Solitary maxillary cysts (author's transl)

Four cases of solitary maxillary cysts are reported, and our current knowledge of these rare lesions reviewed. Their diagnosis should be suspected whenever bone lacunae are detected, that are not the result of dental disorders. Surgical exploration demonstrates the presence of a cavity that is almost always unilocular, and contains blood-stained fluid, or is completely empty in some cases. Curettage may be employed but filling by a bone graft is not necessary. No recurrence occurs, in contrast to those present in the long bones, and bone repair is rapid after curettage. Though of a probable dystrophic nature, their true significance is still unknown.     

Echography of the paranasal sinuses (author's transl)]

Echography, combined with routine X-rays of the paranasal sinuses, has been used in more than 300 patients. The diagnosis was controlled by clinical examination, endoscopy and operation. The combination of the two techniques reduces the diagnostic error in paranasal sinus disease to 5%.     

Treatment of maxillary fractures in children and adolescents (author's transl)

Facial and mandibular fractures in 139 children and adolescents were treated in the maxillofacial surgery department of the University Hospital in Cologne (RFA) between 1st January 1974 and 30th June 1979. A critical analysis of this group of patients demonstrates the manner in which therapeutic directives in the Cologne department are partially modified. Conservative treatment is the rule in children up to 12 years of age. In the older group, aged 13 and 17 years, preference is now given to osteosynthesis by miniaturized screw plates combined with conventional treatment.     

Intraarterial therapy of maxillary adenoid cystic carcinoma using cis-platinum (author's transl)

A woman suffering from extended maxillary adenoid cystic carcinoma of mixed cribriform solid type was treated by selective intraarterial infusion of Cisplatinum using a new intraarterial infusion technique. Within four weeks--the entire dosage of Cisplatinum was 400 mg--the patient came into complete remission, clinically and histologically, suggesting that the adenoid cystic carcinoma may be more susceptible to chemotherapy than thought up to the present day. However, primary chemotherapy should be followed by radiotherapy or surgical treatment.     

Investigations on not cell-bound lipids in the pathologic maxillary sinus (author's transl)

Lipids can be found sporadically in the maxillary sinus especially in connection with chronic sinusitis. Thus, the occurence of cholesterol is known for decades. Nevertheless most of the lipids in the excretions of maxillary sinus are unknown or less investigated still today. It may be that there is a lack of simple analytical methods. The intention of this paper is to demonstrate early results with TLC-separation and determination of lipids in the maxillary sinus excretions during sinusitis. The samples were collected from patients of the HNO-Klinik Würzburg in connection with a therapeutic rinsing of the sinus. The effluent was concentrated and then separated into three fractions by ultracentrifugation: 1. The sediment, consisting of cells and some other undefined organic material. 2. A supernatant clear solution, containing inorganic material, proteins, amino-acids, lipids... 3. Sporadically a very thin layer on the surface of the clear solution. Since fraction 3, which contains lipids too, could not be found each time, our attention was directed on the lipids of the clear solution, where most of these substances are attached to proteins. As well as in the sediment we found in the clear solution cholesterol, free fatty acids, triglycerides and very seldom cholesterol-esters. The concentration of cholesterol is nearly the same as that of free fatty acids. The frequency of occurrence of lipids is considerable which prevents us until now to correlate the lipid-content to some features of diagnosis, prognosis and therapy.     

Functional rehabilitation of irradiated maxillary bones (author's transl)]

The teeth should be conserved before radiotherapy: --in patients with good buccodental hygiene the teeth are conserved and fluoride treatment instituted,--when hygiene is only moderate, the mandibular teeth outside of the treated area are left in place and fluoride treatment is also attempted. The crowns are conserved, and an attempt is even made in some cases to apply them, as for example on the canines.--when hygiene is inexistant, all the teeth are extracted. Following radiotherapy, the authors will restore a prosthesis two months after irradiation in long-standing edentulons patients, and after 6 months for patients who have recently become edentulons. They sometimes recommend conservative treatment and a fixed prosthesis when the social context is favourable.     

Computed tomographic evaluation of multiple mucocoeles of paranasal sinuses

There are some cases in which mucocoeles of the paranasal sinuses are multiple and their structures are complicated. When the mucocoeles are multiple, pre-operative evaluation is especially important for correct surgical management. We describe the usefulness of computed tomography for the evaluation of multiple mucocoeles of the paranasal sinuses.     

Postoperative parenteral nutrition of patients with an extensive carcinoma of the larynx (author's transl)

A comparative clinical evaluation of healing operative wounds and classification of postoperative complications in two analogous groups of patients with an extensive carcinoma of the larynx after radical operations were performed. In group 1 (82 patients) the postoperative nutrition was carried out through the nasoesophageal tube. In group 2 (153 patients) the nutrition was carried out parenterally through a catheter inserted into the subclavian vein with solutions of glucose, fat emulsions, protein hydrolysates, and amino-acidic mixtures. In group 1 healing by the first intention was observed in 51% of patients, healing by the second one in 13%. Stable defects of the pharynx occurred in 26% of patients. Erosive hemorrhage arose in 5%. In group 2 the primary healing was achieved in 77% of patients, the secondary one in 11%. Stable pharyngeal defects appeared in 12% of patients. Erosive hemorrhage occurred only in 1.5% of patients. The duration of stationary treatment of patients by using the parenteral nutrition decreased by 16 days on the average.     

Mycosis of the maxillary sinuses

Fungus infection of the maxillary sinus has been considered a rare disorder; recently, however, such cases have been reported in increasing number. The authors have recently observed five cases of mycosis of the paranasal sinuses. Three of these cases showed the clinical symptoms and signs of swelling and pain in the cheek area and epistaxis and aroused suspicion of maxillary cancer. Of the remaining two cases one was misdiagnosed as maxillary cancer with pulmonary metastasis and radiation therapy without preliminary tissue diagnosis given because of the poor general condition of the patient. On improvement of the patient's condition exploratory maxillotomy and mucosal biopsy revealed mycotic invasion; in the other, chronic bacterial maxillary sinusitis was suspected, but exploratory sin-usostomy showed mycosis. The authors emphasize an apparent increasing frequency of mycosis of the paranasal sinuses and the fact that the symptoms and signs of mycotic invasion may duplicate those of early malignancy of this area.     

Dystrophy and necrosis following radiotherapy for maxillary cancer (author's transl)]

About 10% of patients developed severe sequelae following radiotherapy, which had been associated with surgical treatment, even though they were, or appeared to be cured. Complications affected the skin and soft tissues (causing skin retraction, loss of substance, and sometimes trismus) and bone (necrosis required surgical treatment, and when there was associated cutaneous dystrophy, resulted in exposure of the bone and severe functional and esthetic problems). A critical study of the radiotherapeutic techniques used suggests that the dose given should be reduced, the fields modified, and Cobalt used in preference to electrons in most cases.