Introduction: One of the basic chronic diseases of the MFH domain that is treated on an outpatient basis is temporomandibular dysfunction (TMD). It represents a number of pathological conditions that lead to the dysfunction of the normal function of the stomatognatic system. Observing the etiologic factors of this condition, temporomandibular TM trauma, poor habits such as infantile type of swallowing, tongue depression, and tectogenic disturbance of the myofunctional squamous system are reported in order to reconstruct the defects of neighboring regions. Material and Methods: The study included 60 patients divided into 3 groups: Group I without predetermined temporomandibular dysfunction, Group II with TMD, and Group III where one of the muscles of the masticatory group was used during the reconstruction procedure. Results: Statistically obtained results show that in group III there is a large difference in postoperative measurement after 6 weeks. Discussion: In the mentioned patients divided into three groups, the measurement of the pressure strength expressed in N follows certain states with it measured values, which coincides with comparative studies. Conclusion: From the obtained results we conclude that the parameter used, the strength of the lower jaw bite is a significant indicator of the chewing system functioning.

Introduction: Flap of the temporal muscle (m. temporalis) with its natural position, its mass and its length, compared with other bound and free microvascular flaps, is the method of choice for covering the middle part of the face after the removal of large tumor masses. Material: The study included a sample of 36 patients who were surgically treated due to malignant process at the middle face level with the performed partial, total or bilateral maxillectomy at the Clinic for Maxillofacial Surgery, University Clinical Center in Sarajevo. The sample is divided into three groups. Methods: The usual procedure of lifting the temporal flap in the first group, at the second extension of the coronoid processus. A group of three-elongated myofascial flap, which includes lifting the muscle along with deep temporal branches of maxillary artery with deep temporal fascia, its two layers and associated stem of thesuperficial temporal artery. Results: Statistical analysis of the length indicated that in group III the mean length was 9.83 cm, group II- 8.25, and group I- 6 cm. The longest segmental lobe in group three provides safer work and the length of the lifted lobe with double vascular stem. This provides coverage of defects that cross over the median line of the middle face. The results coincide with the comparative world studies. Conclusion: For large defects at the meddle part of the face that overlap the median line, an extraordinary solution is elongated myofascial flap with double vascular supply, with a larger flap mass and a length of about 9.83 cm.

The anterior mediastinum is the most common site for thoracic tumors in pediatrics. Benignant and malignant lesions include various tumors, most frequently lymphomas. The histological diagnosis obtained by biopsy is the most important determinant for the further treatment. Introduction of a known biopsy method - the Chamberlain procedure in our institution has been commenced as one of the methods for obtaining tissue samples of the anterior mediastinal masses. An anterior mini thoracotomy in the 2nd or 3rd intercostal space gives an excellent approach to the tumor. Three children were operated by this method. The volume of three obtained tissue samples was sufficient for the pathologist and gave a 100% accurate diagnosis. The Chamberlain mini anterior thoracotomy is a good biopsy operative method. It can be used in hospitals which do not have endoscopic thoracic equipment or trained endoscopic surgeons, it is easy to perform and gives comfort to the anaesthesiologist.

Adenocarcinoma is a carcinoma originating from epithelium of glandular tissue. It has higher incidence in smokers and most often is a common type of lung cancer find in non-smokers women. Adenocarcinoma tumors are highly heterogeneous and there are several major subtypes: adenocarcinoma, papillary adenocarcinoma, bronchoalveolar carcinoma, solid adenocarcinoma with mucin production. Adenocarcinoma of the lung is prone to give metastases to the liver, spleen, brain and most to cervical limphonodes. We present a case of a 55-year-old woman with an unusually localized metastatic adenocarcinoma with its primary focus originating from the lungs. Formation reached size of 15 cm in diametre during three months along with destruction of frontal bone ad intracranial penetration. We couldn't find similary localised metastatic adenocarcinoma in world literature.

A cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epidermis. Vary from a few milimeters to a several centimeters in length. The cutaneous horn is a clinical diagnosis and different histologic lesions have been documented at the base of the keratin mound. We presented a 77 years old female with a large "horn" of 3 years duration, arising from her forehead. Excision was performed and defect was covered by split thickness skin graft. Hystopathology reported keratoacanthoma at the base of the horn. By reviewing cutaneous horns presented in literature we can declare that this is one of the biggest cutaneous horn recorded cases. Also it is important to mention that horn itself is not the most important issue, but rather the underlying condition, which may be malignant.

INTRODUCTION Reconstruction of nose defects after tumor resection, trauma or infection disease is imperative for full patient rehabilitation. For satisfying esthetic and functional results achievement, it is necessary to use surrounding skin with similar semblance, which precisely restores and imitates missing part with its outlines. MATERIAL AND METHODS This paper represents management of the patients with subtotal and total nose defects using forehead and nasolabial flaps. During a period from 2007 to 2010, 20 patients with total or subtotal nasal defects were observed. Among them, 6 defects had traumatic etiology and 14 of them resulted after tumor resection. All of them were full thickness defects overtaking the nasal mucosa, skin of the nasal antechamber, cartilage frame and external nasal skin. In all cases there was indication for local flap reconstruction. Median forehead flap has been used in 12 cases and nasolabial flap in 6 cases. Combination of these two flaps has been used in 2 cases. RESULTS Good and satisfying results were achieved in all of 20 cases, except for one speech dysfunction. Nose function was maintained with proper porosity of the nostril. Three-dimensional appearance of the nose was reconstructed with achievement of acceptable esthetics results. DISCUSSION AND CONCLUSION Because of its good vascularisation, adaptability, color and outlining without hair, nasolabial and median forehead flap, as well as surrounding area flaps are the most frequent used flaps in nose defect reconstruction.

Tumors of the mouth basis, tongue root and oropharynx present a challenge for surgical treatment. High recurrence rates, poor survival, and significant postoperative alterations in speech and swallowing function are common experiences for patients with malignancies in these anatomic sites. This paper reviews the evaluation of displayed patients: pathologic features, surgical approaches and postoperative complications reported in recent managing patients with these neoplasms. A modification of usual surgical techniques has been used by the author to treat 30 tumors in this region and it is presented in this paper. Out of the 30 tumors, 4 were benign lesions and 26 were malignant neoplasms. Transmandibular approach was the method of choice. The wide field of access offers a lot of advantages: wide direct and indirect visualization, better manipulation, and good control of bleeding and light insertion of free and related composites used in primary reconstruction of postoperative defects.