Evolution of design considerations in complex craniofacial reconstruction using patient-specific implants.

Previously published evidence has established major clinical benefits from using computer-aided design, computer-aided manufacturing, and additive manufacturing to produce patient-specific devices. These include cutting guides, drilling guides, positioning guides, and implants. However, custom devices produced using these methods are still not in routine use, particularly by the UK National Health Service.

Postoperative radiographs after open reduction and internal fixation of mandibular fractures: clinical need or unnecessary radiation?

Postoperative radiographs are conventionally taken after open reduction and internal fixation (ORIF) of mandibular fractures, but routine radiographic exposure in patients who have no clinical signs may not be justified. To find out whether radiographs influence immediate postoperative management, and whether they can be used to predict long-term complications, we retrospectively reviewed the radiographs and case notes of 92 patients who had ORIF of isolated mandibular fractures between June 2010 and June 2012. We evaluated them for the adequacy of reduction and fixation using locally agreed criteria, and correlated them with immediate and long-term outcomes as recorded in the case notes.

Le Fort I advancement osteotomies of 1 cm or more. How safe or stable?

We studied the results and stability of Le Fort I maxillary osteotomies with advancement of at least 1cm. We analysed prospective data from 32 consecutive patients who were operated on by a single surgeon between 1985 and 2007, and who had mean advancement of the maxilla of 14 mm (range 10-22 mm). Mean relapse for all cases antero-posteriorly was 1mm, 10% (range 0-4mm).

Metastatic cutaneous head and neck renal cell carcinoma with no known primary: case report.

Renal cell carcinoma represents 2-3% of all adult malignancies, and metastasis to the head and neck is a presenting complaint in 8% of these patients. Cutaneous facial renal cell carcinoma with no known primary renal tumour is unusual. We report a case of renal cell carcinoma of the nose with no known primary.