The risk of fistulae is especially high in patients initially treated with radiotherapy for nonglottic advanced stage tumors. A significant decrease in the number of performed salvage laryngectomies over the 10 years was seen. Over the same time period, the annual number of fistulae remained almost constant. The resulting more than doubling of fistulae rate could thus in part be explained by less surgical routine.
Two cases of rare benign facial neurilemmomas are presented. In both cases the only complaint was a parotid mass and both patients had normal facial function. The true nature of the tumors was not discovered before operation. Repeated fine-needle aspiration biopsy did not contribute to a correct preoperative diagnosis. In both instances the facial nerve had to be sacrificed and free autogenous nerve grafting was done.
One hundred and five patients with zygomatic fractures are presented. The main cause of the fracture was violence, followed by traffic accidents, fall and sport. In more than 25% of the cases, the fractures were accompanied by another fracture of the facial skeleton, viz maxillary, mandibular and nasal fractures. In severe cases of traffic accidents there were associated fractures in more than half of the cases. The follow-up study showed visible asymmetry of the face in 17 patients and sensory disturbances in 37 patients. We did not find the X-ray subdivision by Knight & North useful in the evaluation of the stability of the fractures. As a method of choice in cases of dislocated zygomatic fractures, we used reposition by the method of Gillies and in cases of instability this reposition was combined with internal wiring, reconstruction of the orbital floor and antral packing. An active attitude towards reconstruction of the orbital floor is recommended.
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