ÖGMKG - und Gesichtschirurgie

Landes, Constantin A
Die vertikale und horizontale Kondylenabstützung konnte operativ erfolgreich rekonstruiert
werden (insbesondere Klassen IV und V). Allerdings trat eine nicht unwesentliche Kondylenre-
sorption bei Klasse V auf. Misserfolgsrate insgesamt: 4(8%), die problematischsten Fälle waren
Klasse V bei 3 Misserfolgen von 5 Patienten.
Schlussfolgerung: Die Versorgung erreichte mit diesem Vorgehen nur 8% erhebbare Misser-
folge. Die Klasse V stellt die grösste Herausforderung dar und sollte mit schonender Reposition
des Kondylus erfolgen um nicht durch geschädigte Perfusion trotz erfolgreicher Reposition
grössere postoperative Kondylenresorption zu riskieren. Die Probandenzahl ist aufgrund
schlechter Compliance zur Wiedervorstellung begrenzt; es muss jedoch von einer Negati-
vauswahl wiedervorstellungswilliger Patienten ausgegangen werden, d.h. völlig symptomfreie
Patienten haben die Mühe der Wiedervorstellung häufig vermieden.
Beck-Mannagetta, Johann
Radiodense „concrements“ in colonizing aspergillosis of the maxillary
sinus consist of extruded endodontic sealer (Poster 06-14)
Johann Beck-Mannagetta 1, Gernot Friedbacher 2, Elisabeth Eitenberger 2 (j.beck-mannaget-
108 109
ta@salk.at)
(1) Clinic of Oral & Maxillofacial Surgery/SALK, Müllner Hauptstr. 48, A-5020 Salzburg (2) Inst. f.
Chemical Technologies and Analytics, Div. of Instrumental Analytical Chemistry/TU, Getreide-
markt 9/164-IAC, A-1060 Wien
Background : Radiopaque „concrements“ have been described as being characteristic for
colonizing aspergillosis of the maxillary sinus (CAMS). The aim of this retrospective study is to
investigate the origin of these particles.
Patients and methods : The records of 104 patients with the histopathological diagnosis of
CAMS operated at the Clinic of Oral & Maxillofacial Surgery reviewed. Age, sex, symptoms and
radiology were documented.- The retrieved „concrements“ of 66 patients were analyzed by en-
ergy-dispersive x-ray analysis at the Div. of Instrumental Analytical Chemistry, Vienna University
of Technology. Four commercially available sealers were analyzed for comparison.
Results : Age ranged from 18 to 89 years (mean 42 yrs.); 77 patients were female, 27 male.
Symptoms ranged from none to severe sinonasal infection. On radiographs 83 patients reve-
aled a small sharply delineated radiodense particle within the maxillary sinus. In 21 patients
no „concrement“ could be observed. In 66 patients the material could be analyzed: It was
consistent with the endodontic sealers Endomethasone (38x), Riebler´s Paste (13x), N2 (6x)
and AH26 (2x). In seven cases the material could not be attributed to a specific sealer but the
artificial origin was beyond doubt.
Conclusions : Our clinical, radiographic and analytical findings confirm a close correlation of
CAMS and extruded endodontic sealer. Due to the very different composition of these sealers
it seems that the heavy elements (causing the radiopacity) are not directly leading to CAMS.
Other possibly causative factors (e.g. cytotoxic components of the sealer, local tissue necrosis
or inhalation of organic dust) or spontaneous loss of the foreign body via the nasal orifice have
to be considered. In all these patients a high concentration of zinc ions from the sealer may
promote the growth of aspergillus spores and lead to the typical radiographic appearance of
CAMS.