Bone source for repair of craniofacial defects

Eight cases were included in this study, three cases were scheduled for frontal sinus obliteration, one case of cranioplasty for a congenital cranial defect and another four cases for facial augmentation and proper contouring. Frontal sinus obliteration was performed in three cases. Two cases suffered from large frontal sinus mucoceles encroaching on the orbit and perforating the roof of the orbit and the posterior table. The mucoceles were pathologic in nature causing chronic sinus disease. All skin incisions above the implantation sites were healed well without an evidence of excess scar formation or local tissue inflammation. There were no wound infections or hematomas and none of the implants became exposed or extruded. The surface area of the defects ranged from 4 to 15 cm2 with an average defect size of 10.2 cm2. The amount of HAC averaged 9.2 g with a range of 5-15 g. The largest amount of HAC was used to obliterate the frontal sinus. The difference in the amount was attributable to the depth of the osseous defect. There were no metabolic or surgical complications attributable to the use of HAC

Intraarticular meniscus surgery for internal derangement of the TMJ

A study was carried out on 23 patients who had undergone TMJ surgery because of disc displacement. Surgery was not considered until all the nonsurgical modalities were depleted. A review of the different surgical procedures utilized in the management of intrameniscal dysfunction was discussed. Clinical and radiographic assessments of 30 joints were undertaken. The clinical experience with meniscoplasty and meniscorrhaphy proved to be effective sound procedures when surgical treatment was suggested for patients with internal derangement of the TMJ. The role of surgery in TMJ dysfunction was studied. A total of 30 joints in the patients were operated upon, 24 of them were in 18 female patients and six were in five male patients. The most prevalent symptom preoperatively was TMJ pain, which presented 78%, 85% of them had mild TMJ pain and 10% reported moderate pain. The second most common symptom was joint noises, which presented 78%, 65% of them were painful clicks and 13% were non- painful

Surgical management of dislocated subcondylar process fracture

Nine cases were treated for dislocated condylar process fracture. They showed shortening of the ramus and were associated with molar prematurity. Radiographic examination included conventional radiography and coronal and axial CT. Open reduction was carried out and the plate was fixed to the condyle extracorporeally, then reinserted and fixed to the ramus. Follow up was done for 6-9 months. All the results were satisfactory and no aseptic necrosis of the condylar segment was noted. The technique appeared to be useful in cases of dislocated condyle where normal repositioning is not feasible

topography of the mandibular canal

Eighteen dried human adult mandibles were collected and sectioned in an attempt to study the anatomic location of the mandibular canal and its relation to the buccal and lingual cortices. After dividing the mandibles into two halves, they were sectioned vertically at three sites: The first cut extended from the most posterior point at the retromolar triangle to the gonion, the second cut extended from a point just posterior to the third molar to a point perpendicular to the inferior border of the mandible and the third cut extended from the tip of the interseptal bone between the second and third molar to a point perpendicular to the inferior border of the mandible. Various surgical and dental procedures in the lower jaw present the possibility of complications to the mandibular canal and its components. Nerve damage is a frequent surgical complication. It has been reported in conjunction with several surgical procedures. A review of literature showed that nerve damage occurs following 0.6% to 5% of third molar removals 1, 5, 16. Spontaneous recovery has been reported representing 96% in relation to the inferior alveolar nerve due to the nerve, being retained within a bony canal which allows the injured nerve endings to be better approximated, the high frequency of the surgery makes the percentage of complication still unacceptable 3, 10