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  1. Article ; Online: Cavernous sinus metastasis in head and neck cancer: Focus on oral squamous cell cancer.

    Segna, E / Civita, F / Denaro, N / Beltramini, G A

    Oral oncology

    2024  Volume 152, Page(s) 106784

    Abstract: Intracranial metastatic disease is rarely found in head and neck cancer (HNC), in particular, cavernous sinus (CS) involvement is difficult to recognize, because of its rarity, not specific symptoms associated and challenging imaging features. We report ... ...

    Abstract Intracranial metastatic disease is rarely found in head and neck cancer (HNC), in particular, cavernous sinus (CS) involvement is difficult to recognize, because of its rarity, not specific symptoms associated and challenging imaging features. We report our experience in 4 cases, reviewing also the English literature. We analysed data from 21 patients showing that CS metastasis is a dramatic event, with rapid onset, usually starting with neurological manifestations (ophthalmoplegia, headache and trigeminal dysesthesia) and almost unavoidable outcome (DOD in 18/21 patients). Furthermore, we assessed that the diagnostic confirmation could be difficult to perform because of the need for multiple exams and time consuming procedures. Unfortunately, usual antineoplastic therapies seem to be not effective in prolonging survival, also because patients are already weakened by primary tumour treatments. The only option that seems useful in improving outcomes is immunotherapy.
    Language English
    Publishing date 2024-04-08
    Publishing country England
    Document type Letter
    ZDB-ID 1120465-5
    ISSN 1879-0593 ; 0964-1955 ; 1368-8375
    ISSN (online) 1879-0593
    ISSN 0964-1955 ; 1368-8375
    DOI 10.1016/j.oraloncology.2024.106784
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    Zs.A 4869: Show issues Location:
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    Zs.A 456: Show issues Location:
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  2. Article: Sonidegib in Locally Advanced Basal Cell Carcinoma: A Monocentric Retrospective Experience and a Review of Published Real-Life Data.

    Nazzaro, Gianluca / Benzecry, Valentina / Mattioli, Maria A / Denaro, Nerina / Beltramini, Giada A / Marzano, Angelo V / Passoni, Emanuela

    Cancers

    2023  Volume 15, Issue 14

    Abstract: Basal cell carcinoma (BCC) represents the most common skin cancer and locally advanced BCC (laBCC) refers to an aggressive, large, infiltrative BCC that cannot be treated by surgery or radiotherapy. Sonidegib is a Hedghehog inhibitor (HHi) indicated for ... ...

    Abstract Basal cell carcinoma (BCC) represents the most common skin cancer and locally advanced BCC (laBCC) refers to an aggressive, large, infiltrative BCC that cannot be treated by surgery or radiotherapy. Sonidegib is a Hedghehog inhibitor (HHi) indicated for laBCC. This is a monocentric retrospective real-life study of laBCCs receiving Sonidegib treatment. Although Sonidegib is widely used, since its approval by Food and Drug Administration in 2015, only a limited number of real-life experiences have been reported. Eleven patients, including four patients diagnosed with Basal Cell Naevus syndrome, received treatment with Sonidegib for laBCCs. Seven (63.6%) patients experienced adverse events (AEs) but only three had to discontinue treatment and were therefore excluded from the following results. Four patients (50%) achieved complete clinical remission (CR); in all cases the remission was confirmed by biopsy. Partial response (PR) was found in three patients out of eight (37.5%). One patient out of eight (12.5%) showed a steady disease (SD). None of the patients showed signs of progression during treatment with HHi. Sonidegib showed the same efficacy in treating laBCCs as already seen in trials. All four patients suffering from Basal Cell Naevus syndrome achieved disease control by being treated with Sonidegib. Consequently, we strongly advise the joint management of laBCCs through a multidisciplinary team whenever feasible.
    Language English
    Publishing date 2023-07-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers15143621
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  3. Article: Clinical and functional outcomes of cad/cam mandibular reconstruction with free fibular flap comparing traditional versus micro-invasive intraoral surgical approaches.

    Bolzoni, A R / Pollice, A / Nuti, M / Baj, A / Rossi, D S / Beltramini, G A

    Journal of biological regulators and homeostatic agents

    2021  Volume 34, Issue 5 Suppl. 3, Page(s) 175–184. Technology in Medicine

    Abstract: The surgical incision plays a pivotal role in any surgical procedure. A good surgical approach should allow optimal visualization, respect the anatomy and ensure the best aesthetic outcome possible, especially when the lesions involve the face. In this ... ...

    Abstract The surgical incision plays a pivotal role in any surgical procedure. A good surgical approach should allow optimal visualization, respect the anatomy and ensure the best aesthetic outcome possible, especially when the lesions involve the face. In this retrospective study, carried out from June 2014 to April 2018, different types of surgical approaches to perform mandibular reconstruction were compared. Twentyone patients who underwent mandibular reconstruction with free fibular flap (FFFs) using CAD-CAM technology and Virtual Surgical Planning (VSP) were included in the study, regardless the condition, the timing of reconstruction (primary vs secondary), the number of fibular segments or the type and size of the mandibular defect. The patients were treated for mandibular defects secondary to benign or low-grade oncological lesions and different non-oncological conditions. However, patients requiring neck dissection were excluded from the study. Patients were divided into two groups according to the type of surgical approach used: 7 patients received a traditional transcervical approach together with an intraoral approach, while 14 patients were operated through an intraoral approach combined with different microinvasive approaches, including the sub-mandibular, the retro-mandibular and the preauricular approaches. Different factors were statistically compared: characteristics of the harvested fibula, surgical timing, days of hospitalization, as well as complication, functional and aesthetic outcomes. According to this study, no statistically significant differences were observed between the two groups in any of the features considered. These results support the hypothesis that the combination of different microinvasive approaches and the traditional approach are superimposable, and they can be safely exchanged when the underlying defects allow it.
    MeSH term(s) Computer-Aided Design ; Fibula/surgery ; Free Tissue Flaps/surgery ; Humans ; Mandible/surgery ; Mandibular Reconstruction ; Reconstructive Surgical Procedures ; Retrospective Studies
    Language English
    Publishing date 2021-01-01
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 639196-5
    ISSN 1724-6083 ; 0393-974X
    ISSN (online) 1724-6083
    ISSN 0393-974X
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    Zs.A 2270: Show issues Location:
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  4. Article: Cemiplimab in Ultra-Octogenarian Patients with Cutaneous Squamous Cell Carcinoma: The Real-Life Experience of a Tertiary Referral Center.

    Denaro, Nerina / Passoni, Emanuela / Indini, Alice / Nazzaro, Gianluca / Beltramini, Giada Anna / Benzecry, Valentina / Colombo, Giuseppe / Cauchi, Carolina / Solinas, Cinzia / Scartozzi, Mario / Marzano, Angelo Valerio / Garrone, Ornella

    Vaccines

    2023  Volume 11, Issue 9

    Abstract: Background: The incidence of cutaneous squamous cell carcinoma (cSCC) is rapidly increasing, paralleling the aging of the population. cSCC predominantly affects chronically sun-exposed areas, such as the head and neck region. At our tertiary center, a ... ...

    Abstract Background: The incidence of cutaneous squamous cell carcinoma (cSCC) is rapidly increasing, paralleling the aging of the population. cSCC predominantly affects chronically sun-exposed areas, such as the head and neck region. At our tertiary center, a multidisciplinary approach to non-melanoma skin cancer is provided for locally advanced cSCC.
    Methods: We retrospectively revised all patients with locally advanced/metastatic cSCC treated with anti-PD1 antibody (Cemiplimab) at our Institution from January 2020 to March 2023 (minimum follow-up of 4 months on treatment).
    Results: Overall, we consecutively treated 20 ultra-octogenarian patients, of whom 15 were males and 5 were females (median age: 86.9 years). Despite age, a median number of concomitant drugs, and comorbidities, efficacy, and safety were superimposable with the available literature. No patients reported treatment-related adverse events of grade 3 or higher. Grade 2 adverse events were reported in 25% of patients. Overall, the response rate was 65%, with 50% partial responses and 20% long-lasting stable disease. The median duration of response was 14 months. The G8 elderly score was assessed in all patients, and the median score was 12 (range 9-14).
    Conclusions: Among ultra-octogenarian patients, a clinical benefit from Cemiplimab was obtained in most, including tumor shrinkage and pain relief. Cemiplimab confirmed its effectiveness in elderly patients in a real-life setting, with no new safety concerns.
    Language English
    Publishing date 2023-09-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2703319-3
    ISSN 2076-393X
    ISSN 2076-393X
    DOI 10.3390/vaccines11091500
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  5. Article ; Online: Factors influencing CAD/CAM accuracy in fibula free flap mandibular reconstruction.

    Sweed, Ahmed Hassan / Bolzoni, Alessandro Remigio / Kadubiec, Aleksandra / Beltramini, Giada Anna / Cherchi, Alessandro / Baj, Alessandro

    Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale

    2020  Volume 40, Issue 2, Page(s) 138–143

    MeSH term(s) Adolescent ; Adult ; Aged ; Computer-Aided Design ; Female ; Fibula/surgery ; Free Tissue Flaps ; Humans ; Male ; Mandibular Reconstruction/instrumentation ; Mandibular Reconstruction/methods ; Middle Aged ; Patient Care Planning ; Retrospective Studies ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2020-05-29
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 604898-5
    ISSN 1827-675X ; 0392-100X
    ISSN (online) 1827-675X
    ISSN 0392-100X
    DOI 10.14639/0392-100X-N0400
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    Zs.B 2608: Show issues Location:
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  6. Article ; Online: The Effect of Orthognathic Surgery on Soft-Tissue Facial Asymmetry: A Longitudinal Three-Dimensional Analysis.

    Da Pozzo, Filippo / Gibelli, Daniele / Beltramini, Giada A / Dolci, Claudia / Giannì, Aldo Bruno / Sforza, Chiarella

    The Journal of craniofacial surgery

    2020  Volume 31, Issue 6, Page(s) 1578–1582

    Abstract: In modern orthognathic surgery, the functional results cannot disregard a good aesthetic outcome. In this study, a stereophotogrammetric longitudinal analysis of the symmetry of facial thirds was performed in 18 patients affected by Class III skeletal ... ...

    Abstract In modern orthognathic surgery, the functional results cannot disregard a good aesthetic outcome. In this study, a stereophotogrammetric longitudinal analysis of the symmetry of facial thirds was performed in 18 patients affected by Class III skeletal malocclusion, with clinical asymmetry, treated with a bimaxillary osteotomy. Their 3-dimensional facial images were acquired in the preoperative phase and 6, 12, and 24 months after surgery, and compared to those obtained in a control group of 23 subjects with Class I skeletal occlusion, without clinical asymmetry and no history of traumas or alterations at the maxillo-facial area. Images of the hemi-faces of the subjects were divided into thirds (upper, middle, lower), mirrored and superimposed to their contralateral ones; soft-tissue facial symmetry was obtained as the root mean square distance between the hemi-faces in the three thirds.In patients, no significant differences in facial symmetry (root mean square distance) were found among the study time points (analysis of variance, P > 0.05); the lower facial third was more asymmetric than the upper one (Tukey honestly significant difference P < 0.05). Patients were significantly more asymmetric than the control subjects (Student t, P < 0.05). In conclusion, patients with Class III malocclusion exhibited a higher level of facial asymmetry than control subjects; their asymmetry did not change significantly in the different phases of the surgical and orthodontic treatment and throughout a 24-month follow-up. In skeletal Class III patients, bimaxillary osteotomy did not modify the level of asymmetry in any facial third.
    MeSH term(s) Adolescent ; Adult ; Cephalometry ; Facial Asymmetry/diagnostic imaging ; Facial Asymmetry/surgery ; Facial Bones ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Malocclusion, Angle Class III/surgery ; Orthognathic Surgical Procedures ; Photogrammetry ; Young Adult
    Language English
    Publishing date 2020-04-11
    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.0000000000006403
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    Zs.A 3761: Show issues Location:
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  7. Article ; Online: Comparing prognostic utility between the 8th edition of TNM staging system and the lymph node ratio for oral squamous cell carcinoma.

    Beltramini, Giada A / Belloni, Laura M / Fusco, Nicola / Sacconi, Andrea / Muti, Paola / Baj, Alessandro / Bolzoni, Alessandro R / Giannì, Aldo B

    Head & neck

    2021  Volume 43, Issue 10, Page(s) 2876–2882

    Abstract: Background: Lymph node metastasis in oral squamous cell carcinoma (OSCC) is associated with poor prognosis. The 8th edition of TNM has implemented new nodal staging criteria. We assess the prognostic utility of the lymph node ratio (LNR) and compare it ... ...

    Abstract Background: Lymph node metastasis in oral squamous cell carcinoma (OSCC) is associated with poor prognosis. The 8th edition of TNM has implemented new nodal staging criteria. We assess the prognostic utility of the lymph node ratio (LNR) and compare it to that of pN in the TNM 8th edition.
    Methods: One hundred and forty-two patients with OSCC were retrospectively studied. Nodal staging was performed using the TMN 8th edition and the prognostic value of the LNR in terms of overall survival (OS) and disease-free survival (DFS) was evaluated.
    Results: Fifty-seven patients were eligible for inclusion. The LNR was independently prognostic of OS (p = 0.02). Instead N classification was not significantly predictive of OS (p = 0.10). High LNRs resulted in decreases in OS of approximately 40% within 6 months after surgery.
    Conclusions: The LNR identifies patients with poor outcomes better than N classification. The lack of reliable LNR cutoffs compromises its utility in clinical practice.
    MeSH term(s) Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/surgery ; Head and Neck Neoplasms ; Humans ; Lymph Node Ratio ; Lymph Nodes/pathology ; Mouth Neoplasms/pathology ; Mouth Neoplasms/surgery ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck
    Language English
    Publishing date 2021-06-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645165-2
    ISSN 1097-0347 ; 0148-6403 ; 1043-3074
    ISSN (online) 1097-0347
    ISSN 0148-6403 ; 1043-3074
    DOI 10.1002/hed.26769
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  8. Article ; Online: Use of CAD-CAM technology to improve orthognathic surgery outcomes in patients with severe obstructive sleep apnoea syndrome.

    Rossi, Diego Sergio / Romano, Michele / Sweed, Ahmed Hassan / Baj, Alessandro / Gianni, Aldo Bruno / Beltramini, Giada Anna

    Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery

    2019  Volume 47, Issue 9, Page(s) 1331–1337

    Abstract: Introduction: Although multilevel surgery is the mainstay treatment for severe obstructive sleep apnoea syndrome (OSAS), bi-maxillary surgery (maxillomandibular advancement [MMA]) is the most efficacious single procedure for the expansion of the whole ... ...

    Abstract Introduction: Although multilevel surgery is the mainstay treatment for severe obstructive sleep apnoea syndrome (OSAS), bi-maxillary surgery (maxillomandibular advancement [MMA]) is the most efficacious single procedure for the expansion of the whole pharyngeal airway. MMA is an alternative to the gold standard of continuous positive airway pressure and is equivalent to tracheotomy.
    Patients and method: Computer-aided design/computer-aided manufacturing (CAD-CAM) technology was used to virtually assess the degree of mandibular and/or maxillary advancement and rotation required to obtain adequate posterior airway space (PAS) in eight patients (seven males, one female). The mean age of the patients was 45.5 years (range, 27-51 years), and the average body mass index was 28.9 kg/m
    Results: The study group showed significant mandibular advancement, widening of the PAS, and reduction of the apnoea hypopnea index (p < 0.0001, p < 0.0001, and p < 0.0002, respectively). Moreover, patient satisfaction scores regarding postoperative facial profile changes showed excellent compliance.
    Conclusion: This study demonstrated that bi-maxillary surgery is an efficient single surgical procedure in patients with multilevel OSAS. CAD-CAM technology aided surgeons in performing this operation precisely and enabled patients to expect specific facial profiles.
    MeSH term(s) Adult ; Cephalometry ; Computer-Aided Design ; Female ; Humans ; Male ; Mandibular Advancement ; Middle Aged ; Orthognathic Surgery ; Patients ; Sleep Apnea, Obstructive ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2019-06-25
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 91267-0
    ISSN 1878-4119 ; 1010-5182 ; 0301-0503
    ISSN (online) 1878-4119
    ISSN 1010-5182 ; 0301-0503
    DOI 10.1016/j.jcms.2019.06.010
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    Zs.A 882: Show issues Location:
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  9. Article ; Online: Computer-Aided Design and Computer-Aided Manufacturing Versus Conventional Free Fibula Flap Reconstruction in Benign Mandibular Lesions: An Italian Cost Analysis.

    Bolzoni, Alessandro Remigio / Segna, Eleonora / Beltramini, Giada Anna / Sweed, Ahmed Hassan / Giannì, Aldo Bruno / Baj, Alessandro

    Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

    2019  Volume 78, Issue 6, Page(s) 1035.e1–1035.e6

    Abstract: Purpose: The cost of computer-aided design and computer-aided manufacturing (CAD-CAM) technology has created obstacles for its widespread use despite its several advantages. This study compared the cost of CAD-CAM technology with that of the ... ...

    Abstract Purpose: The cost of computer-aided design and computer-aided manufacturing (CAD-CAM) technology has created obstacles for its widespread use despite its several advantages. This study compared the cost of CAD-CAM technology with that of the conventional freehand technique in fibula reshaping for mandibular reconstruction.
    Materials and methods: A retrospective comparative study was conducted at the Maxillofacial and Dental Unit of the Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico (Milan, Italy). The study compared 15 patients in the CAD-CAM group with 10 patients in the conventional freehand group. Only benign pathologic lesions that required at least 3 fibular segments for reconstruction were included. The consumption of resources was estimated using micro-costing analysis (activity-based costing approach).
    Results: The CAD-CAM group included 15 patients (7 men and 8 women) with a mean age of 42.2 ± 1.5 years, and the conventional freehand group included 10 patients (4 men and 6 women) with a mean age of 40.8 ± 0.9 years. Although CAD-CAM was a statistically expensive procedure in the perioperative phase (P < .0001), no significant difference was shown in total health care costs between the 2 groups (P = .98).
    Conclusion: CAD-CAM technology had a comparable expense to the conventional freehand technique, specifically for defects requiring at least 3 fibular segments.
    MeSH term(s) Adult ; Computer-Aided Design ; Female ; Fibula ; Free Tissue Flaps ; Humans ; Italy ; Male ; Mandibular Reconstruction ; Retrospective Studies
    Language English
    Publishing date 2019-03-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392404-x
    ISSN 1531-5053 ; 0278-2391
    ISSN (online) 1531-5053
    ISSN 0278-2391
    DOI 10.1016/j.joms.2019.03.003
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  10. Article: Role of Axial Split Osteotomy of Free Fibula Flap in Mandibular Reconstruction and Dental Rehabilitation.

    Bolzoni, Alessandro Remigio / Baj, Alessandro / Sweed, Ahmed Hassan / Giannì, Aldo Bruno / Montrasio, Edoardo Francesco / Beltramini, Giada Anna

    Plastic and reconstructive surgery. Global open

    2020  Volume 8, Issue 1, Page(s) e2546

    Abstract: The fibula free flap (FFF) is regarded as the gold standard in mandibular reconstruction. Dental rehabilitation is important to improve the health-related quality of life of patients undergoing mandibular reconstruction. FFF provides adequate cortical ... ...

    Abstract The fibula free flap (FFF) is regarded as the gold standard in mandibular reconstruction. Dental rehabilitation is important to improve the health-related quality of life of patients undergoing mandibular reconstruction. FFF provides adequate cortical bone osseous tissue for use in dental implantation. The application of "axial split osteotomy" via a double-barrel fibula graft may enable discrepancies between the native mandible and FFF to be avoided, thereby improving the likelihood of early and successful dental rehabilitation.
    Language English
    Publishing date 2020-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000002546
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