Basal cell carcinoma (BCC) is the most common type of carcinoma worldwide. BCC development is the result of a complex interaction between environmental, phenotypic and genetic factors. However, despite the progress in the field, BCC biology and mechanisms of resistance against systemic treatments have been poorly investigated. The aim of the present review is to provide a revision of BCC histological and molecular features, including microRNA (miRNA) dysregulation, with a specific focus on the molecular basis of BCC systemic therapies. Papers from the last ten years regarding BCC genetic and phenotypic alterations, as well as the mechanism of resistance against hedgehog pathway inhibitors vismodegib and sonidegib were included. The involvement of miRNAs in BCC resistance to systemic therapies is emerging as a new field of knowledge.
Summary:
The CAD/CAM technology for mandibular reconstruction has improved the results in terms of outcomes in restoring mandibular complex defects. Augmented reality (AR) represents an evolution of the navigation-assisted surgery. This technology merges the images of the virtual planning with the anatomy of the patient, representing in this way an enhanced scene for the surgeon’s eye. AR can also display in a single scene additional information for the surgeon. Despite of classical navigation, this scenario can be obtained with marker-less registration method, without using reference points or fiducial markers. This technologic evolution together with the large use in our experience of CAD/CAM protocol for mandibular reconstruction we developed this feasibility study to evaluate the possibility of using a marker-less image registration system. Moreover, we tried to evaluate the overlaying of the virtual planning and its reproducibility using AR. We performed a case series of 3 consecutive patients who underwent mandibular reconstruction using AR-assisted fibular free flap harvesting applying our digital workflow. Once launched, the mobile app installed on our tablet, the registration is performed according to a shape recognition system of the leg of the patient, rendering in real time a superimposition of the anatomy of the bony, vascular, and skin of the patient and also the surgical planning of the reconstruction. AR-assisted fibular free flap harvesting was performed. We believe that AR can be a prospective improving technology for mandibular complex reconstruction.
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