Endoscopically assisted treatment of condylar fractures--experiences following an educational course.

The main methods of managing condylar fractures are non-operative; closed reduction and maxillomandibular fixation; and open reduction and internal fixation. Endoscopically assisted reduction and fixation, although a recognised method, is not commonly used. As with all new techniques, training must be available to enable surgeons to gain experience and achieve competence. We surveyed consultant maxillofacial surgeons who attended a structured educational course with practical experience in the techniques of endoscopically assisted reduction and fixation of condylar fractures, with the aim of establishing the value of such a course, and the subsequent clinical experience of those surgeons with this new technique. The results indicated that over a quarter of all surgeons had already used this method of repair after attending the course.

Ganglioneuroma of the mandible resulting from metastasis of neuroblastoma.

Neuroblastoma, ganglioneuroblastoma and ganglioneuroma are neuroblastic tumours derived from primordial neural crest tissue. The authors report a rare presentation of a ganglioneuroma of the mandible arising from a metastasis of an adrenal neuroblastoma. The pathogenesis and behaviour of ganglioneuromas is discussed, together with recommendations for their management.

Fixation of dicapitular fractures of the mandibular condyle with a headless bone screw.

The fixation of diacapitular fractures of the mandibular condyle utilising a headless cannulated bone screw (Martin HBS((R))) is described. An open approach was used with primary fixation of the fracture with a K-wire, over which the cannulated screw was inserted. The method and results are described.

Vascularisation of Norian CRS bone cement and its replacement by autologous bone when used for orbital reconstruction.

Various bone cements based on calcium phosphate have been used as adjuncts for repairing both the craniofacial and axial skeleton. Ideally these materials should provide initial strength and contour for the reconstruction, and be replaced over time by physiological absorption and bony deposition. Although there is evidence from animal models to support this, opportunities for human studies are rare. Here we offer clinical and histological evidence of this process.

Endoscopically assisted reduction and fixation of condylar neck/base fractures--The learning curve.

Following the introduction of a new technique for fixation of fractures of the condylar neck and base in our department, the operative times were compared with those for the traditional and frequently used method of open reduction and internal fixation. A distinct learning curve was seen.

Buccal mucosal grafts for urethroplasty: surgical technique and morbidity.

We present an outline of the surgical technique for harvesting free buccal mucosal grafts for urethroplasty in 23 patients and an assessment of morbidity at the donor site. Any problems were recorded, particularly injury to the lingual and mental nerves, symptoms of obstruction of the parotid duct, and trismus. There were four early (less than 6 weeks) complaints of mild trismus and one late complaint. All the grafts were successful.

Subclassification of fractures of the condylar process of the mandible.

We present the definitions of various types of fracture of the condylar process, which have been adopted for the Strasbourg Osteosynthesis Research Group (SORG), in their Pan-European prospective randomised controlled trial into the management of such fractures. We think that this will assist people in their description of the various types of fracture of the condylar process.

Protection of the lip from the activator arm of maxillary distractors.

The long spring-loaded distractor arms of maxillary distraction devices can cause pain and ulceration of the upper lip. We describe a simple method to relieve the tension and discomfort on the soft tissues using Silastic tubing.

Orthodontic and orthognathic management of a patient with osteogenesis imperfecta and dentinogenesis imperfecta: a case report.

This case report describes a patient's severe Class III malocclusion, managed with a combination of orthodontic and orthognathic treatment. The medical history was complicated by osteogenesis imperfecta and dentinogenesis imperfecta. In addition the patient was a Jehovah's Witness. Patients with osteogenesis imperfecta carry an increased risk of perioperative haemorrhage, and this led to bimaxillary surgery being carried out as two discrete surgical episodes for the patient described. In addition, the risk of enamel fracture led to orthodontic bands being cemented on all teeth. In spite of the increased risks a successful outcome was achieved.

Lack of tooth eruption following maxillary fracture: case report.

Aberrant tooth development following facial fractures is unusual. It is commonly reported that tooth buds involved in the line of a mandibular fracture will continue to develop normally and erupt sequentially. Few cases have been cited regarding developing teeth in the line of maxillary fractures. In the case reported, the normal growth and position of a maxillary third molar can be seen to be retarded at the position of a maxillary fracture, sustained by a child in the mixed dentition phase of dental development.