Papers by sara buonaccorsi
Journal of Craniofacial Surgery
Introduction: Shared vehicles, such as e-scooters and electric bicycles, could potentially accele... more Introduction: Shared vehicles, such as e-scooters and electric bicycles, could potentially accelerate the transition toward sustainable mobility. Focusing on e-scooters, the aim of this study is to show, compared with previous years when e-scooter use was significantly reduced, the increased incidence of maxillofacial bone injuries from e-scooters and the most frequent type of fractures. Methods: We conducted a monocentric observational retrospective and prospective analysis during the pandemic, from January 1, 2020, until December 31, 2022, on patients’ access for maxillofacial traumas at the San Giovanni Addolorata emergency department, trauma hub center, for Lazio district. A total of 383 patients were included. Data on the causes of traumas, type of injury produced, age, gender, nationality, and helmet use were collected. Especially, we analyzed the e-scooter–related facial traumas that had gained a lot of popularity in this period due to the restriction in mobility because of C...
Journal of Craniofacial Surgery, Nov 1, 2005
Journal of Craniofacial Surgery, Jul 1, 2008
Journal of Craniofacial Surgery, Mar 1, 2013
Objective: A variety of techniques have been described for the repair of cerebrospinal fluid (CSF... more Objective: A variety of techniques have been described for the repair of cerebrospinal fluid (CSF) leaks at the anterior skull base. Conservative management includes bed rest, avoidance of straining activities, and temporary CSF diversion with serial lumbar punctures or lumbar drains. Surgical repair may be achieved transcranially through a bifrontal craniotomy, extracranially through an external ethmoidectomy or frontal sinusotomy, or transnasally with microscopic or endoscopic visualization. Method: Between January 2006 and May 2011, 30 patients with nontraumatic and traumatic CSF rhinorrhea were treated at the Departments of Neurosurgery and Maxillofacial Surgery of the Universities of Rome WLa SapienzaW. All patients underwent surgery: 5 patients (15%) were treated by a combined intracranial and endoscopic endonasal approach and 25 patients were treated (91.1%) by the endoscopic endonasal approach alone. In our study, we used autologous material, the fascia lata, free grafts of septal or middle turbinate mucoperichondrium, and septal cartilage grafts, and in cases with a large deficit in the posterior wall of the sphenoid or clivus, a pedicle flap from sphenopalatine artery of septal mucosa is used. Results: Only in 2 cases was there an appearance of secondary rhinoliquorrhea with a success rate of 94%, in line with what is described in international literature. Conclusions: Posttraumatic cerebrospinal leak in our experience can be treated through endoscopic approach, in selected cases, using autologous materials with a few relapse of the pathology. Endoscopic endonasal technique offers a high viewing of surgical field and it permits to manage even larger lesions with minimally invasivity.
Journal of Craniofacial Surgery, Jul 1, 2012
Angiolipomas are benign mesenchymal tumors infrequently affecting the head and neck region, manif... more Angiolipomas are benign mesenchymal tumors infrequently affecting the head and neck region, manifesting themselves as small (<4 cm), slow-growing mass that are painful or tender to palpation. Ultrasonography, fine needle aspiration biopsy, computed tomography, and magnetic resonance imaging can be used to make a diagnosis. Surgical excision is the treatment of choice in both infiltrating and noninfiltrating forms, even if liposuction can be considered in multiple forms. We describe a case of infiltrating intramasseterin angiolipoma, in which diagnosis was suspected after magnetic resonance imaging with gadolinium; then a transoral surgical excision was performed. To the best of our knowledge, only 1 other case of intramasseterin-infiltrating angiolipoma has been previously described.
Journal of Craniofacial Surgery
Medial wall fracture of the orbit is a condition that requires surgical correction should the pat... more Medial wall fracture of the orbit is a condition that requires surgical correction should the patient presents a series of signs and symptoms such as diplopia and enophthalmos. The classical external approaches for exposure like the transconjunctival or transcutaneous approach have been replaced in specific cases by endoscopic approaches as they are less invasive and they eliminate any risk of potential scarring. Larger defects where the medial wall is comminuted or bony fragments are missing could be reconstructed with permanent autogenous or alloplastic materials. When bony fragments are present, a reduction of the fracture can be performed instead, with only a temporary alloplastic material for support. In this study, the authors discuss our experience regarding the management of orbital medial wall fractures by endoscopic endonasal balloon in 14 patients and describe its indications and contraindications. The authors concluded that the balloon achieves satisfactory mechanical su...
Biomaterials - Physics and Chemistry, 2011
Maxillofacial prosthetics is considered in literature as ''... the art and science of anatomic, f... more Maxillofacial prosthetics is considered in literature as ''... the art and science of anatomic, functional and cosmetic reconstruction, by the use of non-living substitutes, of those regions in the maxillae, mandible and face that are missing or defective..." 1. In the maxillofacial surgery where malformative, oncologic traumatologic pathology and the plastic surgery are treated, the maxillofacial prostheses, in selected cases, can reach a satisfactory therapeutic result from functional, aesthetic, psychologic, and social point of views. In a delicate district, such as the face, where a heavy deficit can determine huge psychologic and social problems, the conventional reconstructive surgery intervenes with reconstructive techniques and with the biomaterials insertion, often insufficient to guarantee the restoration of the harmony of the face. When these conditions are verified, the solution resides in the osteointegration concept and in the application of the epithesis. There are certainly some limits of application of these prostheses, first, the ethics limits: the epithesis constitute in fact an alternative only when the conventional reconstructive surgery cannot be applied, but inside these limits, it is really possible to find an excellent therapeutic resource in patients who cannot undergo surgical interventions. In literature, it is possible to find different kinds of reconstruction of missing body parts by the application of prothesis2.The osteointegration concept was introduced at first time by Professor Branemark in 1960 to describe the ''direct structural and functional connection between living bone and the surface of a plant exposed to load, understood as a not static but dynamic process3. According to his school of thought, the technique of positioning of the implant is fundamental, to take place in the most complete precision and to allow the initial stability of one's self. Other elements conditioning the success of the osteointegration are the material of the implant, the form, the areas of the application, and the patient's clinical conditions. The first titanium osteointegration implant was positioned in 1965 in the jaw without dental elements 4;in 1977, implants were positioned in mastoid areas for the application of an acoustic translator. In 1979,implants for the fixation of epithesis of ears, noses, and eyes were positioned. At present, the indication to the position of epithesis as the first choice of treatment is when the conventional reconstructive interventions turn out to be inapplicable or ineffective. The epithesis is a good resolution for the patient because it is not traumatic and has short-time result, removing every psychologic physique obstacle for the inclusion in a normal social life.
Biomaterials - Physics and Chemistry, 2011
Plastic and Reconstructive Surgery, 2005
El sÃndrome de Parry-Romberg, también conocido como hemiatrofia facial progresiva, es un sÃndrome... more El sÃndrome de Parry-Romberg, también conocido como hemiatrofia facial progresiva, es un sÃndrome neurocutáneo raro de etiologÃa desconocida. Las principales caracterÃsticas son la atrofia de los tejidos blandos, y algunas veces del hueso, en una mitad de la cara o parte frontal de la cabeza, sin debilitamiento facial. Estudios recientes plantean la posibilidad hereditaria de esta patologÃa, ya
Oral Oncology, 2013
Purpose The importance of primary prevention is nowaday accepted as the most useful way to avoid ... more Purpose The importance of primary prevention is nowaday accepted as the most useful way to avoid oral cavity precancerosis transformation in malignant conditions. Prevention includes clinical observation, stopping smoking, and removing risk factors. Furthermore the introduction of laser CO2 surgery allows to manage such lesions through evaporation, without any scar retractions and consequent chewing discomfort, thanks to the haemostatic effect and the preserving of muscular layer. The reduction of surgical timing and low relapse of disease make this procedure to be considered safe. Materials and methods Authors show their experience in a series of 93 patients observed (25 female and 36 males, mean age 55Â years) from 2002 to 2012. 61 of them underwent to CO2 laser evaporation to remove a total of 157 heterogeneous lesions of oral cavity. Definitive histologic examinations were performed. The procedure included the resection as an excisional biopsy without involving the deep muscular layer. Results In 37% lesions involved the tongue. In 63% pre cancerous lesion were found out and 7% of cases showed squamous cell carcinoma. In a 7Â years period of follow up a 4,3% of pathology relapse has been observed. 93% cases have shown a good wound healing, combinig diclofenac mouth washes and ialuronic acid therapy via aerosol were carried out, during the post operative period to improve wound closure. Conclusion Sterilization due to thermic effect permits a better pain control, without any antibiotic in the post operative period, edema reduction. Despite of high temperature laser allows to conserve tissue layer and the margin resection. According to literature our experience could confirm the importance of the laser surgical treatment of all the suspicious lesions of the oral cavity. The histologic diagnosis of precancerosis prevents malignant transformation and so demolitive and reconstructive surgery that may interfere with the patients quality of life.
Journal of Cranio-Maxillofacial Surgery, 2006
Abstracts, EACFMS XVIII Congress survived during a follow-up of 3 years. Two of the 23 (9%) compl... more Abstracts, EACFMS XVIII Congress survived during a follow-up of 3 years. Two of the 23 (9%) complicated tumour and trauma patients were re-operated due to a local mucocele. Conclusions: Treatment of severe head and neck defects with biomaterial is a suitable alternative to conventional methods. Bioactive materials seems to be stable and reliable in clinical follow-ups. The reconstructions with bioactive glass and hydroxyapatite are associated with good functional and aesthetic results without donor-site morbidity. O.191 Cranial reconstruction with biomaterials. Our experience in the last 5 years
Journal of Cranio-Maxillofacial Surgery, 2006
Porous polyethylene (Medpor ® ) is an alloplastic material commonly used in craniofacial reconstr... more Porous polyethylene (Medpor ® ) is an alloplastic material commonly used in craniofacial reconstruction. We report about our first clinical experiences with Medpor ® for facial augmentation procedures. We treated 27 patients between 2001 and 2005 (11 female, 16 male) with 48 Medpor ® implants. The indications for application of porous polyethylene implants in our clinic were congenital malformations (15), post-traumatic defects (10) and reconstructions after tumour resection (2). The implants were used for nasal/paranasal augmentations ( ), for zygomatico-orbital augmentations ( ) and for augmentations of the chin and malar region (11). The procedures were performed in a standardized manner. We used prefabricated, self-contoured implants and fixed them subperiostally with titanium ostheosynthesis screws. All operations were performed under general anaesthesia. We evaluated the esthetic results and the ingrowth behaviour clinically and histologically. We achieved good aesthetic results and the patients showed no signs of discomfort or rejection. Four patients were in need for a second intervention. These revision surgeries included two cases of local infections and two for aesthetic contouring. The necessary reduction of the implants allowed the harvesting of tissue and implant samples for microscopy. Porous polyethylene implants showed a good fibrovascular integration without an encapsulation in the light microscopy. Giant cells were detected on the surface of the implants. Besides this there is evidence for resorption of the implant material. The fixation with titanium screws is very effective. No implant dislocation or implant fracture occurred. The implants showed high volume stability and were easily handled. It is not possible to visualize Medpor implants with current imaging techniques.
Journal of Cranio-Maxillofacial Surgery, 2006
Hemangiomas are the most common tumour of infancy and childhood affecting approximately 2.6% of i... more Hemangiomas are the most common tumour of infancy and childhood affecting approximately 2.6% of infants by the age of 1 year. They are characterized by presentation at birth or shortly thereafter, and a rapid proliferative phase over the first 12 months. These lesions occur mainly in head and neck district and are preponderant in females. Hemangiomas typically appear during the first 9-10 months of life as an erythematous lesion characterized by an initially rapid growth, followed by spontaneous involution characterized by a decrease in tumour size and colour change from bright red to grey. This involutional process continues over the next 5 to 7 years. In cavernous haemangiomas, this involution can be incomplete. The management of hemangiomas depends on several factors such as age of patient, location, size and growth phase of the tumour. Surgical excision is indicated in small size lesion when can be easily excized, in the treatment of residual hemangiomas after pharmacological therapy or after involution phase and in presence of facial hemangiomas causing functional disturbance or serious psychological distress. We report a case of a giant involuting cavernous hemangioma of left side of the face. Even with a complete involution, signs of the hemangioma persist in the form of fibrosis with lossing of facial muscle activity and facial deformity. Surgical treatment performed in multiple sessions, we have permitted to achieve excellent results with a minimal morbidity.
Journal of Cranio-Maxillofacial Surgery, 2006
Ca/Si decreased up to values of monitoring group because of normalization of concentrations Ca an... more Ca/Si decreased up to values of monitoring group because of normalization of concentrations Ca and Si. Without 'VINIBIS' this ratio did not change at POWP and TOP because of high density Ca (p less than 0.05). At POW through increase of a ratio Ca/Si was watched. However it was by outcome of useful increase Ñà (p less than 0.05). The factor of a synergy of vitamins in the standards makes 1, whereas for the drug 'VINIBIS' it is peer 15. This drug has low concentration of vitamins (up to 1000 times), however because of a synergy of vitamins it is successfully applied as antioxidant in treatment on resorption of a mandible (Patent RU).
Journal of Cranio-Maxillofacial Surgery, 2008
Journal of Craniofacial Surgery, 2005
Journal of Craniofacial Surgery, 2008
Journal of Craniofacial Surgery, 2006
The nevus sebaceus of Jadassohn (SNJ) is a hamartomatous disorder of the skin and its adnexa pert... more The nevus sebaceus of Jadassohn (SNJ) is a hamartomatous disorder of the skin and its adnexa pertaining to the group of "organoid nevi,'' most frequently involving the face and scalp. During adulthood, patients with SNJ have a 10% to 20% risk of the development of cutaneous or adnexal neoplasia, so that prophylactic excision before puberty is recommended by most authors, and tissue expansion is considered to be the best method of reconstruction. It has been largely demonstrated in literature that most of the lesions that have been interpreted as basal cell carcinoma (BCC) are actually examples of primitive follicular induction or trichoblastomas, not authentic BCCs. A literature review on histopathologic findings associated with SNJ and a retrospective chart review of two cases occurring in young females are presented. In one case, the lesion was treated by intraoperative expander-assisted reduction and scalp graft (Case 1); in the other one, a primary closure with adjacent tissue was performed (Case 2). No signs of malignant degeneration or residual pathology have been found. For treatment of the biggest lesions, when preoperative tissue expansion cannot be performed, intraoperative one, transfer of a scalp graft has been shown to be a good reconstructive method. For the smallest lesions, a primary closure with adjacent tissue is sufficient.
Journal of Craniofacial Surgery, 2008
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Papers by sara buonaccorsi