ACR Appropriateness Criteria® Imaging of Facial Trauma Following Primary Survey.

Maxillofacial trauma patients comprise a significant subset of patients presenting to emergency departments. Before evaluating for facial trauma, an emergency or trauma physician must perform a primary survey to ensure patient stabilization. Following this primary survey, this document discusses the following clinical scenarios for facial trauma: tenderness to palpation or contusion or edema over frontal bone (suspected frontal bone injury); pain with upper jaw manipulation or pain overlying zygoma or zygomatic deformity or facial elongation or malocclusion or infraorbital nerve paresthesia (suspected midface injury); visible nasal deformity or palpable nasal deformity or tenderness to palpation of the nose or epistaxis (suspected nasal bone injury); and trismus or malocclusion or gingival hemorrhage or mucosal hemorrhage or loose teeth or fractured teeth or displaced teeth (suspected mandibular injury).

A Rare Case of Porocarcinoma and Trichoblastoma Arising in a Nevus Sebaceus of Jadassohn.

Nevus sebaceus of Jadassohn, or "organoid nevus," is a common, benign hamartoma of the skin consisting of epithelial and adnexal components. Its natural history and association with neoplastic growths is well documented. The majority of concomitant neoplasms are benign-trichoblastoma and syringocystadenoma papilliferum are most frequently discovered-but malignant tumors have been described.

Indications and Outcomes of Mohs Micrographic Surgery Using a Multidisciplinary Approach: A Decade of Experience.

Background: Traditional approaches of staged outpatient Mohs Micrographic Surgery (MMS) in nonmelanoma skin cancer (NMSC) followed by reconstruction is not possible in a subset of patients.

Objective: Assess the indications and outcomes of a multidisciplinary approach MMS.

Methods And Materials: Retrospective, single-surgeon, single Mohs specialist, university-based tertiary care referral practice, including all MMS performed in the operating room setting with concurrent reconstruction in patients from 2008 to 2018 with minimum follow-up of 6 months.

Oral Hedgehog Pathway Inhibition as a Means for Ocular Salvage in Locally Advanced Intraorbital Basal Cell Carcinoma.

Background: Basal cell cancer is the most common cutaneous malignancy. It rarely presents with locally advanced or metastatic disease. Rare presentations such as intraorbital invasion remain a difficult clinical problem with significant potential morbidity.

Desmoplastic Melanoma of the Head and Neck: Incidence and Survival, 1992-2013.

Objective To describe the epidemiological characteristics and survival of desmoplastic melanoma of the head and neck (DMHN) and discuss the factors influencing survival variation among DMHN, DM of other sites (DMnHN), and conventional melanoma of the head and neck (CMHN). Study Design Retrospective cohort study. Setting Surveillance, Epidemiology, and End Results (SEER) database (years 1992-2013).

Reporting of Postoperative Pain Management Protocols in Randomized Clinical Trials of Mandibular Fracture Repair: A Systematic Review.

Importance: The control of pain associated with mandibular fractures is an important treatment outcome that affects function, adherence to treatment regimens, and patient comfort and satisfaction.

Objective: To explore the pain management protocols reported in studies of mandibular fractures, including the reporting of quality-of-life measures.

Evidence Review: PubMed/MEDLINE, EMBASE, Cochrane CENTRAL, and clinicaltrials.

Evidence-Based Facial Fracture Management.

With demands for an evidence-based approach to patient care, the management of facial fractures will come under increasing scrutiny because there is an overall deficiency in higher level clinical evidence. This article reviews the management of facial fractures, focusing on an evidence-based approach. It focuses on select areas of facial trauma in which there is controversy and presents randomized studies and meta-analysis to help define best practice.

Utility of computed tomography scans in predicting need for surgery in nasal injuries.

In many centers, computed tomography (CT) scan is preferred over plain film radiographs in the setting of acute nasal injury because CT scan is thought to be more sensitive in predicting nasal bone fracture. However, the usefulness of CT scans in predicting the need for surgery in acute nasal injury has not been well-studied. We conducted a retrospective review of 232 patients with known nasal bone fracture and found very similar rates of surgery in patients with a diagnosis of nasal fracture by CT scan as by nasal radiographs (41 and 37%, respectively).

Early tracheotomy in elderly patients results in less ventilator-associated pneumonia.

Objectives: To determine if the timing of tracheotomy in elderly patients results in less ventilator associated-pneumonia, mortality, and morbidity.

Study Design: Historical cohort study.

Subjects And Methods: This study included 158 ICU patients aged >65 who underwent tracheotomy from March 2003 to June 2007.

Soft tissue sarcoma in the setting of chronic cutaneous graft versus host disease after allogenic bone marrow transplantation.

Second primary cancers are approximately 2.1-2.8 times more common in survivors of bone marrow transplant than in the age-matched general population.

Facial fracture repair in the traumatic brain injury patient.

Purpose: To review the surgical complications of patients who had facial fractures repairs in the setting of a traumatic brain injury (TBI).

Patients And Methods: A review of all individuals admitted with the diagnosis of TBI based on an evaluation by the neurotrauma service who also underwent facial fracture repair was performed. More than 600 charts were reviewed and 99 patients met study criteria.

Lipoplasty of the face and neck.

Purpose Of Review: Facial aesthetic surgery has gained wider acceptance and demand for it is increasing. Patients seeking a more youthful facial look often request lipoplasty. This article reviews the recent advances in lipoplasty and related fat contouring for the face and neck.

Plasma cell tumors of the skull base: four case reports and literature review.

Four patients (mean age, 46 years; range, 28 to 60) with skull base plasmacytomas are presented along with a review of the literature examining the progression of anterior and central skull base plasma cell tumors to multiple myeloma. The primary sites were the nasopharynx, orbital roof, sphenoid, and clivus. Three patients presented with extensive local spread of tumor.

Treatment of idiopathic sudden sensorineural hearing loss.

Conclusion: The therapeutic role of corticosteroids and/or corticosteroids with antiviral agents for sudden sensorineural hearing loss (SSNHL) has yet to be fully elucidated; however, in cases where deafness is profound and of recent onset, a therapeutic trial is indicated.

Objectives: To investigate treatment regimens and their efficacies, as well as evaluating the potential prognostic correlates and allowing comparison between local and national standards of care for SSNHL.

Patients And Methods: A retrospective evidence-based case series of 143 patients seen at the University of Rochester, Department of Otolaryngology between 1999 and 2002 was investigated.

Review of nasopharyngeal carcinoma.

We review the literature on nasopharyngeal carcinoma that has been published within the past 5 years. Nasopharyngeal carcinoma is a highly morbid disease, and survival is poor. Its management remains extremely difficult, not just for otolaryngologists but for radiation oncologists and medical oncologists, as well.

Hyaluronan and its receptors in mucoepidermoid carcinoma.

Background: Hyaluronan (HA) is a prominent extracellular matrix component undergoing continuous production and degradation. Increased HA levels have been described in a variety of tumors. The objective of this study was to examine the staining patterns of HA and two of its associated receptors (CD44 and HARE) in relation to the metastatic potential of mucoepidermoid carcinoma (MC).

Infectious mononucleosis and corticosteroids: management practices and outcomes.

Objective: Although many studies have examined the effects of systemic corticosteroid therapy (SCT) on the clinical course of infectious mononucleosis (IM), few have evaluated the influence of these studies on treatment patterns and outcomes. The purpose of this study was to review current therapeutic strategies and outcomes in uncomplicated and complicated IM.

Design: Retrospective case series.

Craniomaxillofacial fractures during recreational baseball and softball.

Purpose: Baseball and softball are leading causes of sports-related facial trauma in the United States. We review our institutional experience (Strong Memorial Hospital, Rochester, NY) with these injuries and discuss measures to reduce their incidence.

Patients And Methods: We review our institutions experience with facial fractures sustained during the course of a softball or baseball game over a 12-year period.

Expression of urokinase-type plasminogen activator and its receptor in keloids.

Background: The urokinase-mediated plasminogen activation (uPA) system plays a central role in a number of cellular processes including tissue remodeling, cell migration, and angiogenesis. Elevated uPA activity has also been seen with tumor invasion and metastasis in a variety of malignancies. Keloids represent an aberrant form of wound healing characterized by uncontrolled growth with invasion beyond the margins of the original wound.

Urokinase-type plasminogen activator receptor expression in adenoid cystic carcinoma of the skull base.

Background: Head and neck adenoid cystic carcinoma (ACC) is a malignancy of the salivary and lacrimal glands with a variable growth pattern and propensity for perineural spread. Involvement of the skull base indicates a poor prognosis. Despite surgical resection and adjuvant radiotherapy, tumor recurrence and metastases are common.