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Sobrero F, Roccia F, Omedè M, Merlo F, Dubron K, Politis C, Rabufetti A, Scolozzi P, Ramieri G, Birk A, Vesnaver A, Rizvi AO, Laverick S, Jelovac D, Konstantinovic VS, Vilaplana V, Roig AM, Goetzinger M, Bottini GB, Knežević P, Dediol E, Kordić M, Sivrić A, Derkuş FE, Yilmaz UN, Ganasouli D, Zanakis SN. Current Strategies for Treatment of Mandibular Fractures With Plate Osteosynthesis: A European Prospective Study. J Craniofac Surg 2024:00001665-990000000-01537. [PMID: 38713082 DOI: 10.1097/scs.0000000000010128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/22/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE The training and preferences of surgeons influence the type of surgical treatment for mandibular fractures. This multicentre prospective study analyzed the current treatment strategies and outcomes for mandibular fractures with open reduction and internal fixation (ORIF). MATERIAL AND METHODS This prospective study included patients aged ≥16 years who underwent ORIF for mandibular fractures in 12 European maxillofacial centers. Age, sex, pretrauma dental status, fracture cause, site and type, associated facial fractures, surgical approach, plate number and thickness (≤1.4 or ≥1.5 mm), duration of postoperative maxillomandibular fixation, occlusal and infective complications at 6 weeks and 3 months, and revision surgeries were recorded. RESULTS Between May 1, 2021 and April 30, 2022, 425 patients (194 single, 182 double, and 49 triple mandibular fractures) underwent ORIF for 1 or more fractures. Rigid osteosynthesis was performed for 74% of fractures and was significantly associated with displaced (P=0.01) and comminuted (P=0.03) fractures and with the number of nonsurgically treated fracture sites (P=0.002). The angle was the only site associated with nonrigid osteosynthesis (P<0.001). Malocclusions (5.6%) and infective complications (5.4%) were not associated with osteosynthesis type. CONCLUSION Rigid osteosynthesis was the most frequently performed treatment at all fracture sites, except the mandibular angle, and was significantly associated with displaced and comminuted fractures and the number of nonsurgically treated fracture sites. No significant differences were observed regarding postoperative malocclusion or infections among osteosynthesis types.
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Affiliation(s)
- Federica Sobrero
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Fabio Roccia
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Michela Omedè
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Francesca Merlo
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Kathia Dubron
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Alessandro Rabufetti
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Guglielmo Ramieri
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Aleš Vesnaver
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Ali O Rizvi
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, United Kingdom
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, United Kingdom
| | - Drago Jelovac
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Vitomir S Konstantinovic
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Valentines Vilaplana
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Antonio Mari Roig
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Maximilian Goetzinger
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Predrag Knežević
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mario Kordić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Anamaria Sivrić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Fatma Eriş Derkuş
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Utku Nezih Yilmaz
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Dimitra Ganasouli
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Stylianos N Zanakis
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
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Mandić K, Milutin Gašperov N, Božinović K, Dediol E, Krasić J, Sinčić N, Grce M, Sabol I, Barešić A. Integrative analysis in head and neck cancer reveals distinct role of miRNome and methylome as tumour epigenetic drivers. Sci Rep 2024; 14:9062. [PMID: 38643268 PMCID: PMC11032388 DOI: 10.1038/s41598-024-59312-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/09/2024] [Indexed: 04/22/2024] Open
Abstract
Head and neck cancer is the sixth most common malignancy worldwide, with the relatively low 5-year survival rate, mainly because it is diagnosed at a late stage. Infection with HPV is a well known aetiology, which affects the nature of these cancers and patients' survival. Besides, it is considered that the main driving force for this type of cancer could be epigenetics. In this study we aimed to find potential epigenetic biomarkers, by integrating miRNome, methylome, and transcriptome analyses. From the fresh head and neck cancer tissue samples, we chose a group for miRNome, methylome and transcriptome profiling, in comparison to adequate control samples. Bioinformatics analyses are performed in R v4.2.2. Count normalisation and group differential expression for mRNA and the previously obtained miRNA count data was performed with DESeq2 v1.36. Gene set enrichment analysis was performed and visualised using gProfiler2 v0.2.1 Identification of miRNA targets was performed by querying in miRTarBase using multiMiR v1.18.0. Annotation of CpG sites merging into islands was obtained from RnBeads.hg19 v1.28.0. package. For the integrative analysis we performed kmeans clustering using stats v4.2.2 package, using 8-12 clusters and nstart 100. We found that transcriptome analysis divides samples into cancers and controls clusters, with no relation to HPV status or cancer anatomical location. Differentially expressed genes (n = 2781) were predominantly associated with signalling pathways of tumour progression. We identified a cluster of genes under the control of the transcription factor E2F that are significantly underexpressed in cancer tissue, as well as T cell immunity genes and genes related to regulation of transcription. Among overexpressed genes in tumours we found those that belong to cell cycle regulation and vasculature. A small number of genes were found significantly differentially expressed in HPV-positive versus HPV-negative tumours (for example NEFH, ZFR2, TAF7L, ZNF541, and TYMS). In this comprehensive study on an overlapping set of samples where the integration of miRNome, methylome and transcriptome analysis were performed for head and neck cancer, we demonstrated that the majority of genes were associated exclusively with miRNome or methylome and, to a lesser extent, under the control of both epigenetic mechanisms.
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Affiliation(s)
- Katarina Mandić
- Division of Electronics, Ruđer Bošković Institute, Zagreb, Croatia
| | | | - Ksenija Božinović
- Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, Clinical Hospital Dubrava, Zagreb, Croatia
| | - Jure Krasić
- Department of Medical Biology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Nino Sinčić
- Department of Medical Biology, University of Zagreb School of Medicine, Zagreb, Croatia
- Centre of Excellence in Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, Zagreb, Croatia
- Biomedical Research Centre Šalata, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Magdalena Grce
- Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Ivan Sabol
- Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia.
| | - Anja Barešić
- Division of Electronics, Ruđer Bošković Institute, Zagreb, Croatia
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Mihovilovic A, Martinovic D, Martinic J, Markovic D, Tarle M, Jerkovic D, Vuk S, Dediol E. Dynamometric outcomes of the donor site leg after vastus lateralis free flap harvest. J Craniomaxillofac Surg 2023; 51:755-759. [PMID: 37704506 DOI: 10.1016/j.jcms.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023] Open
Abstract
The vastus lateralis muscle is one of the four muscles that make up the quadriceps femoris muscle, and it is also the largest of them. Some studies have shown that patients experience lower quality of life and muscle weakness after surgical treatment of thigh muscles in order to perform reconstructive surgery of the head and neck. The aim of our study was to assess the quantitative and qualitative function of the lower extremities using an isokinetic dynamometer and a validated questionnaire on subjective difficulties in patients who underwent reconstructive surgery with the vastus lateralis free flap. Fourteen participants aged 20-70 years who suffered from malignant tumor in the head and neck region. The free vastus lateralis flap was used for reconstruction. All patients underwent isokinetic dynamometric measurement with the isokinetic dynamometer to test the isokinetic functions of the thigh muscles after surgery. In addition, subjective assessment of the lower extremities was performed using the validated questionnaire Lower Extremity Functional Scale. All isometric dynamometer measurements of the donor leg were compared with those of the unoperated leg. Peak torque and average power were significantly lower in the operated leg compared with the unoperated leg after 60°/s extension (p = 0.018 for peak torque, p = 0.021 for average power) and 180°/s extension (p = 0.019 for peak torque, p = 0.015 for average power). On the other hand, there was no statistically significant difference in dynamometer measurements after 60°/s flexion (p = 0.700 for peak torque, p = 0.854 for average power, and 180°/s flexion (p = 0.634 for peak torque, p = 0.571 for average power). The median value for the LEFS was 65.5 (40.00-71.25). The results of this study showed that there is a significant deterioration regarding the biophysical properties of the operated leg after harvesting vastus lateralis free flap.
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Affiliation(s)
- Ante Mihovilovic
- Department of Maxillofacial Surgery, University Hospital of Split, 21000, Split, Croatia; Department of Maxillofacial Surgery, University of Split School of Medicine, 21000, Split, Croatia.
| | - Dinko Martinovic
- Department of Maxillofacial Surgery, University Hospital of Split, 21000, Split, Croatia; Department of Maxillofacial Surgery, University of Split School of Medicine, 21000, Split, Croatia
| | - Jure Martinic
- Department of Oral Surgery, University of Split School of Medicine, 21000, Split, Croatia
| | - Domagoj Markovic
- Department of Cardiovascular Diseases, University Hospital of Split, 21000, Split, Croatia
| | - Marko Tarle
- Department of Maxillofacial Surgery, University Hospital Dubrava, 10000, Zagreb, Croatia
| | - Daniel Jerkovic
- Department of Oral Surgery, University of Split School of Medicine, 21000, Split, Croatia; Department of Oral Surgery, University Hospital of Split, 21000, Split, Croatia
| | - Sasa Vuk
- Department of Kinesiology of Sport, University of Zagreb Faculty of Kinesiology, 10000, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, 10000, Zagreb, Croatia; Department of Maxillofacial Surgery, University of Zagreb School of Medicine, 10000, Zagreb, Croatia
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Sobrero F, Roccia F, Vilaplana V, Roig AM, Raveggi E, Ramieri G, Goetzinger M, Bottini GB, Rizvi AO, Laverick S, Knežević P, Dediol E, Kordić M, Sivrić A, Ganasouli D, Zanakis SN, Jelovac D, Konstantinovic VS, Birk A, Vesnaver A, Rabufetti A, Scolozzi P, Derkuş FE, Yilmaz UN, Politis C, Dubron K. Manual versus rigid intraoperative maxillo-mandibular fixation in the surgical management of mandibular fractures: A European prospective analysis. Dent Traumatol 2023; 39:448-454. [PMID: 37140473 DOI: 10.1111/edt.12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/18/2023] [Accepted: 04/11/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE Intraoperative stabilisation of bony fragments with maxillo-mandibular fixation (MMF) is an essential step in the surgical treatment of mandibular fractures that are treated with open reduction and internal fixation (ORIF). The MMF can be performed with or without wire-based methods, rigid or manual MMF, respectively. The aim of this study was to compare the use of manual versus rigid MMF, in terms of occlusal outcomes and infective complications. MATERIALS AND METHODS This multi-centric prospective study involved 12 European maxillofacial centres and included adult patients (age ≥16 years) with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate or partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, modality of intraoperative MMF (manual or rigid), outcome (minor/major malocclusions and infective complications) and revision surgeries. The main outcome was malocclusion at 6 weeks after surgery. RESULTS Between May 1, 2021 and April 30, 2022, 319 patients-257 males and 62 females (median age, 28 years)-with mandibular fractures (185 single, 116 double and 18 triple fractures) were hospitalised and treated with ORIF. Intraoperative MMF was performed manually on 112 (35%) patients and with rigid MMF on 207 (65%) patients. The study variables did not differ significantly between the two groups, except for age. Minor occlusion disturbances were observed in 4 (3.6%) patients in the manual MMF group and in 10 (4.8%) patients in the rigid MMF group (p > .05). In the rigid MMF group, only one case of major malocclusion required a revision surgery. Infective complications involved 3.6% and 5.8% of patients in the manual and rigid MMF group, respectively (p > .05). CONCLUSION Intraoperative MMF was performed manually in nearly one third of the patients, with wide variability among the centres and no difference observed in terms of number, site and displacement of fractures. No significant difference was found in terms of postoperative malocclusion among patients treated with manual or rigid MMF. This suggests that both techniques were equally effective in providing intraoperative MMF.
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Affiliation(s)
- Federica Sobrero
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Valentines Vilaplana
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Antonio Mari Roig
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Elisa Raveggi
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Maximilian Goetzinger
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Ali O Rizvi
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Predrag Knežević
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mario Kordić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Anamaria Sivrić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Dimitra Ganasouli
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Stylianos N Zanakis
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Drago Jelovac
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Vitomir S Konstantinovic
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Aleš Vesnaver
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Alessandro Rabufetti
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Fatma Eriş Derkuş
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Utku Nezih Yilmaz
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Constantinus Politis
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Kathia Dubron
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
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Lulić L, Jakovčević A, Kovačić I, Manojlović L, Dediol E, Skelin J, Tomaić V. HPV16 Impacts NHERF2 Expression in Oropharyngeal Cancers. Pathogens 2023; 12:1013. [PMID: 37623973 PMCID: PMC10459660 DOI: 10.3390/pathogens12081013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Infection with human papillomaviruses (HPVs), in particular with HPV type 16, is now considered to be a key risk factor for the development of a subset of oropharyngeal squamous cell carcinomas (OPSCC) that show different epidemiological, clinical, and prognostic characteristics from HPV-negative (HPV-) OPSCCs. So far, extensive research efforts aiming to distinguish these two distinct entities have not identified specific biomarkers, nor led to different therapies. Previous research has shown that HPV16 E6 oncoprotein binds NHERF2, inducing its proteasomal degradation, and consequently increasing cell proliferation; we therefore aimed to investigate how this might be reflected in human histological samples. We analyzed NHERF2 expression patterns in HPV16-positive (HPV16+) and HPV- OPSCC samples, to investigate any potential differences in NHERF2 pattern. Interestingly, we observed a statistically significant decrease in NHERF2 levels in HPV16+ and poorly differentiated HPV- OPSCCs, compared with healthy tissue. Furthermore, we observed a significant reduction in the percentage of NHERF2 immunoreactive cancer cells in HPV16+ tumors, compared with well and moderately differentiated HPV- OPSCCs, suggesting the importance of 16E6's targeting of NHERF2 in HPV-driven oncogenesis in the head and neck area.
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Affiliation(s)
- Lucija Lulić
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| | - Antonia Jakovčević
- Clinical Department of Pathology and Cytology, University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Iva Kovačić
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| | - Luka Manojlović
- Department of Pathology and Cytology, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Josipa Skelin
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| | - Vjekoslav Tomaić
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
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Anić P, Golubić Talić J, Božinović K, Dediol E, Mravak-Stipetić M, Grce M, Milutin Gašperov N. Methylation of Immune Gene Promoters in Oral and Oropharyngeal Cancer. Int J Mol Sci 2023; 24:ijms24097698. [PMID: 37175405 PMCID: PMC10178514 DOI: 10.3390/ijms24097698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023] Open
Abstract
The proportion of oral and oropharyngeal squamous cell carcinoma (OOSCC) that can be attributed to human papillomavirus (HPV) infection is growing nowadays. A potential factor indicating the occurrence of HPV-positive OSCC is a change in the degree of methylation of gene promoters that play a key role in the immune response. In this study, we investigated the difference in the methylation of EDARADD, GBP4, HAVCR2, HLA DPB1, IL12RB1, MARCO, and SIGLEC12 gene promoters in samples of healthy oral mucosa versus samples of oral and oropharyngeal cancer. The presence of HPV infection in samples was examined earlier. To determine the difference in methylation of those gene promotors, isolated and bisulfite-modified DNA was analysed by the methylation-specific PCR method. The investigated gene promoters were found to be more hypomethylated in the oral and oropharyngeal cancer samples in comparison to normal tissue. The proportion of unmethylated gene promoters was similar in HPV-positive and HPV-negative cancers, although the data should be confirmed on a larger set of samples. To conclude, in samples of healthy oral mucosa, the investigated gene promoters were found to be methylated in a high percentage (73.3% to 100%), while in oral and oropharyngeal cancer samples, they were methylated in a low percentage (11.1% to 37%), regardless of HPV infection.
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Affiliation(s)
- Petra Anić
- Research Department, Srebrnjak Children's Hospital, 10000 Zagreb, Croatia
| | | | - Ksenija Božinović
- Department of Molecular Biology, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, Clinical Hospital Dubrava, 10000 Zagreb, Croatia
| | - Marinka Mravak-Stipetić
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Magdalena Grce
- Department of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
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Šimić I, Božinović K, Milutin Gašperov N, Kordić M, Pešut E, Manojlović L, Grce M, Dediol E, Sabol I. Head and Neck Cancer Patients' Survival According to HPV Status, miRNA Profiling, and Tumour Features-A Cohort Study. Int J Mol Sci 2023; 24:ijms24043344. [PMID: 36834756 PMCID: PMC9959828 DOI: 10.3390/ijms24043344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
Head and neck cancers (HNC) are a heterogeneous group of tumours mainly associated with tobacco and alcohol use and human papillomavirus (HPV). Over 90% of all HNC are squamous cell carcinomas (HNSCC). Sample material from patients diagnosed with primary HNSCC (n = 76) treated with surgery as primary treatment at a single centre were assessed for HPV genotype, miR-9-5p, miR-21-3p, miR-29a-3p and miR-100-5p expression levels. Clinical and pathological data were collected from medical records. Patients were enrolled between 2015 and 2019 and followed-up until November 2022. Overall survival, disease-specific survival and disease-free survival were assessed and correlated with clinical, pathological, and molecular data. Kaplan-Meier and Cox proportional hazard regression was used to assess different risk factors. In the study, male gender, HPV-negative HNSCC (76.3%) mostly located in the oral region (78.9%) predominated. Most patients had stage IV cancer (47.4%), and the overall survival rate was 50%. HPV was found not to affect survival, indicating that in this population, classic risk factors predominate. The presence of both perineural and angioinvasion was strongly associated with survival in all analyses. Of all miRNAs assessed, only upregulation of miR-21 was consistently shown to be an independent predictor of poor prognosis and may thus serve as a prognostic biomarker in HNSCC.
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Affiliation(s)
- Ivana Šimić
- Laboratory for Molecular Virology and Bacteriology, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Ksenija Božinović
- Laboratory for Cell Biology and Signalling, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Nina Milutin Gašperov
- Laboratory for Molecular Virology and Bacteriology, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Mario Kordić
- Department of Maxillofacial Surgery, Clinical Hospital Dubrava, 10000 Zagreb, Croatia
- Department of Maxillofacial Surgery, Clinical Hospital Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Ena Pešut
- Laboratory for Molecular Virology and Bacteriology, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Luka Manojlović
- Clinical Department of Pathology and Cytology, Clinical Hospital Dubrava, 10000 Zagreb, Croatia
| | - Magdalena Grce
- Laboratory for Molecular Virology and Bacteriology, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, Clinical Hospital Dubrava, 10000 Zagreb, Croatia
- Correspondence: (E.D.); (I.S.)
| | - Ivan Sabol
- Laboratory for Molecular Virology and Bacteriology, Ruđer Bošković Institute, 10000 Zagreb, Croatia
- Correspondence: (E.D.); (I.S.)
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8
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Roccia F, Sobrero F, Raveggi E, Rabufetti A, Scolozzi P, Dubron K, Politis C, Ganasouli D, Zanakis SN, Jelovac D, Konstantinovic VS, Birk A, Vesnaver A, Knežević P, Dediol E, Kordić M, Sivrić A, Rizvi AO, Laverick S, Vilaplana NV, Roig AM, Derkuş FE, Yilmaz UN, Goetzinger M, Bottini GB, Ramieri G. European multicenter prospective analysis of the use of maxillomandibular fixation for mandibular fractures treated with open reduction and internal fixation. J Stomatol Oral Maxillofac Surg 2023; 124:101376. [PMID: 36587846 DOI: 10.1016/j.jormas.2022.101376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The goal of mandibular fracture treatment is to restore static and dynamic occlusal functions. Open reduction and internal fixation (ORIF) of these fractures can be associated with an intraoperative and/or postoperative maxillo-mandibular fixation (MMF). The aim of this study was to analyse the use of perioperative MMF and its effects on occlusal outcomes in the management of mandibular fractures. MATERIAL AND METHODS This multicentric prospective study included adult patients with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate, partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, type of ORIF (rigid, non-rigid or mixed), thickness and number of plates, modality of intraoperative MMF (arch bars, self-tapping and self-drilling screws [STSDSs], manual, other) and duration of postoperative MMF. The primary outcome was malocclusion at 6 weeks and 3 months. Statistical analyses were performed with Fisher's exact test or chi-square test, as appropriate. RESULTS Between 1 May 2021 and 30 April 2022, 336 patients, 264 males and 72 females (median age, 28 years) with mandibular fractures (194 single, 124 double and 18 triple fractures) were hospitalized. Intraoperative MMF was performed in all patients. Osteosynthesis was rigid in 75% of single fractures, and rigid or mixed in 85% and 100% of double and triple fractures, respectively. Excluding patients who underwent manual reduction, postoperative MMF (median duration, 3 weeks) was performed in 140 (64%) patients, without differences by type or number of fractures (p > 0.05). No significant difference was found in the incidence of malocclusion in patients with postoperative MMF (5%, 95% confidence interval [CI], 2-10%) compared to those without (4%; 95% IC, 1-11%) (p > 0.05). CONCLUSION Postoperative MMF was performed in more than half of the patients despite adequate fracture osteosynthesis, with wide variability amongst centers. No evidence of a reduction in the incidence of postoperative malocclusion in patients treated with postoperative MMF was found.
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Affiliation(s)
- Fabio Roccia
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy
| | - Federica Sobrero
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy.
| | - Elisa Raveggi
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy
| | - Alessandro Rabufetti
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Kathia Dubron
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Dimitra Ganasouli
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Stylianos N Zanakis
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Drago Jelovac
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Serbia
| | | | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Aleš Vesnaver
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Predrag Knežević
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mario Kordić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Anamaria Sivrić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Ali O Rizvi
- Department of Oral and Maxillofacial Surgery, University of Dundee, United Kingdom
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, United Kingdom
| | - Nil Valentines Vilaplana
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Antonio Mari Roig
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Fatma Eriş Derkuş
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Utku Nezih Yilmaz
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Maximilian Goetzinger
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Guglielmo Ramieri
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy
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Milutin Gašperov N, Sabol I, Božinović K, Dediol E, Mravak-Stipetić M, Licastro D, Dal Monego S, Grce M. DNA Methylome Distinguishes Head and Neck Cancer from Potentially Malignant Oral Lesions and Healthy Oral Mucosa. Int J Mol Sci 2020; 21:ijms21186853. [PMID: 32961999 PMCID: PMC7554960 DOI: 10.3390/ijms21186853] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/15/2022] Open
Abstract
There is a strong need to find new, good biomarkers of head and neck squamous cell carcinoma (HNSCC) because of the bad prognoses and high mortality rates. The aim of this study was to identify the potential biomarkers in HNSCC that have differences in their DNA methylome and potentially premalignant oral lesions, in comparison to healthy oral mucosa. In this study, 32 oral samples were tested: nine healthy oral mucosae, 13 HNSCC, and 10 oral lesions for DNA methylation by the Infinium MethylationEPIC BeadChip. Our findings showed that a panel of genes significantly hypermethylated in their promoters or specific sites in HNSCC samples in comparison to healthy oral samples, which are mainly oncogenes, receptor, and transcription factor genes, or genes included in cell cycle, transformation, apoptosis, and autophagy. A group of hypomethylated genes in HNSCC, in comparison to healthy oral mucosa, are mainly involved in the host immune response and transcriptional regulation. The results also showed significant differences in gene methylation between HNSCC and potentially premalignant oral lesions, as well as differently methylated genes that discriminate between oral lesions and healthy mucosa. The given methylation panels point to novel potential biomarkers for early diagnostics of HNSCC, as well as potentially premalignant oral lesions.
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Affiliation(s)
- Nina Milutin Gašperov
- Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia; (I.S.); (K.B.)
- Correspondence: (N.M.G.); (M.G.)
| | - Ivan Sabol
- Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia; (I.S.); (K.B.)
| | - Ksenija Božinović
- Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia; (I.S.); (K.B.)
| | - Emil Dediol
- Department of Maxillofacial Surgery, School of Medicine, Clinical Hospital Dubrava, University of Zagreb, 10000 Zagreb, Croatia;
| | - Marinka Mravak-Stipetić
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Danilo Licastro
- ARGO Open Lab Platform for Genome sequencing, AREA Science Park, Padriciano, 99, 34149 Trieste, Italy; (D.L.); (S.D.M.)
| | - Simeone Dal Monego
- ARGO Open Lab Platform for Genome sequencing, AREA Science Park, Padriciano, 99, 34149 Trieste, Italy; (D.L.); (S.D.M.)
| | - Magdalena Grce
- Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia; (I.S.); (K.B.)
- Correspondence: (N.M.G.); (M.G.)
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10
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Filipan D, Dediol E, Blivajs I, Milic M. The Effects of Dextran on Postoperative Thrombosis and Hemodilution in Microvascular Head and Neck Reconstruction. Ann Plast Surg 2020; 85:38-42. [PMID: 31904651 DOI: 10.1097/sap.0000000000002148] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Free tissue transfer is an integral part of reconstructive head and neck surgery today. Although increased experience and refinements in techniques have minimized flap loss, pharmacological agents have been used to prevent thrombus formation and flap failures, despite their questionable effectiveness. The aim of this study is to investigate the use of dextran 40 in thrombosis prophylaxis, as well as its effects on blood coagulability and flap survival. METHODS This is a retrospective analysis of 176 free flaps performed at University Hospital Dubrava, Zagreb, Croatia, during a 4-year period. A comparison was made between 2 patient groups, based on their respective postoperative prophylaxis protocols. All patients were treated with low-molecular-weight heparin as deep vein thrombosis prevention, until patient mobilization. Group 1 was on dextran 40 protocol, whereas group 2 did not receive additional treatment. Primary outcome of the study was determined as flap loss rate, whereas secondary outcome was evaluated as the rate of thrombosis or hemorrhage. The hemodilution potential of dextran 40 was examined through blood count laboratory values. RESULTS Total flap survival rate was 90.34%. There were 16 free flap losses and 1 partial loss overall. Anastomoses were re-explored in a total of 27 cases, of which 17 were salvaged. There were 29 events of hemorrhage or arterial or venous thrombosis: 17 in group 1 and 12 in group 2. A sum of 26 incidences of other postoperative complications was recorded, 13 in each group. Hemodilution status showed a statistically significant reduction in erythrocyte count and hemoglobin and hematocrit levels in the group receiving dextran 40, on postoperative days 1 and 3, but no such effect was observed on postoperative platelet count. CONCLUSIONS Although dextran 40 has been shown to have a valuable effect on hemodilution, which is beneficial in microsurgery, it did not demonstrate better outcomes in terms of flap survival. Because it can cause serious systemic complications, it is better not to administer it routinely. However, its important influence on reduction in erythrocyte count and hemoglobin and hematocrit levels should be further investigated.
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Affiliation(s)
| | | | - Igor Blivajs
- Department of Maxillofacial Surgery, University Hospital Dubrava
| | - Morena Milic
- Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Zagreb, Croatia
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11
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Dediol E. Regarding "Mandibular Reconstruction With a Deep Circumflex Iliac Artery Flap Using Computer-Assisted and Intraoral Anastomosis Techniques". J Oral Maxillofac Surg 2020; 78:859. [PMID: 32156522 DOI: 10.1016/j.joms.2020.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 11/27/2022]
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12
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Dediol E, Kordić M. Regarding Incidence of Inadequate Perforators and Salvage Options for the Anterior Lateral Thigh Free Flap. Laryngoscope 2020; 130:E387. [PMID: 32073657 DOI: 10.1002/lary.28573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Emil Dediol
- School of Medicine, University of Zagreb, Department for Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mario Kordić
- Department for ENT and Maxillofacial Surgery, Clinical Hospital Centre Mostar, Mostar, Bosnia and Herzegovina
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13
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Brucoli M, Boffano P, Romeo I, Corio C, Benech A, Ruslin M, Forouzanfar T, Starch-Jensen T, Rodríguez-Santamarta T, de Vicente JC, Snäll J, Thorén H, Tarle M, Dediol E, Pechalova P, Pavlov N, Daskalov H, Doykova I, Kelemith K, Tamme T, Kopchak A, Shumynskyi I, Corre P, Bertin H, Goguet Q, Anquetil M, Louvrier A, Meyer C, Dovšak T, Vozlič D, Birk A, Aničić B, Konstantinovic VS. Management of maxillofacial trauma in the elderly: A European multicenter study. Dent Traumatol 2020; 36:241-246. [PMID: 31863620 DOI: 10.1111/edt.12536] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/14/2019] [Accepted: 12/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS Management of maxillofacial trauma in the geriatric population poses a great challenge due to anatomical variations and medical comorbidities. The aim of this study was to analyze the management variables, timing, and outcomes of facial fractures in elderly patients (aged 70 years or more) at several European departments of oral and maxillofacial surgery. MATERIALS AND METHODS This study was based on a systematic computer-assisted database that allowed the recording of data from all geriatric patients with facial fractures from the involved maxillofacial surgical units across Europe between 2013 and 2017. RESULTS A total of 1334 patients were included in the study: 665 patients underwent closed or open surgical treatment. A significant association (P < .005) was found between the presence of concomitant injuries and a prolonged time between hospital admission and treatment. The absence of indications to treatment was associated with comorbidities and an older age (P < .000005). CONCLUSIONS Elderly patients require specific attention and multidisciplinary collaboration in the diagnosis and sequencing of trauma treatment. A prudent attitude may be kept in selected cases, especially when severe comorbidities are associated and function is not impaired.
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Affiliation(s)
- Matteo Brucoli
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Paolo Boffano
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Irene Romeo
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Chiara Corio
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Arnaldo Benech
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | | | - Juan Carlos de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Thorén
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, Finland.,Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
| | - Marko Tarle
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Petia Pechalova
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | | | - Hristo Daskalov
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Iva Doykova
- Department of maxillofacial surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Kadri Kelemith
- Department of maxillo-facial surgery, North Estonia Medical Centre Foundation, Tallinn, Estonia
| | - Tiia Tamme
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Andrey Kopchak
- Stomatological Medical Center, Bogomolets National Medical University, Kyiv, Ukraine
| | - Ievgen Shumynskyi
- Kyiv City Clinical Emergency Hospital, Bogomolets National Medical University, Kyiv, Ukraine
| | - Pierre Corre
- Division of Maxillofacial Surgery, Nantes, France
| | | | | | | | - Aurélien Louvrier
- Department of Oral and Maxillofacial Surgery, Hospital Dentistry Unit, University Hospital of Besançon, Besançon, France.,EA 4662 Nanomedicine Lab Imagery and Therapeutics, University of Bourgogne, Besançon, France
| | - Christophe Meyer
- Department of Oral and Maxillofacial Surgery, Hospital Dentistry Unit, University Hospital of Besançon, Besançon, France.,EA 4662 Nanomedicine Lab Imagery and Therapeutics, University of Bourgogne, Besançon, France
| | - Tadej Dovšak
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - David Vozlič
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Boban Aničić
- Department of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Vitomir S Konstantinovic
- Department of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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14
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Brucoli M, Boffano P, Romeo I, Corio C, Benech A, Ruslin M, Forouzanfar T, Rodríguez-Santamarta T, Vicente JCD, Tarle M, Dediol E, Pechalova P, Pavlov N, Daskalov H, Doykova I, Kelemith K, Tamme T, Kopchak A, Shumynskyi I, Corre P, Bertin H, Bourry M, Guyonvarc'h P, Dovšak T, Vozlič D, Birk A, Aničić B, Konstantinovic VS, Starch-Jensen T. Surgical management of unilateral body fractures of the edentulous atrophic mandible. Oral Maxillofac Surg 2019; 24:65-71. [PMID: 31848774 DOI: 10.1007/s10006-019-00824-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 12/06/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Management of body fractures in patients with edentulous atrophic mandibles represents a challenging task due to patient's age, medical comorbidities, poor bone quality, and vascularity, as well as reduced contact area between the fracture ends. The aim of the study was to assess the demographic and clinical variables, the surgical technique, and outcomes of unilateral body fractures of the edentulous atrophic mandible managed at several European departments of oral and maxillofacial surgery. METHODS This study is based on a systematic computer-assisted database that allowed the recording of data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between 2008 and 2017. The following data were recorded for each patient: gender, age, comorbidities, etiology, synchronous body injuries, degree of atrophy of the mandible according to Luhr classification, type of surgical approach and fixation, length of hospitalization, and presence and type of complications. RESULTS A total of 43 patients were included in the study: 17 patients' mandibles were classified as class I according to Luhr, 15 as class II, and 11 as class III. All patients underwent open reduction and internal fixation by extraoral approach in 25 patients, intraoral in 15 patients, and mixed in 3 patients. A single 2.0 miniplate was used in 16 patients, followed by a single 2.4 reconstruction plate in 13 patients, by two 2.0 miniplates, and three 2.0 miniplates. Outcome was considered to be satisfying in 30 patients, with no complications. Complications were observed in 13 cases. CONCLUSIONS Treatment of unilateral body fractures of the edentulous mandible must still be based on the type of fracture, degree of atrophy, experience of the surgeon, and patients' preference. An adequate stability can be obtained by different plating techniques that have to be appropriately tailored to every single specific patient.
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Affiliation(s)
- Matteo Brucoli
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Paolo Boffano
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy.
| | - Irene Romeo
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Chiara Corio
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Arnaldo Benech
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Juan Carlos de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Marko Tarle
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Petia Pechalova
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Nikolai Pavlov
- Private practice of oral surgery, University of Eastern Piedmont, Plovdiv, Bulgaria
| | - Hristo Daskalov
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Iva Doykova
- Department of maxillofacial surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Kadri Kelemith
- Department of maxillo-facial surgery, North Estonia Medical Centre Foundation, Tallinn, Estonia
| | - Tiia Tamme
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Andrey Kopchak
- Bogomolets National Medical University, Stomatological medical center, Kyiv, Ukraine
| | - Ievgen Shumynskyi
- Bogomolets National Medical, University, Kyiv City Clinical Emergency Hospital, Kyiv, Ukraine
| | - Pierre Corre
- Division of Maxillofacial Surgery, Chu de Nantes, Nantes, France
| | - Helios Bertin
- Division of Maxillofacial Surgery, Chu de Nantes, Nantes, France
| | - Maeva Bourry
- Division of Maxillofacial Surgery, Chu de Nantes, Nantes, France
| | | | - Tadej Dovšak
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - David Vozlič
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Boban Aničić
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Vitomir S Konstantinovic
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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15
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Brucoli M, Boffano P, Romeo I, Corio C, Benech A, Ruslin M, Forouzanfar T, Rodríguez-Santamarta T, de Vicente JC, Tarle M, Dediol E, Pechalova P, Pavlov N, Daskalov H, Doykova I, Kelemith K, Tamme T, Kopchak A, Shumynskyi I, Corre P, Bertin H, Bourry M, Guyonvarc'h P, Dovšak T, Vozlič D, Birk A, Aničić B, Konstantinovic VS, Starch-Jensen T. The epidemiology of edentulous atrophic mandibular fractures in Europe. J Craniomaxillofac Surg 2019; 47:1929-1934. [DOI: 10.1016/j.jcms.2019.11.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 11/01/2019] [Accepted: 11/20/2019] [Indexed: 11/16/2022] Open
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16
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Brucoli M, Boffano P, Romeo I, Corio C, Benech A, Ruslin M, Forouzanfar T, Rodríguez-Santamarta T, de Vicente JC, Tarle M, Dediol E, Pechalova P, Pavlov N, Daskalov H, Doykova I, Kelemith K, Tamme T, Kopchak A, Shumynskyi I, Corre P, Bertin H, Bourry M, Guyonvarc'h P, Dovšak T, Vozliè D, Birk A, Anièiæ B, Konstantinovic VS, Starch-Jensen T. Management of mandibular condylar fractures in patients with atrophic edentulous mandibles. J Stomatol Oral Maxillofac Surg 2019; 121:226-232. [PMID: 31655226 DOI: 10.1016/j.jormas.2019.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Treatment of condylar fractures in patients with atrophic edentulous mandibles is a peculiar field that has been little considered in the literature. The aim of the study was to assess the demographic and clinical variables as well as management and outcome of mandibular condylar fractures in edentulous patients with atrophic mandibles that were treated at several European departments of oral and maxillofacial surgery. METHODS The data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between January 1, 2008, and December 31, 2017. Only patients that were diagnosed with condylar fractures of the edentulous atrophic mandible were included. RESULTS A total of 52 patients met the inclusion criteria and were included in the study: 79% of patients reported one or more comorbidities. Thirty-four unilateral neck or subcondylar fractures, 9 bilateral neck or subcondylar condylar fractures, 7 unilateral head condylar fractures, and 2 bilateral head condylar fractures were diagnosed. No treatment was performed in 37 cases, whereas in 4 patients a closed treatment was decided, and 11 patients underwent open reduction and internal fixation. Outcome was considered to be satisfying in 48 patients, with no complications. CONCLUSIONS The golden rule still remains that the diagnosis of a subcondylar or neck fracture in an edentulous patient should constitute an indication for open reduction and internal fixation. However, an appropriate choice of management options has to be individualized on a case by case basis, also depending on the patient consent.
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Affiliation(s)
- M Brucoli
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - P Boffano
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy.
| | - I Romeo
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - C Corio
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - A Benech
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - M Ruslin
- Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - T Rodríguez-Santamarta
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J C de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - M Tarle
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - E Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - P Pechalova
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - N Pavlov
- Private practice of oral surgery, Plovdiv, Bulgaria
| | - H Daskalov
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - I Doykova
- Department of maxillofacial surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - K Kelemith
- Department of maxillo-facial surgery, North Estonia Medical Centre Foundation, Tallinn, Estonia
| | - T Tamme
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - A Kopchak
- Bogomolets National Medical University, Stomatological medical center, Kyiv, Ukraine
| | - I Shumynskyi
- Bogomolets National Medical University, Kyiv City Clinical Emergency Hospital, Kyiv, Ukraine
| | - P Corre
- Division of Maxillofacial Surgery, CHU de Nantes, Nantes, France
| | - H Bertin
- Division of Maxillofacial Surgery, CHU de Nantes, Nantes, France
| | - M Bourry
- Division of Maxillofacial Surgery, CHU de Nantes, Nantes, France
| | - P Guyonvarc'h
- Division of Maxillofacial Surgery, CHU de Nantes, Nantes, France
| | - T Dovšak
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - D Vozliè
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - A Birk
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - B Anièiæ
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Serbia
| | - V S Konstantinovic
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Serbia
| | - T Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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Dediol E. How important is cephalic vein for venous drainage of the forearm. J Plast Reconstr Aesthet Surg 2019; 72:2064-2094. [PMID: 31590991 DOI: 10.1016/j.bjps.2019.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/27/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Medical School, University of Zagreb, Croatia.
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18
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Brucoli M, Boffano P, Romeo I, Corio C, Benech A, Ruslin M, Forouzanfar T, Starch-Jensen T, Rodríguez-Santamarta T, de Vicente JC, Snäll J, Thorén H, Aničić B, Konstantinovic VS, Pechalova P, Pavlov N, Daskalov H, Doykova I, Kelemith K, Tamme T, Kopchak A, Shumynskyi I, Corre P, Bertin H, Goguet Q, Anquetil M, Louvrier A, Meyer C, Dovšak T, Vozlič D, Birk A, Tarle M, Dediol E. Epidemiology of maxillofacial trauma in the elderly: A European multicenter study. J Stomatol Oral Maxillofac Surg 2019; 121:330-338. [PMID: 31533064 DOI: 10.1016/j.jormas.2019.09.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/30/2019] [Accepted: 09/04/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The progressive aging of European population seems to determine a change in the epidemiology, incidence and etiology of maxillofacial fractures with an increase in the frequency of old patients sustaining craniofacial trauma. The objective of the present study was to assess the demographic variables, causes, and patterns of facial fractures in elderly population (with 70 years or more). MATERIALS AND METHODS The data from all geriatric patients (70 years or more) with facial fractures between January 1, 2013, and December 31, 2017, were collected. The following data were recorded for each patient: gender, age, voluptuary habits, comorbidities, etiology, site of facial fractures, synchronous body injuries, Facial Injury Severity Score (FISS). RESULTS A total of 1334 patients (599 male and 735 female patients) were included in the study. Mean age was 79.3 years, and 66% of patients reported one or more comorbidities. The most frequent cause of injury was fall and zygomatic fractures were the most frequently observed injuries. Falls were associated with a low FISS value (P<.005). Concomitant injuries were observed in 27.3% of patients. Falls were associated with the absence of concomitant injuries. The ninth decade (P<.05) and a high FISS score (P<.005) were associated with concomitant body injuries too. CONCLUSIONS This study confirms the role of falls in the epidemiology of facial trauma in the elderly, but also highlights the frequency of involvement of females, and the high frequency of zygomatic fractures.
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Affiliation(s)
- M Brucoli
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - P Boffano
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy.
| | - I Romeo
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - C Corio
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - A Benech
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - M Ruslin
- Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - T Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - T Rodríguez-Santamarta
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J C de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - H Thorén
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Finland; Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
| | - B Aničić
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Serbia
| | - V S Konstantinovic
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Serbia
| | - P Pechalova
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - N Pavlov
- Private practice of oral surgery, Plovdiv, Bulgaria
| | - H Daskalov
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - I Doykova
- Department of maxillofacial surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - K Kelemith
- Department of maxillofacial surgery, North Estonia Medical Centre Foundation, Tallinn, Estonia
| | - T Tamme
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - A Kopchak
- Bogomolets National Medical University, Stomatological medical center, Kyiv, Ukraine
| | - I Shumynskyi
- Bogomolets National Medical University, Kyiv City Clinical Emergency Hospital, Kyiv, Ukraine
| | - P Corre
- Division of Maxillofacial Surgery, CHU de Nantes, 1 place Alexis-Ricordeau, 44000 Nantes, France
| | - H Bertin
- Division of Maxillofacial Surgery, CHU de Nantes, 1 place Alexis-Ricordeau, 44000 Nantes, France
| | - Q Goguet
- Division of Maxillofacial Surgery, CHU de Nantes, 1 place Alexis-Ricordeau, 44000 Nantes, France
| | - M Anquetil
- Division of Maxillofacial Surgery, CHU de Nantes, 1 place Alexis-Ricordeau, 44000 Nantes, France
| | - A Louvrier
- Department of Oral and Maxillofacial Surgery-Hospital Dentistry Unit, University Hospital of Besançon, 3 boulevard Alexandre-Fleming, 25000 Besançon, France; University of Bourgogne-Franche-Comté, EA 4662 Nanomedicine Lab Imagery and Therapeutics, 25000 Besançon, France
| | - C Meyer
- Department of Oral and Maxillofacial Surgery-Hospital Dentistry Unit, University Hospital of Besançon, 3 boulevard Alexandre-Fleming, 25000 Besançon, France; University of Bourgogne-Franche-Comté, EA 4662 Nanomedicine Lab Imagery and Therapeutics, 25000 Besançon, France
| | - T Dovšak
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - D Vozlič
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - A Birk
- Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia
| | - M Tarle
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - E Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
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Ruslin M, Brucoli M, Boffano P, Benech A, Dediol E, Uglešić V, Kovačič Ž, Vesnaver A, Konstantinović VS, Petrović M, Stephens J, Kanzaria A, Bhatti N, Holmes S, Pechalova PF, Bakardjiev AG, Malanchuk VA, Kopchak AV, Galteland P, Mjøen E, Skjelbred P, Bertin H, Corre P, Løes S, Lekven N, Laverick S, Gordon P, Tamme T, Akermann S, Karagozoglu KH, Kommers SC, de Visscher JG, Forouzanfar T. Motor vehicle accidents–related maxillofacial injuries: a multicentre and prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:199-204. [DOI: 10.1016/j.oooo.2018.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/17/2018] [Accepted: 12/04/2018] [Indexed: 11/30/2022]
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20
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Brucoli M, Boffano P, Pezzana A, Benech A, Corre P, Bertin H, Pechalova P, Pavlov N, Petrov P, Tamme T, Kopchak A, Romanova A, Shuminsky E, Dediol E, Tarle M, Konstantinovic VS, Jelovac D, Karagozoglu KH, Forouzanfar T. The “European Mandibular Angle” research project: the analysis of complications after unilateral angle fractures. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:14-17. [DOI: 10.1016/j.oooo.2019.02.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/25/2019] [Indexed: 11/16/2022]
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21
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Uglesic V, Amin K, Dediol E, Kosutic D. Combined Karapandzic–Abbé/Estlander/Stein flap for subtotal and total lower lip reconstruction. J Plast Reconstr Aesthet Surg 2019; 72:484-490. [DOI: 10.1016/j.bjps.2018.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 10/07/2018] [Accepted: 11/11/2018] [Indexed: 11/25/2022]
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22
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Božinović K, Sabol I, Dediol E, Milutin Gašperov N, Manojlović S, Vojtechova Z, Tachezy R, Grce M. Genome-wide miRNA profiling reinforces the importance of miR-9 in human papillomavirus associated oral and oropharyngeal head and neck cancer. Sci Rep 2019; 9:2306. [PMID: 30783190 PMCID: PMC6381209 DOI: 10.1038/s41598-019-38797-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/10/2019] [Indexed: 12/18/2022] Open
Abstract
Head and neck cancer is the sixth most common malignancy worldwide, predominantly developing from squamous cell epithelia (HNSCC). The main HNSCC risk factors are tobacco, excessive alcohol use, and the presence of human papillomavirus (HPV). HPV positive (+) cancers are etiologically different from other HNSCC and often show better prognosis. The current knowledge regarding HNSCC miRNA profiles is still incomplete especially in the context of HPV+ cancer. Thus, we analyzed 61 freshly collected primary oral (OSCC) and oropharyngeal (OPSCC) SCC samples. HPV DNA and RNA was found in 21% cases. The Illumina whole-genome small-RNA profiling by next-generation sequencing was done on 22 samples and revealed 7 specific miRNAs to HPV+ OSCC, 77 to HPV+ OPSCC, and additional 3 shared with both; 51 miRNAs were specific to HPV− OPSCC, 62 to HPV− OSCC, and 31 shared with both. The results for 9 miRNAs (miR-9, -21, -29a, -100, -106b, -143 and -145) were assessed by reverse transcription-quantitative polymerase chain reaction on the whole study population. The data was additionally confirmed by reanalyzing publicly available miRNA sequencing Cancer Genome Atlas consortium (TCGA) HNSCC data. Cell signaling pathway analysis revealed differences between HPV+ and HPV− HNSCC. Our findings compared with literature data revealed extensive heterogeneity of miRNA deregulation with only several miRNAs consistently affected, and miR-9 being the most likely HPV related miRNA.
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Affiliation(s)
- Ksenija Božinović
- Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Ivan Sabol
- Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia.
| | - Emil Dediol
- Clinical hospital Dubrava, Department of Maxillofacial Surgery, Zagreb, Croatia
| | | | - Spomenka Manojlović
- Clinical hospital Dubrava, Department of Maxillofacial Surgery, Zagreb, Croatia
| | - Zuzana Vojtechova
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Vestec, Czech Republic
| | - Ruth Tachezy
- Department of Genetics and Microbiology, Faculty of Science, Charles University, BIOCEV, Vestec, Czech Republic
| | - Magdalena Grce
- Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia.
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23
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Brucoli M, Boffano P, Broccardo E, Benech A, Corre P, Bertin H, Pechalova P, Pavlov N, Petrov P, Tamme T, Kopchak A, Hresko A, Shuminsky E, Dediol E, Tarle M, Konstantinovic VS, Petrovic M, Holmes S, Karagozoglu KH, Forouzanfar T. The "European zygomatic fracture" research project: The epidemiological results from a multicenter European collaboration. J Craniomaxillofac Surg 2019; 47:616-621. [PMID: 30765246 DOI: 10.1016/j.jcms.2019.01.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 01/23/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Fractures of the zygomaticomaxillary complex (ZMC) are common injuries that may lead to loss of an aesthetically pleasing appearance and functional impairment. The aim of this study was to analyze the demographics, causes, characteristics, and outcomes of zygomatic fractures managed at several European departments of oral and maxillofacial surgery. MATERIALS AND METHODS This study is based on a multicenter systematic database that allowed the recording of all patients with ZMC fractures between 1 January 2013 and 31 December 2017. The following data were recorded: gender, age, personal medical history, etiology, side of zygomatic fracture, classification of ZMC fracture, associated maxillofacial fractures, symptoms at diagnosis, type of performed treatment, and sequelae/complications. RESULTS A total of 1406 patients (1172 males, 234 females) were included in the study. Statistically significant correlations were found between assault-related ZMC fractures and the A3 class (p < .0000005) and between Infraorbital Nerve (ION) anesthesia and B class (p < .00000005). CONCLUSION The most frequent cause of ZMC fractures was assault, followed by falls. The most frequently involved decade of age was between 20 and 29 years. The decision and type of surgical treatment of ZMC fractures depends on several issues that need to be considered on a case by case basis.
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Affiliation(s)
- Matteo Brucoli
- Division of Maxillofacial Surgery at the University of Eastern Piedmont, Novara, Italy.
| | - Paolo Boffano
- Division of Maxillofacial Surgery at the University of Eastern Piedmont, Novara, Italy
| | - Emanuele Broccardo
- Division of Maxillofacial Surgery at the University of Eastern Piedmont, Novara, Italy
| | - Arnaldo Benech
- Division of Maxillofacial Surgery at the University of Eastern Piedmont, Novara, Italy
| | - Pierre Corre
- Service de Stomatologie et Chirurgie Maxillo-faciale at the Chu de Nantes, Nantes, France
| | - Helios Bertin
- Service de Stomatologie et Chirurgie Maxillo-faciale at the Chu de Nantes, Nantes, France
| | - Petia Pechalova
- Department of Oral Surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | | | - Petko Petrov
- Department of Maxillofacial Surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Tiia Tamme
- Department of Maxillofacial Surgery, Stomatology Clinic, Tartu University, Tartu, Estonia
| | - Andrey Kopchak
- Department for Oral and Maxillofacial Surgery at the Bogomolets National Medical University, Kiev, Ukraine
| | - Andrii Hresko
- Department for Oral and Maxillofacial Surgery at the Bogomolets National Medical University, Kiev, Ukraine
| | - Eugen Shuminsky
- Department for Oral and Maxillofacial Surgery at the Bogomolets National Medical University, Kiev, Ukraine
| | - Emil Dediol
- Department of Maxillofacial Surgery at the University Hospital Dubrava, Zagreb, Croatia
| | - Marko Tarle
- Department of Maxillofacial Surgery at the University Hospital Dubrava, Zagreb, Croatia
| | - Vitomir S Konstantinovic
- The Clinic of Maxillofacial Surgery of the School of Dentistry at the University of Belgrade, Belgrade, Serbia
| | - Milan Petrovic
- The Clinic of Maxillofacial Surgery of the School of Dentistry at the University of Belgrade, Belgrade, Serbia
| | - Simon Holmes
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - K Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
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24
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Dediol E, Uglešić V, Knežević P, Lemac D. Donor-Site Outcomes for the Osteocutaneous Radial Forearm Free Flap. J Reconstr Microsurg 2018; 33:e3-e4. [PMID: 29510415 DOI: 10.1055/s-0038-1635087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.,Medical School, University of Zagreb, Croatia
| | - Vedran Uglešić
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.,Dental School, University of Zagreb, Croatia
| | - Predrag Knežević
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.,Dental School, University of Zagreb, Croatia
| | - Domagoj Lemac
- Department of Traumatology, University Hospital Dubrava, Zagreb, Croatia
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25
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Vuletic M, Marcinko D, Vrazic D, Milosevic M, Dediol E, Knezevic P. DEVELOPMENT OF A VALID AND RELIABLE INSTRUMENT FOR THE ASSESSMENT OF QUALITY OF LIFE IN ADOLESCENTS WITH CLEFTS - DETECTION OF POTENTIAL MENTAL HEALTH ISSUES. Psychiat Danub 2017; 29:360-368. [DOI: 10.24869/psyd.2017.360] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dediol E, Čvrljević I, Dobranić M, Uglešić V. Extended Karapandzic Flap Technique for Reconstruction of Lower Lip and Chin Defect. J Oral Maxillofac Surg 2017; 76:213-220. [PMID: 28697350 DOI: 10.1016/j.joms.2017.06.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/08/2017] [Accepted: 06/09/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE Near total defect of the lower lip adjacent to the chin remains a reconstructive challenge for surgeons in function and esthetics. The objective of this study was to present a modified extended Karapandzic technique for reconstruction of near total defects of the lower lip adjacent with the chin. MATERIALS AND METHODS From 2000 to 2013, patients with lip cancer or oral cavity cancer who required subtotal lower lip and chin resection and subsequently underwent reconstruction with an extended Karapandzic flap were included in this retrospective study. Patient demographics, histopathology, tumor stage, localization, tumor extension, method of reconstruction, and postoperative complications were extracted from patients' documentation. RESULTS Reconstruction of the lower lip and chin was performed in 21 patients using a combination of double local extended Karapandzic flaps with microvascular free flaps for intraoral and mandibular reconstruction. There was no flap necrosis; the main complications were fistula and exposure of the osteosynthesis plate. All lips were functional and the esthetic result was pleasing. All patients returned to a peroral diet, although a variable degree of microstomia was present. CONCLUSION The extended Karapandzic flap technique provides superior results for esthetic and functional lip reconstruction and chin reconstruction compared with any other regional or free flap. Free flaps should be reserved for oral cavity and mandibular reconstruction, if needed.
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Affiliation(s)
- Emil Dediol
- Assistant Professor, School of Medicine, University of Zagreb, Zagreb; Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
| | - Igor Čvrljević
- Resident, Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | | | - Vedran Uglešić
- Professor, Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb; Dental School, University of Zagreb, Zagreb, Croatia
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27
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Abstract
The early techniques of cleft lip repair involved the straight-line technique, the triangular flap technique or some kind of geometric line (triangular, quadrangular closure). A turning point in cleft lip surgery was in 1955 when doctor. Millard presented his method: the rotation-advancement technique or flap, at the First International Congress of Plastic Surgery in Stockholm. Today, the technique, with or without some modifications, is used by more than 85% of cleft surgeons around the world. We are presenting a patient with complete unilateral cleft lip and palate who underwent surgery sixty-five years ago. The scar on his lip was similar to rotation advancement line. Cheiloplasty was performed by Professor Šercer in 1950, five years before Millard's publication. Professor Ante Šercer was an internationally recognized Croatian scholar in the area of ear, nose and throat diseases. He also gave a significant contribution to surgical management of velopharyngeal insufficiency and plastic surgery of the nose and ear.
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Affiliation(s)
- Predrag Knežević
- School of Dental Medicine, University of Zagreb, Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | | | - Igor Blivajs
- Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- School of Dental Medicine, University of Zagreb, Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Darko Macan
- School of Dental Medicine, University of Zagreb, Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mišo Virag
- Professor,DM, MSc, PhD at the School of Medicine, University of Zagreb, Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
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28
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Dediol E, Sabol I, Virag M, Grce M, Muller D, Manojlović S. HPV prevalence and p16INKa overexpression in non-smoking non-drinking oral cavity cancer patients. Oral Dis 2016; 22:517-22. [PMID: 26993152 DOI: 10.1111/odi.12476] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/29/2016] [Accepted: 03/08/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Our aim was to compare HPV and p16INK4a (p16) expression and their influence on survival and prognosis in oral cavity squamous cell cancer (OCSCC), between non-smokers and non-drinkers (NSND) and smokers and drinkers (SD). SUBJECTS AND METHODS Patients with OCSCC treated with surgery from 2000 to 2010 were included in the study. Patients who did not smoke at all or smoked less than 10 pack per years and did not drink alcohol on a daily basis were considered the NSND group. An equal number of SD were the control group. HPV presence was determined from paraffin-embedded blocks investigated by PCR analysis. p16 expression was evaluated with immunohistochemistry. RESULTS The NSND group were mostly younger or older female patients with tongue or gingival cancers. p16 expression was significantly more frequent in NSND patients (27% vs 10%). Patients with stronger p16 expression had significantly worse survival, especially for tongue cancers (P = 0.026). In Cox multivariate analysis, both HPV and p16 expression carried a negative prognosis for NSND patients (P = 0.0351 and P = 0.0260). CONCLUSIONS NSND are a specific population of OCSCC patients. In contrast to oropharyngeal cancer, HPV and p16 expression in OCSCC are negative predictive factors, especially in NSND patients.
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Affiliation(s)
- E Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - I Sabol
- Department of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - M Virag
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - M Grce
- Department of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - D Muller
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Pathology, University Hospital Dubrava, Zagreb, Croatia
| | - S Manojlović
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Pathology, University Hospital Dubrava, Zagreb, Croatia
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Boffano P, Roccia F, Zavattero E, Dediol E, Uglešić V, Kovačič Ž, Vesnaver A, Konstantinović VS, Petrović M, Stephens J, Kanzaria A, Bhatti N, Holmes S, Pechalova PF, Bakardjiev AG, Malanchuk VA, Kopchak AV, Galteland P, Mjøen E, Skjelbred P, Koudougou C, Mouallem G, Corre P, Løes S, Lekven N, Laverick S, Gordon P, Tamme T, Akermann S, Karagozoglu KH, Kommers SC, Forouzanfar T. European Maxillofacial Trauma (EURMAT) project: A multicentre and prospective study. J Craniomaxillofac Surg 2015; 43:62-70. [DOI: 10.1016/j.jcms.2014.10.011] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/15/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022] Open
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Boffano P, Roccia F, Zavattero E, Dediol E, Uglešić V, Kovačič Ž, Vesnaver A, Konstantinović VS, Petrović M, Stephens J, Kanzaria A, Bhatti N, Holmes S, Pechalova PF, Bakardjiev AG, Malanchuk VA, Kopchak AV, Galteland P, Mjøen E, Skjelbred P, Grimaud F, Fauvel F, Longis J, Corre P, Løes S, Lekven N, Laverick S, Gordon P, Tamme T, Akermann S, Karagozoglu KH, Kommers SC, Meijer B, Forouzanfar T. European Maxillofacial Trauma (EURMAT) in children: a multicenter and prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:499-504. [PMID: 25660086 DOI: 10.1016/j.oooo.2014.12.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/01/2014] [Accepted: 12/12/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study is to present and discuss the results of a European multicentre prospective study about pediatric maxillofacial trauma epidemiology during a year. STUDY DESIGN The following data were recorded: gender, age, etiology, site of fracture, date of injury. Of the 3396 patients with maxillofacial fractures admitted within the study period, 114 (3.3%) were children aged 15 years and younger, with a male/female ratio of 2.6:1. Mean age was 10.9 years. Most patients (63%) were aged 11-15 years. RESULTS The most frequent cause of injury was fall (36 patients). Sport injuries and assaults were almost limited to the oldest group, whereas falls were more uniformly distributed in the 3 groups. The most frequently observed fracture involved the mandible with 47 fractures. In particular, 18 condylar fractures were recorded, followed by 12 body fractures. CONCLUSIONS Falls can be acknowledged as the most important cause of facial trauma during the first years of life. The high incidence of sport accidents after 10 years may be a reason to increase the use of mouthguards and other protective equipment. Finally, the mandible (and in particular the condyle) was confirmed as the most frequent fracture site.
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Affiliation(s)
- Paolo Boffano
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
| | - Fabio Roccia
- Department of Maxillofacial Surgery, University of Turin, Turin, Italy
| | | | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Vedran Uglešić
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Žiga Kovačič
- Maxillofacial Department, UKC Ljubljana, Ljubljana, Slovenia
| | - Aleš Vesnaver
- Maxillofacial Department, UKC Ljubljana, Ljubljana, Slovenia
| | | | - Milan Petrović
- Clinic of Maxillofacial Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Jonny Stephens
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - Amar Kanzaria
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - Nabeel Bhatti
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - Simon Holmes
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - Petia F Pechalova
- Department of Maxillofacial Surgery, Medical University, Plovdiv, Bulgaria
| | - Angel G Bakardjiev
- Department of Maxillofacial Surgery, Medical University, Plovdiv, Bulgaria
| | - Vladislav A Malanchuk
- Department for Oral and Maxillofacial Surgery, Bogomolets National Medical University, Kiev, Ukraine
| | - Andrey V Kopchak
- Department for Oral and Maxillofacial Surgery, Bogomolets National Medical University, Kiev, Ukraine
| | - Pål Galteland
- Department of Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway
| | - Even Mjøen
- Department of Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway
| | - Per Skjelbred
- Department of Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway
| | - Fanny Grimaud
- Service de Stomatologie et Chirurgie Maxillo-faciale, Chu de Nantes, France
| | - Fabien Fauvel
- Service de Stomatologie et Chirurgie Maxillo-faciale, Chu de Nantes, France
| | - Julie Longis
- Service de Stomatologie et Chirurgie Maxillo-faciale, Chu de Nantes, France
| | - Pierre Corre
- Service de Stomatologie et Chirurgie Maxillo-faciale, Chu de Nantes, France
| | - Sigbjørn Løes
- Department of Maxillofacial Surgery, University of Bergen, Bergen, Norway
| | - Njål Lekven
- Department of Maxillofacial Surgery, University of Bergen, Bergen, Norway
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, NHS Tayside, University of Dundee, Dundee, UK
| | - Peter Gordon
- Department of Oral and Maxillofacial Surgery, NHS Tayside, University of Dundee, Dundee, UK
| | - Tiia Tamme
- Department of Maxillofacial surgery, Stomatology Clinic, Tartu University, Tartu, Estonia
| | - Stephanie Akermann
- Department of Maxillofacial surgery, Stomatology Clinic, Tartu University, Tartu, Estonia
| | - K Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Sofie C Kommers
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Brigitte Meijer
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Borumandi F, Chadha A, Dediol E, Uglešić V. A Diagnostic Conundrum: Ectopic Nasal Ossification, Submucosal Alveolar Cleft, Absent Posterior Atlantal Arch, and Corpus Callosum Lipoma. Cleft Palate Craniofac J 2014; 52:761-5. [PMID: 25291089 DOI: 10.1597/14-108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 19-year-old woman was referred for nasal breathing and aesthetic concerns regarding her nose. A computed tomography scan revealed a massive osseous shield anterior to the piriform aperture. Furthermore, there was a submucosal median alveolar cleft, and the posterior arch of C1 was missing. The magnetic resonance imaging brain scan revealed a curvilinear lipoma of corpus callosum. The ectopic nasal bone was removed by open rhinoplast,y and nasal function and aesthetics were restored. The described features defy conventional clinical diagnosis and severity classifications and present a diagnostic conundrum somewhere between a mild form of frontonasal dysplasia, oculoauriculofrontonasal syndrome, and Pai syndrome.
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Dediol E, Čvrljević I, Dobranić M, Uglešić V. Comparative study between lag screw and miniplate fixation for straight midline mandibular osteotomy. Int J Oral Maxillofac Surg 2014; 43:399-404. [DOI: 10.1016/j.ijom.2013.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 06/11/2013] [Accepted: 09/03/2013] [Indexed: 11/28/2022]
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Dediol E, Manojlović S. The role of head and neck cancer anatomic subsites in evaluating the prevalence of human papillomavirus. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 115:416-7. [PMID: 23246092 DOI: 10.1016/j.oooo.2012.09.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 08/25/2012] [Accepted: 09/03/2012] [Indexed: 11/18/2022]
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Luksić I, Suton P, Manojlović S, Macan D, Dediol E. Pleomorphic adenoma in ectopic salivary gland tissue in the neck. Coll Antropol 2012; 36 Suppl 2:133-136. [PMID: 23397772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A case of pleomorphic adenoma originating from ectopic salivary gland tissue (ESGT) of the upper neck is reported. A 34-year-old male patient was referred to our Department for a painless swelling in the right submandibular region. Preoperative evaluation (clinical examination, fine-needle aspiration cytology (FNAC) and imaging studies) was performed and the finding was that of pleomorphic adenoma in ESGT A modified "S" incision with extension to the submandibular region was performed and the tumour was extirpated. The histopathological report confirmed our initial diagnosis. No recurrence was obtained during a four-year follow-up period. Isolated neck mass may be overlooked as ectopic salivary gland tissue neoplasm (ESGTN). Proper preoperative assessment and optimal surgical treatment are the keys for successful management of these rare tumours. The distinction between metastatic lesion from a head and neck tumour and ESGTN may present considerable diagnostic problem. A review of the literature on ESGT and associated tumours with emphasis on clinical features, diagnosis and treatment is also presented.
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Affiliation(s)
- Ivica Luksić
- University of Zagreb, School of Medicine, Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
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Dediol E, Manojlović S, Loncarić CT, Biocić J, Hat J. Inflammatory pseudotumor presenting as a facial swelling. Coll Antropol 2012; 36 Suppl 2:143-146. [PMID: 23397774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We present a case of inflammatory pseudotumor (IPT) presenting as a facial swelling after an accidental hit on a right side of a face. As swelling did not resolve, dental examination and teeth extraction were done by a dentist presuming the swelling was misdiagnosed with infection of dental origin. Swelling grew even bigger and patient was referred to Department of Maxillofacial Surgery. CT scan of the face and FNA of the lesion was ordered. A homogenous tumor mass in the right infraorbital region in front of anterior wall of the maxillary sinus was seen on CT The result of the FNA was reactive hyperplasia of the lymph node. Since the lesion was easily accessible surgical exploration and complete extirpation was done. Pathohistological analysis indicated a low grade B-cell Non Hodgkin lymphoma. PCR showed policlonality of B cells discarding the diagnosis of lymphoma. Pathohistological review showed diffuse intramuscular, perineural and perivascular infiltration with small lymphocytes without formation of germinative centers. Imunohistochemistry was positive for CD20 and CD3. Taking into account all features the diagnosis of IPT was established. Diagnosis of IPT is a diagnosis by exclusion, combining clinical, radiological and pathohistological characteristics. Lack of clear histologic criteria makes differential diagnosis extremely difficult. Our case is unique regarding localisation of head & neck IPT no case presenting on the face in infraorbital region has been described in the literature. Although IPT is very rare in general and especially on the face, one should be aware of it when considering differential diagnosis of facial swelling.
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Affiliation(s)
- Emil Dediol
- University of Zagreb, Dubrava University Hospital, Department of Maxillofacial Surgery, Zagreb, Croatia.
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Dediol E, Uglešić V, Cikara I. Advanced atherosclerosis of the vascular pedicle of radial forearm free flap in head and neck diabetic patient. J Plast Surg Hand Surg 2012; 47:73-4. [PMID: 22686431 DOI: 10.3109/2000656x.2012.675882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study reports a case of severe atherosclerosis of the radial artery encountered during raising of a radial forearm free flap in a 56-year-old head and neck diabetic patient which precluded the use of the flap. This is a condition which most reconstructive surgeons are not aware of.
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Affiliation(s)
- Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
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Dediol E. Facial artery pseudoaneurysm as a result of surgical intervention. Int J Oral Maxillofac Surg 2011; 40:770. [DOI: 10.1016/j.ijom.2011.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Accepted: 03/14/2011] [Indexed: 11/27/2022]
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Dediol E, Luksić I, Virag M. Treatment of squamous cell carcinoma of the lip. Coll Antropol 2008; 32 Suppl 2:199-202. [PMID: 19140283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Tumors of the lip are squamous cell carcinomas in 95% of the cases. Also, in 95% of the cases they arise on a vermilion of the lower lip, because of greater exposure of the lower lip vermilion to direct, cumulative UV radiation which is main etiologic factor in development of squamous cell carcinoma. We have reviewed patients that have been treated for lower lip carcinoma at the Department for Maxillofacial surgery, University hospital "Dubrava", from 1990 to 2007. Most common surgical procedure was V-shaped excision of the lip with or without vermilionectomy. For more extensive tumors we used some of the reconstruction methods with local or distant flaps (Webster-Bernard, Karapandzić, free flap). Neck dissection was performed only in patients with clinically evident metastasis or large carcinoma. Although regional metastasis is rare, it significantly lowers five-year survival. Also, we found worse outcome in patients that have been treated previously elsewhere and came for surgical therapy because of recurrent/residual tumor or neck metastasis in comparison to those that were initially treated at the Department of Maxillofacial surgery.
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Affiliation(s)
- Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
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Virag M, Lukčić I, Manojlović S, Dediol E, Sauerborn D. O.021 Cutaneous melanoma of the head and neck – Are the new staging rules better? J Craniomaxillofac Surg 2006. [DOI: 10.1016/s1010-5182(06)60049-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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