[Gustatory rhinorrhea after hemiresection of the maxilla]. / Gustatorische Rhinorrhoe nach Halbseitenresektion des Oberkiefers.

A case of gustatory rhinorrhea after maxillary resection is reported about. The symptoms can be explained as defective regeneration of secretory nerves, especially of the nasopalatinal nerve.

Healing of dentate or edentulous mandibular fractures treated with rigid or semirigid plate fixation--an experimental study in dogs.

The right mandibles of 40 dogs were fractured with a bending clamp, at a site being either dentate or edentulous, and treated with compression-plates or miniplates. After 1, 2, 4, 6, 8, 12 and 24 weeks the mandibles were examined by microradiography and histology. Some variation in the healing mode within the groups was observed, interindividual as well as intra-individual in different layers of the same mandible. Generally, healing displayed slightly more time-related progression with compression plates compared with miniplates and similarly in dentate fracture sites when compared with edentulous ones. The so-called indirect healing mode through cartilaginous callus was found to take place in the group with miniplates and edentulous fracture sites, whereas in the three other groups a type of direct bone healing through woven bone in the presence of more or less callus could be observed. The conclusions drawn from these findings are: that compression plates as well as miniplates are suitable for treatment of mandibular fractures in dogs, and the presence of teeth appears to exert a stabilizing effect on the fracture.

Experience with AO reconstruction plates after partial mandibular resection involving its continuity.

A report is presented on experience with the use of 54 plates, without primary bone grafts, after resections for malignant tumours involving the continuity of the mandible, in 52 patients. There were complications in 27 cases: postoperative infection or soft tissue dehiscence occurred 20 times, chronic soft tissue perforation once, screw loosening twice, and plate fracture four times. Adjuvant radiotherapy and/or chemotherapy had no effect on the incidence of the complications. Seventeen of the plates (a good 30%) had to be removed prematurely due to the complications. Major deformity did not always occur if relative stabilization had developed through cicatrix formation. Thirty-seven plates (barely 70%) remained: in 19 cases until the death of the patient, in 3 cases until recurrence, in 12 cases until bone grafting, and in 3 cases they were still in situ up to 65 months. In principle, reconstruction plates have proven themselves. However, application and soft tissue coverage need great care and a great deal of experience.

[Surgical treatment of fronto-maxillary tumors]. / Uber die operative Thearpie fronto-maxillärer Tumoren.

Surgical treatment of fronto-maxillary tumors requires interdisciplinary cooperation of maxillofacial surgeons and neurosurgeons. Depending on the site and extension of the tumor, it may be necessary to resort to generous excision of the frontal, temporal, sphenoid, zygomatic bones, orbita and nasal bone, including their soft-tissue covers; possibly even exenteration of the orbita and excision of dura are required. Closure of open subarachnoid space is mandatory. Dural defects are supplied with periosteum or free fascial grafts. Calvarial defect are usually repaired with large rotation flaps of the scalp. In exceptional cases pedicled flaps from more remote areas or microsurgically vascularized grafts are used. The facial area is supplied either with flaps or split skin grafts, depending on the situation. Open paranasal sinuses must be drained via the nasal sinus. Remaining facial defects are treated prosthetically.

[Epidemiology of Borrelia burgdorferi infection. Relation of the prevalence rate on determination by serologic procedures]. / Zur Epidemiologie der Borrelia burgdorferi-Infektion. Abhängigkeit der Durchseuchungsrate von den serologischen Bestimmungsverfahren.

Investigation of subclinical infections with Borrelia burgdorferi in risk groups in Switzerland, Austria and southern Germany showed an infection rate of 16%-27%. Random samples of patients admitted to the neurological department of a hospital on the outskirts of Hamburg gave the following results: in 100 sera there was in 27% a positive Elisa-test, in 77 sera the IFT-test was positive in 13%, and in 210 sera 6% showed a positive IFT-test after absorption; the IFT- and IFT-Abs. were compared in 15 sera. The investigation confirms that subclinical infection with Borrelia burgdorferi in northern Germany is not uncommon. The fact that increased levels of IgG and IgM antibodies do not necessarily mean the presence of an acute or chronic disease should be remembered in making decisions about treatment.

Lower lip carcinoma. Infiltration of the mandible along the mental nerve.

In general, carcinoma of the lower lip has a good prognosis after radical surgery. In rare cases, however, recurrences may be seen because of spread of the tumour along the mental nerve into the mandible. The earliest symptom of this is pain in the mandible and radiological evidence of widening of the mental foramen. Large resections and reconstructive procedures will be necessary. Three cases are presented.