Marius G Bredell

Pivate Pratice and and Wnterhur Canthonal Hspital · Maxillofacial and Oral Surgery

Background and purpose Preclinical data suggest that cetuximab should be continued after end of concurrent radiotherapy + cetuximab due to its efficacy against residual tumor cells in the irradiated tumor bed. Based on this concept the phase II add-on cetuximab (AOC) study was designed. Materials and methods Altogether 63 patients with advanced he...

Implant born prosthetic rehabilitation of tumour patients can be difficult to perform. Challenges in treating such patients include disrupted anatomy with limited mouth opening due to previous ablative surgery as well as free-flaps or simple bone grafts, adjuvant therapy such as radiotherapy and, in general, poorer general health. Combining classic...

This study was performed to report the outcomes of patients with oral squamous cell carcinoma (OSCC) of the tongue over a 10-year period with the aim of testing the hypothesis that the lymph node ratio (LNR) has a significant influence on loco-regional recurrence. The charts of 227 patients with OSCC of the mobile tongue treated at the University H...

Purpose: Dental rehabilitation in patients receiving free flap reconstructive surgery on the mandible or maxilla is an important part of bringing patients back to normality in both a physical and psychological way. It is therefore important to be able to do this in the fastest way possible. Virtual preplanned reconstructions of jaws with implants...

Purpose Treatment of mandibular angle fractures using one or two osteosynthesis plates is still a controversial topic. Fracture, treatment, and patient-dependent influencing factors could affect the overall outcome. In the present retrospective study, complication rates of mandibular angle fractures treated by open reduction were assessed according...

The Surgical reconstruction of defects of the face is challenging. Local and regional flaps have an important part to play, but large defects of bone and soft tissue are a greater problem. Microvascular tissue transfer has become the standard for such patients, and preoperative planning of bony reconstructions is now common. To use these preplannin...

This study was performed to report the usage of sentinel lymph node biopsy (SLNB) in clinical stage I or II tongue cancer patients with cN0 necks seen over a 14-year period. Data were collected prospectively, and a retrospective analysis was performed of 41 patients with early stage oral squamous cell carcinoma of the tongue and a cN0 neck. Sentine...

According to recognized guidelines, a total alloplastic replacement may be indicated to resolve temporomandibular pain and functional limitations in cases where conservative and less aggressive surgical management strategies have failed. It is broadly believed that, as a result of the surgical procedure, the function of the lateral pterygoid muscle...

Purpose: Giant cell granuloma (GCG) of the jaw is a rare disease with high morbidity. Various treatment options have been discussed in the past. Since 2010, a pharmaceutical therapy with denosumab seems to have been successful for giant cell tumors of the femur. The authors hypothesized the equally successful use of denosumab for GCGs of the jaws....

http://www.sso.ch/pubmed.cfm?a=sdj-2017-06-02

Background: Inpatient rehabilitation for cancer patients has been demonstrated to improve patients' health related quality of life (HRQoL) effectively. The purpose of this study was to compare changes in general health and HRQoL of cancer patients who were referred to inpatient rehabilitation (IR) with those in two control groups who underwent outp...

Merkel cell carcinoma (MCC) is one of the most aggressive skin malignancies. Many studies have shown that the best oncological treatment of MCC consists of wide local excision and adjuvant radiotherapy due to the tumour's radio-sensitivity. However, only a low percentage of MCC is recognized before excision and functional as well as aesthetic conce...

To assess the diagnostic potential of multi-slice single-photon emission computed tomography/computed tomography (SPECT/CT) for preoperative sentinel node (SN) mapping in early stage head and neck squamous cell carcinoma (HNSCC). Retrospective case-control study including data of consecutive HNSCC patients treated between November 2011 and December...

Objectives: To explore the prognostic role of CK19 expression in squamous cell carcinomas within a well-defined cohort of oral tongue cancer patients. Methods: In our retrospective study, we investigated 129 patients with tongue cancer that had suitable material for inclusion in a tissue microarray (TMA). Where possible, samples were taken from...

Objective: Elderly patients with malignant head-and-neck tumors (HNT) often pose a therapeutic challenge. They frequently have significant comorbidities which may influence their ability to tolerate tumor-specific therapies. Our aim was to investigate the outcome of patients aged 80+ years undergoing curative intent intensity- or volume-modulated...

The aim of this study was to qualitatively and quantitatively describe the biomechanics of existing total alloplastic reconstructions of temporomandibular joints (TMJ). Fifteen patients with unilateral or bilateral TMJ total joint replacements and 15 healthy controls were evaluated via dynamic stereometry technology. This non-invasive method combin...

Bei Tumoren des Kopf-Hals-Bereichs stellen Plattenepithelkarzinome (Head & Neck Squamous Cell Carcinoma, HNSCC) die häufigste Histologie dar und machen mehr als 90% aller malignen Erkrankungen dieser Region aus. Die durch die «klassischen» Risikofaktoren, Nikotin- und Alkoholkonsum, verursachten HNSCC treten im ganzen oberen Aerodigestivtrakt auf.

Objectives: Free fibula flap remains the flap of choice for reconstruction of mandibular defects. If free fibula flap is not possible, the subscapular system of flaps is a valid option. In this study, we evaluated the possibility of dental implant placement in patients receiving a scapular free flap for oromandibular reconstruction. Material and...

The risk for osteoradionecrosis (ORN) of the mandible is positively related to bone volume exposed to > ~ 60 Gy. We hypothesized that in combined treatment, surgery may also be a risk factor. The impact of mandibular surgery on ORN in locally disease-free IMRT cohorts was retrospectively analyzed. Between October 2002 and October 2013, 531 of 715 p...

Head and Neck cancer (HNC) is a complex mix of cancers and one of the more common cancers with a relatively poor prognosis. One of the factors that may assist us in predicting survival and allow us to adjust our treatment strategies is the presence of tumor hypoxia. In this overview we aim to evaluate the current evidence and potential clinical rel...

The purpose of this paper was to describe a rare unusual case of primary mandibular condylar tenosynovial giant cell tumor of diffuse type with predominantly intraosseous growth and its management by resection and functional reconstruction with a vascularized costochondral graft. Clinical presentation was swelling in the right condylar area and lim...

A diagnosis of squamous cell carcinoma of an unknown primary (CUP) is a major burden for patients. Because the location of the primary tumor is unclear, patients remain fearful of recurrence, which aggravates the uncertain prognosis of the disease. This study evaluates factors associated with long-term recurrence-free and overall survival of patien...

We developed a limited proteolysis assay for estimating dynamics in plasma-borne protease activities using MALDI ToF MS analysis as readout. A highly specific limited proteolysis activity was elicited in human plasma by shifting the pH to 6. Mass spectrometry showed that two singly charged ion signals at m/z 2753.44 and m/z 2937.56 significantly in...

Salivary duct carcinoma (SDC) is a rare and aggressive parotid malignancy that most commonly affects males in the fifth and sixth decades of life. Histopathology specimens obtained from SDC patients demonstrate a resemblance to ductal carcinoma of the breast. Therefore, to distinguish SDC from breast ductal carcinoma, several immunohistochemical ma...

In the past few years, advances in three-dimensional imaging have conducted to breakthrough in the diagnosis, treatment planning and result assessment in orthognathic surgery. Hereby error-prone and time-consuming planning steps, like model surgery and transfer of the face bow, can be eluded. Numerous positioning devices, in order to transfer the t...

Management of the temporomandibular joint in ablative head and neck surgery is controversial with no standardized approach. The aim of the study was to establish risk-based guidelines for the management of the temporomandibular joint after ablative surgery. Analysis of all patients' records receiving ablative surgery involving the temporomandibular...

OBJECTIVES/HYPOTHESIS: Preservation of the submandibular gland (SMG) during a neck dissection is gaining popularity and is showing an increasing tendency. The potential benefit, if the SMG is preserved, can be manifold. The aim of this study was to assess the benefit of the preservation of the SMG and the associated risk of recurrent disease in pat...

Basaloid squamous cell carcinoma (BSCC) is a rare, but distinct histologic variant of squamous cell carcinoma in the head and neck region. It is considered to have a poor prognosis due to its aggressive behavior and tendency to metastasize. The usual sites of BSCC are the floor of the mouth, hypopharynx and base of the tongue, and according to the...

Ameloblastic fibro-odontoma (AFO) is a rare benign tumor which contributes to 1–3% of all odontogenic tumors. AFO is mainly localized in the posterior region of the mandible and typical patients are children who present to their dentists due to non-erupting teeth. We describe an unusual example of a large AFO located in the upper right maxilla and...

Rehabilitation with implant-retained prostheses is a key step in the rehabilitation of patients after ablative head and neck surgery. Data of patients who underwent mandibular restoration with Astra Tech implants were gathered consecutively and analyzed retrospectively. Implant survival was calculated by Kaplan-Meier analysis, and Cox models were u...

TNM status is questioned as an exact predictor of survival in different tumour entities. Recently, lymph node ratio (LNR) has been described as a predictor of survival in patients with HNSCC. The purpose of this study was to evaluate to which degree LNR could be used as a more accurate predictor than TNM staging? A total of 291 patients, with a fol...

The aim was to quantify severe transient and persisting late term effects in our single institution head neck cancer (HNC) cohort treated with curatively intended intensity modulated radiation therapy (IMRT). Hypothesis was if a 2-year follow up (FU) is sufficient to estimate the long term tolerance in HNC irradiated in the IMRT era. Between 01/200...

Einbau von freien Knochentransplantaten nur in gut vaskularisiertes Gebiet

The treatment of large bone defects still poses a major challenge in orthopaedic and cranio-maxillofacial surgery. One possible solution could be the development of personalized porous titanium-based implants designed to meet all mechanical needs with a minimum amount of titanium and maximum osteopromotive properties so that it could be combined wi...

Purpose Successful occlusal rehabilitation with implant retained prosthesis is a key step in restoring patient’s functional dignity in the midst of challenges, like poor tissue quality after radiation and surgery in head and neck oncology patients. The study aimed to ascertain the success of Astra-Tech implants in this patient group. Material and...

Head and neck cancer patients’ quality of life is improved (1) by the surgical reconstruction of resection defects and (2) by the dental rehabilitation with an implant-supported prosthesis. Understanding the implant behavior in these compromised situations may improve treatment planning. Purpose Therefore, the survival rates of dental implants ins...

Purpose Management of the temporomandibular joint (TMJ) in ablative head and neck surgery is controversial with no standard approach being advocated. Reconstruction options range from complete joint replacement, free vascularised grafts to osseodistraction. Materials and methods Analysis of all patients’ records receiving ablative surgery involvin...

Background: Functional closure of floor of mouth defects remain a challenge. A new method of reconstruction of the anterior and antero-lateral floor of mouth and mandibular defects after ablative surgery is described. Methods: Six consecutive patients with suitable T1 and T2 floor of mouth and mandibular alveolar carcinomas were investigated regard...

Die Inzidenz von Kopf-Hals-Tumoren beträgt etwa 7/100 000 pro Jahr. Etwa 75% dieser Patienten werden definitiv oder postoperativ bestrahlt. Der Einsatz modulierter Bestrahlungstechniken zur Reduktion von Langzeit-Nebenwirkungen höheren Grades ist bei diesen Patienten von besonderer Bedeutung.

The mortality of oral cancer (OC) has shown only moderate improvement over recent decades. Treatment of OC remains mainly surgical with increasing contributions from radio- and chemotherapy. Early diagnosis and adequate management improves patient prognosis whilst lymphatic spread worsens the prognosis significantly. Copious extirpation of the tumo...

Unlabelled: Tumorous lesions of the oral cavity are mostly of dental or local pathological origin. On occasion, they may have a distant origin outside the field of dentistry. Under certain circumstances, this can lead to serious consequences. Renal cell carcinomas are known for their frequent metastasis to the lungs, liver, bones, and brain. Metas...

PURPOSE: Except for early stages (T1/2 N0), the prognosis for patients with oral cavity cancer (OCC) is known to be worse than for those with pharyngeal carcinoma. While definitive intensity modulated radiation therapy (IMRT)-chemotherapy affords loco-regional control rates (LRC) of approximately 80% in advanced pharyngeal cancer, corresponding rat...

This article presents the case of a 26-year-old woman with tongue cancer. The median age at the diagnosis of the tongue's cancer is 61 years. Only approximately 2% of patients are diagnosed before the age of 35. Our patient survived acute myeloid leukemia (AML) before her second year. She had been having recurrent, poorly healing aphtae on the righ...

Tumorous lesions of the oral cavity are mostly of dental or local pathological origin. On occasion, they may have a distant origin outside the field of dentistry. Under certain circumstances, this can lead to serious consequences. Renal cell carcinomas are known for their frequent metastasis to the lungs, liver, bones, and brain. Metastases to the...

Although free flaps are reliable for head and neck reconstructions, the pectoralis major flap (PMF) is still often used. In cases of a large PMF, the closure of the donor side can be a challenge. A technique, originally developed for the treatment and prevention of abdominal ruptures after laparotomy, is presented as an alternative for closure of l...

Head and neck squamous cell carcinoma (HNSCC) is currently the eighth leading cause of cancer death worldwide. The often severe side effects, functional impairments and unfavorable cosmetic outcome of conventional therapies for HNSCC have prompted the quest for novel treatment strategies, including the evaluation of nanotechnology to improve e.g. d...

The purpose of the study was to evaluate the indications, reliability, and complications of the radial forearm fasciocutaneous flap (RFFF) procedure in reconstructive head and neck surgery. The records of 81 patients who were treated with an RFFF between 1998 and 2009 were systematically reviewed. Data of recipient localization, previous T status,...

The pectoralis major myocutaneous flap (PMMF) is a commonly used flap in reconstructive head and neck surgery, but in literature, the flap is also associated with a high incidence of complications in addition to its large bulk. The purpose of the study is the evaluation of the reliability and indication of this flap in reconstructive head and neck...

The face is a central part of one’s existence. Our daily life is intertwined with facial expressions and thus depends on good facial function. Facial fractures are common, and correct treatment has to be undertaken from the start to avoid debilitating sequelae. Emergency treatment of the patient may be compromised if the effect of patient’s facial...

At the Clinic for Radiation Oncology at the Zurich University Hospital (UniversitätsSpital Zürich [USZ]), head-and-neck tumor (HNT) patients have been treated with intensity-modulated radiotherapy (IMRT) since 01/2002 (n 〉 800). This method causes less damage to normal tissues adjacent to the tumor, and thus it was possible in the head/neck region...

We review current clinical applications of photodiagnosis (PD) and photodynamic therapy (PDT) in the head and neck field and highlight the actual status, problems, challenges as well as the future of this emerging treatment modality. In recent years literature presented input from many new developments and their applications. This is due to better...

Surgical navigation is a commonly used tool in cranio-maxillofacial surgery. Registration is the key element for precision, and a number of studies have shown different techniques to be accurate. Nonetheless, uncertainty surrounds the special situation in edentulous patients and a practical approach to what can be a challenging problem. Four regist...

Of the many different factors associated with an increased risk for oral squamous cell carcinoma (SCC), tobacco and alcohol seem to be the most studied. The aim of the current study was to evaluate the clinicopathologic characteristics of patients without the mentioned risk factors. Out of 278 patients (159 male and 119 female patients) with oral S...

Treatment of elderly patients is in many ways different from that for younger ones. The aim of the present study was to identify the particular characteristics and needs of elderly patients suffering from head and neck cancer. From these patterns, considerations for this special group can be deduced. The subjects for this study consisted of 376 pat...

Sentinel lymph node (SLN) detection and biopsy is gaining popularity in the treatment of Head and Neck cancer. Various methods in this regard have been described, each with their respective advantages and disadvantages. The aim of this paper was to evaluate the potential application of Indocyanin Green (ICG) in the mapping and detection of sentinel...

Because female user habits for tobacco and alcohol are changing and the female incidence of oral squamous cell carcinoma (SCC) has increased, the aim of the study was to evaluate the possible differences between male and female patients suffering from oral SCC. The files of 159 male and 119 female patients with oral SCC, who were treated between 19...

Fibular grafts are commonly used in reconstructive head and neck surgery, and several complications have been reported. Tibial stress fracture, however, is rare. A 65-year-old woman presented with a tibial stress fracture 10 weeks after a vascularized fibular flap had been harvested for a mandibular defect due to osteoradionecrosis. The main sympto...

Apocrine hidrocystoma is an uncommon benign cystic proliferation of the apocrine sweat glands. Malignant melanoma, eccrine hidrocystoma, angioma, and follicular cysts have to be considered as differential diagnoses. A 63-year-old man is presented with a dark mass measuring 2 x 2 cm on his right cheek. An exocrine tumor or, more unlikely, a melanoma...