PubMed Health⌕ Search

Biomedical subjects

F Biglioli

Publications and source records attributed to F Biglioli.

14 recordsLinked to original sources

Surgical approaches to cavernous haemangiomas of the orbit.

Cavernous haemangiomas are the most common orbital masses and the second most common cause of unilateral proptosis after thyroid ophthalmopathy. We retrospectively analysed 19 patients with retrobulbar cavernous haemangiomas, 9 of whom had lateral orbitotomy to remove retrobulbar cavernous haemangiomas located superior (n=4), inferior (n=2) or lateral (n=3) to the optic nerve. Seven patients had lateral orbitotomy together with an anterior medial approach to gain access to retrobulbar cavernous haemangiomas located medially to the optic nerve in the posterior half of the orbit. An anterior approach was used in 3 patient with an anteriorly located cavernous haemangioma. We describe here the planning of surgical treatment based on the site of the lesion.

Adult↗

Primary intraosseous hemangiomas of the orbit.

INTRODUCTION: Primary intraosseus orbital hemangiomas are rare vascular anomalies, of which only 23 cases have been previously reported in the literature. We here describe a further two cases. MATERIALS AND METHODS: An anterior approach was used to remove a mass located in the inferior orbital rim in one case, and in the orbital floor in the other. RESULTS: Good restoration of the orbital walls with no signs of recurrence. DISCUSSION: Intraosseous hemangiomas of the orbit are usually located anteriorly, and can be removed by anterior surgical approaches. The main surgical problem is due to the removal of the involved areas of the orbital walls because resection without reconstruction may cause functional impairments and secondary deformities that are more damaging for the patient than the tumour itself. In order to avoid defects, the integrity of the orbital walls must be immediately restored by means of autologous bone or alloplastic grafts.

Adult↗

[Cyst of the floor of the mouth causing respiratory obstruction. Report of one case].

Three major groups of lesions can cause swelling in the floor of the mouth: infectious, neoplastic, and cystic. We present the case of a patient with inflammatory cyst in the floor of the mouth that reached, in a little while, huge dimensions. Needle aspiration of the lesion caused an infectious process that enlarged the cyst and led to progressive difficulties in breathing. Treatment was by emergency tracheostomy and enucleation of the lesion using an intraoral approach. The enucleation was performed through a mucosal incision along the midline of the floor of the mouth, starting just behind the lingual fold, and extending along the ventral surface of the tongue.

Aged↗

Conservative treatment of arteriovenous malformations of the mandible.

A modified technique is reported on the treatment of arteriovenous malformations in the mandibular body. The technique consists of highly selected embolization and piecemeal removal of the lesion through burred holes made in the cortex. This way the mandible and the teeth may be saved in selected patients.

Adolescent↗

Temporal galeal fascia cover of custom-made gold lid weights for correction of paralytic lagophthalmos: long-term evaluation of an improved technique.

BACKGROUND: Chronic paralytic lagophthalmos is a condition that is often conservatively treated with ophthalmic ointments and eye drops, but usually requires definitive surgical correction. PURPOSE: An effective modification of the gold lid loading technique is described, which we have found to be the simplest and most reliable method for lid reanimation. MATERIAL: After empiric evaluations with lead fisherman's weights 'glued' to the eyelid, a custom-made gold lid weight is made by a jeweller on the basis of the tarsal dimensions of the individual patient, and then sutured to the tarsus under local anaesthesia and covered with a fine sheet of temporal galea. Other ancillary procedures (lower lid suspension, lateral tarsal strip, lateral tarsoplasty) are added as required. METHODS: Between 1990 and 1996, 27 patients underwent this type of surgery, of whom 24 were re-evaluated after a mean follow-up period of 73.2 months (range 36-96 months), 14 of these for a minimum of 5 years. RESULTS: None of the gold weights was extruded, all 24 patients experienced marked improvement of their dry-eye symptoms and expressed a high degree of satisfaction. Six patients underwent further minor surgery (lateral McLaughlin tarsorrhaphy) in order to improve relative underaction. Two patients had ptosis (less than 2 mm of asymmetry) of the affected side but refused further correction. CONCLUSION: The use of custom-made gold lid weights and a protective galeal layer is a simple, reliable and successful means for permanently rehabilitating paralysed eyelids.

Adult↗

Reconstruction of the orbital walls in surgery of the skull base for benign neoplasms.

Surgery for benign neoplasm extending into the orbital roof requires immediate reconstruction to avoid complications, which include transmission of the cerebral pulse to the globe, bulbar dystopia, diplopia, and fibrosis of the oculomotor muscles. Many alloplastic materials have been employed for such reconstruction, but currently most authors agree that autologous bone graft is the best option. Using calvarial bone in adults and split ribs in children, we have operated on eight patients for fibrous dysplasia (five cases), neurofibroma (two cases), or meningioma (one case). After a median follow-up period of two years and six months, good morphology of the orbit was maintained with no ocular symptoms.

Adolescent↗

Technical refinements in surgical treatment of benign parotid tumours.

Over the last 15 years, a number of techniques have been developed that make it possible to treat benign parotid tumours surgically with virtually no morphofunctional sequelae. Given that the main objectives of the intervention are the complete removal of the lesion as well as isolation and preservation of the facial nerve and its branches, the authors recommend the following procedure: a face-lifting type of incision in order to disguise the cutaneous scar better; preservation of the posterior branch of the great auricular nerve, in order to maintain the sensitivity of the ear lobe; coverage of the residual defect by means of a flap composed of superficial and deep temporalis fascia in order to reduce the postoperative depression in the parotid region and the onset of Frey's syndrome.

Adenolymphoma↗

Analysis on photographs of the growth of the cleft lip following a rotation-advancement flap repair: preliminary report.

A preliminary report is submitted on the growth of the lip after repair of a unilateral complete cleft (with a modified rotation-advancement flap) in 20 patients. In half of these cases an additional small Z-plasty was performed. The patients were photographed by a standardized method immediately after surgery and again after 18 months. Lip length on the operated side was measured and compared with the opposite side; possible results were: equal, long and short. After 18 months, 65% of all cases remained unchanged, 25% had lengthened and 10% shortened. Among cases treated with an additional small Z-plasty, unchanged and lengthened cases had an almost equal distribution, while the majority (8 out of 10) of the cases treated without Z-plasty remained unchanged. Consequently, the authors emphasize the benefits of reconstructing the cleft lip as symmetrical to the opposite side as possible or, at the most, moderately shorter only in cases treated with an additional Z-plasty.

Calibration↗

Recovery of infraorbital nerve function after zygomaticomaxillary cheek pedicled flap.

The zygomaticomaxillary cheek pedicled flap (ZMCF) involves the intentional section of the infraorbital nerve to reflect the flap laterally in order to give access to the rhinopharynx, clivus and upper cervical spine. The aim of this trial was to examine the recovery of sensation of the infraorbital nerve, both quantitatively (touch sensation, localisation test, two-point discrimination) and qualitatively (sharp/blunt test, temperature sensation, pain sensitivity, dental sensitivity) in 7 patients, at least 12 months after surgery. In each patient, four cutaneous areas (lower eyelid, nose ala, upper lip, cheek) and the upper vestibulum were tested. Results of each test in all the examined areas were evaluated and compared with the data obtained on the nonoperated side (control side). Results of neurosensory tests indicated good recovery of sensation with little difference in comparison with the control side, showing that the functional consequence of ZMCF should actually be considered only as a transitory event.

Adolescent↗

[A new "light" maxillomandibular fixation system].

BACKGROUND: A new "light" maxillo-mandibular fixation system for treatment of mandibular fractures, based on use of special pins, is proposed. METHODS: Fifteen patients with non-displaced mandibular fractures (angle, body and symphysis), have been treated at the Department of Maxillofacial Surgery, S. Paolo University Hospital, Milan. The system is based on pins formed by a no. 1 metal wire and a bead. The free end of the pin is threaded around a tooth and then wound three or four times around the bead to fix it in place and, at the same time, separate it from the gingiva. One pin is usually positioned on each quadrant. Once the pins are in place they are tied to each other using a loop no. 0 to complete the maxillo-mandibular fixation. Particular attention was paid to maintain a correct individual occlusion. The time of maxillo-mandibular block was 10-15 days. RESULTS: Results were good with complete healing of all fractures, restoration of individual occlusion, minimal periodontal lesions and a good compliance for the treatment by the patients. CONCLUSIONS: It is suggested to use this system routinely because quick, economic, easy on periodontium and relatively comfortable for the patients. The contraindication include an unstable occlusion, the absence of a suitable pair of teeth on both sides of the jaws, avulsion or trauma or periodontopathy of one of the teeth needed for the fixation system.

Bone Nails↗