Maxillofacial pathology and therapy

A.Y. 2019/2020
9
Max ECTS
120
Overall hours
SSD
BIO/16 MED/28 MED/29 MED/31
Language
Italian
Learning objectives
- to provide an exhaustive picture of the main diseases involving the maxillo-facial region showing a wide clinical series;
- to emphasize the pathogenetic and diagnostic (clinical and instrumental) aspects of the pathologies, with only a quick reference to the surgical treatment and surgical techniques;
Expected learning outcomes
knowing the clinical feature of the main traumatic, oncological and malformative diseases involving the maxillo-facial region.
Course syllabus and organization

Unique edition

Responsible
Prerequisites for admission
- Notions of general anatomy, physiology and physiopathology are required
- Knowledge of the macroscopic and microscopic systematic anatomy of the structures of the cervico-facial district is required.
- Notions of general anatomy, physiology of upper aero-digestive tract, ear, and neck
Assessement methods and criteria
The exams will take place with a written test with open questions possibly supplemented with an oral examination always oriented to test the student's ability to know the pathologies described during lessons
The assessment of the head and neck anatomy module involves a work in small groups to prepare a presentation with slides that illustrate the main anatomical aspects of interest for the correct diagnosis of the proposed clinical cases. Each student will orally exhibit part of the work in front of the whole class in order to allow a discussion and to verify the proper description of the anatomical structures identifiable in images of the cervico-facial district.
Each student will be given a mark in 30/30 according to the quality and correctness of the prepared material and its oral presentation.
Anatomia umana e dell'apparato stomatognatico
Course syllabus
Stratigraphic examination of the following regions (including vascularization and innervation) and description of the related deep spaces:
- Temporal, nose, lip and chin, cheek regions
- Parotid-masseteric regions, deep lateral spaces of the face
- supra- and infra- hyoid regions, carotid sheath and carotid space, supraclavicular space.
Teaching methods
· Frontal lessons supported by visual and audiovisual media of many clincal cases, video clips of surgical techniques
· Discussion of clinical cases
· At the specific request of the student professional clinical activity in the unit or in the operating room will be provided
Bibliography
- Petra Kopf-Maier. Anatomia Umana. Atlante di Wolf-Heidegger. Edi.Ermes, Milano.
- F.H. Netter. Atlante di Anatomia Umana. Masson, Milano.
- E. Pernkopf. Atlante di anatomia sistematica e topografica dell'uomo. Vol. 1° (testa e collo), Piccin Editore, Padova.
- B. Tillman. Atlante di anatomia- Odontoiatria e Medicina. RC Edizioni Scientifiche, Milano.
- Gilroy et al. Atlante di Anatomia. Prometheus Università, UTET.
- Brizzi et al. Anatomia Topografica. Edi. Ermes, Milano. Estratto riservato per Odontoiatria
(esclusivamente Testa e Collo) dal volume.
Chirurgia maxillo-facciale
Course syllabus
1 Cranio facial malformations
Lip and palate clefts
· Facial clefts
· Craniostenosis and craniofaciostenosis (general principles, plagiocephaly, trigonocephaly, scaphocephaly, brachycephaly, S. of Appert, S. of Crouzon etc.)
· Latero-facial microsomies

2 Cranio-maxillofacial traumatology: general principles, pathogenesis, diagnostic aspects and treatment notes
· Management of the traumatized patient and emergencies in facial traumatology
· Soft tissue traumatology (wound healing, lesions of the glandular ducts etc.)
· Traumatology of the facial skeleton (mandibular fractures, maxillary fractures, nose fractures, zygomatic fractures, orbital fractures, craniofacial fractures, complex fractures)

3 Growth anomalies of the maxilla and the mandible
· Etiopathogenesis of maxillary and mandibuar deformities
· Physical examination in orthognathic surgery (facial examination, occlusal examination, teleradiographic and cephalometric examination)
· Treatment planning and role of pre and post surgical orthodontic therapy
· Classification and treatment of maxilary and mandibular deformities
· Dento-facial asymmetries

4 Surgical pathology of the temporomandibular joint. Diagnostic aspects and elements of therapy
· Temporomandibular disorders.
· Arthrosis and arthritis
· Ankylosis
condylar fractures
malformations
· Tumors

5 Malignant oro-maxillofacial tumors
· Carcinoma of the oral cavity (epidemiology, risk factors, biology, clinical features , staging, treatment and prognosis)
· Nose-ethmoid-maxillary tumors and main sarcomas of the extreme cephalic
· Skin tumors (classification, risk factors, biology, clinical features, staging, treatment)

6 Maxillofacial reconstructive surgery
· General principles (surgical problems, classification and biology of grafts, flaps and microvascular flaps)
· Reconstructive modalities of the facial skeleton (jaw, upper jaw, etc)
· Reconstructive modalities of soft tissues (skin, lips, oral floor etc.)
CAD CAM customized recostruction of the facia skeleton

7 Surgery of the trigeminal and facial nerves
· Classification of nerve injuries
· Injury of the trigeminal nerve and of the facial nerve: diagnostic features and therapy modalities
Teaching methods
· Frontal lessons supported by visual and audiovisual media of many clincal cases, video clips of surgical techniques
· Discussion of clinical cases
· At the specific request of the student professional clinical activity in the unit or in the operating room will be provided
Bibliography
- R. Brusati, M. Chiapasco
Elementi di Chirurgia Oro-Maxillo-Facciale
Edizione Masson, Milano 1999
- AAVV Trattato di patologia chirurgica maxillo-facciale della Società Italiana di Chirurgia Maxillo-Facciale, minerva medica
Chirurgia orale
Course syllabus
1 Oro-maxillofacial cystic lesions: diagnostic and treatment aspects
· Definition and classification of cystic lesions
· Bone cysts (odontogenic, non-odontogenic and pseudocyst)
· Soft tissue cysts (of the thyroglossal duct, dermoids, brachials etc.)

2 Benign oro-maxillofacial tumors:
diagnostic aspects and treatment modalities
· Classification of benign tumors
· Odontogenic and non-odontogenic benign bone tumors (clinical, radiographic and microscopic pictures)
· Benign soft tissue tumors (clinical and instrumental pictures)

3 Inflammatory pathologies of oro-maxillofacial hard and soft tissues
microbiology, clinic and treatment principles
· Abscesses and odontogenic phlegmons
· Osteitis and osteomyelitis
· sinusitis
· Necrotizing fasciitis
Teaching methods
· Frontal lessons supported by visual and audiovisual media of many clincal cases, video clips of surgical techniques
· Discussion of clinical cases
· At the specific request of the student professional clinical activity in the unit or in the operating room will be provided
Bibliography
- R. Brusati, M. Chiapasco
Elementi di Chirurgia Oro-Maxillo-Facciale
Edizione Masson, Milano 1999
Otorinolaringoiatria
Course syllabus
- Notions of anatomy, physiology and physiopathology of upper airways and digestive tract
- Classification of rhinitis and rhinosinuistis
- Rhinitis and chronic rhinosinusitis
- Odontogenic maxillary sinusitis and possible sequelae
- Complications of sinusitis
- Disorders of lymphatic ring of Waldeyer and associated diseases
- Snoring, breathing disorders, OSAS
- Acute and chronic tonsillitis, indication to tonsillectomy
- Recurrent acute otitis media (OMAR) and otitis media with effusion (OME)
- Indication to adenoidectomy
- Dysfunction of Eustachian tube and palate
- Salivary disorders and obstructive sialadenitis (stones, duct anomalies, autoimmune disorders, bruxism)
- Relationship between salivary stones and gengival bacterial placque
- Neoplasms of salivary glands: diagnosis and principles of treatment
- Cervical swelling: differential diagnosis between lymphoadenopathy, branchial cysts, salivary and thyroid lesions
- Introduction to transoral robotic surgery (TORS) and robotic neck dissection
Teaching methods
· Frontal lessons supported by visual and audiovisual media of many clincal cases, video clips of surgical techniques
· Discussion of clinical cases
· At the specific request of the student professional clinical activity in the unit or in the operating room will be provided
Bibliography
Trattato di Otorinolaringoiatria ed Audiologia
Pignataro, Cesarani, Felisati, Schindler
Edises.
Anatomia umana e dell'apparato stomatognatico
BIO/16 - HUMAN ANATOMY - University credits: 1
Lessons: 10 hours
Chirurgia maxillo-facciale
MED/29 - MAXILLOFACIAL SURGERY - University credits: 3
Lessons: 30 hours
Chirurgia orale
MED/28 - ORAL DISEASES AND DENTISTRY - University credits: 4
Lessons: 20 hours
Practicals - Exercises: 50 hours
Shifts:
Polo Centrale
Professors: Beltramini Giada Anna, Rossi Diego
Otorinolaringoiatria
MED/31 - OTORHINOLARYNGOLOGY - University credits: 1
Lessons: 10 hours
Professor: Capaccio Pasquale