Parotidectomy and submandibulectomy for benign diseases in Thuringia, Germany: a population-based study on epidemiology and outcome.

Although salivary gland surgery for benign diseases is an integral part of clinical routine of head and neck surgeons, there is not many population-based data published on incidence and efficiency of this surgery. Parotidectomy was performed in 180 patients and submandibulectomy in 97 patients for benign diseases in eight otorhinolaryngology and two maxillofacial surgery departments in Thuringia, Germany, in 2005. All patients were analysed regarding patients' characteristics, therapy, complications and further course of disease. Predominant indications were epithelial tumours for parotidectomy (79 %) and sialolithiasis for submandibulectomy (50 %). The most frequent tumour types were pleomorphic adenoma (46 %) and Warthin tumours (29 %). Pleomorphic adenoma was significantly more frequent in female patients and Warthin tumours in male patients and smokers. The incidence of parotidectomy, i.e. the surgical rate, was 7.8/100,000 habitants and of submandibulectomy 4.1/100,000 habitants. One hundred and seventy-eight tumours including 154 epithelial tumours resulted in an incidence of 7.6/100,000 habitants for all treated tumours and of 6.6/100,000 for epithelial tumours, respectively. The majority of parotid cases were treated by lateral parotidectomy (79 %). Relevant complications were observed in 22 % of patients. After parotidectomy and submandibulectomy a postoperative facial palsy was observed in 28 and 2 % of cases, respectively. Only 1 % was permanent. During a mean follow-up time of 9.6 months, 3 % of parotidectomy patients developed a Frey's syndrome needing treatment and 0.8 % developed a tumour recurrence. This population-based analysis shows that salivary gland surgery is performed in higher incidence than expected, effectively and with low-risk in daily routine of head and neck surgeons.

[Treatment results after surgery for basal cell carcinomas of the head and neck region taking into consideration various reconstruction techniques]. / Behandlungsergebnisse nach chirurgischer Therapie von Basalzellkarzinomen im Kopf-Hals-Bereich unter Berücksichtigung unterschiedlicher Rekonstruktionsverfahren.

BACKGROUND: Basal cell carcinomas are the most frequently occurring malignant tumors in the white population. They exhibit a multitude of histological/morphological forms. PATIENTS AND METHOD: All cases of basal cell carcinoma treated at the department for oral and maxillofacial and regional plastic surgery of the HELIOS hospital in Erfurt between 1976 and 2003 were analyzed and partly reexamined in a retrospective study. RESULTS: A total of 648 patients with 765 basal cell carcinomas were treated. Occurrences in females dominated those in males with a frequency distribution of 1.24:1. The average age was 70.6 years with a significantly larger number of female seniors above 60. In 64% of the cases the basal cell carcinomas were nodular, in 16% infiltrative. Other morphological/histological forms occurred with a frequency of

[Monstrous benign schwannoma of the mandible. Clinical aspects, morphology and therapy]. / Monströses benignes Schwannom der Mandibula. Klinik, Morphologie und Therapie.

BACKGROUND: Schwannomas are rare benign neurogenic tumors that arise from Schwann cells of the peripheral nervous system. The most frequent localisation is the head and neck area. Extracranial schwannomas are most often located in the deep soft tissues. Intraosseous tumor types are rare; the mandible is the most common site. CASE REPORT: We present the case of a 63-year-old woman with a schwannoma which originated from the mandible nerve and describe the therapy of this neoplasm. A rare malignant transformation cannot be excluded. Therefore, the treatment of choice is radical local resection.

[Giant benign mandibular schwannoma. Clinical features, morphology, and treatment]. / Monströses benignes Schwannom der Mandibula : Klinik, Morphologie und Therapie.

BACKGROUND: Schwannomas are rare benign neurogenic tumors that arise from Schwann cells of the peripheral nervous system. The most frequent localisation is the head and neck area. Extracranial schwannomas are most often located in the deep soft tissues. Intraosseous tumortypes are rare; the mandible is the most common site. CASE REPORT: We present the case of a 63-year-old woman with a schwannoma which originated from the mandible nerve and describe the therapy of this neoplasm. A rare malignant transformation cannot be excluded. Therefore, the treatment of choice is radical local resection.

[Tooth replacement by BIONIT-implants]. / Zahnersatz durch BIONIT-Implantate.

Aluminium oxide ceramics, apart from Titan, must be regarded at present as the most favourable material for dental implants, due to the fact it has adequate parameters of stability in addition toits inert biocompatibility. It is reported on dental implants of BIONIT capable of being produced in deries for the most various applications, and the results obtained in clinical routine.

[Rapid setting calcium phosphate cement for craniomaxillofacial surgery. 6 years experience]. / Schnell abbindender Kalziumphosphatzement für die kraniomaxillofaziale Chirurgie. Erfahrungen über sechs Jahre.

BACKGROUND: Long-term results using hydroxyapatite cement (Bone Source) for the reconstruction of the facial skeleton and the forehead are reported. MATERIAL AND METHODS: The cement consists of 73% tetracalcium phosphate and 27% dicalcium phosphate. Using 0.25 M phosphoric acid instead of water, the primary setting time can be shortened from 20 to 5 min in an isothermic reaction. Twenty-two patients suffering from consequences of trauma, tumor-like lesions, or neoplasm as well as dysmorphia were treated. RESULTS: Following implantation, the healing process proceeded in most cases without complications. Due to hematoma and seroma as well as infection, two implants were lost. Follow-up examinations could be performed in 19 of the 22 patients on a average 40 months after operation. Most patients had good clinical long-term results. X-ray-analysis showed some discrete resorption of the implants in six patients. The further course must be decided based on clinical relevance. DISCUSSION: The hydroxyapatite cement used in this study evidenced good intraoperative handling, an excellent histologically proved biocompatibility, and good long-term stability in normal body fluid. Up to now we have limited its use to non-load-bearing applications in craniofacial surgery.

[Computer aided, examiner independent screening for inapparent eye misalignment among 590 infants and preschoolers--a pilot study with an orthoptic gold standard]. / Computergestützte, untersucherunabhängige Früherkennung des unauffälligen Schielens bei 590 Klein- und Vorschulkindern--eine orthoptisch kontrollierte Pilotstudie.

BACKGROUND: The purpose of the study was to investigate the computer aided screening method using Purkinje image I and IV reflection patterns for the detection of inapparent eye misalignment and to compare this to an orthoptic examination. MATERIALS AND METHODS: 590 subjects up to 72 months of age with inapparent eye misalignment were recruited from the orthoptic outpatient department and externally. The computer aided screening consisted of taking a series of still video pictures with Purkinje reflection patterns. These were evaluated in an examiner independent way to reach a recommendation whether the child needed an ophthalmological referral or not. As gold standard, an orthoptic examination was performed. For analysis, the data were split by age groups. The orthoptic results were tested for certainty and repeatability. RESULTS: The computer aided examination had the highest sensitivity of 0.82 in the age group up to 2.5 years of age, and a specificity of 0.90. With an estimated prevalence for microtropia of 0.01, the extrapolated positive predictive value was 0.08, and the negative predictive value was 0.998. In the age group up to 2.5 years of age, the percentage of orthoptic examinations without clear result (neither non-referral, nor strabismic) was 22.4%, and 6.1% in the screening examination. Among the cases which were examined repeatedly, some were classified as "strabismic" in the beginning, and as "non-referral" in the end in the orthoptic examinations. CONCLUSIONS: The examiner independent, computer aided screening method is a cost effective option for the screening for inapparent eye misalignment, especially in the age group up to 2.5 years of age. If an orthoptic examination was carried out for screening, one should expect a higher rate of false positives, which entails more costly ophthalmological checks. Future studies should assess the validity of the single ortoptic examination as the gold standard in this age group.