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Mannelli G, Bassani S, Cosi G, Fermi M, Gazzini L, Liberale C, Mazzetti L, Parrinello G, Saibene AM, Molteni G, Comini LV. Global frequency and distribution of head and neck sarcomas in adulthood: a systematic review. Eur Arch Otorhinolaryngol 2024; 281:2553-2567. [PMID: 38381151 DOI: 10.1007/s00405-024-08477-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/12/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE Head and neck sarcomas (HNS) constitute a rare and heterogeneous cancer entity. Management remains a challenge due their rarity and different biological behaviour among tens of subtypes. This systematic review aimed to describe HNS global frequency and distribution in adulthood. METHODS A systematic review was performed using PICOTS search strategies for qualitative question and it was written in accordance with PRISMA 2020 Statement. 70,653 publications were identified, and 15 variables were evaluated for a total of 2428 patients. RESULTS We identified 47 studies from 21 different countries from 5 different continents. Most of studies (83.3%) were performed in single institutions and America and Asia overruled for number of papers included (21 and 10, respectivelly). Osteosarcoma was more frequent, followed by chondrosarcoma, angiosarcoma and malignant fibrous histiocytoma. Early stage accounted for almost 80% of cases; advanced stage prevailed in developing countries. 1783 patients (90.1%) underwent surgery and 780 (39.4%) had adjuvant therapy. 50.8% of patients experienced tumour recurrence and the lowest mortality rate was reported in Europe (29.9%). CONCLUSIONS HNS holds a relative poor prognosis possibly explained by the heterogeneity of the disease. Treatment of HNS has shown to be highly diverse among different countries, underlining the importance of uniformed treatment guidelines to achieve better patient management and to improve survival outcomes.
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Affiliation(s)
- Giuditta Mannelli
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sara Bassani
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Unit of Otorhinolaryngology, Head and Neck Department, University of Verona, Verona, Italy
| | - Ginevra Cosi
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Matteo Fermi
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Luca Gazzini
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Carlotta Liberale
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Unit of Otorhinolaryngology, Head and Neck Department, University of Verona, Verona, Italy
| | - Luca Mazzetti
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giampiero Parrinello
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Otolaryngology-Head and Neck Surgery, IRCCS San Martino Polyclinc Hospital, Genoa, Italy
| | - Alberto Maria Saibene
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otolaryngology Department, Department of Health Sciences, Santi Paolo e Carlo Hospital, Università Degli Studi di Milano, Milan, Italy
| | - Gabriele Molteni
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Lara Valentina Comini
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria.
- Head and Neck Oncology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale, 142-KM 3.95, 10060, Candiolo, TO, Italy.
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Sandeep KS, Rathod P, Dalvi R, Pawar A, Thottiyen S, Pandya S, Sharma M, Patel S, Warikoo V, Pandya S. Osteosarcoma of Head and Neck Region: Tertiary Cancer Care Center Experience. Indian J Otolaryngol Head Neck Surg 2024; 76:581-586. [PMID: 38440650 PMCID: PMC10908908 DOI: 10.1007/s12070-023-04216-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/04/2023] [Indexed: 03/06/2024] Open
Abstract
Head and neck osteosarcoma is an uncommon yet aggressive tumor which presents therapeutic challenges to get favourable results. Surgery remained the most effective treatment modality in this entity eventhough chemoradiotherapy have been tried in various studies for better outcome but still not yet becomes the standard in the management of these cases unlike in extremity osteosarcoma. We present our experience in the management of this uncommon yet lethal malignant tumor, i.e. head and neck osteosarcoma. To study the clinicopathological and prognostic features of Osteosarcoma in head and neck subsite. Retrospective study of patients diagnosed with head and neck osteosarcoma between 2003 and 2019. Total of 25 patients were included in our study. Mean age of our population is 27.5 years with slight male predominant. Mandible is the most commonly involved site. Multimodal treatment applied with surgical resection forms the main part in the management. Median DFS and OS were 16 and 36 months respectively with 5 year overall survival of 42%. Out of the various factors studied, absence of surgery, margin positivity are the principle features affecting the prognosis. Head and neck osteosarcoma is generally a jaw bone tumor commonly occurs in young adults with poor outcome. Since there is no universal guidelines to address this uncommon tumor, multiple studies have shown various results in the management. Till date, surgery remained the curative modality with mixed response on the role of chemotherapy and radiotherapy.
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Affiliation(s)
- K. S. Sandeep
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | | | - Raisha Dalvi
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | - Ajinkya Pawar
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | | | | | - Mohit Sharma
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | | | - Vikas Warikoo
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | - Shivam Pandya
- Gujarat Cancer and Research Institute, Ahmedabad, India
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Brauner E, Laudoni F, Amelina G, Cantore M, Armida M, Bellizzi A, Pranno N, De Angelis F, Valentini V, Di Carlo S. Dental Management of Maxillofacial Ballistic Trauma. J Pers Med 2022; 12:jpm12060934. [PMID: 35743719 PMCID: PMC9225066 DOI: 10.3390/jpm12060934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Maxillofacial ballistic trauma represents a devastating functional and aesthetic trauma. The extensive damage to soft and hard tissue is unpredictable, and because of the diversity and the complexity of these traumas, a systematic algorithm is essential. This study attempts to define the best management of maxillofacial ballistic injuries and to describe a standardized, surgical and prosthetic rehabilitation protocol from the first emergency stage up until the complete aesthetic and functional rehabilitation. In low-velocity ballistic injuries (bullet speed <600 m/s), the wound is usually less severe and not-fatal, and the management should be based on early and definitive surgery associated with reconstruction, followed by oral rehabilitation. High-velocity ballistic injuries (bullet speed >600 m/s) are associated with an extensive hard and soft tissue disruption, and the management should be based on a three-stage reconstructive algorithm: debridement and fixation, reconstruction, and final revision. Rehabilitating a patient with ballistic trauma is a multi-step challenging treatment procedure that requires a long time and a multidisciplinary team to ensure successful results. The prosthodontic treatment outcome is one of the most important parameters by which a patient measures the restoration of aesthetic, functional, and psychological deficits. This study is a retrospective review: twenty-two patients diagnosed with outcomes of ballistic traumas were identified from the department database, and eleven patients met the inclusion criteria and were enrolled.
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Affiliation(s)
- Edoardo Brauner
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
| | - Federico Laudoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Giulia Amelina
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Correspondence:
| | - Marco Cantore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Matteo Armida
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Andrea Bellizzi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Francesca De Angelis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00167 Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
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Brauner E, Mezi S, Ciolfi A, Ciolfi C, Pucci R, Cassoni A, Battisti A, Piesco G, De Felice F, Pranno N, Armida M, De Angelis F, Romeo U, Capocci M, Tenore G, Tombolini V, Valentini V, Ottolenghi L, Polimeni A, Di Carlo S. A New Medical Record Proposal to the Prognostic Risk Assessment for MRONJ in Oncologic Patients: "Sapienza Head and Neck Unit" Proposal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041851. [PMID: 33672876 PMCID: PMC7918934 DOI: 10.3390/ijerph18041851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/17/2021] [Accepted: 01/27/2021] [Indexed: 11/30/2022]
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is an adverse event associated with antiresorptive and antiangiogenic drugs. The use of these drugs in the treatment of cancer patients with bone metastasis is necessary and standardized in the literature. A multidisciplinary approach for the patient’s management is strongly recommended. Therefore, it should be necessary to integrate the path of these subjects with a dedicated dental screening in order to first assess the individual risk of developing a MRONJ, and then to plan dental treatments and oral hygiene sessions, and finally to schedule a follow-up to intercept and treat early osteonecrosis. The aim of this manuscript is to propose a new simple medical report to evaluate patients affected by metastatic bone cancer in order to reduce the risk of developing MRONJ.
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Affiliation(s)
- Edoardo Brauner
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Silvia Mezi
- Department of Radiological Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy; (S.M.); (G.P.); (F.D.F.); (V.T.)
| | - Alessandro Ciolfi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
- Correspondence: ; Tel.: +39-3397737410
| | - Chiara Ciolfi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Resi Pucci
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Andrea Cassoni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Andrea Battisti
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Gabriele Piesco
- Department of Radiological Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy; (S.M.); (G.P.); (F.D.F.); (V.T.)
| | - Francesca De Felice
- Department of Radiological Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy; (S.M.); (G.P.); (F.D.F.); (V.T.)
| | - Nicola Pranno
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Matteo Armida
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Francesca De Angelis
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Umberto Romeo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Mauro Capocci
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Gianluca Tenore
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Vincenzo Tombolini
- Department of Radiological Oncological and Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy; (S.M.); (G.P.); (F.D.F.); (V.T.)
| | - Valentino Valentini
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Livia Ottolenghi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Antonella Polimeni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
| | - Stefano Di Carlo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Roma, Italy; (E.B.); (C.C.); (R.P.); (A.C.); (A.B.); (N.P.); (M.A.); (F.D.A.); (U.R.); (M.C.); (G.T.); (V.V.); (L.O.); (A.P.); (S.D.C.)
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Cassoni A, Pucci R, Mangini N, Fadda MT, Battisti A, Giovannetti F, Terenzi V, Della Monaca M, Priore P, Raponi I, Valentini V. Head and Neck Cancer Treatment during COVID-19 Pandemic: A Central Experience in Rome. Emergency Management, Infection Prevention and Control. Cancers (Basel) 2020; 13:E33. [PMID: 33374237 PMCID: PMC7795055 DOI: 10.3390/cancers13010033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 12/02/2022] Open
Abstract
The COVID-19 pandemic has significantly affected the surgical units, especially those operating on the airways. This study evaluates the series of patients with tumors of the head and neck treated by our unit during Phase-1 of the pandemic and the efficacy of the preventive measures implemented for protecting both the patients and staff. A screening program was administered to all the patients who had to undergo surgery. None of the patients tested and operated during Phase 1, between 10 March and 18 May 2020, were positive for COVID-19. A significant portion of the patients was suffering from tumors in advanced stages (T3 and T4). Two patients developed respiratory symptoms during their stay at the unit, so they were put in precautionary isolation and tested, but resulted negative for COVID-19. All the surgical department staff followed the Italian Ministry of Health's prevention protocol and underwent serological testing. IgG and IgM were negative in everyone, thus confirming that nobody had been exposed to the virus. This study highlights the commitment to efficiently treating patients suffering from tumors of the head and neck region and confirms the effectiveness of the safety measures used to protect our patients and staff's health.
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Affiliation(s)
- Andrea Cassoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.C.); (N.M.); (M.T.F.); (V.T.); (M.D.M.); (I.R.); (V.V.)
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, D.A.I. testa e collo. Viale del Policlinico 155, 00161 Rome, Italy; (A.B.); (F.G.); (P.P.)
| | - Resi Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.C.); (N.M.); (M.T.F.); (V.T.); (M.D.M.); (I.R.); (V.V.)
| | - Nicolò Mangini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.C.); (N.M.); (M.T.F.); (V.T.); (M.D.M.); (I.R.); (V.V.)
| | - Maria Teresa Fadda
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.C.); (N.M.); (M.T.F.); (V.T.); (M.D.M.); (I.R.); (V.V.)
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, D.A.I. testa e collo. Viale del Policlinico 155, 00161 Rome, Italy; (A.B.); (F.G.); (P.P.)
| | - Andrea Battisti
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, D.A.I. testa e collo. Viale del Policlinico 155, 00161 Rome, Italy; (A.B.); (F.G.); (P.P.)
| | - Filippo Giovannetti
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, D.A.I. testa e collo. Viale del Policlinico 155, 00161 Rome, Italy; (A.B.); (F.G.); (P.P.)
| | - Valentina Terenzi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.C.); (N.M.); (M.T.F.); (V.T.); (M.D.M.); (I.R.); (V.V.)
| | - Marco Della Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.C.); (N.M.); (M.T.F.); (V.T.); (M.D.M.); (I.R.); (V.V.)
| | - Paolo Priore
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, D.A.I. testa e collo. Viale del Policlinico 155, 00161 Rome, Italy; (A.B.); (F.G.); (P.P.)
| | - Ingrid Raponi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.C.); (N.M.); (M.T.F.); (V.T.); (M.D.M.); (I.R.); (V.V.)
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (A.C.); (N.M.); (M.T.F.); (V.T.); (M.D.M.); (I.R.); (V.V.)
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I of Rome, D.A.I. testa e collo. Viale del Policlinico 155, 00161 Rome, Italy; (A.B.); (F.G.); (P.P.)
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Patient-Specific Surgical Implant Using Cavity-Filled Approach for Precise and Functional Mandible Reconstruction. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10176030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mandibular reconstruction is a complicated task because of the complex nature of the regional anatomy. Computer-assisted tools are a promising means of improving the precision and safety of such complex surgeries. The digital techniques utilized in the reconstruction of mandibular defects based on medical data, computer-aided-design approaches, and three-dimensional (3D) printing are widely used to improve the patient’s aesthetic appearance and function, as well as the accuracy and quality of diagnosis, and surgical outcomes. Nevertheless, to ensure an acceptable aesthetical appearance and functional outcomes, the design must be based on proper anatomical reconstruction, mostly done in a virtual environment by skilled design engineers. Mirroring is one of the widely used techniques in the surgical navigation and reconstruction of mandibular defects. However, there are some discrepancies and mismatches in the mirrored anatomical models. Hence, in order to overcome these limitations in the mirroring technique, a novel approach called the cavity-filled technique was introduced. The objective of this study was to compare the accuracy of the newly recommended cavity-filled technique with the widely used mirror reconstruction technique in restoring mandibular defects. A prominent 3D comparison technique was employed in this work, where the resected and the reconstructed mandibles were superimposed to quantify the accuracy of the two techniques. From the analysis, it can be inferred that the cavity-filled technique with a root-mean-square value of 1.1019 mm produced better accuracy in contrast to the mirroring approach, which resulted in an error of 1.2683 mm. Consequently, by using the proposed cavity-filled design, the discrepancy between the reconstruction plate and the bone contour was mitigated. This method, owing to its high precision, can decrease the number of adjustments and the time of surgery, as well as ensure a quick recovery time with better implant tissue in-growth.
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