The use of piezosurgery in cranial surgery in children.

Piezosurgery is an alternative surgical technique, now widely tested, that uses ultrasounds for bone cutting. This device uses ultrasounds to section hard tissues without harming surrounding soft tissues. The authors analyzed their experience in craniomaxillofacial procedures with piezosurgery. A comparison between operation timing and complication rates between piezosurgery and traditional cutting instruments has been performed. A total of 27 patients were examined (15 females and 12 males; average age, of 5.5 months) affected by craniosynostosis. The aim of this study was to analyze the advantages and disadvantages of piezosurgery in pediatric craniofacial procedures. Piezoelectric device in this study has shown being a valid instrument for bone cutting in accurate procedures, because it allows performing a more precise and safer cutting, without the risk of harming surrounding tissues.

Forehead trauma outcomes: restoration of brain, soft tissues, and bone defects: a 3-step treatment.

Head injuries are one of the most common causes of treatment in the emergency and accidents ward. The first causes of head traumatology are still car or motorcycle accidents, followed by personal aggressions. The authors here present a case of forehead trauma outcome after a severe injury in growing age. The interesting aspect is the triple challenge of cerebral, bone, and soft tissue restoration. The main goal was to restore functionality of the brain and to re-establish the integrity of cranial vault. Excision of pathologic cerebral cortex and well-known surgical techniques have been adopted to achieve this result. Moreover, the peculiar technique that led to the good result was to create a barrier between bone layer and soft tissues. The authors present their personal suggestions for the best functional and aesthetic outcome.

Today's medical knowledge. Evolution of data exchange between tradition and globalization.

The authors historically review bibliographic research concepts and define globalization in time. Moreover, recent free online data exchange is important in terms of medical progress, scientific updating and patient-care improving. In the author's opinion, data globalization is favoring medical knowledge flow even more. The concept of a traditional library has radically changed over time, gradually missing their pivotal role in research activity. To date, the birth of the Internet and its sudden development has given a great boost to the spread of worldwide information, quickly and cheaply. Nevertheless, besides the advantages, the Internet also hides misleading risks. In this paper, the professional Medline source is compared to common Internet sources. The authors state that Internet sources have a great importance in the spread of medical knowledge. They conclude, however, that the risk of too much available information could lead to a decrease in quality.

Combined surgical therapy of temporomandibular joint ankylosis and secondary deformity using intraoral distraction.

Temporomandibular joint (TMJ) ankylosis is a pathological process caused by damage of the mandibular condyle. When this event takes place in subjects during the developmental age, it results in an alteration of the entire maxillofacial complex. Therefore, surgical methods able to remove the temporomandibular ankylosis also include necessary operations to correct the secondary maxillofacial deformity. The distraction osteogenesis has induced our center to modify the surgical protocol for the therapy of patients who have developed TMJ ankylosis and secondary maxillomandibular deformity. We have treated four patients with monolateral ankylosis of the TMJ and serious deformities of the maxillomandibular complex secondary to functional limitation. During the same operation, arthroplasty was performed with the removal of the ankylotic block and the interposition of a temporal muscle flap in the new articular space; an intraoral osteodistractor was also positioned to lengthen the mandible. All patients showed recovery of the eurhythmy of the face and good re-establishment of the symmetry. An average 12-month follow-up showed the average opening of the mouth to be at least 35 mm. The combination of TMJ arthroplasty and intraoral osteodistraction provides good functional and aesthetic results in patients affected by ankylosis who have developed secondary maxillofacial deformities.