Surgical rescue of recurrent carcinoma of the nasal columella.

Background: Tumors involving the nasal columella have been noted for their aggressive behavior. Columellar malignancies exhibit perhaps the highest incidence of recurrence and metastasis of all nasal and midfacial cancers of cutaneous origin. Periosteal invasion of maxillary bone and nasal floor may occur "barrier free.

A-O reconstruction plate and sternal osteomyocutaneous flap in primary mandibular reconstruction.

Mandibular arch reconstruction remains a functional and aesthetic challenge for the head and neck surgeon. The recent popularity of vascularized free composite flaps has made them a first choice for many surgeons. However, the increased operating time, high failure rate, frequent need for operative rescue, specialized postoperative care and facilities, and specialized training required to perform them have prompted many extirpative surgeons to attempt other techniques or to leave the mandible unreconstructed.

Metastatic disease to the mandible.

Metastatic lesions to the mandible are rare, comprising less than 1% of all malignancies. Twenty-two cases of metastatic disease to the mandible were seen from 1938 to 1985. The records of 17 cases were available for detailed review.

Delayed failure of myocutaneous flaps in head and neck reconstruction.

Since the concept of myocutaneous flap reconstruction of the head and neck region was introduced it has opened a new approach to surgical management in this area. This flap not only reduced the number of operations as compared to "staged procedure", but also reduced the costs of medical care. We are, however, experiencing significant failures as the applications of this flap are extended.

Effect of intranasal cocaine on experimental pain in man.

Sixteen healthy male volunteers had 30 mg of cocaine HCI solution or normal saline placebo impregnated in cotton-covered applicators administered intranasally on different days in a double-blind procedure. Ischemic tourniquet pain was significantly less after cocaine than it was in pretreatment control. It was also significantly less than after administration of a placebo.