What is the proper role of oral antibiotics in the treatment of patients with chronic sinusitis?

Purpose Of Review: Chronic rhinosinusitis is a common illness for which systemic antibiotics are frequently prescribed, although high-level evidence for this practice is largely lacking. We review the available literature addressing the proper role of oral antibiotics in the treatment of chronic rhinosinusitis.

Recent Findings: Chronic rhinosinusitis is an incompletely understood disease process for which the role of antibiotics remains difficult to define despite its historical prominence.

Paranasal sinus exostoses: possible correlation with cold temperature nasal irrigation after endoscopic sinus surgery.

Exostoses of the external auditory canal (EEAC) are a commonly encountered clinical exam finding; however, exostoses in other locations are vanishingly rare. The postoperative paranasal sinuses are penetrated with cold water solutions, the reputed etiological agent for EEAC, and development of exostoses in this unexpected location may be observed endoscopically. The surprising appearance of these protuberant lesions within the sinuses could be mistaken for more ominous processes, subjecting the patient to biopsy, surgery, or unnecessary medical therapy.

Angiomatosis of the paranasal sinuses.

Angiomatosis is a rare benign lesion of the head and neck that can be mistaken for either a vascular malformation or malignant disease as a result of its infiltrative nature. The recurrence rate of angiomatosis requiring surgery is reported to be >90%, and as such the otolaryngologist treating this condition should endeavor to remove all disease during the first operation while maintaining a high level of suspicion for recurrence during postoperative surveillance. This case represents the first report of angiomatosis involving the nose and/or paranasal sinuses, and extends the differential diagnosis of sinonasal tumors, of which the otolaryngologist must be aware.

The spectrum of isolated congenital nasal deformities resembling the cleft lip nasal morphology.

Objective: To define the intrinsic (hypoplasia) and extrinsic (deformational) contributions to congenital nasal deformities and the potential of a carrier state for orofacial clefting.

Methods: Retrospective case series.

Results: The factors affecting 4 congenital nasal deformities are postulated after contrasting the patient's characteristics.

Analysis of flap tension in surgical rejuvenation of the midface: a cadaver study.

Objective: To determine the flap tension present for 2 different surgical approaches for midface lifts and whether a gingivobuccal incision for release of the midface periosteum will diminish the resultant load on the midface flap.

Study Design: Cadaver study.

Setting: Anatomy laboratory at the University of Florida.

The efficacy of rhinoplasty alone in facial rejuvenation.

Purpose: The aim of the study was to demonstrate whether rhinoplasty alone is a rejuvenating procedure for the aging face.

Materials And Methods: Photographs of the right profile of 48 white females older than 55 years were recorded using standardized techniques. Each of the subjects' noses underwent computer-simulated rhinoplasty to conform to aesthetic canons of the ideal nose.

Temporalis muscle flap for reconstruction of skull base defects.

Background: The temporalis muscle flap (TMF) is a valuable reconstructive technique utilized in a variety of challenging defects. However, its use for repair of skull base defects is less commonly reported.

Methods: A retrospective chart review was conducted for 35 patients who underwent reconstruction of skull base defects between March 1999 and July 2006 at a tertiary referral hospital.

Comparison of closed reduction alone versus primary open repair of acute nasoseptal fractures.

Objective: Nasoseptal injuries have traditionally been treated via closed reduction. Historically, the high incidence of postreduction deformities has led some surgeons to consider alternative approaches to obtain superior results. Here we compare simple closed reduction versus primary open repair of the nasoseptal fracture.

The secondary correction of post-traumatic craniofacial deformities.

Objective: To analyze the aesthetic and functional outcomes in a large series of patients who underwent secondary correction of post-traumatic craniofacial deformities (PTCD) and to highlight the underlying principles and formulate treatment guidelines.

Methods: A single surgeon's retrospective case series of 57 patients who underwent correction of PTCD.

Outcome Measures: Evaluation by multiple surgeons who assessed aesthetic results and functional parameters after secondary correction of PTCD.

Objective assessment of the accuracy of computer-simulated imaging in rhinoplasty.

Objective: The objective of the study was to evaluate the accuracy by which computer-simulated rhinoplasty images reflect surgical results in 6-month postoperative photographs.

Methods: We performed a retrospective, objective evaluation of 5 features of the facial profile in the computer-simulated images and in the 6-month postoperative photographs of 36 rhinoplasty patients. Data recorded for the nasolabial angle, nasofrontal angle, columella tip angle, columella/infratip lobule ratio, and an established method of assessing tip projection were subjected to statistical analysis by 2-tailed t test and analysis of variance testing.

Botulinum neurotoxins: fundamentals for the facial plastic surgeon.

The most commonly performed nonsurgical cosmetic procedure in the facial plastic surgery armamentarium involves the various commercial preparations of botulinum neurotoxins. These drugs have undergone a transformation from public health scourge to near ubiquitous therapeutic modality across the entire medical spectrum. Herein, the history of botulinum neurotoxins is reviewed, including an exploration of their pharmacology, neuromuscular junction physiology, a description of the commercially available preparations, and the recent research concerning the practicalities of their clinical use.

Integrity of craniofacial plating systems after multiple sterilization procedures.

Purpose: To determine the effect of multiple autoclave sterilization cycles on the integrity of titanium plates and screws used in craniofacial reconstruction.

Materials And Methods: Torque to fracture was evaluated for 36 titanium 6AL-4V (Ti 6/4) screws divided evenly into 3 groups and tested as machined (control), after 10 cycles of autoclaving or after 50 cycles of autoclaving. Sterilization was carried out by autoclaving for 15 minutes followed by 8 minutes of drying at 270 degrees to 272 degrees F.

Liposarcoma of the tongue: case report and review of the literature.

Liposarcoma is the most common soft-tissue malignancy in adults, but the appearance of a liposarcoma in the head and neck region is distinctly unusual. Intraoral liposarcomas represent a particularly interesting subset of this tumor in that (1) they are exceedingly rare and (2) affected patients tend to have a better prognosis than do patients with a similar lesion located elsewhere in the head and neck. An understanding of the histologic subtypes and corresponding clinical behavior of liposarcomas will assist physicians in appropriately managing these patients.

Asymmetric sensorineural hearing loss evaluation with T2 FSE-MRI in a public hospital.

Conclusions: T2-weighted fast-spin echo magnetic resonance imaging (MRI) can be an economically beneficial protocol for screening patients with asymmetric sensorineural hearing loss without other neurologic findings in a public hospital population.

Objective: The goal of this study was to determine if fast spin echo T2 MRI is similar to gadolinium-enhanced MRI in evaluating asymmetric sensorineural hearing loss in a county hospital population.

Patients And Methods: This was a retrospective chart review of all outpatients seen at a public hospital, comprising patients with no other cranial nerve findings who underwent gadolinium-enhanced MRI of the internal auditory canal and brain between January 2002 and September 2003.

Rhinoplasty in male patients.

The complexities of rhinoplasty are further emphasized when this operation is undertaken in the male patient, and a growing percentage of the rhinoplasty population comprises men. We review the senior author's approach to rhinoplasty analysis, preoperative consultation, and surgical techniques that have been successfully employed for over 40 years. Specific recommendations and modifications to these techniques are discussed as they relate to the rhinoplasty operation in male patients.

Minimally invasive transoral catheter-assisted drainage of a danger-space infection.

We report the case of a 3-year-old boy who was brought to the emergency department for evaluation of a prolonged upper respiratory infection and diminished neck movement. Computed tomography identified a unilocular abscess extending from the level of C2 inferiorly to the diaphragm at the level of the T9 vertebral body. We successfully treated this transcervical, transthoracic infection surgically via a transoral approach to the retropharyngeal abscess combined with catheter drainage and irrigation of the abscess cavity at a depth of 13 cm.

Kaposiform hemangioendothelioma: case report and literature review.

We report the identification of a kaposiform hemangioendothelioma (KH) in the oropharynx of a 3-year-old boy. This is a rare endothelial-derived spindle cell neoplasm affecting children and early adolescents with features common to capillary hemangioma and Kaposi sarcoma. Nine cases of head and neck KH have been reported, this being the first in the otolaryngology literature.

Fungal rhinosinusitis: state-of-the-art diagnosis and treatment.

The past 30 years has been witness to a period of tremendous growth and innovation within the field of rhinology, facilitating a better understanding and improved management techniques for a variety of local and systemic conditions manifesting within the nose and paranasal sinuses. Of these disease states, the spectrum of conditions considered under the rubric of fungal rhinosinusitis best exemplifies modern rhinology's position as a truly multidisciplinary specialty. We review the classification of the various forms of fungal rhinosinusitis and their clinical presentations, radiologic findings, and treatment options.

Metastatic breast cancer of the oral cavity.

Objective: To present a rare case of breast carcinoma initially presenting as an oral cavity mass.

Study Design: Case report with review of the literature.

Results: A case is presented of a postmenopausal woman with a remote history of treated breast carcinoma who was declared disease-free 2 years before presentation.