Mund-, Kiefer- und Gesichtschirurgie : MKG
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Mund Kiefer Gesichtschir · Dec 2007
Case Reports[Severe upper airway obstruction due to retropharyngeal haematoma formation following cervical trauma].
Mechanical airway obstruction secondary to retropharyngeal bleeding is rare. In most cases such a complication is described after head and neck trauma. Complicating factors include anticoagulant therapy, tumour, aneurysm, infection or major cervical spine injury. ⋯ Treatment depends upon size of the haematoma as well as the clinical course of the patient. Smaller haematomas may be observed. Lager haematomas and those that fail to reabsorb should undergo drainage.
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Obstructive sleep apnea (OSA) is a common disorder in adults, however it also occurs in neonates with severe mandibular hypoplasia. The clinical significance of OSA results from hypoxemia and sleep fragmentation due to a collapse of the upper airway. Recently OSA has received much attention due to its potentially serious consequences on cardiac function. Besides daytime sleepiness and fatigue life expectancy is significantly shortened by a higher risk for apoplectic insults and heart failures. This paper reviews common surgical procedures with an emphasis on jaw advancement procedures. ⋯ Standard treatment of OSA is the CPAP-therapy. In some patients, however, CPAP-therapy cannot be applied, fails or is not well accepted. A great variety of surgical procedures for the treatment of OSA have been described. Bimaxillary advancement in adults and osteodistraction in neonates are safe and successful surgical techniques for an immediate improvement in OSA. Osteodistraction treatment can help to avoid tracheotomy in neonates.
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Mund Kiefer Gesichtschir · Jan 2006
Comparative Study[Preoperative radiochemotherapy of advanced resectable cancer of the oral cavity with cisplatin vs paclitaxel/carboplatin. Analysis of two multimodality treatment concepts].
The purpose of simultaneous chemoradiotherapy is to increase local tumor control and to decrease the incidence of distant metastases. Platinum-based chemotherapy regimens are widely accepted as standard treatment in advanced head and neck cancer. Due to their remarkable activity as well as radiosensitizing effects, taxanes play in increasing role in multimodality treatment concepts of solid tumors. ⋯ Based on a retrospective analysis of two different concepts of preoperative chemoradiation and supported by recent data from the literature it is justified to conclude that taxane-based combination regimens are more effective compared to cisplatin-based regimens.
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Mund Kiefer Gesichtschir · Sep 2005
[Simultaneous noninvasive monitoring for radial forearm and fibula flaps using laser Doppler flowmetry and tissue spectrophotometry].
In the literature currently available monitoring devices are usually divided into two major groups: those for monitoring perfusion and those for measuring tissue oxygenation. The O(2)C (oxygen to see) system combines these two ways of monitoring free flap viability. The aim of this prospective study was to determine the necessity of flap revision and when unnecessary revision can be avoided. Another point of interest was the question of whether critical values for the successful course of free flaps could be defined and in addition whether such values would differ for different flap types. ⋯ O(2)C combines laser Doppler flowmetry and tissue spectrophotometry and for the first time allows simultaneous measurement of the microcirculatory parameters including blood flow, flow velocity, hemoglobin concentration, and hemoglobin oxygenation. We found this new noninvasive technique to be a reliable and accurate method for evaluating flap viability and improving the success rate in free flap transfer.
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Mund Kiefer Gesichtschir · Jul 2005
Case Reports[Critical odontogenic infection involving the mediastinum. Case report].
Occasionally, trivial odontogenic infections may develop into complex diseases. This may even result in an unrestrained phlegmonous spread causing life-threatening complications. These problems have decreased since the introduction of antibiotics and also due to improved oral hygiene and improved diagnostic measures resulting in optimized medical treatment. However, life-threatening forms are still seen, in particular if infections spread along the cervical fascial sheaths down towards to the mediastinum. Over the past decade the number of critical infections has increased in other medical specialties. This is usually explained by the development of multiresistant pathogens in the context of nosocomial infections. ⋯ The prognosis of patients with mediastinitis crucially depends on (a) early diagnosis including computed tomography of the neck and thorax, (b) early radical surgical intervention, and (c) optimized pathogen-oriented antibiotic treatment.