Group A streptococcal fasciitis after submental tumescent liposuction.

Tumescent liposuction is a procedure with a good safety record. Local infection is rare but can result in devastating consequences. We report a rare case of group A streptococcal fasciitis complicating tumescent liposuction and highlight the importance of early diagnosis and treatment of this condition. A 62-year-old woman presented 8 days after submental liposuction and a platysmal plication procedure with signs and symptoms of cervical fasciitis. Microbiological analysis confirmed a group A streptococcal infection. By using early aggressive medical and surgical treatments, the disease was arrested before the onset of any necrotizing process. A high index of suspicion is required to make an early diagnosis of this potentially disfiguring and life-threatening infection.

Ignition potential of the 585-nm pulsed-dye laser. Review of the literature and safety recommendations.

BACKGROUND: The 585-nm pulsed-dye laser is the treatment of choice for many port-wine stains. The risk of accidental flash fires occurring with the pulsed-dye laser is considered minimal. Recently, however, there have been several reports of unwanted ignitions. These cases all share two features: 1) oxygen delivery by face mask, and 2) the ignition of a hair-bearing surface. OBJECTIVE: We report a case of a laser-induced fire that occurred on a non-hair-bearing surface in a patient who was receiving oxygen by nasal cannula. The mechanisms, risk factors, and guidelines for the prevention of pulsed-dye laser-induced fires are presented. METHODS: We reviewed the literature regarding the safety of pulsed-dye laser use. RESULTS: Pulsed-dye laser-induced fires can occur on non-hair-bearing regions and in patients receiving oxygen by nasal cannula. CONCLUSION: Precautions should be taken to prevent pulsed-dye laser fires regardless of treated region or method of oxygen delivery.

The nasal septum.

The nasal septum plays a paramount role in determining nasal aesthetics and nasal function. Surgical management of the nasal septum often presents a challenge to even the most skilled nasal surgeon. A firm understanding of anatomic and physiologic aspects of the nasal septum will allow the rhinoplasty surgeon to better deal with this component of nasal reconstruction.

Chemical face peeling without taping.

Chemical face peeling is a simple surgical procedure which usually provides dramatic results. The potential for serious complications does exist and cautious assessment and management is essential. Aesthetically pleasing long-term results can be obtained by using chemexfoliation without taping, when employed with a "moist dressing" technique. This technique eliminates the need for repeated anesthetics and postoperative visits in order to remove facial taping, and provides an atmosphere for accelerated wound healing.

Plaster of paris as an alloplastic implant in the frontal sinus.

The use of calcium sulfate (plaster of Paris) has been advocated to repair bony defects because of its unique capability of stimulating osteoneogenesis. Plaster of Paris can be used as a bony alloplast, and it can be analyzed histologically. Sinus roentgenograms and technetium Tc 99m medronate bone scanning further support the use of plaster of Paris as an alloplast and assess its osteoneogenic capacity when implanted in the frontal sinus of dogs; complete bone regeneration was demonstrated in six dogs within four to six months. The use of plaster of Paris for bone reconstruction in the head and neck can be applied in surgery. The experience with plaster of Paris to date, although limited, shows it to be safe and highly encouraging as an effective bone allograft.

Congenital fibrosarcoma in the oral cavity. First reported case.

Fibrosarcoma is uncommon in the head and neck and constitutes less than 1% of malignancies and approximately 6% of the soft tissue sarcomas. Congenital fibrosarcomas are characterized by rapid proliferation and frequent local recurrence following excision. Unlike other sarcomas, metastasis is a rare event. The literature contains less than 50 cases of congenital, solitary fibrosarcoma, with none occurring in the oral cavity. This paper describes a unique case of fibrosarcoma in the oral cavity of a neonate. A 12 month follow-up is provided with an analysis of the histopathology including electron microscopy. The spectrum of fibroproliferative lesions in the pediatric patient is reviewed, and the evaluation and treatment modalities applicable to this age group are outlined.