The Journal of craniofacial surgery
-
Unique anatomic and pathophysiologic features of the thermally burned pediatric hand are reviewed, with a focus on direct management of the injured tissue in the early phases of the treatment process. A nonoperative approach to most pediatric hand burns is advocated, and principles of early wound care, including antimicrobial therapy, and escharotomy are described. ⋯ Finally, basic techniques for splinting, positioning, and exercising the burned pediatric hand are described. When properly applied, the principles discussed herein have rendered the severely scarred, functionless hand a rarity after thermal injury.
-
Sturge-Weber syndrome (SWS), Klippel-Trenaunay syndrome (KTS), and Parkes-Weber syndrome (PWS) represent a wide range of congenital vascular abnormality syndromes. Although many of the diagnostic criteria overlap for these syndromes, there are important differences among these diseases that carry important prognostic and therapeutic implications. This review attempts to clearly distinguish among SWS, KTS, and PWS, although loosely categorizing them as a family of congenital vascular disorders. A review of literature reveals that a variety of diagnostic tools exist that can help differentiate between the syndromes and assess risk for certain complications, which may help tailor various treatment modalities for a particular patient.
-
Congenital epulis is a rare benign hamartoma of the alveolar ridge found in the newborn. The clinical characteristics of this lesion show some variability, and opinion of its pathogenesis lacks consensus. ⋯ A case report and review of the literature is presented. The diagnosis, pathology, and treatment are reviewed.
-
Bone grafting to augment skeletal healing has become one of the most common techniques in surgical practice. However, the morbidity and limited availability associated with autografts, and the potential for disease transmission, immunogenic response, and variable quality associated with allografts, have engendered a plethora of alternative materials. ⋯ This article reviews the structure and function of calcium sulfate as a synthetic bone void filler and speculates on its future surgical role. It is anticipated that this foundation will also help assist in the understanding of how other bone graft alternatives may operate.
-
Review Case Reports
Traumatic optic neuropathy complicating facial fracture repair.
Blindness can result from traumatic optic neuropathy following facial trauma and can complicate the management of concomitant facial fractures. Traumatic optic neuropathy can cause a substantial delay in the repair of facial fractures, leading to compromised surgical results. It can also result in postoperative visual loss following facial fracture repair. ⋯ The management of facial fractures in patients with traumatic optic neuropathy must proceed cautiously. Delayed primary repair of midface fractures by postponing surgery for 10 to 14 days may be of benefit in avoiding further deterioration of vision. In addition, megadose corticosteroids and/or optic nerve decompression is useful in the management of these patients.