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PURPOSE: One of the goals of mandible resection and reconstruction is achieving optimal occlusion. Therefore, the aim of the present study was to evaluate the pre- and post-operative condyle distances. PATIENTS AND METHODS: All computed tomography (CT) scans of 32 patients with a partial mandible resection who were treated between 2006 and 2011 were evaluated retrospectively. The distances between the condyle centres were measured before and after mandible resection. RESULTS: The preoperative intercondylar distance of the 32 patients was between 85.8 and 109.5 mm (median = 100.5 mm), and the post-operative distance was between 87.0 and 110.5 mm (median = 100.6 mm). There was no significant difference between pre- and post-operative distances. CONCLUSION: Reconstruction plates and bony reconstructions do not significantly change the intercondylar distance.

Growing skull fractures (GSFs) are rare complications after severe head injuries in the early childhood and rarely occur after craniosynostosis repair. The aim of this study was to define an algorithm for sufficient treatment for GSF after craniofacial procedures. Literature research was performed to clarify risk factors for GSFs after cranial vault reshaping. Conclusions of the literature and experiences of the authors based on a case of GSF after craniofacial surgery were matched to establish guidelines for successful therapy.

OBJECTIVES: Oral and oropharyngeal squamous cell carcinoma puts the patient at risk for bilateral neck lymph node metastasis. For this reason, routine bilateral neck dissection is preferred by some surgeons as the treatment of choice, even in N0-necks, despite the morbidity of this procedure. METHODS: Utilising data of 496 patients with squamous cell carcinoma of the head and neck region treated at the Department of Otorhinolaryngology and Head and Neck at the Medical University Hospital, Graz from 1999 to 2009, we retrospectively evaluated the effect of bilateral neck dissection on recurrence-free and overall survival rates in patients with oral and oropharyngeal cancer. RESULTS: Long-term survival of 152 patients with oral and oropharyngeal cancer did not show a statistical benefit of elective contralateral neck dissection in patients with contralateral clinically negative neck. Neither locoregional recurrence-free survival nor overall survival rates differed. CONCLUSION: We could not find a statistical benefit for operating on patients with oral and oropharyngeal squamous cell carcinoma with an elective neck dissection in contralateral clinically negative neck.

INTRODUCTION: Knowledge of independent prognostic factors in patients with head and neck squamous cell carcinoma is important for appropriate treatment decisions. Given the availability of aggressive therapeutic options with known side effects and burdens for the patient, choosing the correct treatment option is vital. MATERIALS AND METHODS: Using a retrospective database of patients treated over a 10-year period, independent prognostic factors for disease-free survival and overall survival were assessed. Univariate analysis was used to identify significant variables, and multivariate Cox regression analysis was used to determine independent prognostic factors. RESULTS: Between 1 January 1999 and 31 December 2009, 291 patients with head and neck squamous cell carcinomas were analysed to identify prognostic factors for disease-free survival and overall survival. Although univariate analysis identified several significant factors, multivariate Cox regression analysis showed that capsule penetration and lymph node ratio were the only significant factors for disease-free survival and overall survival. CONCLUSION: Lymph node ratio is an independent predictor of survival and should be examined in every patient undergoing neck dissection. Capsule penetration of lymph nodes was another independent prognostic factor. In cases of capsule penetration or inappropriate lymph node ratio, adjuvant therapies are necessary.

Dentale Herde sind potentielle Infektionsquellen und müssen - neben ihrer lokalen Bedeutung - oftmals auch aus allgemeinmedizinischen Gründen gesucht und saniert werden. Nach Anamnese und klinischer Untersuchung sind Röntgenstrahlen seit ihrer nobelpreisgewürdigten Entdeckung durch Wilhelm Conrad Röntgen am 8. November 1895 [1, 2] die dritte diagnostische Säule in der Medizin und Zahnmedizin. Der vorliegende Artikel soll die Möglichkeiten und Grenzen der verschiedenen radiologischen Untersuchungsmodalitäten aufzeigen und dem Behandlungsteam eine Orientierungshilfe zur Auswahl der jeweils optimalen radiologischen Technik geben.

BACKGROUND: Buried intraoral devices for distraction osteogenesis in mandibular deformities have numerous advantages, but success depends on the precise positioning of these devices. Although most centers nowadays use template-guided techniques for precise positioning, computer navigation has been described as a promising technique. Surgical navigation during device placement could become a viable method because it affords certainty in defining a device position. METHODS: A clinical situation was simulated by means of mounting a mandible model inside a phantom head. Screws were positioned according to a preoperative plan through transoral and transbuccal approaches, with both template-coded and freehand computer navigation. RESULTS: With template-coded navigation, the medium deviation from the planned position was 0.63 mm (range, 0.00-1.24 mm). With commercial freehand surgical computer navigation, the medium deviation was significantly higher at 0.98 mm (range, 0.00-3.13 mm). CONCLUSIONS: Computer-assisted surgery can provide a high level of accuracy in the region of the mandibular angle where precision is crucial for buried intraoral distraction devices. However, template-coded guidance does provide a significantly higher level of accuracy and therefore represents the gold standard.

Exact positioning of the transbuccal set can be tricky, especially under aggravating circumstances as present scarring or high body mass index. It may result in multiple skin incisions. This article presents a simple and fast guidance technique that can help in the exact positioning of skin incision and transbuccal set.

Computer navigation is a common tool in the daily routine of craniomaxillofacial surgery, particularly for the mid-face region, but experience in mandible application is still limited. Materials and methods Three cases are presented with navigation of the mandible: two cases of removal of a wisdom tooth fragment and one case of resection of an ameloblastoma. Results The described method is simple and time-saving. In all three patients the surgical technique was easy to perform. No typical complications followed, like damage of the lingual nerve or a hematoma of the mouth floor, which can appear when the surgeon intensely looks for a tooth fragment. Conclusions Computer navigation of the mandible is a promising tool, in particular for removal of foreign bodies, tooth fragments, and cystic or tumor lesion with clear margins. Advantages are 3D presentation of the lesion, evaluation of nerve location, and possible preoperative evaluation of graft size. Further applications could be orthognathic surgery, including distraction planning, bony tumor surgery, cyst removal, and planning for bony reconstructions.