Faisal A. Quereshy

Early experience with biodegradable fixation for congenital pediatric craniofacial surgery

We describe early experience using a polymeric bioresorbable bone fixation system in a consecutive series of eight pediatric patients for the correction of craniofacial malformations. Indications for surgical treatment included craniosynostosis (7) and enceph-alocele (1). All patients underwent bifrontal craniotomies with cranial vault or orbital reconstruction or both. Segments were then stabilized using bioresorbable fixation systems. Patients were evaluated pre-and postoperatively clinically and with radiographs and photographs. Mean follow-up was 4.5 months, with a minimum follow-up of 3 months. In seven of eight patients, there was no incidence of infection, extrusion, exposure, erythema, instability of the advanced segments, relapse, hematoma, seroma formation, or adverse inflammatory reaction. One patient experienced difficulty with respect to system imperfections (i.e., drill holes after tapping were too large for screws). This study demonstrated the efficacy of bioresorbable plates and screws for the growing pediatric craniofacial patient; excellent short-term results were achieved. Prospective studies and longer longitudinal follow-up of larger numbers of patients are desirable to confirm these findings.

Report of a Case of Cervicothoracic Necrotizing Fasciitis Along With a Current Review of Reported Cases

p t p f t e ( e i w w j p d s r i o c T U s a f t ervical necrotizing fasciitis (CNF) is an infection that preads along the fascial planes causing subcutaneous issue death hallmarked by rapid progression and sysemic toxicity. The infection is relatively rare in the ead and neck compared with other reported areas of he body, including the extremities, abdominal fascia, nd perineum. Although the term CNF is somewhat oosely used as there are no definite criteria for diagosis, it is generally agreed upon that the presence of rapidly evolving polymicrobial infection in a suscepible host (ie, immunocompromised) with suspicious adiographic and clinical signs is a clear indication for mminent surgical intervention. On the other hand, a ubstantial number of cases present in the otherwise ealthy individual with equivocal radiographic signs. lso, a number of criteria used to characterize the more sual localized head and neck infection (eg, leukocytois, fever, signs of inflammation) tend to overlap with hat is found in CNF cases. Nevertheless, it is clear that nce the diagnosis is suspected, prompt surgical as well s medical intervention is warranted.

Single-stage implant surgery using a tissue punch

The goals of single stage surgery for anterior maxillary implant placement should be directed at minimizing disruption of the gingival architecture and creation of proper implant/gingival margins. The most prevalent surgical technique to achieve this goal uses vertical releasing incisions placed inside the papillae adjacent to the edentulous space. A full-thickness mucoperiosteal flap is then raised to expose the underlying bone. The purpose of this report is to present a new single-stage surgical technique that optimizes aesthetics and minimizes disruption of the soft tissues by not raising a mucoperiosteal flap.

Diamond fraise technique for dermal grafts in temporomandibular disk reconstruction.

Dermal grafts have been described for a variety of applications, including preprosthetic surgery, reconstructive surgery, and temporomandibular joint surgery. Several reports have described the procedural techniques for acquiring a dermal graft. The surgical technique for harvesting a dermal graft with the use of the dermabrading diamond fraise bur is described. The use of the diamond fraise bur offers many unique surgical advantages: it allows minimal damage to the dermal layer; the healing surface is smooth, cosmetic, homogenous, and devoid of scratches or debris; an adequate graft of uniform thickness is obtained; the technique allows access to a variety of donor sites; and minimal patient postoperative donor site morbidity. The use of this technique provides a simple, cosmetic approach to obtaining an adequate dermal graft for temporomandibular joint reconstructive procedures, while minimizing the potential complications associated with other commonly used techniques.

Infantile hemangioma of the accessory parotid gland.

Parotid gland tumors, especially those of the accessory parotid gland, are rare in infancy. Although infantile hemangiomas have been frequently reported as a cause of parotid gland tumors, their association with the accessory parotid gland has not been reported. This article describes the presentation of a hemangioma of the accessory parotid gland in an infant. Review of the literature and treatment methods are discussed.