Oral and maxillofacial surgery has long needed a methodology for accurate definition of the third dimension. The introduction of computer-aided tomography in the 1970s provided surgeons with multiple 2-D maps which they themselves had to conceptualize into a third dimension. The later advent of computerized summation of these data made it possible to display a perspective view of the third dimension on a TV monitor. CT, and more recently MRI, with the further analytical refinement afforded by software processing (interactive data presentation, contour detection and summation, hypothetical 3-D construction and interactive visualization) now provide the basic information that is needed for the fabrication of an individual model. Such models can be milled from a variety of materials. More recently, laser-hardened acrylic resins have been shown to be a useful alternative. Both systems are described and their advantages and disadvantages in the planning and performance of oral and maxillofacial surgical procedures are discussed.

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The case of a 38 year-old-man with a mass at the S2 level similar to a benign nerve root tumor (neuroma) is reported. The CT scan examination revealed the mass close underneath but not in connection with a disc herniation at the L5/S1 level. During operation the mass was not encountered as tumor but as free sequestered disc herniation, which was confirmed by histological examination. The reasons for considering the mass a tumor are discussed.

Within the last 10 years, 102 cases of chronic pancreatitis have been observed, indicating that the incidence of chronic pancreatitis in Zurich is much higher than previously claimed. 84% of our patients are male with an average age of 43 years at onset. Pancreatic calcifications were demonstrated in 63%. Chronic alcoholism occurs in 62% of all patients. In our experience, ‘acute pancreatitis’ in chronic alcoholics is almost always the first manifestation of chronic relapsing pancreatitis, which is detected on the average 5 years after the first pain episode. Pancreatic exocrine insufficiency demonstrated by the CCK-secretin test was found in 99% of the patients tested, steatorrhea in 72%, and clinical or subclinical diabetes in 83%. 29 of the 102 patients died during the average follow-up time of 8.6 years. Death was due to complications of pancreatitis in about 30%. 35% of all patients were operated on for complications or for severe pain. But 36% of patients with chronic relapsing pancreatitis became painless spontaneously (‘secondary painless’ pancreatitis) after an average period of 6.6 years. In patients with ‘secondary painless’ pancreatitis, severe pancreatic insufficiency is predominantly present, indicating that chronic pancreatitis has the tendency to ‘burn out’ spontaneously.

The side effects associated with the use of Iopamidol for myelography were determined in 100 patients and compared with metrizamide in a double-blind study.