Steven A. Guttenberg

Costochondral grafting in condylar replacement and mandibular reconstruction

Thirty costochondral grafts in 22 patients were retrospectively studied with a mean follow-up of five (range, 2 to 11) years. The functional results, esthetics, and incidence of complications in these patients were determined. A discussion of these findings as well as the surgical technique is included. The results confirm previous studies and indicate that free costochondral grafting is a successful and physiologically sound method for reconstruction of portions of the mandible and its temporal articulation.

Microsporidiosis of the mandible in a patient with acquired immunodeficiency syndrome

Patients afflicted with acquired immune deficiency syndrome (AIDS) often present with gastrointestinal involvement and refractory diarrhea accompanied by progressive weight loss. Among the many causes, microsporidia has been increasingly identified as one of the responsible organisms.’ In patients with AIDS, microsporidia has been responsible for up to 50% of cases of unexplained chronic diarrhea.’ Microsporidia are obligate, intracellular, spore-forming, protozoa1 parasites. They are ubiquitous, and their host range is widespread, including all classes of vertebrates and most invertebrates.3 The term microsporidia is a nontaxonomic designation used to describe organisms belonging to the order Microsporidia of the phylum Microspora. More than 100 genera and nearly 1,000 species are contained in this phylum.3 Of these genera, five have been implicated in human infections, including Encephalitozoon, Enterocytozoon, Nosema, Pleistophora, and Septata.4 Intestinal microsporidiosis was first reported in a patient with AIDS in 1985. Since then, over 400 cases in human immunodeficiency virus (HIV)-infected patients and 10 cases in non-HIV-infected patients have been documented.3X5 Multiple organ systems have been targeted, including the small intestine, conjunctiva, cornea, and sinonasal tissues.4 However, the spectrum of infection appears to be broadening and now includes bronchiolitis, nephritis, ureteritis, myositis, cystitis, hepatitis, and peritonitis.5’6 Skeletal involvement has remained virtually unreported, with only one case of a patient with fibrotic,

Cranial arteritis mimicking odontogenic pain: report of case

A 65-year-old patient treated for pain of apparent odontogenic origin did not respond to appropriate dental treatment. While the signs and symptoms mimicked a dental problem, further diagnostic evaluation determined the culprit--cranial arteritis. Proper treatment immediately after diagnosis is advised as the complications of cranial arteritis can include the rapid onset of blindness.

Benign mesenchymoma of the palate: report of a case.

A case of benign mesenchymoma of the hard palate is presented. The lesion was completely excised and the tumor margins were shown to be free of disease. Within 4 months a second noncontiguous lesion arose of the opposite side of the palate and was also removed. Whether this represented a distinctly new lesion or possibly one which was seeded through previous diagnostic efforts was difficult to ascertain. Follow-up for more than 2 years has not revealed any further evidence of neoplasia.