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Biomedical subjects

M Raffaini

Publications and source records attributed to M Raffaini.

At least 19 recordsLinked to original sources
PubMed2001

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↗
PubMed2000

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↗
PubMed1998

[Secondary oro-mandibular reconstruction using revascularized bone flaps].

BACKGROUND: Oro-mandibular reconstruction using vascularized bone-containing free-flaps can be accomplished with flap survival rates in the range of 95%. Primary reconstruction offers the best opportunity to achieve the optimal aesthetic and functional results. Patients presenting for secondary oro-mandibular reconstruction have a unique set of problems; these include the presence of soft tissue contracture displacing the mandibular segments in malposition and soft tissue deficiencies, that makes surgical correction more difficult and potentially more hazardous. Vascularized bone-containing free-flaps are indicated in secondary oro-mandibular reconstruction where both hard and soft tissues replacement is needed or when the recipient bed is unfavourable due to previous surgery and/or radiation. METHODS: Authors presents personal experience in ten cases of secondary oro-mandibular reconstruction treated at Maxillofacial Department of Parma from September 1995 to September 1996 with secondary oro-mandibular reconstruction using bone containing free flaps. Two different donor sites were used to harvest bone-containing free flaps: iliac crest in 2 cases and fibula in the others. In 4 cases the flap was only osseous while in the other 6 cases it was osteocutaneous. RESULTS: All flaps were transplanted successfully; in 1 case necrosis of the skin component of the flap was observed. CONCLUSIONS: The introduction of vascularized bone containing free flaps transferred from distant sites by microvascular techniques has changed mandibular reconstruction. Vascularized bone transferred into tissue beds compromised by salivary contamination and previous irradiation and the rational use of the soft tissutal components of the flap permit also the restoration of articulation, deglutition and mastication with quality of life better than non-vascularized alternatives.

Adult↗
PubMed1997

[Secondary reconstruction, after maxillectomy, using an osteocutaneous flap from the fibula. Report of a case].

Surgical functional reconstruction after partial maxillectomy with fibula free flap. A bilateral upper alveolar bone, gingival and palatal defect after tumor resection, has various problems originating from reconstruction with prosthesis or temporalis muscle flap. We report a secondary reconstructive procedure using the fibula osteocutaneous free flap. The combined bone segments created the upper alveolar arch, and the skin paddle closed the palatal defect. This procedure restored the patient to masticatory function of the upper jaw, intelligible speech and natural facial appearance. As a result quality of life of patient was extremely improved.

Aged↗
PubMed1994

Orbital marginotomies for treatment of orbital and periorbital lesions.

Access osteotomies allowing temporary displacement of various segments of the orbital rim provide direct visualization of deep orbital and paraorbital regions. These marginotomies are classified, according to the orbital region involved, as lateral, medial, superior, or inferior, and they provide adequate exposure of the corresponding orbital wall and its surrounding structures. Since these procedures are without complications and cause no unpleasant cosmetic effects, they are highly recommended for the treatment of various lesions in this area as well as for correction of malformations.

Bone Plates↗
PubMed1994

The temporoparietal fascial flap in reconstruction of the cranio-maxillofacial area.

An improved understanding of the vascular supply of the layers of the temporal fossa has increased the potentiality of reconstructive techniques involving this area. Each separate vascularized layer of this region can be used, yet the temporoparietal fascial flap is the more useful for treating a wide range of composite defects. It represents an ultra thin coverage which is useful in resurfacing exposed bone, tendons and vital structures such as nerves and vessels, in providing neovascularity as a recipient graft bed and in providing coverage or lining in major facial reconstructions. We describe our experience with the temporoparietal fascial flap which represents our choice for reconstructing composite defects in orbital, malar, auricular and cheek areas when what is required is a thin, pliable, well vascularized flap to carry a scalp or skin graft, to resurface exposed cartilage, bone and nerve, and to fill soft tissue contour defects. Illustrative cases from the authors' clinical experience are presented, to demonstrate various combinations of the temporoparietal fascial pedicle with other tissues in the reconstruction of the ear, eyebrows, eyelids, malar, cheek and parotid areas.

Adolescent↗
PubMed1991

[Orthopedic surgery for edentulous malocclusion].

The treatment of maxillary deformities in edentulous patients, with reference to tooth-bearing ones shows some differences concerning both the treatment planning and the surgical procedures. The Authors present in detail their way of planning the treatment and some expedients and modifications they apply to the usual surgical procedure in this special kind of maxillary deformities.

Adult↗
PubMed1991

[The oral manifestations during Kaposi's disease].

Kaposi's sarcoma is a rare neoplastic disease of the vascular system with multiple foci. Oral manifestations are uncommon. The authors report an oral localization of a Kaposi's disease; the etiopathogenesis, the clinical features and the treatment of such lesions are discussed.

Aged↗
PubMed1990

Mandibular leiomyoma in an infant. Report of a case.

A case of mandibular leiomyoma in a 8-month-old baby is reported. This is the 5th case of intrabony leiomyoma of the jaws reported so far. The tumor presented as a symptomless swelling of the mandibular ramus and required a limited resection. The pertinent literature is reviewed and the histological features discussed.

Diagnosis, Differential↗
PubMed1990

The temporalis muscle flap in temporo-mandibular joint surgery.

In the treatment of the severely damaged TMJ structural components (ankylosis, arthrosis, tumour, perforation or degeneration of the disc), it is advisable to insert a biological interposition between bony articular surfaces. The temporal muscle, due to its anatomical, topographical, and functional properties, can be successfully employed for this purpose. Based on the experience of Tessier, Delaire and Rowe, a temporalis muscle flap, inferiorly based, is rotated downwards and medially to the zygomatic arch, interposed and then fixed to condyle and capsule. Using this surgical technique, 12 patients and 13 temporo-mandibular joints were treated with good functional results and without any complication.

Adolescent↗
PubMed1990

[Aggressive juvenile fibromatosis].

Aggressive juvenile fibromatosis is not metastasizing disease characterized by a neoplastic proliferation of fibroblasts that rarely involves surrounding bone. The Authors describe one case observed by them and suggest the surgical procedure as elective treatment of the disease. In cases where a mandibular resection is performed, a simultaneous bone reconstruction, when feasible, is indicated.

Child↗
PubMed1989

Jaeger's jugal extended incision to approach the pterygomaxillary region.

In oncological surgery of the pterygomaxillary fossa it is essential to achieve a wide access. For this purpose we have employed the old Jaeger's incision extended posteriorly in association with access osteotomies (zygoma and coronoid). In our experience (9 cases) the jugal access has provided good results without noticeable cutaneous scars. The technique is described with the presentation of 2 cases.

Cheek↗
PubMed1989

On the feasibility of intraoral maxillo-malar osteotomy.

The maxillo-malar osteotomy is one of the osteotomies developed over the years to correct the deformities of the midface without modifying the nasal projection. After having for many years approached the osteotomy through the classic double access, intraoral and subciliary, we verified the feasibility of this osteotomy via an intraoral route only. For this purpose we modified slightly the classic osteotomy lines, however still including in the mobilized fragment the most prominent and therefore the most aesthetically important portion of the zygoma. At the lower orbital rim the medial osteotomy cut is performed with a fissure bur, the lateral one with an oscillating saw. Both the osteotomies are extended posteriorly in the orbital floor with a fine osteotome. Then, after having performed all other osteotomy cuts, the maxillo-malar complex is down-fractured. The residual thin bone structures which connect the maxillo-malar complex to the cranio-facial skeleton are broken during a careful downfracture, avoiding fracture between the maxilla and zygoma. The complex is advanced and stabilized with intermaxillary fixation, osteosynthesis and bone grafts. A bone graft to the orbital floor is unnecessary.

Adult↗
PubMed1988

Melanotic neuroectodermal tumour of infancy (MNTI). Immunohistochemical and ultrastructural study of a case.

A case of melanotic neuroectodermal tumour of infancy (MNTI) which occurred in the left lower jaw of a 15-months old child was studied by electron microscopy and immunohistochemical methods to verify the neural crest origin of this tumour. Two cell population were observed: pigment melanocyte-like cells and non-pigmented nerve-like cells. Immunohistochemical analysis with neuron-specific enolase (NSE) and S-100 protein visualized two cell subtypes in the non-pigmented cell population. The combined ultrastructural findings and immunohistochemical data confirm the neural crest origin of MNTI.

Cytoplasm↗
PubMed1988

[Osteomas of the paranasal sinuses: review of the literature and personal cases].

The sinusal osteomas: a review of literature and personal cases. The osteoma is a osteogenetic benign tumour formed by a fully developed bone, characterized by a slow growth, which, as far as the maxillo-facial region is concerned, shows to be frequently located in the paranasal sinuses. The osteoma originates from one of the sinus walls and spreads into the sinus cavity itself producing symptoms related to a lesion space occupying. In the present report, taking into consideration 4 personal cases, some literature datas are examined concerning the epidemiology, clinical behaviour and especially the therapeutic implications to be adopted by the surgeon in the presence of sinusal osteoma.

Adolescent↗