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Article: Orbital Exenteration in Recurrence Cancer: 5 Years Experience.

Barbera, Giorgio / Todaro, Mattia / Saponaro, Gianmarco / Gasparini, Giulio / Moro, Alessandro

2023 Volume 12, Issue 19

Abstract: Introduction: The purpose of this study was to assess the overall survival (OS) and disease-free survival (DFS) of patients who underwent orbital exenteration for periorbital, conjunctival, and primary intraorbital carcinomas. Additionally, we assessed ... ...

Abstract	Introduction: The purpose of this study was to assess the overall survival (OS) and disease-free survival (DFS) of patients who underwent orbital exenteration for periorbital, conjunctival, and primary intraorbital carcinomas. Additionally, we assessed the outcomes of anterior retrograde temporalis muscle flap restoration. Methods: For all patients who had orbital exenteration in the previous five years, a non-comparative retrospective assessment of their medical records, histology, and radiographic imaging was carried out. We investigated the relationships between the various qualitative factors using Cramer's V Kaplan-Meier (KM) analysis. For each of the patient's categorical factors that were of relevance, estimates of the survival distribution were displayed, and log-rank tests were used to determine whether the survival distributions were equal. Results: This study looks at 19 participants. The sample is made up of 13 men (68%) and 6 women (32%). The degree of relationship (Cramer's V index) between lymph node metastases (N) and the existence of distant metastases (M) is high, at 64%, and is statistically significant because the Conclusion: Our findings show how crucial it is to identify any lymph node involvement that orbital neoplasms may have. In patients who have received many treatments, sentinel lymph node biopsy (SLNB) may be used to determine the stage and spread of the cancer. To determine whether additional tumor characteristics may be explored, more expertise in the SLNB field for patients with orbital cancer who have received many treatments may be helpful. To prevent additional scarring and to be comparable to previous techniques for facial nerve lesions, the anterior retrograde approach and the transorbital procedure for temporal muscle flap in-setting are both effective methods.
Language	English
Publishing date	2023-09-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12196180
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Article ; Online: Patient-Specific Facial Implants in Polyetheretherketone and Their Stability: A Preliminary Study.

Saponaro, Gianmarco / Todaro, Mattia / Barbera, Giorgio / Scivoletto, Giulia / Foresta, Enrico / Gasparini, Giulio / Moro, Alessandro

Annals of plastic surgery

2023 Volume 90, Issue 6, Page(s) 564–567

Abstract: Background: Polyetheretherketone (PEEK) is a synthetic material with many favorable characteristics; PEEK implants are increasingly used for a variety of applications ranging from cranioplasty to orthopedic surgery and facial implants.: Methods: This ...

Abstract	Background: Polyetheretherketone (PEEK) is a synthetic material with many favorable characteristics; PEEK implants are increasingly used for a variety of applications ranging from cranioplasty to orthopedic surgery and facial implants. Methods: This study is a retrospective review of patients who underwent PEEK implant placement in our department over the last 5 years. Polyetheretherketone computer-aided design and manufacture facial implants were designed from high-resolution computed tomography (CT) scans of each patient. The implants placed were onlay implants used for facial rehabilitation purposes to correct malformative and posttraumatic malformations. Results: Twenty-eight consecutive patients (11 males and 17 females) underwent PEEK implant positioning between January 2015 and December 2020. Common indications were anterior plagiocephaly, hemifacial microsomia, and residual facial imbalance after orthognathic surgery. No complications of implant breakdown, exposure, infection, or displacement were noticed during the follow-up period. During routine controls on 3 patients, we requested a craniomaxillofacial CT scan for reasons unrelated to the implanted prostheses. The CT scans were all high resolution (<1-mm slices). The CT images indicated that bone was starting to form around the implant in all 3 patients as well as in the penetrating holes that were planned in the implants. Conclusions: In our experience, computer-designed, patient-specific PEEK onlay implants are a valid option for the treatment of malformative and posttraumatic malformations. This is, to the best of our knowledge, the first clinical report on bone reaction to PEEK implantation in the maxillofacial field. Moreover, based on the signs of bone regrowth that we observed in CT controls we can presume that the design of this type of prosthesis can probably take advantage of some technical stratagems not yet codified and fully exploited. Despite our preliminary favorable results, further multicentric and comparative studies are necessary to evaluate outcomes and better understand the behavior of this promising material and thus optimize its use in craniomaxillofacial surgery.
MeSH term(s)	Male ; Female ; Humans ; Polymers ; Polyethylene Glycols/therapeutic use ; Benzophenones ; Ketones/therapeutic use ; Prostheses and Implants
Chemical Substances	polyetheretherketone (31694-16-3) ; Polymers ; Polyethylene Glycols (3WJQ0SDW1A) ; Benzophenones ; Ketones
Language	English
Publishing date	2023-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003527
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Zs.A 1419: Show issues

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Article: Our problems and observations in 3D facial implant planning.

Saponaro, Gianmarco / Paolantonio, Chiara / Barbera, Giorgio / Foresta, Enrico / Gasparini, Giulio / Moro, Alessandro

Maxillofacial plastic and reconstructive surgery

2022 Volume 44, Issue 1, Page(s) 32

Abstract: Background: Three-dimensional renderings of two-dimensional computed tomography data have allowed for more precise analysis in the craniofacial field. Design, engineering, architecture, and other industries have paved the way for the manipulation and ... ...

Abstract	Background: Three-dimensional renderings of two-dimensional computed tomography data have allowed for more precise analysis in the craniofacial field. Design, engineering, architecture, and other industries have paved the way for the manipulation and printing of three-dimensional objects. The usual planning is only carried out based on the bony structures, often without taking into consideration the presence of soft tissues and soft structures. During our practice, we have found ourselves facing the challenge posed by these structures; the aim of this article is to discuss our experience in designing implants presenting our tips and tricks for a better planning leading to an easy and reliable positioning. Case presentation: We have retrieved all patients in 5 years among those who underwent computer-aided design/computer-aided manufacturing implant placement in the last 5 years in order to review the eventual problems and the solutions found. A total number of 25 patients were retrieved and, among them, 10 patients were selected, in which planning inaccuracy caused difficulties during implant placement and which then led to induced changes during the planning of similar cases or in which the problems were noted before or during the planning which led to changes in the plan to address those problems. Six of the selected cases were polyetheretherketone facial implants for the correction of residual deformities in malformed or deformed patients. One case was a delayed orbital reconstruction with a titanium implant. Two cases were titanium functional and anatomical reconstruction of the mandible in patients with failed post-oncological reconstructions. There was 1 case with a mandibular ramus complex and hard-to-treat fracture. Conclusions: The planning of the implant mostly relies on hard tissue three-dimensional reconstruction, but it should not be limited at what is immediately evident. A surgeon's clinical experience should always guide the process, with knowledge of the patient's anatomy and evaluation of the quality and of the soft tissue response being taken into consideration. The implant should always be tailored not only based on the bone defect and evaluations but also using the patient's previewed and actual anatomy, evaluating eventual interferences and pitfalls.
Language	English
Publishing date	2022-10-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2815852-0
ISSN	2288-8101 ; 2288-8586
ISSN	2288-8101 ; 2288-8586
DOI	10.1186/s40902-022-00362-6
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Article ; Online: Patient First: Surgery First and More.

Azzuni, Camillo / Moro, Alessandro / Saponaro, Gianmarco / Gasparini, Giulio / Soverina, Davide / Barbera, Giorgio / Pelo, Sandro

The Journal of craniofacial surgery

2021 Volume 32, Issue 8, Page(s) e751–e754

Abstract: Introduction: The success of surgery first approach has been defined by the number of advantages offered and is definitively determined by the satisfaction of the patients themselves. The strength of this protocol resides in its philosophy that puts the ...

Abstract	Introduction: The success of surgery first approach has been defined by the number of advantages offered and is definitively determined by the satisfaction of the patients themselves. The strength of this protocol resides in its philosophy that puts the patient at the center of the whole diagnostic-therapeutic process. The compliance of the patient, its happiness and comfort are the best guarantee of a good final results. While pursuing this philosophy we have wondered whether there was way to increase the comfort of surgery first approach even more and to make it even more appealing for the patients. For these reasons, we have decided to work on a preliminary protocol in order to reduce or even eliminate the use of orthodontic braces and wires during perioperative stages. Materials and Methods: No orthodontic braces or wires are bonded on the teeth before surgery. Intraoperatory intermaxillary fixation (IMF) is carried out with the use of IMF screws which are positioned at the beginning of the operation on the edge between keratinized and nonkeratinized gingiva. Once the osteotomies are performed IMF with IMF screws is carried out on the planned occlusion with the use of surgical splints.Discussion and Conclusions: In selected cases the postsurgical orthodontic treatment can be carried out with the use of clear aligners, completely eliminating the need of braces and wires with an additional level of comfort.
MeSH term(s)	Bone Screws ; Bone Wires ; Fracture Fixation, Internal ; Humans ; Jaw Fixation Techniques ; Osteotomy
Language	English
Publishing date	2021-11-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1159501-2
ISSN	1536-3732 ; 1049-2275
ISSN (online)	1536-3732
ISSN	1049-2275
DOI	10.1097/SCS.0000000000007766
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Zs.A 3761: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Three-Dimensional Comparison of the Maxillary Surfaces through ICP-Type Algorithm: Accuracy Evaluation of CAD/CAM Technologies in Orthognathic Surgery.

Cassoni, Andrea / Manganiello, Luigi / Barbera, Giorgio / Priore, Paolo / Fadda, Maria Teresa / Pucci, Resi / Valentini, Valentino

International journal of environmental research and public health

2022 Volume 19, Issue 18

Abstract: Purpose: This retrospective study aims to compare the accuracy of two different CAD/CAM systems in orthognathic surgery. The novelty of this work lies in the method of evaluating the accuracy, i.e., using an Iterative Closest Point (ICP) algorithm, ... ...

Abstract	Purpose: This retrospective study aims to compare the accuracy of two different CAD/CAM systems in orthognathic surgery. The novelty of this work lies in the method of evaluating the accuracy, i.e., using an Iterative Closest Point (ICP) algorithm, which matches a pair of 2D or 3D point clouds with unknown dependencies of the transition from scan Methods: The study population was composed of ten patients who presented to the Maxillofacial Surgery Department of the University "Sapienza" of Rome for the evaluation and management of skeletal malocclusions. The patients were divided into two groups, depending on the technique used: group 1: splintless group (custom-made cutting guide and plates); group 2: splint group (using a 3D-printed splint). STL files were imported into Geomagic Results: Group 1 showed a 3D error of 1.22 mm ± SD 0.456, while group 2 showed a 3D error of 1.63 mm ± SD 0.303. These results have allowed us to compare the accuracy of the two CAD/CAM systems ( Conclusions: The ICP algorithm provided a reproducible method of comparison. The splintless method would seem more accurate (
MeSH term(s)	Algorithms ; Computer-Aided Design ; Humans ; Imaging, Three-Dimensional ; Maxilla/diagnostic imaging ; Maxilla/surgery ; Orthognathic Surgery ; Retrospective Studies ; Surgery, Computer-Assisted/methods
Language	English
Publishing date	2022-09-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph191811834
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Article ; Online: Endoscopy-Assisted Intraoral Removal of Elongated Styloid Process: Mini-Invasive Surgical Treatment of Eagle Syndrome.

Terenzi, Valentina / Giovannetti, Filippo / Barbera, Giorgio / Raponi, Ingrid / Valentini, Valentino

The Journal of craniofacial surgery

2019 Volume 30, Issue 8, Page(s) e775–e776

Abstract: The aim of this work is to illustrate a transoral mini-invasive approach to safely remove elongated styloid process in Eagle syndrome. A 34-year-old Asian male came to our center referring pharyngeal and cervical pain on the right side on swallowing and ... ...

Abstract	The aim of this work is to illustrate a transoral mini-invasive approach to safely remove elongated styloid process in Eagle syndrome. A 34-year-old Asian male came to our center referring pharyngeal and cervical pain on the right side on swallowing and opening the mouth. Computed tomography showed elongation of the right styloid process. Surgical removal was performed through endoscopy-assisted intraoral approach using a pituitary curette to perform dissection and piezosurgery for the osteotomy. Surgical intervention was completed in 25 minutes. Postoperative period was uneventful except for transient (12 hours) right facial palsy that resolved spontaneously. Two months after surgery, patient referred resolution of symptoms. This technique is easy to perform and permits to obtain good result with reduction of surgical time and with low risk of complication.
MeSH term(s)	Adult ; Humans ; Male ; Neck Pain/etiology ; Neuroendoscopy ; Ossification, Heterotopic/diagnostic imaging ; Ossification, Heterotopic/surgery ; Osteotomy ; Piezosurgery ; Temporal Bone/abnormalities ; Temporal Bone/diagnostic imaging ; Temporal Bone/surgery ; Tomography, X-Ray Computed
Language	English
Publishing date	2019-07-11
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1159501-2
ISSN	1536-3732 ; 1049-2275
ISSN (online)	1536-3732
ISSN	1049-2275
DOI	10.1097/SCS.0000000000005767
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Zs.A 3761: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 175: Show issues

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Article ; Online: Secondary Rhinoplasty in Binder Syndrome: Considerations and Management of Complex Problem With Heterologous Bone Graft.

Barbera, Giorgio / Raponi, Ingrid / Nocini, Riccardo / Della Monaca, Marco / Priore, Paolo / Valentini, Valentino

The Journal of craniofacial surgery

2020 Volume 32, Issue 1, Page(s) e5–e8

Abstract: Abstract: Binder Syndrome occurs in less than 1 per 10,000 live births. Mean features of the syndrome include arhinoid face, abnormal position of the nasal bones, intermaxillary hypoplasia with associated malocclusion, reduced or absent anterior nasal ... ...

Abstract	Abstract: Binder Syndrome occurs in less than 1 per 10,000 live births. Mean features of the syndrome include arhinoid face, abnormal position of the nasal bones, intermaxillary hypoplasia with associated malocclusion, reduced or absent anterior nasal spine, atrophy of the nasal mucosa and absence of the frontal sinus. Treatment of these facial deformities is obviously surgical. In the present work, the authors describe, step by step, their technique in secondary rhinoplasty in a 36-years-old patient affected by Binder Syndrome. In this case, the authors used autologous cartilage graft and heterologous bone graft.Satisfying results are achieved in 12 months of follow-up: graft resorption is acceptable, position of the graft is stable, the authors have no signs of infection and the patient is satisfied with the aesthetical and functional results. The authors believe that the first option, in complex nose's reconstruction, is the use of autologous grafts but, the use of cartilage heterologous bone graft should be taken in account, in the future, as a secondary option in Binder Syndrome and in malformed patients.
MeSH term(s)	Adult ; Humans ; Maxillofacial Abnormalities/surgery ; Nose/surgery ; Retrospective Studies ; Rhinoplasty
Language	English
Publishing date	2020-07-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	1159501-2
ISSN	1536-3732 ; 1049-2275
ISSN (online)	1536-3732
ISSN	1049-2275
DOI	10.1097/SCS.0000000000006789
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Zs.A 3761: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 175: Show issues

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Article ; Online: Odontogenic-Related Head and Neck Infections: From Abscess to Mediastinitis: Our Experience, Limits, and Perspectives-A 5-Year Survey.

Pucci, Resi / Cassoni, Andrea / Di Carlo, Daniele / Bartolucci, Piero / Della Monaca, Marco / Barbera, Giorgio / Di Cosola, Michele / Polimeni, Antonella / Valentini, Valentino

International journal of environmental research and public health

2023 Volume 20, Issue 4

Abstract: Background: Head and neck infections are commonly caused by affections with an odontogenic origin. Untreated or non-responsive to treatment odontogenic infections can cause severe consequences such as localized abscesses, deep neck infections (DNI), and ...

Abstract	Background: Head and neck infections are commonly caused by affections with an odontogenic origin. Untreated or non-responsive to treatment odontogenic infections can cause severe consequences such as localized abscesses, deep neck infections (DNI), and mediastinitis, conditions where emergency procedures such as tracheostomy or cervicotomy could be needed. Methods: An epidemiological retrospective observational study was performed, and the objective of the investigation was to present a single-center 5-years retrospective analysis of all patients admitted to the emergency department of the hospital Policlinico Umberto I "Sapienza" with a diagnosis of odontogenic related head and neck infection, observing the epidemiological patterns, the management and the type of surgical procedure adopted to treat the affections. Results: Over a 5-year period, 376,940 patients entered the emergency room of Policlinico Umberto I, "Sapienza" University of Rome, for a total of 63,632 hospitalizations. A total of 6607 patients were registered with a diagnosis of odontogenic abscess (10.38%), 151 of the patients were hospitalized, 116 of them were surgically treated (76.8%), and 6 of them (3.9%) manifested critical conditions such as sepsis and mediastinitis. Conclusions: Even today, despite the improvement of dental health education, dental affections can certainly lead to acute conditions, necessitating immediate surgical intervention.
MeSH term(s)	Humans ; Abscess/diagnosis ; Abscess/etiology ; Abscess/surgery ; Retrospective Studies ; Mediastinitis/diagnosis ; Mediastinitis/etiology ; Mediastinitis/surgery ; Neck ; Communicable Diseases
Language	English
Publishing date	2023-02-16
Publishing country	Switzerland
Document type	Observational Study ; Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20043469
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Article ; Online: Reconstruction of the mandibular symphysis: pilot study compares three different flaps.

Barbera, Giorgio / Della Monaca, Marco / Manganiello, Luigi / Battisti, Andrea / Priore, Paolo / Cassoni, Andrea / Terenzi, Valentina / Valentini, Valentino

Minerva dental and oral science

2021 Volume 71, Issue 3, Page(s) 139–148

Abstract: Background: Restoration of mandibular continuity, functionality and attempting to return to the patient's premorbid state is the ultimate goal of reconstruction. Some studies compare different flaps, but the reconstructed portions vary and there is ... ...

Abstract	Background: Restoration of mandibular continuity, functionality and attempting to return to the patient's premorbid state is the ultimate goal of reconstruction. Some studies compare different flaps, but the reconstructed portions vary and there is little consensus on the best option for a particular defect. Methods: This pilot study compares three different reconstructive options with free flaps. We will analyze the accuracy of the reconstruction, the postoperative complications related to the reconstruction, the morbidity of the donor site. This pilot study compares three different reconstructive options with free flap in the reconstruction of the mandibular symphysis: iliac crest, scapula and fibula. Results: In our sample the morbidity of the donor site was overlapping, as for all three choices free from complications. In post resection edentulous patients, the fibula seems to guarantee better positioning, while in patients with residual occlusion the iliac crest seems to allow a more congruous repositioning. The fibula seems to have a superiority over the other flaps in terms of accuracy in all types of patients. Conclusions: Contrary to the most recent work on the accuracy of CAD/CAM, we have analyzed the error in the reconstruction of a specific segment and in the repositioning of the residual mandibular component without the use of guided computer programming.
MeSH term(s)	Adult ; Female ; Fibula/surgery ; Free Tissue Flaps ; Humans ; Ilium/surgery ; Male ; Mandible/surgery ; Middle Aged ; Pilot Projects
Language	English
Publishing date	2021-12-01
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3062693-6
ISSN	2724-6337
ISSN (online)	2724-6337
DOI	10.23736/S2724-6329.21.04597-6
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Zs.B 159: Show issues

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Article ; Online: Minimally-Invasive Endoscopic-Assisted Sinus Augmentation.

Giovannetti, Filippo / Raponi, Ingrid / Priore, Paolo / Macciocchi, Antonio / Barbera, Giorgio / Valentini, Valentino

The Journal of craniofacial surgery

2019 Volume 30, Issue 4, Page(s) e359–e362

Abstract: Objectives: The purpose of this article is to evaluate endoscopic-assisted technique by lateral approach for sinus floor augmentation, to reduce the incidence of Schneiderian membrane perforation, and to guarantee a sufficient apposition of new bone ... ...

Abstract	Objectives: The purpose of this article is to evaluate endoscopic-assisted technique by lateral approach for sinus floor augmentation, to reduce the incidence of Schneiderian membrane perforation, and to guarantee a sufficient apposition of new bone even in the posterior maxillary sinus. Methods: From January 2017 to December 2017, 10 patients affected by severe maxillary atrophy underwent endoscopic-assisted sinus augmentation using a lateral approach. Results: In only 1 patient, a little perforation of sinus membrane was observed intraoperatively and it was repaired. No abnormal postoperative bleeding was observed. None of the patients experienced oro-antral fistula, infection, or V2 dysesthesia. The authors did not find radiologic evidences of biomaterial displaced on the maxillary sinus or postoperative sinusitis. Conclusions: The authors evaluated endoscopic-assisted maxillary sinus augmentation technique using a lateral approach that allows a direct and clear view of the surgical field. This technique, as the preliminary results demonstrate, is safe and helpful, especially in avoiding membrane perforation and in xenograft optimal distribution. It could be very useful in retreatment patients.
MeSH term(s)	Endoscopy/adverse effects ; Endoscopy/methods ; Humans ; Maxillary Diseases/surgery ; Maxillary Sinus/surgery ; Postoperative Complications/prevention & control ; Sinus Floor Augmentation/adverse effects ; Sinus Floor Augmentation/methods
Language	English
Publishing date	2019-02-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1159501-2
ISSN	1536-3732 ; 1049-2275
ISSN (online)	1536-3732
ISSN	1049-2275
DOI	10.1097/SCS.0000000000005365
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