Maxillo facial Surgery

Rostock, Germany

Maxillo facial Surgery

Rostock, Germany
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Dassonville O.,Institut Universitaire de France | Bozec A.,Institut Universitaire de France | Chateau Y.,Epidemiology and Biostatistics Unit | Devauchelle B.,Maxillo Facial surgery | And 11 more authors.
European Archives of Oto-Rhino-Laryngology | Year: 2016

Free-flap mandibular reconstruction is a highly specialized procedure associated with severe complications necessitating re-interventions and re-hospitalizations. This surgery is expensive in terms of health workers’ time, equipment, medical devices and drugs. Our main objective was to assess the direct hospital cost generated by osseocutaneous free-flap surgery in a multicentric prospective micro-costing study. Direct medical costs evaluated from a hospital perspective were assessed using a micro-costing method from the first consultation with the surgeon until the patient returns home, thus confirming the success or failure of the free-flap procedure. The mean total cost for free-flap intervention was 34,009€ (5151–119,604€), the most expensive item being the duration of hospital bed occupation, representing 30–90% of the total cost. In the event of complications, the mean cost increased by 77.3%, due primarily to hospitalization in ICU and the conventional unit. This surgery is effective and provides good results but remains highly complex and costly. © 2016 Springer-Verlag Berlin Heidelberg


PubMed | Epidemiology and Biostatistics Unit, University of Nice Sophia Antipolis, University of Lorraine, Center Oscar Lambret and 5 more.
Type: | Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery | Year: 2016

Free-flap mandibular reconstruction is a highly specialized procedure associated with severe complications necessitating re-interventions and re-hospitalizations. This surgery is expensive in terms of health workers time, equipment, medical devices and drugs. Our main objective was to assess the direct hospital cost generated by osseocutaneous free-flap surgery in a multicentric prospective micro-costing study. Direct medical costs evaluated from a hospital perspective were assessed using a micro-costing method from the first consultation with the surgeon until the patient returns home, thus confirming the success or failure of the free-flap procedure. The mean total cost for free-flap intervention was 34,009 (5151-119,604), the most expensive item being the duration of hospital bed occupation, representing 30-90% of the total cost. In the event of complications, the mean cost increased by 77.3%, due primarily to hospitalization in ICU and the conventional unit. This surgery is effective and provides good results but remains highly complex and costly.


Cerda T.,Radiation Oncology | Sun X.S.,Radiation Oncology | Vignot S.,Medical Oncology | Marcy P.-Y.,Center Antoine Lacassagne | And 7 more authors.
Critical Reviews in Oncology/Hematology | Year: 2014

Background: Salivary gland carcinomas constitute a heterogeneous group of tumors, with over 20 histological subtypes of various prognoses. The mainstay of treatment is surgery, with radiotherapy advocated for unresectable disease or postoperatively in case of poor prognostic factors such as high grade, locally advanced and/or incompletely resected tumors. Concurrent chemotherapy is sometimes advocated in routine practice based on criteria extrapolated from squamous cell carcinomas of the head and neck, on radioresistance of salivary gland tumors and on results obtained in the metastatic setting. The aim of this review was to identify situations where chemotherapy is advocated. Material and methods: A search of literature was performed with the following key words: parotid, salivary gland, neoplasm, cancer, malignant tumor, chemoradiation, chemotherapy, radiotherapy and treatment. Case report and studies published before 2000 were not included. Results: Platinum-based regimens were the most frequent. Other regimens were reported and seemed dependent on histology. The level of evidence for the concurrent delivery of chemotherapy with radiation therapy is supported by a low level of evidence. Prescribing chemotherapy mostly relies on poor prognostic factors similar to those used to indicate high dose radiotherapy. Protocols vary with histology. Conclusion: The rationale for adding chemotherapy to radiotherapy remains to be demonstrated prospectively. Although the type of systemic treatments used may be adapted on histology, the strongest rationale remains in favor of cisplatin. © 2014 Elsevier Ireland Ltd.


Vescovi P.,University of Parma | Campisi G.,University of Palermo | Fusco V.,Hospital of Alessandria | Mergoni G.,University of Parma | And 8 more authors.
Oral Oncology | Year: 2011

Invasive local procedures are often reported in clinical history of patients suffering from Bisphosphonates-Related Osteonecrosis of the Jaws (BRONJ) but over 40% of spontaneous forms have been also described in literature. We compared age, gender, underlying bone disorders, bisphosphonate therapy, clinical features and surgical outcome of 205 cases (36.2%) of BRONJ non surgery-triggered (group 1) with 362 (63.8%) cases of surgery-triggered forms (group 2). Differences between group 1 and 2 were analysed using Mann-Whitney U and χ2 tests. Statistical analysis was performed using STATA 8. Zoledronate was the most used type of bisphosphonate (63.4% versus 69.0%) and the mandible was the most frequently involved site (63.9% versus 63.4%) in both groups. BRONJ in group 1 was more frequently multicentric (9.3% versus 5%, p < 0.05), had a lower clinical stage (45.9% versus 13.8% in stage 1, p < 0.01) and had a better outcome after surgical therapy (improvement in 74.1% versus 58.6%, p < 0.05). The high prevalence of non surgery-triggered forms of BRONJ should be considered by oncologists, haematologists and general physicians who are advised to inform their patients regarding the importance of preventive dental protocols to control the possible causes of osteonecrosis not related to dental invasive procedures. © 2010 Elsevier Ltd. All rights reserved.


Gasparini G.,Columbus University | Saponaro G.,Columbus University | Marianetti T.M.,Columbus University | Tamburrini G.,Policlinico Universitario melli | And 3 more authors.
Child's Nervous System | Year: 2013

Purpose: Maxillary and mandibular alterations in children affected by anterior synostotic plagiocephaly have, until today, received only scarce attention. The goal of this paper is to focus on the mandibular alterations, persisting after the early correction of anterior plagiocephaly during the first year of life. Methods: Maxillary and mandibular metric measurements were performed on high resolution, thin slices CT scans; all images were reconstructed into 3D models which were used to perform the metrical assessments. Results: Twelve patients were selected; all of them had been treated in early age with a neurosurgical intervention and had reached the end of maxillo-mandibular growth at the time of the evaluation. Significant discrepancies were documented between the two affected sides, with all measured distances being shorter on the synostotic side than the nonsynostotic one, the only exception being the vertical dimension of the mandibular ramus. Discussion: Mandibular alterations resulted to be characterized by lower jaw hypoplasia on the side of the affected suture and anterior displacement of the glenoid fossa; these two entities compensated each other uncompletely, ending in a rotation of the mandibula towards the synostotic side. © 2012 Springer-Verlag Berlin Heidelberg.


Schneider D.,HELIOS Hospital Schwerin Oral and Maxillofacial Surgery | Radloff S.,Maxillo facial Surgery | Bolz M.,University of Rostock | Briese V.,University of Rostock
Zeitschrift fur Geburtshilfe und Neonatologie | Year: 2014

Background: This communication presents precise percentile values for birth weight, birth length and cranial circumference of infants in Mecklenburg-Pomerania, Germany. Material and Methods: Based on data from the German Perinatal Survey of the years 1994-2011 in Mecklenburg-Pomerania, the 3rd, 10th, 25th, 50th, 75 th, 90th and 97th percentile values for birth weight, birth length and head circumference are specified. The measurements of a total of 174084 infants from non-multiple births are shown. Results: The statistically calculated percentile values are presented in tabular and graph forms. The mean birth weight of the infants was 3437.8g. The average age of the mothers was 27.9 years. The average duration of pregnancy was 39.4 complete weeks. Conclusions: The insights gained from many years of data collection are presented as standardised, regional percentile values and curves for Mecklenburg-Pomerania for the first time. The differentiated presentation for the federal state opens the possibility for individually tailored consultations in clinical practice and may provide support for recognised national curves for these values.©Georg Thieme Verlag KG Stuttgart. New York.


Gasparini G.,Catholic University of the Sacred Heart | Torroni A.,Maxillo Facial Surgery | Di Nardo F.,CatholicUniversity of the Sacred Heart | Pelo S.,Catholic University of the Sacred Heart | And 6 more authors.
BioMed Research International | Year: 2015

Introduction. This study aims to investigate the reasons that discourage the patients affected by OSAS to undergo orthognathic surgery and compares the postoperative discomfort of phase I (soft tissue surgery) and phase II (orthognathic surgery) procedures for treatment of OSAS. Material and Methods. A pool of 46 patients affected by OSAS was divided into two groups: "surgery patients" who accepted surgical treatments of their condition and "no surgery patients" who refused surgical procedures. The "surgery patients" group was further subdivided into two arms: patients who accepted phase I procedures (IP) and those who accepted phase II (IIP). To better understand the motivations behind the refusal of II phase procedures, we asked the patients belonging to both the IP group and "no surgery" group to indicate the main reason that influenced their decision to avoid II phase procedures.We also monitored and compared five parameters of postoperative discomfort: pain, painkiller assumption, length of hospitalization, foreign body sensation, and diet assumption following IP and IIP procedures. Results.Themain reason to avoid IIP procedures was the concern of a more severe postoperative discomfort. Comparison of the postoperative discomfort following IP versus IIP procedures showed that the former scored worse in 4 out of 5 parameters analyzed. Conclusion. IIP procedures produce less postoperative discomfort. IIP procedures, namely, orthognathic surgery, should be the first choice intervention in patients affected by OSAS and dentoskeletal malformation. Copyright © 2015 Giulio Gasparini et al.


Martinelli M.,University of Bologna | Carinci F.,University of Ferrara | Morselli P.G.,University of Bologna | Palmieri A.,University of Ferrara | And 4 more authors.
International Journal of Immunopathology and Pharmacology | Year: 2011

The 12q13 region has been suggested as a candidate locus for orofacial cleft by different investigators. In the present study we tested the region for linkage with non syndromic cleft lip with or without cleft palate in a collection of 39 Italian multigenerational families, using microsatellite markers. No evidence of linkage was detected between the marker map and NSCLP under different mode of inheritance nor with a nonparametric method. Formal level of linkage exclusion, were obtained for each point of the map. Genetic heterogeneity and the different impact of the candidate locus among populations could explain conflicting results obtained in different studies. © SAGE Publications.


PubMed | Catholic University of the Sacred Heart and Maxillo Facial Surgery
Type: | Journal: BioMed research international | Year: 2015

This study aims to investigate the reasons that discourage the patients affected by OSAS to undergo orthognathic surgery and compares the postoperative discomfort of phase I (soft tissue surgery) and phase II (orthognathic surgery) procedures for treatment of OSAS.A pool of 46 patients affected by OSAS was divided into two groups: surgery patients who accepted surgical treatments of their condition and no surgery patients who refused surgical procedures. The surgery patients group was further subdivided into two arms: patients who accepted phase I procedures (IP) and those who accepted phase II (IIP). To better understand the motivations behind the refusal of II phase procedures, we asked the patients belonging to both the IP group and no surgery group to indicate the main reason that influenced their decision to avoid II phase procedures. We also monitored and compared five parameters of postoperative discomfort: pain, painkiller assumption, length of hospitalization, foreign body sensation, and diet assumption following IP and IIP procedures.The main reason to avoid IIP procedures was the concern of a more severe postoperative discomfort. Comparison of the postoperative discomfort following IP versus IIP procedures showed that the former scored worse in 4 out of 5 parameters analyzed.IIP procedures produce less postoperative discomfort. IIP procedures, namely, orthognathic surgery, should be the first choice intervention in patients affected by OSAS and dentoskeletal malformation.

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