Mönckeberg's arteriosclerosis: vascular calcification complicating microvascular surgery.

Mönckeberg's arteriosclerosis is often an incidental finding, identified either clinically or on plain radiography. It can occasionally be associated with diabetes mellitus or chronic kidney disease. It differs from the more common atherosclerosis in that the tunica intima remains largely unaffected and the diameter of the vessel lumen is preserved.

Intra-operative internal jugular vein thrombosis complicating microvascular free flap transfer.

Internal jugular vein thrombosis is rare. It is often secondary to prolonged central venous cannulation and associated with local or distant malignancy. The authors present a case of intra-operative thrombosis of the internal jugular vein which complicated subsequent microvascular anastomosis of a radial forearm free flap.

Infection of surgical wounds in the maxillofacial region and free flap donor sites with methicillin-resistant Staphylococcus aureus.

We studied the acquisition of methicillin-resistant Staphylococcus aureus (MRSA) in two groups of patients who had free flap reconstructions of defects after excision of lesions in the head and neck. The first group (n=31) was given a 5-day perioperative course of antibiotic prophylaxis (long-term) and the second (n=33) a 24-h course (short-term). MRSA was the main infecting organism.

Involvement of the jaw bones in systemic mastocytosis.

Systemic mastocytosis is characterised by proliferation of mast cells and infiltration of organs. Severe bony pain may result from release of chemical mediators from mast cells and affected patients are at an increased risk of anaphylaxis. Traditional analgesics such as non-steroidal anti-inflammatory agents and opioids are contraindicated.

Fine needle aspiration cytology in the management of a parotid mass: a two centre retrospective study.

Objectives: There is a diversity of opinion regarding the role of fine needle aspiration cytology (FNAC) in the pre-operative evaluation of the parotid mass. This study further investigates the role of FNAC from the standpoint of the clinician attempting to resolve one or more clinical issues.

Methods: A retrospective study conducted at two UK Hospitals with no overlap of cytopathologists or surgeons.

Traumatic isolated unilateral hypoglossal nerve palsy--case report and review of the literature.

Isolated unilateral hypoglossal nerve palsy may be caused by fracture through the occipital condyle. This is a rare but previously documented event, and can easily go undetected at time of injury, both clinically and radiographically. In addition, there is a potential for late presentation of the palsy.

Cutaneous leishmaniasis. An unusual cause of facial swelling.

Tropical disease may not figure highly in the differential diagnosis of a facial swelling in the United Kingdom but should be considered in those who have been in a tropical area. This case history documents details of the presentation and investigation of a case of leishmaniasis that appeared as a facial swelling in a 4-year-old boy who had recently returned from the Middle East.

Complications of tracheostomy in major head and neck cancer surgery; a retrospective study of 60 consecutive cases.

Employment of tracheostomy in head and neck cancer surgery remains controversial. This study details those cases in which the life-saving potential of tracheostomy placement was considered to outweigh the observed disadvantages. Sixty consecutive cases of tracheostomy in head and neck cancer patients were assessed and revealed a relatively low complication rate (11% of cases).