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Biomedical subjects

R F Mazzola

Publications and source records attributed to R F Mazzola.

At least 19 recordsLinked to original sources
PubMed2001

Platysma flap for oral reconstruction.

In the authors' series of 12 consecutive patients who had oral reconstruction using the indications described above, flap survival always was achieved. Venous congestion was observed often: the flap became intensively red, showing a disappointing color that resolved spontaneously with only skin de-epithelialization. In one case of floor-of-the-mouth repair, a marginal necrosis of the distal portion of the flap occurred, possibly because of a venous drainage problem. The secondary defect healed spontaneously, without fistula formation. The time required to outline the flap is less than for most other flaps, and donor site morbidity is minimal. In selected cases, a platysma flap is an easy and rewarding solution for repairing various oral defects.

Humans↗
PubMed1998

A possible sequela of transoral approach to the upper cervical spine. Velopharyngeal incompetence.

The authors describe a case of velopharyngeal incompetence (VPI), as a consequence to the neurosurgical treatment for a complex malformation of the cranio-spinal junction. A 61-year-old woman underwent a transoral-transvelar surgical approach for odontoid resection. One month later surgical fixation of the posterior spine with autologous iliac bone graft was performed. Following these operations the patient presented a marked alteration of speech intellegibility due to hypernasal voice resonance and through incapability to articulate the oral phonemes correctly. She also complained of nasal regurgitation of fluids and solids while swallowing. She underwent a clinical phoniatric assessment of voice and speech. Videonasopharyngoscopy allowed us to inspect the velopharyngeal sphincter and to show clearly the type and morphology of its closure defect. Correction of VPI was achieved by means of a velopharyngoplasty (pharyngeal flap), in spite of technical difficulties due to local scarring and to a problematic exposure of the surgical field.

Cervical Vertebrae↗
PubMed1997

Secondary rhinoplasty: analysis of the deformity and guidelines for management.

Secondary rhinoplasty aims at modifying the functional and cosmetic defects caused by an improperly performed a primary procedure. Correction follows a logical sequence from which there is no reason to deviate if one wishes to achieve sure results. The sequence includes analysis of the deformity, accurate photographic documentation, functional and diagnostic examination, consultation with the patient, and precise planning of the different steps of surgery. Deformities are grouped in four different sectors depending on the characteristics of the repair: upper, intermediate, lower, and inner. However, defects may involve more than one sector, making it difficult or impossible to establish a precise boundary between them. The surgical technique requires a wide exposure of the operating field so that the surgeon can clearly evaluate the anatomical deformities and carry out the necessary corrections. For this reason, the open approach is the solution of choice. Two types of grafts are commonly used in revision rhinoplasty, cartilage and bone. They become necessary to reestablish function and to restore volume and/or contour. We strongly believe that only autologous grafts can be used. Grafting materials, their sources, and applications in different clinical cases are described here.

Bone Transplantation↗
PubMed1996

Secondary unilateral cleft lip nose: the external approach.

No single procedure developed until now has given satisfactory results to provide an ideal surgical method for cleft lip nasal deformity correction. This paper emphasizes the concept that nasal surgery is the end result on an overall treatment program for secondary cleft lip. The first step is correcting skeletal deformities. The second step of modifying the overlying nasal pyramid can only be performed when the alar base and the floor of the nose are at the same level through orthodontic alignment of the maxillary segments and bone grafting. Prior to deciding on the type of strategy, it is essential to carefully analyze the severity of the deformity, the patency of the airways, the nasal lining, and the nasal tip projection. An external approach, using the marginal-transcolumellar incision, provides excellent visualization essential for the accuracy of the correction to be carried out. The technique presented here includes modification of the following points as a single stage operation: septal surgery, suturing the medial crura together, suspension of the alar cartilage to the periosteum of the nasal bone, alar base repositioning, orbicularis muscle suturing, and increasing tip projection.

Bone Transplantation↗
PubMed1996

The back-and-forth septoplasty.

This paper describes a new technique of septoplasty especially devised to minimize and simplify surgery and to preserve at the same time the integrity of mucosa at the critical area of articulation between the caudal quadrangular cartilage and the vomeropremaxillary crest. Two special instruments specifically designed for this type of operation are illustrated. The technique finds a specific clinical application to cosmetic surgery of the nose when a functional problem exists.

Adolescent↗
PubMed1995

Alessandro Benedetti, a fifteenth century anatomist and surgeon: his role in the history of nasal reconstruction.

Alessandro Benedetti (about 1445-1525) was Professor of Anatomy and Surgery at Padua University. He became famous for the construction of the first anatomical theater ever built, where he personally used to carry out dissections. He published articles on many subjects, first of all on anatomy. His work Anatomice, sive Historia Corporis Humani (Anatomy, or the History of the Human Body), first printed in Venice in 1502, was very popular and influential at that time. Of the many topics treated in the book, one is of special interest to plastic surgeons, i.e., the description of nasal reconstruction by means of a skin flap taken from the arm. The procedure is the same as the one the Branca family practiced in Sicily in the middle of fifteenth century. It is well known that the Brancas kept secret the operation and never published it. Hence, Alessandro Benedetti played an important role in the history of plastic surgery because he first reported in the Western surgical literature the procedure of nasal repair, later called the "Italian" method, almost 100 years before Tagliacozzi's publication in 1597.

Anatomy↗
PubMed1990

A forgotten innovator in facial reconstruction: Pietro Sabattini.

Pietro Sabattini (1810-1864), a creative surgeon from Bologna, Italy, first had the idea of repairing a posttraumatic upper lip defect using a flap taken from the lower. The flap contains the three elements--skin, muscle, and mucosa--and is based on a specific vessel, the circumlabial artery. Therefore, it anticipates the musculocutaneous flap concept of today. Sabattini published his paper in 1838, 60 years before Abbé. This paper provides the first English translation of the original text and a biography of this forgotten innovator in facial reconstruction.

Face↗
PubMed1987

Guidelines for pharyngostome closure.

The reconstructive procedure for pharyngostome closure includes single-stage restoration in three steps: lining, intermediate layer, and covering. The lining repair is the key factor to the successful outcome of the operation. Three clinical situations may be distinguished. First, the mucosa is sufficient to restore a new gullet. In this case, it is widely undermined and sutured along the midline without any tension. Second, the mucosa is only partially sufficient. The same procedure as above is adopted to close the lower two-thirds of the pharyngostome, while an advancement flap is outlined from the base of the tongue to restore the upper third. Third, the mucosa is not sufficient. A musculocutaneous flap solves the problem. Reconstruction of the intermediate layer involves rotation of one (or both) sternomastoid muscle(s), if present. The possibilities for coverage include a submandibular flap, a thoracoacromial flap, and/or musculocutaneous flaps. By following these guidelines, the authors have successfully closed 37 pharyngostomes.

Female↗
PubMed1987

History of nasal reconstruction. A brief survey.

Nasal reconstruction goes back to very early times; it was practised in ancient India about 1000 B.C. The first reports in the Western World come from the Branca family in Sicily (mid XV century) and from the Vianeo family in Calabria (mid XVI century): this art was later taken up by Tagliacozzi and published by him in 1597. A review of the literature reveals that the numerous procedures now available to repair the nose had already been devised by the middle of the nineteenth century in Germany and France as well as in England. Outstanding contributions were also made in Italy and the United States.

History, 15th Century↗
PubMed1987

Choice of techniques in nasal repairs.

The authors after classifying skin loss of the nose according to their size and site, resume the techniques they normally use in every kind of loss. They suggest those most reliable and easy to perform.

Humans↗
PubMed1984

Evolving concepts in lip reconstruction.

An extensive review of world literature reveals that current innumerable procedures to repair upper and lower lip defects were already devised about the middle of the nineteenth century. There is little that can be defined as original after that time. In fact, most of the so-called new methods for labial reconstruction are a modification of old ideas. In tracing the steps of evolution in lip repair, the authors emphasize that only few concepts should be regarded as decisive to achieve a good final result. The use of lip tissue to repair lip defects should be one of the aims of modern cheiloplasty. Following this principle, it is possible to reestablish interrupted sphincteric functions of the orbicularis oris and, at the same time, most of the expression of emotions. When insufficient material is available for reconstruction, full-thickness local flaps of cheek can be considered the alternative solution, far better than distant lined flaps, which create a static, unaesthetic barrier.

Cleft Lip↗
PubMed1984

Our experience with lip reconstruction. A lesson from history.

The authors' philosophy in performing labial reconstruction has evolved from unsatisfactory results using classic procedures. Such results prompted attempts with procedures that are both more cosmetic and functional and that give greater emphasis to the restoration of the oral sphincter.

Adult↗
PubMed1984

Reconstruction of the hypopharynx following extensive loss of mucosa.

Mucosal loss of the hypopharynx, following pharyngostome or wide resection of carcinoma, poses problems for repair. The authors emphasize a reconstructive procedure based on the use of three elements combined together in various ways: residual strip of mucosa of the posterior pharyngeal wall, a musculomucosal pedicled flap obtained from the base of the tongue, a pectoralis major musculocutaneous flap. Thus any defect of the hypopharynx can be repaired in one stage. The safety of the procedure is well tested with good clinical results and lack of complications.

Adult↗
PubMed1983

History of total nasal reconstruction with particular emphasis on the folded forehead flap technique.

The history of plastic surgery is identified throughout the centuries with the history of rhinoplasty. The Indian Koomas first and later the Italian surgeons found valid solutions to the problems caused by partial loss of the nasal pyramid. However, the idea of rebuilding, with a single forehead flap, the tip and columella and providing at the same time a lining of skin for the newly formed nose goes back to the middle of the nineteenth century. The Italian Natale Petrali (1842) and the Germans Johann Friedrich Dieffenbach (1845) and Ernst Blasius (1848) contend for precedence in carrying out this important procedure still used today, which, barring postoperative contracture, represented a great advance in successful total rhinoplasty.

Germany↗
PubMed1983

Cerebro-craniofacial and craniofacial malformations: an embryological analysis.

A macro- and/or microscopical study on the normal and abnormal development of the forebrain with the eyes, nose, and cranium, was performed in 139 mouse embryos, 120 normal and 19 abnormal human embryos and fetuses, and in about 2,300 human skulls. The results suggest that from the embryological point of view, a distinction should be made between facial defects involving the brain and/or the neural elements of the eyes, i.e., the cerebro-craniofacial dysplasias, and malformations of the face and cranium only, called the craniofacial dysplasias. Both groups can be subdivided into early or primary defects (in embryos less than or equal to 17 mm C-RL) and late or secondary defects (in embryos greater than or equal to 17 mm C-RL). Almost all of the primary defects can be considered to originate from disorders occurring during the transformation of the brain and face. The secondary defects concern defective differentiation of neurectoderm and of the mesenchyme into bone centers, cartilage, and muscles. All of the defects in question can be explained by insufficient cell proliferation, degeneration, and/or differentiation. New terminology is proposed.

Animals↗