P.286 Condylar and disc position after sagittal split ramus osteotomy with and without Le Fort I osteotomy

204 Journal of Cranio-Maxillofacial Surgery 34(2006) Suppl. S1 and ultrasonography were taken, following a diagnostic protocol constructed. Further investigations, such as CT, MR were performed to discover when differential diagnostic problem occours. Invasive investigations such as sialography and sialoendoscopy were not used. Results: The sensitivity of sonography was in parotis 75%, in submandibular gland 56.25% and in sublingual gland 100%. The sensitivity of panoramic X-ray varied between 0% and 37.50%, the same at intraoral occlusal radiograph varied between 65.63% and 100%. 34.38% of the stones were found in the proximal third of the duct or inside the gland. Conclusions: Despite of the advantages of CT and MR evaluations, sonography and native X-ray keeps their priorities as diagnostic methods, because they are cost-effective and easily available in dental care. The lack of intraductal imaging ability might be considered as one of major disadvantages in evaluation of possible diagnostic alternatives. P.281 Metastasizing atypical cutaneous malignant histiocytoma in head and neck V. Popovski, G. Pancevski. Clinic for Maxillofacial Surgery, University “St.Ciril and Methodius”, Skopje, Macedonia Introduction: Malignant fibrous histocytoma or soft tissue sarcoma is predominantly localized in the extremities and retro peritoneum, rarely occurs in the head and neck. In this study the clinicopathological features of two patients with malignant histocytoma with the metastases in the orbital and parotid gland region are surgically and pathologically analysed. Material and Methods: The clinical course of two consecutive patients with malignant histocytoma surgically treated in our clinic in 5 year period was evaluated for the study. Pre-operative diagnostic procedures and the potential impact of the timing of post-operative radiation therapy on the rate of local control were evaluated. Results: The essential point for both patients was defined by a rapidly growing mass in the parotid area. Surgical therapy was the first treatment of choice in these two patients and radical parotidectomy was performed associated with radical local removal on primary site. Selective neck dissection was performed in one case. Post-operative treatment included radiation and chemotherapy. There was no evidence of local recurrence. One patient died as a consequence of intracranial metastases within the 36 months after diagnosis, whereas second patient is alive and free of the disease after a follow-up of 48 months. Conclusion: Amplified radical surgery is the first choice of treatment. The second surgery has special value to the recurrent patients. Radiotherapy alone or chemotherapy alone is not effective to metastases of malignant histocytoma in head and neck region. P.285 Electropuncture as a part of effective anaesthesia method I.A. Shugailov1 , I.O. Pohodenko-Chudakova2 , O.P. Chudakov2 . 1 Russian Medical Postgraduates Academy, Moscow, Russia; 2 Belarusian State Medical University, Belarusian Collaborating Center of EACMFS, Minsk, Belarus Introduction: Effective, adequate, safety anaesthesia at the time of operation is a problem in oral surgery. Aim of the research is to determine effectiveness of electropuncture as a part of anaesthesia in oral surgery. Materials and Methods: Seventy five patients with radical cyst have been kept under observation. Cystectomy and resection of one or two roots apexes have been applied for all of them. Patients

Abstracts, EACFMS XVIII Congress were divided into three groups by 25 person each. Conduction analgesia with Ultracaini D-C forte has been applied for all groups. “Dormicum” was applied for 2nd group patients as additional drug. Patients of the 3rd group had electropuncture course. Anaesthesia effectiveness was estimated according to the necessity to apply additional drugs, haemodynamics, frequency of complications arisen. Average haemodynamics data of 20 healthy peoples in dormant state has been considered as control ones. Results: Additional drugs have been applied for 57% of patients of the 1st group, for 27% in 2nd group, for 16% in 3rd group at the time of operation. According to the hemodynamics data, all patients had increased blood pressure and tachycardia before operation (p < 0.01, p < 0.02, p < 0.05, conformably). For patients of the 1st group indices remained high (p < 0.001) 5 min after the operation has began. Indices for patients of the 2nd, 3rd groups were identical to the control data. Complications have been found in 30%, 10% and 0% of examinations, respectively. Conclusion: Electropuncture as a part of the anaesthesia is effective in oral surgery.

Orthognatic surgery P.286 Condylar and disc position after sagittal split ramus osteotomy with and without Le Fort I osteotomy K. Ueki, K. Nakgawa, S. Takatsuka, E. Yamamoto. Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kanazawa University, Japan Introduction and Objectives: The purpose of this study is to examine the changes in temporomandibular joint (TMJ) morphology and clinical symptoms after sagittal split ramus osteotomy (SSRO) with and without a Le Fort I osteotomy. Material and Methods: Of 45 Japanese patients with mandibular prognathism, 23 underwent IVRO (intraoral vertical ramus osteotomy) and 22 underwent SSRO in combination with a Le Fort I osteotomy. The TMJ symptoms and joint morphology, including disc tissue, were assessed pre-operatively and post-operatively by magnetic resonance imaging (MRI) and axial cephalography. Results: There were significant differences between pre- and post-operative horizontal changes in the condylar long axis on the right side in the group undergoing SSRO (sagittal split ramus osteotomy) alone. However, there were no other significant differences in pre- and post-operative measurements in this group as compared with the group receiving SSRO plus osteotomy, and the pre-operative disc position could not be changed in either group. Conclusions: These results suggest that SSRO, either with or without Le Fort I osteotomy, could not change the pre-operative disc position or correct anterior disc displacement, although these procedures did improve the symptoms associated with TMJ dysfunction. P.287 The influence of the lip pressure on the surgical relapse after Le Fort I advancement A.S. Mager1 , C. Lippold2 , J. Kleinheinz1 . 1 Department of Cranio-Maxillofacial Surgery, University of M¨unster, Germany; 2 Department of Orthodontics, University of M¨ unster, Germany Aim: This study should help to understand the reasons and the factors of post-treatment relapse after Le Fort I osteotomy. Material and Methods: Twelve subjects revealing class III malocclusion receiving orthognathic surgery including a Le Fort I