[Results of the LeClerc operation in habitual temporomandibular joint and discuss articularis luxation].
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Biomedical subjects
Publications and source records attributed to H F Sailer.
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A review of the surgical treatment of 17 cases of mandibular osteomyelitis is presented in which, following certain special indications, resection and simultaneous reconstruction of parts of the mandible were performed. This treatment was successful in 15 of the 17 patients considered. In two cases, the necrotic graft had to be removed. In one of them, the immediate reconstruction was successfully repeated. The indications for immediate reconstruction are given and the principles of the procedure described.
A case of facial duplication with its surgical correction in childhood and the consequences on facial growth is reported. It is a unique case in the duration of observation. The following structures were fully duplicated: the nose, the premaxilla, the cribriform plate, the crista galli. In addition there was an enormous facial cleft including lip, alveolus and palate. Additionally there were two rudimentary eye sockets, eyes, and two supplementary eyebrows. The monstrous hypertelorism with the facial duplication was corrected at the age of ten. The surgical procedure is described and the postoperative complications are discussed. Gross lack of growth of the middle third of the facial skeleton was observed. This was probably the consequence of the initial corrective surgery. Overgrowth of the mandible created a gorilla-like appearance by the end of the growth period. This was corrected in one operation by advancement of the middle third in three sections and repositioning of the mandible as a whole together with the mandibular anterior alveolar segment. Finally all parts of the lower half of the nose had to be enlarged, both soft tissues as well as the cartilaginous framework. A pharyngoplasty in addition to the correction of the intermaxillary abnormalities did much to improve the speech quality of the patient. A large secondary cranial defect was successfully reconstructed with the use of 14 halved ribs. In spite of the removal of four ribs from one side and three ribs from the other, there were no postoperative respiratory problems. Spontaneous rib regeneration was found where ribs had been removed one year earlier.
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In the Maxillo-Facial Surgical Clinic in Zurich lyophilized bank cartilage (LBC) is used for facial contour reconstruction and elsewhere. In 122 paitents LBC was transplanted 265 times in different sites. The rate of infection was 2.6% the degree of resorption up to 20%. In 7 cases transplanted LBC was removed for histological examination because of over-correction. Xeroradiography is suggested as a method of control even when the cartilage is not calcified.
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Osseointegrated implants are widely used in dental rehabilitation. They are particularly valuable if the structures supporting a denture had to be removed because of oral cancer. Additionally, many of these patients undergo radiotherapy, but cancer and radiotherapy are seen as relative contraindications for implant therapy. In the literature, there are few clinical studies documenting successful oral rehabilitation using implants in such patients. The authors report a clinical case in which histologic evidence of osseointegration can be demonstrated in an irradiated and reconstructed mandible. This observation should encourage the extended application of implants in rehabilitation following oral cancer surgery.
Double contrast arthrotomography combined with cinematography as a diagnostic instrument establishing functional and structural TMJ alterations is evaluated for its diagnostic value and reliability within the chain of diagnostic measures applied. In 131 patients double-contrast arthrotomography was followed by a comprehensive history of joint problems, and verification of the clinical findings as well as the arthrographic diagnosis and the post-arthrographic TMJ alterations. Our interest was focussed, among others, on the question whether arthrography alone would have any therapeutic effect or produce an alteration in TMJ function.
18 cases of metastases to the jaws in the last 10 years obtained from the Clinic of Maxillofacial Surgery and the Department of Pathology, University Hospital Zürich, are described. They were seen in patients with carcinoma of the breast, lung, prostate gland, uterus and seminoma of the testis. In 16 cases the metastases were situated in the mandible, in 2 cases in the maxilla. The average age of these patients was 61.6 years with no sex predilection. The initial symptoms were pain swelling. In 4 cases a pathologic fracture was diagnosed. The majority of the metastatic lesions are osteolytic in nature. The metastases were diagnosed, in average 3.3 years after diagnoses of the preliminary tumor. In 2 cases the metastases were diagnosed before the occult primary tumor. Death usually ensues 1 year after diagnoses.