Burns from orthodontic pliers.

A case of burn injury from orthodontic pliers resulting in a partial-thickness burn is presented. A brief description of the injury, a review of the pertinent literature, and general guidelines for out-patient management of such burns are also presented.

Dermatography as a treatment after periocular surgery.

Dermatography is the application of tattooing techniques in medicine. In the past, several techniques have been tried but none of these led to reproducible results. Over the last 17 years, dermatography has been developed into a technique that is both generally applicable and reproducible. It is a suitable treatment modality for disturbing skin discolorations and scars. With dermatography these can be permanently camouflaged. In this paper, the use of dermatography as a treatment after periocular interventions is discussed.

Harnessing the osseointegration principle for anchorage of fingernail prostheses.

On the basis of this preliminary report series of patients, it seems that the achievement of fixed anchorage for nail prostheses is feasible using the process of osseointegration, the use of standard dental implants, and abutment and maxillofacial rehabilitation laboratory to build the superstructure system. The osseointegrated procedure is relatively simple, cost-effective, and less time-consuming compared with other reconstruction techniques. Using local anesthesia and day-care facilities the operative time was only 35 minutes for the first stage and 15 minutes for the second stage. The attachment should be lifelong, as in the face. Loosening and infection are infrequent.

[Dermatography. An effective method for pacemaker marking after spinal cord injuries and implantation of a Brindley stimulator for neurogenic bladder]. / Dermatographie. Eine effektive Methode zur Pacemakermarkierung nach Rückenmarkverletzungen und Anlage eines Brindley-Stimulators für neurogene Blase.

In our department, two spinal cord lesion patients suffering from neurogenic bladder dysfunction were selected for the implantation of a Brindley stimulator, as they could not be managed by conservative treatment. Accurate positioning of the external transmitter block over the subcutaneous receiver block, which is essential for the Brindley stimulator to function correctly, posed problems for the relatives who had to apply the external transmitter. In order to facilitate positioning, dermatography was used to mark the exact spot where the external transmitter should be placed. A 3-year follow-up showed that this marking solved the problem completely and that recurrent urinary tract infections stopped.

Garlic burns.

A patient with a second-degree burn of the forehead, induced by topical application of crushed garlic is reported. The literature on garlic burns is reviewed.

Povidone-iodine related burns.

Skin preparation burns associated with chemical agents are uncommon. They occur most frequently in patients placed in the lithotomic position undergoing gynaecologic or urologic operations, the burn being on the buttocks, and in those undergoing orthopaedic operations, the burn being on the extremities and under a tourniquet. The basic mechanism involves irritation coupled with maceration and pressure. If the betadine solution has not been allowed to dry and has been trapped under the body of the patient in a pooled dependent position, such as the buttocks or under a tourniquet, the solution may irritate the skin and result in a skin burn. The irritation coupled with pressure leads to a situation analogous to that seen in the development of an acute accelerated decubitus ulcer; irritation, maceration, friction and pressure compounding each other to result in a skin burn or superficial ulcer in the skin. Our experience with three illustrative patients who presented with various burns following exposure to povidone-iodine (betadine) is described below.

Pediatric sialolithiasis.

Pediatric sialolithiasis is a rare condition. This article characterizes 15 cases in children between 5 and 14 years of age. The diagnoses of this condition were made with routine radiograph and ultrasound, as well as with sialography whenever possible. Sialoendoscopy was performed as a diagnostic and treatment modality. Thirteen of the 15 affected children were boys, and 12 of 15 cases occurred in the submandibular gland. We were able to diagnose 67% by our imaging methods; the remainder were diagnosed by clinical examination.

An unusual iatrogenic burn from a heated dental instrument.

The following report describes an unusual iatrogenic contact burn from a heated dental instrument. The potential hazard of inflicting a contact burn using a glass bead sterilizer must be kept in mind.

Long-term experience with endoscopic diagnosis and treatment of salivary gland inflammatory diseases.

OBJECTIVES: To assess the efficacy of the sialoendoscopic technique for treatment of inflammatory salivary gland diseases. This report documents the authors' long-term experience with sialoendoscopy and discusses the long-term results of the procedure, technical issues, and varieties that they have utilized, as well as the advantages and limitations of this modality. STUDY DESIGN: Retrospective clinicopathologic study of 236 patients who were endoscopically treated from 1994 to 1999 for suspected salivary gland obstructive disease. METHODS: Endoscope employed was the third generation sialoendoscope (Nahlieli Sialoendoscope, Karl Storz, Tuttlingen, Germany). RESULTS: Ten sialoendoscopies were immediate failures as a result of technical problems. In the remaining 226 glands, 170 had obstructions and 56 had sialadenitis without evidence of obstructions. The success rate was 83%. Multiple endoscopic findings were encountered. No severe complications were noted. CONCLUSION: This report demonstrates the efficacy and safety of sialoendoscopy as a promising new method for use in the diagnosis, removal, and postoperative management of sialolithiasis, sialadenitis, and other obstructive salivary gland diseases.

Diagnosis and treatment of cervical tuberculous lymphadenitis.

PURPOSE: This study presents the long-term results of treatment of a series of patients with tuberculous mycobacterial lymphadenitis of the head and neck. PATIENTS: Twenty-one patients were seen in a 10-year period. The median age at onset was of 41.2 years (range, 4 to 79 years), and the male-to-female ratio was 11:10. Sixteen patients were of Ethiopian origin, 3 from the former USSR, and 2 were Israeli women (1 of Indian and 1 of Morrocan origin). Symptoms started between 2 weeks and 6 months before presentation (mean, 5.8 weeks). Most patients had negative chest radiographs, a variable response to the tuberculin skin test, and a negative culture for mycobacterial organisms. RESULTS: Fine-needle aspiration (FNA) of the cervical lymph nodes was the most reliable method to confirm the bacteriologic agent causing the lymphadenopathy. Acid-fast bacilli smears of the aspirate were positive in all but 3 patients, whereas histologic examination of the lymph nodes gave diagnostic results in only two thirds of cases examined. All patients were treated with antituberculous chemotherapy. Sixteen patients also underwent surgical excision of their cervical lymph nodes, and all of them showed a complete response to the combined treatment. The remaining patients reacted to chemotherapy alone with complete cure. One patient died of gastric carcinoma, and the only acquired immune deficiency syndrome (AIDS) patient died a year later of cytomegalovirus encephalitis. CONCLUSION: The most reliable indicator of cervical mycobacterial infection is an acid-fast smear from the FNA specimen. Antituberculous chemotherapy, with or without surgical excision of the involved cervical lymph nodes, is the method of choice for treatment of this disease.

Endoscopic technique for the diagnosis and treatment of obstructive salivary gland diseases.

PURPOSE: This article describes the use of endoscopy for diagnostic and surgical intervention in the major salivary glands of patients who have obstructive pathology, reviews past experience with this technique, and describes the microanatomy and pathophysiologic findings encountered during endoscopy of these glands. PATIENTS AND METHODS: A total of 154 salivary glands (96 submandibular glands, 57 parotid glands, 1 sublingual gland) suspected of having obstructive pathology (89 males, 65 females; aged 5 to 72 years) were treated using a mini-endoscope. Most procedures were performed under local anesthesia in an outpatient clinic. All patients underwent preoperative and postoperative screening by routine radiography, sialography, and ultrasound. The indications for endoscopy were: 1) calculus removal that could not be performed by conventional methods, 2) screening of the salivary ductal system for residual calculi after sialolithotomy, 3) positive evidence of ductal dilatation or stenosis on the sialogram or ultrasound examination, and 4) recurrent episodes of major salivary gland swellings without known cause. RESULTS: Of the 154 endoscopies performed, 9 were immediate failures as a result of technical problems. Of the remaining 145 glands, 112 had obstructions and 33 had sialadenitis alone. The success rate was 82% for calculus removal. Thirty-two percent of the submandibular and 63% of the parotid sialoliths, and the 1 stone in the Bartholin's duct, were undetected before sialoendoscopy. Multiple endoscopic findings were encountered. No major complications were noted. CONCLUSIONS: Sialoendoscopy is a minimal invasive technique for the diagnosis and removal of obstructive pathologic tissue in the major salivary glands.

A rare form of burn injury sustained during defaecation.

An unusual mechanism of burn injury during defaecation is described.

Central palatal burns associated with the eating of microwaved pizzas.

Burns of the oral mucosa can be caused by heat, cold, radiation, electricity and mechanical or chemical stimuli. Acids, alkalis and salts can cause considerable damage to the oral mucosa, membranes and lips. Most damage is found in the oropharynx, besides the pharynx and tonsils, the alveolar mucosa of the tongue and the masticatory mucosa of the palate or gingiva show localized or diffused damage. The clinical appearance depends on the severity of the tissue damage and the destructive properties and mode of application of the causative agent. We present an illustrative case of central palatal burn associated with the eating of microwaved pizzas and discuss similar mechanisms of injury.