Biomedical subjects

R Becelli

Publications and source records attributed to R Becelli.

At least 19 recordsLinked to original sources

PubMed2004

A case report of osteochondroma of the frontotemporosphenoidal suture.

Osteochondroma, also known as osteocartilaginous exostosis, is the most frequent benign bone tumour of the skeletal system. Despite its preference for long bones (tibia and femur), osteochondroma may occur in some short bones developing endochondral ossification. Seventy-five percent of the patients present only with a single lesion, whereas 25% have multiple lesions; this last clinical condition, defined as osteochondromatosis (disorder of autosomal dominant inheritance) shows a high risk of malignant transformation (about 11%). In the craniofacial area this tumour is very rare. The sites of predilection are the coronoid process and mandibular condyle, even though osteochondromas arising from the base of the skull, maxillary sinus and zygomatic arch have been previously described. However, an osteochondroma originating from the frontotemporosphenoidal suture has not been reported before in the literature. We present a unique case of osteochondroma of the frontotemporosphenoidal suture. Moreover, the relevant international literature has been reviewed and all diagnostic and surgical matters have been discussed.

Adult↗

PubMed2003

Diagnosis of Bell palsy with gadolinium magnetic resonance imaging.

Bell palsy is a condition resulting from a peripheral edematous compression on the nervous fibers of the facial nerve. This pathological condition often has clinical characteristics of no importance and spontaneously disappears in a short time in a high percentage of cases. Facial palsy concerning cranial nerve VII can also be caused by other conditions such as mastoid fracture, acoustic neurinoma, tumor spread to the temporal lobe (e.g., cholesteatoma), neoformation of the parotid gland, Melkersson-Rosenthal syndrome, and Ramsay-Hunt syndrome. Therefore, it is important to adopt an accurate diagnostic technique allowing the rapid detection of Bell palsy and the exclusion of causes of facial paralysis requiring surgical treatment. Magnetic resonance imaging (MRI) with medium contrast of the skull shows a marked increase in revealing lesions, even of small dimensions, inside the temporal bone and at the cerebellopontine angle. The authors present a clinical case to show the important role played by gadolinium MRI in reaching a diagnosis of Bell palsy in the differential diagnosis of the various conditions that determine paralysis of the facial nerve and in selecting the most suitable treatment or surgery to be adopted.

Adult↗

PubMed2002

Mandibular ameloblastoma: analysis of surgical treatment carried out in 60 patients between 1977 and 1998.

Ameloblastoma, a benign tumor of odontogenic type, represents 10% of all tumors of the jawbone. It is localized in the mandible in 80% of cases and in the upper jaw in the remaining 20%. In every case, the selection of the surgical treatment to be applied must consider some fundamental elements, including the age and general state of health of the patient, the clinicopathological variant, and the localization and extent of the tumor. In addition, it is necessary to evaluate whether the neoplasm to be treated is a primitive lesion or a recurrence. Although ameloblastoma has relative histological characteristics of benignity, this neoplasm has a high percentage of local recurrence and possible malignant development when treated inadequately. The aim of this study was to carry out a follow-up of 60 patients treated for ameloblastoma of the mandible between 1977 and 1998, analyzing the problems faced in removing this benign neoplasm and those concerning reconstruction of the surgical defect.

Adult↗

PubMed2002

Evaluation of homologous bone graft versus biomaterials in the aesthetic restoration of the middle third of the face.

BACKGROUND: Bone deficits of the midface can be observed following tumor surgery, facial traumas or malformations, and can determine aesthetic deformities requiring surgical corrections. The goal of this study is to illustrate the 23 years experience of the Maxillo-Facial Department of the "La Sapienza" University of Rome, in surgical correction of middle third bone loss for aesthetic improvement, and to compare postsurgical results from the use of biomaterials and homologous bone grafts. METHODS: From January 1977 to January 2000, 18 patients were surgically treated with bone grafts for bone deficit of the midface requiring aesthetic improvements, and 23 received biomaterial placement in the same district. A retrospective analysis regarding aesthetic improvements following corrective (reconstructive) surgery was carried out in order to compare long-term results obtained with bone grafts and biomaterials. RESULTS: Of the 19 implants of the zygomatic bone, 1 patient suffered from infection, observ-ed on the 8th day, following iliac bone graft in the maxillary area. Of the 32 prostheses, 7 became infected and in 1 case the material became exposed: Proplast(R) became infected 2 times, Gore-tex(R) 3 times and 1 time became exposed; 2 of the 24 Medpor(R) implants resulted in infection. The employment of bone graft obtained a good short term aesthetic result. Medpor(R) employment, was evaluated as an optimal aesthetic improvement. We cannot evaluate the results obtained with Gore-tex(R) and Proplast(R) because of the few cases treated. Anyway we consider unsatisfactory the corrections obtained with these 2 materials. CONCLUSIONS: Homologous bone grafts are still considered as the best choice when a further fixture positioning is planned for prosthetic rehabilitation of the alveolar ridge of the upper jaw or mandible. At the present time, some biomaterials are the definitive solution for restoring facial harmony in the 3 spatial dimensions.

Biocompatible Materials↗

PubMed2002

Von Recklinghausen neurofibromatosis with palatal localization. Diagnostic and surgical problems in two clinical cases.

This paper illustrates the clinical findings and aims at report surgical matters observed in 2 patients affected by neurofibromatosis type I with a rare palatal localization. By means of retrospective analysis 2 cases of neurofibromatosis type I with a palatal mass are selected. Both cases were surgically treated and underwent 12 months follow-up. Patients underwent surgical removal of the palatal neurofibroma. At 12 months follow-up a good local condition without any recurrence was observed. Malignant transformation was very rarely reported in oral neurofibromata and can follow incomplete removal. Surgical treatment of neurofibromata requires the sacrifice of the nerve trunk from where they originate, together with the complete removal of the mass with security margins. Therefore, risks and benefits from surgery should be carefully weighted in each patient and where surgery is not performed clinical and radiographic trials are advisable.

Adolescent↗

PubMed2001

Abrikossoff's tumor.

Abrikossoff's tumor is a disease that more commonly affects the oral cavity but can also occur at other sites. It develops between the second and sixth decades of life, more frequently among women and blacks. The neoplasm can affect all parts of the body. The head and neck areas are affected in 45% to 65% of cases and of these, 70% are located interorally (tongue, oral mucosa, hard palate). The benign form shows polygonal cells with granular, eosinophilic cytoplasm and small nuclei. The malignant form, however, is associated with a high mitotic index and pleomorphic cellular tissue. The clinical aspect of the neoformation is a swelling covered by mucus of normal appearance. Studies of the neoformation show that in addition to the objective examination, further instrumental research is necessary, i.e., with nuclear magnetic resonance or computed tomography with contrast CT scan. However, the only examination that can confirm the clinical diagnosis is the histological examination. The only treatment for Abrikossoff tumor is surgery. The surgical treatment provides for an extirpation of the neoformation with the overhanging mucus and the underlying periosteum. In this work, the authors discuss a case of Abrikossoff tumor affecting the mucus of the right side of the hemipalate in a 53-year-old patient and present a review of the literature.

Granular Cell Tumor↗

PubMed2001

Pleomorphic adenoma of the minor salivary glands of the palate.

A retrospective test was carried out on a sample of 11 patients, 8 women and 3 men, suffering from pleomorphic adenoma of the minor salivary glands of the palate. These sample patients were treated at the Department of Maxillofacial Surgery at the University of Rome "La Sapienza" between 1/1/90 and 31/12/95. Some diagnostic methodologies have been analysed, such as incisional biopsy and instrumental research (X-ray Orthopantomography and CT of the maxillofacial district with and without contrast medium in axial and coronal projections), surgical techniques for the removal of the neoformation and techniques for an immediate reconstruction. The surgical treatment foresaw, during the same operation, removal of the neoformation, reconstruction of the resulting defect and complete restoration of functions and aesthetics. The patients of the examined sample underwent a 5-year follow-up, based on clinical examinations and instrumental research. No immediate or delayed postoperative complications were evident, nor recurrence of the neoplasia. The purpose of this assignment is to compare the results that transpired from the retrospective test with those reported in the international bibliography.

Adenoma, Pleomorphic↗

PubMed2001

Surgical treatment of recurrences of pleomorphic adenoma of the parotid gland.

From 1989 to 1999 a retrospective study was conducted on 7 patients with recurrent pleomorphic adenomas of the parotid gland who were referred to the MaxilloFacial Department of the University of Rome "La Sapienza" after having undergone surgery elsewhere. The mean time interval between the first operation and recurrences ranged from 15 months to 13 years, and the average time interval was 7.7 years. Implantability of the lesion and inadequate surgery that produced rupture of tumour capsule and tumour cells bleeding into surrounding glandular parenchyma, were the reasons for tumour recurrence. The instrumental examinations used for planning the surgical treatment to be applied and for studying the relations of recurrence with glandular parenchyma were CT (with contrast medium) or MR of head and neck. These patients underwent total parotidectomy with facial nerve preservation and no recurrence occurred in any patient. The results of this study underscore the importance of adequate surgical excision of initial recurrences as well as primary tumours to prevent tumour recidivism. Finally, tumour control rates and facial nerve preservation are enhanced with formal parotidectomy for recurrent tumour when feasible.

Adenoma, Pleomorphic↗

PubMed2000

The long styloid process syndrome or Eagle's syndrome.

Eleven cases of Eagle's syndrome or long styloid process syndrome are presented. It is a rare entity, which is not commonly suspected in clinical practice. Symptoms were dull and persistent pharyngeal pain, dysphagia, and facial pain. In addition to careful clinical examination, the use of plain radiographs, orthopantomograms or CT scan has allowed accurate preoperative diagnosis of this syndrome. Surgical treatment has positively resolved the symptoms in these cases. The International literature is discussed regarding anatomy, symptoms and treatment of the long styloid process syndrome.

Adult↗

PubMed2000

Craniofacial traumas: immediate and delayed treatment.

In 1998, 28 patients with craniofacial fractures have been under observation at the Emergency Room of the Policlinico Umberto I of Rome. Twenty-six patients have undergone reduction and contention surgery of the fractures. The diagnosis of the fractures has been achieved through CT axial scanning and coronal reconstruction as well as with three-dimensional CT. The CT spiral was used in those cases that required more rapid intervention, whereas the MRI was used to evaluate the condition of the eyeball. Twenty of such patients underwent surgical treatment a few hours after the trauma and, in such cases, excellent aesthetic and functional results were achieved. The general and neurological conditions of six patients did not permit prematurely proceeding with surgery. Two patients died a few hours after the trauma of the injuries sustained. Of the six patients who underwent delayed treatment, acceptable functional and aesthetic results were achieved in four, whereas the remaining two patients had inadequate results. The results we have obtained show that it is possible to achieve the best results, both aesthetic and functional, through immediate treatment. Delayed treatment is carried out at least 2 weeks after the trauma because of the patient's condition and presents reconstruction difficulties that do not guarantee a satisfactory aesthetic reconstruction as well as, in some cases, an effective functional restoration.

Adolescent↗

PubMed1999

Facial nerve functionality after parotid tumors surgery.

The purpose of this study is to show the connection among tumor histology, surgical treatments and facial nerve postoperative functionality. A retrospective review was conducted on 69 patients with benign and malignant parotid tumors: they underwent surgical treatment for benign and malignant parotid tumors at the Maxillofacial Division of Rome University "La Sapienza" from 1988 to 1997. In our series of patients, we performed conservative superficial parotidectomy, conservative total parotidectomy and radical parotidectomy. Tumor enucleation was reserved for those neoplasms with a limited and restricted mass. The surgical approach was based on mass extension and on histopathologic features. Our findings showed that a careful and a timely diagnosis is very important in order to select a conservative surgical treatment for benign and intermediate grade of malignancy tumors with limited dimensions. Most aggressive histological types, and large mass dimensions require a radical treatment with consequent facial nerve postoperative dysfunctions. Our experience demonstrates that this surgical approach provides a very high rate of success in the cure of tumors and a low rate of facial nerve postoperative dysfunctions.

Adenoma↗

PubMed1998

Surgical and implantation reconstruction in a patient with giant-cell central reparative granuloma.

The giant-cell central reparative granuloma, unlike other giant-cell neoplasias, is mainly found in maxillary bones, particularly in the mandible. We report a patient study of giant-cell central reparative granuloma in the mandible extending from dental elements 34 to 44. The patient underwent excision of a neoplasm and reconstruction of the mandible via an autologous bone graft of the iliac crest. To restore fully, functionally, and aesthetically the masticatory apparatus after verification of graft stability, four osseointegrated implants were fixed, and an "overdenture" prosthesis was then applied, thus finally solving the problem.

Adult↗

PubMed1998

[A primary pleomorphic adenoma of the parapharyngeal space].

The rarity of benign primary neoformations in the parapharyngeal space associated with aspecific clinical symptomatology often leads to the identification of large size lesions with deformation of the lateral wall of the pharynx and homolateral hemiplate. The improved diagnostic specificity of radiological instruments like CT and NMR allows a precise topographical localisation of the mass and the diagnosis of its nature in 90% of cases. The deep position of the neoplasia makes it necessary to search for the most conservative surgical approach possible that enables a sufficiently broad operating field to be obtained for complete exeresis and the control of neck vessels. This paper describes the therapeutic protocol used and makes a critical revision of the surgical approaches in an exemplary case of primary pleomorphic adenoma in this region.

Adenoma, Pleomorphic↗

PubMed1998

[Parapharyngeal involvement in neoformation of the deep parotid lobe].

The parapharyngeal space can be often interested by the extension of neoplasms starting at the deep lobe of the parotid gland level. According to many international authors, usually benign neoplasm originating at the parotid gland, tend to grow in the above mentioned area, while malignant tumors invade more easily the infratemporal fossa. Several diagnostic methods and ways of approaching the benign tumors of the parapharyngeal space have been proposed over the years. Personal experience at the Maxillo-Facial Department of the University of Rome "La Sapienza" and a typical clinical case for the diagnostic approach and surgical technique used by the authors, is described.

Adenoma, Pleomorphic↗

PubMed1998

[Maxillofacial fractures in children].

BACKGROUND: Facial traumas in the younger population involve esthetic and functional matters. According to the international bibliography these problems are due to the fixation technique employed and to a delayed surgical treatment. METHODS: This article contains a list of 68 pediatric facial fractures treated at the Maxillofacial Department of the University of Rome "La Sapienza" including diagnosis and therapy over a period of 16 years (January 1981-October 1997). RESULTS: The results of this research show that the ability to treat such traumas is based on the early and careful identification of the fracture and on the choice of the best therapy to carry out according to the patient's age and with the fracture site pattern. RIF fixation is good to obtain healing in adults, but it may be responsible of disturbances in bone tissues growth. Hence, it was used in selected cases only, in order to avoid bone growth restriction as stressed in international bibliography. CONCLUSIONS: A delayed surgical repair of pediatric facial fractures does not guarantee the return to a correct functionally and to an appropriate esthetic feature.

Adolescent↗

PubMed1998

[The importance of the correct restoration of the transverse dimension in midfacial fractures].

The final goal, in reconstructing the facial skeleton of trauma patients, is to obtain good aesthetic and functional outcomes. The surgical technique shown, consists in the reduction and contention of the midfacial fractures. It is based on right placing of the zygomatic arch. In fact, the key to repair midfacial fractures, is the correct placing of the zygomatic arch in relation to the cranial base and the midface. In this way the transversal, vertical and sagittal diameters are regained in their correct space relationships.

Esthetics, Dental↗

PubMed1998

[A diagnostic protocol in cherubism].

Cherubism is a rare hereditary maxillo-facial pathology with unknown pathogenesis. The purpose of the present study is to describe a correct diagnostic approach to cherubism, especially for the differential diagnosis with other maxillo-mandibular cystic diseases. Therefore, the typical clinical, radiological, genetical and histopathological aspects of this pathology are examined. Moreover, an adequate therapy for the cases examined in this study is suggested.

Adolescent↗

PubMed1997

Schwannoma of the mandible.

Schwannoma is a benign neoplasm originating from Schwann's cell. It involves neurons and axons of peripheral nerves. This tumor has a predilection for the head and neck region, and often occurs as soft tissue lesion. Intraosseous sheath tumors are rare, comprising less than 1% of all bone tumors; the mandible is the most common site. The literature reports only 30 acceptable cases of schwannoma of the mandible. We report a new case of schwannoma that is unusual in its intraosseous localization and the patient's comparatively young age.

Child↗