[The Linz model: separation--divorce--new beginning]. / Das Linzer Modell: Trennung--Scheidung--Neubeginn.

The Linz-Project is a secondary-preventive and therapeutic model for coping with divorce. It contains a children's group (for children with age 8-12) and parallelly a parent group. The authors describe context, theoretical and practical fundamentals, aims, methods, basic structure and process of this specific group model. Their article outlines similarities and differences to other group models for coping with divorce and resumes the experiences with the Linz-Project.

Revascularized jejunal grafts in oral reconstruction.

Since 1983 we have used the vascularized small bowel graft for oral reconstruction after resection of extensive carcinomas at different locations within the oral cavity and oropharynx. Our experience with this technique in 27 cases over a period of six years is discussed with particular reference to the specific problems encountered. The future place of the free jejunum as an ideal tissue in oral reconstructions restoring speech and deglutition will become apparent.

Repair of unilateral and bilateral cleft noses--an experience of 103 cases.

The following is our experience with the correction of 103 uni- and bilateral cleft noses at the Department of Oral and Maxillofacial Surgery at the University of Münster from 1982 to 1989. The typical features of this kind of nose deformity, certain surgical aspects, the aesthetic and functional postoperative results as well as perioperative rhinomanometric findings are reported. To achieve optimal results in these cleft cases, which should be carried out by an experienced maxillofacial surgeon, we recommend: 1. A one-step nose repair, which will be not only aesthetic but also give improved function. 2. Avoiding interference with any primary repair of a cleft palate. 3. Simultaneous secondary cleft lip and palate correction in order to minimize hospital admissions.

[Autologous blood transfusion in elective operations. Procedures with 102 blood retransfusion cases]. / Autologe Hämotransfusion bei Elektivoperationen. Erfahrungen mit 102 Eigenblutspendern.

Since June 1987 a total of 102 patients undergoing elective operations have donated autologous blood for a later possible retransfusion. Although autologous transfusion was time-consuming, nearly all patients accepted this method because they received the safest of all possible transfusions. This way, preoperative psychological anxieties could be reduced and it was made easier for the patients to decide in favor of the operation. Severe somatic pains caused by blood donation were not observed.

Free jejunal transfer in oral reconstruction.

Free jejunal transfers have been used for intra-oral reconstruction after extensive oral carcinoma resection in Münster since 1983. Reconstruction has been carried out for tumours at different locations within the oral cavity and oro-pharynx. The indications are presented for this procedure and a description is given of the surgical technique. The follow-up experience of 27 patients over a period of 6 years is discussed with particular reference to problems encountered.

Intra-oral keratoacanthoma: an eruptive variant and review of the literature.

Intra-oral keratoacanthoma, occurring in the absence of cutaneous lesions, is a rare lesion which may resemble a well-differentiated squamous cell carcinoma both clinically and histologically. A case is reported of two simultaneously occurring keratoacanthomas, of the eruptive variant, on the hard palate of a 25-year-old woman. A review of the English literature, which has identified ten documented cases to date, is presented.

[Failure of dental implants following psychosomatic disturbances in the stomatognathic system--a clinical-catamnestic study]. / Misserfolg zahnärztlicher Implantate bei psychosomatischen Störungen im stomatognathen System--eine klinisch-katamnestische Studie.

Nowadays dental implantations are highly successful if individual indications are taken into consideration. From our experiences with patients from the Research Institute for Psychopathology and Psychosomatics, we would like to point out a contraindication for the treatment of dental implants, which until now has been hardly considered. A special case report shows that psychosomatic problems and pains in the maxillofacial region can be the cause of failure of dental implants.

[A modified Macintosh blade with an angulated tip for difficult intubations]. / Ein modifizierter Macintosh-Spatel mit abwinkelbarer Spitze für schwierige Intubationen.

The depth of the proximal part of a normal Macintosh blade was carved more shallow and the tip of the blade was made adjustable in its angle by means of a joint controlled by a screw-lock fixation via a small wire parallel to the blade. Clinical experience with this modified blade in 33 patients is reported. In 10 of 13 patients with severely reduced mouth opening less than or equal to 25 mm and 19 of 20 patients with a mouth opening greater than 25 mm, visibility during laryngoscopy with the modified blade was improved, compared to the normal Macintosh blade. The carved proximal part of the blade improves its maneuverability in a small mouth avoiding undue pressure on the incisors, the adjustable tip increases the blade's pressure on the base of the tongue lifting the epiglottis.

A transcoronoidal approach of fractures of the condylar neck.

Open reduction of condylar neck fractures is a contentious issue. The majority of these fractures can be treated conservatively. There are, however, specific situations, where open reduction is indicated. In recognition of the high morbidity associated with extra-oral procedures, we advocate an intra-oral transcoronoidal approach to gain direct access to the fracture site.

Surgical management of macrocheilia of the lower lip.

The indications for and the surgical management of macrocheilia of the lower lip are presented. The use of the technique in two cases of differing aetiology and degree of functional and aesthetic deformity is described.

[Autologous blood transfusion in elective mouth, jaw, and facial surgery. Experience with 53 patients]. / Die autologe Bluttransfusion bei elektiven Eingriffen in der Mund-, Kiefer-, Gesichtschirurgie. Erfahrungen mit 53 Patienten.

From June 1987 to July 1989 53 patients with elective operations donated their own blood for a later possible retransfusion. Although autologous transfusion was time-consuming nearly all patients accepted this method because they received the safest of all possible transfusions. So preoperative psychological anxieties could be reduced and the decision for the operation was made easier.

[Interdisciplinary investigations on the criticism of the term 'anesthesia dolorosa']. / Interdisziplinäre Untersuchungen zur Kritik am Begriff der Anaesthesia dolorosa.

3291 patients with facial pain and/or complaints in the orofacial region were examined from 1972-1988 by both the maxillofacial surgeon and the neurologist at the departments of maxillofacial surgery and psychosomatic medicine of the Zentrum für Zahn-, Mund- und Kieferkrankheiten of the University of Münster. Only 27 cases of genuine trigeminal neuralgia could be found in those 17 years. At the same time, however, 31 patients presented with anaesthesia dolorosa after various operations on the fifth cranial nerve. Referring to the criteria set up by Marxkors and Müller-Fahlbusch (1981) these findings were based on psychosomatic diseases. Thus, any indication for an operation on the trigeminal nerve should be very carefully reconsidered.

[Maxillary antrum surgery with or without bone lid formation. Retrospective comparative study]. / Kieferhöhlenoperation mit oder ohne plastischen Zugang? Eine retrospektive Vergleichsstudie.

A long-term study was performed after conservative maxillary antrum surgery with (50) and without (106) bone lid formation including a total of 154 patients. While no differences were found regarding the patients' sensitivity to changes in the weather, neurological disorders, or complaints of pressure sensations, considerably better results were obtained with respect of the time until a stable postoperative condition was achieved, the radiographic and the local findings, after surgery with the use of a bone lid.