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We review here our substantial experience in using Alexis Carrel’s technique with a geometrical optimization for microsurgical end-to-end anastomoses. The technique used for microsurgical end-to-end anastomoses is described. We performed a retrospective analysis of head and neck free flaps where we used the described microsurgical anastomoses technique at Bufalini Hospital in Cesena, Italy. Patients’ demographic data, intraoperative findings, and postoperative progress, including complications, were accurately recorded. We also recorded the cases where vessel size discrepancy was observed intraoperatively, either arterial or venous. The described technique has been used in 300 consecutive flaps in the last 18 years, with an average of 16 free flaps per year. No significant problems were encountered using this simple technique. Comprehensive flap survival was 98%. We had 5 free flap failures, and in all cases, the main problem was not related to the microvascular anastomoses. Vessel size discrepancy was recorded in 25% of the total. Alexis Carrel’s technique for microvascular end-to-end anastomoses is still a very efficient end safe technique. Our geometrical optimization of it is a useful trick to keep in mind for the microvascular surgeon, especially in hospitals with a small volume of microsurgical procedures per year. Level of evidence: Level III, therapeutic study.

The tongue is the most dominant structure of the oral cavity. It is a frequent site of benign and malignant diseases. In this paper we describe five rare cases of benign tongue lesions. Two of these were intravascular papillary endothelial hyperplasia, one was a Schwannoma, one case was a juvenile xanthogranuloma, one was a granular cell myoblastoma and the last one was a tongue abscess. Clinical and radiological features, differential diagnosis, and treatment are discussed for each of these. The tongue is the most dominant structure of the oral cavity. It is a frequent site of benign and malignant diseases. It is subject to: dental trauma, local and systemic inflammatory conditions. In this paper we describe five rare cases of benign tongue lesions. Two of these were intravascular papillary endothelial hyperplasia (IPEH), one was a Schwannoma, one case was a juvenile xanthogranuloma (JXG), one was a granular cell myoblastoma and the last one was a tongue abscess. The appropriate treatment of these lesions is total excision in healthy margins. The clinical appearance of these lesions is very similar between them. The aim of this work was to analyze different, rare, benign lesions of the tongue presenting clinical features very similar between them. Vascular lesions were not taken into account because their clinical presentation is characterized by well known and obvious aspects. language: English

Aim. Chronologic age is still a cause of unjustified substandard treatment for head and neck malignancies, which worsens significantly prognosis. The aim of this study was to analyse the role of age and related comorbidities as prognostic factors in patients affected by oral squamous cell carcinoma (OSCC). Methods. We retrospectively studied 165 consecutive patients with OSCC admitted to our Units from September 1998 to January 2009: 23 stage I subjects (13.9%); 33 stage II subjects (20.0%); 41 stage III subjects (24.8%); and 68 stage IV subjects (41.2%). Furthermore, we determined for each patient the grade of systemic illness using the Kaplan-Feinstein Comorbidity Index modified by Piccirillo, which is a widely validated simple tool. To identify the role of age in survival we splitted our study group into two sub-groups: young patients (>70) and elderly patients (

Osteosarcoma of the jaws (OSJ) is a relatively rare disease, accounting for between 2% and 10% of all cases of osteosarcoma. It is morphologically and radiologically identical to the trunk and extremity variant, but distinct in several crucial aspects. : The lesion is characterized by sarcomatous cells which produce a variable amount of osteoid bone. It arises centrally within the bone and can be subdivided into osteoblastic, chondroblastic and fibroblastic subtype, depending on the predominant cell type. : Radiographically, these tumors display a spectrum of bone changes from well-demarcated borders to lytic bone destruction with indefinite margins and variable cortical bone erosion or, in some cases, images of sclerotic bone. : Therapeutic options for OSJ include surgery, chemotherapy and radiotherapy, which are employed according to age of the patient, histological classification and localization of the tumor. Today, there is no general consensus in the treatment guidelines for the OSJ though surgery represents the key to the treatment. The main prognostic factor deeply influencing the patient’s prognosis remains the complete tumor resection with negative surgical margins. : The aim of the present review is to describe state of the art regarding diagnostic and surgical treatment aspects of the primary osteosarcoma of the jaws.