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Solitary bone cysts in the mandible
ABSTRdCTS
OF CURRENT
415
LITERATURE
and the cartilage involved by neoplasm xere suggested as being vulnerable to early necrosis. “Late” necrosis was discussed as a clinical state. Windeger indicated that particular attention should be given to radionecrosis of cartilage and bone because of (1) the latency of occurrence, (2) the likelihood of occurrence when certain sites are irradiated, and (3) the prolonged sufl’ering and pain wheu it or,curs. Heavy irradiation of bone causes changes which are permanent and not. always apparent. When hone is compared with soft tissue, bone is known to absorb more irradiation owing to it,s greater content of tha hearier elements. The blood supply to the irradiated bone then becomes restricted, due to endarteritis, thus rendering it incapable of responding to an inflammatory reaction, He also related that when lesions in and about the mouth are irradiated, the mandible and the maxilla -may receire heavy doses. These hones may remain normal for years until they are traumatized or become seeondarily infected, such as might well happen in the jaw when an infected tooth is removed or when an intrabuccal ulcerat.ion is present. It was affirmed that necrosis is associated with pain and edema. Sequestration is slow and may take years to accomplish. In the roentgenogram there may be areas with a relative increase in density which mav be confused with osteoplastic metast.asis, or there may be areas of absorption of bone which may resemble osteolytic secondar)- processes. With secondary infection? such as occurs in the mandible, there is marked decalcification and absorption of bone which may be impossible to distinguish from invasion of the hone bp recurrence of the neoplasm. He further Windever sppke in general regarding the treatment. of radionecrosis. categories. Finally, classified radionec.rosis under certain “ justifiable? ’ and . l unjustifiable the essayist advised that radiothera.peuticP not be used when other simpler and less dangerous methods are available. KARL
Beitrage
zur Krankheitsbild
Pratt.
Oto-rhino-larg-ng.
der propagierenden
IT.
Oberkieferosteomyelitis.
BRUCE.
Ludwig
Pesti.
9: 44, 1947,
In Case 1 the inThee cases of osteomyelitis of the upper jaw are published in detail. fection of the seventh and eighth tooth brought about an osteomyelitis of the lateral posterior maxillary wall which spread to the fossa pterygopalatina as a ca.peous abscess, the opening of which, partly permaxillary? partly through resection of the alreolar process, produced a quick recovery. Case 2 resulted in a facionasal fistula and its rapid closure after an operation on the maxillary sinus, Such a fistula is a rare complication of a traumatic osteomyelit,is. Case 3 is of interest because of the combination of trauma and osteomyelitis with a maxillalT cyst. The transorbital nerve blocking anesthesia of the maxillary nerx-e described hy Pay gives very satisfa.ctorresults in cases of severe extension of the infection processes of the upper jaw, whereas the customary procedure of local anesthesia is iuadvisable.
CYSTS OF THE JAWS Solitary
Bone Cysts in the Mandible.
Martin
A. Rushton.
Brit.
D. J. 81: 37~49, July
19,
19, 1946. The lesion of aolita.rg cyst in t.he long hones is rence in the mandible is mentioned. Three case histories of the lesion in the mandible and one with bone expansion. The author uses the following criteria in reporting no epithelial lining, and shorn no evidence of acute or principally fluid and not soft tissue: its malls should he
discussed and the ra.rity are given, two without
of the occurhone expansion
cases: The cyst should be single, have prolonged infection; it should contain of bone which is hard, though possibly
Malignant, Lyxnphoma: The Value of Radical Surg., Gynec. 15 Ohi. 84: 930. Ma;:, 1947.
Surgery
in Selected
Cases.
C. A. Itieilwig.
.‘,ithough In comparison with other r;vpe-9 of cancer, malignanr Ipmplionia is not c0wmon. the nlalignant. lymphoma ii; extremely radiosensitive and roentge&herap~ in some CBses maF be life saving, it does not seem :o prolong the average duration of life. Malignant lyrnpl~oma has been regwded as a spstemic. disease and surgery has been abandoned in faror of radiation therapy. Believing t.hat radical surgery has a definite place in the treatment. oi’ malignant ly3phom:~, lhe author reviewed 234 cases of malignant lymph~~ms. He uses 13fi such cases in this analy3ii. classification of lymphoid tumors is Jeaeribed, :utd *he Gall and ?riallory ‘s qtolcrgic RUI~LJ~ diridcd his mater% tm lymphoid tumors into e&l& groups. The four most common groups are reticulocyioma, Hodgkin ?s disease. I~mphobla,stoma, iLlId Iymphoicyt.oma. Ten per Cent of the autolq cases reriemed showed l~mphomxs were not systenxr in character but were yingle locaiizrd leaions accessible for surgical excision. The aulhor suggests that in certain cases of tnaligxaut. !ynphoma v&h localized lesions patients may be treated more succesr*fuII~- hp sufgica! procedure Tather than b.v radiation therap?. Tlrirt~ fire-year surrivale after radical aurger;r- without radiation are charted. In tI;is series there are nine neck, three t,onail, ow -an-, and one g
~~F~RM~TIE~ The Trestmeng Clarkson,
of Severe Prognathism a.nd A. FX Green, Brit..
OF THE JAWS
by Kastelcks’s Operation. W. Grossman, D. J. 80: 1X-187: March I;, IS&i.
The :~urho~~ rnenrion !imt minor deg~-ee- :jP ;~rogn:aritism xc Jontic methods. some raseb vail often be treatell by a combina;iou extractions, and a. denture, To um& t,he maxillary IlnderderelopmPrit functional.and cosmetic result.
Patrick
best :corrected 9~ 2rGoof orthodontic merhods. sad give a sa:i&%etor-
OF CURRENT
415
LITERATURE
and the cartilage involved by neoplasm xere suggested as being vulnerable to early necrosis. “Late” necrosis was discussed as a clinical state. Windeger indicated that particular attention should be given to radionecrosis of cartilage and bone because of (1) the latency of occurrence, (2) the likelihood of occurrence when certain sites are irradiated, and (3) the prolonged sufl’ering and pain wheu it or,curs. Heavy irradiation of bone causes changes which are permanent and not. always apparent. When hone is compared with soft tissue, bone is known to absorb more irradiation owing to it,s greater content of tha hearier elements. The blood supply to the irradiated bone then becomes restricted, due to endarteritis, thus rendering it incapable of responding to an inflammatory reaction, He also related that when lesions in and about the mouth are irradiated, the mandible and the maxilla -may receire heavy doses. These hones may remain normal for years until they are traumatized or become seeondarily infected, such as might well happen in the jaw when an infected tooth is removed or when an intrabuccal ulcerat.ion is present. It was affirmed that necrosis is associated with pain and edema. Sequestration is slow and may take years to accomplish. In the roentgenogram there may be areas with a relative increase in density which mav be confused with osteoplastic metast.asis, or there may be areas of absorption of bone which may resemble osteolytic secondar)- processes. With secondary infection? such as occurs in the mandible, there is marked decalcification and absorption of bone which may be impossible to distinguish from invasion of the hone bp recurrence of the neoplasm. He further Windever sppke in general regarding the treatment. of radionecrosis. categories. Finally, classified radionec.rosis under certain “ justifiable? ’ and . l unjustifiable the essayist advised that radiothera.peuticP not be used when other simpler and less dangerous methods are available. KARL
Beitrage
zur Krankheitsbild
Pratt.
Oto-rhino-larg-ng.
der propagierenden
IT.
Oberkieferosteomyelitis.
BRUCE.
Ludwig
Pesti.
9: 44, 1947,
In Case 1 the inThee cases of osteomyelitis of the upper jaw are published in detail. fection of the seventh and eighth tooth brought about an osteomyelitis of the lateral posterior maxillary wall which spread to the fossa pterygopalatina as a ca.peous abscess, the opening of which, partly permaxillary? partly through resection of the alreolar process, produced a quick recovery. Case 2 resulted in a facionasal fistula and its rapid closure after an operation on the maxillary sinus, Such a fistula is a rare complication of a traumatic osteomyelit,is. Case 3 is of interest because of the combination of trauma and osteomyelitis with a maxillalT cyst. The transorbital nerve blocking anesthesia of the maxillary nerx-e described hy Pay gives very satisfa.ctorresults in cases of severe extension of the infection processes of the upper jaw, whereas the customary procedure of local anesthesia is iuadvisable.
CYSTS OF THE JAWS Solitary
Bone Cysts in the Mandible.
Martin
A. Rushton.
Brit.
D. J. 81: 37~49, July
19,
19, 1946. The lesion of aolita.rg cyst in t.he long hones is rence in the mandible is mentioned. Three case histories of the lesion in the mandible and one with bone expansion. The author uses the following criteria in reporting no epithelial lining, and shorn no evidence of acute or principally fluid and not soft tissue: its malls should he
discussed and the ra.rity are given, two without
of the occurhone expansion
cases: The cyst should be single, have prolonged infection; it should contain of bone which is hard, though possibly
Malignant, Lyxnphoma: The Value of Radical Surg., Gynec. 15 Ohi. 84: 930. Ma;:, 1947.
Surgery
in Selected
Cases.
C. A. Itieilwig.
.‘,ithough In comparison with other r;vpe-9 of cancer, malignanr Ipmplionia is not c0wmon. the nlalignant. lymphoma ii; extremely radiosensitive and roentge&herap~ in some CBses maF be life saving, it does not seem :o prolong the average duration of life. Malignant lyrnpl~oma has been regwded as a spstemic. disease and surgery has been abandoned in faror of radiation therapy. Believing t.hat radical surgery has a definite place in the treatment. oi’ malignant ly3phom:~, lhe author reviewed 234 cases of malignant lymph~~ms. He uses 13fi such cases in this analy3ii. classification of lymphoid tumors is Jeaeribed, :utd *he Gall and ?riallory ‘s qtolcrgic RUI~LJ~ diridcd his mater% tm lymphoid tumors into e&l& groups. The four most common groups are reticulocyioma, Hodgkin ?s disease. I~mphobla,stoma, iLlId Iymphoicyt.oma. Ten per Cent of the autolq cases reriemed showed l~mphomxs were not systenxr in character but were yingle locaiizrd leaions accessible for surgical excision. The aulhor suggests that in certain cases of tnaligxaut. !ynphoma v&h localized lesions patients may be treated more succesr*fuII~- hp sufgica! procedure Tather than b.v radiation therap?. Tlrirt~ fire-year surrivale after radical aurger;r- without radiation are charted. In tI;is series there are nine neck, three t,onail, ow -an-, and one g
~~F~RM~TIE~ The Trestmeng Clarkson,
of Severe Prognathism a.nd A. FX Green, Brit..
OF THE JAWS
by Kastelcks’s Operation. W. Grossman, D. J. 80: 1X-187: March I;, IS&i.
The :~urho~~ rnenrion !imt minor deg~-ee- :jP ;~rogn:aritism xc Jontic methods. some raseb vail often be treatell by a combina;iou extractions, and a. denture, To um& t,he maxillary IlnderderelopmPrit functional.and cosmetic result.
Patrick
best :corrected 9~ 2rGoof orthodontic merhods. sad give a sa:i&%etor-