An ultrasound device in the diagnosis of acute maxillary sinusitis.

This multicenter study comprised 161 consecutive and unselected patients with suspected acute maxillary sinusitis (AMS). Altogether 322 maxillary sinuses were examined radiologically and by untrasound device (US). Of these, 234 antra were punctured, aspirated and irrigated. The volume of secretion coming out by irrigation was evaluated. The results of US, x-ray and irrigation were compared. For US, the proportion of correct positive results was 82.7% when the secretion volume was heavy, 78.6% when the secretion volume was moderate and 84.3% when the secretion volume was slight. When US finding was compared with the puncture result, the US gave false positive results in 8% of the cases and false negative results in 18.5% of the cases. Out of 187 positive irrigation findings, radiographs revealed fluid retention in 99 cases (score 3-6) (53%). Similarly, 11 radiographs showed fluid retention in 47 cases of negative irrigation findings (23.4%). Statistical calculation shows that both US and radiology were equally reliable in diagnosing fluid retention and sinusitis, when the results are compared with the findings of the sinus puncture. US and radiology gave false positive findings almost equally (p > 0.05). On the other hand, when the volume of secretion was slight (< 1 ml), US gave a fluid echo finding more often than radiology showed fluid retention.

Severe bone resorption and osteoarthrosis after miniplate fixation of high condylar fractures. A clinical and radiologic study of thirteen patients.

Thirteen cases of high condylar fracture treated by open reduction and fixation with miniplates were monitored for an average of 18 months postoperatively. Satisfactory functional results were achieved clinically in all but one patient. Radiologically, however, signs of condylar resorption and osteoarthrosis were diagnosed in all patients. In four patients with associated multiple fractures of the facial bones, rapid complete resorption of the condyle was observed. These changes were markedly more severe than those observed in our previous study, in which osteosynthesis was performed by transosseous wiring and subsequent intermaxillary fixation for 3 to 7 weeks. Indications for rigid and nonrigid fixation in the surgical treatment of condylar fractures are discussed.

Reconstruction of orbital floor with polydioxanone plate.

The use of a polydioxanone (PDS) plate for orbital reconstruction was evaluated in 20 patients with various traumatic defects of the orbital floor. The follow-up time was 9 to 45 months (mean 20.4 months). A CT scan was obtained in 13 patients. Radiographic analysis showed that in 12 of the 13 patients there was new bone in the orbital floor. Clinically, most patients had transitory postoperative diplopia (lasting for a mean of 29 days) because of overcorrection. Only 2 patients, however, suffered from persistent diplopia. In one patient, abducens nerve paresis was the cause. It is concluded that PDS is suitable for orbital floor reconstruction, at least in cases in which defects do not exceed 1-2 cm in diameter. Overcorrection seems necessary. The material is well tolerated, is totally absorbed and appears to be replaced by bone in nearly all cases.

Osteotomy-osteosynthesis in displaced condylar fractures.

Nine male patients were treated for condylar fractures of the mandible by a method involving detachment of the condylar head. Pre-operatively, all patients had severe malocclusion. Radiologically, most condyles were anteromedially displaced. Open reduction was indicated but repositioning of the condyle was impossible without ramus osteotomy followed by temporary condylectomy. On follow-up roughly 32 months after surgery no permanent complications were seen. Joint function was almost completely restored. Radiographic evaluation revealed some shortening and deformation of the condyles which had been operated. Translation and rotation movements were almost normal. The method described appears useful in those rare cases of fractures in which normal repositioning of a dislocated condyle is difficult.

The importance of ophthalmic diseases in the economy and national health care system.

The incidence of eye diseases in Finland and the use of glasses has not been much investigated. During 1979-80 an inquiry was made in which a questionnaire was sent by mail to 12 000 people. 1500 volunteers from Estern, Western and Southern Finland were invited to a clinical eye examination. The incidence of eye diseases was low. A little over 2% of the respondents needed continuous ophthalmic treatment. The mean visual acuity was normal in 80% with glasses. About half of the patients examined wore glasses, slightly more females than males.