We evaluated the accuracy of computer-assisted mandibular reconstructions. Patients and methods: We retrospectively reviewed data for 26 patients who had mandibular reconstruction with a microvascular free fibula flap, January 2015 to June 2018. Postoperative mandible models were obtained from computed tomography scans. After registering the models to the corresponding preoperative plan, we performed comparative measurements. Patients were grouped by condylar involvement and subdivided based on number of fibular segments used for reconstruction. For each segment, we measured length and osteotomy angles. For the final postoperative outcome, we compared intercoronoid, intergonial, and anteroposterior distances and intersegmental plane shift. Results: Means (SD) for deviation of each osteotomy angle and fibular segment length were 1.98°(2.98) and 1.78 mm (2.69), respectively, remaining constant across subgroups. Other mean values were as follows: intercoronoid distance deviation, 3.86 mm (range, 0.20-11.21 mm); intergonial distance deviation, 3.14 mm (range, 0.05-8.28 mm); anteroposterior distance deviation, 2.92 mm (range, 0.03-8.49 mm); and intersegmental plane shift, 11.00°(range, 2.76-24.15°). Where the condyle was preserved, the intercoronoid and intergonial deviation means differed significantly (respectively 5.02 mm and 4.88 mm, both P < 0.05) for one-segmented and threesegmented fibular reconstructions. Furthermore, reconstructions involving the condylar region compared with condyle preservation showed significantly different intersegmental plane shifts (7.18°; P < 0.05). Conclusion: Computer-assisted surgery provides cutting guides for obtaining accurate fibular segments, but current fixation methods lead to inaccuracies and reproducibility errors. In multisegmental transfer with condylar involvement, computer-assisted fixation is recommended to ensure accuracy of the preoperative plan.

Background: The recent increase in computer-aided design and computer-aided manufacturing (CAD/CAM)-assisted surgery has warranted a thorough evaluation of the accuracy of virtual plan execution. Mandibular reconstructions with a fibula free flap were evaluated by comparing the fibular segments postoperatively with the virtual surgical plans. Methods: This study included computed tomography data for 20 patients (11 males; mean age 61.3 years, range 47–74) that received a mandibular reconstruction with a fibula free flap. Linear distances (superior and inferior borders) of 41 fibula segments and intercoronoid distances were measured. Results: The mean difference was 3.11 ± 2.80 mm for superior borders (range 0.02–12.20 mm), and 2.75 ± 2.61 mm for inferior borders (range 0.22–13.58 mm). The mean intercoronoid difference was 3.57 ± 1.80 mm (range 0.91–6.11 mm). Conclusion: This study confirmed the presumed accuracy regarding the use of fibular and mandibular cutting guides. CAD/CAM is an attractive technique which enhances efficiency and assurance during surgery and preoperative planning.

Highlights Subperiosteal orbital abscess is a rare complication of a dental infection. Antibiotics alone are ineffective and do not guarantee arrest of the infection spread. The possible route of infection spread should be determined, and is illustrated in this report. Postseptal infections require a more aggressive approach compared to preseptal infections. In case of an orbital infection, intraoral examination and dental radiography may not be overlooked.

Non-Hodgkin lymphomas comprise a heterogeneous group of malignancies, with a wide scope of clinical, radiological and histological presentations. In this paper, a case is presented of a 59-year-old white male with an infraorbital follicular B-cell lymphoma, which appeared as a painless mass in the left cheek. The lymphoma achieved spontaneous remission five and a half months after his diagnostic incision biopsy. The literature is reviewed, focusing on this rare site of presentation and spontaneous remission. In literature, only four cases have been reported with a follicular B-cell lymphoma of the cheek or infraorbital region, and only 26 cases of spontaneous remission of an extracranial non-Hodgkin lymphoma in the head and neck region have been described. To the authors’ best knowledge, this is the first time spontaneous remission of an infraorbital follicular lymphoma could be observed. The nature of the processes inducing spontaneous remission remains obscure. It is important to recognize this phenomenon as this might prevent unnecessary treatment.

Introduction: There has been a shift towards shorter hospital stays and greater efficiency to reduce overall cost and increase economic benefit. Parotidectomy has traditionally been an inpatient procedure due to drain insertion; however, outpatient parotidectomy has recently become an attractive alternative.Materials and Methods: Here, studies were identified that compared the safety of outpatient parotidectomy to that of inpatient (at least overnight stay) parotidectomy. Primary outcome was to compare complication rates. Secondary outcome was to assess the re-admission rate. A systematic literature search was performed on different electronic databases from 01/01/1990 to 05/10/2019. Abstract review of all articles, full article revision of included studies, data extraction and quality assessment were performed by four independent assessors.Results: 445 studies were identified. Six articles were selected for inclusion in the systematic review, five of which were included into the meta-analysis. All articles reported outpatient parotidectomy and inpatient parotidectomy and used retrospective observational designs, representing moderate-level evidence. A total of 3664 patients were included (1646 in the outpatient group and 2018 in the inpatient group). Comparing the outpatient to inpatient cohorts, there were lower complications in outpatient groups though not statistically significant for haematoma (OR = 0.45; 95% CI = 0.11-1.92; p = 0.28), surgical site infection (OR = 0.88; 95% CI = 0.46-1.69; p = 0.70), seroma (0.79; 95% CI = 0.21-3.03; p = 0.74), facial nerve weakness (OR 0.39; 95% CI = 0.14-1.08; p = 0.07) and hospital readmission (OR 0.58; 95% CI = 0.33-1.04; p = 0.07).Conclusions: Outpatient parotidectomy appears to be safe with comparable peri-and post-operative complication rates as compared to inpatient procedures.