Steven Kaltman

The use of corticosteroids and nonsteroidal antiinflammatory medication for the management of pain and inflammation after third molar surgery: A review of the literature

The use of medication to relieve pain and inflammation after removal of third molars has been explored thoroughly in the literature. Narcotic analgesics, nonsteroidal antiinflammatory drugs (NSAIDs), corticosteroids, and combinations of these all have a role in the postoperative management of pain and swelling within this group of patients. This article addresses the use of NSAIDs and corticosteroids after third molar surgery, along with a review of the literature, which is incorporated to provide practitioners helpful, quick, and reliable information regarding patients undergoing third molar surgery.

Craniofacial trauma and cerebrospinal fluid leakage: A retrospective clinical study

PURPOSE The study examines the efficacy of antibiotic treatment in patients with traumatic cerebrospinal fluid (CSF) leakage and identifies a consistent clinical approach for better management of these patients. PATIENTS AND METHODS A retrospective study of traumatic CSF leakage in 88 patients with craniofacial fractures was performed. The mechanism of injury, etiology and source of leakage, decision to treat conservatively (without surgery) versus aggressively (with surgery), decision to use early versus late repair, and decision to provide prophylactic antibiotic coverage were recorded. Both timing of repair and the decision to use antibiotics were compared with the incidence of meningitis resulting from CSF leakage. RESULTS Of 48 patients treated with antibiotics, 5(10.4%) developed meningitis. In the remaining 40 who were not treated with antibiotics, only one patient acquired meningitis. Five of 53 (9.4%) patients with conservative treatment developed meningitis versus 1 of 35 (2.9%) after aggressive treatment. CONCLUSION There was no statistically significant difference in the rate of occurrence of meningitis between the conservative and the aggressive treatment group. However, the data suggest that there may be no benefit in treating these patients with antibiotics to prevent meningitis, whereas aggressive treatment and early repair of facial fractures may, in fact, be helpful.

Vascular malformation: Report of a case with eight-year follow up

An interesting example of a vascular malformation of the mandible has been presented. Early diagnosis made conservative treatment possible. Although the lesion was small, a considerable amount of hemorrhage was encountered during surgery. Adequate treatment was provided with ligation of external carotid arteries bilaterally in conjunction with curettage and packing. After an eight-year follow up, there has been no clinical or radiographic evidence of recurrence.

Virtual rounding via videoconference-enabled smartphones: a case for multifacility rounds

Telemedicine is defined as the use of medical information exchanged from one site to another via electronic communications to improve delivery of care. This improvement in delivery of care is evident by more-efficient consults, triaging, and real-time communication between patient and surgeon. Internet-capable smartphones are capable of transferring radiographs and other images. Aziz and Ziccardi in 2009 demonstrated using smartphones for downloading images from the hospital archiving system to the residents phone and then e-mailing or texting them to the attending for immediate review. Here we build on the work of Aziz and Ziccardi as we describe a novel use of smartphones for virtual rounding between residents and faculty based on improvements in technology, specifically video capability and increased accessibility of compatible devices.

Central Mucoepidermoid Carcinoma: A Rare Entity Analysis of Five Cases

Mucoepidermoid carcinoma (MC) is one of the most common salivary gland neoplasms. When it develops inside the bone, is called Central Mucoepidermoid Carcinoma.(CMC) MC is the most common malignant salivary gland tumor in children, and the most common central salivary gland neoplasm. Misdiagnosis of CMC occurs frequently, due to the rareness of the location for a salivary gland tumor and the clinical and radiographic manifestations, which are suggestive of an odontogenic lesion. It is often treated inappropriately or late, leaving undesired sequelae. We report four cases of CMC and analyze five, with different manifestations and diagnostic problems. The dental profession should be aware of the fact that this malignant tumor may mimic benign processes.

Managing the Untoward Anesthetic Event in an Oral and Maxillofacial Surgery Practice

The safe and efficient use of outpatient surgical anesthesia modalities is a significant part of the training and expertise of the oral and maxillofacial surgeon. Although adverse outcomes are rare, they can have considerable traumatic psychological and professional consequences for the surgeon involved. The goal of this article is to develop guidelines to educate the doctor, the second victim, on how to manage a bad outcome and how to navigate through a difficult and arduous process.