Medical Honey in Head and Neck Cancer.

Medical honey has been recognized for its medicinal properties for thousands of years, and several medical honey products have entered the market over the last two decades. In vitro studies have shown that honey has antimicrobial properties, protects against bacterial growth, and improves wound healing. However, these products are not widely used for wound treatment in head and neck surgery. Additionally, honey has been utilized in those undergoing radiotherapy for head and neck cancer (HNC) to treat radiation-induced mucositis. This literature review aims to describe and assess the utility of medical honey for patients undergoing treatment for HNC and thus review publications on medical honey for treating postoperative wounds and preventing radiation-induced mucositis. Ovid (Medicine), PubMed (Medline), and Google Scholar were searched using keywords related to medical honey and HNC. All abstracts retrieved in the search were screened for content relevance. Three randomized controlled trials on wound healing were reviewed and assigned a score using the revised Cochrane risk of bias tool for methodological quality. Three meta-analyses assessing radiation-induced mucositis were reviewed and evaluated. Using medical honey on postoperative wounds was associated with shorter hospital stays, faster healing of palatal graft defects, and reduced pigmentation of thyroidectomy scars. Medical honey had no impact on bacterial culture rates or other aesthetic measures. For patients undergoing radiation for HNC, orally ingested honey was associated with less weight loss and delayed the onset of severe radiation-induced mucositis. However, results across different meta-analyses were mixed. Minimal evidence supporting the use of honey in postoperative wounds for patients with HNC exists. However, the studies reviewed here, combined with in-vitro studies and studies in other anatomical regions, show honey may offer some wound healing benefits. More robust studies are needed to confirm the potential benefits of medical honey in the postoperative wounds of HNC patients. While radiation-induced mucositis continues to be a debilitating adverse effect of HNC treatment, the literature reviewed supports honey as a safe complementary therapy in preventing radiation-induced mucositis.

Spontaneous Resolution of an Osteochondroma.

A 13-year-old girl presented with an apparent classic osteochondroma. Because she was skeletally immature, the decision was made to observe the lesion. She returned to the clinic at age 17 for unrelated reasons and was noted to no longer have the palpable mass. Magnetic resonance imaging confirmed resolution of the osteochondroma. The age range of this case fits with reported cases of childhood osteochondromas. The mechanism of resolution has been theorized to be incorporation of the lesion back into the bone during remodeling, fractures, or pseudoaneurysms. An initial period of observation is thus recommended with new patients.

Pulmonary Artery Aneurysm: A Rarity and Surgical Enigma.

Given the low incidence of pulmonary artery aneurysms (PAAs), proven surgical indications do not yet exist. We present a patient with a 6.3 cm PAA who underwent an open sternotomy, pulmonary artery aneurysmectomy, and repair with an aortic homograft. We discuss surgical indications, including pain, growth in diameter, and diameter of 5.5 cm and larger. The current recommended surgical indication for the size of PAAs is based on recommendations for aortic aneurysms and observation in a small number of operable patients, highlighting the need for more discussion and reporting of this rare presentation.

Mycobacterium abscessus Causes Highly Resistant Infection as a Breast Abscess.

Mycobacterium abscessus is an increasing threat to public health due to its multi-drug resistance and increasing prevalence. The pathogen most commonly causes chronic respiratory infections, but it may also invade locally through the skin and soft tissue damage caused by trauma, piercings, or tattoos. A 58-year-old African American female presented with a five-month history of recurrent abscesses in the right breast. She had previously been treated with doxycycline and ceftriaxone injections at an outside clinic with minimal improvement. Following incision and drainage, cultures and susceptibilities showed M. abscessus infection with a high level of drug resistance. Due to financial barriers, the patient received a suboptimal antibiotic regimen and required multiple surgical procedures, resulting in only temporary wound healing. At the time of this report, the patient is recovering from her fourth incision and drainage, with cultures and susceptibilities pending and discussions of a total mastectomy. M. abscessus is a highly resistant bacteria capable of causing skin and soft tissue infections of the breast. Such infections may occur without an inciting event and require extensive surgical and antimicrobial management.