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.

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.

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.

Metastatic head and neck carcinoma to a percutaneous endoscopic gastrostomy site.

Background: Percutaneous endoscopic gastrostomy (PEG) tube placement is a safe and widely accepted alternate route for enteral alimentation in the head and neck cancer patient population. Cancer metastatic to a PEG tube exit site is a rare but serious complication of this procedure. We sought to determine the route of spread responsible for PEG site metastases such that we may prevent further occurrences of this highly morbid condition.

T-cell prolymphocytic leukemia presenting as an ear canal mass.

Objective: We discuss the first reported case of a chronic leukemia involving the external auditory canal.

Study Design: Case report and review of the literature (Medline, 1962-2003).

Methods And Results: An adult man in good health came to receive medical attention because of a sensation of aural fullness.

Spontaneous cervical haematoma resulting from intrathoracic pathology.

Spontaneous cervical haematomas are rare occurrences for which a wide variety of aetiologies have been reported. Although the pathogenesis of this condition can be quite diverse, all known cases have emanated from a cervical source. The authors report the first case of a spontaneous cervical haematoma arising from an intrathoracic source.