Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
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J Craniomaxillofac Surg · Apr 2012
Multicenter StudyCustom made bioceramic implants in complex and large cranial reconstruction: a two-year follow-up.
Large cranial defects still represent a challenge in neurosurgery. Currently different biomaterials are available for cranial reconstruction including titanium, acrylic mesh and different types of calcium phosphate-based bone grafts. The goal of surgery is a perfect fit of the implant without infection and absorption, and a good aesthetic result. This paper describes a surgical method for cranioplasty, using a customised porous hydroxyapatite (HA) prosthesis. ⋯ Cranioplasty performed with a customised porous-HA prosthesis gave a positive outcome, showing it to be an appropriate technique for use in large and complex cranial reconstruction.
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J Craniomaxillofac Surg · Apr 2012
Comparative StudyPremature craniosynostosis--the role of skull base surgery in its correction. A surgical and radiological experience of 172 operated infants/children.
Most craniofacial abnormalities are non-syndromic craniosynostoses due to premature fusion of one or more craniofacial sutures. Functional impairment is caused either by a pathological growth pattern or increased intracranial pressure. The indications for surgery are to increase intracranial volume and to correct aesthetics. ⋯ Cephalometric parameters represent an excellent method to compare the postoperative outcome. Standard skull base procedures need to be adapted carefully to the individual form of craniosynostosis to avoid an unfavourable result. Single Photon Emissin Computed Tomography (SPECT) studies give evidence that correction of single cranial suture synostosis allows for normalization of cerebral blood flow and should be performed within first 6-8 months of life.
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J Craniomaxillofac Surg · Feb 2012
Clinical TrialTreatment of trigeminal neuralgia with bupivacaine HCL using a temporary epidural catheter and pain pump: preliminary study.
Trigeminal neuralgia (TN) is a rare form of neuropathic facial pain characterised by severe paroxysmal pain in the face. The treatment for trigeminal neuropathic pain disorder continues to be a major therapeutic challenge, as relief provided by medical therapy generally decreases over time. When medical therapy fails either due to poor or diminishing responses to drugs or to unacceptable side effects, peripheral intervention or surgical management of TN should be considered. ⋯ Continuous administration of 60 mL of 0.5% bupivacaine HCl at 1 mL h(-1) with a pain pump and epidural catheter can be used as a transition treatment for patients with side effects from high-dose antiepileptic drugs and for patients awaiting neurosurgery or individuals who refuse cranial surgery. It should not be considered as an alternative treatment of neurosurgical approaches, such as MVD, which has a definite long-lasting results.
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J Craniomaxillofac Surg · Jan 2012
Case ReportsGiant trigeminal schwannoma with parapharyngeal extension: report of a case.
The authors present their experience in the treatment of a giant trigeminal schwannoma with wide extension in the parapharyngeal space using a combination of the orbito-zygomatic and the transcervical-transmandibular approaches. The clinical and radiological findings, advantages of surgical approach and clinical outcome will be discussed.
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J Craniomaxillofac Surg · Jan 2012
The role of elective supraomohyoidal neck dissection in the treatment of early, node-negative oral squamous cell carcinoma (OSCC): a retrospective analysis of 122 cases.
The adequate treatment of the neck in early, clinically node-negative oral squamous cell carcinoma (OSCC) remains controversial. To assess whether elective supraomohyoid neck dissection is reasonable and efficient in early, locally circumscribed OSCC, the outcomes of treatment of 122 patients with an OSCC of clinical UICC stage I or II were retrospectively analysed in this study. ⋯ Subsequent multivariate survival analysis found that the presence of occult metastases was an independent predictor of reduced disease-free survival after 5 years (82.2% vs. 62.5%, p=0.004, and 61.9% vs. 17.8%, p<0.001, respectively). Elective supraomohyoid neck dissection detects occult metastases in early, node-negative OSCC, and patients with early OSCC exhibiting occult metastases should be considered as high risk patients, warranting additional therapeutic regimes.