CURRENT LITERATURE Abstracts Orbito-maxillo-malar Fractures (in French). Reychler PE. Ann Chir Plast Esthet 32: 112. 1987
the bases for the decision not to operate on the pulmonary lesion. The concept of benign metastatic ameloblastoma is analyzed and findings compared with data in the
Fractures of the lateral orbital complex are common, representing about 22% of midface fractures. They need to be distinguished clinically and therapeutically from pure fractures of the floor of the orbit, which account for 10 to 40% of the cases of midface fractures. The aim of treatment is to reduce the deformity and to restore the esthetic appearance and function of the area. Fractures without deformity and pure “blow-out” fractures without functional impairment need no treatment. The operation is usually performed 4 to 8 days after injury. Reduction is preferably obtained with traction hooks rather than pushing devices. Stable fixation of the malar bone is obtained with miniplate osteosynthesis, generally on the lateral orbital rim. Simple wire ligature osteosynthesis must be performed at least at two separate points. The orbital floor is generally reached through a subcilliary incision. The transconjunctival approach is recommended in cases of pure “blow-out” fracture. Whenever possible, the repair is completed in one stage. Complex or cornminuted fractures require multiple osteosynthesis, usually with wire ligatures, and the use of grafts, usually iliac bone grafts. The secondary correction of esthetic and functional sequelae is always difficult. requiring multiple surgical approaches and segmental osteotomies of the orbital complex .- JEAN DELAIRE
Malignant Lymphoma of the Oral Cavity: Clinicopathologic Analysis of 20 Cases. Fukuda Y, Ishida T, Fujimoto M. J Oral Pathol 16:8. 1987 Twenty cases of oral malignant lymphoma occurring in both hard and soft tissues are reviewed. The Ann Arbor staging classification is outlined and the clinical staging of the twenty cases was listed. Results showed 75% (15) of tumors to be ordinary non-Hodgkin’s lymphoma, with the remaining five cases undefinable by present HNL classification schemes. Sixty percent of lesions occurred in individuals over the age of 50 years, but the age range was 11 to 80 years. Of 11 lesions occurring on the gingiva, four showed destruction of neighboring bony structures, whereas two patients presented with well-circumscribed mandibular bony lesions. Long-term follow-up data to 10.5 years is presented and a correlation between longterm prognosis and stage of the tumor at presentation is noted. Therapy is generally felt to be most successful employing a combination of radiotherapy and aggressive chemotherapy.-MICHAEL E. MILLER Reprint requests to Dr. Fukuda: Clinical Laboratory,
versity Dental School. Hospital. 565, Japan.
Reprint requests to Dr. Reychler: Unite de Chirurgie-MaxilloFacilae, du Service de Stomalogie et Chirurgie Maxilla-Faciale. Cliniques Universitaires St.-Luc, Universite Catholique de Louvain-en-Woluwe, av. Hippocrate 15, B-1200 Bruxelles. Belgique.
Osaka UniSuita City.
Prediction of Malignant Hyperthermia Susceptibility by Clinical Signs. Larach, MC, et al. Anesthesiology 66547. 1987
Oromandibular and Limb Malformation Syndromes. Reflections on Hypoglossia-Hypodactyly (in French). Boutsen M, Mercier J, Delaire J. Rev Stomatol Chir Maxillofac 3:168, 1987
Malignant hyperthermia (MH) is a potentially fatal disorder triggered by certain anesthetics that presents with multiple signs of variable intensity and time course. These signs, in and of themselves, are not unique to MH, and may have an extensive differential diagnosis. Therefore, the early diagnosis of MH during anesthesia is often difficult. This study consisted of two parts. First, the initial anesthetic experience of a group of children who subsequently proved to be MH susceptible, were analyzed to determine which clinical signs might be predictive of MH susceptibility. The clinical signs were defined as otherwise unexplained masseter or generalized muscle rigidity, tachycardia, temperature elevation, or arrhythmias. Second, the patients were analyzed for their response to one specific general anesthetic technique often used for MH diagnostic muscle biopsy. Dantrolene was not used on these patients. Thus, the safety of presumed “nontriggering” anesthetic agents could be evaluated in the absence of the MH protective effect of dantrolene. It was found that the presence of generalized muscle rigidity during an anesthetic was associated with a significant 18-fold increase in risk of being MH susceptible, as determined later by muscle biopsy. Only the patients with two or more adverse anesthetic signs were noted to be MH susceptible, however. Thiopental. N,O/Oz, narcotic, pancuronium, neostigmine. atropine. and/or glycopyrrolate appeared to be a safe anesthetic
Oromandibular and limb syndromes present particular types of orofacial lesions. Six personal cases and about one hundred cases reported in the literature are reviewed using Hall’s classification. Etiopathogenic mechanism are related to fetal epigenetic and environmental factors. -JEAN DELAIRE Reprint requests to Dr. Delaire: Clinique de Stomatologie et Chirurgie. Maxilla-Faciale de Nantes, F 44000 Nantes, France.
Benign Metastatic Ameloblastoma. A Case Report and Literature Review (in French). Firedel M, Bescond YL, Hyvernat P, et al. Rev Stomatol Chir Maxillofac 88:246, 1987 A 38-year-old woman with a history of maxillary ameloblastoma from age 18 was found on routine examination to have a pulmonary lesion. The lesion was atypical with respect to its clinical appearance and slow progression. histology of several nodules removed by lung biopsy confirmed the benign nature and identity of the maxillary and pulmonary lesions. The diagnosis was therefore pulmonary metastases from a benign ameloblastoma. The age of the patient and the slow course of the lesion, combined with the absence of any functional disorder, were