Preoperative digital three-dimensional planning for rhinoplasty

BACKGROUND: This report describes preoperative digital planning for rhinoplasty using a new three-dimensional (3D) radiologic viewer that allows both patients and surgeons to visualize on a common monitor the 3D real aspect of the nose in its inner and outer sides. METHODS: In the period 2002 to 2008, 210 patients underwent rhinoplasty procedures in the authors' clinic. The patients were randomly divided into three groups according to the type of preoperative planning used: photos only, a simulated result by Adobe Photoshop, or the 3D radiologic viewer. The parameters evaluated included the number of patients that underwent surgery after the first consultation, the number of patients who asked for a reintervention, patient satisfaction (according to a test given to the patients 12 months postoperatively), the surgical time required for a functional intervention, and the improvement in nasal function by postoperative rhinomanometry and subjective evaluation. RESULTS: Computer-aided technologies led to a higher number of patients deciding to undergo a rhinoplasty. Simulation of the postoperative results was not as useful in the postoperative period due to the higher number of reintervention requests. CONCLUSION: The patients undergoing rhinoplasties preferred new technologies in the preoperative period. The advantages of using the 3D radiologic viewer included improved preoperative planning, reduction in intraoperative stress, a higher number of patients undergoing surgery, reduction in postoperative surgical corrections, reduction in surgical time for the functional intervention, a higher rate of improvement in nasal function, a higher percentage of postoperative satisfaction, and reduced costs

Autologous fat grafting in facial volumetric restoration

The authors reported their surgical experience about structural fat grafting in the management of facial volumetric deficit. The purpose of this study was to assess the real indications, cosmetic results, complications, and global patient satisfaction of the Coleman technique in redefining facial contours in congenital and postoperative deformities. A retrospective analysis of 32 patients grafted according to Coleman's technique was performed, and the long-term outcomes and patient satisfaction were evaluated. The mean postoperative clinical follow-up was 14 months. The morphological changes were analyzed by comparing the photographic presurgical facial contour and the postoperative correction of soft tissue defects. All consecutive cases reported showed a progressive fat resorption for 3 months after surgery and its stable integration only after this period. Best results were performed in the treatment of genetically determined syndromes, such as the Franceschetti and Romberg syndromes. The authors suggest this surgical technique also for the treatment of unaesthetic cutaneous abscess cavity after incision and drainage. Unsatisfactory outcomes were obtained in the treatment of the posttraumatic facial scar, which needed more surgical procedures

PIEZOELECTRIC BONE SURGERY IN THE TREATMENT OF AN OSTEOMA ASSOCIATED WITH AN IMPACTED INFERIOR THIRD MOLAR: A CASE REPORT

Operative removal of impacted mandibular third molars is a common and not riskless surgical procedure. We present an emblematic case of an osteoma closely associated with an impacted third left mandibular molar treated by Mectron Piezosurgery medical ultrasonic device

Vertiginous crisis following temporomandibular joint athrocentesis: a case report

Temporomandibular joint arthrocentesis and arthroscopy have recently exceeded open surgeries for disorders that failed to respond to conservative treatment. The efficacy of arthrocentesis in reestablishing normal mouth opening and reducing pain and dysfunctions is now commonly accepted, but in contrast to arthroscopy, there are no large series studies on arthrocentesis complications. We report the major complication occurred in our experience: a case of a patient that complained of a violent vertigo, without hearing disorders, following the procedure

Mandibular coronoid process tumor resembling a mandibular condyle: A case report

Abnormal elongation of mandibular coronoid process, often defined as coronoid hyperplasia, is a rare condition, which is frequently associated with limited mouth opening. In some cases, the enlarged coronoid pushes the zygoma forward causing facial asymmetry. This case report describes a 16-year-old boy whose chief complaint was a progressive difficulty and deviation in mouth opening, together with a deformity appearing at maximum opening at the zygomatic area. The diagnosis was Unilateral Accessory Mandibular Condyle at coronoid process, without reduction of the mouth opening capacity. A coronoidectomy was carried out by means of piezoelectric surgery, instead of a coronoidotomy which is usually performed in these cases, due to a suspect of ramus neoplasm. Keywords: Coronoid hyperplasia, Accessory condyle, Temporomandibular disorder, Piezoelectric surgery, Adolescen

Sphenopalatine ganglion deficit syndrome: An unusual complication after septoplasty

Abstract Background In 1908 Sluder described a clinical picture of unilateral facial pain, lachrymation, rhinorrhea and mucosal congestion deriving from the Sphenopalatine Ganglion (SPG) irritation. We described a case of monolateral xerophthalmia, dry palate and mouth, deriving from SPG lesion after septoplasty that we called "SPG Deficit Syndrome". Methods In our study a woman complaining functional nasal disorders and Computer Tomography (CT) images of a huge condro-vomerian septal spur in right nasal cavity, was underwent to septoplasty. After surgery she complained monolateral xerophthalmia, xerostomia and migraine. Results We formulated hypothesis of parasympathetic postgangliar nerve transmission interruption due to a lesion of effector fibers, supported by post-operative CT images of posterior wall of maxillary sinus lesion and by endoscopic evaluation of dryness of palatal mucosa and right nasal cavity. Conclusion To the best of our knowledge this is the first case of this kind of symptomatology reported as complication after septoplasty

The mandibular condyle as uncommon metastatic site of neuroendocrine carcinoma: Case report and review of literature

Temporo-mandibular joint (TMJ) metastases are a very rare event and only 73 cases are reported in literature. In about 40% of cases condylar metastases represent the first clinical manifestation of a tumor of elsewhere and may then allow an early diagnosis. However, the identification of this tumoral process can be difficult as in over 50% of the cases it has a nuanced clinical presentation that is very similar to temporo-mandibular disorders. The first case of metastatic neuroendocrine carcinoma (NEC) of the temporo-mandibular joint (TMJ) mimicking a temporo-mandibular joint disorder is presented in this report. Furthermore, an extensive review of the literature has been performed in order to establish a correct diagnosticâ\u80\u93therapeutic protocol for these oncologic patients