National cultural autonomy and linguistic rights in Central and Eastern Europe

The theory and practice of national cultural autonomy (NCA) are examined from the perspective of national minorities’ linguistic rights in four countries of Central and Eastern Europe (CEE): Hungary, Estonia, Serbia and Russia. The idea of NCA dates back to the end of the nineteenth century and is based on the principle of ethnic communities’ autonomy—within a multi-ethnic state—to manage their own linguistic and cultural affairs. The notion of NCA was rediscovered in the 1990s and incorporated into the law and practice of the said four countries. Using a comparative approach, the chapter reflects upon NCA’s potential contribution in advancing the linguistic rights of national minorities in CEE. It concludes that, while the actual autonomy afforded to minority institutions in CEE is often restricted, NCA may serve as a platform to articulate concerns of great salience to national minorities, encompassing minority participation and multilingual education

Flail Mandible and Immediate Airway Management: Traumatic Detachment of Mandibular Lingual Cortex Results in Obstructive Dyspnea and Severe Odynophagia

Isolated mandibular fractures usually represent themselves as non-life-Threatening injuries and are not treated in emergency setting. However, some rare patterns of them may result in airway obstruction as a result of displacement of bony fragments. The authors report a patient of an open comminuted fracture of mandibular symphysis which exhibited an uncommon split pattern with retrogression of lingual cortical plate, and thereby induced glossoptosis, painful deglutition, and obstruction of the upper airway within a few hours. The patient underwent immediate intubation for establishing a definitive airway, followed by open reduction and internal fixation of fracture. Surgical airway management was not needed. Anatomic reduction of the fracture was achieved, by reestablishing the patency of upper airway and resolving the painful deglutition. Patient's occlusion and mouth opening returned to the preinjury status. Timely osteosynthesis surgery offered early relief of patient's signs and symptoms, prevented airway complications and development of traumatic mandibular osteomyelitis, as well as obviated the potential need for surgical airway management. The appropriate management of mandibular fractures placing the airway at risk requires immediate diagnosis based on knowledge of specific clinical and radiographic findings. This case emphasizes that emergency clinicians should be able to distinguish those patients who will need airway securing techniques in emergent or prophylactic context, due to an uncommon fracture pattern of facial skeleton. Moreover, emergency clinicians should be conversant with wiring techniques to achieve stabilization of the mandibular framework and to control the pain, hemorrhage, and airway patency. Copyright © 2017 by Mutaz B. Habal, MD

A method for marking histopathological specimens of neck - technical note

The authors present a technical note for marking the location of lymph nodes of the neck for histopathological examination. A more precise histopathological report permits more effective overall management of patients with neoplastic disease of the head and neck. © 2009 International Association of Oral and Maxillofacial Surgeons

Management of malignant parotid tumors

Introduction: The aims of this study were to review our experience in the treatment of malignant parotid tumors in material from one center over a 12-year period and to assess treatment outcome and particularly survival. Materials and methods: Thirty-one patients treated primarily by surgery were included in the study. Complete data regarding the demographic details of the patients, tumor stage, presence of regional/distant metastases, treatment, tumor histology, grade, and follow up were compiled. With reference to the extent of tissue removed, partial superficial parotidectomy was performed in 11 patients, superficial parotidectomy, in 14 patients, and total radical parotidectomy, in six patients. Results: The median time of follow-up was 64 months, ranging from 8 to 144 months. Eight patients developed recurrences. Six patients died within the follow-up time. The overall survival rates at 5 and 10 years were 82. 2% and 76. 7%, respectively. The 5- and 10-year disease-free survival rates were 74. 8% and 69. 8%, respectively. Discussion: For patients with malignant parotid tumors, the treatment should be individualized according to the findings of each specific case, and regarding surgery, particular care and attention should be paid to maintaining all or part of the facial nerve whenever possible. © 2010 Springer-Verlag

The impact of glucocorticosteroids administered for systemic diseases on the osseointegration and survival of dental implants placed without bone grafting—A retrospective study in 31 patients

Purpose To evaluate the impact of glucocorticosteroids, administered for the treatment of systemic diseases, on the osseointegration and survival of dental implants placed without bone grafting. Materials and methods A retrospective study was conducted in search of patients treated with dental implants while receiving glucocorticosteroid therapy for various systemic diseases. In these cases, a conventional two-stage surgical protocol was used, without bone regeneration procedures. The osseointegration was clinically and radiographically tested at the uncovering of the implants. The follow-up after loading was set at a minimum of 3 years. Results A total of 31 patients were included in the study. Of the 105 dental implants placed, 104 were osseointegrated (99%). No bone absorption was radiographically noted at the uncovering of the osseointegrated implants. All of the osseointegrated implants were successfully loaded for the prosthetic restoration. The mean follow-up period after loading was 71 months, with an implant survival rate of 99%. Conclusions Glucocorticosteroid intake for systemic diseases does not have a significant impact on the osseointegration and the 3-year survival of dental implants placed with a conventional two-stage surgical protocol and without bone grafting. Therefore, it should not be considered a contraindication for dental implant placement. © 2017 European Association for Cranio-Maxillo-Facial Surger

The impact of buccal bone defects and immediate Placement on the esthetic outcome of maxillary anterior Single- Tooth implants

This study aimed to evaluate the impact of buccal bone defects and immediate placement on the esthetic outcome of maxillary anterior single- Tooth implants. The archives of the Department of Dental Implants & Tissue Regeneration at Hygeia Hospital during a 5-year period (2010-2014) were retrospectively analyzed, in search of patients treated with a single- Tooth implant after extraction of a maxillary incisor. The status of the buccal bone plate and the time of implant placement were recorded. The pink esthetic score (PES) of each case was evaluated, with a maximum score of 14. In total, 91 patients were included in the study. The mean PES was 10.5. The outcome was considered satisfactory (PES≥8) in 89% and (almost) perfect (PES ≥12) in 35% of the cases. Immediate implant placement had no impact on PES (P>.05), even though it demonstrated slightly greater variability. On the other hand, buccal bone defects had a negative effect on PES (P <.0001). In conclusion, a satisfactory esthetic outcome can be achieved in single- Tooth implants in the anterior maxilla. The presence of buccal bone defects is considered a negative prognostic factor, whereas immediate implant placement does not affect the esthetic outcome

Treatment of Eagle syndrome with transcervical approach secondary to a failed intraoral attempt: Surgical technique and literature review

The styloid or Eagle syndrome is characterized by recurrent episodes of pharyngeal pain irradiating in various additional sites of head and neck, owing to an elongated stylohyoid process or calcification of stylohyoid ligament or complex. This article aimed to report a case of surgical treatment of Eagle syndrome by applying transcervical approach for styloidectomy, after a previous but failed intraoral attempt. Aside from the description of the surgical steps of this technique, the current literature was reviewed too. Subsequently to the operation, the patient cited significant resolution of symptomatology from the first postoperative week and remained pain-free the following 6 months. After this follow-up period, the esthetic outcome of the external scar was very satisfactory, without other complications. If not properly diagnosed, patients with Eagle syndrome may receive ineffective or unsuccessful treatments. Secondary to failed intraoral attempt, which results in an elongated residual stump, it is advisable to use transcervical approach for successful resection of the stylohyoid process. In the presented case, the establishment of both adequate exposure and control of neurovascular injury was preoperatively considered essential for dissection in a previously operated field. The selection of either transcervical or intraoral approach is a surgeon-dependent decision, which relies on surgeon's experience, skills, and available equipment and may be influenced by the patient's expectations. Despite the reported disadvantages of transcervical approach, various modifications of this technique have lessened the possible morbid consequences. © 2017 Elsevier Masson SA

Parapharyngeal space tumors: surgical approaches in a series of 13 cases

Tumors originating in the parapharyngeal space are rare; they comprise approximately 0.5% of head and neck tumors. Most (70-80%) are benign and the most frequent origins are salivary and neurogenic. The aim of this study is to present the surgical procedures used for the treatment of 13 patients with parapharyngeal space tumors; 11 of them were suffering from benign tumors (the most frequent being pleomorphic adenoma; 8 cases) and 2 from malignant lesions. The following surgical approaches were used: intraoral (2 cases), transcervical (4 cases) and transmandibular (7 cases) with different types of mandible osteotomies. The type of surgical approach was dictated by the type of the lesion (malignant or benign), the exact location, the size, the vascularity and the relation of the tumor to the neck neurovascular bundle. In all cases the selected surgical approach allowed the complete resection of the tumor, obtaining clear margins in cases of malignancy, without adding to the patient’s preoperative morbidity. It was concluded that the surgical approach to the parapharyngeal space tumors must be adjusted to the tumor characteristics and be as wide is necessary to achieve its complete removal with safety