Biomedical subjects

Andrea Carboni

Publications and source records attributed to Andrea Carboni.

12 recordsLinked to original sources

PubMed2004

Posttraumatic trigeminal nerve impairment: a prospective analysis of recovery patterns in a series of 103 consecutive facial fractures.

PURPOSE: To report the incidence of peripheral trigeminal nerve posttraumatic impairments and to compare different recovery patterns as observed in consideration of different fracture-related variables within 12-month follow-up. PATIENTS AND METHODS: Ninety-seven consecutive patients with 103 facial fractures were included involving emergence areas of supraorbital nerve, infraorbital nerve, or the region between the mandibular and mental foramina. Presurgical and postsurgical clinical neurosensory testing sessions were performed in each patient. Results of these assessments were compared within fracture characteristics and different sites of trauma. Statistical analysis (chi-square test) was performed on clinical observations. RESULTS: The incidence of trigeminal nerve impairments was 70.9% (54.4% in nondisplaced fractures, 88.2% in dislocated fractures, 100% in fractures with a direct nerve injury). Severe impairment was found in direct nerve injures and in many dislocated fractures. Mean recovery time was smaller in nondisplaced fractures than in dislocated fractures. Considering fracture site, the highest incidence of initial trigeminal nerve impairment was found in midfacial nondisplaced fractures. Midfacial fractures had better prognosis than mandibular fractures, and best prognosis was encountered in nondisplaced midfacial fractures. Residual hypoesthesia persisted in 11 sides with direct nerve injury after 12 months and involved tactile and discriminative sensibilities. CONCLUSION: Recovery patterns of posttraumatic trigeminal dysfunction are related to site and type of fracture; intraoperative assessment of involvement of nerve bundles within fracture rimes was associated with an incomplete recovery at the 12th month. Impairment of temperature and nociception are highly related to a direct nerve injury.

Adolescent↗

PubMed2003

The inheritance of chemical phenotype in Cannabis sativa L.

Four crosses were made between inbred Cannabis sativa plants with pure cannabidiol (CBD) and pure Delta-9-tetrahydrocannabinol (THC) chemotypes. All the plants belonging to the F(1)'s were analyzed by gas chromatography for cannabinoid composition and constantly found to have a mixed CBD-THC chemotype. Ten individual F(1) plants were self-fertilized, and 10 inbred F(2) offspring were collected and analyzed. In all cases, a segregation of the three chemotypes (pure CBD, mixed CBD-THC, and pure THC) fitting a 1:2:1 proportion was observed. The CBD/THC ratio was found to be significantly progeny specific and transmitted from each F(1) to the F(2)'s derived from it. A model involving one locus, B, with two alleles, B(D) and B(T), is proposed, with the two alleles being codominant. The mixed chemotypes are interpreted as due to the genotype B(D)/B(T) at the B locus, while the pure-chemotype plants are due to homozygosity at the B locus (either B(D)/B(D) or B(T)/B(T)). It is suggested that such codominance is due to the codification by the two alleles for different isoforms of the same synthase, having different specificity for the conversion of the common precursor cannabigerol into CBD or THC, respectively. The F(2) segregating groups were used in a bulk segregant analysis of the pooled DNAs for screening RAPD primers; three chemotype-associated markers are described, one of which has been transformed in a sequence-characterized amplified region (SCAR) marker and shows tight linkage to the chemotype and codominance.

Cannabidiol↗

PubMed2002

Surgical management of macroglossia: discussion of 7 cases.

OBJECTIVE: We present an overview of international literature concerning macroglossia-related etiology, clinical and instrumental diagnoses, surgical treatments, complications, and recurrences. Moreover, we present a series of cases of patients affected by macroglossia who have been treated surgically at the Department of Maxillofacial Surgery of the University of Rome "La Sapienza". METHODS: Between 1990 and 1999, only after attempts to solve this pathologic condition with medical and orthodontic treatment, we treated surgically a total of 7 patients (4 male and 3 female). The surgical techniques used were Köle glossectomy and Dingman and Grabb glossectomy. We analyzed the clinical and instrumental study and the surgical treatment, including possible complications and recurrences. RESULTS: After follow-up of a period from 2 to 9 years, macroglossia recurrences were absent, showing that the Köle and the Dingman and Grabb glossectomies are viable surgical options for treatment of macroglossia. CONCLUSION: The best therapy for each case macroglossia must be carefully evaluated, with the right medical therapy and orthodontic therapy attempted first and surgical treatment performed only when the first and second therapy fail. Moreover, surgical techniques must be chosen in accordance with the functional results that one wants to achieve and must be the most conservative technique to preserve the vascular-nerve bundle.

Adolescent↗

PubMed2002

Taste and olfactory disturbances after upper and middle third facial fractures: a preliminary study.

To estimate smell and taste after traumatic disturbances, the authors questioned a sample of 92 patients who underwent surgical treatment for upper third and/or middle third facial fractures between January 1, 1988, and May 31, 1996, at the Department of Maxillofacial Surgery, University of Rome "La Sapienza," Italy. A total of 86 patients included in the study had a facial fracture sustained during a motor vehicle accident. Twenty-nine patients reported smell and/or taste after the traumatic disturbance. Of these 29 patients, 8 patients had hyposmia and/or anosmia without taste deficit, 10 patients had taste disturbances without smell loss, and 11 patients noted disturbance in both smell and taste. The authors encountered posttraumatic smell disturbances in 19 patients in their sample. Nasozygomatic-Le Fort fractures, fronto-orbital fractures, and pure Le Fort fractures were found to determine posttraumatic smell disturbances in these 19 patients. Nasal fractures, nasoorbital-ethmoidal fractures, ethmoidal fractures, frontal-Le Fort fractures, and nasal-Le Fort fractures did not determine any olfactory dysfunction. Posttraumatic hypogeusia and ageusia were found in 21 patients and was caused by nasozygomatic-Le Fort fractures, fronto-orbital fractures, and pure Le Fort fractures. The authors did not find any taste deficits after patients sustained other kinds of facial fractures. In the 11 patients observed, disturbances in both smell and taste were noted. Nasozygomatic-Le Fort fracture was the most common in these 11 patients. At 5 years' of follow-up, the results indicate that hypogeusia and hyposmia are connected with the etiology of fracture, the violence of the trauma, and the involvement of specific facial bone regions.

Accidents, Traffic↗

PubMed2002

Pleomorphic adenoma of the lachrymal gland: presentation of a clinical case of relapse.

Pleomorphic adenoma affecting the lachrymal gland requires a well-grounded clinical and therapeutic protocol to avoid the risk of malignant transformation or disease recurrence, which is quite dangerous at this site. The authors present a clinical case of pleomorphic adenoma recurrence affecting the right lachrymal gland in a patient who first underwent a biopsy, with subsequent resection of the neoplasm. The authors also review the clinical and radiological features enabling a differential diagnosis and describe the radical "exenteratio orbitae" surgery for pleomorphic adenoma recurrence 7 years after the first operation, which was performed because of total derangement of the orbital cavity. The patient remains disease-free 5 years after this surgical treatment. Therefore, it turns out that an incisional biopsy carries a higher biological cost for the patient.

Adenoma, Pleomorphic↗

PubMed2002

Inferior alveolar nerve impairment after mandibular sagittal split osteotomy: an analysis of spontaneous recovery patterns observed in 60 patients.

Sensory impairment after bilateral sagittal split osteotomy (BSSO) due to inferior alveolar nerve (IAN) lesions may be either temporary or permanent and either complete or partial. The aim of this prospective study is to evaluate, by means of objective sensory testing, IAN sensory disturbances development in patients who underwent BSSO.IAN sensory disturbances development at the first week, fourth week, sixth month, and twelfth month of follow-up review in a group of 60 patients who underwent BSSO from January 1, 1998, to July 31, 1999, at the Maxillofacial Surgery Department of the "La Sapienza" University of Rome. The 60 patients were examined in the presurgical period; the IAN functionality regarding thermal sensibility, nociception, and two-point discrimination, was assessed at follow-up in 120 sides. In our study the highest rate of spontaneous recovery of the entire IAN functionality was observed at the sixth month. This finding witnesses how neuropraxia and axonotmesis give a spontaneous recovery that most frequently occurs within 6 months from surgery, independently from age and sex of the patient. The persistence of anesthesia over 12 months could be a sign of neurotmesis.

Adolescent↗

PubMed2002

Endo-orbital osteoma: two case reports.

Osteoma is a benign, slow-growing tumor, which mainly occurs in the bones and cavities of the middle third of the face, representing the most frequent benign tumor of the paranasal sinuses. Osteoma of the paranasal sinuses is generally asymptomatic and it is discovered only as a coincidental radiological finding; when it becomes symptomatic, the most common presenting symptoms are headaches and facial pain. Rarely the sinusal osteoma may entail secondary orbital extension, with ocular signs and symptoms. Primary intraorbital involvement is extremely rare. The authors present a review of the literature and report two cases of primary orbital osteoma. In both cases surgical treatment led to the complete remission of symptoms. Diagnosis and surgical therapy are discussed.

Adult↗

PubMed2002

Soccer-related craniomaxillofacial injuries.

The authors assessed the rate of craniomaxillofacial fractures in soccer and the areas where they occur, describing above all the injury pattern of this sport. Over a 5-year period (1995-2000) 46 cases of 329 with fractures associated with different sports activities have been surgically operated at the maxillofacial surgery department of the Policlinico "Umberto I" Hospital, University "La Sapienza" of Rome. All data collected have been selected on the basis of sex, age, anatomic site of the fracture, and the practiced sport. Information on injury patterns, severity, and play circumstances have been documented. The department examined 7 sports disciplines, but soccer was responsible for sports-related maxillofacial fractures in 34 of 46 cases (73.9%). All 34 fractures occurred to men. In soccer, the zygomatic and nasal regions are mainly involved. In fact the authors examined zygomatic fractures in 15 cases and nasal fractures in 10 cases. Direct contact between players generally causes soccer-related maxillofacial fractures: head-elbow impacts (21 cases) or head-head impacts (14 cases). The male:female ratio is 6.6:1, while the average age is 25 years for males and 23 years for females. In comparison with other sports (rugby, football, etc.) where physical contact occurs more frequently and the higher incidence of traumatic events justifies the use of protective measures, soccer is not a particularly violent sport. In soccer, maxillofacial traumas are caused by violent impacts between players that take place mainly when the ball is played with the forehead. In this moment there can be an elbow-head impact or a head-head impact. The authors believe that the low incidence of fractures, severity of the lesions, and discomfort caused by possible protective masks make their use unjustified. The data collected during this study witness that in soccer 21 of 34 cases of maxillofacial fractures are caused by elbow-head impacts. This fact suggests a preventive strategy against violent behavior in soccer play. Because the use of any sort of helmet proved impossible, the introduction of more severe penalties and a greater respect for the rules of the game by the players could reduce the percentage of impacts during matches. Impacts cause the most serious and frequent lesions in the maxillofacial region.

Adolescent↗

PubMed2002

A rare condition of Hand-Schüller-Christian disease.

The authors present the clinical case of a 61-year-old patient with Hand-Schüller-Christian disease associated with multisystemic involvement. The onset of such puzzling symptoms and the extremely rarity of this disease in a patient of such advanced age resulted in a delayed diagnosis and subsequently delayed treatment of the patient.

Anti-Inflammatory Agents↗

PubMed2002

Intraoperative measurement of maxillary repositioning in a series of 30 patients with maxillomandibular vertical asymmetries.

Vertical asymmetry of the maxilla can determine the inclination of the occlusal plane and result in a lack of internal reference points usually employed to measure surgical movements. Maxillary repositioning is therefore based upon surgical planning, which is commonly elaborated on dental casts and model surgery. The absolute precision of surgical planning is not guaranteed by dental casts and model surgery, and the intraoperative assessment of maxillary repositioning is considered to be of paramount importance in such cases. This article describes a simple, noninvasive intraoperative technique that is useful in measuring the vertical dimension of the maxilla and helps to indicate precise repositioning. It illustrates the technique and reports the results obtained in a series of 30 patients treated surgically for maxillomandibular malformations with vertical asymmetries and occlusal plane inclination from January to December 2000 at the Maxillofacial Surgery Department of "La Sapienza" University in Rome, Italy.

Adult↗

PubMed2002

Evaluation of the esthetic results of a 40-patient group treated surgically for dentoskeletal class III malocclusion.

A dentoskeletal Class III malocclusion results in unesthetic alterations of the soft tissues, which may cause psychologic and interpersonal problems. Surgical treatment, if based on cephalometric evaluations alone, can result in inadequate correction of facial esthetics. The aim of this paper is to discuss the esthetic needs observed in surgical planning of a group of 40 Class III patients and to compare the presurgical esthetic parameters with those recorded in the sixth month of follow-up. To obtain the proper esthetic result and to restore proper stomatognathic functionality, surgical treatment planning required the integration and correction of skeletal cephalometric planning. In 24 of the 40 patients, the skeletal and esthetic planning were in agreement with each other. In the remaining 16 patients, the correction of skeletal planning with the esthetic planning was necessary to obtain the correct esthetic and functional restoration. In all patients, esthetic, radiographic, and functional analysis at the sixth month of follow-up revealed the restoration of correct facial esthetics in the vertical, transverse, and sagittal planes; no temporomandibular joint problems; and a high degree of personal satisfaction regarding the esthetic and functional result obtained, including improvements in social life and in masticatory function. Cephalometric indications should always be compared with esthetic clinical indications and, possibly, the skeletal planning must be corrected by the esthetic needs, so that esthetic and functional success can be reached at the same time.

Adult↗

PubMedDate not supplied

Delayed and inadequately treated malar fractures: evolution in the treatment, presentation of 77 cases, and review of the literature.

Seventy-seven cases of delayed or inadequately treated zygoma fractures, treated between 1977 and 1999 in the Maxillofacial Surgery Division of the La Sapienza University in Rome, are presented. The functional and aesthetic problems caused by this pathology are analyzed. The results achieved resolve some of the various aspects of inadequately treated malar fractures. These are possible because of the development of great biomaterials and the introduction of rigid internal fixation. As a consequence the surgical techniques have been revolutionized. Cases, with functional-aesthetic deficits or only aesthetic deficits, are studied separately. An accurate preoperative study permits the operation suitable for the specific features of the individual case to be carried out.

Adolescent↗