[Perspectives of maxillary surgery in Switzerland]. / Perspektiven der Kieferchirurgie in der Schweiz.

In Switzerland maxillofacial surgery is qualified as a special surgical discipline according to the regulations of the Foederatio Medicorum Helveticorum. The Swiss Association of Maxillofacial Surgeons has acquired the membership of the Union of Swiss Surgical Specialties. Even before this step maxillofacial divisions were built up in several surgical centers. The urgent need for a special surgery in the field of the viscerocranium has shown up in traumatology, orthopedics and tumor surgery. This experience leads to concrete perspectives which lead to a controlled postgraduate training and intensification of the cooperation with adjacent surgical specialties and with dental medicine.

[TNM classification of malignant tumors: the new 1987 edition]. / TNM-Klassifikation maligner Tumoren: Neue Auflage 1987.

A new edition of the TNM classification of malignant tumours will be published in spring 1987 by UICC. This 4th edition is an internationally uniform and updated classification of tumours by their anatomical extent and is indispensable for treatment planning and evaluation of treatment results in cancer patients.

Lipomatosis of the neck (Madelung's neck).

Benign symmetrical lipomatosis of the neck is a rare disease that has to be differentiated from goiter, sialadenitis, obesity or a lymphatic tumor. Most patients are severe alcoholics, but they may have other endocrine disorders, such as diabetes mellitus, hyperuricemia, or hyperlipidemia. Aside from the cosmetic disfigurement and consequent psychological stress, respiratory distress may be the indication for surgical treatment. Excision of the lipomatosis requires technical skill because the extensive and sometimes infiltrative growth makes dissection of muscle and nerves difficult. The computer tomogram provides good information on the extent of the disease. Three of our 5 patients died 2 1/2 to 6 years after the first operation because of their primary disease.

[Extraoral care of mandibular angle fractures]. / Die Extraorale Versorgung der Kieferwinkelfrakturen.

The article reports on the complications occurring with all 144 fractures of the mandibular angle surgically treated during 1970 to 1982. The various systems of osteosynthesis are considered and discussed. Case reports are used to illustrate and complement the explantations.

[Functionally stable fixation in severe midface fractures using an external cranial fixator]. / Die funktionsstabile Fixation schwerer Mittelgesichtsfrakturen mit dem Craniofixateur externe.

With the external Cranial-fixator we can achieve a stable fixation of the severe maxillofacial injuries. In a period of 10 years (1973-1982) 61 patients were treated with a external cranial fixation, which is tolerated very well by the patients. The intermaxillary fixation is not necessary, the application is easy, the morbidity rate is low and the results are good (table 3 und 4).

[Treatment results of cheekbone fractures. Follow-up studies of 300 cases]. / Behandlungsergebnisse bei Jochbeinfrakturen. Nachuntersuchungsstudie an 300 Fällen.

Zygomatic bone fractures should be reset as early and as accurately as possible. Osteosynthesis by wiring is usually sufficient if interfragmentary fixation becomes necessary. Any further primary decompression measure at the nerve should be omitted. This will help to avoid severe late sequels at the infraorbital nerve (1.3%). Late resetting as well as late measures to effect decompression are definitely known to have a poor prognosis (300 cases followed up).

[A mechanical carrier for the functional load of the mandible (author's transl)]. / Support mécanique permettant la charge fonctionnelle du maxillaire inférieur.

An apparatus is described in which mandibles can be suspended according to natural conditions. The masticator muscles can be simulated so that static equilibrium is ensured between these muscles, the two joints, and a resting point corresponding to the site of the incisors. As far as this is possible direction and force of the simulated muscles are respected. The total force at site of the incisors is about 24 kg. Holes were perforated at chosen sites in the compact bone. The deformation of these holes produced by tension or compression in the compact bone was measured by a capacitive transducer. In the 8 mandibles measured, tension characterized the pars alveolaris, compression the inferior edge of the corpus mandibulae. The highest values (tensions) were observed at the angular mandibulae (superior edge) and the lowest at the inferior edge of the protuberantia mentalis. Three mandibles were fractured and reconstructed with osteo-synthesis-plates. The load of 24 kg were applied at a rate of 1 to 2 per sec for approx. 15 min. The dislocation of the bony fragments produced by these loads oscillated between 19 and 47 micrometer. Repeated application of the load never produced a systematic increase of the displacement. The sites of measurement did not always show the displacement that might have been expected.

[Fractures of the jugal bone -- signs, therapy and late sequelae (A study on 141 cases treated on the basis of a uniform concept) (author's transl)]. / Jochbeinfrakturen -- Symptomatik, Therapie und Spätfolgen. (Eine Studie über 141 nach einheitlicher Konzeption behandelter Fälle).

The article discusses the signs and treatment of fractures of the jugal bone. Basing on 141 patients treated in our clinic, a detailed analysis is given of the problems connected with post-traumatic sinusitis maxillaris, as well as the neurological late sequelae of the n. infraorbitalis. Accurate repositioning and fixation of the fragments are essential; the authors give preference to wire suture. No routine revision of the maxillary sinus and decompression of the nerve are necessary.