Malignant melanoma presenting as amelanotic caruncular lesion in a child.

Conjunctival melanoma is a rare malignant neoplasm that can present in childhood in any part of the conjunctiva. The infrequency with which conjunctival melanoma is encountered in childhood caruncular lesions makes it a formidable but important aspect of the differential diagnosis. We report the case of a 10-year-old boy who presented with a left caruncular lesion.

5-Level spondylectomy for en bloc resection of thoracic chordoma: case report.

Background And Importance: Primary tumors of the spine are considered for en bloc resection to improve local control and even obtain cure. Anatomic restrictions often prohibit extensive resections with negative margins that are safe and feasible. We report the first case involving a patient with a large chordoma of the thoracic spine who underwent a successful 5-level spondylectomy with bilateral chest wall resection for en bloc resection without neurologic compromise.

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.

A comparison of combinations of titanium and resorbable plating systems for repair of isolated zygomatic fractures in the adult: a quantitative biomechanical study.

Multiple studies have sought to determine the postreduction stability of internal fixation in zygomaticomaxillary complex (ZMC) fractures. Three-point fixation with titanium miniplates is increasingly recommended to repair these injuries. Use of bioresorbable plates has been suggested to eliminate potential postoperative hardware complications.

Canal wall reconstruction with Mimix hydroxyapatite cement: results in an animal model and case study.

Objective/hypothesis: To assess Mimix hydroxyapatite cement for its applicability in canal wall reconstruction using the gerbil as a canal wall model. A case is presented to illustrate a novel technique of canal wall reconstruction using Mimix on the basis of the findings of our animal research.

Study Design: This was a preclinical study.