOI: 10.3390/biomedicines12010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Despite significant advances in understanding the molecular pathways of glioma, translating this knowledge into effective long-term solutions remains a challenge. Indeed, gliomas pose a significant challenge to neurosurgical oncology because of their diverse histopathological features, genetic heterogeneity, and clinical manifestations. Relevant sections: This study focuses on glioma complexity by reviewing recent advances in their management, also considering new classification systems and emerging neurosurgical techniques. To bridge the gap between new neurosurgical approaches and standards of care, the importance of molecular diagnosis and the use of techniques such as laser interstitial thermal therapy (LITT) and focused ultrasound (FUS) are emphasized, exploring how the integration of molecular knowledge with emerging neurosurgical approaches can personalize and improve the treatment of gliomas. CONCLUSIONS The choice between LITT and FUS should be tailored to each case, considering factors such as tumor characteristics and patient health. LITT is favored for larger, complex tumors, while FUS is standard for smaller, deep-seated ones. Both techniques are equally effective for small and superficial tumors. Our study provides clear guidance for treating pediatric low-grade gliomas and highlights the crucial roles of LITT and FUS in managing high-grade gliomas in adults. This research sets the stage for improved patient care and future developments in the field of neurosurgery.
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Affiliation(s)
- Matteo De Simone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (G.P.); (G.I.)
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (G.P.); (G.I.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi, D’Aragona”, 84131 Salerno, Italy
| | - Giuseppina Palermo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (G.P.); (G.I.)
| | - Lucio De Maria
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy;
- Unit of Neurosurgery, Department of Clinical Neuroscience, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
| | - Giorgio Iaconetta
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (G.P.); (G.I.)
- Neurosurgery Unit, University Hospital “San Giovanni di Dio e Ruggi, D’Aragona”, 84131 Salerno, Italy
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9
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Colamaria A, Leone A, Carbone F, Dallos Laguado YA, Fochi NP, Sacco M, Fesce C, Sanguedolce F, Giordano G, Iaconetta G, Spetzger U, Coppola L, De Santis E, Coppola G, De Notaris M. Primary Anaplastic-Lymphoma-Kinase-Positive Large-Cell Lymphoma of the Central Nervous System: Comprehensive Review of the Literature. J Clin Med 2023; 12:7516. [PMID: 38137585 PMCID: PMC10743784 DOI: 10.3390/jcm12247516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Primary anaplastic-lymphoma-kinase (ALK)-positive large-cell lymphoma of the central nervous system (PCNS ALK-positive ALCL) is a rare entity, with a limited consensus reached regarding its management. While this pathology often presents as solitary lesions, the occurrence of multiple tumors within the brain is not uncommon. The lack of distinctive radiological features poses a diagnostic challenge, leading to delays in initiating targeted therapy. METHODS We conducted a comprehensive literature search, identifying seventeen publications for qualitative analysis. RESULTS The management options and reported patient outcomes in the literature varied significantly, emphasizing the need for a patient-specific approach. The emergence of ALK-specific inhibitors represents a new frontier in this field, demonstrating promising results. CONCLUSION PCNS ALK-positive ALCL necessitates a comprehensive understanding and optimized management strategies. A tailored therapeutic approach, integrating surgical intervention with radiotherapy and chemotherapy, appears pivotal in addressing this pathology. The implementation of a therapeutic protocol is anticipated for further advancement in this field.
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Affiliation(s)
- Antonio Colamaria
- Division of Neurosurgery, Policlinico “Riuniti”, 71122 Foggia, Italy;
| | - Augusto Leone
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
- Faculty of Human Medicine, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Francesco Carbone
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
| | | | - Nicola Pio Fochi
- Division of Neurosurgery, University of Foggia, 71122 Foggia, Italy
| | - Matteo Sacco
- Division of Neurosurgery, “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy;
| | - Cinzia Fesce
- Hematology Unit, University Hospital, 71122 Foggia, Italy;
| | | | - Guido Giordano
- Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;
| | - Giorgio Iaconetta
- Unit of Anatomy, Pathological Histology and Diagnostic Cytology, Department of Diagnostic and Pharma-Ceutical Services, Sandro Pertini Hospital, 00157 Rome, Italy; (G.I.); (L.C.)
| | - Uwe Spetzger
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
| | - Luigi Coppola
- Unit of Anatomy, Pathological Histology and Diagnostic Cytology, Department of Diagnostic and Pharma-Ceutical Services, Sandro Pertini Hospital, 00157 Rome, Italy; (G.I.); (L.C.)
| | - Elena De Santis
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic sciences, La Sapienza University, 00185 Roma, Italy;
| | - Giulia Coppola
- Department of Radiological, Oncological and Pathological Sciences, La Sapienza University, 00185 Roma, Italy;
| | - Matteo De Notaris
- Department of Neurosurgery, University of Salerno, 84084 Salerno, Italy;
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10
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de Notaris M, Sacco M, Corrivetti F, Grasso M, Corvino S, Piazza A, Kong DS, Iaconetta G. The Transorbital Approach, A Game-Changer in Neurosurgery: A Guide to Safe and Reliable Surgery Based on Anatomical Principles. J Clin Med 2023; 12:6484. [PMID: 37892624 PMCID: PMC10607762 DOI: 10.3390/jcm12206484] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
During the last few years, the superior eyelid endoscopic transorbital approach has been proposed as a new minimally invasive pathway to access skull base lesions, mostly in ophthalmologic, otolaryngologic, and maxillofacial surgeries. However, most neurosurgeons performing minimally invasive endoscopic neurosurgery do not usually employ the orbit as a surgical corridor. The authors undertook this technical and anatomical study to contribute a neurosurgical perspective, exploring the different possibilities of this novel route. Ten dissections were performed on ten formalin-fixed specimens to further refine the transorbital technique. As part of the study, the authors also report an illustrative transorbital surgery case to further detail key surgical landmarks. Herein, we would like to discuss equipment, key anatomical landmarks, and surgical skills and stress the steps and details to ensure a safe and successful procedure. We believe it could be critical to promote and encourage the neurosurgical community to overcome difficulties and ensure a successful surgery by following these key recommendations.
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Affiliation(s)
- Matteo de Notaris
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, 84125 Salerno, Italy
- Department of Neuroscience, Neurosurgery Operative Unit, “San Pio” Hospital, 82100 Benevento, Italy
| | - Matteo Sacco
- Department of Neurosurgery, University of Foggia, 71122 Foggia, Italy
| | - Francesco Corrivetti
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, 84125 Salerno, Italy
| | - Michele Grasso
- Department of Surgery, Otorhinolaryngology Operative Unit, “San Pio” Hospital, 82100 Benevento, Italy
| | - Sergio Corvino
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, 84125 Salerno, Italy
- Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, 80055 Naples, Italy
| | - Amedeo Piazza
- Laboratory of Neuroanatomy, EBRIS Foundation, European Biomedical Research Institute of Salerno, 84125 Salerno, Italy
- Department of Neurosurgery, Sapienza University, 00185 Rome, Italy
| | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06531, Republic of Korea
| | - Giorgio Iaconetta
- Unit of Neurosurgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, University of Salerno, 84084 Salerno, Italy
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11
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De Luca P, Di Stadio A, Marra P, Colacurcio V, Scarpa A, Ricciardiello F, Ralli M, Longo F, Salzano G, de Vincentiis M, Iaconetta G, Salzano FA, Camaioni A. Systematic Review of Management and Survival Outcome of Parotid Cancers with Lateral Skull Base Invasion. Indian J Otolaryngol Head Neck Surg 2023; 75:2713-2721. [PMID: 37636674 PMCID: PMC10447298 DOI: 10.1007/s12070-023-03787-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 08/29/2023] Open
Abstract
Lateral skull base involvement from parotid cancers is a rare condition and is considered a poor prognostic indicator. The aim of this study was to systematically review the literature of parotid tumors with temporal bone invasion to analyze the survival outcome. A systematic literature review was performed in August 2022, without time limits, and 289 patients affected by parotid gland cancers and lateral skull base involvement were included. The most common symptoms in parotid tumors at the onset were indolent mass, facial weakness, pain, and hearing loss; the chi-square value is 23.1063, with a statistically significance (p = < 0.000121). The five most common histologies were adenoid cystic carcinoma, acinic cell carcinoma, mucoepidermoid carcinoma, adenocarcinoma, and squamous cell carcinoma. The facial nerve function after surgery showed statistically significance (functional vs. non-functional; chi-square was 91.7698, p = < 0.00001). Mean follow-up was 36.2 months (range 0.3-192). At the last follow-up, more patients died of disease (DOD; 60/289, 21%) than other causes (DOOC; 5/289, 2%). There is a statistically significant correlation between patients died for tumor (DOD) and patients died for other causes (DOOC) (p = < 0.0001), suggesting that the lateral skull base invasion negatively impacts on survival. Basing on the results of our systematic review, lateral skull base involvement from parotid recurrent/advance tumors should be considered a poor prognostic factor, as the majority of patients die due to this condition. It also would be necessary to have "clear"works, with full data (demographic, clinical, surgical data), and with a longer follow up, in order to assess the best treatment modality of these patients.
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Affiliation(s)
- Pietro De Luca
- Head and Neck Department, Otolaryngology Unit, San Giovanni-Addolorata Hospital, Rome, Italy
| | | | - Pasquale Marra
- ENT Department A.O.R.N. “S.G., Moscati”, Avellino, Italy
| | - Vito Colacurcio
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | | | - Massimo Ralli
- Department of Sense Organs, University Sapienza, Rome, Italy
| | - Francesco Longo
- Hospital “Casa Sollievo della Sofferenza” IRCCS – San Giovanni Rotondo, Foggia, Italy
| | - Giovanni Salzano
- Maxillo-Facial and ENT Surgery Unit, INT- IRCCS “Fondazione G. Pascale”, Naples, Italy
| | | | - Giorgio Iaconetta
- Department of Neurosurgery, University Hospital of Salerno, Fisciano, Italy
| | | | - Angelo Camaioni
- Head and Neck Department, Otolaryngology Unit, San Giovanni-Addolorata Hospital, Rome, Italy
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12
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Corvino S, Villanueva-Solórzano PL, Offi M, Armocida D, Nonaka M, Iaconetta G, Esposito F, Cavallo LM, de Notaris M. A New Perspective on the Cavernous Sinus as Seen through Multiple Surgical Corridors: Anatomical Study Comparing the Transorbital, Endonasal, and Transcranial Routes and the Relative Coterminous Spatial Regions. Brain Sci 2023; 13:1215. [PMID: 37626571 PMCID: PMC10452901 DOI: 10.3390/brainsci13081215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/27/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Background: The cavernous sinus (CS) is a highly vulnerable anatomical space, mainly due to the neurovascular structures that it contains; therefore, a detailed knowledge of its anatomy is mandatory for surgical unlocking. In this study, we compared the anatomy of this region from different endoscopic and microsurgical operative corridors, further focusing on the corresponding anatomic landmarks encountered along these routes. Furthermore, we tried to define the safe entry zones to this venous space from these three different operative corridors, and to provide indications regarding the optimal approach according to the lesion's location. Methods: Five embalmed and injected adult cadaveric specimens (10 sides) separately underwent dissection and exposure of the CS via superior eyelid endoscopic transorbital (SETOA), extended endoscopic endonasal transsphenoidal-transethmoidal (EEEA), and microsurgical transcranial fronto-temporo-orbito-zygomatic (FTOZ) approaches. The anatomical landmarks and the content of this venous space were described and compared from these surgical perspectives. Results: The oculomotor triangle can be clearly exposed only by the FTOZ approach. Unlike EEEA, for the exposure of the clinoid triangle content, the anterior clinoid process removal is required for FTOZ and SETOA. The supra- and infratrochlear as well as the anteromedial and anterolateral triangles can be exposed by all three corridors. The most recently introduced SETOA allowed for the exposure of the entire lateral wall of the CS without entering its neurovascular structures and part of the posterior wall; furthermore, thanks to its anteroposterior trajectory, it allowed for the disclosure of the posterior ascending segment of the cavernous ICA with the related sympathetic plexus through the Mullan's triangle, in a minimally invasive fashion. Through the anterolateral triangle, the transorbital corridor allowed us to expose the lateral 180 degrees of the Vidian nerve and artery in the homonymous canal, the anterolateral aspect of the lacerum segment of the ICA at the transition zone from the petrous horizontal to the ascending posterior cavernous segment, surrounded by the carotid sympathetic plexus, and the medial Meckel's cave. Conclusions: Different regions of the cavernous sinus are better exposed by different surgical corridors. The relationship of the tumor with cranial nerves in the lateral wall guides the selection of the approach to cavernous sinus lesions. The transorbital endoscopic approach can be considered to be a safe and minimally invasive complementary surgical corridor to the well-established transcranial and endoscopic endonasal routes for the exposure of selected lesions of the cavernous sinus. Nevertheless, peer knowledge of the anatomy and a surgical learning curve are required.
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Affiliation(s)
- Sergio Corvino
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università di Napoli “Federico II”, 80131 Naples, Italy; (S.C.); (L.M.C.)
- PhD Program in Neuroscience, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università di Napoli “Federico II”, 80131 Naples, Italy
| | - Pedro L. Villanueva-Solórzano
- Department of Neurosurgery, National Institute of Neurology and Neurosurgery “Manuel Velasco Suarez”, Mexico City 14269, Mexico;
| | - Martina Offi
- Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy;
- Division of Neurosurgery, Catholic University of Rome, 00153 Rome, Italy
| | - Daniele Armocida
- Neurosurgery Division, Human Neurosciences Department, “Sapienza” University, 00185 Rome, Italy;
| | - Motonobu Nonaka
- Department of Neurosurgery, Kochi University Hospital, 185-1, Oko-cho, Kohasu, Kochi 783-8505, Japan;
| | - Giorgio Iaconetta
- Neurosurgical Clinic A.O.U. “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy;
| | - Felice Esposito
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università di Napoli “Federico II”, 80131 Naples, Italy; (S.C.); (L.M.C.)
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università di Napoli “Federico II”, 80131 Naples, Italy; (S.C.); (L.M.C.)
| | - Matteo de Notaris
- Neurosurgery Operative Unit, Department of Neuroscience, Coordinator Neuroanatomy Section Italian Society of Neurosurgery, G. Rummo Hospital, 82100 Benevento, Italy;
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13
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De Luca P, Calvanese M, Camaioni A, Iaconetta G, Iemma M. Recurrent acinic cell carcinoma of the parotid gland with lateral skull base invasion: Case report and discussion of the literature. Clin Case Rep 2023; 11:e7512. [PMID: 37469364 PMCID: PMC10352549 DOI: 10.1002/ccr3.7512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 07/21/2023] Open
Abstract
Medical records of a 76-year-old woman with a recurrent acinic cell carcinoma of the left parotid gland with lateral skull base invasion were reviewed. She underwent subtotal petrosectomy followed by radiation therapy. After surgery, she remained disease-free for more than 16 months.
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Affiliation(s)
- Pietro De Luca
- Otolaryngology DepartmentSan Giovanni‐Addolorata HospitalRomeItaly
| | - Matteo Calvanese
- Department of OtorhinolaryngologyUniversity Hospital “San Giovanni di Dio e Ruggi d'Aragona”SalernoItaly
| | - Angelo Camaioni
- Otolaryngology DepartmentSan Giovanni‐Addolorata HospitalRomeItaly
| | - Giorgio Iaconetta
- Neurosurgery Unit, Department of Medicine, Surgery and DentistryUniversity Hospital “San Giovanni di Dio e Ruggi d'Aragona” University of SalernoSalernoItaly
| | - Maurizio Iemma
- Department of OtorhinolaryngologyUniversity Hospital “San Giovanni di Dio e Ruggi d'Aragona”SalernoItaly
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14
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Orabona GD, Abbate V, Maffia F, Romano A, Bonavolontà P, Valletta A, Iaconetta G, Califano L. Piezoelectric Condylectomy Through Transoral Endoscopic Approach: A Cadaveric Study. Indian J Otolaryngol Head Neck Surg 2023; 75:963-966. [PMID: 37275105 PMCID: PMC10235273 DOI: 10.1007/s12070-022-03168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/09/2022] [Indexed: 11/08/2022] Open
Abstract
Surgical approaches in the treatment of TMJ pathologies are a much-debated topic in literature. We propose a new surgical approach performed by intraoral access and completed by endoscopic magnification and long-tip piezosurgery assistance. A piezosurgery (Piezosurgery Plus, Mectron s.p.a. 2014) with a long angled tip (MT5-10 L) was used to perform an endoscopically assisted condylectomy. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03168-0.
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Affiliation(s)
- Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Francesco Maffia
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Alessandra Valletta
- Dentistry Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
| | - Giorgio Iaconetta
- Neurosurgery Unit Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano Salerno, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Pansini 5, 80100 Naples, Italy
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Abbate V, Dell’Aversana Orabona G, Seidita F, Committeri U, Bonavolontà P, Piombino P, Audino G, Iaconetta G, Califano L. Facial Soft Tissue Ptosis: A Quantitative Analysis using 3d Facial Scan App For iPhone. J Maxillofac Oral Surg 2023; 22:75-82. [PMID: 36703646 PMCID: PMC9871103 DOI: 10.1007/s12663-021-01683-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 12/18/2021] [Indexed: 01/29/2023] Open
Abstract
Although the modifications of the aging face have been widely described, to our knowledge, there are no studies that quantitatively analyze the degree of soft tissues facial ptosis. Using a specific iPhone application, the faces of a heterogeneous group of volunteers were scanned and studied with the aim to virtually measure the entity of facial ptosis.Two facial scans, upright and supine, were performed by using the Bellus3D Face app for iPhone in a sample of 60 volunteers. We virtually superimposed the two scans, and then, we calculated the discrepancy between them through the Geomagic Design X 3D software. A multivariate regression statistical model was used to analyze the correlation between the mean discrepancy values compared to three main variables: age, BMI and gender. Mean ptosis increases with age (coeff. = 0.02; 95% CI = 0.01-0.02, p < 0.001), BMI (coeff. = 0.03; 95% CI = 0.01-0.05; p < 0.001) and has been found higher in females (female versus male: coeff. = 0.22; 95% CI = 0.13-0.31; p < 0.001). The method we used allowed us to measure the degree of ptosis, and to make a complete morphological study of the effect of gravity on the facial surface in a very accurate, low cost and easily reproducible way.
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Affiliation(s)
- Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Francesco Seidita
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Umberto Committeri
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Pasquale Piombino
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giovanni Audino
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giorgio Iaconetta
- Neurosurgery Unit, Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
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Abbate V, Togo G, Dell’Aversana Orabona G, Bonavolontà P, Iaconetta G, Califano L. Soft Air Bullet in the Pterygopalatine Fossa: A Minimally Invasive Endoscopic Approach for Safe Extraction. J Maxillofac Oral Surg 2023; 22:54-57. [PMID: 36703667 PMCID: PMC9871092 DOI: 10.1007/s12663-022-01712-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/21/2022] [Indexed: 01/29/2023] Open
Abstract
Ballistic traumas among civilians are usually from low velocity, low calibre weapons such as soft air guns. The facial skeleton is an area of high aesthetic/functional value, and therefore, this is a showcase for technical description of a minimally invasive endoscopic approach for the removal of a bullet from the pterygopalatine fossae.
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Affiliation(s)
- Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Giulia Togo
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | | | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
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Corvino S, Sacco M, Somma T, Berardinelli J, Ugga L, Colamaria A, Corrivetti F, Iaconetta G, Kong DS, de Notaris M. Functional and clinical outcomes after superior eyelid transorbital endoscopic approach for spheno-orbital meningiomas: illustrative case and literature review. Neurosurg Rev 2022; 46:17. [PMID: 36513789 DOI: 10.1007/s10143-022-01926-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/02/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022]
Abstract
The pattern of growth of spheno-orbital meningiomas accounts for the main presenting symptoms, such as proptosis, eye motility deficit, visual impairment, diplopia. As these are benign tumors, the postoperative patient's quality of life is an important factor to consider during the preoperative planning. A detailed literature review of superior eyelid transorbital endoscopic approach for spheno-orbital meningiomas, including our own case, was made. A Medline search up to March 2022 in PubMed online electronic database was made using the following key phrases: "superior eyelid endoscopic transorbital approach spheno-orbital meningiomas," "superior eyelid endoscopic transorbital approach," "spheno-orbital meningiomas endoscopic approach." The inclusion criteria were surgical series, reviews, and case reports in English language, as well as papers written in other languages, but including the abstract in English. Cadaveric studies, multiportal combined approaches for SOM, were excluded. The literature review has disclosed five studies for a total of 65 patients, whose demographic, clinical, pathological, surgical, complications, and outcome data were analyzed. Functional and esthetic outcome data after superior eyelid transorbital approach are the following: improvement of proptosis (100%), of visual deficits (66.66%) and of ocular paresis (75%), with only 11 complications (4 trigeminal dysesthesia, 2 CSF leak, 2 wound complications, 1 upper eyelid necrosis, 1 hemorrhage of surgical field, 1 keratitis) reported, but at the expense of extent of resection (gross total resection 33.39%). Based on the outcome data, the superior eyelid transorbital endoscopic approach results in a suitable operative technique for selected spheno-orbital meningiomas.
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Affiliation(s)
- Sergio Corvino
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", 80131, Naples, Italy.
| | - Matteo Sacco
- Department of Neurosurgery, "Riuniti", 71122, Foggia, Italy
| | - Teresa Somma
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", 80131, Naples, Italy
| | - Jacopo Berardinelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", 80131, Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", 80131, Naples, Italy
| | | | - Francesco Corrivetti
- Department of Neurosurgery, San Luca Hospital, Vallo Della Lucania, Salerno, Italy
| | - Giorgio Iaconetta
- Neurosurgical Clinic A.O.U. "San Giovanni Di Dio E Ruggi d'Aragona", Salerno, Italy
| | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Matteo de Notaris
- Department of Neuroscience, G. Rummo Hospital, Neurosurgery Operative Unit, 82100, Benevento, Italy
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Bonavolontà P, Togo G, Fossataro F, Romano A, Abbate V, Iaconetta G, Califano L. Recurrence of Exophthalmos after 10 Years from Orbital Floor Decompression for Dysthyroid Orbitopathy: A Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:4673-4675. [PMID: 36742715 PMCID: PMC9895134 DOI: 10.1007/s12070-021-03003-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023] Open
Abstract
Dysthyroid orbitopathy or Graves' ophthalmopathy (GO) is an autoimmune disease with a complex pathogenesis that usually occur in patients with hyperthyroidism. Surgical decompression of the orbit is an accepted and validated treatment of thyroid eye disease (TED). This is a case of a patient with left exophthalmos and ipsilateral maxillary sinusitis after 10 years from the surgical bone decompression of the orbital floor for TED.
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Affiliation(s)
- Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Giulia Togo
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Federica Fossataro
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | | | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, Naples, Italy
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Romano A, Audino G, Abbate V, Dell’Aversana Orabona G, Salzano G, Seidita F, Sani L, Iaconetta G, Califano L. Combined Endonasal Endoscopic and Sub-brow Orbitotomy Access to Manage a Lateral Extending Frontal Sinus Inverting Papilloma with Endo-orbital Invasion: A Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:1510-1513. [PMID: 36452793 PMCID: PMC9702497 DOI: 10.1007/s12070-021-02640-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022] Open
Abstract
Sinonasal inverting papilloma is a rare benign, locally aggressive tumour, arising from sinus and/or nasal fossa mucosa, with high recurrence rate, and risk of malignant transformation. This is a case of orbital invasive, lateral extending inverting papilloma approached via combined external and endoscopic surgery.
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Affiliation(s)
- Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giovanni Audino
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Francesco Seidita
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Lorenzo Sani
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giorgio Iaconetta
- Neurosurgery Unit, Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
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Orabona GD, Abbate V, Maffia F, Sani L, Romano A, Maglitto F, Iaconetta G, Califano L. Bilateral coronoid hyperplasia: A case report of an intraoral endoscopically assisted coronoidectomy with CAD/CAM cutting guides. Oral and Maxillofacial Surgery Cases 2022. [DOI: 10.1016/j.omsc.2022.100267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Migliorini F, Chiu WO, Scrofani R, Chiu WK, Baroncini A, Iaconetta G, Maffulli N. Magnetically controlled growing rods in the management of early onset scoliosis: a systematic review. J Orthop Surg Res 2022; 17:309. [PMID: 35690867 PMCID: PMC9188689 DOI: 10.1186/s13018-022-03200-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Early onset scoliosis (EOS) presents in patients younger than 10 years. Magnetically controlled growing rods (MCGR) were developed as an outpatient distraction system for EOS, allowing to avoid multiple surgeries. This systematic review investigated the efficacy and feasibility of MCGR in EOS. Methods This systematic review was conducted according to the PRISMA guidelines. PubMed, Google scholar, Embase, and Scopus were accessed in May 2022. All the clinical trials which investigate the role of MCGR for early onset scoliosis were accessed. Only studies reporting data in patients younger than 10 years with a preoperative Cobb Angle greater than 40° were eligible. The following data was extracted at baseline and at last follow-up: mean kyphosis angle, overall mean Cobb angle, mean T1–S1 length. Data from complication were also collected. Results Data from 23 clinical studies (504 patients) were included in the present study. 56% (282 of 504) were females. The average length of the follow-up was 28.9 ± 16.0 months. The mean age of the patients was 8.7 ± 1.9 years old. The mean BMI was 17.7 ± 7.6 kg/m2. The mean kyphosis angle had reduced by the last follow-up (P = 0.04), as did the overall mean Cobb angle (P < 0.0001), while the overall T1–S1 length increased (P = 0.0002). Implant-associated complications, followed by spinal alignment failure, wound healing ailments, pulmonary complications, progressive trunk stiffness, persistent back pain, and fracture. Conclusion The management of EOS remains challenging. The current evidence indicates that MCGR may be effective to distract the spine and model the curve in EOS.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedics, Trauma, and Reconstructive Surgery, University Clinic Aachen, RWTH Aachen University Hospital, Pauwelsstraße 31, 52074, Aachen, Germany.
| | - Wai On Chiu
- Master Program of Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Raffaele Scrofani
- Department of Neurosurgery, University Hospital of Salerno, Fisciano, Italy
| | - Wai Kwong Chiu
- MBBS School of Medicine, Jinan University, Guangzhou, China
| | - Alice Baroncini
- Department of Orthopaedics, Trauma, and Reconstructive Surgery, University Clinic Aachen, RWTH Aachen University Hospital, Pauwelsstraße 31, 52074, Aachen, Germany
| | - Giorgio Iaconetta
- Department of Neurosurgery, University Hospital of Salerno, Fisciano, Italy
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, Italy.,School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, ST4 7QB, Stoke-on-Trent, England, UK.,Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, E1 4DG, London, England, UK
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22
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Committeri U, Fusco R, Di Bernardo E, Abbate V, Salzano G, Maglitto F, Dell’Aversana Orabona G, Piombino P, Bonavolontà P, Arena A, Perri F, Maglione MG, Setola SV, Granata V, Iaconetta G, Ionna F, Petrillo A, Califano L. Radiomics Metrics Combined with Clinical Data in the Surgical Management of Early-Stage (cT1-T2 N0) Tongue Squamous Cell Carcinomas: A Preliminary Study. Biology (Basel) 2022; 11:biology11030468. [PMID: 35336841 PMCID: PMC8945467 DOI: 10.3390/biology11030468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Abstract
Objective: To predict the risk of metastatic lymph nodes and the tumor grading related to oral tongue squamous cell carcinoma (OTSCC) through the combination of clinical data with radiomics metrics by computed tomography, and to develop a supportive approach in the management of the lymphatic cervical areas, with particular attention to the early stages (T1−T2). Between March 2016 and February 2020, patients with histologically confirmed OTSCC, treated by partial glossectomy and ipsilateral laterocervical lymphadenectomy and subjected to computed tomography (CT) before surgery, were identified by two centers: 81 patients (49 female and 32 male) with 58 years as the median age (range 19−86 years). Univariate analysis with non-parametric tests and multivariate analysis with machine learning approaches were used. Clinical, hematological parameters and radiological features extracted by CT were considered individually and in combination. All clinical parameters showed statistically significant differences (p < 0.05) for the Kruskal−Wallis test when discriminating both the tumor grading and the metastatic lymph nodes. DOI, PLR, SII, and SIRI showed an accuracy of 0.70 (ROC analysis) when identifying the tumor grading, while an accuracy ≥ 0.78 was shown by DOI, NLR, PLR, SII, and SIRI when discriminating metastatic lymph nodes. In the context of the analysis of radiomics metrics, the original_glszm_HighGrayLevelZoneEmphasis feature was selected for identifying the tumor grading (accuracy of 0.70), while the wavelet_HHH_glrlm_LowGrayLevelRunEmphasis predictor was selected for determining metastatic lymph nodes (accuracy of 0.96). Remarkable findings were also obtained when classifying patients with a machine learning approach. Radiomics features alone can predict tumor grading with an accuracy of 0.76 using a logistic regression model, while an accuracy of 0.82 can be obtained by running a CART algorithm through a combination of three clinical parameters (SIRI, DOI, and PLR) with a radiomics feature (wavelet_LLL_glszm_SizeZoneNonUniformityNormalized). In the context of predicting metastatic lymph nodes, an accuracy of 0.94 was obtained using 15 radiomics features in a logistic regression model, while both CART and CIDT achieved an asymptotic accuracy value of 1.00 using only one radiomics feature. Radiomics features and clinical parameters have an important role in identifying tumor grading and metastatic lymph nodes. Machine learning approaches can be used as an easy-to-use tool to stratify patients with early-stage OTSCC, based on the identification of metastatic and non-metastatic lymph nodes.
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Affiliation(s)
- Umberto Committeri
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy; (R.F.); (E.D.B.)
| | - Elio Di Bernardo
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy; (R.F.); (E.D.B.)
| | - Vincenzo Abbate
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Fabio Maglitto
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Pasquale Piombino
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Paola Bonavolontà
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Antonio Arena
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
| | - Francesco Perri
- Head and Neck Medical Oncology Unit, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy;
| | - Maria Grazia Maglione
- Division of Surgical Oncology Maxillo-Facial Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131 Naples, Italy; (M.G.M.); (F.I.)
| | - Sergio Venanzio Setola
- Divisions of Radiology, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (S.V.S.); (V.G.)
| | - Vincenza Granata
- Divisions of Radiology, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (S.V.S.); (V.G.)
| | - Giorgio Iaconetta
- Department of Neurosurgery, University of Salerno, 84084 Salerno, Italy;
| | - Franco Ionna
- Division of Surgical Oncology Maxillo-Facial Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131 Naples, Italy; (M.G.M.); (F.I.)
| | - Antonella Petrillo
- Divisions of Radiology, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (S.V.S.); (V.G.)
- Correspondence:
| | - Luigi Califano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; (U.C.); (V.A.); (G.S.); (F.M.); (G.D.O.); (P.P.); (P.B.); (A.A.); (L.C.)
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Diana F, Frauenfelder G, Saponiero R, Iaconetta G, Romano DG. Endovascular Flow diversion in cervical internal carotid artery dissections. World Neurosurg 2022; 162:10. [DOI: 10.1016/j.wneu.2022.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
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Dell'Aversana Orabona G, Togo G, Calvanese C, Ferri A, Committeri U, Improta G, Iaconetta G, Califano L. A comparison of a SARS-CoV-2 rapid-test and serological-test in a Public Health Hospital. J Infect Dev Ctries 2022; 16:258-264. [PMID: 35298419 DOI: 10.3855/jidc.15144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/13/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Nowadays, with the start of the vaccination campaign is very important to assess the extent of exposure of the population and identifying rapid, sensitive and accurate test to quickly identify new cases of SARS-CoV-2. The rapid test, cheap and easy to perform, is therefore very useful in developing countries, where the vaccination campaign has not yet reached adequate coverage. METHODOLOGY We compared the VivaDiag COVID-19 IgM/IgG Rapid Test (VivaCheck Biotech Co., Ltd) with the Roche Elecsys Anti-SARS-CoV-2 (Roche Diagnostics, Rotkreuz, Switzerland) to recognize past infections and to compare VivaDiag COVID-19 IgM/IgG Rapid Test (VivaCheck Biotech Co., Ltd) with Abbott Real Time PCR SARS-CoV-2 assay to recognize infection during its acute phase so that it's possible to evaluate the use of commercially available assays in clinical practice. RESULTS Of the 1,100 patients tested with serological and rapid test, 1,085 were negative both to serological and rapid test, 4 patients were positive at rapid (2 for IgM and 2 for IgG) but negative serological test, 11 patients were positive at serological test but negative to rapid. Of the 300 tested with oropharyngeal swab and rapid test, 294 were negative both to swab and rapid test, 2 positives both to swab and rapid test, 3 positives at swab but negative at rapid test, 1 negative at swab but positive at rapid test. CONCLUSIONS the combined use of these tests according to the specific needs of users, allows a reliable identification of infected patients in the acute phase, distinguishing them from subjects with an antibody response from a previous infection.
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Affiliation(s)
- Giovanni Dell'Aversana Orabona
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University Of Naples, Naples, Italy
| | - Giulia Togo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University Of Naples, Naples, Italy
| | - Carlo Calvanese
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University Of Naples, Naples, Italy
| | - Andrea Ferri
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University Of Naples, Naples, Italy.
| | - Umberto Committeri
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University Of Naples, Naples, Italy
| | - Giovanni Improta
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University Of Naples, Naples, Italy
| | - Giorgio Iaconetta
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Luigi Califano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University Of Naples, Naples, Italy
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Puca AA, Lopardo V, Montella F, Di Pietro P, Cesselli D, Rolle IG, Bulfoni M, Di Sarno V, Iaconetta G, Campiglia P, Vecchione C, Beltrami AP, Ciaglia E. The Longevity-Associated Variant of BPIFB4 Reduces Senescence in Glioma Cells and in Patients' Lymphocytes Favoring Chemotherapy Efficacy. Cells 2022; 11:294. [PMID: 35053408 PMCID: PMC8774353 DOI: 10.3390/cells11020294] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/16/2022] Open
Abstract
Glioblastoma (GBM) is the most common primary brain cancer with the median age at diagnosis around 64 years, thus pointing to aging as an important risk factor. Indeed, aging, by increasing the senescence burden, is configured as a negative prognostic factor for GBM stage. Furthermore, several anti-GBM therapies exist, such as temozolomide (TMZ) and etoposide (ETP), that unfortunately trigger senescence and the secretion of proinflammatory senescence-associated secretory phenotype (SASP) factors that are responsible for the improper burst of (i) tumorigenesis, (ii) cancer metastasis, (iii) immunosuppression, and (iv) tissue dysfunction. Thus, adjuvant therapies that limit senescence are urgently needed. The longevity-associated variant (LAV) of the bactericidal/permeability-increasing fold-containing family B member 4 (BPIFB4) gene previously demonstrated a modulatory activity in restoring age-related immune dysfunction and in balancing the low-grade inflammatory status of elderly people. Based on the above findings, we tested LAV-BPIFB4 senotherapeutic effects on senescent glioblastoma U87-MG cells and on T cells from GBM patients. We interrogated SA-β-gal and HLA-E senescence markers, SASP factors, and proliferation and apoptosis assays. The results highlighted a LAV-BPIFB4 remodeling of the senescent phenotype of GBM cells, enhancement of their sensitivity to temozolomide and a selective reduction of the T cells' senescence from GBM patients. Overall, these findings candidate LAV-BPIFB4 as an adjuvant therapy for GBM.
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Affiliation(s)
- Annibale Alessandro Puca
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138 Milan, Italy
| | - Valentina Lopardo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
| | - Daniela Cesselli
- Department of Medicine, University of Udine, 33100 Udine, Italy; (D.C.); (I.G.R.); (M.B.); (A.P.B.)
| | - Irene Giulia Rolle
- Department of Medicine, University of Udine, 33100 Udine, Italy; (D.C.); (I.G.R.); (M.B.); (A.P.B.)
| | - Michela Bulfoni
- Department of Medicine, University of Udine, 33100 Udine, Italy; (D.C.); (I.G.R.); (M.B.); (A.P.B.)
| | - Veronica Di Sarno
- Department of Pharmacy, University of Salerno, Via G. Paolo II 132, Fisciano, 84084 Salerno, Italy; (V.D.S.); (P.C.)
| | - Giorgio Iaconetta
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
- Department of Neurosurgery, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Pietro Campiglia
- Department of Pharmacy, University of Salerno, Via G. Paolo II 132, Fisciano, 84084 Salerno, Italy; (V.D.S.); (P.C.)
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, 86077 Isernia, Italy
| | - Antonio Paolo Beltrami
- Department of Medicine, University of Udine, 33100 Udine, Italy; (D.C.); (I.G.R.); (M.B.); (A.P.B.)
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
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Diana F, Frauenfelder G, Saponiero R, Iaconetta G, Romano DG. Transvenous Embolization with Ethylene Vinyl Alcohol and Arterial Flow Control of a Dural Arteriovenous Fistula of the Isolated Transverse Sinus. World Neurosurg 2021; 157:35. [PMID: 34626846 DOI: 10.1016/j.wneu.2021.09.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 10/20/2022]
Abstract
Dural arteriovenous fistulas draining into an isolated sinus often require a multimodal treatment, with transarterial and transvenous approaches.1-6 However, there is no consensus about the injection technique. Some authors suggest filling the sinus with coils in order to have a compact cast without unnecessary migration of the embolic material. We present a case of a patient with left temporal hemorrhage caused by a dural arteriovenous fistula on the isolated left transverse sinus. In this operative video we demonstrate how the arterial flow control during treatment allows us to obtain a compact cast of the embolic material inside the isolated sinus without coils (Video 1).
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Affiliation(s)
- Francesco Diana
- Department of Neuroradiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy.
| | - Giulia Frauenfelder
- Department of Neuroradiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - Renato Saponiero
- Department of Neuroradiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - Giorgio Iaconetta
- Department of Neurosurgery, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - Daniele Giuseppe Romano
- Department of Neuroradiology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
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Abstract
The aim of this work is to clarify the incidence of meningitis/encephalitis in SARS-CoV-2 patients. We conducted an initial search in PubMed using the Medical Subject Headings (MeSH) terms "meningitis," and "encephalitis,", and "COVID-19" to affirm the need for a review on the topic of the relationship between meningitis/encephalitis and SARS-CoV-2 infection. We included case series, case reports and review articles of COVID-19 patients with these neurological symptoms. Through PubMed database we identified 110 records. After removal of duplicates, we screened 70 record, and 43 were excluded because they focused on different SARS-CoV-2 neurological complications. For eligibility, we assessed 27 full-text articles which met inclusion criteria. Seven articles were excluded, and twenty studies were included in the narrative review, in which encephalitis and/or meningitis case reports/case series were reported. Neurological manifestations of COVID-19 are not rare, especially meningoencephalitis; the hypoxic/metabolic changes produced by the inflammatory response against the virus cytokine storm can lead to encephalopathy, and the presence of comorbidities and other neurological diseases, such as Alzheimer's disease, predispose to these metabolic changes. Further study are needed to investigate the biological mechanisms of neurological complications of COVID-19.
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Affiliation(s)
- G Iaconetta
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - P De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - A Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - C Cassandro
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - E Cassandro
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Abbate V, Iaconetta G, Sani L, Bonavolontà P, Di Lauro AE, Masone S, Califano L, Orabona GDA. The Use of Dermal Substitutes for Donor Site Closure After Radial Forearm Free Flap Harvesting. J Craniofac Surg 2021; 32:e205-e208. [PMID: 33705075 DOI: 10.1097/scs.0000000000006808] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of our study was to analyze the aesthetic and functional outcome in the radial forearm free flap donor site using a simple split thickness skin grafting (STSG) closure compared with the use of dermal scaffold supporting the STSG closure. METHODS The study analyzed 18 patients, divided in 2 groups based on the donor site closure modality. In STSG group, a simple STSG was used to cover the defect. In the DS + STSG group, the defect was covered by the use of dermal substitute (MatriDerm) supporting the STSG. Groups were compared on the following outcome variable: scar status; hand function; circumferences at most proximal and most distal point of the graft. All patients were followed up 1, 6, and 12 months post-operative. RESULTS Nine patients from STSG group showed a difference in circumference between the operated and contralateral limbs respectively of 2.9 mm proximal and 1.2 mm distal; in the 9 patients of DS + STGS group the difference was respectively of 1.2 mm proximal and 1.3 mm distal. Welch unequal variances t-test demonstrated statistical significance of the values with P < 0.004 (P < 0.5). The average VSS was 1.82 ± 0.2 for STSG group and 1.75 ± 0.2 for DS + STGS group. The DASH score was 21.8% in STSG group and 19.4% in DS + STGS group. CONCLUSION Our study shows that patients treated with Matriderm + STSG obtained a better result both in esthetic and functional outcomes.
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Affiliation(s)
- Vincenzo Abbate
- University of Naples "Federico II," Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, Naples
| | | | - Lorenzo Sani
- University of Naples "Federico II," Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, Naples
| | - Paola Bonavolontà
- University of Naples "Federico II," Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, Naples
| | - Alessandro E Di Lauro
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II;"
| | - Stefania Masone
- University of Naples "Federico II", Department of Clinical Medicine and Surgery, General Surgery Unit, Naples, Italy
| | - Luigi Califano
- University of Naples "Federico II," Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, Naples
| | - Giovanni D A Orabona
- University of Naples "Federico II," Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, Naples
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Abbate V, Dell'Aversana Orabona G, Troise S, Bonavolontà P, Romano A, Piombino P, Califano L, Iaconetta G. Sphenopalatine ganglion deficit syndrome: An unusual complication after septoplasty. Oral and Maxillofacial Surgery Cases 2020. [DOI: 10.1016/j.omsc.2020.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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30
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Romano A, Lo Faro C, Iaconetta G, Committeri U, Audino G, Salzano G, Maglitto F, Califano L, Dell'aversana Orabona G. Adenoid cystic carcinoma of accessory parotid gland: A case report and review of the literature. Oral and Maxillofacial Surgery Cases 2020. [DOI: 10.1016/j.omsc.2020.100188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bonavolontà P, Giovanni DO, Goglia F, Romano A, Abbate V, Arena A, Iaconetta G, Califano L. A new surgical approach for the treatment of Rhinophyma. Ann Ital Chir 2020; 9:S2239253X20033150. [PMID: 33427205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Rhinophyma is a rare and benign pathological condition affecting the nose. It can be localized or generalized causing a nasal deformity, mainly of the lower 2/3 of the nose. Clinically, rhinophyma is characterized by the aberrant development of the vascularization of the skin of the nose. The nose becomes particularly sensitive, and even a minimal external trauma can cause bleeding. Different treatment methods have been described during the last few years, but surgery still remains the gold standard. The aim is to obtain a reduction of the abnormal tissue, by debulking and fine contouring followed by hemostasis and a very careful postoperative care. Herein we report one case of Rhinophyma treated with the Microdebrider (Storz®). CASE REPORT A 70 year old male with a diagnosis of rhinophyma was admitted to the Department of Maxillo-Facial Surgery of "Federico II" University of Naples. The patient underwent a debridment of rhinophyma, combining dermabrasion and decortication, using a Microdebrider (Storz®). After the surgery, the wound was covered with an advanced dressing, a collagen sponge equina (Condress®) applied at the end of the procedure and routinely during the follow up control to promote the healing process. CONCLUSION After 2 months the patient was completely healed without any complications and without any signs of recurrence, obtaining a good aesthetic and functional result. After 25 months of follow up the result is still stable. KEY WORDS Rhinophyma, Microdebrider.
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Iaconetta G, De Luca P, Scarpa A, Cassandro C, Cassandro E. Meningoencephalitis Associated with SARS-Coronavirus-2. Transl Med UniSa 2020; 23:42-47. [PMID: 33457322 PMCID: PMC8370532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
The aim of this work is to clarify the incidence of meningitis/encephalitis in SARS-CoV-2 patients. We conducted an initial search in PubMed using the Medical Subject Headings (MeSH) terms "meningitis," and "encephalitis,", and "COVID-19" to affirm the need for a review on the topic of the relationship between meningitis/encephalitis and SARS-CoV-2 infection. We included case series, case reports and review articles of COVID-19 patients with these neurological symptoms. Through PubMed database we identified 110 records. After removal of duplicates, we screened 70 record, and 43 were excluded because they focused on different SARS-CoV-2 neurological complications. For eligibility, we assessed 27 full-text articles which met inclusion criteria. Seven articles were excluded, and twenty studies were included in the narrative review, in which encephalitis and/or meningitis case reports/case series were reported. Neurological manifestations of COVID-19 are not rare, especially meningoencephalitis; the hypoxic/metabolic changes produced by the inflammatory response against the virus cytokine storm can lead to encephalopathy, and the presence of comorbidities and other neurological diseases, such as Alzheimer's disease, predispose to these metabolic changes. Further study are needed to investigate the biological mechanisms of neurological complications of COVID-19.
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Affiliation(s)
- G Iaconetta
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - P De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - A Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - C Cassandro
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - E Cassandro
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Dell'Aversana Orabona G, Salzano G, Abbate V, Bonavolontà P, Committeri U, Seidita F, Petrocelli M, Somma T, Improta G, Vaira LA, Iaconetta G, Califano L. Malignant tumours of the parotid gland: management of the neck (including the clinically negative neck) and a literature review. Br J Oral Maxillofac Surg 2020; 59:665-671. [PMID: 33952405 DOI: 10.1016/j.bjoms.2020.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
Major salivary gland malignancies are rare, constituting 1%-3% of head-neck tumours. The surgical management of the clinically negative neck (cN0) does not have a univocal consensus yet. We have carried out a retrospective study on 119 cases of malignant parotid tumours that were surgically treated between January 1999 and January 2014. Our aim was to analyse preoperative findings (cytotype, cTNM) and to correlate these with postoperative results (grading, histotype, occult neck metastasis) in patients with parotid tumours to obtain an appropriate indication for neck management. In cN0 patients with a T1, T2 low-grade cancer a wait-and-see approach is preferred. Instead, in cNO patients with high-grade or low-grade T3, T4 tumours an elective neck dissection (END) is always planned. Levels II, III and IV, at least, must be dissected. The decision to dissect level V or I depends on the location of the primary tumour. In the cN0 group 19 of 58 (32.7%) patients who underwent an END had occult metastases. In clinically positive neck (cN+) patients a Modified Radical Neck Dissection (MRND), at least, must be performed. The criteria to add adjuvant radiotherapy (PORT) include deep lobe parotid tumours, advanced lesions (T3-T4), microscopic (R2) or macroscopic (R1) residual disease after surgery, high grade tumours, perineural diffusion, lymph node metastasis, capsular rupture, and local recurrence after previous surgery. Kaplan-Meier analyses have shown a reduction in the overall survival (OS) from 100% to 91% and in disease-free survival (DFS) from 100% to 95.5% for the NO-PORT and PORT group, respectively. In our study, the cN0 pN+ patients had a higher degree of DFS compared to the cN+.
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Affiliation(s)
- G Dell'Aversana Orabona
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - G Salzano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.
| | - V Abbate
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - P Bonavolontà
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - U Committeri
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - F Seidita
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - M Petrocelli
- Operative Unit of Maxillofacial Surgery, Bellaria-Maggiore Hospitals, Bologna, Italy
| | - T Somma
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - G Improta
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - L A Vaira
- Operative Unit of Maxillofacial Surgery, University of Sassari, Viale San Pietro 43/b, Sassari, Italy
| | - G Iaconetta
- Department of Neurosurgery, University of Salerno, Salerno, Italy
| | - L Califano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
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Russo AG, De Martino M, Mancuso A, Iaconetta G, Manara R, Elia A, Laudanna A, Di Salle F, Esposito F. Semantics-weighted lexical surprisal modeling of naturalistic functional MRI time-series during spoken narrative listening. Neuroimage 2020; 222:117281. [PMID: 32828929 DOI: 10.1016/j.neuroimage.2020.117281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/22/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022] Open
Abstract
Probabilistic language models are increasingly used to provide neural representations of linguistic features under naturalistic settings. Word surprisal models can be applied to continuous fMRI recordings during task-free listening of narratives, to detect regions linked to language prediction and comprehension. Here, to this purpose, a novel semantics-weighted lexical surprisal is applied to naturalistic fMRI data. FMRI was performed at 3 Tesla in 31 subjects during task-free listening to a 12-minute audiobook played in both original and word-reversed (control) version. Lexical-only and semantics-weighted lexical surprisal models were estimated for the original and control word series. The two series were alternatively chosen to build the predictor of interest in the first-level general linear model and were compared in the second-level (group) analysis. The addition of the surprisal predictor to the stimulus-related predictors significantly improved the fitting of the neural signal. In average, the semantics-weighted model yielded lower surprisal values and, in some areas, better fitting of the fMRI data compared to the lexical-only model. The two models produced both overlapping and distinct activations: while lexical-only surprisal activated secondary auditory areas in the superior temporal gyri and the cerebellum, semantics-weighted surprisal additionally activated the left inferior frontal gyrus. These results confirm the usefulness of surprisal models in the naturalistic fMRI analysis of linguistic processes and suggest that the use of semantic information may increase the sensitivity of a probabilistic language model in higher-order language-related areas, with possible implications for future naturalistic fMRI studies of language under normal and (clinically or pharmacologically) modified conditions.
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Affiliation(s)
- Andrea G Russo
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy; Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy.
| | - Maria De Martino
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy
| | - Azzurra Mancuso
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy
| | - Giorgio Iaconetta
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy; Department of Diagnostic Imaging, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Renzo Manara
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy; Department of Diagnostic Imaging, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Annibale Elia
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy
| | - Alessandro Laudanna
- Department of Political and Communication Sciences, University of Salerno, Fisciano, Salerno, Italy
| | - Francesco Di Salle
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy; Department of Diagnostic Imaging, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy; Department of Diagnostic Imaging, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
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Friscia M, Bonavolontà P, Arena A, Committeri U, Maglitto F, Salzano G, Iaconetta G, Califano L. Syngnathia: a rare case of maxillo-mandibular fusion in an adult patient. Chirurgia (Bucur) 2020. [DOI: 10.23736/s0394-9508.19.04955-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bonavolontà P, Dell'Aversana Orabona G, Cama A, Romano A, Abbate V, Salzano G, Boschetti CE, D'Andrea L, Iaconetta G, Califano L. Application of a computer navigation system in the treatment of silent sinus syndrome: Case reports and technical note. J Plast Reconstr Aesthet Surg 2019; 73:783-808. [PMID: 31812443 DOI: 10.1016/j.bjps.2019.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 10/01/2019] [Accepted: 11/23/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy.
| | - Giovanni Dell'Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Antonia Cama
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Ciro Emiliano Boschetti
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Luca D'Andrea
- Ophthalmology Unit Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Giorgio Iaconetta
- Neurosurgery Unit Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
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Bonavolontà P, Dell'Aversana Orabona G, Maglitto F, Abbate V, Committeri U, Salzano G, Improta G, Iaconetta G, Califano L. Postoperative complications after removal of pleomorphic adenoma from the parotid gland: A long-term follow up of 297 patients from 2002 to 2016 and a review of publications. Br J Oral Maxillofac Surg 2019; 57:998-1002. [PMID: 31500918 DOI: 10.1016/j.bjoms.2019.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022]
Abstract
Pleomorphic adenomas are rounded, lumpy, capsulated lesions that are more common in women. They are typically benign, but can be associated with malignancy in a minority of cases (such as carcinoma ex pleomorphic adenoma), between 3% - 12% of the time, according to available data. The purpose of our study was to evaluate clinical outcomes in patients with benign parotid gland tumours after extracapsular dissection (ECD) or superficial parotidectomy (SP). We made a retrospective study of 297 patients who had had benign tumours of the parotid gland, and had been referred to our department from 2002 - 2016 to have either procedure. We measured the statistical differences between the two techniques (evaluated recurrence rate and complications) with the chi squared test. The chosen level of statistical significance was p<0.05. Median (range) follow-up time was 43 months (25-168) months. Haematoma and hypoaesthesia were significantly more common after SP than after ECD (8.9% compared with 7.7%, and 16.8% compared with 5.6%, respectively). Transient facial nerve injury, Frey syndrome, and facial paralysis were significantly more common after SP than after ECD (23.6% compared with 1.5%, 6.7% compared with 1% and 6,7% compared with 0%, respectively). ECD had the advantage of reduced operating time, lower morbidity and lower recurrence rate, and could be considered the treatment of choice for pleomorphic adenoma of the parotid gland up (to 3cm) which are mobile and sited in the superficial lobe of the parotid gland.
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Affiliation(s)
- Paola Bonavolontà
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.
| | - Giovanni Dell'Aversana Orabona
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Fabio Maglitto
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Vincenzo Abbate
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Umberto Committeri
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.
| | - Giovanni Salzano
- Department Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy
| | - Giovanni Improta
- Department of Public Health, Federico II University of Naples, Naples, Italy
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Romano A, Dell'Aversana Orabona G, Pansini A, Abbate V, Cama A, Iaconetta G, Califano L. Endoscopic approach for paranasal sinuses osteomas: Our experience and review of literature. Oral and Maxillofacial Surgery Cases 2019. [DOI: 10.1016/j.omsc.2019.100094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Dell'Aversana Orabona G, Romano A, Abbate V, Salzano G, Piombino P, Farina F, Pansini A, Iaconetta G, Califano L. Effectiveness of endoscopic septoplasty in different types of nasal septal deformities: our experience with NOSE evaluation. ACTA ACUST UNITED AC 2019; 38:323-330. [PMID: 30197423 PMCID: PMC6146582 DOI: 10.14639/0392-100x-1067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 06/06/2017] [Indexed: 11/23/2022]
Abstract
Septal deviations are the most frequent cause of nasal obstruction, and represent a common complaint in rhinologic practice. Since the first description of Lanza et al. in 1991, the use of the endoscope for the correction of septal deformities is increasingly more frequent. The purpose of this study is to evaluate the effectivenes of the endoscopic septoplasty for the correction of each of the 7 types of septal deformities according to the Mladina’s classification. A retrospective chart review was performed in 59 consecutive patients presenting to our Department for Endoscopic Septoplasty from February 2012 to August 2014. For each deviation, descriptive statistics (mean and standard deviation, significant increase/decrease) was used to asses the corrective capacity and time-dependent effects at follow-up. This study shows that the corrective power of endoscopic septoplasty is different according to the type of deviation. To our knowledge this is the first study that evaluates the corrective capacity of this technique for each deviation by analysing pre- and postoperative objective outcomes as well as subjective outcomes gathered from the validated NOSE questionnaire. Even if endoscopic septoplasty may now be considered a reliable alternative to the classic technique, it is essential to identify the right deformity preoperatively in order to provide the correct therapeutic choice.
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Affiliation(s)
| | - A Romano
- Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - V Abbate
- Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - G Salzano
- Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - P Piombino
- Department of Otorhinolaryngology, University of Naples SUN, Naples, Italy.,Present address: Department of Otorhinolaryngology, University Luigi Vanvitelli of Naples, Italy
| | - F Farina
- Department of Economy and Business, University of Sannio, Benevento, Italy
| | - A Pansini
- Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - G Iaconetta
- Department of Neurosurgery, University of Salerno, Italy
| | - L Califano
- Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
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Petrocelli M, Sbordone C, Salzano G, Dell'Aversana Orabona G, Cassandro FM, Scarpa A, Ramaglia L, Iaconetta G, Califano L, Cassandro E. Benign Paroxysmal Positional Vertigo After Oral and Maxillofacial Surgery: Our Experience and Review of Literature. J Maxillofac Oral Surg 2019; 19:527-531. [PMID: 33071500 DOI: 10.1007/s12663-019-01209-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 03/11/2019] [Indexed: 02/07/2023] Open
Abstract
Objectives The aim of our study is to evaluate the influence of patient risk factors and the length of surgical time on the onset of BPPV (benign paroxysmal positional vertigo) and suggest surgical and clinical strategies to prevent this rare complication. Method Our retrospective study analyzes that, in 2 years, 281 patients, divided into three groups, underwent wisdom teeth extraction, sinus lift elevation and orthognathic surgery, at the Oral and Maxillofacial Department of the University of Naples "Federico II." Results Twenty-one patients presented postoperative BPPV. Some comorbidities, like dyslipidemia, high cholesterol levels, vascular problems, endocrinological disorders, perimenopausal age, female gender, cranial trauma, neurologic disorders, migraine, hypovitaminosis D, autoimmune disease, flogosis of inner ear, can be risk factors to the occurrence of postoperative vertigo. Conclusion Our statistical analysis revealed a relationship between surgical time and comorbidity and onset of vertigo for each group of patients.
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Affiliation(s)
- Marzia Petrocelli
- Otolaryngology Unit, Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
| | - Carolina Sbordone
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Giovanni Dell'Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Francesco Maria Cassandro
- Dentistry Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Alfonso Scarpa
- Otolaryngology Unit, Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
| | - Luca Ramaglia
- Dentistry Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Giorgio Iaconetta
- Neurosurgery Unit, Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100 Naples, Italy
| | - Ettore Cassandro
- Otolaryngology Unit, Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
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Abbate V, Dell'Aversana Orabona G, Salzano G, Bonavolontà P, Maglitto F, Romano A, Tarabbia F, Turri-Zanoni M, Attanasi F, Di Lauro AE, Iaconetta G, Califano L. Pre-treatment Neutrophil-to-Lymphocyte Ratio as a predictor for occult cervical metastasis in early stage (T1-T2 cN0) squamous cell carcinoma of the oral tongue. Surg Oncol 2018; 27:503-507. [PMID: 30217309 DOI: 10.1016/j.suronc.2018.06.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 06/01/2018] [Accepted: 06/02/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Optimum management of clinically negative neck (cN0) remains controversial in early stage (T1-T2) squamous cell cancer of the oral tongue (OTSCC). The purpose of this study was to investigate the value of pre-treatment Neutrophil-to lymphocyte ratio (NLR) in predicting occult cervical metastasis in stage I and II OTSCC. METHODS We carried out a retrospective chart review on 110 patients suffering from early stage OTSCC who were surgically treated with tumour excision and elective neck dissection (END). Our cohort was divided in pN+ and pN0 groups basing on histopathological examination after elective neck dissection. For each patient pre-treatment NLR was calculated. RESULTS A statistically significant relationship between high levels of pre-treatment NLR and probability rate for neck occult metastases (0.000496 p-value) has been found. On our model the cut-off value was set for NLR >2.93. Above this level the probability to finding metastasis in a clinically negative neck increases exponentially. CONCLUSION These preliminary results offer clinicians an easily obtainable tool to stratify patients based on risks of metastatic node in whom END could be indicated.
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Affiliation(s)
- Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100, Naples, Italy.
| | - Giovanni Dell'Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100, Naples, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100, Naples, Italy
| | - Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100, Naples, Italy
| | - Fabio Maglitto
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100, Naples, Italy
| | - Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100, Naples, Italy
| | - Filippo Tarabbia
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100, Naples, Italy
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Federica Attanasi
- Department of Statistical Sciences, University La Sapienza, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Alessandro Espedito Di Lauro
- Neurosurgery Unit Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084, Fisciano, Salerno, Italy
| | - Giorgio Iaconetta
- Division of Dentistry, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100, Naples, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100, Naples, Italy
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Romano A, Lo Faro C, Salzano G, Dell’aversana Orabona G, Petrocelli M, Corvino R, Vaira LA, Iaconetta G, Califano L. Synovial chondromatosis of temporomandibular joint spreading into the cranial space. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 2018. [DOI: 10.1016/j.ajoms.2018.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Romano A, Orabona GD, Pansini A, Salzano G, Cozzolino I, Cieri M, Iaconetta G, Califano L. Clear cell myoepithelial carcinoma ex pleomorphic adenoma of parotid gland: Case report and review of literature. Oral and Maxillofacial Surgery Cases 2018. [DOI: 10.1016/j.omsc.2017.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Romano A, Iaconetta G, Pansini A, Mascolo M, Cieri M, Abbate V, Salzano G, Dell'Aversana Orabona G, Califano L. Sinonasal mucosal melanoma extended to nose bridge: A one-time reconstruction treatment report. Oral and Maxillofacial Surgery Cases 2018. [DOI: 10.1016/j.omsc.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Abstract
PURPOSE The aim of this study was to report management and outcomes in patients affected by eyelids carcinomas involving regional lymph nodes. METHODS We have retrospectively analyzed the data of patients affected by eyelids carcinoma with nodal involvement. The clinical records of 10 patients with malignant eyelid carcinoma and regional nodal metastasis treated between September 2011 and March 2015 have been analyzed. RESULTS The study included 5 women and 5 men (median age 54,5 years; range 37-80 years). The most common tumor was the squamous cell carcinoma (4 cases) followed by sebaceous carcinoma (2 cases): 1 case of epidermoid carcinoma, 1 case of malignant melanoma, 1 case of Merkel carcinoma, and 1 case of basal cell carcinoma. All patients were treated by surgical resection; in 2 cases, orbital exenteration was required. The treatment of regional nodal metastasis consisted of parotidectomy and radical neck dissection followed by radiation therapy. None of the patients developed local recurrence. Three patients died: one, affected by Merkel cell carcinoma, died after 2 months because of metastatic dissemination to the lung; another one, affected by epidermoid carcinoma involving the orbit, died because of liver metastasis; the third one, affected by malignant melanoma, died because of other causes. The follow-up time ranged from 9 to 36 months (median 19.3 months). CONCLUSIONS Patients affected by advanced malignant eyelid carcinoma need to be strictly controlled because metastasis can develop at least 5 years after surgical treatment. Therapy may include a combination of local surgery, neck dissection, and radiation.
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MESH Headings
- Adenocarcinoma, Sebaceous/mortality
- Adenocarcinoma, Sebaceous/pathology
- Adenocarcinoma, Sebaceous/surgery
- Carcinoma, Basal Cell/mortality
- Carcinoma, Basal Cell/pathology
- Carcinoma, Basal Cell/surgery
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Eyelid Neoplasms/mortality
- Eyelid Neoplasms/pathology
- Eyelid Neoplasms/surgery
- Female
- Humans
- Italy/epidemiology
- Lymph Nodes/pathology
- Lymph Nodes/surgery
- Lymphatic Metastasis/pathology
- Male
- Melanoma/mortality
- Melanoma/pathology
- Melanoma/surgery
- Middle Aged
- Neck Dissection/methods
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/surgery
- Orbit Evisceration/methods
- Retrospective Studies
- Skin Neoplasms/mortality
- Skin Neoplasms/pathology
- Skin Neoplasms/surgery
- Melanoma, Cutaneous Malignant
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Affiliation(s)
- Paola Bonavolontà
- *Head and Neck Departement, University of Naples Federico II, Naples †Neurosurgery Departement, University of Salerno, Salerno, Italy
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Dell'Aversana Orabona G, Salzano G, Abbate V, Piombino P, Astarita F, Iaconetta G, Califano L. Use of the SMAS flap for reconstruction of the parotid lodge. Acta Otorhinolaryngol Ital 2017; 35:406-11. [PMID: 26900246 PMCID: PMC4755052 DOI: 10.14639/0392-100x-395] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of our study was to evaluate the benefits of the SMAS flap in patients with benign tumours of the parotid gland treated by superficial parotidectomy. We carried out a retrospective chart review on 123 patients suffering from benign tumours of the parotid gland admitted to our Institution between March 1997 and March 2010. A superficial parotidectomy was performed in all the cases reported. Our sample was divided in two groups basing SMAS flap reconstruction done (Group 2) or not (Group 1) after superficial parotidectomy. Reconstruction using SMAS flap was accomplished in 64 patients. Chi-square test was used to assess statistical difference between the two groups. The level of statistical significance was P < 0.05. No significant differences concerning hematoma, wound infection and facial paralysis were observed between the first and second group (3.38 vs 1.56% [P > 0.05], 8.47% vs 4.68% [P > 0.05], 5.08% vs 0.00% [P > 0.05]). Transient facial nerve weakness, fistula, dip skin and Frey's syndrome were significantly more frequent without SMAS flap reconstruction (10.16% vs 3.125% [P < 0.05], 13.55% vs 3.125% [P < 0.05], 13.55% vs 3.125% [P < 0.05], 20.33% vs 0% [P < 0.05] respectively). The use of the SMAS flap is able to reduce the cosmetic and functional complications that occur after the removal of a benign tumour of the parotid through the superficial parotidectomy technique, above all, it reduces the occurrence of Frey's syndrome.
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Affiliation(s)
- G Dell'Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neuroscience, Reproductive and Odontostomatological Science, Federico II University
| | - G Salzano
- Maxillofacial Surgery Unit, Department of Neuroscience, Reproductive and Odontostomatological Science, Federico II University
| | - V Abbate
- Maxillofacial Surgery Unit, Department of Neuroscience, Reproductive and Odontostomatological Science, Federico II University
| | - P Piombino
- Maxillofacial Surgery Unit, Department of Neuroscience, Reproductive and Odontostomatological Science, Federico II University
| | - F Astarita
- Maxillofacial Surgery Unit, Department of Neuroscience, Reproductive and Odontostomatological Science, Federico II University
| | - G Iaconetta
- Neurosurgery Department, University of Salerno, Salerno, Italy
| | - L Califano
- Maxillofacial Surgery Unit, Department of Neuroscience, Reproductive and Odontostomatological Science, Federico II University
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Friscia M, Sbordone C, Petrocelli M, Vaira LA, Attanasi F, Cassandro FM, Paternoster M, Iaconetta G, Califano L. Complications after orthognathic surgery: our experience on 423 cases. Oral Maxillofac Surg 2017; 21:171-177. [PMID: 28251364 DOI: 10.1007/s10006-017-0614-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 02/20/2017] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Orthognathic surgery is widely used to correct dentofacial discrepancies. However, this procedure presents numerous possible complications. The aim of our study is to review intraoperative and postoperative complications related to orthognathic surgery based upon a 10-year period in the Maxillofacial Surgery Department of Federico II University of Naples. MATERIALS AND METHODS Medical records of 423 patients who undergone orthognathic surgery in a 10-year period were retrospectively analyzed and complications was noted. Statistical analysis was conduced in order to understand if the type of surgical procedure influenced complications rate. RESULTS One hundred eighty-five complications in 143 (33.8%) of the 423 treated patients were reported. Complications detected were nerve injury (49 cases, 11.9%), infections (10 cases, 2.4%), complications related to fixation plates or screws (30 cases, 7.1%), bad split osteotomy (8 cases, 1.9%), secondary temporo-mandibular joint disorders (36 cases, 8.5%), dental injuries (21 cases, 5%), condilar resorption (2 cases, 0.5%), and necessity of a second-time surgery (24 cases, 5.7%). CONCLUSIONS Serious complications seem to be quite rare in orthognathic surgery. Some of the surgical complications found are related to the surgeon experience and not strictly to the risks of the operation itself. Understanding potential complications allows the surgeon to guarantee safe care through early intervention and correctly inform the patient in the preoperative colloquy.
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Affiliation(s)
- Marco Friscia
- Department of Maxillo-Facial Surgery, School of Medicine, University of Naples "Federico II", Via S. Pansini 5, 80100, Naples, Italy
| | - Carolina Sbordone
- Department of Maxillo-Facial Surgery, School of Medicine, University of Naples "Federico II", Via S. Pansini 5, 80100, Naples, Italy
| | - Marzia Petrocelli
- Department of Maxillo-Facial Surgery, School of Medicine, University of Naples "Federico II", Via S. Pansini 5, 80100, Naples, Italy
| | - Luigi Angelo Vaira
- Department of Maxillo-Facial Surgery, School of Medicine, University of Naples "Federico II", Via S. Pansini 5, 80100, Naples, Italy.
| | - Federica Attanasi
- Statistical Science Department, School of Statistic Science, University of Rome "La Sapienza", Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Francesco Maria Cassandro
- Dentistry Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 9, 80100, Naples, Italy
| | - Mariano Paternoster
- Department of Advanced Biomedical Sciences, Legal Medicine Unit, School of Medicine, University of Naples "Federico II", Via S. Pansini 5, 80100, Naples, Italy
| | - Giorgio Iaconetta
- Department of Neurosurgery, School of Medicine, University of Salerno, Via S. Allende, 84081, Baronissi, Salerno, Italy
| | - Luigi Califano
- Department of Maxillo-Facial Surgery, School of Medicine, University of Naples "Federico II", Via S. Pansini 5, 80100, Naples, Italy
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Bonavolontà P, Dell'aversana Orabona G, Abbate V, Vaira LA, Lo Faro C, Petrocelli M, Attanasi F, De Riu G, Iaconetta G, Califano L. The epidemiological analysis of maxillofacial fractures in Italy: The experience of a single tertiary center with 1720 patients. J Craniomaxillofac Surg 2017; 45:1319-1326. [PMID: 28606439 DOI: 10.1016/j.jcms.2017.05.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/06/2017] [Accepted: 05/11/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Maxillofacial fractures represent a serious public health problem. Their epidemiology is extremely variable, and its analysis is crucial to establish effective treatment and prevention of these injuries. However only two works have been published about maxillofacial fracture epidemiology in Italy. MATERIALS AND METHODS The records of 1720 patients diagnosed with maxillofacial fractures in a 15-years period (2001-2015) in our department were retrospectively reviewed. RESULTS A total of 1108 male and 612 female patients were included in the study. The most frequent aetiology of fracture was road traffic injuries (57.1%), followed by assault (21.7%), falls (14.2%), work accidents (3.5%), sport accidents (3.3%) and other causes (0.2%). Significant variations of aetiology were detected between males and females and between Italians and individuals from other countries. The most frequently observed fracture involved the mandible (861 cases, 36%), followed by zygoma (489 cases, 20.4%), orbital walls (386 cases, 16.1%) and maxilla (282 cases, 11.8%). CONCLUSION Road traffic legislation enforcement and continuous public education regarding the use of security devices remain an ongoing problem in our region and should be encouraged. In the same way, as migration flows influence and change the epidemiology of facial traumas, it is crucial to establish social support programs that avoid these disadvantaged categories of victims of violence and crime.
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Affiliation(s)
- Paola Bonavolontà
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | - Giovanni Dell'aversana Orabona
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
| | - Carmelo Lo Faro
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | - Marzia Petrocelli
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | | | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit (Head: Dott. Giacomo De Riu), University Hospital of Sassari, Viale San Pietro 43B, 07100 Sassari, Italy
| | - Giorgio Iaconetta
- Neurosurgery Operative Unit (Head: Prof. Giorigio Iaconetta), University Hospital of Salerno, Via Allende, 84081 Baronissi, Salerno, Italy
| | - Luigi Califano
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
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Iaconetta G, De Bernardo M, Rosa N. Coronal Axis Measurement of the Optic Nerve Sheath Diameter. J Ultrasound Med 2017; 36:1073. [PMID: 28390163 DOI: 10.1002/jum.14198] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 12/07/2016] [Indexed: 06/07/2023]
Affiliation(s)
- Giorgio Iaconetta
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy
| | - Maddalena De Bernardo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy
| | - Nicola Rosa
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Salerno, Italy
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Romano A, Salzano G, Dell'Aversana Orabona G, Cama A, Petrocelli M, Piombino P, Schonauer F, Iaconetta G, Salzano FA, Califano L. Comparative study between biodegradable nasopore (BNP) and Merocel hemox 10 cm after septo-turbinoplasty procedure. Eur Rev Med Pharmacol Sci 2017; 21:669-673. [PMID: 28272718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The purpose of our study was to compare Merocel (Merocel Hemox 10 cm) and BNP (biodegradable nasopore) during a septoturbinoplasty procedure in terms of efficiency and patient comfort. PATIENTS AND METHODS We carried out a retrospective review of 72 patients who had undergone septoturbinoplasty between January 2015 and January 2016. Each group, packed with BNP or Merocel Hemox 10 cm was composed of 36 patients. A standard visual analogue scale ranging from zero (no symptoms) to 10 (the most severe symptoms) was used to assess subjective symptoms. To compare the usefulness of materials we evaluated the postoperative bleeding, infection and adhesion after the removal of packing with and endoscopic examination using a 5-point scale (zero, absent; 1, mild; 2, moderate; 3, severe; and 4, very severe). Secretions and crusts were evaluated 1 week and 4 weeks after surgery in both groups using a 5-point scale (zero, absent; 1, mild; 2, moderate; 3, severe; and 4, very severe). RESULTS A total of 72 patients were enrolled in the study, 45 women and 27 men; age range 15-78 with a mean age of 47 years. In the group A (Merocel group), 21 cases showed grade 1 bleeding (58%), 11 cases grade 2 (30%) and 4 patients grade 0 (11.1%). In the group B (BNP group), 29 cases showed grade 0 bleeding (80.56%) and 7 cases showed grade 1 bleeding (19.44%). There was a statistical significant difference between the Merocel group and the BNP group in terms of bleeding after removal of packing material (p < 0.05). In the group A, 16 patients developed mild adhesion (44%), 8 patients moderate adhesion (22.2%), 3 patients severe adhesion (8.33%) and 1 patient very severe adhesion (2.77%). BNP nasal packing didn't cause any adhesion in 25 patients (69.4%), 11 patients developed mild adhesion (30.5%). So there was a statistical significant difference between group A and group B regarding the adhesion (p < 0.05). There was a statistically significance reduction of nasal secretions and crusts at a week after surgery in the BNP group vs. Merocel group. The difference is not statistically significant 4 weeks after surgery. About the severity of symptoms related to nasal packing, we found a statistically significant difference (p < 0.05) between Merocel and BNP group regarding the pain during packing removal, the general satisfaction and the pressure. CONCLUSIONS Biodegradable nasopore reduced pain and patient discomfort during packing removal and causes less bleeding compared to Merocel hemox 10 cm. This type of material can be used after septoturbinolplasty.
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Affiliation(s)
- A Romano
- Division of Maxillofacial Surgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
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