Use of ITAP implants for prosthetic reconstruction of extra-oral craniofacial defects.

We report the outcomes of a single-stage, surface-mounted implant used as a bone-anchor for prosthetic reconstruction of complex facial defects. The implant used differs from other designs of osseointegrated bone-anchor because it was designed to be implanted in one-stage with the added intention of integrating with the adjacent soft-tissue. Our aim was to extend the principles underlying the intraosseous transcutaneous amputation prosthesis (ITAP) into the design of infection-free implants suitable for direct skeletal attachment of a prosthesis to the craniofacial skeleton.

Management of isolated sagittal synostosis in the absence of scaphocephaly: a series of eight cases.

Background: The diagnosis of isolated sagittal synostosis is usually made at birth, with a boat-shaped deformity of the skull (scaphocephaly). The Oxford Craniofacial Unit has successfully managed eight cases of isolated sagittal synostosis without scaphocephaly. To the authors' knowledge, there have been no reports of this in the literature.

The increase of metopic synostosis: a pan-European observation.

Metopic synostosis is thought to have an incidence of about 1 in 15,000 births. Traditionally, this makes it the third most frequent single-suture craniosynostosis, after scaphocephaly (1 in 4200-8500) and plagiocephaly (1 in 11,000). Our units have, independently from each other, noted a marked increase in the number of metopic synostosis over the recent years.

A 10-year review of benign and malignant peripheral nerve sheath tumors in a single center: clinical and radiographic features can help to differentiate benign from malignant lesions.

Background: Malignant peripheral nerve sheath tumors are rare, and their aggressive nature mandates treatment in specialist centers. In contrast, benign peripheral nerve sheath tumors are common and are treated by a variety of specialist surgeons, including plastic surgeons. The authors aimed to detect features in the clinical presentation of peripheral nerve sheath tumors that point toward a diagnosis of malignant peripheral nerve sheath tumor and therefore prompt referral to a specialist center.

Acute transection of the left internal mammary artery remote from the anastomosis following coronary artery bypass surgery.

We report a case of spontaneous transection of the left internal mammary artery 4h after a patient underwent coronary artery bypass surgery. This complication has been reported in two patients following minimal access coronary artery bypass grafting, but to our knowledge, this is the first case of transection of the left internal mammary artery, following conventional myocardial revascularization via median sternotomy. Possible mechanisms leading to this rare, but potentially life-threatening complication are also discussed.

A paramedian cleft of the lower lip.

We report the unusual case of a baby with a paramedian cleft of the lower lip. In 1976, Tessier described a classification of craniofacial clefts based on personal observations, and he predicted the possibility of further clefts being discovered by labeling midline mandibular clefts "30." This case of a paramedian cleft of the lower lip would fit into what could be a new Tessier 28/29 cleft.

Bullous pemphigoid mistaken for a burn.

Burns in the elderly are extremely common. Often, the history is obscure or nonexistent because of confusion or dementia. We describe the case of a 78-year-old woman who was admitted to a burns center with the history of a 21% scald burn.