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At least 847 records · Page 47Linked to original sources
PubMed1976

[Use of formalinized homologous bone in reconstructive operations on the mandible].

An experience with 69 osteoplastic operations with formalinized homografts in 66 patients having various affections and injuries of the lower jaw is summarized. The grafts were preserved in 0.5% formalin solution or gel containing 0.25% formalin and 0.25% betapropiolactone as sterilizing agents. Positive issues during the follow-up from 4 months to 4 years 7 months were noted in 60 operative procedures, negative--in 9. It is concluded that the formalinized homobone shows good osteoplastic properties and may be used as a plastic material in reparative operations on the lower jaw bone.

Adolescent↗
PubMed1994

[Results of the use of titanium mandibular reconstruction plates].

The aim of this study was to assess the use of titanium mandibular reconstruction plates after cancer surgery. The medical records of 36 patients were reviewed. The mean follow-up was 22 months. All patients had primary reconstruction of the mandible with Leibinger titanium plates. Thirty patients underwent postoperative radiotherapy with the plate in the field. The mean dose was 60 Grays over 6 weeks and the overdosage into tissues was reduced to 5%. Thirty patients (83%) had retained the plate at 6 months and no sign of osteomyelitis was found in any patient. Quality of speech and deglutition were satisfactory in 63% and 94% of the patients respectively; sixty-six p. cent of them found their cosmetic appearance good or excellent. The overall success rate of the technique was 74%. This technique did not excessively prolong operating time unlike microvascular transfer. Plates are an effective method of primary reconstruction in patients with advanced cancer and uncertain long-term survival. Tolerance of plates after radiotherapy is outstanding. Speech, deglutition and facial contour are immediately restored and further bone reconstruction is feasible.

Adult↗
PubMed1976

[Treatment of malpighian epitheliomas of the floor of the mouth with gingival involvement].

Within the clinical context of carinomas of the upper respiratory/digestive tract (special underlying features, frequency of multiple localisations), pelvi-gingival tumours pose special problems essentially related to the proximity of the mandible. Over the past 15 years, treatment protocols at the Institut Gustave-Roussy have been progressively oriented towards a surgical solution preceded by short period of chemotherapy and followed by radiotherapy on an "as required" basis. In certain instances (bone resection with defect, especially naterior), such excision surgery results in serious functional and aesthetic impairment and cannot be envisaged in the absence of concomitant reparative surgery. The latter is clearly defined as far as the soft tissues are concerned thanks to the use of facial or thoracic flaps, whilst solutions for restoring bone continuity remain imperfect. The difficulties of covering a bone transplant and the need for postoperative radiotherapy compromise its future. From a tumour standpoint, the results are aggravated essentially by the existence of bone involvement or of histological lymph node invasion. Furthermore, it is closely related to the manifestations of the malignant disease in general. The survival obtained with the current therapeutic protocol is 38% at 3 years and 32% at 5 years.

Bone Transplantation↗
PubMed1994

Humoral hypercalcemia of malignancy associated with ameloblastoma in a horse.

Humoral hypercalcemia of malignancy was evident in a horse that had a locally invasive ameloblastoma of the left hemimandible. Surgical removal of the neoplasm resulted in prompt return of serum calcium and parathyroid hormone concentrations to within reference limits. The tumor contained parathyroid hormone-related protein, as demonstrated by immunohistochemistry and western blot analysis. It is likely that production of this protein by the neoplasm was important in the pathogenesis of the hypercalcemia. The case represented a sporadic form of humoral hypercalcemia of malignancy attributable to an uncommon epithelial neoplasm, and indicated that humoral hypercalcemia of malignancy can develop with neoplasms in horses.

Ameloblastoma↗
PubMed1994

[Functional dynamic bridging plate and its use in the mandible].

The principle of the functionally dynamic bridging plate can be compared with the construction of a double bridge. The first bridge, which performs a protective function, is established by means of a plate which extends from one stump of the mandible to the other. The homogeneous, square-sectioned, central bar of the plate tolerates micromovements when stressed and demonstrates no predetermined breaking points. The second bridge ist established with the aid of the primary or secondary bone transplants, which are fixed to each other separately and to the stumps of the mandible with supplementary gracile implants. An adequate degree of functional stress on the bone transplant, i.e. the transmission of functional dynamical forces, is essential for the remodelling of the bone and must extend from one resected stump to the other. The choice of a square cross-section for the functionally dynamic bridging plate bar simplifies the three-dimensional bending and shaping of the plate on a template or the bone, thereby stressing the plate material uniformly and protecting it accordingly. This considerably facilitates the intraoral fixation of the plate. The functionally dynamic bridging plate system has proved successful in cases of partial mandibular resections, after tumour resections or in cases of defects following traumas and inflammations. It is suitable for cases with or without immediate bone reconstruction. It can be placed on the buccal side of the mandible, the caudal side or a combination of both. Positioning bone transplants can thus be carried out by a direct approach without obstruction and is consequently technically simpler.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Alloplastic implants. Their role in reconstruction of the mandible.

This article discusses the use of osseointegrated implants in mandibular reconstruction. Although the article presents the history, indications, and complications of this technique, the primary focus of the article is the technique itself, especially how the technique varies from patients not undergoing reconstruction to those who are. The effect of radiation therapy on the treatment planning of patients undergoing reconstruction also is discussed. Intraoral soft-tissue management also is addressed, as this area often differs significantly in patients undergoing radiation therapy from that in patients not undergoing radiation therapy and reconstruction.

Adult↗
PubMed1993

[Clinical and radiation physics studies on the influence of mandibular reconstruction plates on the dose distribution of ultrahard photons].

The effect of mandibular reconstruction plates on the dose distribution of megavoltage photons was analysed. All treated patients showed the normal reactions expected from radiation therapy regardless the modification of dose distribution by the metal plates. For dose estimation measurements were done in a phantom with photons of the energy 60Co to 42 MV and different material.

Alveolar Process↗
PubMed1996

[The musculus pectoralis major rib flap. Personal experiences with 7 cases].

We present a report of our experience with one-step reconstruction of the mandible after resection in tumor cases using an osteomyo-cutaneous flap. We performed a pectoralis major flap with a segment of the fifth rib, blood supplied by the periosteum. In seven cases we had one pseudoarthrosis. The complications in the donor site were none. We see in the pectoralis major-rib flap an alternative to microsurgical techniques, especially in patients with defects in the horizontal part of the mandible.

Adult↗
PubMed1996

[Therapeutic concept in comminuted and defect fractures of the mandible].

Immediate live-saving emergency treatment of patients with heavily communited and partially defective mandibles by airway intubation, control of haemorhage and primary treatment of wounds necessarily must be followed by a staged concept of treatment for the functional and aesthetic rehabilitation of hard and soft tissue in order to enable the patient to survive not only biologically but also socially. Out of 384 patients with surgically treated mandibular fractures, 120 had multiple fractures, 24 heavily comminuted fractures and 6 sustained vast defects. All multiple and communited fractures could be treated successfully by an intraoral approach using function-orientated miniplate-osteosynthesis and in 30 cases functionally stable plates. In patients having sustained vast avulsions of soft and hard tissue, immediate emergency-revascularisation was well to the fore. In cases of tissue destruction, primarily the position of the jaw stumps was secured by plates and reconstruction was done in the early secondary stage using composed microvascularly transferred scapular flaps.

Adult↗
PubMed1995

Temporomandibular joint derangement with multiple surgical interventions: a case report.

This case report describes the experience of a 26-year-old woman who underwent multiple jaw surgeries. An initial 22 months of unsuccessful nonsurgical therapy was followed by a 7-year period during which the following were performed: 12 surgeries of her right temporomandibular joint; one surgery of her left temporomandibular joint; bilateral coronoidectomies; one surgery of her right mandible; and three surgeries of her left mandible. This case is important because although the existence of multiple jaw surgery cases are widely noted throughout the literature, this is the first case report that presents in-depth prospective documentation.

Adult↗
PubMed1997

[A clinical x-ray analysis of the results of using titanium mandibular endoprostheses].

Late results of repair surgery are analyzed in 40 patients with segmented mandibular defects of different origin. Titanium constructions were used for repair of defects in 21 patients and in 19 others combined endoprostheses were used, consisting of the crest of the patient's iliac bone and a titanium carcass. Check-ups 1.5-2 years after repair showed a higher reliability of combined endoprostheses.

Adolescent↗
PubMed1976

Application of contemporary reconstructive techniques in head and neck surgery for anterior oral-facial cancers.

One hundred and seventy-eight patients underwent surgical therapy for oral and cervical cancers from 1964 to 1975. About 25 percent of the patients underwent neck dissection and/or "pull-through" procedures. However, majority of patients required a spectrum of reconstructive techniques extending from marginal mandibulectomy with or without skin flaps (39), partial mandibulectomy with immediate prosthetic mandible reconstruction (36), to extended resections with skin flaps or staged reconstructive procedures (48). The advantages and disadvantages of each reconstructive procedure have been observed and a scheme of graded management has been developed. The therapeutic goal is to maximize functional oral reconstruction without compromising tumor cure. There were two operative deaths--one from myocardial infarction after operation and one from halothane hepatitis. The tumors were grouped according to TNM classification. In the follow-up of the 178 patients, 47 per cent are known to be alive and free of tumor. The better results (greater than 70% free of tumor) are in the group with smaller tumors (less than 2 cm.) and no node involvement, and there are less favorable rates for those patients with larger tumors and nodal metastasis or invasion of adjacent structures. There was a 49 percent 2 year survival rate and 12 of the deaths were from nontumor causes. Ninety percent of these patients smoked more than one pack of cigarettes per day, accounting for the high rate of synchronous or subsequent oroairway cancers (7 percent). Seventy-five percent were considered to be "heavy alcoholics" with evidence of cirrhotic liver disease. These two factors significantly decreased the survival from rate 54 to 47 percent. The series shows that planned primary reconstructive surgery can be done at a low risk, that it can enhance resectability of head and neck cancers, and that it does improve oral function after operation.

Adenocarcinoma↗
PubMed1998

Primary reconstruction of mandible in head and neck cancer with silastic implant--a review of 69 cases.

Different methods of primary mandibular reconstruction carried out at the Tata Memorial Cancer Hospital range from the pectoralis major myocutaneous or osteomyocutaneous composite flap, which is the most frequently performed procedure, to a free vascularised composite tissue transfer with microvascular anastomosis, including, iliac crest free vascularised bone grafts or radial artery forearm flap free vascularised radius bone grafts, free vascularised fibular bone grafts and silastic mandibular implants. The clinical results of immediate mandibular reconstruction with a silastic mandibular implant (SMI) in 69 patients is presented. Out of the 69 cases, 2 patients died in the early post-operative period. Twenty (30%) SMI were retained for a period of 1 year to 5 years. Forty seven (70%) SMI were retained for a period of less than 1 year. These implants have been used in a variety of cases, with or without major flap reconstruction, where a skeletal support was indicated, especially after mandibular arch resection. The results of this series indicates the importance of these implants as a short term spacer, even in advanced, fungating lesions of head and neck cancer where the risk of infection, haematoma and salivary leak is very high. Bone replacements were undertaken at a later date in suitable cases. The effects of preoperative chemotherapy and radiotherapy on the retention of these implants has also been studied.

Carcinoma, Squamous Cell↗