Congenital prearticular temporo-mandibular ankylosis in two siblings.

A report of congenital ankylosis of the temporo-mandibular joint has only very rarely been published. The existence of this entity has been met with great scepticism and therefore believed to be due to perinatal trauma and subsequent development of the ankylosis. However, publications are now available of observations at birth after an uneventful pregnancy and spontaneous delivery. Our cases are the first publication of congenital TMJ ankylosis in two siblings, although there are hints in the histories in two other papers that a sibling may have suffered from the same condition. We discuss the hypothesis that the potential to ankylose in the temporomandibular area is a congenital disorder as in our cases, and that even later in life trauma or infection are only supervening initiating factors.

[Intubation with the new ultra thin flexible fiberoptic scope in small children with congenital ankylosis of the temporomandibular joints]. / Intubation mit der neuen ultradünnen flexiblen Fiberoptik bei Kleinkindern mit kongenitaler Ankylose der Kiefergelenke.

Management of anaesthesia and intubation using a flexible endoscope of the ultra-thin generation (external diameter on the distal end 2.7 mm) of brother and sister with congenital ankylosis of the temporomandibular joint is described. Sedation was provided with ketamine while maintaining spontaneous breathing. Alternative methods to overcome difficult intubation in infants and small children with consideration of their specific anatomical conditions are discussed. Insertion of a fiberoptic endoscope through the endotracheal tube in the age group reported here was not possible hitherto. The new ultra-thin generation of flexible fiberscopes now makes it possible to perform direct fiberoptic intubation of infants and small children.

[Care of skull injuries in childhood]. / Die Versorgung des Schädeltraumas im Kindesalter.

Fractures and injuries of the face and jaws in children differ from those in adults with regard to common occurrence and seriousness of injury. Injuries occur predominantly at school or during sports, whereas car accidents are not significant. 7% of our children had fractures of the middle face , compared with a much higher incidence in adults. In such cases, it is always necessary to look for a fracture of the skull base. For the transport of the seriously injured child, respiration and circulation must be safeguarded . Intubation and treatment of haemorrhage must, in the case of serious injury, be placed first. It is only then that transport to a specialised clinic can be carried out. Special features of diagnosis and therapy in children are indicated.

[Experts' experiences in lesions of the lingual nerve connected with dental-surgical interventions]. / Gutachterliche Erfahrungen bei Verletzungen des Nervus lingualis in Verbindung mit zahnärztlich-chirurgischen Eingriffen.

On rare occasions, the lingual nerve may be damaged during operative removal of a third molar. Anesthesia and paresthesia of this nerve have been observed following conduction anesthesia in the mandibular foramen. In terms of the damage to the lingual nerve associated with conduction anesthesia in the mandibular foramen, no technique is absolutely reliable. The patient with a manifest iatrogenic deficit in one branch of the trigeminus should be referred to a hospital for oral surgery which is experienced with microsurgical techniques and which is in a position to cooperate closely with a neurologist.

Diagnostic and therapeutic problems of myxomas (myxofibromas) of the jaws.

During the period from 1969 to 1977 11 cases of myxoma or myxofibroma in the jaw region have been treated at the Maxillofacial Surgery Clinic of the University of Mainz. Various kinds of diagnostic problems are discussed. We observed, inter alia, rapid tumour growth and a imitative dynamics in the radiographs, giving rise to a suspicion of malignancy in some cases. The locally infiltrative type of growth of myxomas must be taken into account during therapy, since insufficiently radical management is liable to be followed by a recurrence.