Reconstruction of extensive defects from posterior en bloc resection of sacral tumors with human acellular dermal matrix and gluteus maximus myocutaneous flaps.

Background: Performing a sacrectomy from an exclusively posterior approach allows the en bloc resection of tumors without the morbidity of a laparotomy. However, reconstruction of the resultant extensive soft-tissue defects is challenging because a vertical rectus abdominis myocutaneous flap is not harvested.

Objective: To report the largest series (with the longest follow-up) of sacral reconstructions using a combination of human acellular dermal matrix (HADM) and gluteus maximus myocutaneous flaps.

Sublabial approach for the treatment of symptomatic basilar impression in a patient with Klippel-Feil syndrome.

Background: Basilar impression (BI) is an uncommon condition in which there is upward displacement of the elements forming the foramen magnum, causing translocation of vertebral elements into the brainstem. Most commonly a developmental anomaly, BI is often associated with congenital conditions such as Down syndrome. Symptomatic BI is often difficult to treat surgically secondary to the anatomic variants associated with many of the coinciding congenital syndromes.

Definitive treatment of persistent frontal sinus infections: elimination of dead space and sinonasal communication.

Background: Frontal sinus injury involving nasofrontal outflow tract obstruction is routinely managed by obliteration or cranialization; however, a small percentage of patients develop persistent indolent infections despite routine measures. The authors discuss the course of persistent infection following frontal sinus fractures and propose a novel treatment that definitively obliterates and separates the nasofrontal outflow tract from the cranium in these patients.

Methods: Seven consecutive patients with persistent indolent infections associated with frontal sinus fractures were identified and treated at the R Adams Cowley Shock Trauma Center and The Johns Hopkins Hospital from 2005 to 2008.

Twenty-six-year experience treating frontal sinus fractures: a novel algorithm based on anatomical fracture pattern and failure of conventional techniques.

Background: Frontal sinus fracture treatment strategies lack statistical power. The authors propose statistically valid treatment protocols for frontal sinus fracture based on injury pattern, nasofrontal outflow tract injury, and complication(s).

Methods: An institutional review board-approved retrospective review was conducted on frontal sinus fracture patients from 1979 to 2005.

Comparison of tensile strength of resorbable plating systems used in monocortical mandible angle osteotomy repair.

Objective: To determine the usefulness of resorbable plating systems in load-bearing applications of the mandible and the location of critical failure.

Methods: An osteotomy was created in 24 fresh cadaveric mandibles at the angle and fixated by the Champy technique with similar resorbable craniofacial plating systems from 4 manufacturers. Each mandible was held rigid as a material test system applied a downward force anteriorly.