The treatment for the pineal region tumors depends on tumor histology. Nowadays, germinomas can be cured by radiotherapy and chemotherapy without surgical resection but the other pineal region tumors should be primary treated by surgery. Two microsurgical approaches, the infratentorial supracerebellar and the occipital transtentorial, are accepted as the main standard accesses to the pineal region. For benign pineal tumors (pineocytoma, meningioma, mature teratomas, symptomatic pineal cysts, etc.) radical surgical resection can be curative. For malignant tumors radical surgical resection is not an objective. Serum and CSF markers contribute to the diagnosis of pineal parenchymal tumors. b-HCG is mainly positive in choriocarcinomas, embryonal carcinomas and mixed germ cell tumors and AFP is expressed by yolk sac tumors, embryonic carcinomas, immature teratomas and mixed germ cell tumors, b-HCG is usually low in germinomas which are often positive for PLAP on immunohistochemistry. Fifty-one pineal region tumors were surgically treated by senior author (NdT). Only 17 of them were the neoplasms originating from pineal body (pineal tumors). In conclusion it can be stressed that management of pineal tumors requires a multidisciplinary cooperation. With the exception of germinoma where only a biopsy is needed, the role of the surgeons still remains prominent as resection of pineal tumors requires high technical skill and experience as well as precise clinical judgment.

Color Doppler and intravenous angiography (digital technique) can widely be used in experimental medicine. Their wide clinical application, availability, simplicity and small cost impose their importance. Color Doppler analysis of the vascular activity of certain region is more precise than the classic intravenous angiography, but requires contact of highly sophisticated equipment with the experimental animal. Intravenous angiography gives somewhat rougher image, but is more available and does not require the potentially unwanted contact. In this research, we used both methods to mark the vein bypass of the modified infrahyoid lobe dissected from the dog (used as experimental animal). We marked the horizontally placed vein bypass at the level of the thong bone using Color Doppler and intravenous angiography. Applied vein bypass performed the vein drainage of the modified infrahyoid lobe. Results obtained with these two diagnostic methods were compared with the pathohistological (PH) analysis. Results obtained using Color Doppler (using the probe GE Vivid 3 frequency of 5 to 12 MHz) were somewhat closer to the results of PH analysis which we consider as the most objective. Result obtained using intravenous angiography (digital technique using the Siemens Siregraph machine) were satisfactory in marking the required blood vessel for the experiment. Color Doppler and intravenous angiography as digital diagnostic procedures in experimental surgery are usable and as such significantly objective, widely available and do not require additional financial investments.

Bone metastases of breast cancer since recently, among others, are treated with Zolendric acid. Often in the world are mentioned necroses of mandible surrounding mucosa and oral cavity in such patients, with unproven causal relation. First time at the Department of Maxillofacial Surgery of the Clinical Center Sarajevo verified the two cases with the same pathology. Goal of this review is to show the social aspect of medical treatment of the mouth, which has great significance. Dilemmas are present, on how to treat, as surgically well as with medications. Results of treatment are not satisfactory since it stems to mutilate the patient, in terms of functional and aesthetic deficit, and that the duration is unfavorable for the community and patients. Open dilemma remains how to create algorithms (protocols of treatment and post surgical resocialization).

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.

The perioperative management of a deeply comatose patient (Glasgow Coma Score, GCS 5) following a spontaneous subarachnoid hemorrhage is presented. Six intracranial aneurysms of the anterior circulation were discovered at operation, contrary to angiographic findings. These were successfully clipped by the author (KD). Postoperatively, the patient's cerebral energy metabolism was monitored by bedside cerebral microdialysis in real time. The ICP (volume)-targeted therapy (Lund concept) was utilised in accordance with findings of intrinsic brain biochemistry. Three-month follow-up showed excellent outcome (Glasgow Outcome Score, GOS 5).

UNLABELLED Post surgical and posttraumatic defects of head and neck, until couple of years ago, was treated with the surgical procedures which did not produced satisfactory results in terms of reconstruction of lost function and esthetic appearance. Only during last couple of years these defects are treated with the more aggressive methods than before. Esthetic appearance, functions of speech and swallowing became important features in the post surgical evaluation of the reconstruction value. PATIENTS AND METHODOLOGY This research involved 40 patients with head and neck defects in the time period from 1998 until 2000, surgically treated at the "Department for maxilla and facial surgery of the Cantonal Hospital in Zenica". In all cases there was a significant deficit in speech and swallowing functions, with anatomic deformations, which were solved using the four groups of slices: local, free transplants, bounded and free (micro vascular) composites. RESULTS Results indicated on significant difference of the post surgical functional results between simple procedures (smaller defects) and the complex surgeries. In that sense there was advantage of bounded or free composites, while in treatment of esthetic part situation was different, sometimes the slice of choice was the local slice of skin. CONCLUSION Finally we reach the conclusion that the best results are sometimes produced with the simplest surgical procedures. With the complex surgeries (free tissue composites) we can restore function and esthetic appearance within single procedure, but their lacks are once again in the complexity of the surgical procedure and its duration.

Introduction: Digital intravenous angiography techniques in experimental medicine have importance from aspect of their availability, simplicity and small cost. Compared to Color Doppler, distraction technique of angiography gives the same or even more accurate results, while the classic digital technique is with somewhat rougher image, but much cheaper and simpler in work on experimental animal with larger bio mass (dog). In this research with digital technique of classic intravenous angiography we marked the vein by-pass, in modified infrahioid lobe dissected from the dog. Sample and methodology: With intravenous angiography we marked the horizontally placed vein by-pass at the level of thong bone on ten dogs which, by performing the vein drainage of the lobe, take the blood into the contra lateral jugular flow. Comparison of the results obtained with this technique and Color Doppler analysis was performed. Results: Results of intravenous angiography (digital technique) on machine Siregraph made by „Siemens“ were satisfactory in this experiment in marking wanted blood vessel, while the results of Color Doppler probe of the machine GE Vivid 3 frequency from 5 to 12 MHz were somewhat closer to the results of PH analysis which we considered to be the most objective. Conclusion: Digital technique of intravenous angiography is quite objective in experimental medicine and as such, and much cheaper than other diagnostic procedures, can be easy accessible and useful in work on animals with larger bio mass (dog).

INTRODUCTION This is excellent technique for orbital cavity reconstruction. The pericranial flap and flap of superficial temporoparietal fascia are supplied by superficial temporal artery and vein. These flaps are used as skin carrier without hairs of retroauricular area that can be moved to area of eye socket. PATIENT AND METHODS In twenty patients the temporoparietal peduncular fascial flap (TPFF) for reconstruction of orbital bone defects regardless of etiology. The soft structures and periorbital bones were reconstructed. RESULTS The reconstruction gave good esthetic and functional results in all patients that were followed in next six months. In six patients the bottom of eye socket is reconstructed and prepared for eye prosthesis. The occlusion of eye socket is done in ten patients after eye removal. In four patients bone defect were reconstructed with vascular pericranial peduncular flap of parietal bone.

UNLABELLED Surgical procedure of transfacial translocation is one of procedures that ensure the best approach and visualization of the whole medial and lateral region of the middle third of the face, base of calvaria and rhinopharynx, sphenoid sinus, pterygomaxillary fossa, odontoid process and clivus. PATIENT AND METHODS In ten patients using transfacial approach, the tumors of base of calvaria and subbasal space were removed. There were six planocellular carcinomas, two transitional carcinomas and two tumors with endocranial origin. We analyzed following parameters; the location of tumor, used surgical procedures, results and complications. RESULTS This approach allowed resection of bone part of base of calvaria and subbasal space in middle and lower third of skull. The bone defect was replaced by iliac and parietal bone grafts. There were no cases of graft rejection. In three patient bones defect was repaired with titanium mesh covered by pericranial flap. In one patient necrosis of nasal bone occurred and defect was repaired with titanium mesh. There was no dehiscence of wound either on skin or oral mucosa. Three to five months after operation there were no facial esthetic problems. Functional disturbances were found in two patients with infraorbital hypoaesthesia at the side where flap was rotated. CONCLUSION Middle face translocation technique ensure good surgical approach to base of skull and subbasal space with good visualization and comfort with good outcome for patient.

The complex craniofacial surgery of solitary bone plasmacytoma (SBP) of the skull base with excellent postoperative outcome was presented. This surgical management was result of the team approach and strategy of neurosurgeon (KD) and maxillofacial surgeon (TM). SBP of the skull base is very rare condition which should be treated by radical microsurgical resection and postoperative radiotherapy.

Education is a process of accepting knowledge and skills or manners modification throught training. One of the most important characteristics in surgery education are classical education program through adequate literature and observation in operation room. Lip and palate clefts are relative rare diseases and classical knowledge acquirement of surgery methods in this field is sometimes defficient. Progress in computer technologies have potential and capacity to improve continuate and self-education training. We used this advancement in additional education in field of lip and palate clefts surgery, thanks to our partnership relations with Smile Train International Organisation. Accent of our cooperation was put in straight of new technology of virtual surgery--The Smile Train Virtual Surgery Videos.