[Neurinoma of the hard palate in an 11-year-old girl. Case report]. / Neurinom des harten Gaumens bei einem elfjährigen Mädchen. Ein Fallbericht.

BACKGROUND: Neurinomas or schwannomas are benign, encapsulated growing tumors of the Schwann cells of the nerve sheets; 25-45% are located in the head and neck region. They are found rarely in the oral cavity. Most of the intraoral schwannomas are located on the tongue. Other less common locations are the buccal mucosa, palate, floor of the mouth, gingiva and lips. The therapy of choice is complete surgical excision. CASE REPORT: An 11-year-old girl presented with a 3-month history of painless swelling of the hard palate. CT scan showed a right palatinal mass of 2 cm, reaching into the right maxillary sinus. After complete surgical excision the histological findings showed a neurinoma (Antoni type A). During a 2-year follow-up, there were no signs of recurrence. Because of the benign tumor type we considered the young patient to be healed.

[Ampicillin and sulbactam concentrations in the irradiated mandible after oral squamous cell cancer]. / Untersuchungen zum Ampicillin/Sulbactam-Spiegel im bestrahlten Unterkieferknochen bei Patienten mit oralen Plattenepithelkarzinomen.

INTRODUCTION: Radiation therapy of the oral and maxillo-facial region increases the risk of an infected osteoradionecrosis (IORN) which is a severe complication. Therefore, perioperative antibiotics for the prophylaxis of ORN is a standard in clinical oncology. The combination therapy of ampicillin and sulbactam (Unacid) promises a good therapeutic and prophylactic outcome. PATIENTS: We compared the concentration of Unacid in bone and blood specimens of 22 irradiated patients. All patients were irradiated with 39.6 Gy prior to surgery. The specimens were obtained during the operation 3 weeks after the end of the radiation therapy. RESULTS: The concentration of ampicillin/sulbactam in the blood was 124.9/64.5 microg/ml. The bone specimens showed a concentration of ampicillin/sulbactam of 5.54/1.21 microg/g. The concentration of the antibiotic in the bone was three to four times lower than in non-irradiated patients. Nevertheless, this concentration exceeds the minimum inhibitory concentration for bacteria in the oral cavity such as streptcoccae (MHK90<0.25 microg/ml) or staphylococcae (MHK90=0.12-2.0 microg/ml). CONCLUSIONS: The results of this study suggest, that Unacid is an effective antibiotic in the prophylaxis of ORN in irradiated patients with head and neck tumors.

[Cortical thickness of the mandible with special reference to miniplate osteosynthesis. Morphometric analysis of autopsy material]. / Kortikalisdicke am Unterkiefer unter besonderer Berücksichtigung der Miniplattenosteosynthese. Morphometrische Analyse an Sektionsmaterial.

Thirty-two human mandibles were marked with three typical fracture lines: a low condylar fracture, a fracture of the mandibular angle, and one through the mental foramen on each side. The mandibles were sectioned at the fixation sites of the miniplate screws. The thickness of the cortical layer was measured with a scaled magnifying glass at the points of anthropological interest and at the marked screw holes. The inferior cortical layer turned out to be thickest in the anterior area. In contrast, it was very thin at the mandibular angle, which might explain the higher complication rate in treating fractures in this region. The thickness of the lingual cortex increased up to the symphysis, whereas the buccal cortical layer showed a decline in size from the mandibular angle up to the chin. The cortical bone at the alveolar ridge was porous. The cortical supply for miniplate osteosynthesis at the condylus ranged from 1.1 mm up to 1.74 mm, which seems to be limited, but due to the small diameter of the condylus most common screws obtain additional anchorage in the inner cortex. The thickness of the cortical layer at the mandibular angle increased from 1.47 mm at the ramus up to 1.97 mm at the beginning of the corpus, reaching 2.14-2.38 mm for the lower plate at the mental foramen. The results for the upper plate were slightly lower.