An unusual complication of the treatment of a hemangioma.

A 3-month-old infant was administered high-dose systemic prednisolone for management of a hemangioma of the nasal sidewall. After 10 weeks of therapy, medical evaluation of weight loss disclosed hypertrophic obstructive cardiomyopathy. After discontinuation of the steroid, the cardiomyopathy resolved.

Cranial vault expansion: a comparison of magnetic coupled distraction to traditional surgical repositioning.

We compared the effectiveness of transcutaneously activated magnetic distraction of an osteotomized cranial bone flap to surgical repositioning of the flap with immediate, rigid internal fixation. Thirty immature rabbits were studied. All 30 rabbits underwent complete circumferential osteotomies of both parietal bones and postoperatively all were fitted with head frames.

Acquisition of surgical skills: a randomized trial of didactic, videotape, and computer-based training.

Background: Although computer-based training (CBT) can enhance didactic instruction, few studies have assessed the efficacy of CBT for basic surgical skills training. This study compares CBT with traditional methods of basic surgical skills training.

Methods: Sixty-nine naive medical students were randomized into 3 treatment groups for basic surgical skills instruction: didactic, videotape, or CBT.

Cranial vault expansion using transcutaneously activated magnetic implants.

The technique of distraction osteogenesis has not been widely used in the treatment of problems of the head and face because of the need for external fixators. By using magnetic, rather than mechanical, forces to drive bone movement we hope to expand the applications of the technique to include the treatment of cranial vault deformities. Thirty immature rabbits were studied.

Mandibulomaxillary fixation with bone anchors and quick-release ligatures.

Mandibulomaxillary fixation (MMF) is an essential technique for accurate treatment of maxillary and mandibular fractures. Traditional techniques of obtaining MMF (circumdental wires and load-distributing arch bars with or without plastic splints) often work poorly in children and adults with partial or absent dentition, require significant operative time, are at risk for glove puncture, and are painful to patients at time of removal. We have developed two new techniques for the rapid establishment of MMF in all ages and all types of dentition with or without splints.

Growing skull fractures: strategies for repair and reconstruction.

Most skull fractures in growing children heal rapidly and without significant contour irregularity. Skull fractures in infants associated with dural injuries, however, may progressively enlarge as a result of bone erosion by leptomeningeal herniation at the dural tear sites and are known as "growing skull fractures." Over a 6-year period, seven growing skull fractures occurred in a population of 592 consecutive pediatric head injuries at Cardinal Glennon Children's Hospital (prevalence, 1.

Cranial vault moulding by the transcutaneous activation of implanted magnets.

The technique of distraction osteogenesis has not been widely used in the treatment of injuries of the head and face because of the need for external fixators. By using magnetic, rather than mechanical, forces to drive bone movement we hope to expand the applications of the technique to include the treatment of cranial vault deformities. Fifteen immature rabbits were studied.

Computer-based multimedia in plastic surgery education.

Computer animation complements text explanation, image documentation, and graphic analysis techniques. It is compatible with the development of interactive multimedia science. Computer animation may emerge as a critical tool to assist in the efficient processing and analysis of greater volumes of educational data in plastic surgery training.

Management of locally aggressive sinus disease using craniofacial exposure and the galeal frontalis fascia-muscle flap.

Histologically, benign sinus diseases can behave aggressively, potentially causing sight- and life-threatening conditions requiring surgical treatment. Four patients illustrating acute and chronic infection, single and multiple sinus polyposis, and mucoceles are presented and discussed to illustrate how the principles of craniofacial exposure, resection, and reconstruction may be employed to treat aggressive sinus disease. The bicoronal and buccal sulcus approaches minimize visible scarring; wide exposure of the orbital contents and dura reduce the risk of excessive bleeding, neurologic complications, and orbital volume derangements.

Computer-based multimedia in plastic surgery education.

Rapid developments in communications networks (cellular telephone, direct-link satellite, and international high-speed computer nets) and the continued success of affordable powerful personal computers (desktop, laptop and soon "palmtop" devices) have set the stage for educational materials accessible by electronic means. Computer-based multimedia are sophisticated audiovisual teaching materials built from digitized illustrations, photographs, audio and video recordings viewed by display on a computer screen. The computer interface allows interactive access to information, and connectivity to other sources of information.

Three-dimensional surface reconstructions using a general purpose image processing system.

A general purpose two-dimensional (2-D) image processing software system was used to produce high quality three-dimensional (3-D) surface reconstructions from serial sections such as CT scan slices. Depth-encoded 3-D surface images, gradient-shaded 3-D surface images, and weighted sums of these two images were computed. Images that simulate transmission radiographs ("volumetric" views) were created from the same slice data.

Internal fixation of malar fractures: an experimental biophysical study.

Open reduction and internal fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial disfigurement. Interosseous wires, Kirschner wires, and more recently, rigid metallic miniplates have been recommended for fixation of these and other midfacial fractures. However, the precise physical stability of the zygoma with respect to wire versus miniplate fixation methods and with respect to the number and location of miniplates applied is not known.

Management of synovial sarcoma of the median nerve at the elbow.

Synovial sarcoma is a high-grade malignancy with a marked propensity for local recurrence and a moderate rate of regional lymph node involvement. It usually causes death from massive pulmonary metastases. Despite its aggressive biologic behavior, en bloc wide local resection of small extremity tumors rather than amputation may be indicated if removal of all gross disease is possible.