Anaplastology in times of facial transplantation: Still a reasonable treatment option?

Optimum functional and aesthetic facial reconstruction is still a challenge in patients who suffer from inborn or acquired facial deformity. It is known that functional and aesthetic impairment can result in significant psychosocial strain, leading to the social isolation of patients who are affected by major facial deformities. Microvascular techniques and increasing experience in facial transplantation certainly contribute to better restorative outcomes.

Incidence and management of severe odontogenic infections-a retrospective analysis from 2004 to 2011.

The management of odontogenic infections is a typical part of the spectrum of maxillofacial surgery. Normally these infections can be managed in a straight forward way however under certain conditions severe and complicated courses can arise which require interdisciplinary treatment including intensive care. A retrospective analysis of all patients affected by an odontogenic infection that received surgical therapy from 2004 to 2011 under stationary conditions was performed.

Transpalatal distraction--state of the art for the individual management of transverse maxillary deficiency--a review of 50 consecutive cases.

Transpalatal distraction has been established as a technique for surgical assisted rapid palatal/maxillary expansion (SARPE/SARME) in order to correct transverse maxillary deficiency. From 2007 until 2013 bone borne transpalatal distraction devices have been inserted in 50 patients affected by transverse maxillary deficiency and transpalatal distraction has been performed by the same surgical team. Patient records were retrospectively evaluated after ending of the active distraction phase with respect to indication, achieved expansion, additional procedures and side effects.

Significance of distraction osteogenesis of the craniomaxillofacial skeleton - a clinical review after 10 years of experience with the technique.

Distraction osteogenesis (DO) has been applied to the field of craniomaxillofacial surgery for more than two decades. Although relevant factors for successful distraction osteogenesis are well known there are ongoing controversies about indications and limitations of the method and there is still a lack of evidence based data. Since 2003 the principle of gradual lengthening has been applied to patients affected by different types of skeletal craniomaxillofacial deficiency within individualized treatment protocols at the Campus Virchow Klinikum - Charité Universitätsmedizin Berlin - by the same surgical team.

Virtual planning for craniomaxillofacial surgery--7 years of experience.

Contemporary computer-assisted surgery systems more and more allow for virtual simulation of even complex surgical procedures with increasingly realistic predictions. Preoperative workflows are established and different commercially software solutions are available. Potential and feasibility of virtual craniomaxillofacial surgery as an additional planning tool was assessed retrospectively by comparing predictions and surgical results.

Frontofacial advancement by internal distraction devices. A technical modification for the management of craniofacial dysostosis in early childhood.

Normal craniofacial growth is characterized by a different growth pattern of neuro- and viscerocranium. In craniofacial dysostosis (CFD) syndromes there is complex disturbance of this physiological growth pattern. Modern surgical management of CFD is staged with respect to the severity of the deformity, the age and the development of the patient.

The oculo-auriculo-fronto-nasal syndrome (OAFNS) - description of a rare and complex craniofacial deformity and its interdisciplinary management before school age.

Craniofacial clefts are certainly among the most challenging congenital malformations with respect to functional, aesthetic and psychosocial consequences. The aetiology is still under discussion, recent molecular genetic findings suggest defects in the ciliary function of neural crest cells during facial development. The severity of craniofacial clefting is known to be extremely variable.

Asymmetric, disproportionate craniofacial hyperostoses of mosaic pattern in a patient not meeting Proteus syndrome criteria.

A 34-year-old patient with asymmetric hyperostosis of the craniofacial skeleton much more pronounced on the right side is presented. A long-term follow-up of 16 years showed progression of overgrowth even after skeletal maturity and despite repeated surgical corrections focusing on regional reduction of the hyperostoses. Clinical situation during infancy, adolescence, and adulthood is documented.

Dentoalveolar injury related to general anaesthesia: a 14 years review and a statement from the surgical point of view based on a retrospective analysis of the documentation of a university hospital.

Introduction: Damage to dentoalveolar structures related to general anaesthesia is a well-known complication and may represent a relevant morbidity for affected patients. Central documentation of perioperative dentoalveolar injuries was performed since 1990 in the Department of Anaesthesiology and Intensive Care Medicine in cooperation with the Department of Oral and Maxillofacial Surgery at the Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum. Documentation of perioperative dentoalveolar injury consisted of anaesthesia charts, reports of the anaesthesiologists and consultant maxillofacial surgeons.

Necrotizing soft tissue infection of the scalp after fronto-facial advancement by internal distraction in a 7-year old girl with Gorlin-Chaudhry-Moss syndrome--a case report.

In 1960, Gorlin, Chaudhry and Moss described a syndrome consisting of craniofacial dysostosis in association with hypertrichosis, cardiac, genital, dental and ocular anomalies. Diagnosis is based on typical clinical findings and cannot be performed by molecular genetic analysis until now. There is little in the clinical literature concerning this rare craniofacial syndrome.

Antley-Bixler-syndrome--staged management of craniofacial malformations from birth to adolescence--a case report.

In 1975 Antley and Bixler described an unusual syndromal disorder consisting of complex craniosynostosis with midfacial hypoplasia, dysplasia of ears and nose, radiohumeral synostosis, congenital fractures of the femur and upper airway impairment in a newborn. Additional urogenital and cardiac malformations can be associated however diagnosis is based on a characteristic craniofacial deformity in association with humeroradial synostosis. Complex disturbance of craniofacial growth due to premature synostoses of the cranial base and vault results in a characteristic phenotype.

Therapy of percutaneous infection around craniofacial implants.

This study sought to develop treatment strategies for managing percutaneous infection around craniofacial implants. The present general pathogen situation together with a bacterial resistance were determined in 57 infected peri-implant sites. Forty-four implants were randomly assigned for wound cleaning and split into three groups-two with local antibiotics of proven efficacy and one with 3% hydrogen peroxide (H2O2).

[Analysis of quality of life in patients with a facial prosthesis].

Objective: This clinical study examined the quality of life of face-disabled patients who had received a facial prosthesis.

Patients And Methods: The examination of the 58 patients was performed using different questionnaires. For the evaluation of the subjective health-related quality of life an instrument constructed by the WHO was used (WHOQOQL-Bref).

Endovascular management of a mandibular arteriovenous malformation in a patient with severe hemophilia a.

The unusual case of a mandibular arteriovenous malformation in a patient with severe hemophilia A and hepatitis C is reported. Supplementary substitution of various coagulation factors allowed direct puncture and intralesional injection of a liquid adhesive, resulting in complete anatomic and clinical cure without peri- or postoperative bleeding. Replacement therapy providing normal levels of relevant coagulation factors enables endovascular treatment in a safe and effective manner in hemophiliac patients.

Treatment of a cavernous sinus dural arteriovenous fistula by deep orbital puncture of the superior ophthalmic vein.

In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula.

Reconstruction of the contracted ocular socket with free full-thickness mucosa graft.

Patients who have undergone enucleation of the eye can be treated with glass eye prostheses, provided retention is adequate. Inadequate retention due to contraction of the conjunctival mucosa is a common problem which frequently affects the lower fornix first. This can be corrected using a free full-thickness buccal mucosa graft.

Improvement of epidermal adhesion by surface modification of craniofacial abutments.

Craniofacial implants may present peri-implant inflammation because there is no close adhesion of the epithelium to abutments and because of bacteria infiltrating the subcutaneous tissue through the gap. Therefore an attempt was made to improve adhesion of epithelium to abutments. In an in vitro model, adhesion of epithelial cells (HaCat cells) to nonmodified and 3 modified Brånemark System abutment surfaces was quantified.

[Bilateral rehabilitation with an implant-anchored orbital prosthesis].

From the aesthetic point of view, a patient can be completely rehabilitated after the loss of an eye with the insertion of an artificial eye made of glass. If the delicate structures of the eyelids have been severely damaged, however, or if the eye socket does not provide adequate retention for an eye prosthesis, rehabilitation becomes more difficult, and sometimes cannot be achieved with a cosmetically satisfactory result. In such cases, a facial prosthesis offers an alternative solution.

[Postoperative management of bone-anchored facial epitheses].

The long-term and successful treatment of facial defects with bone-anchored prostheses requires daily cleaning of the prosthesis, any retention elements and surrounding skin. This keeps a potential problem zone around the implant healthy and free of inflammation. Suitable concepts for care and cleaning aids are discussed.

Treatment of squamous cell carcinomas of the floor of the mouth and tongue by interstitial high-dose-rate irradiation using iridium-192.

The results are presented of afterloading high-dose-rate-radiation with iridium-192 in 34 patients with squamous cell carcinomas of the floor of the mouth and tongue. Some patients were also treated surgically or given percutaneous radio- or chemotherapy. At the time of diagnosis, 28.

Computed tomographic study of bone availability for facial prosthesis-bearing endosteal implants.

In a computed tomographic study, 56 patients with facial defects were examined to assess the availability of bone for extraoral Brånemark implants (3 or 4 mm long, 3.75 mm diameter) to bear facial prostheses. Bone depths were determined in the auriculotemporal (2-8 mm), infraorbital (0-10 mm), lateroorbital (8-14 mm), supraorbital (1-14 mm) and medioorbital (1-6 mm) areas as well as at the base of the nasal skeleton (1-5 mm).

The infrahyoid flap. A technique for defect closure in the floor of the mouth, the tongue, the buccal mucosa, and the lateral pharyngeal wall.

The surgical technique, indications, and results of the infrahyoid muscle flap are presented. This flap is fed by the superior thyroid vessels and innervated by the ansa cervicalis. The flap is indicated in case of medium-sized defects in the floor of the mouth, the tongue, the buccal mucosa, and the lateral pharyngeal wall.

Venous graft as temporary arteriovenous shunt in free tissue transfer.

A new method of interpositional venous graft in microvascular tissue transfer is described. The interpositional vein is transferred to the vessels of the recipient site primarily, forming an arteriovenous shunt. Later, when the microanastomosis to the flap is created, the shunt is divided into an arterial branch and a venous branch.