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The treatment of malar bone fractures by stable osteosynthesis represents a well established method. The necessity of a second surgery is one of the major disadvantages of using metal implants. Resorbable plates can only be deformed by very difficult methods. We found out that, cause of the anatomical structure of malar bone region, only three types of plates are necessary to treat every kind of malar bone fracture of males and females.

Twenty-two patients with squamous cell carcinoma of the oral cavity were treated intra-arterially with epirubicin and cisplatin. Biopsies were taken before, during, and after treatment and analysed by DNA flow cytometry. Clinical response to therapy was better in the diploid group as well as in previously aneuploid tumors which showed complete disappearance of the abnormal clone in the course of treatment. Poor reduction of tumor volume corresponded with persistence of aneuploid cells.

The cellular DNA content of 90 primary squamous cell carcinomas of the floor of mouth was determined by flow cytometry. Aneuploid cell lines were detected in 86% of the cases. The proportion of diploid carcinomas decreased with size (T1: 63%, T2: 11%, T3: 7%) and histologic grade (G1: 17%, G2: 16%, G3: 9%). Only 15% of the diploid, but 61% of the aneuploid tumors showed evidence of lymph node involvement. A 96% sensitivity of the test and a negative predictive value of 85% emphasize the prognostic importance of DNA ploidy in the primary tumor to evaluate the risk of subclinical dissemination.

A total of 47 primary squamous cell carcinomas of the tongue were analysed by DNA flow cytometry. With respect to their clonal DNA content two distinct tumor groups could be distinguished. In 14 cases the tumors (29.8%) were dipoid, whereas in 33 cases (70.2%) additional cell lines characterized by abnormal DNA content could be detected. A significant increase of aneuploid cases with tumor size as well as with decreasing histological differentiation could be detected. Aneuploid cell lines are lacking in T1 as well as in most G1 carcinomas but predominate in T3 and G3. Furthermore, cervical lymph node involvement was recognized in the majority of aneuploid primary carcinomas (81.8%) but was largely lacking in diploid tumors (21.4%). Hence, the presence of aneuploid cell lines is clearly connected with clinical and histopathological parameters, each of which have turned out to worsen the prognosis in tongue carcinomas.

Compared with a control group, cholesterol and triglyceride values are significantly elevated (chi2 = 14.52 and 21.65) in patients with odontogenous cysts. No statistically significant difference could be established in terms of the enzyme work-up (lipase). No statistically significant differences could be established in fractions of protein metabolism via electrophoresis.

CT is very suitable for showing cervical lymphatic spread in malignant tumors of the head and neck. The regional lymph-node areas of 123 patients with histologically proven malignant tumours of the oral cavity, hypopharynx and larynx were evaluated in a prospective study. Clinical examination, CT-findings and pathological work up of the surgical specimens were comparatively analysed in 53 patients. The proportion of false negative lymph-nodes on palpation was 21%. This error could be reduced by the use of CT to 7.5%.

Forty-six computed tomographic examinations on 39 patients with histologically confirmed malignant oral tumors are reported on. The value of information by CT is compared to clinical staging in 24 operated cases. In determination of the T-category, clinical examination is superior to CT. The local metastases and the outline of the tumor are better diagnosed by CT. Provided that a subtle examination technique is used, CT can be of great help to the surgeon in choosing the adequate therapy in oral malignant tumors.

This review evaluates anatomical, anthropological, and radiographic cephalometric data of the growing nasomaxillary complex, with special regard to their reliability and value for therapy planning. Within the two post-natal years and during puberty parts of the nose grow faster than during other periods of life. After the second decade there is still some growth measurable in some nasal parts up to an advanced age.

Among 441 CT scans of 303 patients with a malignant tumor of the head or neck 138 scans of 83 patients were performed for evaluation of recurrent tumor. In diagnosing nodal recurrence computed tomography (CT) had a sensitivity of 92% (52 out of 56) and a specificity of 96% (55 out of 57). In diagnosing recurrence at the primary site sensitivity of 72% (56 out of 77) and specificity of 60% (30 out of 50) was lower and clearly inferior to physical examination with 92 and 88% respectively. CT was very useful in delineating advanced recurrencies, especially in regions that were not readily accessible by physical examination or were indurated by flat scarring. In addition to the complete staging of nodal involvement this makes CT the radiologic method of choice in follow-up of patients with malignant tumors of the head and neck. A post-therapeutic baseline scan obtained 6-8 weeks after surgery resp. radiotherapy is expected to further improve results, especially in differentiating scar from recurrent tumor.

The lymphatic spread in 123 patients with biopsy-proven malignant head and neck tumors was evaluated by CT in a prospective study. In 53 cases, clinical examination, CT and pathological-histological work-up of the surgical specimens were comparatively analysed. The fraction of false-negative judged lymph nodes by palpation was 21%. This high error in judgement could be diminished to 7.5% by the use of CT. 83% of squamous cell metastases showed a central decrease in density due to necrosis after intravenous infusion of contrast material.

In 11 patients with chronic snoring and 12 subjects with obstructive apnoea syndrome the percentage of snoring duration above a preset sound pressure level during one night's sleep was correlated with the radiocephalometric data. Cephalometric distances PAS, PM-Pg, MP-H and angles SNA and SNB representing measures for posterior airway space, size of soft palate, relative position of hyoid bone and relative position of maxilla and mandibula were evaluated. Each patient showed pathological deviations from normal values in at least one of the cephalometric parameters. A significant correlation between snoring duration and a single cephalometric distance could not be found. However, an index combining pathological deviations from all three cephalometric distances showed a highly significant correlation with snoring duration (p less than 0.01 - Fig. 11), as did deviations from normal values of angle SNB (p less than 0.03 - Fig. 10). Our findings indicate that snoring and obstructive apnoea syndrome are not only caused by neurologic dysregulation, and that in addition specific craniofacial anomalies are prerequisites for the development of the disease. For the first time it is demonstrated that these anomalies exist in chronic snorers as well as in apnoeic patients. Our findings support Lugaresi's hypothesis that heavy snoring and obstructive apnoea syndrome are based on the same defect and differ in severity only.

A skull from the baroque period is presented which attracted our attention because of its round piriform aperture and enlarged nasomaxillary bones. The deformity is very probably due to large nasal polyps. Some medical documents in literature and an oil-painting with the portrait of an old woman with a bloated nose from the 17th century show that this type of nasal disease was well known three hundred years ago.

Shuttle vectors based on Epstein-Barr virus (EBV) replicate autonomously in the nuclei of human cells. These vectors represent reasonable models for chromosomes, have low background mutation frequencies, and have been useful for studying induced mutation in human cells. Two improvements in the EBV vector system are discussed. Attempts are described to increase vector copy number per cell by using a limited period of replication driven by the simian virus 40 (SV40) origin of replication. Isolation of human sequences that can replace the viral origin of replication in providing for autonomous replication of the vectors is also described. These improvements are leading toward shuttle vectors that are more efficient and more closely resemble authentic chromosomes.

Nasal speech, which is in many cases the first and only sign of many different diseases, is frequently misinterpreted by the otolaryngologist who examines the patient first. This is demonstrated by an analysis of 23 patients having a submucous cleft palate. A simple diagnostic procedure is suggested that enables the clinician to distinguish between different forms of nasality, its underlying causes and localisation.