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Biomedical subjects

E Pomatto

Publications and source records attributed to E Pomatto.

At least 19 recordsLinked to original sources

Third molar extraction. Current trends.

Extraction of third molars is the operation most frequently performed by oral and maxillofacial surgeons. The American National Institute of Health (1979) and the American Association of Oral and Maxillofacial Surgeons (1993) have organised consensus conferences to systematically analyse the scientific evidence and provide official guidelines for the management of third molars. However, some clinical aspects are still controversial: indications for preventive extraction, early extraction, prognosis of impacted teeth, continuous follow-up, relationship with anterior crowding and temporo-mandibular disorders. This article reviews the conclusions from the consensus conferences and integrates them with more recent data. The actual trend seems to justify a more conservative clinical approach rather than an aggressive extraction policy.

Adolescent↗

Unilateral fibroadipose degeneration of the masticatory muscles.

A unique case of fatty replacement of the masticatory muscles, causing progressive limitation of mouth opening, is presented. Both CT and MRI revealed an almost total substitution of the masticatory muscles with fatty tissue, confirmed by the histopathology at surgery. Myotomy of masseter and internal pterygoid muscles and coronoidotomy improved his symptoms. There is no known cause of fibroadipose replacement of muscle fibres.

Adipose Tissue↗

[Evaluation of psychological disorders in patients with cancer of the oral cavity].

BACKGROUND AND AIMS: This study aimed to evaluate the possible onset of forms of anxiety, major and minor depression and behaviour towards the disease shown by patients with oral cavity neoplasms. METHOD: An explorative comparative study was performed in 28 patients referred to the department of Stomatological Surgery at the Odontostomatology Clinic of Turin University. Ten patients were examined before surgery and 18 after. The tests were performed using Hamilton's scale, STAI X1 and X2 and IBQ. These tests were carried out either during hospitalisation or during outpatient check-ups by an interviewer who was not familiar with the diagnosis or the patient's personal history. RESULTS: In the group of subjects evaluated before surgery, there was a scant presence of psychological correlations to disease. This shows that negation is widely used. Almost all subjects revealed the presence of anxiety symptoms and 60% of subjects were affected by minor depression. The level of negation was even higher in the postoperative group. This shows that the characteristics of the defensive structure did not change. CONCLUSIONS: Patients showed a psychological structure, even some time after surgery, which was similar to that in the first group of subjects, namely those facing an active phase pathology. The above findings underline the need for greater attention to be paid to the quality of life of these subjects who, owing to improved treatment, are becoming increasingly numerous. The scores obtained show that the majority of these patients encounter major difficulties at a psychological level, even if they manage to overcome the disease in physical terms. In conclusion, this study highlights the need to offer these subjects valid psychological support during diagnostic and therapeutic procedures. It also underlines the need for longitudinal studies in larger and more homogeneous groups of patients suffering from this disease since they appear to be somewhat neglected by modern literature.

Anxiety↗

Parosteal osteosarcoma of the maxilla.

We describe the case of a 47-year-old female who presented with a small nodule in the buccal sulcus in the left maxillary incisor region. Clinical and radiographic examination revealed a small sclerotic neoplasm with a short pedicle. Histopathological examination confirmed a diagnosis of parosteal osteosarcoma. The contribution of CT to the diagnosis and management is discussed.

Female↗

[Multidisciplinary treatment in advanced stages of spinocellular carcinoma of the oral cavity. Initial results].

As in almost all forms of tumour, the best therapeutic results for those of the oral cavity is obtained following the first treatment which must be incisive and appropriate because it often represents the sole decisive possibility of recovery. In advanced forms (stages III and IV) it is best to establish a close collaboration between surgeon, cancer specialist and radiotherapist: this paper reports the authors' experience over the past 5 years with regard to advanced stages of spinocellular carcinoma of the oral cavity treated according to a chemoradiosurgical therapeutic protocol. Of the 134 cases treated by our unit, 77 were included in the protocol showing a 78% actuarial survival rate over 40 months.

Adult↗

[Extracapsular lymph node metastasis in squamous cell carcinoma of the oral cavity after chemo-radio-surgical treatment protocol].

A total of 134 cases of spinocellular carcinoma of the oral cavity were treated by our division during the period March 1988-June 1992. This carcinoma histotype has a predominantly local evolution with rare long-distance hematic metastases. On the other hand, there are more frequent reports of metastases along the lymphatic route with an incidence which varies according to the site of tumour onset. Among the 134 patients treated a group of 77 were selected and admitted to a chemo-radio-surgical protocol consisting of four stages. During surgery patients in this group showed a marked reduction of both intracapsular and extracapsular lymph node involvement in almost all sites examined.

Carcinoma, Squamous Cell↗

[A retrospective study on the importance of preoperative control in the prognosis of spinocellular carcinoma of the oral cavity].

Surgical treatment of advanced forms of spinocellular carcinoma of the oral cavity (stages 3-4) has been integrated for a number of years with cycles of chemo- and/or radiotherapy both before and after surgery. This chemo-radio-surgical therapeutic protocol consists of four distinct stages, separated by precise treatment-free intervals, which enable the best efficacy to be achieved through synergy. A total of 60 patients were treated by our Ward using this protocol during the period March 1988-June 1992. At the time of surgery a complete negative outcome in the histological picture (pTO) was observed in 40% of cases; lesions had not regressed on only 16% of patients. A retrospective type study has been carried out using Kaplan-Meier's statistical analysis to evaluate the prognostic factors in this population: a significant correlation was found between disease-free time and survival, calculated at 40 months from the completion of the protocol, and histopathological TNM. Non correlation was found with clinical TNM: therefore, rather than the extent of the lesion at the time of diagnosis, its control during preoperative stages appears to be the major prognostic factor.

Adult↗

[Warthin's tumor. Review of the literature and personal experience].

Warthin's tumour is a much debated clinical case-characterised by the presence of epithelial proliferation and lymphoreticular stroma. Numerous controversies concern this type of tumour so much so that recently is was even denied that it can be considered a real tumour. The present paper aims to review the state of the art and report the authors' personal experience.

Adenolymphoma↗

[Verrucous carcinoma of the oral cavity. Personal experience with combined chemo-surgical treatment].

Following an introduction regarding the anatomo-pathological and clinical aspects of verrucous carcinoma of the oral cavity, the authors review several recent reports concerning the prognosis and treatment of this tumour and its possible evolution. This is followed by a wide-ranging discussion of the differing opinions put forward by various researchers regarding the possible role of radiotherapy and in particular the high risk of triggering off latent forms and provoking the differentiated and more aggressive forms of carcinoma. The authors then illustrate their experience of integrated chemo-surgical treatment, excluding radiotherapy, administered over the past six years to patients who were brought to their attention suffering from this form of carcinoma.

Aged↗

Histopathological findings after preoperative chemo-radiotherapy in oral and oropharyngeal carcinoma. A study of 28 resected specimens.

Serial sections of whole surgical specimens from 28 patients with locally advanced oral carcinoma were examined to assess the histopathological effects of a preoperative intravenous (i.v.) chemotherapy and radiotherapy protocol. In 15 cases (54%), no residual neoplastic tissue was found: in 9, the tumour area showed a dense hyalinised connective tissue, whereas in the other 6 cases foci of keratotic material were surrounded by a foreign body-type reaction. In 13 patients (46%), residual neoplastic tissue was observed: small fields of tumour were present in 6 cases, whereas tumour was widely persistent in 7. Lymph node metastases were observed in 9 cases (32%), with extracapsular spreading in 6 (21%). In 93% of cases, pathological staging on the specimen was more favourable than the clinical preoperative staging. 23 patients (82%) are alive without evidence of disease 30-55 months after surgery; 10 (43%) did not show any residual neoplastic tissue in the specimen; 10 patients (43%) showed persistence of tumour, but in 5 (21%) only small fields of tumour were observed. 4 patients (14%) died due to their tumour. The pathological data show that this protocol is successful in the treatment of advanced oral carcinoma; furthermore, they provide reliable information about the response to therapy and the subsequent course of the disease.

Adult↗

[The role of the dentist in the pre- and postoperative treatment of the cancer patient].

The importance of an early diagnosis in neoplastic pathologies of the oral cavity is now universally recognised and accepted, and dental treatment in this field requires particular care and preparation. Having identified the suspected lesions, it is necessary to eliminate those conditions which might favour the onset of neoplasia in the oral cavity, and then follow the patient during the pre- and post-radiotherapeutic stages. Dentistry is also responsible for following and carrying out the prosthetic recovery of patients undergoing radical jaw surgery, in order to enable them to return to normal day-to-day and working life in esthetic and functional terms.

Combined Modality Therapy↗