Total mandibular replacement in a patient with Hand-Schüller-Christian disease

An unusual case of mandibular agnathia due to Hand-Schüller-Christian disease reconstructed using a combination of a titanium mandibular appliance and autologous corticocancellous bone is reported.     

Management of postoperative hemorrhage following the Le Fort I maxillary osteotomy

The assessment and management of patients with postoperative hemorrhage following Le Fort I osteotomies is discussed. The results of a questionnaire to investigate this complication, as well as the authors' protocol for dealing with this problem, are presented. Three illustrative case histories are also presented.     

Management of bilateral fractures three weeks after mandibular skin graft vestibuloplasty

Management of bilateral fractures of the atrophic mandible is a difficult problem. A recent skin graft vestibuloplasty with lowering of the floor of the mouth compromises the blood supply to the fractured segments and jeopardizes the changes for bony union. The viability of the skin graft and the stability of the vestibular extension are also at risk. The successful management of such a case is presented and discussed.     

Adenocarcinoma metastatic to the temporomandibular joint

There are many causes for painful limitation of the temporomandibular joint. Among the rarer conditions that must be considered is a metastatic tumor. A case is presented in which progressively worsening limitation and increasing pain lead to a biopsy and diagnosis of metastatic adenocarcinoma of the TMJ.     

Microsurgical reconstruction of the infraorbital nerves

The pathogenesis of damage to and the microsurgical anatomy of the infraorbital nerve are reviewed. Indications for surgery and a microsurgical technique for decompression and scar removal or anastomosis of the nerve are presented. Results from seven surgical cases indicate a high degree of successful regeneration, with complete return of sensation occurring in six cases.     

Repair of the adult temporomandibular joint meniscus with an autogenous dermal graft

A surgical procedure for the successful repair of the temporomandibular joint meniscus is described. Twenty-three patients have been treated by this procedure, with both objective and subjective improvement. The procedure is accomplished with minimal technical difficulty and minimal cosmetic defect.     

Microsurgical reconstruction of the lingual nerve

The surgical anatomy and common causes of lingual nerve damage are reviewed. Surgical indications for decompression, neurorrhaphy, and nerve grafting are discussed based on the review of 18 cases.     

Clinical and anatomic observations on the relationship of the lingual nerve to the mandibular third molar region

The position of the lingual nerve in the mandibular third molar region was measured and photographed in 34 cadaver dissections and 256 cases of third molar extraction. In 17.6% of the dissections the lingual nerve was found at the level of the alveolar crest or higher. Horizontally the nerve contacted the lingual plate of the third molar in 62% of the specimens. Of 256 patients, the nerve was visualized above the height of the lingual plate of the lower third molar in 12 (4.6%). These results document the vulner-ability of the lingual nerve as it passes medially to the mandibular third molar.     

Myxoma of the oral soft tissues

Twenty-one cases of myxomas and myxofibromas reported in the literature are reviewed, and a new case is presented. The pathogenesis, clinical picture, differential diagnosis, and histopathology of this rare neoplasm are discussed.