Lippen-Kiefer-Gaumenspalten (LKGS) und isolierte Gau-menspalten (GS) sind in Europa auch weiterhin die zweithäufigste angeborene Fehlbildung. Die gute ästhe-tische und funktionelle Rehabilitation eines Spaltpatien-ten bedarf einer engen interdisziplinären Zusammen-arbeit von Hals-Nasen-Ohrenheilkunde, Kieferortho-pädie, Kinderzahnheilkunde, Genetik und Logopädie un-ter der Federführung eines Mund-Kiefer-Gesichtschirur-gen. Die individuelle Behandlung jedes einzelnen Patien-ten und die chirurgischen Interventionsschritte unter-scheiden sich von einem zum anderen Behandlungszen-trum. Die Philosophie unserer Klinik ist es, die Behandlung der Patienten unter strenger Berücksichtigung der wachs-tumsphysiologischen Gesichtspunkte durchzuführen, um keine chirurgisch induzierte Wachstumsbeeinträchtigung hervorzurufen. Die funktionelle Rehabilitation ermöglicht so ganz im Sinne von Roux (1893) die ästhetische Rehabilitation: „Form Follows Function“. Eine weitere wichtige Aufgabe ist die kontinuierliche Kontrolle der Patienten und die Beratung über die Mög-lichkeiten einer Prävention in belasteten Familien. Diese wird seit den 1980er Jahren an unserer Klinik mit gro-ßem Erfolg durch die hochdosierte Gabe von B-Vitami-nen durchgeführt.

The aim of this study is to describe the growth of the upper lip after reconstruction with a Pfeifer wave-line incision in patients with unilateral and bilateral cleft lip and palate (CL/P) in the long term. This was a longitudinal, monocentric, retrospective study. Metric standardized lip length measurements were taken annually from the age of 6 months to the age of 16 years. Defined anatomical points were determined which describe the lip length from the nasal entrance to the highest point of the Cupid's bow. The lip length of the unaffected side in unilateral cleft patients was taken as control. A total of 234 patients with cleft lip with/without cleft palate (CL/P) were included in the study. At the time of the primary surgery, the medial sides in unilateral clefts were 2-4 mm and the lateral sides 1.5-2 mm shorter than the normal unaffected side (p≤0.001). Two main periods of growth, one during childhood (first to sixth years) and one during adolescence (12th-16th years) were seen. At the age of 16 years, the end of the observation period, the lip length in unilateral clefts resulted in a clinically not noticeable shortening of the cleft side (0.37±0.26 mm). There was no correlation between lip length development and primary cleft width at the time of primary cleft lip surgery at 6 months. The upper lip in patients with bilateral clefts developed symmetrically without any obvious asymmetry. Both sides showed a lip length difference of 0.1±0.05 mm at the age of 16 years (p=0.1). Compared to the upper lip length of the control group, bilateral clefts showed a slight tendency toward a longer upper lip (p=0.52). Within the limitations of the study it seems that when lip length development is a priority in cleft lip surgery, Pfeifer wave-line procedure is good option to achieve symmetric results in unilateral and bilateral cleft lip surgery and, therefore, is a relevant option among a variety of other techniques.

The aim of the study was to describe the attractiveness of a newborn with CL/P and the maternal reaction in relation to the child. Another purpose was to explore and describe the experience and subjectively perceived reaction of the mother and the social environment to the child before and after cleft lip surgery. Material and methods: A study to describe and evaluate mothers' experiences, feelings and emotions (n = 84) regarding having a child with CL/P was performed. Therefore mothers were asked to complete a self-reported, standardized Likert-scale questionnaire. The questions were focused on the mother's own experiences, and the reaction of close family members and the social environment (friends, unknown people) to the child. Therefore two essential situations during the first year of life were analyzed: the first contact with the child, and a second one after lip surgery. The influence of lip reconstruction on the attractiveness of the child and the following reactions were analyzed. The timeline includes surveys from 01/2014 to 12/2016. Results: 84 mothers of affected children (CL/P) replied to the questionnaire (84/103). Most mothers (n = 64) described the attractiveness of their child at birth as "very good" (n = 37) and "good" (n = 27). After lip reconstruction the subjective attractiveness in the mothers' opinions increased to 90.5% (n = 76): 24 "good" (p = 0.23) and 52 "very good" (p = 0.73). 50 mothers defined the postoperative surgical result as "very good", 21 did not see any improvement (p = 0.001). Poor postoperative evaluations like "very poor" (n = 0), "insufficient" (n = 1) or "sufficient" (n = 1) were found two times. The majority of mothers (n = 78) reported negative reactions of the social environment to the child before lip surgery. Friends reacted in general more positively to the child with the visible deformity than did the social environment. 41 mothers described that their life partner or husband reacted "always" more positively to the child (p = 0.018). After surgical lip closure, strangers (n = 22) and even friends (n = 27) did not change their reactions obviously. Conclusion: For the mother, the attractiveness of a child with CL/P is not significantly affected by the visible facial malformation. Even if the lip reconstruction increases the child's attractiveness from the mother's perspective, the often negative reactions of the family and social environment did not change. (C) 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

A 2016 published randomized multicenter phase III trial of prophylactic nimodipine treatment in vestibular schwannoma surgery showed only a tendency for higher hearing preservation rates in the treatment group. Gender was not included in statistical analysis at that time. A retrospective analysis of the trial considering gender, preoperative hearing, and nimodipine treatment was performed. The treatment group received parenteral nimodipine from the day before surgery until the seventh postoperative day. The control group was not treated prophylactically. Cochlear nerve function was determined by pure-tone audiometry with speech discrimination preoperatively, during in-patient care, and 1 year after surgery and classified according to the Gardner-Robertson grading scale (GR). Logistic regression analysis showed a statistically significant effect for higher hearing preservation rates (pre- and postoperative GR 1–4) in 40 men comparing the treatment ( n = 21) and the control ( n = 19) groups ( p = 0.028), but not in 54 women comparing 27 women in both groups ( p = 0.077). The results were also statistically significant for preservation of postoperative hearing with pre- and postoperative GR 1–3 ( p = 0.024). There were no differences in tumor sizes between the treatment and the control groups in men, whereas statistically significant larger tumors were observed in the female treatment group compared with the female control group. Prophylactic nimodipine is safe, and an effect for hearing preservation in 40 men with preoperative hearing ability of GR 1–4 was shown in this retrospective investigation. The imbalance in tumor size with larger tumors in females of the treatment group may falsely suggest a gender-related effect. Further investigations are recommended to clarify whether gender has impact on nimodipine’s efficacy.

BACKGROUND:The emotional impact on parents at the birth of their new-born with cleft lip and/or palate (CL/P) can be traumatic for parents, especially mothers, and affect the sensitive early parent-child relationship. Unlike many other congenital malformations facial deformities are visible to all. The uncommon facial appearance creates feelings and reactions in the mother, families and other people. Only few studies deal with this psychosocial burden of these mothers. MATERIAL AND METHODS:This pilot-study deals with mothers' early experiences (n=84) having a child with CL/P. Mothers were asked to complete a questionnaire at diagnosis, birth and after lip surgery. The questions were focused on the social background of the mother (educational degree, marital status, lifestyle and prenatal care), the medical information at diagnosis and the following reaction. The surveys were administrated from 01/2014 - 12/2016. RESULTS:84 mothers of affected children (CL/P) replied the completed questionnaire (84/103, 81.5%). At diagnosis 65 mothers (77%) lived in a solid partnership and 44% worked full-time (40h). The diagnosis caused fear among the mothers (60.7%, p≤0.01), despair (27.4%, p≤0.01), grief (17.9%, p≤0.01) and guilt (16.7%, p≤0.01). Despite the emotional stress after the diagnosis only 5 mothers asked for psychological support (6.0%). The medical information by the gynecologist (41.6%) or maxillofacial surgeon (32.2%) was rated as "good" (n=26) or "very good" (n=26) in 60.2%. A lack of medical information and care was rated with "insufficient" (11.9%) or "poor" (14.3%). CONCLUSIONS:There are only few studies about mothers' early feelings and emotions having a child with a CL/P. We found high parental stress, physical and emotional strain among the mothers after diagnosis, mostly caused due to insufficient information's. This stress was not correlated with the educational level and CLP appearance showed no relation about the socioeconomic status. Key words:Cleft lip/palate, mother's emotional experience, psychosocial aspects.

Objectives: This study describes a modified method for secondary correction of whistling deformities in patients with unilateral and bilateral cleft lip/palate (CL/P), using a horizontal double transposition vermilion flap, including parts of the orbicularis oris muscle. The pre- and postoperative results were objectively evaluated. Study design: 34 patients with a whistling deformity who underwent secondary reconstruction between 07/2013 and 11/2018 were included in this study (mean age 20.2 +/- 11.6 years). 24 patients were male and 10 female. 30 patients presented with cleft lip and palate (CLP) - 15 bilateral, nine on the left side and six on the right. Four patients had only a left-side cleft lip (CL). The whistling deformity reconstruction was carried out using two triangular transposition vermilion flaps with muscle parts, for a vertical Z-plasty. The surgical procedure is normally performed under local anesthesia in all patients older than 10 years. For statistical evaluation, the size of the whistling defect in the vermilion was determined on photographs before and 6-9 months after surgery. The individual defect score (DS) was evaluated pre- and postoperatively. In all patients, no additional surgical procedures, such as rhinoplasty or scar correction in the upper lip, were carried out simultaneously. Results: Minor (DS < 400), moderate (DS 400-1400), and severe (DS > 1400) whistling defects were surgically corrected. The whistling defect score was significantly reduced in all patient groups (p < 0.001). In six patients the result of surgery was rated as 'acceptable' (DS > 30), in five patients as 'good' (DS 10-30), and in 23 patients as 'very good' (DS 0-10). Conclusions: This study describes a modified method for whistling deformity reconstruction in uni- and bilateral clefts. The aesthetic results are based on a reconstruction of the subcutaneous muscle layers and the creation of a symmetrical lip contour and prolabium using transposition flaps from the lateral side of the cleft. The great advantage is the uncomplicated performance under local anesthesia, even for all children over 10 years, and the short operation time. Postoperative complications did not occur. (C) 2019 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Journal of Small Animal PracticeVolume 61, Issue 2 p. 141-141 IMAGES IN SMALL ANIMAL PRACTICE Surgical management of a traumatic mouth floor perforation in a wild mute swan (Cygnus olor) K. Scheller, Corresponding Author K. Scheller konstanze.scheller@uk-halle.de Department of Oral and Maxillofacial and Facial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, Halle, 06120 GermanyCorresponding author email: konstanze.scheller@uk-halle.deSearch for more papers by this authorT. Spretke, T. Spretke Provisional zoo director (retired) and expert in ornithology, Halle, 06114 GermanySearch for more papers by this authorR. Wenkel, R. Wenkel Practice for Veterinary Medicine, Halle (Saale), 06108 GermanySearch for more papers by this author K. Scheller, Corresponding Author K. Scheller konstanze.scheller@uk-halle.de Department of Oral and Maxillofacial and Facial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, Halle, 06120 GermanyCorresponding author email: konstanze.scheller@uk-halle.deSearch for more papers by this authorT. Spretke, T. Spretke Provisional zoo director (retired) and expert in ornithology, Halle, 06114 GermanySearch for more papers by this authorR. Wenkel, R. Wenkel Practice for Veterinary Medicine, Halle (Saale), 06108 GermanySearch for more papers by this author First published: 13 November 2019 https://doi.org/10.1111/jsap.13086 Presented as a poster at the German Congress of Maxillofacial Surgery of the DGMKG in Dresden 06.-09.06.2018 Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume61, Issue2February 2020Pages 141-141 RelatedInformation

Introduction: The need to resect and reconstruct the condylar process of the mandible in a teenager is rare. Reconstruction strategy must be accurately assessed in terms of donor side morbidity, postoperative risks (ankylosis) and the possibility of sufficient development in a growing patient. Observation: A 14-year-old boy presented with the radiographic finding of a large cystic lesion of the right condylar process. There were no clinical symptoms as pain, a limitation of mouth opening or malocclusion. Pathohistological examination confirmed a solitary bony cyst. The resected ascending jaw and condylar process was reconstructed by a costochondral rib graft. Commentaries: Over 8 years the development of the reconstructed ascending jaw and condyle was observed. There was an undisturbed growth. The cartilaginous part of the costochondral graft remodeled to a sufficient condylar process without ankylosis, resorption or overgrowth. Conclusion: The reconstruction of the growing mandible and condylar process in an adolescent is a challenge. Observation over 8 years showed a sufficient reconstruction. Intraoperative the chondral portion of the graft has to be handled carefully to avoid a separating from the bony part. The growth potential of the costochondral rib transplant allows a functional reconstruction without substantial donor side morbidity in adolescent patients.

Clinical and experimental studies show a clear positive effect of B-vitamins in the prevention of oromaxillofacial clefts, especially cleft lip and palate (CL/P). Hereby the local effect of thiamin (B1) in the amniotic fluid is very important for the embryonic facial development as seen in palatal organ models stimulated by topical B-vitamin application (Scheller et al., 2013a). Moreover a low B1 concentration in the serum and amniotic fluid was found in pregnant mice with clefts in their offspring (Scheller et al., 2013b). Immunochemical analyses of midface sections (ThTr-1 transporter) and the placenta (ThTr-2 transporter) of cleft fetuses with orofacial clefts showed an atypical cytoplasmatic localization (Scheller et al., 2017). mRNA nalyses of different B-vitamin transporters (B1, B2, B5, B7, B9) were performed and showed ThTr2 transporter in a short splice variant in all cleft fetuses. This splice variant may cause a functional loss of the transport capacity through the placenta barrier and result in a low amniotic fluid concentration of vitamin B1. All other analyzed transport proteins showed no functional change. These findings confirm the hypothesis that cleft prevention by high vitamin B1 substitution fails in genetically determined cleft mice, caused by an insufficient B1 uptake and missing local effect.

PURPOSE:Cleft lip and palate (CL/P) are one of the most common human birth defects. Animal experiments and clinical investigations show a clear reduction of teratogenic clefts by a high-dose vitamin B supplementation during early pregnancy, especially in families at risk (reduction of recurrence). The aim of this work was to examine the influence of thiamine (vitamin B1) on CL/P appearance in genetically determined A/WySn mice within different supplementation starting points.MATERIALS AND METHODS:A total of 24 A/WySn female mice were orally supplemented with high doses (80 mg/kg) of thiamine at different times of pregnancy (5 groups, n = 90). The influence of thiamine on the abortion rate and CL/P appearance in the offspring was analyzed with respect to the concentration of thiamine in the serum and amniotic fluid (HPLC-chromatography). Immunochemical analyses of the ThTr-1 und ThTr-2 receptor-status were performed in midface sections of A/WySn-fetuses and the corresponding placenta, with and without CL/P.RESULTS:High doses of orally supplemented thiamine did not reduce the CL/P appearance in A/WySn mice. However, the different starting points of vitamin B1 substitution had some influence. Additionally, an obvious decrease in aborted fetuses was noticed in all supplemented groups. The oral substitution caused a clear increase of the serum concentration in all mothers, but showed no increase of the amniotic fluid concentration. Then immunohistochemistry detected an overexpression of ThTr-1 in the midface and an irregular localization of ThTr-2 in the placenta of fetuses with clefts.CONCLUSION:Our results suggest a time-dependent influence of thiamine on CL/P appearance in female mice. The prophylactic/periconceptional, but not the therapeutic supplementation, starting point can be proposed as a crucial step for regular facial and palatal fusion in embryonic development. The absolute rate of CL/P was not reduced, and the concentration of the water-soluble thiamine could not increase in the amniotic fluid. Thus the proposed local effect of thiamine failed in the development of genetically determined mice.

Evidence of a high interobserver variability of the subjective House-Brackmann facial nerve grading system (HBGS) would justify cost- and time-consuming technological enhancements of objective classifications for facial nerve paresis.

PURPOSE:Cleft lip and/or palate (CL/P) shows a gender-related distribution in human beings. The reason is unknown. This study analyzed the gender-related cleft appearance with respect to teratogenically and genetically determined cleft appearance and the response to thiamine (vitamin B1) supplementation.MATERIAL AND METHODS:Cyclophosphamide (CPA; 0.6 mg) and dexamethasone (0.25 mg) were injected intraperitoneally to A/B-Jena mice on different days of pregnancy. The abortion and malformation rate in the A/B-Jena and A/WySn mice with genetically determined clefting was documented to be gender-specific. Vitamin B1 was given to A/B-Jena dams at different times during pregnancy before, simultaneously and after the teratogenic agent was given to the pregnant mothers. A/WySn mice received oral supplementation at different times during embryonic/fetal development.RESULTS:There were significantly more living female fetuses when mothers were treated with teratogens, and the embryo lethality and malformation affected more male individuals. However, the survival and malformation rate in A/WySn mice was not gender-specific. Especially in male fetuses, vitamin B1 decreased the teratogenic cleft rate (CPA: p < 0.001, dexamethasone: p = 0.6), whereas there was no effect in the A/WySn mice.CONCLUSION:There was a strong anti-teratogenic effect of vitamin B1, especially in the male fetuses. Genetically determined cleft appearance was not positively influenced. These findings confirm observations about cleft appearance in human beings.

Abstract Background and Study Aims/Object Oral nimodipine is recommended to reduce poor outcome related to aneurysmal subarachnoid hemorrhage (SAH). In addition, animal experiments and clinical trails revealed a beneficial effect of enteral and parenteral nimodipine for the regeneration of cranial nerves following skull base, laryngeal, and maxillofacial surgery. Despite these findings there is a lack of pharmacokinetic data in the literature, especially concerning its distribution in nerve tissue. Patients/Material and Methods Samples were taken from a consecutive series of 57 patients suffering from skull base lesions and treated with nimodipine prophylaxis from the day before surgery until the seventh postoperative day. Both groups received standard dosages for enteral (n = 25) and parenteral (n = 32) nimodipine . Nimodipine levels were measured in serum, cerebrospinal fluid (CSF), and tissue samples, including vestibular nerves. Results Nimodipine levels were significantly higher following parenteral as compared with enteral administration for intraoperative serum (p < 0.001), intraoperative CSF (p < 0.001), tumor tissues (p = 0.01), and postoperative serum (p < 0.001). In addition, nimodipine was significantly more frequently detected in nerve tissue following parenteral administration (Fisher's exact test, p = 0.015). Conclusions From a pharmacokinetic point of view, parenteral nimodipine medication leads to higher levels in serum and CSF. Furthermore, traces are more frequently found in nerve tissue following parenteral as compared with enteral nimodipine administration, at least in the early course.

OBJECTIVES:Eagle's syndrome is caused by an elongated or mineralised styloid process and characterised by facial and pharyngeal pain, odynophagia and dysphagia. Diagnosis is based on clinical findings. However radiologic imaging, like panoramic radiograph, helps to confirm the diagnosis. There are different treatments of the Eagle's syndrome. Anti-inflammatory medication (carbamazepime, corticosteroids) and/or surgical interventions are established. The aim of the different surgical techniques is to resect the elongated styloid process near the skull base.STUDY DESIGN:A transoral, retromolar, para-tonsillar approach was performed to expose and resect the elongated calcified styloid process in a consecutive series of six patients. The use of different angled ring curettes, generally used in hypophysis surgery, facilitated the preparation of the styloid process through the surrounding tissue to the skull base, without a compromise to the surrounding tissue. Clinical examinations were performed pre- and postoperatively (3 month and after 1 year after surgery) in all patients.RESULTS:No intra- or postoperative complications were observed. The hypophysis ring curettes facilitated the preparation of the styloid process to the skull base.CONCLUSIONS:The transoral, retromolar, para-tonsillar approach is a secure and fast method to resect an elongated symptomatic styloid process. Side effects of the classical transoral trans-tonsillar approach did not occur.

Objetivos: El sindrome de Eagle esta causado por la elongacion o mineralizacion del proceso estiloides y se caracteriza por dolor facial y faringeo, odinofagia y disfagia. El diagnostico se basa en los hallazgos clinicos. Sin embargo, la imagen radiologica, como la de la radiografia panoramica, ayuda a confirmar el diagnostico. Hay diferentes tratamientos del Sindrome de Eagle. Se han establecido medicacion antinflamatoria (carbamacepina, corticosteroides) y/o intervenciones quirurgicas. El objetivo de las distintas tecnicas quirurgicas es resecar el proceso estiloides elongado cerca de la base del craneo. Diseno del estudio: se realizo un abordaje transoral, retromolar, para-tonsilar para exponer y resecar el proceso estiloides elongado calcificado en una serie consecutiva de seis pacientes. El uso de curetas de anillo con distintas angulaciones, utilizadas generalmente en la cirugia de la hipofisis, facilito la preparacion del proceso estiloides a traves del tejido circundante de la base del craneo, sin comprometer dicho tejido. Se realizaron exploraciones clinicas pre y postoperatorias (3 meses y despues de un ano tras la cirugia) en todos los pacientes. Resultados: No se observaron complicaciones intra o postoperatorias. Las curetas de anillo para la hipofisis facilitaron la preparacion del proceso estiloides de la base del craneo. Conclusiones: El abordaje transoral, retromolar, para-tonsilar es un metodo seguro y rapido para resecar un proceso estiloides elongado sintomatico. No se produjeron los efectos secundarios clasicos del abordaje transoral trans-tonsilar.

Background and Study Aims/Object Oral nimodipine improves neurologic outcome after aneurysmal subarachnoid hemorrhage. In addition, the neuroprotective efficacy of nimodipine has been revealed following skull base, laryngeal, and maxillofacial surgery. Pharmacokinetic investigations showed nimodipine to reach higher serum levels following parenteral versus enteral administration. Furthermore, a correlation between nimodipine levels in serum, cerebrospinal fluid, and nerve tissue could be quantified. These observations raise the question whether the proven neuroprotective effect of nimodipine is related to its serum level.Patients/ Material and Methods A consecutive series of 37 patients with vestibular schwannoma treated with nimodipine from the day before surgery until the seventh postoperative day was analyzed retrospectively. Both groups received standard dosages for enteral (n = 17) and parenteral (n = 20) nimodipine medication. Nimodipine levels were measured in pre- and postoperative serum and cerebrospinal fluid samples. Cochlear and facial nerve functions were documented before surgery, in the early postoperative course, and 1 year after surgery.Results Facial nerve outcome was significantly better in the group with parenteral nimodipine medication (p = 0.038). Logistical regression analysis revealed a seven times smaller risk for a deterioration of facial nerve function in the group with parenteral treatment. There was no difference in hearing preservation between both groups despite tumor size tending to be larger in the parenteral group. Intraoperative (p = 0.004), postoperative (p = 0.001), and serum and cerebrospinal fluid (p = 0.024) nimodipine levels were significantly higher following parenteral administration as compared with enteral administration. Both groups were comparable regarding tumor size and extent of resection.

Muscle & NerveVolume 50, Issue 6 p. 1026-1027 Letter to the Editor Nimodipine for peripheral nerve recovery after maxillofacial and vestibular schwannoma surgery Konstanze Scheller MD, Konstanze Scheller MD Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, GermanySearch for more papers by this authorChristian Scheller MD, Christian Scheller MD Department of Neurosurgery, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, GermanySearch for more papers by this author Konstanze Scheller MD, Konstanze Scheller MD Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, GermanySearch for more papers by this authorChristian Scheller MD, Christian Scheller MD Department of Neurosurgery, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, GermanySearch for more papers by this author First published: 26 September 2014 https://doi.org/10.1002/mus.24462Citations: 4Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume50, Issue6December 2014Pages 1026-1027 RelatedInformation

BACKGROUND:The unspecific, idiopathic isolated osteolysis is a rare condition in the various known osteopathies and better known as Gorham-Stout syndrome (Gorham's disease, GD). It belongs to the primary idiopathic osteolysis, and its aetiology is poorly understood. Many different localisations have been described, but there are only 48 cases affecting the maxillofacial region until now.CASE REPORT:A 76-year-old patient with the singular localisation of GD in the left condylar process is presented. After radical resection of the condylar process, the clinical, radiological and pathological examinations made the diagnosis of GD. Until now, there is no recurrence for two and a half years.DISCUSSION:The unspecific and inconsistent clinical and radiological symptoms complicate the diagnosis of GD. Clinical, pathological and radiological correlation is essential to make the diagnosis. The different therapeutical options and the specific outcome are discussed.

Komplexe Mittelgesichtsverletzungen erfordern ein interdisziplinäres Management und ein breites Repertoire an rekonstruktiven Techniken. Wenn notwendig, muss der geeignete Zeitpunkt für Korrekturen bestimmt werden. Wir berichten über einen 45-jährigen Patienten, der ein komplexes periorbitales Weichteiltrauma erlitten hatte. Die Wiederherstellung unter funktionellen und ästhetischen Aspekten steht im Mittelpunkt der Präsentation. Angesichts der Schwere des Traumas ist der letzte Status als sehr ansprechendes Ergebnis zu werten. Besonderheiten der Rekonstruktion bei traumatologischen Patienten werden diskutiert und Lösungswege aufgezeigt.