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INTRODUCTION: Treatments used in head and neck cancer greatly impact the physical, psychological and functional state of patients. Evaluation of quality of life has become an integral part of the treatment. OBJECTIVE: This retrospective study evaluates features involved in changes in quality of life after major surgery for head and neck cancer within six months, according to self-reported outcomes. METHODS: One hundred and thirty patients completed the University of Washington Quality of Life questionnaire one and six months after major surgery for head and neck cancer. A multivariate model was used to evaluate which diagnostic and therapeutic features were related to improvement of quality of life within a six-month period. RESULTS: Significant improvement in most features related to quality of life was already recognizable at six months. Patients submitted to more invasive treatment had the biggest improvement in quality of life between time-points, as well as those patients with bigger tumors. CONCLUSION: After major surgery, patients may undergo fast recovery, with overall quality of life likely to improve in the short-term. Clinicians must be aware of the importance of dealing with treatment-related issues immediately after surgery, with hopeful possibility of on-the-upgrade results. Resumo Introdução: Os tratamentos adotados em câncer de cabeça e pescoço causam grande impacto nos estados físico, psicológico e funcional dos pacientes. A avaliação da qualidade de vida tornou-se parte integrante do tratamento. Objetivo: Este estudo retrospectivo avaliou os aspectos envolvidos nas mudanças da qualidade de vida pós-cirurgia de grande porte para câncer de cabeça e pescoço no período de seis meses, de acordo com os resultados autorrelatados. Método: Cento e trinta pacientes responderam ao Questionário de Avaliação de Qualidade de Vida da Universidade de Washington, um e seis meses após cirurgia de grande porte para câncer de cabeça e pescoço. Um modelo multivariado foi usado para avaliar quais características terapêuticas e diagnósticas estavam relacionadas à melhora da qualidade de vida no período de seis meses. Resultados: Melhora significativa na maioria dos aspectos relacionados à qualidade de vida já podia ser percebida em seis meses. Os pacientes submetidos a um tratamento mais invasivo apresentaram os melhores avanços na qualidade de vida entre os tempos de avaliação, bem como os pacientes portadores de tumores maiores. Conclusão: Após uma cirurgia de grande porte, os pacientes podem ter recuperação rápida, com melhora da qualidade de vida global em pouco tempo. Os médicos devem estar cientes da importância de lidar com questões relacionadas ao tratamento imediatamente após a cirurgia, devido à possibilidade de resultados melhores.

Purpose: To achieve the desired outcome in rhinoplasty depends on many factors. Osteotomy and surgical reshaping of nasal bones are important steps that require careful planning and execution. The availability of different tools raises the question of which one provides significant advantages for both technique and surgical outcome. Our prospective randomized pilot study compared the outcome of post-traumatic rhinoplasty performed with two different external techniques: ultrasound osteotomic cut using the Piezosurgery Medical Device (Mectron, Carasco, Italy) and traditional external osteotomy. Material and methods: Forty-four lateral osteotomies of the nasal wall were performed in twenty-two patients. In twelve patients the osteotomies were conducted with a 2-mm traditional osteotome (control group), while in the remaining ten patients these were done with the Piezosurgery Medical Device (experimental group). Results: At the postoperative evaluation, significantly lower pain, edema and ecchymosis were noticed in the experimental group (p < 0.05). Moreover, the endoscopic evaluation showed fewer mucosal injuries in the experimental group (p < 0.05), whereas bleeding, symmetry of the pyramid and presence of external scars, were similar in the two groups. Conclusions: In the present study, Piezosurgery Medical Device allowed for safe lateral osteotomies in rhinoplasty preliminarily demonstrating the potential to reduce some of the most frequent complications of rhinoplasty.

Aims: Sudden hearing loss is defined as a sensory neural hearing deafness of at least 30 dB in three consecutive speech frequencies that as occurred within the 3 days. It is a medical emergency and the treatment should start as soon as possible; up to now therapies are empirically addressed to improve hearing. Materials and Methods: We have evaluated 558 patients with a diagnosis of sudden hearing loss. In our study, we have investigated possible prognostic factors of hearing loss and their influence on the recovery of the pathology. Results and Discussion: Sudden hearing loss requires an immediate therapeutic intervention. The corticosteroid therapy remains the most accredited one at which are reported the most satisfactory results. We have recognized as negative prognostic factors hearing loss on acute frequencies in the audiometric exam, the presence of a severe-deep hearing loss and a delay in starting therapy. Conclusion: The sudden hearing loss is an otologic emergency which requires an immediate therapeutic intervention. The most accredited therapy remains the corticosteroid therapy. Frequencies we have recognized as negative prognostic factors hearing loss on acute frequencies. The presence of a severe-deep hearing loss, and a delay in starting therapy.

Objectives Wegener's granulomatosis (WG) is an uncommon multisystemic vasculitis characterized by a pathological triade, consisting of necrotizing granulomatous lesions of the respiratory tract, systemic vasculitis involving small arteries and veins, and necrotizing glomerulonephritis. We report a case of WG in a patient who initially presented with ulcerative gingivitis. Materials and methods A 59-year-old woman was referred to the Department of Oral Pathology and Medicine, School of Dental Sciences, University of Trieste, for an uncommon form of gingivitis with ulcerative and necrotic lesions. On the basis of the clinical, serologic, and histologic findings, the condition was provisionally diagnosed as an orofacial granulomatous condition. During follow-up, bilateral serous otitis media and acute ulceronecrotic rhinitis were also diagnosed by an otorhinolaryngologist. Systemic steroid therapy (prednisolone 25 mg for 10 days) was prescribed. It produced partial remission of the ear and nasal symptoms, as well as good improvement of the oral lesions. Results Considering the clinical, histological, laboratory, and instrumental findings (maxillofacial CT, chest radiography), the final diagnosis was WG. Conclusions Lesions involving the ear, nose, and oral cavity can be an early manifestation of WG. The mean survival of untreated patients is very low. Therefore, otorhinolaryngologists and dentists should both be aware of this condition as prompt referral and early diagnosis can be of crucial importance to the treatment outcome.

Malignant tumours of the upper gum and hard palate account for 1-5% of malignant neoplasms of the oral cavity; two thirds of the lesions which involve these areas are squamous cell carcinomas. Most of these carcinomas are diagnosed late, when they invade the underlying bone. The procedures of choice for removal are: alveolectomy, palatectomy, maxillectomy, which may be total or partial. Surgical reconstruction of the defect may be carried out using a wide range of microvascularized flaps: osteomuscolocutaneous of the internal iliac crest, an osteocutaneous flap of the fibula or scapula, fascia, or osteocutaneous radial flap, or a pedicled flap of temporal muscle. These flaps are supported by single or multiple obturator prostheses. Rehabilitation via palatal obturators is preferred in patients with a poor prognosis or in weak condition. Rehabilitation aims to: restore the separation between the oral and nasal cavities, enable the patient to swallow, maintain or provide mastication, sufficient occlusion and mandibular support, support the soft facial tissues, re-establish speech and restore an aesthetically pleasing smile. Hence, it is crucial to work in close cooperation with the staff who makes the prosthesis and who evaluates the case when the surgery is planned and obtains the necessary gnatological, anatomical and functional information. Thereafter, during the surgical stage, for the immediate obturators, or in the successive days, for the temporary obturators, work is devoted to making the prostheses. In this regard, the Odonto-prostheses Service of the Stomatological Clinic does not follow a rigid protocol but materials and techniques are selected on a personal basis, according to the features of each individual clinical case. Mobile rehabilitative systems are the systems of choice, both of which related to the traditional concepts of retention and stability and systems of self-stabilizing prostheses according to J. Dichamp, albeit modified in materials, limiting, when possible the use of prostheses which are fixed on natural teeth, on appliances or combined.